ASSESSMENT 2 BRIEF

Subject Code and Title CCA206 Care of Children and Adolescents

Assessment Case study analysis and developing a care plan

Individual/Group Individual

Length 1800 words (+/- 10%)

Learning Outcomes The Subject Learning Outcomes demonstrated by successful

completion of the task below include:
a) Define and apply the key concepts related to the growth and
development of children and adolescents to nursing assessment
and care planning
c) Critically analyse the psychosocial and cultural needs of the child
or adolescent and their significant other and essential support in
relation to acute illness in child and adolescent primary health
care.
d) Explore the complexities of medication management with
children and adolescents and interpret and apply to care
planning.
e) Recognise child protection responsibilities and collaborative
processes with a multidisciplinary team.
f) Identify and determine suitable risk assessment tools for use
within children’s health care (as outlined in the National Safety
and Quality Health Services (NSQHS) Standards).

Submission Due by 11:55pm AEST Sunday end of Module 4.2 (Week 8)

Weighting 40 %

Total Marks 100 marks

Assessment Task
In this assessment, you will be required to
• Choose one (1) case study detailing a common clinical presentation in childhood
• Research and write a critical appraisal on your chosen case study.
• The word limit for this assessment is 1800 words (+/- 10%). This is an individual assessment.
• Please refer to the Assessment Instructions for details on how to complete this assessment.

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Context
This assessment provides an opportunity for you to use the theoretical knowledge you have
acquired so far in CCA206 Care of Children and Adolescents. You are encouraged to analyse the
information presented to you in the case study, recommend appropriate courses of action based on
best practices, supported by academic references and peer reviewed literature. When making
recommendations, keep in mind the philosophy of patient and family-centred care. Develop a
nursing care plan for the selected case after your analysis.

Instructions
To complete this assessment, you must:

• Read the two case studies presented.

• Choose one (1) case study to analyse
• Please ensure you consider the following points as you complete your case study report
1. Define the clinical diagnosis/es.
2. Enumerate the aetiology and risk factors of the clinical diagnosis/ es.
3. Describe the pathophysiology of the clinical diagnosis.
4. Analyse the signs and symptoms of the clinical presentation.
5. Describe and interpret the growth and development of the child in your case study
based on the expected characteristics for their age/ developmental stage
6. Identify the child protection responsibilities of a Registered Nurse in your
state/territory
7. Based on the child protection responsibilities identified in 6. above, describe and
analyse the multidisciplinary processes for managing any complex safeguarding
issues related to the child in the case study.
8. Identify and explore medication management complexities in your chosen case
study to include the interpretation and application to care planning.
9. Appraise suitable risk assessment tools, and apply one tool to determine the risk
management measures to be integrated into the child’s care plan.
10. Based on your analysis above, develop a nursing care plan for the child chosen for
your case study highlighting FIVE care priorities/problems identified. In your care
plan, include assessment data, nursing diagnosis/ collaborative problems, planning
(goals/expected outcomes), nursing interventions, and evaluation. As you are not
providing care in the real world, to write your evaluation, consider that the child’s
condition is improving after your interventions.

Please also consider the following requirements:

• Write your case study report in the third person.

• Present your own original work using multiple academic references from academic books,
peer reviewed scientific journal articles and other credible sources (government documents,
reports, publications, authentic webpages etc.).

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 • Familiarise yourself with the rubric to ensure you are addressing the relevant elements
within your case study.
• Present your academic references on a separate page using APA (7th ed.) guidelines.
• Submit your report as a word document and not in protected view.
• Present your assessment in 12-point font, Arial or Times New Roman, 1.5 line spaced and a
minimum of 2.5cm margins.
• Page numbers should be included in the footer along with student ID number
• Suggested Structure
o A brief succinct introduction should be written to introduce the case study and
intention of the case study analysis (100-150 words).
o A conclusion should be written which sums up any significant findings and concludes the
case study analysis in an engaging way. No new information should be introduced in the
conclusion (100-150 words).
o Use Headings and Subheadings where appropriate to indicate the question is being
addressed

Referencing
15+ references are required for this assessment. Use recent, relevant and reliable resources to
complete this task. These should be peer-reviewed literature, related to the subject matter and not
older than seven years.
It is essential that you use appropriate APA style for citing and referencing research.
Please see more information on referencing in the Academic Skills webpage.

Submission Instructions
The case study report should be submitted via the Assessment 2 link in the main navigation menu in
CCA206 Care of Children and Adolescents Blackboard site. The learning facilitator will provide
feedback via the Grade Centre in the LMS portal. Feedback can be viewed in My Grades.

Academic Integrity
All students are responsible for ensuring that all work submitted is their own and is appropriately
referenced and academically written according to the Academic Writing Guide. Students also need
to have read and be aware of Torrens University Australia Academic Integrity Policy and Procedure
and subsequent penalties for academic misconduct. These are viewable online.

Students also must keep a copy of all submitted material and any assessment drafts.

Special Consideration
To apply for special consideration for a modification to an assessment or exam due to unexpected or
extenuating circumstances, please consult the Assessment Policy for Higher Education Coursework
and ELICOS and, if applicable to your circumstance, submit a completed Application for Assessment
Special Consideration Form to your Learning Facilitator.

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 Case Studies

Case Study (Option 1)

Patient Name: Amar

Patient age: 5 months

Mrs. Sooma, attends the Emergency Department (ED) with her 5-month-old son Amar.
She is concerned that her son has had a cough, runny nose and congestion for three days, and is
gradually getting worse. Overnight, he coughed very forcefully until he vomited, and this morning,
his mother noticed he was breathing faster, feels like he has a fever and is taking in less formula.

He has not had a wet nappy in four hours. His 4-year-old sister has a cold and attends a local
day care centre. Mrs. Sooma has four children under six years of age, which she brings up alone after
her husband died recently in car accident. You are Amar’s admitting nurse.

Amar was born at 32 weeks gestation measuring 38.1cm and weighing 1421 grams.

He remained in hospital until six weeks of age. Since discharge, he has been weighed/measured
regularly and you perform an admission weight/length and plot Amar’s growth on the World Health
Organisation (WHO) growth charts. His mother is concerned that he is not growing well as he is
much smaller than children of a similar age.

Age Corrected Age Weight (kg) Length (cm)

3 months 1 month 3.0 50.9
5 months 3 months 4.5 55.9

When you are weighting Amar, you notice that he has several small bruises on his left lateral upper
arm, which are on the bicep and tricep region. Further observation notes a non-blanching petechiae
on his neck, jaw line and upper chest.

Mrs. Sooma openly explains that her 4-year-old toddler has begun to bite with her temper tantrums.
Mrs. Sooma recounts events relating to the bruise/bite mark and becomes quite emotional, she sheds
some tears. She explains Amar’s 4-year-old sister had bitten him on the left arm which she thinks looks
more like a bruise now almost a week later. She explained how she noticed the ‘little pinpoint spots’
on his chest this morning when she bathed him. You clearly document and report to the senior nurse
on duty and the attending Doctor regarding your findings whilst weighing Amar.

Further physical examination shows Amar’s vital signs as:

• Temperature: 38.4°C
• Heart rate:150 beats per minute
• Respiratory rate: 60 breaths per minute
• Blood pressure:90/50 mmHg.
• Oxygen saturation: 91% on room air.

He appears alert and smiles sometimes but is clearly tachypnoeic and has a moist cough. You note
moderate subcostal and intercostal retractions, with mild nose flaring.

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On auscultation of his chest, there are widespread crackles audible throughout both lung fields, which
have a “wet” quality. There is equal air entry bilaterally with a faint lower bibasal wheeze evident on
expiration only.

The admitting Doctor reviews Amar and documents a clinical diagnosis of moderate viral bronchiolitis.
He informs Amar’s mother that he will need admission to hospital.

The plan of care includes:

• Intravenous fluids
• Intravenous antibiotics
• Insertion of an IV cannula
• Oral liquid paracetamol
• Monitor Vital signs every 30 minutes
• Continuous Sp02 monitoring
• Nebulised Salbutamol 4 hourly
• Review by a doctor in four hours unless further deterioration is noted by nursing staff.

You are aware of the hospital guideline for the management of Bronchiolitis and note that a Paediatric
Medical review and consultation is expected, to identify whether bronchiolitis is moderate or severe.

Case Study (Option 2)

Patient name: Lucy

Patient age: 6 years

Mrs Hawkins attends the Emergency Department (ED), with her 6-year-old daughter Lucy.

She is concerned that Lucy has developed a rash, her cough is worsening, and her fever continues
despite treatment from her General Practitioner (GP). Mrs Hawkins first brought her daughter to see
the GP three days beforehand, when she developed a fever for 48hrs, had a troublesome cough, itchy
watery eyes, and a runny nose and complained of a sore ear.

The GP diagnosed conjunctivitis with otitis media and prescribed oral antibiotics. Since then, Lucy has
deteriorated, and earlier today she developed a facial rash that proceeded to spread to her torso.

You take scales into Lucy’s treatment room, undress her to take a weight and height:

• Weight: 15kg
• Height: 115cm

On first impressions, you are very concerned that Lucy looks extremely underweight, as you can see
the bones in her rib cage. Her skin is smudged with dirt and her clothes stained and smelly. She also
has a visible red rash on her face which has progressed to her back. She is quiet and somewhat
unresponsive with inconsistencies between her responses and her mother’s.

You observe that Mrs Hawkins does not comfort Lucy when she becomes upset and appears to be
rough and impatient when instructing her to re-dress.
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Lucy was born by vaginal delivery at 39.4 weeks. Her birth weight was 3.4 kg. She has no medical or
surgical history, or previous hospitalisations. She does not take any medication, other than the oral
antibiotics prescribed the GP. She has no known drug allergies. Lucy has no siblings and her Father is
reported to be healthy.

Mrs Hawkins has Type 1 diabetes. No other diseases noted paternally or maternally. Mrs Hawkins
explains to you that her daughter has not had any of the recommended immunisations as she (the
Mother) has refused consent. Lucy is also home schooled.

Meanwhile, you become increasingly concerned that Lucy appears to be deteriorating clinically
(changes to her vital signs) and you escalate your reporting to an immediate assessment and
treatment by the Paediatrician in the Emergency Department.

On physical examination:
• Temperature: 39.6°C
• Heart rate: 130 beats per minute
• Respiratory rate: 52 breaths per minute
• No blood pressure was recordable.
• Oxygen saturation: 90% on room air

You commence supplemental oxygen via nasal prongs at 2L/min. Lucy has bilateral conjunctivitis, a
normal oral pharynx, decreased breath sounds with fine crepitation throughout, moderate subcostal
retractions and a generalised erythematous macular-papular rash to her face, trunk and upper
extremities.

The Paediatrician is working on a clinical diagnosis of measles with moderate to severe pneumonia.
She informs Lucy’s mother that admission is required and recommends close monitoring in an
isolation room.

The plan of care includes:

• Oxygen to maintain saturations >92% with continuous Sp02 monitoring
• Continuous cardiac monitoring via a 3 lead ECG
• Regular reassessment for possible further respiratory support.
• Urgent chest x-ray
• Nose & throat swabs
• IV cannula
• IVT Normal saline 1000ml over 12 hours
• Oral liquid paracetamol
• Blood cultures
• Full blood count
• Electrolytes
• C-reactive protein
• Measles serology

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Assessment Rubric
Assessment Attributes
Understanding and
application of theoretical
underpinnings and key
concepts
• The definition, etiology
and pathophysiology of
the clinical diagnosis, and
the signs and symptoms
of the clinical
presentation, for your
chosen case study
• Growth and development
of the child and their
application to chosen
case study
Percentage for this criterion =
35%
CCA206_Assessment_2_Brief
Fail
(Yet to achieve
minimum standard)
0-49%
Limited understanding and/or
application of theoretical
underpinnings and key
concepts:
• Failing to identify or
describe any
pathophysiological
processes of the clinical
diagnosis; or
• Failing to identify the any
signs and symptoms of the
clinical presentation.
• Failure to describe or
interpret growth pattern;
or
• Failure to identify any
important concepts to
discuss with the child and
family.
Pass Credit
(Functional) (Proficient)
50-64% 65-74%
Demonstrates a functional Demonstrates a proficient
understanding of the understanding of the
theoretical underpinnings and theoretical underpinnings and
key concepts by: key concepts by:
• Identifying the key • Identifying the key
pathophysiological pathophysiological
processes of the clinical processes of the clinical
diagnosis, and providing a diagnosis, and providing a
limited description and description of them to a
cursory analysis of them; cellular level; and
• Identifying the key signs • Identifying the key signs
and symptoms of the and symptoms of the
clinical presentation, and clinical presentation and
providing a limited provides a description that
description and cursory links them to the
analysis of them; and pathophysiology and
• Providing a limited includes some analysis
description and from one or two sources
interpretation of growth with little correlation.
pattern. Above average understanding
Demonstrates functional of key concepts related to
application by growth and development
• Identifying some demonstrated by:
important concepts to •Providing a detailed
discuss with the child and description and interpretation
their family without of growth pattern; and
referencing any relevant •Identifies the important
sources. concepts and provides some
analysis of the concepts to
discuss with the child and
Distinction
(Advanced)
75-84%
Demonstrates an advanced
understanding of the
theoretical underpinnings and
key concepts by:
• Identifying and providing a
detailed description of all
pathophysiological
processes of the clinical
diagnosis to a cellular
level, and an analysis,
which is linked to at least
two appropriate resources
that provide relevant
correlation; and
• Identifying and providing a
detailed description of the
signs and symptoms of the
clinical presentation, and
an analysis that links them
to the pathophysiology,
and includes at least two
appropriate resources that
provide relevant
correlation.
Advanced understanding of
key concepts related to
growth and development
demonstrated by:
•Providing a detailed
description and interpretation
of growth pattern; and
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High Distinction
(Exceptional)
85-100%
Demonstrates an exceptional
understanding of the
theoretical underpinnings and
key concepts by:
• Identifying and providing
an extensive description of
all pathophysiological
processes of the clinical
diagnosis to a cellular level
supported by analysis and
interpretation of evidence
from three or more
relevant sources; and
• Identifying and providing
an extensive description
and analysis of
pathophysiological basis of
signs and symptoms,
supported by analysis and
interpretation of evidence
from three or more
relevant sources.
Exceptional understanding of
key concepts related to
growth and development
demonstrated by:
•Identifying and providing an
extensive description and
interpretation of growth
pattern; and

Recognition of the child
protection responsibilities
of a Registered Nurse in
own region/state and
describe the
multidisciplinary processes
for handling complex
safeguarding issues for
chosen case study
Percentage for this
criterion = 15%
Medication management
and care planning
CCA206_Assessment_2_Brief
Limited recognition and Basic recognition and
description demonstrated description demonstrated
by: by:
• Failing to recognise the • Identifying some of the
regional/state child key regional/state child
protection protection
responsibilities of a responsibilities of a
Registered Nurse as Registered Nurse but
applied to the case with limited application
study; and to case study; and
• Failing to identify or • Providing a basic
describe description of the
multidisciplinary multidisciplinary
processes for managing processes for managing
complex safeguarding complex safeguarding
issues related to chosen issues related to chosen
case study. case study without
sufficient evidence to
support the approach.
Limited clinical reasoning Basic clinical reasoning
demonstrated by: demonstrated by:
their family with reference to
at least one relevant source.
Sufficient recognition and
description by:
• Identifying all key
regional/state child
protection
responsibilities of a
Registered Nurse with
basic application to case
study; and
• Providing a clear, logical
description of the
multidisciplinary
processes for managing
complex safeguarding
issues related to chosen
case study with
reference to at least
one relevant source.
Above average clinical
reasoning demonstrated
by:
•An in-depth analysis of all
the important concepts to
discuss with the child and
their family, to include, some
reference to relevant health
promotion activities and
evidence from two or more
relevant sources.
Above average recognition
and description by:
• Identifying all of the key
regional/state child
protection
responsibilities of a
Registered Nurse with
some detailed
application to case
study; and
• Providing a detailed
description of the
multidisciplinary
processes for managing
complex safeguarding
issues related to chosen
case study with
evidence from two or
more relevant sources.
Advanced clinical
reasoning demonstrated
by:
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•Providing an in-depth
correlation and interpretation
of core concepts including
general health and
development, feeding
practices, social history,
relevant health promotion
activities and future
monitoring, with supporting
evidence from three or more
relevant sources.
Advanced recognition and
description demonstrated
by:
• Identifying all of the
potential regional/state
child protection
responsibilities of a
Registered Nurse with
considerable
application to case
study; and
• Providing an in-depth
description with some
analysis of the
multidisciplinary
processes for managing
complex safeguarding
issues related to chosen
case study with
evidence three or more
sources used to validate
understanding.
Exceptional clinical
reasoning demonstrated
by:
 Apply sound clinical
reasoning to identify and
explore medication
management complexities
in your chosen case study,
to include interpretation
and application to care
planning from a nursing
perspective.
Percentage for this
criterion = 15%
Risk assessment and care Limited clinical reasoning
planning skills demonstrated by:
Apply sound clinical
reasoning skills needed to
perform an appropriate
risk assessment for chosen
case study, to include
identifying and appraising
suitable risk assessment
tools, applying one tool,
and determining risk
management measures to
be integrated into patient
care plan.
CCA206_Assessment_2_Brief
• Failing to identify any • Recognising the key
concerns/complexities concern/complexity
related to medication related to medication
management; or management; and
• Identifying some • Formulating a basic plan
concerns, but failing to for how this concern
incorporate these into could be addressed and
patient care planning. incorporated into
patient care planning,
which includes
reference to an
evidence-based
guideline only.
Basic clinical reasoning
skills demonstrated by:
• Failing to fully consider • Identifying at least two
the patient situation important risk
and not identifying any assessment tools,
risk assessment tools providing rationale for
relevant to the case your choice; and
study; or • Basic application of one
• Identifying a list of risk risk assessment tool
assessment tools but and integration of
failing to apply them information into patient
appropriately to patient care planning, but
case and/or care without sufficient
planning. evidence to support the
approach.
• Identifying and partially • Critical analysis of the
appraising the key key concerns/
concerns/complexities complexities related to
related to medication medication
management; and management; and
• Formulating a logical • Formulating a detailed
plan for how these plan for how these
concerns could be concerns could be
addressed, identifying addressed, the nursing
nursing interventions interventions that could
that could be applied be applied and
and integrated into care integrated into care
planning, which planning, which
includes reference to an includes reference to an
evidence- based evidence- based
guideline and one other guideline and two or
relevant source. more relevant sources.
Above average clinical Advanced clinical
reasoning skills reasoning skills
demonstrated by: demonstrated by:
• Identifying and partially • Critical analysis of all
appraising the key risk important risk
assessment tools as assessment tools as
they relate to the case they relate to the case
study; and study, with reference to
• Appropriately applies appropriate NSQHS
one risk assessment standards; and
tool and the evidence • Appropriately applies
obtained is used to one or more risk
formulate a focused assessment tools and
care plan, with formulates a detailed
appraisal that includes care plan that
reference to evidence appropriately integrates
evidence from one or
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• Critical evaluation of
the complexities related
to medication
management; and
• Formulating a holistic
family centred care plan
addressing the
concerns, outlining the
nursing interventions to
be applied and
integrated into care
planning, including an
evidence-based
guideline, and three or
more relevant sources.
Exceptional clinical
reasoning skills
demonstrated by:
• Critical evaluation of
the risk assessment
tools used in children’s
health care using
criteria governed by
NSQHS standards; and
• Formulating a holistic
family centred care
plan, which integrates
the evidence from risk
assessments and
determines detailed risk
management measures
to be integrated into
 Percentage for this
criterion = 25%
Academic Skills Required APA referencing
style not followed for most
Demonstration of correct references provided.
citation and referencing
Demonstration of Inconsistent use of good
appropriate grammar, quality, credible and
language and structure relevant resources to
support and develop
understanding.
Percentage for this Insufficient paraphrasing
criterion = 10% present throughout report.
Inconsistent use of correct
grammar, spelling,
language and structure;
writing difficult to follow
with frequent mistakes.
CCA206_Assessment_2_Brief
Required APA referencing
style not followed for some
references provided.
Fewer than seven
appropriate resources used
to support and develop
understanding that are of
good quality, credible and
relevant.
Sufficient paraphrasing
present throughout report.
Basic use of correct
grammar, spelling,
language and structure;
writing difficult to follow
with some mistakes.
from one or more
relevant sources.
Required APA referencing
style followed for most
references provided.
Seven to ten appropriate
resources used to support
and develop understanding
that are of good quality,
credible and relevant.
Paraphrases well
throughout case study.
Consistent use of correct
grammar, spelling,
language and structure;
writing easy to follow with
some mistakes.
more relevant sources
for each tool identified.
Required APA referencing
style followed for all
references provided.
Ten to fifteen appropriate
resources used to support
and develop understanding
that are of good quality,
credible and relevant.
Great demonstration of
paraphrasing skills
throughout case study.
Advanced use of correct
grammar, spelling,
language and structure;
writing easy to follow with
minimal mistakes.
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care planning, including
the evidence from three
or more relevant
sources.
Required APA referencing
style followed for all
references provided.
Fifteen or more
appropriate resources used
to support and develop
understanding that are of
good quality, credible and
relevant.
Exceptional paraphrasing
present throughout case
study.
Exceptional use of correct
grammar, spelling,
language and structure;
writing easy to follow with
very few mistakes
 The following Subject Learning Outcomes are addressed in this assessment
SLO a) Define and apply the key concepts related to the growth and development of children and adolescents to nursing assessment and care planning
Critically analyse the psychosocial and cultural needs of the child or adolescent and their significant other and essential support in relation to
SLO c)
acute illness in child and adolescent primary health care.
SLO d) Explore the complexities of medication management with children and adolescents and interpret and apply to care planning.
SLO e) Recognise child protection responsibilities and collaborative processes with a multidisciplinary team.
Identify and determine suitable risk assessment tools for use within children’s health care (as outlined in the National Safety and Quality Health
SLO f)
Services (NSQHS) Standards).

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