Assignment Instructions
Aim
The primary aim of this assignment is to enable you to develop and apply your foundational knowledge of essential medication concepts. These include medication safety, pharmacological modes of action, side effects, and nursing considerations associated with medication administration.
By engaging with a case study (Aunty Lorraine Jackson), you will strengthen your understanding of the Registered Nurse’s responsibilities in implementing safe medication practices within clinical practice.
This assignment addresses Course Learning Outcomes 2 and 3.
Task
This assessment comprises three distinct parts, each designed to evaluate different aspects of your foundational medication knowledge and skills:
Part 1: Case Study Analysis
You are required to provide a comprehensive written response to two questions (parts a and b) directly related to the provided case study (Lorraine Jackson) and medication chart (Appendix
a) Identify three invalid medication orders from the medication chart and thoroughly justify your reasoning by explicitly referring to the “Six Rights” of medication administration.
b) Utilising the systems approach to medication errors, outline three factors within the case study that could lead to medication errors. Then, subsequently, discuss evidence-based strategies that a Registered Nurse should implement to reduce these identified risks. Your response must also include a clear and accurate explanation in response to Aunty Lorraine’s query regarding Crestor.
Part 2: Concept Map
Create a single page, colour-coded concept map that visually illustrates the mode of action of metoprolol.
Your map should clearly demonstrate how metoprolol affects the physiology of the related body system/s to achieve its stated clinical indication (in the case study). Additionally, include the mechanisms behind the two side effects experienced by Aunty Lorraine in the case study that are attributed to metoprolol.
Part 3: Critical Review of Patient Education (ChatGPT Response)
You will critically review and revise a response generated by ChatGPT (version 3.5) (Appendix
This ChatGPT response addresses key nursing considerations and patient education messages for two medications prescribed for Aunty Lorraine's discharge from the hospital, as outlined in the case study and PRN section of the medication chart (Appendix 1).
Instructions
- Carefully review the accompanying Case Study Part 1: Hospitalisation (medication safety).
- Thoroughly examine the medication chart (Appendix 1) to inform your responses for Parts 1 and 3.
- Respond to Part 1a and Part 1b comprehensively. The approximate word count for Part 1 is 1000 words.
- Complete Part 2: Concept Map. This should be a single-page map created using PowerPoint or Microsoft Word. Refer to the resources on the L@G course site and attend your in-person tutorials for guidance on creating concept maps.
- Review Part 3: Discharge Planning (nursing considerations and patient education). Critically analyse the response generated through ChatGPT (Appendix 2) before attempting part 3.
- Rewrite the ChatGPT response for Part 3: The maximum word count for Part 3 is 500 words.
- Combine all three parts of the assignment (Part 1, Part 2 concept map and Part 3) into a single PDF document for submission.
- Ensure you review the “Additional Information” under the A2 assessment tab on the L@G course site for further details and support.
Case Study
Background
Aunty Lorraine Jackson is a 78-year-old woman who identifies as an Elder in a remote Queensland town. Aunty Lorraine lives alone uses a walking frame to mobilise following a left femur fracture two years ago. She experiences ongoing pain from osteoarthritis at the fracture site and frequently takes ibuprofen to manage her pain.
Aunty Lorraine has a medical history of hypertension, atrial fibrillation, stable angina, and chronic Hepatitis B infection, diagnosed in her 40s. Aunty Lorraine's regular medications include Metoprolol for high blood pressure, Rosuvastatin for dyslipidaemia, Warfarin for treatment of arrhythmias, and glyceryl trinitrate (GTN) spray PRN for angina symptoms.
Part 1: Hospitalisation (Medication Safety)
Aunty Lorraine recently experienced an episode of wheezing and has been noticing cold hands and feet, both of which she attributes to being caused by the cold weather. Her general practitioner (GP) was concerned about these symptoms and the appropriateness of her current medications and recommended a medical review. As Aunty Lorraine lives alone, she was admitted overnight to the medical ward at Beaudesert Hospital for a 24-hour observation and comprehensive medication review. Her medications have been charted accordingly (see Appendix 1).
Aunty Lorraine is admitted to a general medical ward and placed in a private room. While the ward is relatively quiet, the hospital has recently transitioned to a new integrated electronic Medical Record (ieMR) system, which has been causing occasional technical disruptions.
At 08:00, the registered nurse (RN), Priya, begins preparing Aunty Lorraine’s morning medications. Priya is experienced but unfamiliar with the updated ieMR system, having just returned from extended leave. While checking Aunty Lorraine’s chart, she notices an issue with the metoprolol order in the ieMR. Unsure whether it's an accidental issue, Priya decides to delay its administration and prepares the other medications.
Priya is accompanied by a student RN who is shadowing her for the day. As they enter Aunty Lorraine’s room, Priya begins discussing Aunty Lorraine’s reason for admission to hospital. During the conversation, Priya hands Aunty Lorraine a medication cup without conducting a verbal confirmation of the medications at the bedside.
Just then, Priya’s pager goes off, and she’s been called urgently to assist with a MET call on another ward. She turns to the RN student and says:
“Can you follow this up? I’ve got to run.” She exits the room quickly.
Aunty Lorraine, whose reading glasses recently broke, cannot see the tablets clearly. She picks up a round yellow tablet and asks:
“Is this my Crestor? Mine at home looks a bit different and I only take one.”
The student RN replies:
“It should be. Pharmacy often changes brands it’s probably the same.”
The tablets provided to Aunty Lorraine by the RN is shown below.
Part 1: Case Study Analysis
a) Medication Order Validity and Justification
Carefully review the provided medication chart (Appendix 1). Identify three (3) specific medication orders that you deem invalid. For each identified invalid order, provide a detailed justification. Your justification must explicitly reference relevant details from the medication chart and clearly explain how the order violates one or more of the "Six Rights” of Medication Administration.
(Approximate word count: 500 words)
b) Factors Contributing to Medication Errors and Mitigation Strategies
Utilising the five broad factors in the systems approach to medication errors, identify three (3) distinct factors present within the case study that could potentially contribute to medication errors. For each identified factor, discuss evidence-based strategies that a Registered Nurse can implement to reduce or prevent these errors. Your discussion must include a comprehensive and accurate explanation of the RN's appropriate response to Lorraine's specific query regarding Crestor.
(Approximate word count: 500 words)
Mode of Action and Side Effects of Metoprolol
a) Concept Map Development
Develop a comprehensive, single-page, colour-coded concept map using either Microsoft PowerPoint or Microsoft Word.
Your concept map must visually represent the following key elements:
- Mode of Action of Metoprolol:
- Clearly identify and interpret the pharmacological mode of action of metoprolol.
- Illustrate a clear, step-by-step sequence detailing how metoprolol exerts its effects across the relevant body system(s) to achieve its therapeutic purpose (clinical indication) stated in the case study. This sequence must be grounded in evidence-based literature.
- Mechanism of Two Common Side Effects:
- Provide a detailed and logical mechanistic sequence connecting the mode of action of metoprolol with two (2) specific side effects that Aunty Lorraine experiences as listed in the case study. Ensure these connections are also grounded in evidence-based literature.
Important Note on Referencing: You are not required to include reference citations directly on your concept map.
Critical Review of Patient Education (ChatGPT Response)
A few days later, Aunty Lorraine is due to be discharged home from the ward. Her discharge medications include metoprolol, warfarin, paracetamol (PRN) and GTN (PRN). As part of her discharge planning, the RN plans a short education session with Aunty Lorraine about the medications she will be taking at home.
Please address the following points (approximately 500 words):
As the RN prepares Aunty Lorraine for discharge, it is crucial to ensure she is adequately educated about the medications she will be taking at home. Following a discussion, it is identified that Aunty Lorraine requires further detailed information, specifically about two of her medications: Warfarin and Paracetamol (PRN).
To assist with this, the RN initially generates key nursing considerations and patient education messages for these medications using ChatGPT (3.5). However, upon critical review of the ChatGPT response (Appendix 2), the RN discerns significant inaccuracies, omissions, and details that are not clinically applicable to Lorraine's specific situation.
Your primary task is to critically evaluate and rewrite the provided ChatGPT response. Your rewrite must ensure absolute accuracy and clarity regarding essential nursing considerations and patient education messages for both Warfarin and Paracetamol, tailored explicitly to Aunty Lorraine's clinical situation. You are required to refer to relevant scholarly literature to identify and rectify any errors or missing details from the original ChatGPT output.
Furthermore, for each revised nursing consideration you present, you must include a concise, clear, and patient-friendly educational message example that is directly relevant to Aunty Lorraine.
General Writing Requirements for Parts 1 and 3
- Support your responses with a minimum of fifteen (15) scholarly sources (e.g., peer-reviewed journal articles, edited textbooks, official government body reports, professional clinical guidelines). All sources must have been published within the last five (5) years.
- All written responses must be presented in the third person, utilising formal academic language appropriate for university-level study.
- Do not use bullet points or numbered lists within the main body of your written responses.
- An introduction and conclusion are not required for Parts 1 and 3.
- Ensure in-text citations support all information that isn’t your own. The word count includes these in-text citations.
- Provide a comprehensive reference list at the end of Part 3, encompassing all literature cited throughout Parts 1 and 3.
- All formatting, including referencing, must strictly adhere to the guidelines outlined in the Griffith Health.
Summary of Assessment Requirements
The assessment is divided into three main parts:
- Part 1: Case Study Analysis (1000 words)
- Part 1a: Identify three invalid medication orders from Aunty Lorraine’s chart and justify why they are invalid using the Six Rights of Medication Administration.
- Part 1b: Using the systems approach to medication errors, identify three risk factors from the case study that could lead to errors, and provide evidence-based strategies to reduce them. Must also explain Aunty Lorraine’s query regarding Crestor clearly.
- Part 2: Concept Map (single page, colour-coded)
- Explain the mode of action of metoprolol step by step.
- Show how the drug affects the body system to achieve its indication.
- Include the mechanisms of two side effects Lorraine experienced.
- Part 3: Critical Review (500 words)
- Critically analyse a ChatGPT-generated response about Warfarin and Paracetamol (PRN).
- Rewrite the content to ensure accuracy, patient-specific education, and clinical relevance.
- Provide clear patient-friendly messages alongside nursing considerations.
Other requirements:
- Use 15+ scholarly references (last 5 years).
- Write in formal academic style (3rd person, no bullet points in main answers).
- Combine all parts into one PDF submission.
- Reference list must follow Griffith Health guidelines.
Guidance by Academic Mentor
Step 1: Understanding the Case Study
The mentor first guided the student to carefully read Lorraine Jackson’s medical history, current medications, and the scenario in the hospital ward. The focus was on identifying risks, potential errors, and the nurse’s role in ensuring safe medication administration.
Step 2: Tackling Part 1a (Invalid Orders)
- The mentor explained how to check each order against the Six Rights (right patient, drug, dose, route, time, documentation).
- Together, they identified three invalid orders (e.g., wrong dose, incomplete instructions, or unsafe duplication).
- The student was shown how to justify errors with references to medication safety guidelines.
Step 3: Tackling Part 1b (Medication Error Risks)
- Using the systems approach (patient factors, healthcare professional factors, environment, communication, equipment/technology), the mentor guided the student to pick three clear risks (e.g., RN distraction, unfamiliarity with new electronic system, patient’s poor vision).
- Evidence-based strategies (e.g., double-checking, effective handovers, use of teach-back for education) were suggested.
- Mentor helped frame an accurate patient-friendly explanation for Crestor (brand vs generic differences).
Step 4: Building the Concept Map (Part 2)
- The mentor explained how metoprolol works: blocking beta-1 adrenergic receptors → reduced heart rate and contractility → lower BP and angina control.
- Showed how to visually map: drug → receptor → physiological response → therapeutic outcome.
- Side effects (cold extremities, wheezing) were connected to the mechanism in the concept map.
- Tools like Word/PowerPoint SmartArt and color-coding were demonstrated.
Step 5: Reviewing ChatGPT’s Response (Part 3)
- The mentor encouraged a critical lens: what did ChatGPT miss, what was inaccurate, and what wasn’t patient-specific?
- For Warfarin, the rewrite focused on INR monitoring, dietary interactions (vitamin K), bleeding risks, and consistent patient education.
- For Paracetamol, the rewrite included safe dosage, liver toxicity risks, and avoiding unnecessary PRN use.
- Mentor guided the student to provide patient-friendly explanations alongside nursing considerations (e.g., “Take Warfarin at the same time daily. If you notice unusual bruising, contact your doctor immediately”).
Step 6: Final Assembly and Referencing
- Student was guided to combine Parts 1–3 into one document.
- Mentor reviewed citations and reference list to ensure APA/Griffith style compliance.
- Formatting was checked for professionalism (headings, spacing, no bullet points in analysis sections).
Final Outcome and Learning Objectives Achieved
By the end of the process, the student was able to:
- Apply the Six Rights of medication administration to identify unsafe orders.
- Use a systems-based approach to analyse and mitigate medication errors.
- Demonstrate understanding of pharmacology (metoprolol action and side effects) using a concept map.
- Critically evaluate AI-generated content, identifying inaccuracies and rewriting it into clinically accurate, patient-centered education.
- Strengthen skills in academic writing, referencing, and safe nursing practice.
The final submission aligned with the assessment criteria, addressed learning outcomes, and demonstrated the student’s ability to integrate theory into practical, safe nursing care.
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