ASSESSMENT 1A: Response Template

ASSESSMENT 1A: Response Template

Student Name Student ID Date Course HLT54115 Diploma of Nursing

Subject Code and Title APN108 Applying 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: 1.1,1.2 1.3, 1.4, 1.5, 2.1, 2.3, 2.4, 2.5.

PE:

HLTENN012: 1,2

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 and short-answer questions

Type of Assessment Task Section 1: Case study with short answer questions

Section 2: Short-answer questions

Length 11 questions. See each individual question for word limit.

Submission Due by 11:55pm AEST Sunday end of Week 5 (module 3.1).

Task Instructions

To complete Assessment 1, Part A, you must answer Section 1 and Section 2. Section 1 includes questions based on the case study below and developing a plan of care for the client, on the response template provided. Section 2 includes other questions required for the subject, but which are NOT related to the case study. All 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.

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 McFarlanes 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 McFarlanes 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 aspecialist wound clinic. Investigations included a full blood count (FBC). The white blood cell (WBC) count was 17x 10/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 became febrile 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 McFarlanes 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)

left14224000

Reference:

https://www.gettyimages.com.au/detail/news-photo/amputation-due-to-diabetes-news-photo/151032672?adppopup=true

Section 1

This section relates to Mr. McFarlanes case study

TASK Assessment Criteria

Question 1 Discuss the pathophysiology of each of the chronic illnesses of Mr McFarlane:

Type 2 Diabetes Mellitus

Osteoarthritis

Peripheral Vascular Disease

Chronic Obstructive Pulmonary Disease

Peripheral Neuropathy

What are the signs and symptoms of each condition?

Discuss how these signs and symptoms impact on the patients different body systems and how this can affect his quality of life and independence.

References required

(word limit 300-500 words)

Response:

Chronic Condition Signs & Symptoms Pathophysiology and Quality of Life/Independence

References:

TASK Assessment Criteria

Question 2 Outline the possible implications of a chronic illness on a clients lifestyle using the headings below:

Social

Emotional

Physical

Psychological

Financial

Include in your answer how might this also impact on their family and loved ones?

References required

(word limit 200 - 400 words)

Response:

Implications to Patient and/or family and loved ones

Social Emotional Physical Psychological Financial References:

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 Mr. McFarlane. 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 Mr. McFarlanes care.

(Word limit: 300-500 words total)

Please also briefly outline the use of the following rehabilitation techniques (50 words maximum per technique)

Hydrotherapy

Pilates

Art therapy

Prosthetics

References required

Response:

Part 1:

Five Strategies:

Strategy / technique / equipment Benefit Multidisciplinary Team Member / s

Part 2:

Technique Technique Use

Hydrotherapy

Pilates

Art therapy

Prosthetics References:

TASK Assessment Criteria

Question 4 Discuss what further education and preventative strategies would be required to reduce the risk of this scenario re-occurring to Mr. McFarlane. 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 for Mr. McFarlane.

Discuss, in your answer, areas including the following:

prevention

use of various treatments

principles of and practices for person-focused nursing practice

maintenance of positive life roles

enabling change of a persons behaviour over time to improve health outcomes

establishing readiness for attitudinal and behavioural change

References required

(word limit 200-400 words)

Response:

References:

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 three (3) nursing diagnoses associated with the clients current health presentations. (Ensure each diagnosis chosen relates to a different chronic condition of Mr McFarlane).

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 clients 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 Expected Outcome

Section 2.

The following questions are not related to Mr. McFarlane's case study

TASK Assessment Criteria

Question 6 Describe the World Health Organisation's (WHO) focus on chronic illness, and provide a description of one of the following Chronic disease models/ programs:

The Chronic Care Model

The Flinders Model (program)

The Stanford Model

The National chronic disease strategy

The Chronic Care for Aboriginal people model of care

References required

(Word limit 200 words)

Response:

References:

TASK Assessment Criteria

Question 7 Identify the 10 National priorities for chronic disease in Australia.

Provide a diagram for the continuum of chronic disease and briefly explain the model.

References required

Response:

References:

TASK Assessment Criteria

Question 8 For the chronic disease or chronic health condition listed below, state three (3) clinical manifestations for each (Signs and symptoms)

Chronic asthma

Chronic pain including back pain

Chronic renal failure

Congestive heart failure

Eczema

Incontinence

Neurological injury

Long- term unconsciousness

Parkinsons disease

Rheumatoid arthritis

Stroke

Systemic lupus erythematosus

References Required

(100 words for each)

Response:

Disease/Chronic Health Condition Clinical Manifestation

Chronic Asthma Chronic pain including back pain Chronic renal failure Congestive heart failure Eczema Incontinence Neurological injury Long-term unconsciousness Parkinsons disease Rheumatoid arthritis Stroke Systemic lupus erythematosus References:

TASK Assessment Criteria

Question 9 Regarding palliative care, what would be the nurse's goal to manage chronic disease within the palliative care environment?

References required

(word limit 150 words)

Response:

References:

TASK Assessment Criteria

Question 10 Discuss three (3) sites within the human body for common cancer development for individuals from Australians.

References required

Response:

References:

TASK Assessment Criteria

Question 11 Discuss the purpose of a tracheostomy and why a person may have one.

Define both permanent and temporary tracheostomy procedures and explain why each one may be required.

References required

(word limit 100-200 words)

Response:

References: