Obstruction of the proximal ascending colon


Assessment 1:

Lucy was prepared and sent for an urgent colonoscopy, upper barium x-ray and abdominal CT scan. A bowel obstruction at the proximal end of the ascending colon at the ileocecal junction was diagnosed. A balloon dilation of the obstructed colon was attempted, but was unsuccessful. Lucy was scheduled for a surgical resection of the affected proximal ascending colon and end-to-end anastomosis of her colon.

Questions:

Question 1. (250 words)

Explain the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon.

Question 2. (250 words)

Explain the pathophysiological processes that lead to Lucy’s conscious perception of pain in her lower right abdominal quadrant.

Question 3. (165 words)

Describe the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy.

Question 4. (165 words)

Describe the mechanism of action of fentanyl in relation to its administration to Lucy.

Question 5. (165 words)

Prioritise the nursing responsibilities and associated rationales related to the administration of fentanyl to Lucy.

WORD LIMIT:

There is a total word limit of 1000 words for the SAT.

Assessment 2 – Short Answer Test (SAT) based on Case History

Q1. Accurately, clearly and comprehensively explains the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. /10 Provides an accurate, clear and comprehensive explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. Provides an accurate and clear explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. Provides an accurate explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon.

The information may be incomplete or lack clarity in explaining the pathogenesis of Crohn’s disease and the development of Lucy’s obstruction of the proximal ascending colon. Provides a basic explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon.

There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow in explaining the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon. Provides a superficial explanation of the pathogenesis of Crohn’s disease that has led to the development of Lucy’s obstruction of the proximal ascending colon.

Explanation does not accurately identify the events that occur in the pathogenesis of Crohn’s disease and the development of Lucy’s obstruction in her proximal ascending colon.
Response does not demonstrate an understanding of the pathogenesis of Crohn’s disease and the development of a bowel obstruction.

Q2. Accurately, clearly and comprehensively explains the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. /10 Provides an accurate, clear and comprehensive explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. Provides an accurate and clear explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right  abdominal quadrant. Provides an accurate explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right
abdominal quadrant.

The information may be incomplete or lack clarity in explaining the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. Provides a basic explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant.

There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow in explaining the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant. Provides a superficial explanation of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant.

Explanation does not accurately identify the events that occur in the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant.

Response does not demonstrate an understanding of the pathophysiological processes that led to Lucy’s conscious perception of pain in her lower right abdominal quadrant.

Q3. Accurately, clearly and comprehensively describes the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. Provides an accurate, clear and comprehensive description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. Provides an accurate and clear description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy. Provides an accurate description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy.

Some information may be incomplete or lack clarity. Provides a basic description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy.

There may be minor inaccuracies, omissions or repetition of information, lack of clarity or logical flow. Provides a superficial description of the characteristics of the intravenous fluid that was ordered for Lucy, and the specific rationale, related to the details of the case study, for the administration of this intravenous fluid to Lucy.

Response does not demonstrate an understanding of the characteristics of the intravenous fluid and/or the specific rationale, related to the details of the case study, for its administration to Lucy.

Q4. Accurately, clearly and comprehensively describes the mechanism of action of fentanyl in relation to its administration to Lucy. /5 Provides an exceptionally accurate, clear and comprehensive description of the mechanism of action of fentanyl in relation to its administration to Lucy. Provides an accurate and clear description of the mechanism of action of fentanyl in relation to its administration to Lucy. Provides an accurate description of the mechanism of action of fentanyl in relation to its administration to Lucy.

However, the response may lack some relevant information or clarity. Provides a basic description of the mechanism of action of fentanyl in relation to its administration o Lucy.

Description may contain minor inaccuracies, omission of relevant information, repetition or lack clarity. Provides a superficial description of mechanism of action of fentanyl in relation to its administration to Lucy.

Response does not show an understanding of the mechanism of action of fentanyl in relation to its administration to Lucy.

Q5. Accurately, clearly and comprehensively prioritises the nursing responsibilities and associated rationales in relation to the administration of fentanyl to Lucy. Comprehensively, clearly and accurately prioritises all relevant nursing responsibilities related to the administration of fentanyl to Lucy.

Provides detailed and accurate rationales for each of these actions. Accurately prioritises all relevant nursing responsibilities related to the administration of fentanyl to Lucy. Provides accurate rationales for each of these actions. Accurately prioritises most relevant nursing responsibilities related to the administration of fentanyl to Lucy.

Provides accurate rationales for each of these actions. Identifies most relevant nursing responsibilities related to the administration of fentanyl to Lucy.

Nursing interventions may not be presented in a prioritised order.

Provides superficial rationales for these actions.

Some nursing actions may lack specific rationales. Identifies minimal relevant nursing responsibilities related to the administration of fentanyl to Lucy. Does not provide associated rationales for these actions.

Rationales may be inaccurate, incomplete and not related to specific nursing actions.

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Biology: Obstruction of the proximal ascending colon
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