APA
APN108 Applying Nursing Practices (B) Assessment 1A response template ASSESSMENT 1A: student reponse Student Name Date Course HLT54115 Diploma of Nursing Subject Code and Title APN108 Apply Nursing Practice (B) Unit(s) of Competency HLTENN012 Implement and monitor care for a person with chronic health problems Performance criteria, Knowledge evidence and Performance assessed PC: HLTENN012: 1.1, 1.3, 1.4, 1.5, 2.1, 2.2, 2.3, 2.4, 2.5. PE: HLTENN012: 1 KE: HLTENN012: 1.5 a, b, c, d, e. 2.1, 2.2, 2.5, 2.6, 2.7, 3.3, 3.7, 3.13, 4.1, 4.2, 4.3, 4.4, 4.5 Title of Assessment Task Case Study Type of Assessment Task Case study with short answer questions Length 6 questions with words limits of 300 – 750 per question. Submission Due by 11:55pm AEST Sunday end of Week 5 (module 3.1). Task Instructions To complete Assessment 1, Part A, you must respond to a number of questions and develop a plan of care for the client, on the response template provided. The questions are based on the case study below. These questions must be answered in full. When responding to the questions, please pay attention to the entire question being asked, as well as the prescribed word count, if provided. Use the correct medical terminology when answering all questions. Your answers should be reflective, analytical and based on critical assessments and the Enrolled nurse standards for practice and Codes of Ethics for Nursing. You will be assessed on the responses to the questions and will be deemed as either satisfactory or not satisfactory. ALL of the responses must be marked as satisfactory in order to pass the assessment. If your assessment is not deemed satisfactory, you will be re-assessed as per the THINK Education Assessment Policy for Vocational Education and Training (VET), before being awarded a Non Satisfactory mark for the assessment and the unit. Case Scenario: Mr George McFarlane is a 53 year old Caucasian Male, admitted to hospital after seeing his General Practitioner (GP) for an infected left (L) toe, caused by a blister/ lesion, possibly from ill-fitting shoes. When he realised there was a lesion present, he initially did not consider it serious and did not seek medical treatment straight away. After a week, the smell disturbed him and he sought advice from his GP who prescribed oral antibiotics and stressed the importance of cleansing and changing the dressing on his wound regularly. Due to Mr McFarlane’s job which required being on the road for long hours at a time, these regular dressing changes did not occur. Subsequently, due to irregular dressing changes and Mr McFarlane’s Methicillin-resistant Staphylococcus Aureus (MRSA) status and Type II diabetes, the lesion failed to heal and became larger and deeper. Mr McFarlane returned to his GP five (5) weeks later. The GP immediately referred him to a specialist wound clinic. Investigations included a full blood count (FBC). The white blood cell (WBC) count was 17x 10⁹/L, predominantly neutrophils. The erythrocyte sedimentation rate (ESR) was 75mm/hr. An x-ray showed changes consistent with osteomyelitis. Mr George McFarlane was admitted to hospital for surgical debridement of his wound. A large amount of tissue was excised from his left foot, which resulted in amputation of all 5 toes. The wound was packed and placed on a suction wound dressing (negative-pressure wound therapy), to minimise the exudate at the wound surface and promote healing by granulation. Post-operatively, initially he did well. However, on the seventh day after surgery he developed pyrexia and his diabetic control deteriorated. His left foot had swollen above the bandaging. The dressing was removed, there was tissue engorgement and cellulitis surrounding the wound and evidence of necrosis (as shown in the photograph below). Mr McFarlane has a Past Medical History (PMHx): · Type ll Diabetes needing close management · Osteoarthritis in L) Knee · Peripheral Vascular Disease (PVD) · Chronic Obstructive Pulmonary Disease (COPD) · Methicillin-resistant Staphylococcus Aureus (MRSA) positive · peripheral neuropathy Social History (SHx): · Second marriage · Occupation- Long Haul truck driver · ETOH (Alcohol) usage on a regular basis · Smoker, averages 15/20 cigarettes per day · Often consumes take away/ fast food diet as away from home regularly Mr McFarlane’s current assessment consists of the following: · BP 135/85 · RR 18 · SpO2 92% Room Air (RA) · HR 89 · Temp 38.2oC · BGL 13.8mmol, · U/A (Glucose ++, ketones+, protein +, SG 1010, PH 5) · Pain score 7 at rest · GCS 15 · Water low score of: 15 (High Risk) Reference: https://www.gettyimages.com.au/detail/news-photo/amputation-due-to-diabetes-news-photo/151032672?adppopup=true TASK Assessment Criteria Question 1 Discuss the pathophysiology of Mr McFarlane’s chronic illness. What are the signs and symptoms of each condition? How does each of these conditions impact his body systems? In your answer, discuss the clinical signs and symptoms of Type II Diabetes mellitus, Osteoarthritis, Peripheral Vascular Disease, Chronic Obstructive Pulmonary Disease and peripheral neuropathy. Discuss how these signs and symptoms impact on the patient’s different body systems and how this can affect his quality of life and independence. (word limit 750 words) Response: TASK Assessment Criteria Question 2 Outline the possible social, emotional, physical, psychological and financial implications of a chronic illness on a client’s lifestyle. How might this also impact on their family and loved ones? (word limit 300 - 500 words) Response: TASK Assessment Criteria Question 3 Outline five (5) rehabilitation strategies, techniques and/ or equipment that can be used to assist and provide a greater level of independence to a client. Briefly discuss how each of these would be of benefit to the client and their family and assist with their care. Consider both community and hospital based services. Include, in your answer, strategies that include access to physiotherapy, occupational therapy, massage, music therapy (as a non-pharmacological approach to pain relief), use of a wheelchair and walking aids. Discuss what members of the Multidisciplinary Team could be involved in your client’s care. (word limit 300 - 500 words) Response: TASK Assessment Criteria Question 4 Discuss what further education and preventative strategies would be required to reduce the risk of this scenario re-occurring. In your answer you should discuss members of the Multidisciplinary Team that you could engage with in order to access information for Mr McFarlane. Also discuss appropriate community referrals after discharge. Discuss, in your answer, areas including the following: a. prevention b. use of various treatments c. principles of and practices for person-focused nursing practice d. maintenance of positive life roles e. enabling change of a person’s behaviour over time to improve health outcomes (word limit 300 - 500 words) Response: TASK Assessment Criteria Question 5 Mr McFarlane has a past medical history of · Type ll Diabetes · Osteoarthritis in L) Knee · Peripheral Vascular Disease (PVD) · Chronic Obstructive Pulmonary Disease (COPD) · peripheral neuropathy Using the template below, plan your care, within the Enrolled Nurse scope of practice for Mr McFarlane. Include the following in your response: · Specify five (5) nursing diagnoses or risk factors associated with the client’s current health presentations. (One for each of the chronic conditions. You might consider poor diet, poor lifestyle, decreased activity, smoker, psychosocial effect of recent diagnosis, understanding of potential complications associated with a condition.) · Record at least two (2) nursing interventions that could be applied for each diagnosis. · Specify at least one (1) member of the multidisciplinary team who may be able to support your suggested interventions. · Clarify how your planned intervention reflects the client’s interests, physical, emotional and psychosocial needs Note at least one (1) expected outcome that you would hope for as a result of each intervention. Response: Nursing diagnosis Planning - (Nursing intervention) Multidisciplinary team member to provide support Link to personal needs TASK Assessment Criteria Question 6 Mr McFarlane has become increasingly short of breath following his morning shower. He is distressed and, on assessment, his vital signs are: Respiratory rate 26; SpO2 91% on RA. All other vital signs are within normal range. Outline your actions to this situation. Include in your answer: a. What may be causing Mr McFarlane’s symptoms? b. Your immediate response to ensure the safety of your client. c. Who you would notify of the situation and what information you would handover (consider using ISBAR in your response)? d. How you would evaluate if the care provided was effective? e. Required changes to the nursing care plan. f. What information would you provide to Mr McFarlane about the situation and how this situation could be prevented in the future? (word limit 300 - 500 words) Response: Version 1 23.04.2020 Version 1. RTO Code 0269. Think: Colleges Pty Ltd. CRICOS Provider No. 00246M Page 1 APN108 Applying Nursing Practices (B ) Assessment 1A response template 23.04.2020 Version 1. RTO Code 0269. Think: Colleges Pty Ltd. CRICOS Provider No. 00246M Page 1 Task Instructions To complete A ssessment 1, Part A , you must respond to a number of questions and develop a plan of care for the client , on the response template provided. The questions are based on the case study below . These questions must be answered in full. When responding to the questions, please pay attention to the entire question being asked, as well as the prescribed word count , if provided . Use the correct medical terminology when answering all questions . Y our answers should be reflective, analytical and based on critical assessments and the Enrolled n urs e s tandards f o r p ractice and Codes of Ethics for Nursing. You will be ass essed on the responses to the questions and will be deemed as either satisfactory or not satisfactory. ALL of the responses must be marked as satisfactory in order to pass the assessment. If your assessment is not deemed satisfactory, you will be re - assessed as per the THINK Education Assessment Policy for Vocational Education and Training (VET), before being awarded a Non Satisfactory mark for the assessment and the unit. Case Scenario :