HLTEN505C Contribute to the complex nursing care of clients

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Unit Code / Name

HLTEN505C Contribute to the complex nursing care of clients

Program Code / Name HLT51612 – Diploma of Nursing (Enrolled / Division 2 Nursing)
Assessor Name
Due Date   First Submission Date
Assessment No AS Resubmission Date
Assessment Method  Practical Demonstration    Oral Questions   Presentation     Role Play  

 Assignments     Case Study     Portfolio     Research   Project

 Written Questions     Workplace Project     Exams     Written Tasks

Brief Description of Task Review the case study describing the care of Mr Barber and answer the questions related to his care. This assessment will evaluate your knowledge of:

·         Anatomy, physiology and pathophysiology.

·         Interpretation of vital signs

·         Health policy

·         Communication

·         Documentation

·         Pharmacology

·         Role of the health care team

 

Did the student meet the following criteria:

Note: Ensure that the marking criteria aligns with the Elements and Performance Criteria identified for this assessment in the Unit Assessment Plan FM-342

Please add rows as required

Result

1st submission

 

Result

2nd submission

 

Comments
Question One
Identifies anti-emetic medication prescribed during management of nausea and vomiting ☐ S

☐ U

☐ DNS

☐ S

☐ U

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Implements patient health assessment relevant to the case history ☐ S

☐ U

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☐ S

☐ U

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Applies the correct infection control policy during care of Mr Barber: eg standard, contact, droplet and/or airborne precautions.  ☐ S

☐ U

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☐ S

☐ U

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Dons correct PPE ☐ S

☐ U

☐ DNS

☐ S

☐ U

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Question Two
Documents patient identity information on the top of the ECG using the information in the case study ☐ S

☐ U

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☐ S

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Notes the relevant patient signs and symptoms at the time of recording ☐ S

☐ U

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☐ S

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Question Three
Accurately documents in the progress notes using SBAR format. ☐ S

☐ U

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☐ S

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Question Four
Phrases questions appropriately to evaluate Mrs Barbers safety. Taking into consideration empathy, cultural or spiritual elements.  ☐ S

☐ U

☐ DNS

☐ S

☐ U

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Question Five
Outlines requirements for patient consent prior to divulging personal information. ☐ S

☐ U

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☐ S

☐ U

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Demonstrates understanding of privacy policy ☐ S

☐ U

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☐ S

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Gives an example of information that is appropriate to provide to the neighbour during the telephone call. ☐ S

☐ U

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☐ S

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Question Six
Identifies type of consent required during the care of Mr Barber (eg implied, verbal, written) ☐ S

☐ U

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☐ S

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Identifies abnormal vital signs prior to transfer to X-Ray ☐ S

☐ U

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☐ S

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Interprets vital signs and evaluates requirements for transfer to X-Ray including:

o  A list of vital signs that should be reviewed prior to departure

o  Identifies appropriate escort based on acuity and manual handling

   
☐ S

☐ U

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☐ S

☐ U

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☐ S

☐ U

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☐ S

☐ U

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Implements safe manual handling techniques ☐ S

☐ U

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☐ S

☐ U

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Demonstrates knowledge of scope of practice. ☐ S

☐ U

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☐ S

☐ U

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Question Seven
Dons correct PPE during care of Mr Barber ☐ S

☐ U

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☐ S

☐ U

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Applies the DRABCD process to the case scenario ☐ S

☐ U

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☐ S

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Describes the relationship between patient assessment and evaluation of blood loss ☐ S

☐ U

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☐ S

☐ U

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Question Eight
Discusses pathophysiology of emphysema and relates this to the actions of seretide ☐ S

☐ U

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☐ S

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Identifies the correct type of seretide inhaler ☐ S

☐ U

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☐ S

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Uses patient education techniques to instruct Mr Barber on the correct use of his Seretide inhaler ☐ S

☐ U

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☐ S

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Question Nine
Discusses the actions of at least three medications prescribed for osteoarthritis ☐ S

☐ U

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☐ S

☐ U

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Question Ten
Structures questions to evaluate the impact of osteoarthritis on activities of daily living. ☐ S

☐ U

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☐ S

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Question Eleven
Describes nursing responsibilities after identifying the presence of the wound on Mr Barber’s lower leg. ☐ S

☐ U

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☐ S

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Question Twelve
Identifies medicolegal process to apply when Mr Barber refuses consent ☐ S

☐ U

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☐ S

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Demonstrates knowledge of scope of practice. ☐ S

☐ U

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☐ S

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Interacts with the health care team to provide optimal multidisciplinary treatment. ☐ S

☐ U

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☐ S

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Question Thirteen
Identifies the role of various members of the health care team ☐ S

☐ U

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☐ S

☐ U

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Interacts with the health care team to provide optimal multidisciplinary treatment. ☐ S

☐ U

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☐ S

☐ U

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Additional assessment guidelines:
·      Presents in-depth information from relevant sources representing various points.

·      Information is taken from sources with sound interpretation/evaluation of each procedure and related illness.

·      Information is presented in the students own words, accurately summarising relevant points from their chosen sources.  

·      Use A.P.A. 6th edition referencing style – including in-text referencing plus a separate reference list

·       Spelling, grammar and syntax is consistent with health documentation standards

1st Submission

Feedback to candidate (Including additional requirements for reassessment if applicable) 

 

 

 

 

 

 

 

The Students overall result was: Satisfactory   ☐           Unsatisfactory   ☐ Resit Required   ☐           
This signature confirms that the student has participated in the assessment item and received feedback on the result

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Assessor Signature Date
                             

 

Resubmission (if applicable) Resubmissions will only be granted if the teacher considers that you have made a genuine attempt at the first assessment.  NOTE: Teachers are required to retain the original marked assessment and return a copy to the student.   

Feedback to candidate (Including additional requirements for reassessment if applicable)

 

 

 

 

Unit 23: Employability Skills

 

 

 

 

 

 

 

The Students overall result was: Satisfactory   ☐                                   Unsatisfactory   ☐
This signature confirms that the student has participated in the assessment item and received feedback on the result
Assessor Signature Date
         

Instructions: Read the following case study and then answer the following questions.  Please note: Other than where word limits are specifically identified, you should answer clearly and concisely, and use an adequate number of words to answer the question and meet the marking criteria requirements.

Case Study

HR0277 CHANGE, WORK AND DIVERSITY

 You are working as an Enrolled Nurse in the Emergency Department (ED) when 82 year old Mr Barber (of Greek heritage – and Greek Orthodox religion) is brought in by ambulance at 8pm on the 6/3/2013. Handover from the paramedics is as follows:

·           6 hour history haematemasis and epigastric pain

·           Vomited x 4 bright blood

·           Mr Barber called the ambulance because he felt dizzy, sat down on the floor and was unable to get up

·           Ambulance noted approx 150ml haematemasis in a bucket on arrival

Past History:

·         Diverticulitis

·         Emphysema

·         Ischaemic heart disease

·         Osteoarthritis

·         Morbid obesity: BMI 42

Social History;

·         Mr Barber is the sole carer for his 80 year old wife who has dementia. Mrs Barber has been left in the care of a neighbour.

You note that Mr Barbers clothes are blood stained on arrival. He states that he is feeling nauseous.

 

Please answer each of the following questions:

  1. The nurse completes an assessment of Mr Barber’s condition on arrival. Explain the following in relation to the assessment process.
    1. Discuss the type of infection control policy would be implemented for Mr Barber? (50-100 words)
    2. List the PPE precautions that the nurse would use during assessment.
    3. Review the vital signs on the ADDS chart. Discuss how these parameters relate to evaluating the severity of blood loss? (50 words)
    4. Review the medication chart and discuss the action of the drug prescribed for nausea. (50-100 words)

Managing Across Cultures and Comparative Management

  1. The RN asks you to complete a 12-lead ECG on Mr Barber. Use the information in the case study to label the ECG below. (include patient identity information as well as symptoms)
 

 

  1. Use the information in the presenting history and patient charts to write your initial nursing report in SBAR format for Mr Barber. This report will be written 20 minutes after arrival when you have completed your initial assessment. (100-200 words)
  MRN: 0598371

Family Name: Barber

Given Name: Frederick

Date of Birth: 2/3/1931

PROGRESS NOTES
Date/Time

 

S
B  
A  
R  
         
  1. Mr Barber is upset that his wife is unable to accompany him to the hospital because she isn’t well. Give three questions you could use in your conversation with Mr Barber that would evaluate her safety to remain at home whilst he is in hospital. Ensure that your questions are phrased to take into consideration empathy, cultural or spiritual elements. (100-150 words)
  2. The neighbour looking after Mrs Barber telephones the Emergency Department and asks how Mr Barber is going. How would you respond to this telephone call as the nurse caring for Mr Barber? (50-100 words)
The doctor orders a chest X-ray, Mr Barber is to be transferred to the radiology department at 20:40

 

  1. Outline the preparation required to transfer Mr Barber to the radiology department for these tests. Include the following aspects in your answer:
    1. What type of consent is required for this procedure? (50 words)
    2. Review the categories on the ADDS chart and identify the number and qualifications of staff members that should accompany him to radiology. Base this answer on your evaluation of his level of acuity and manual handling requirements.(100-150 words)

 

After returning from radiology, Mr Barber pushes the buzzer 20:55. When you respond, you note that he is vomiting blood.

HAS 121 Human Development in Social Context

  1. Discuss the nursing interventions you would you initiate. Include the following in your answer:
    1. Review the NSW rural emergency clinical guidelines for adults, non-traumatic shock guideline. List the assessments that you would complete in each of the DRABCD categories using the table below?

 

D
R
A
B
C
D
  1. How do these assessments allow you to make a judgment on the severity of his blood loss? (100-150 words)
Mr Barber is given analgesia and IV fluids. His pain settles and the bleeding ceases

 

Mr Barber tells you that he usually uses a purple Seretide inhaler for his emphysema. His GP changed his inhaler to a different type and he doesn’t really understand how it works although it seems to help him. He is due for a dose and asks you to assist.

 

  1. Discuss the information you would provide to Mr Barber. Include the following in your answer:
    1. Explain to Mr Barber in simple terms how the actions of this drug relate to the pathophysiology of emphysema. (100-200 words)
    2. Review the type of inhaler prescribed on the medication chart provided and list the steps to correctly administer this medication. (50-100 words)
While documenting his complex medical history, you find out that Mr Barber has osteoarthritis.

 

  1. Please read Mr Barber’s medication chart. Identify which of these medications would be used to treat the pain from his osteoarthritis (OA) – briefly describe the actions of each one and explain why they are used for this condition. (200-250 words)
  2. What questions might you ask him to help determine the severity of his OA and how the symptoms impact on his activities of daily living? (100-150 words)
  3. You notice a bandage on Mr Barber’s lower leg and he says that he cut his shin on a sharp piece of wood a few days ago. Summarize your duty of care in relation to this observation. (100-150 words)
Mr Barber is observed in Emergency overnight. He has no further episodes of vomiting. The surgical registrar (Dr Owen) reviews his care at 8am. The plan involves:

o   changing his osteoarthritis medication

o   admission to surgical ward

o   gastroscopy scheduled later in the day

Registered Nurse, Rosalyn Marshal notes the following entry in Mr Barber’s medical record.

 

  MRN: 0598371

Family Name: Barber

Given Name: Frederick

Date of Birth: 2/3/1931

 
Date/Time

7/3/2013

08:00

 

 

 

S

 

Nursing:  Seen by Dr Owen at 08:00. Dr Owen noted that his vomiting has settled overnight.

PROGRESS NOTES
  B  Mr Barber is anxious to go home as he is concerned about his wife.
  A Vital signs within normal limits. Nil nausea or episodes of vomiting overnight
  R For admission to surgical ward- Mr Barber informed by Dr Owen Naprosyn ceased, to continue taking paracetamol osteo. for arthritic pain. Scheduled for gastroscopy this afternoon, informed consent completed by Dr Owen and consent form has been signed by Mr Barber……R Marshal, RN
         

 

When you go to see Mr Barber he states that he doesn’t think he will stay for the gastroscopy because he has no one to care for his wife during the day. He doesn’t think the procedure is necessary given that the vomiting has stopped and he feels better. This means that he is now refusing consent for the gastroscopy procedure.
  1. What actions should you take now that Mr Barber has decided not to proceed with his gastroscopy? (100-150 words)
  2. What community assistance would be available for Mrs Barber whilst Mr Barber remains in hospital? Give an example of an allied health care worker who would make these arrangements prior to Mr Barbers discharge. (100-150 words)
 

Mr Barber agrees to admission once arrangements for his wife are provided. Gastric ulceration is identified on gastroscopy, this resolves with pharmacological treatment and changing osteoarthritis medication.

 

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