questions within given clinical scenarios

Assessment 1: Guided Scenarios Unit learnin" rel="nofollow">ing Outcomes: 1,2,3 & 5 Weightin" rel="nofollow">ing: 40% of unit grade Length: 1000 words. Due Date: Friday 16th September 2016 Instructions This assessment requires you to respond to a series of questions within" rel="nofollow">in given clin" rel="nofollow">inical scenarios and support all your answers with contemporary literary evidence. Consider the relevant contextual factors within" rel="nofollow">in the given scenario when developin" rel="nofollow">ing your responses to the questions. Check the required style and examples in" rel="nofollow">in Black board before you start. You will submit this assessment onlin" rel="nofollow">ine via Turn it in" rel="nofollow">in. Look for the Turn it in" rel="nofollow">in tip sheets and lin" rel="nofollow">inks that are in" rel="nofollow">in the assessment pages of this unit for further in" rel="nofollow">information. Required Style: Your responses to questions in" rel="nofollow">in the learnin" rel="nofollow">ing activities must be typed. Responses may be in" rel="nofollow">in academic prose, sentences and/or poin" rel="nofollow">int form at your discretion. All sources used in" rel="nofollow">in developin" rel="nofollow">ing your answer should be appropriately acknowledged and referenced usin" rel="nofollow">ing an APA approach consistent with QUT citewrite. Include a reference list of resources used in" rel="nofollow">in your assessment at the end. This is additional to the word limit. Number your answers clearly. Do not re-type or in" rel="nofollow">include the scenarios or assessment questions in" rel="nofollow">in the file you submit as this will create a high percentage of matchin" rel="nofollow">ing text in" rel="nofollow">in the academic dishonesty function in" rel="nofollow">in Turn It In. Markin" rel="nofollow">ing: Each mark is awarded for a key poin" rel="nofollow">int in" rel="nofollow">in your response that is correct, responds closely to the focus on the question and is supported with a valid academic resource / reference. Partial marks are used. Please check the examples provided on blackboard to further clarify expectations before you begin" rel="nofollow">in this assessment. Assessment Example on Black Board An Assessment Example is located in" rel="nofollow">in the assessment tab of the unit blackboard site. It in" rel="nofollow">includes sample questions and graded responses to in" rel="nofollow">introduce you to assessment expectations in" rel="nofollow">in this task. Use of Turn It In in" rel="nofollow">in this assessment: You are required to load your assignment in" rel="nofollow">into the Turn It In program. Turn it in" rel="nofollow">in is a text matchin" rel="nofollow">ing and citation checkin" rel="nofollow">ing tool accessed through black board. It allows you to check your assignments contain" rel="nofollow">in your origin" rel="nofollow">inal work, determin" rel="nofollow">ine possible in" rel="nofollow">incidents of paraphrasin" rel="nofollow">ing mistakes that may constitute plagiarism and amend any identified issues prior to submission of your assignment for markin" rel="nofollow">ing. To do this you need to load your draft assessment to Turn it in" rel="nofollow">in [via blackboard] and review the Turn it in" rel="nofollow">in report generated by the program. Once you are happy with your fin" rel="nofollow">inal assessment then load a fin" rel="nofollow">inal version in" rel="nofollow">into Turn it in" rel="nofollow">in. Guided Scenarios Scenario Jamie is a 29 year old male admitted to hospital 6 hours ago with severe asthma. Jamie recently started a new job in" rel="nofollow">in the coal min" rel="nofollow">ines in" rel="nofollow">in central Queensland (3 weeks on 1 week off) and two days ago started his days off at home in" rel="nofollow">in Brisbane. Last night he was out partyin" rel="nofollow">ing with mates in" rel="nofollow">in the Valley and became very breathless and had an acute exacerbation of asthma symptoms. He was brought in" rel="nofollow">in by ambulance. Apart from havin" rel="nofollow">ing asthma sin" rel="nofollow">ince childhood Jamie reports he has good health and an active lifestyle. He usually takes an in" rel="nofollow">inhaled preventative medication daily and a reliever (salbutamol) when he experiences asthma symptoms. He hasn’t taken his preventer medication recently as he forgot to take it with him when he went on shift at the min" rel="nofollow">ine. Currently he is lyin" rel="nofollow">ing on his side flat in" rel="nofollow">in bed and has oxygen 6 litres a min" rel="nofollow">inute delivered via nasal a face mask. He looks pale and has pin" rel="nofollow">ink lips. Peripheral capillary refill time is 3 seconds. Respirations are deep, through the mouth, slightly laboured and chest expansion is equal left and right. He had an in" rel="nofollow">inspiratory wheeze audible with a stethoscope. He has a frequent cough. Jamie’s skin" rel="nofollow">in is warm, with no evidence of central or peripheral cyanosis. Vital signs / observations are BP 130/85 mmhg, pulse 96 b/min" rel="nofollow">in, respiratory rate 32 r/min" rel="nofollow">in, temperature 36.8C and oxygen saturations 92%. On arrival in" rel="nofollow">in the ward for a mornin" rel="nofollow">ing clin" rel="nofollow">inical practice shift you are allocated to look after Jamie, supervised by your buddy nurse. Answer the followin" rel="nofollow">ing questions referrin" rel="nofollow">ing to the above scenario of Jamie [16 marks] Questions. 1. Consider the person and contextual in" rel="nofollow">information in" rel="nofollow">in the scenario and select two poin" rel="nofollow">ints of in" rel="nofollow">information that could be relevant to Jamie’s current acute asthma diagnosis and oxygenation problem. Briefly explain" rel="nofollow">in why you thin" rel="nofollow">ink these could be relevant. [2 marks] 2. Jamie currently has an oxygenation problem. Select three pieces of patient data related to this problem and for each briefly explain" rel="nofollow">in your understandin" rel="nofollow">ing of the underlyin" rel="nofollow">ing pathophysiology of how each piece of data in" rel="nofollow">indicates an oxygenation deficit. [3 marks] 3. Briefly explain" rel="nofollow">in two advantages of deliverin" rel="nofollow">ing oxygen via a face mask as compared to the use of nasal prongs? [2 marks] 4. Briefly explain" rel="nofollow">in what changes in" rel="nofollow">in Jamie’s physical assessment data (excludin" rel="nofollow">ing vital signs) would justify the nurse changin" rel="nofollow">ing current oxygen therapy from a non-rebreather oxygen mask to nasal prongs? [2 marks] 5. Identify changes in" rel="nofollow">in vital signs that would in" rel="nofollow">indicate substantial deterioration in" rel="nofollow">in Jamie’s condition [1 mark] 6. Identify three questions you will ask Jamie about his symptoms to elicit data relevant to his current oxygenation and condition [3 marks] 7. Identify three changes Jamie would report to you that may in" rel="nofollow">indicate substantial deterioration in" rel="nofollow">in his condition. [3 marks] Scenario Mrs Adams is an 84 year old lady transferred from the acute surgical unit to the rehabilitation unit for in" rel="nofollow">intensive physiotherapy and occupational therapy to assist her in" rel="nofollow">in regain" rel="nofollow">inin" rel="nofollow">ing her mobility in" rel="nofollow">in preparation for discharge in" rel="nofollow">in 5 days. Mrs Adams is a slight lady who is approximately 150cm tall and says she weighed 48kg before comin" rel="nofollow">ing to hospital. She had a right total hip replacement 5 days ago followin" rel="nofollow">ing a fall in" rel="nofollow">in the bathroom of her home when she fractured the neck of her femur. Her surgical wound is clean and dry with staples in" rel="nofollow">intact under a dry dressin" rel="nofollow">ing. She also has an area of redness on her right heel. She is takin" rel="nofollow">ing paracetamol and codein" rel="nofollow">ine tablets 6th hourly for pain" rel="nofollow">in. She is also ordered heparin" rel="nofollow">in 5000 units subcutaneously. She is wearin" rel="nofollow">ing compression stockin" rel="nofollow">ings on both legs (with the right heel protected). Mrs Adams is able to weight bear on her right leg, was transferred to the rehabilitation unit on a trolley and was assisted to walk a few steps from the trolley to the bed by a nurse supportin" rel="nofollow">ing her elbows on either side. Mrs Adams has been transferrin" rel="nofollow">ing from the chair to the bed under supervision with 1 nurse assistin" rel="nofollow">ing today and has walked to the bathroom usin" rel="nofollow">ing a walkin" rel="nofollow">ing frame and had a shower sittin" rel="nofollow">ing on a chair. The physio has also taken her for a short walk usin" rel="nofollow">ing the walkin" rel="nofollow">ing frame and she will need to mobilise twice more today with nursin" rel="nofollow">ing staff. The physio notes in" rel="nofollow">in the chart say that Mrs Adams was hesitant but completed her walk satisfactorily. Prior to this hospitalisation she was generally well, mobile and didn’t use any mobility aids. She has a history of bein" rel="nofollow">ing a smoker and has osteoporosis and osteoarthritis. She lives with her husband Mr Adams who is 90 years old. You are workin" rel="nofollow">ing the afternoon shift with a buddy registered nurse. Mrs Adam’s current pain" rel="nofollow">in is 2 on a scale of 1 (no pain" rel="nofollow">in) -10 (worst pain" rel="nofollow">in). Mrs Adams is refusin" rel="nofollow">ing to get out of bed for a walk with you and the buddy RN sayin" rel="nofollow">ing “I’ve done it once today that is enough”. The buddy nurse has a short discussion with Mrs Adams and determin" rel="nofollow">ines she is afraid of fallin" rel="nofollow">ing again" rel="nofollow">in. (case adapted from Crisp and Taylor, 2011) Walkin" rel="nofollow">ing frame Compression stockin" rel="nofollow">ings Area of redness on right heel Answer the followin" rel="nofollow">ing questions referrin" rel="nofollow">ing to the case of Mrs Adams above (14 marks) Questions 8. Identify two factors in" rel="nofollow">in the scenario of Mrs Adams that in" rel="nofollow">increase her risk of falls. Briefly explain" rel="nofollow">in how each in" rel="nofollow">increases risk. [2 marks] 9. Identify two factors in" rel="nofollow">in the scenario of Mrs Adams that in" rel="nofollow">increase her risk of skin" rel="nofollow">in in" rel="nofollow">integrity problems. Briefly explain" rel="nofollow">in how each in" rel="nofollow">increases risk. [2 marks] 10. The nurse documents the characteristics of Mrs Adam’s heel in" rel="nofollow">injury in" rel="nofollow">in the relevant form /chart used at this health service. Describe the characteristics or in" rel="nofollow">information that should be documented at this time by the nurse carin" rel="nofollow">ing for Mrs Adams. [3 marks] 11. Briefly discuss three nursin" rel="nofollow">ing in" rel="nofollow">interventions nursin" rel="nofollow">ing staff could use to prevent Mrs Adam’s heel in" rel="nofollow">injury from deterioratin" rel="nofollow">ing further. [3 marks] 12. Briefly discuss two nursin" rel="nofollow">ing in" rel="nofollow">interventions the nurse could implement to assist Mrs Adams to mobilise safely to the bathroom. [2 marks] 13. Briefly discuss two likely short term health complications of Mrs Adams not mobilisin" rel="nofollow">ing usin" rel="nofollow">ing the walker and stayin" rel="nofollow">ing in" rel="nofollow">in bed. [2 marks] Scenario Clive is a thin" rel="nofollow">in and pale lookin" rel="nofollow">ing 46 year old man who has a history of cardiac failure and severe cardiomyopathy. Clive lives alone in" rel="nofollow">in a small unit, receives a disability pension and community nurses visit weekly. Clive is oxygen dependant, uses nasal prongs on 2 litres per min" rel="nofollow">inute at all times and has been on the waitin" rel="nofollow">ing list for a heart transplant for almost 12 months. He uses an extension cord from his oxygen concentrator to the nasal prongs to allow him mobility. Clive takes many medications to manage his chronic illness symptoms. Clive has been advised to limit his fluid in" rel="nofollow">intake to 1000mls per day due to his cardiac failure. To manage his chronic disease and the medications he takes he needs to self-monitor his signs and symptoms of fluid balance and contact his health management team if he notices problems. Despite his health issues Clive manages to live in" rel="nofollow">independently gettin" rel="nofollow">ing through all his self care and household tasks by spreadin" rel="nofollow">ing them throughout the day and takin" rel="nofollow">ing frequent rests and naps. Answer the followin" rel="nofollow">ing questions referrin" rel="nofollow">ing to the case of Clive above. [10 marks] Questions 14. Briefly explain" rel="nofollow">in how Clive’s health issues are likely to have had an impact on his weight and nutritional status in" rel="nofollow">in the last twelve months. [2 marks] 15. If you suspected Clive was dehydrated identify and describe two pieces of observed data you would look for that would contribute to your assessment of his hydration status? [2 marks] 16. If Clive’s hydration status reflected he was overloaded, identify and describe two pieces of observed data that you would expect to fin" rel="nofollow">ind that would in" rel="nofollow">indicate this. [2 marks] 17. Identify what disease related diet recommendations Clive is likely to be followin" rel="nofollow">ing given the scenario in" rel="nofollow">information. [1 mark] 18. What simple and economical food options would you recommend to Clive that will meet his nutrition needs and not exacerbate his disease? [3 marks] End of questions