The following additional information should be considered when addressing the Academic Essay: NSB025 ACADEMIC ESSAY – CASE STUDY: After surgery John agreed to receive adjuvant chemotherapy that includes 12 cycles of the following every two weeks: • Fluorouracil 400mg/m2 intravenously (IV) on Day 1 and Day 2 per cycle • Leucovorin (Calcium folinate) 200mg/ m2 by IV on Day 1 and Day 2 per cycle • Fluorouracil 1200mg/ m2 by IV infusion over 44 hours commencing on Day 1 per cycle John has returned for his third cycle of chemotherapy and reports feeling nauseated at unpredictable times during the week after his chemotherapy. He also tells you he feels especially nauseated on the morning he is due to begin a new cycle of chemotherapy. A review of John’s chart yields the additional information: • He is prone to motion sickness. • During the first cycle of chemotherapy John vomited several times on the third day following his Day 1 visit and was nauseated for the rest of that week. • John’s antiemetic regimen was reviewed and he now receives: – Dexamethasone 8 mg IV on Day 1 and 2 – Palonosetron 0.25 mg IV on Day 1 and 2 – Dexamethasone 8 mg orally (PO) for 2 to 3 days post chemotherapy – Metoclopramide 10 mg PO one to two tablets every 4 to 6 hours when required In speaking with John about his nausea and considering the information found in his chart the following points are raised: • He does not have a history of anxiety but admits he does not look forward to each cycle of the chemotherapy. He tells you he can’t stop thinking about the time he is missing out on being with his family whilst he is undergoing treatment and does not want to get sick again. • He would like some ideas to help him with the nausea he is experiencing before and after chemotherapy. You tell him that you will come back to discuss the management of his breakthrough and anticipatory nausea after you inform your buddy nurse he is ready to commence his chemotherapy and wants to discuss his nausea with the multidisciplinary team. NSB025 ACADEMIC ESSAY: The NSB025 Academic Essay requires you to address the following points: BREAKTHROUGH AND ANTICIPATORY NAUSEA Explain the possible causes for John’s breakthrough and anticipatory nausea. Use evidence-based literature to support the explanation. NAUSEA ASSESSMENT You decide to assess John’s nausea. Choose up to two (2) assessment tool(s) that would be appropriate to undertake John’s nausea assessment. Provide a justification, with evidence-based literature, as to why these tool(s) are appropriate for John. INTERVENTION 1 (and INTERVENTION 2) With the exception of an antiemetic medication, choose two (2) priority* interventions (nursing and/or collaborative) that will best manage John’s nausea. Use evidence-based literature to justify why each intervention is likely to manage John’s nausea successfully. * There are multiple possible interventions for John that may be appropriate. The term ‘priority’ requires you to focus on the two (2) interventions you feel are the most appropriate based on the research you conduct for this essay. Do not discuss more than two interventions in your essay. NSB025 ACADEMIC ESSAY – POINTS FOR CONSIDERATION: The above assessment task is best addressed using the following format: Use the following headings: Introduction [200 words] Your introduction should include a brief overview of John’s case and the focus of your essay. Breakthrough and anticipatory nausea [250 words] Nausea Assessment [250 words] Intervention 1 [500-700 words] Each intervention should discuss: what the intervention is, how it works to manage the nausea John is experiencing, how the intervention is administered (e.g. how much/how often etc.), what the benefits are of this intervention for John, what the evidenced based literature says about the intervention, what the different perspectives/opinions/findings are regarding this intervention, and why this intervention is most suitable/appropriate for John Intervention 2 [500-700 words] Conclusion [200 words] The conclusion should give a brief summary of the main points of the essay.
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