Analyse the clinical case study and develop a nursing plan of care demonstrating your clinical reasoning


On the 31 December you are working an evening shift in the paediatric section of the Emergency Department at Canberra Hospital. You are a 1st year nursing student. A 9-year-old boy Max O’Connor is brought into the ED by his mother Wendy. Wendy tells the triage nurse that Max was pushed off a trampoline by his older brother. Wendy is a single mother and has left her other two children with her neighbor. Max’s left arm is very swollen and appears deformed, the triage nurse observes Max grimacing with any movement of his arm and upper body, Max says his arm is ok if he keeps it completely still; the triage nurse administers a weight (Max weighs 31kg) based dose of paracetamol and ibuprofen at 1500Hrs. Max is promptly reviewed by one of the senior medical staff who immobilises the limb with a back slab and orders intranasal fentanyl 1.5mcg/kg which is 46.5 mcg dose for Max which is administered by nursing staff at 1515Hrs. Max is brought through to you. You are caring for him in the paediatric area of the Emergency Department, the triage handover includes that an X-ray has been ordered, back slab applied, and pain relief given.

You assist Max into a wheelchair as a wardsman appears to take Max to radiology, Max reports feeling nauseas. After returning from radiology and mobilising to his bed, Max has a large vomit. The medical officer advises Max and Wendy that the X-ray shows a displaced fracture radius and ulna, the Orthopaedic surgery team has been called for a consultation. The medical officer asks you to keep Max nil by mouth in preparation for theatre for a open reduction and internal fixation of his fractures.

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Based on the case information and clinical documentation (Canvas), you are required to analyse the clinical case study and develop a nursing plan of care demonstrating your clinical reasoning.

Using the clinical reasoning cycle (Levett-Jones, 2018) and the following template to format your work Template for use FPP2 Assignment 3 50%.docx  Download Template for use FPP2 Assignment 3 50%.docx

  1. Summarize Max’s current circumstances , highlighting the key issues from a nursing perspective (5 marks).
  2. Identify what integrated person- centred care (physical and non-physical) assessments are required during your shift to care for Max using comprehensive assessment and person-centred approach. Support your chosen assessments with evidence from the peer reviewed literature (10 marks)
  3. Identify 3 focused clinical priorities for the care of Max during the shift. Support each priority with a brief rationale using appropriate evidence from the peer reviewed literature (10 marks)
  4. Identify goals of care related to the three clinical priorities, support identified goals with evidence from the peer reviewed literature (5 Marks)
  5. Outline your plan of care (interventions) to address these identified priorities showing how you have used the information from your assessment to make care decisions. Support your plans with evidence from the peer reviewed literature (5 Marks)
  6. Explain how you will evaluate the plan of care and interventions. Support your answer with peer reviewed evidence. (5 Marks)
  7. Using Borton’s model of reflection, briefly outline approaches/considerations relevant to the assessment/care of a hospitalised child and their family. Support your answer with peer reviewed evidence (5 Marks)

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