Nurse programme

Section 2. Clin" rel="nofollow">inical question. Choose one of the followin" rel="nofollow">ing: 2.1 You are carin" rel="nofollow">ing for a male patient who suffered a fractured shaft of femur 5 days ago. He develops chest pain" rel="nofollow">in and shortness of breath. What would your immediate actions be? 2.2 A patient 2 days post-operative Femoropopliteal bypass is on four hourly vascular observations. You fin" rel="nofollow">ind the foot cool and slightly mottled. What actions should you take? 2.3 Your patient is 2 days post laparotomy and has started takin" rel="nofollow">ing fluids. They are now complain" rel="nofollow">inin" rel="nofollow">ing of abdomin" rel="nofollow">inal discomfort and nausea. What will your actions be? Explain" rel="nofollow">in your answer in" rel="nofollow">in detail in" rel="nofollow">includin" rel="nofollow">ing your assessment, hypotheses and rationales for actions. 500 words (25 marks) Section 3. Prioritization After mornin" rel="nofollow">ing handover of your 4 patients you have reviewed the charts and have entered the room to greet your patients. It is 0730 and breakfast is usually delivered at 0740. Before you can in" rel="nofollow">introduce yourself, the followin" rel="nofollow">ing demands on your time occur concurrently: Patient 1 Mrs Peterson is askin" rel="nofollow">ing for help to the ensuite to use her bowels. You know Mrs Peterson had a stroke 2 weeks ago and has a moderate left hemiplegia and needs assistance to move. She is classified as a high falls risk. Registered Nurse An Nguyen in" rel="nofollow">in the adjacent bed unit enters the room and asks you to check some Endone for her patient. Patient 2 Mrs Walters requires a blood glucose assessment. You noted it was not done at 0600 when you reviewed the chart. She may require slidin" rel="nofollow">ing scale in" rel="nofollow">insulin" rel="nofollow">in prior to eatin" rel="nofollow">ing. Patient 3 Mr Young is nil by mouth and has IV therapy runnin" rel="nofollow">ing at 167mls per hour. The in" rel="nofollow">infusion pump alarm is soundin" rel="nofollow">ing and the IV flask appears to be close to empty. Patient 4 Mr Stavropoulous has been admitted for acute asthma. He is due to have Ventolin" rel="nofollow">in and Seretide at 0800 but as you look at him you note he appears short of breath and he is sittin" rel="nofollow">ing upright with in" rel="nofollow">increased work of breathin" rel="nofollow">ing. In what order would you address these requests? Describe your rationale for each decision. 500 words (25 marks) Section 4 Professional Choose one of the followin" rel="nofollow">ing: 4.1 A colleague has removed every second suture from a long wound on the lower leg. She has asked for your assistance to support the patient’s limb while she reapplies a dressin" rel="nofollow">ing. A small area at the end of the suture lin" rel="nofollow">ine is moist. The wound is bein" rel="nofollow">ing dressed with Melolin" rel="nofollow">in ™, Combin" rel="nofollow">ine and crepe bandage for protection and support. Durin" rel="nofollow">ing the dressin" rel="nofollow">ing your colleague drops a piece of Melolin" rel="nofollow">in ™ on the bed and retrieves this placin" rel="nofollow">ing it back on the dressin" rel="nofollow">ing tray. She remarks it will be fin" rel="nofollow">ine up the clean end of the wound. How will you respond to this situation? 4.2 You are workin" rel="nofollow">ing in" rel="nofollow">in the Day procedure unit. Your postoperative patient requires Morphin" rel="nofollow">ine 2.5mg IV. The order prescribes 2.5 mg every 10 min" rel="nofollow">inutes up to a maximum of 3 doses. This is the first dose. Your colleague comes to the medication room and checks the drug from the schedule 8 storage cupboard with you. You prepare a syrin" rel="nofollow">inge of 10mg of Morphin" rel="nofollow">ine diluted to 10ml with Normal Salin" rel="nofollow">ine accordin" rel="nofollow">ing to the local protocol. You both check the order and drug and all is correct. Your colleague says she is happy for you to go and admin" rel="nofollow">inister the drug alone. “Just remember only give 2.5 ml” she says and she leaves the medication room. How will you manage this situation? 4.3 Your patient Mr Stanley is havin" rel="nofollow">ing an ascitic tap on the ward today. You have reviewed the requirements of the procedure and understand that you need to assist by carin" rel="nofollow">ing for the patient, managin" rel="nofollow">ing analgesia and monitorin" rel="nofollow">ing vital signs durin" rel="nofollow">ing the procedure. It is lunchtime in" rel="nofollow">in your busy ward. Your colleagues in" rel="nofollow">includin" rel="nofollow">ing the ANUM in" rel="nofollow">in charge, are off the ward havin" rel="nofollow">ing lunch. The ANUM handed over to you that Mr Stanley is havin" rel="nofollow">ing the ascitic tap after 1.30 when sufficient staff are available and that she has negotiated this with the resident medical officer (RMO). You are monitorin" rel="nofollow">ing another patient with hypoglycaemia when you see the RMO with the procedure trolley goin" rel="nofollow">ing in" rel="nofollow">into Mr Stanley’s room. The procedure requires a nurse be in" rel="nofollow">in attendance. You have no available staff and you need to monitor your hypoglycaemic patient. How will you manage this RMO? Describe in" rel="nofollow">in detail your response to your chosen scenario drawin" rel="nofollow">ing upon your knowledge and research of professional regulations and requirements, professional behaviour, conflict resolution techniques, education and provision of feedback. 700 words (30 marks) Appropriate use of references in" rel="nofollow">includin" rel="nofollow">ing in" rel="nofollow">in text citations and reference list (5 marks)