HLTAAP003:Analyse and respond to client health information Assessment

Part 1: Case study with short answer questions

Read the case study below, then complete your written responses to the questions in the spaces provided in this document, using relevant resources including textbooks and reputable internet sources. Please take note of the word count requirement where indicated.

At the end of your assessment you must include a bibliography using APA reference style listing the sources you have used to base your answers on. (For guidelines use the following link: A guide to TAFE NSW referencing: APA 7 style)

Once completed you must submit this assessment to your assessor for marking.

Case study

Mrs Robyn Jennings, a 58 year-old-women with type 1 diabetes mellitus, is a patient on your ward. Mrs Jennings was admitted over a week ago with an ulcer on her right toe and under the balls of her right foot. Her right foot and lower leg are cool and without pulses (absent by Doppler).

1. What do these abnormal findings tell us about Mrs Jennings’ peripheral vascular system? (your answer should be 30 – 70 words)  

Mrs Jennings’ arteriogram shows severe atherosclerosis of the right popliteal artery with complete obstruction of blood flow.

2. Describe the pathophysiology of atherosclerosis and the impact of this disorder on the vascular system. (your answer should be 30 – 70 words)  

The decision was made to perform an above-the-knee amputation on Mrs Jennings’ right leg. She has returned to the ward after the surgery, her wound is intact, clean and dry, she is drowsy and on 4L of O2, via the nasal prongs. Her observations on return to the ward are:

SA02 in Rm Air: 90%

HR: 55 beats/min

BP: 88/55 mmHg

RR: 12 breath/min

Temp: 35.5^oC

Mrs Jennings has a PCA running with Fentanyl 1000microg/100mL of normal saline. PCA bolus dose 10microg-20microg, lockout time 5 minutes.

3. Using the internet, MIMS Onlineor a current hard copy of MIMS, research the medication Fentanyl and complete the following table.

Before you leave Mrs Jennings, you ensure that the nurse buzzer is within reach. It is important to ensure Mrs Jennings is not having any adverse reactions to the medication.

4. Identify three things Mrs Jennings would tell you if she was having an adverse reaction to the Fentanyl.  

5. Identify the changes you would find in Mrs Jennings’ observation if she was having an adverse reaction to the Fentanyl.  

Mrs Jennings has a past history of Type 1 diabetes mellitus.

6. Identify the body system commonly associated with Type 1 diabetes mellitus. (your answer should be 1 – 3 words)

7. Describe the pathophysiology of Type 1 diabetes mellitus and the impact it will have on Mrs Jennings homeostatic balance. (your answer should be 50 – 150 words)  

8. Why do cells require glucose? (your answer should be 10 – 20 words)   

9. Which transport system transports glucose into a cell? (your answer should be 2 – 5 words)   

10. There are three other transport systems that move fluid and electrolyte across the semi-permeable membrane into their fluid compartments. Summarise these transport systems by completing the following table.  

You have been asked to assess Mrs Jennings’ blood glucose levels. At 1.30 pm the digital result from the glucometer is 10.4mmols. It is important to maintain Mrs Jennings’ blood glucose within the normal range.

11. Complete the following table with the normal ranges for blood glucose levels.  

 Mrs Jennings’ recovery from surgery will be influenced by a number of factors.

12. How could Mrs Jennings’ medical history affect her wound healing and recovery after surgery? (your answer should be 50 – 100 words)  

13. For each of the following body systems, identify one age-related change that is likely to affect Mrs Jennings’ recovery. (your answer should be 10 – 30 words for each response)

Due to the amputation, a priority care problem for Mrs Jennings will be impaired physical mobility.

14. Explain why you should encourage Mrs Jennings to perform range of movement (ROM) exercises. (your answer should be 20 – 50 words)

After the operation Mrs Jennings is withdrawn and not interacting with her visitors and the other patients. She is obviously avoiding looking at or touching the residual limb and is expressing little interest in any discussion of rehabilitation or prosthesis. You feel that Mrs Jennings may be experiencing a disturbance in her body image and alteration to her self-perception and esteem. You would like to discuss this with other members of the care team.

15. Which members of the health care team would you collaborate with to give Mrs Jennings and her family further information about rehabilitation and support services for amputees? (your answer should be 10 – 30 words)  

Mrs Jennings is in Bed 12 in a four-bedded bay. There are 3 other women in the bay.

Mrs Carmen Dupont is in Bed 9. She is 54 years-old and has a peptic ulcer. Her test results are as follows:

• Upper GI tract x-ray shows abnormalities in the mucosa
• Upper GI endoscopy confirms the presence of an ulcer
• Serological or breath urea test shows the presence of H pylori.

16. In the following table, complete an analysis of the health information and planned care for Mrs Dupont. (your answer should be 5 – 75 words for each response)

Ms Nondita Patel is in Bed 10. She is 63 years-old and has renal calculi. Her test results are as follows:

• X-ray revealed renal calculi
• IV pyelogram confirmed the diagnosis and determined the calculi was less than 5mm and it was in the calyces of the right kidney
• Urinalysis increased specific gravity and pH less than 5.5, haematuria and increased leucocytes
• 24-hour urine collection showed increased uric acid excretion levels

17. In the following table, complete an analysis of the health information and planned care for Ms Patel.(your answer should be 5 – 75 words for each response)

Mrs Mei Wong is in Bed 11. She is 83 years-old and has a past history of a right-sided CVA/stroke 1 year ago, left hemiparesis, slurred speech and dysphagia. Her test results are as follows:

• CT scan shows evidence of thrombotic stroke and revealed ischemia
• Carotid ultrasound detected blockage
• Ophthalmoscopy detected signs of atherosclerosis in retinal arteries

18. In the following table, complete an analysis of the health information and planned care for Mrs Wong.(your answer should be 5 – 75 words for each response)