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Josie Milligan is a 26-year old female who fell off her motorcycle whilst competing in a marathon.

Josie Milligan is a 26-year old female who fell off her motorcycle whilst competing in a marathon.

Josie Milligan is a 26-year old female who fell off her motorcycle whilst competing in a marathon.
Adult Health Case Study–Essay Assignment

Adult Health Case Study – Essay Writing Assignment Help


Josie Milligan is a 26-year old female who fell off her motorcycle whilst competing in a marathon. A riding friend witnessed the fall and called an ambulance to transport Josie to ED. On arrival to ED, Josie complained of pain in her right lower leg, which had an obvious deformity, significant swelling and a 10cm lacerated wound. Josie’s ED admission observations were: T-36.4 o C, HR-90bpm, RR-22pm, BP-136/72mmHg, O 2 -95% RA, and pain score 10/10 on movement. Josie is allergic to Penicillin and she takes the oral contraceptive pill, she has no medical problems.

Josie was given opioid analgesia in ED for her pain, and the ED x-ray confirmed the diagnosis of an open fracture of the Right tibia and fibula. After review by the orthopaedic team, it was arranged for Josie to undergo surgery for open reduction and internal fixation (ORIF) of the fracture.

Adult Health Case Study–Essay Assignment

Adult Health Case Study–Essay Assignment

Adult Health Case Study–Essay Assignment

You are a student nurse looking after Josie since she returned to the surgical ward post-operatively at 12.30hrs. The surgeon’s post-op orders are for routine observations, wound dressing to stay intact for 72hrs, bung IVT when current bag completed, neurovascular observations two-hourly for first 48-hours, and may ambulate non-weight bearing with crutches. She is drowsy and responsive to voice; and has a dressing on her right lower leg, with minimal sanguineous ooze evident. Josie’s observations on return to ward are: T-35.5 o C, HR-66bpm, RR-16pm, BP-109/71mmHg, O 2 -97% via HM at 6LPM, and pain score 2/10. Josie was given prophylactic Ceftriaxone 2g IV during surgery. The anaesthetist has prescribed Paracetamol 1g IV/PO 6 hourly, Ibuprofen 400mg PO TDS, Tramadol SR 100mg PO BD prn, and Ceftriaxone 2g IV/ IM 6 hourly for 2 further doses. IV Compound Sodium Lactate 1L is running at a six-hourly rate into Josie’s left arm.


Students are required to research and write an essay with headings , directly relating to the above scenario. Using the nursing process, outline the nursing management for the patient post-surgery, discussing all care in general, but focussing on the two (2) prioritised nursing diagnosis/ problems. As well as the information in the Unit Plan, please review modules in the Learning Materials content tab on BB; and Assessments content tab on BB for further information about the assessment.

In preparation for the assignment, students are encouraged to make a list of all assessment data – including objective and subjective data, considering all of the body systems, and functional health/ ADLs, post-operative specific, surgery-specific, patient-specific, and what further information would be required to be assessed. From this list, students are encouraged to develop a list of actual and potential issues/ problems/ risks for all assessment data, from which they should identify which of these are their two prioritised issues, and what method was used to prioritise these. Then students are encouraged to complete nursing care plans (similar to the sample NCP) for each of the two diagnoses. This planning material is for student’s personal assignment planning only, and should not to be submitted with their essay . All of the information in this planning will then need to be discussed in the essay in academic writing style.


Format in accordance with School of Nursing & Midwifery guidelines (see BB Assessment tab).

Academic writing style.

Appropriate sentence structure, word use, grammar and spelling (this is an ELP specified unit).

Logical flow. Students should format their essay management section with headings as: Assessments; Nursing Diagnosis Priority 1: (name of nursing diagnosis) – with subheadings for Planning, Implementation, Evaluation;and Nursing Diagnosis Priority 2: (name of nursing diagnosis) – with subheadings for Planning, Implementation, Evaluation. The assignment must flow smoothly and read logically for the reader.


A general overview of the topic and definition of terminology

An outline of the paper


This should be given as an iSoBAR handover (can be with iSoBAR headings, or in paragraph format in iSoBAR sequence).

From the information given in the scenario provide iSoBAR handover, given as though you are updating the nursing team you are working with, after you had completing the first set of post-op observations as is given in the scenario.

For the iSoBAR handover, students may use first person to introduce themselves and their patient, however all other information in the essay and background is to be in third person academic style.


Using the nursing process, outline the nursing management for this patient post-surgery, discussing all care in general, but focussing on two (2) priority nursing diagnosis/ problems.

Ensure that each part of the nursing process is discussed within the essay, showing depth to show critical thinking and coverage of each section.

Assessment – Students should demonstrate that they have looked at all of the assessment data (see preparation paragraph above). Students are not to assume or make up assessment findings, if data is not stated, you should state that it is not known or information has not been provided, and advise what actions you would take. Discuss the assessment findings that have been given, what other assessments that would be required, what appropriate assessment tools (eg Falls Risk, Braden Scale and Pain Assessment) would be used, and if any findings are not within normal parameters, students should identify this, and give a rationale why this is so.

Nursing diagnosis – Students should discuss their two (2) prioritised nursing diagnoses in-depth (focus should be on post-operative care) .After analysing all of the assessment data and patient’s responses that students have gathered above, students should consider the actual and potential nursing problems/ issues, and demonstrate why they have prioritised the diagnoses that they have (eg use of primary survey, use of first-aid DRSABCD, actual v potential, etc) – this should demonstrate the student’s ability to prioritise, not just choosing two that they wish to discuss.

Planning – Students should demonstrate their three (3 ) prioritised plans of care for each nursing diagnosis. These should all utilise SMART goals (specific, measurable, achievable, realistic, and with timeframe), advising of planned outcomes and criteria that are required. Includes psychosocial outcomes and patient involvement in identifying planned outcomes.

Implementations – Students should demonstrate at least three (3 ) prioritised implementations for each plan. Discuss all interventions and actions taken to meet the planned outcomes and achieve the SMART goals. This can be nursing interventions, documentation, referral to multidisciplinary team (nurse needs to ensure multidisciplinary team member has followed up). Each intervention should include the rationale why this intervention is required, and be supported with rationale (reference – see care plan in preparation). This also includes documentation in all areas required (which will become measured criteria from SMART goal as evidence in evaluation section).

Evaluation – Evaluation of planned goals occurs throughout the entire nursing process, but is discussed at the end. Students should demonstrate their evidence of whether planned outcomes and goals were met (or not). If not, then why have they not been met, and whether re-evaluation is required at a later date, or plans changed. Students need to demonstrate how they know whether planned outcomes have been met – what is the evidence that goals have been met, what tools were used, where this is documented (usually documentation as evidence).

Potential complications and post-operative education

Outline the potential complications that the nurse and patient should be aware of.

Outline the post-operative education would need to be provided to your patient, in order to promote a successful recovery.

Involvement of the interdisciplinary team

Discuss all of the members of the interdisciplinary team, and which particular members that would be involved in your patient’s management of care, including what service that they will provide.


Provides an overview of the assignment

No new material introduced


In-text and end-text referencing per current ECU referencing guidelines – APA style.

Minimum of 15 current and credible academic references, using a variety of sources (including a minimum of 4 journal articles and minimum of 2 quality websites).

All sources are up to 5 years old.

Recent and quality sources used – Wikipedia and Dictionary.com will not be accepted as a reference source!

Medical dictionary used for medical terminology.

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.


Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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