Aim of assessment
The purpose of the assessment is to enable students to demonstrate knowledge by
accurately analysing information in a case study of complex critical care patient.
Read the case study attached and answer the following questions-
1. analyse the pathogenesis in relation to the clinical manifestations in the case study
(15 marks).
2. Select ONE (1) appropriate nursing strategy, and explain the underpinning
evidence base for this rational (5 marks)
3. Critically analyse the Arterial blood gas results, and relate them to the underlying
pathogenesis (10 marks)
4. Academic Writing (5 marks).
Resources
i. Examples may be available on the vUWS site.
ii. There are a number of textbooks and resources available through the Western
Sydney University Library that may assist you. Please refer to the unit’s vUWS site
for specific unit resources
3
Case Study Details: Mr Kirkman a 75-year-old male, presented to ED complaining of
burning sensation upon urination and lower abdominal pain radiating into the right flank.
Mr Kirkman was admitted to the ward with a diagnosis of Urinary tract infection. He was
placed on IV NaCl and IV Sulfamethoxazole-trimethoprim 10 mg/kg/day IV in 2 equally
divided doses daily and an Indwelling catheter was inserted.
Twenty-four hours later, his condition deteriorates HR135, BP 80/42, RR 35, TEMP 39
and looks generally unwell.
History from ED notes
• Wife died 12 months ago
• Social drinker
• Heavy smoker 2 packs a day since commencing as a teenager.
• Chronic bronchitis on Ventolin and Atrovent.
• Previous UTI
• No cardiac history
Diagnosis 24 hours later
• UTI with severe sepsis
PRIMARY SURVEY O/E
A – Patient speaking in single words
B – RR 35bpm, accessory muscle use. SPO2 82%, in obvious distress.
C – Sinus rhythm 135bpm, Blood pressure 80/42mmHg, Temperature 39°C
D – E4, V4, M5
E- Use of accessory muscles, lower abdominal pain 6/10, flushed face
F- IVC insitu, IDC- Dark urine passed small amounts approximately 40mls in last
8 hours
G- 8.4mmol/L
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