Nursing care planning

Case Study 1 Ms Sin" rel="nofollow">ingh (Sangeeta) is a 69-year-old retired secretary who lives close to her daughter and grandchild. Other than hypertension she has had nil significant medical history to report. Ms Sin" rel="nofollow">ingh immigrated to Australia 20 years ago from India. English is her second language and she practices the Hin" rel="nofollow">indu religion. Last night Ms Sin" rel="nofollow">ingh was brought in" rel="nofollow">in by ambulance (BIBA) to the emergency department after her daughter found her on her bathroom floor. Ambulance staff report that she was found naked and unable to call for assistance for almost 18 hours. She was diagnosed as havin" rel="nofollow">ing had a cerebrovascular accident (CVA) with residual right (R) sided hemiplegia, dysphagia and dysphasia. She is soon transferred to the acute medical ward where you work and is accompanied by her daughter (Nita) who is obviously quite distressed. Ms Sin" rel="nofollow">ingh appears quiet and drowsy. She is currently Nil by Mouth (NBM) whilst awaitin" rel="nofollow">ing a speech therapist review. Her vital signs on arrival are: T 36.9 degrees C; P 115; R 26; SpO2 94% and BP 170/95. 1. Identify the factors that you would need to consider prior to and durin" rel="nofollow">ing an assessment. Include an issues that may impact on discharge? (min" rel="nofollow">in 50 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... 2a) Identify which of the followin" rel="nofollow">ing vital signs provided above are outside normal range and provide the correct ranges. • Temperature • Pulse • Respirations • Blood Pressure • Oxygen saturation ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... HLTENN003_AT2_W_TQM_v1.docx Ver. 1.1 (21/12/2015) © TAFE Queensland 2016 2 of 10 Uncontrolled Copy If Prin" rel="nofollow">inted b) Usin" rel="nofollow">ing the in" rel="nofollow">information in" rel="nofollow">in the case study, identify which of the vital signs may be usual for Ms Sin" rel="nofollow">ingh? ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... 3. The registered nurse asks you to perform neurological observations on Ms Sin" rel="nofollow">ingh. Identify what data you would collect and how you would perform a neurological assessment. (min" rel="nofollow">in 100 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... 4. You are now asked to complete an admission document for Ms Sin" rel="nofollow">ingh. Considerin" rel="nofollow">ing Ms Sin" rel="nofollow">ingh’s gender, age, cultural, spiritual and religious data, identify six ways in" rel="nofollow">in which these could be addressed in" rel="nofollow">in a plan of care. ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... HLTENN003_AT2_W_TQM_v1.docx Ver. 1.1 (21/12/2015) © TAFE Queensland 2016 3 of 10 Uncontrolled Copy If Prin" rel="nofollow">inted 5. While in" rel="nofollow">in hospital identify how Ms Sin" rel="nofollow">ingh’s condition would affect her ADLs and describe how this would impact on the care she will require while in" rel="nofollow">in hospital. (min" rel="nofollow">in 150 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... After 5 weeks on your ward Ms Sin" rel="nofollow">ingh’s condition has shown no improvement. She requires full assistance with all aspects of her ADLs and still has dysphagia and dysphasia. Her daughter approaches you in" rel="nofollow">in tears statin" rel="nofollow">ing “What’s goin" rel="nofollow">ing to happen to mum now? I work fulltime and cannot look after her. Surely she can’t go home?” 6a) Considerin" rel="nofollow">ing Ms Sin" rel="nofollow">ingh’s dysphagia, outlin" rel="nofollow">ine any potential risks at mealtimes for Ms Sin" rel="nofollow">ingh? (min" rel="nofollow">inimum 50 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... b) What strategies could you used to reduce these risks at mealtimes? (min" rel="nofollow">in 50 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... HLTENN003_AT2_W_TQM_v1.docx Ver. 1.1 (21/12/2015) © TAFE Queensland 2016 4 of 10 Uncontrolled Copy If Prin" rel="nofollow">inted 7. What is the nurse’s role in" rel="nofollow">in the discharge plannin" rel="nofollow">ing of Ms Sin" rel="nofollow">ingh? In your answer in" rel="nofollow">include: • when the discharge plannin" rel="nofollow">ing process should commence • the members of the multidisciplin" rel="nofollow">inary team that should be in" rel="nofollow">involved • any community services she may require (min" rel="nofollow">in 100 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... HLTENN003_AT2_W_TQM_v1.docx Ver. 1.1 (21/12/2015) © TAFE Queensland 2016 5 of 10 Uncontrolled Copy If Prin" rel="nofollow">inted Case Study 2 Ella is a 6-year-old girl who has cerebral palsy who had been brought in" rel="nofollow">into hospital with a chest in" rel="nofollow">infection. You have been asked to perform a health assessment for Ella who is distress at bein" rel="nofollow">ing in" rel="nofollow">in hospital. 1. Cerebral palsy can cause different degrees of developmental delay but in" rel="nofollow">in order to understand the impact the condition has on a person you need to be aware of the stage of growth and development a person should be at. Discuss the stage of human growth and development that you would expect Ella to be at as a six-year old? (min" rel="nofollow">in 100 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... 2. Referrin" rel="nofollow">ing to the Person Centred Health Care Assessment and the Development of Health Care Plans Core Standards for Practitioners to answer this question. a) Identify at least 6 potential health issues associated with cerebral palsy. ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... b) List the 4 essential skills that you need to draw upon when completin" rel="nofollow">ing a health care assessment on Ella? ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... HLTENN003_AT2_W_TQM_v1.docx Ver. 1.1 (21/12/2015) © TAFE Queensland 2016 6 of 10 Uncontrolled Copy If Prin" rel="nofollow">inted c) Identify at least 6 components of a comprehensive care health plan and provide the reasons why they are in" rel="nofollow">included in" rel="nofollow">in a person’s plan? ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... 3. Ella becomes more distressed as you are performin" rel="nofollow">ing the health care assessment. Usin" rel="nofollow">ing problem solvin" rel="nofollow">ing strategies and techniques, discuss the actions you could take to reduce Ella’s distress. (min" rel="nofollow">in 100 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... HLTENN003_AT2_W_TQM_v1.docx Ver. 1.1 (21/12/2015) © TAFE Queensland 2016 7 of 10 Uncontrolled Copy If Prin" rel="nofollow">inted You speak with Ella’s mum, Karen, who is stayin" rel="nofollow">ing in" rel="nofollow">in hospital with Ella and she tell you that their family like to take a wellness approach to health. 4. Explain" rel="nofollow">in what a wellness approach to health means and provide at least 3 examples of how a wellness approach could be used for Ella. (min" rel="nofollow">in 100 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... 5. As a family with a young child, identify some of the family health care needs that Ella and her family may require. (min" rel="nofollow">in 50 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... 6. When checkin" rel="nofollow">ing Ella’s vital signs one afternoon you note that her respiratory rate has in" rel="nofollow">increase from 22 to 32 and that her SpO2 has decreased from 98% to 92%. Identify what actions you would take. In your answer, discuss the followin" rel="nofollow">ing: • who you would in" rel="nofollow">inform of Ella’s condition • what clin" rel="nofollow">inical signs suggest that there is a deterioration in" rel="nofollow">in Ella’s condition. (min" rel="nofollow">in 50 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... HLTENN003_AT2_W_TQM_v1.docx Ver. 1.1 (21/12/2015) © TAFE Queensland 2016 8 of 10 Uncontrolled Copy If Prin" rel="nofollow">inted Case Study 3 Sandra is a 42-year-old woman who has been admitted to hospital for some in" rel="nofollow">investigations as she has been tryin" rel="nofollow">ing for some time to become pregnant. Sandra has a 14-year-old son from a previous marriage. 1. Identify at least 3 possible causes for in" rel="nofollow">infertility. ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... 2. Discuss the impact of in" rel="nofollow">infertility on Sandra. In your answer ensure that you cover the physical, emotional and psychosocial impacts. (min" rel="nofollow">in 150 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... 3. When talkin" rel="nofollow">ing to Sandra about her family, she mentions that her son, Dean, has been very moody lately and is difficult to talk to. What in" rel="nofollow">information about adolescent growth and development could you share with Sandra? (min" rel="nofollow">in 150 words) ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... ....................................................................................................................................................................... HLTENN003_AT2_W_TQM_v1.docx Ver. 1.1 (21/12/2015) © TAFE Queensland 2016 9 of 10 Uncontrolled Copy If Prin" rel="nofollow">inted 4. When Sandra’s son visits, you notice that he is physically very similar to his mother, they both have red hair, blue eyes, freckles and both are tall. Discuss the in" rel="nofollow">influence of both genetics and the environment on growth and development. (min" rel="nofollow">in 150 words)