HLT51612 : Diploma of Nursing : Implement and monitor nursing care for clients with chronic health..

HLT51612 : Diploma of Nursing : Implement and monitor nursing care for clients with chronic health problems

Q1 Provide definitions of each of the following – ‘Health’, ‘Illness’ & ‘Disease’.
A1

Q2
a) Explain the difference between acute and chronic illness.
b) Discuss how you would determine the impact that a chronic health problem has on activities of daily living of a client?
A2
a)

b)

Q3 List 2 clinical manifestations of each condition – Congestive Cardiac Disease, CVA, Type 2 Diabetes, Rheumatoid Arthritis & Breast cancer
A3

Q4 Many patients can become confused when health professionals use medical terminology to describe their condition. Explain briefly what the following are using words you would use when talking with your patient. 1. CVA. 2. MI 3. IV therapy 4.Analgesic 5. Anti- emetic
A4

Q5 During your preliminary assessment your client tells you they have ‘a touch of sugar”, suffers with ‘piles’ and takes ‘a water tablet’ for ‘the fluid’. What is he referring to?
A5

Q6 Thinking holistically, identify 4 actual health issues of a client with Hepatitis C. and list members of the health care team involved in this clients care?

A6

Q7 Thinking holistically, identify 2 potential health issues for a client with Type 2 diabetes and describe briefly resources and rehabilitative support services that are available for this client and their family/carers.
A7

Q8 Confirm the roles and responsibilities of the members of the emergency response team.
A8

Q9 Name and briefly describe the action of 5 drugs commonly stored on the emergency trolley
and used in a cardiac emergency
A9

Q10 Identify 4 pieces of equipment commonly kept on the emergency trolley
A10

Q 11 Define Palliative Care
A11

Q12 Identify available resources and support services for a palliative client being discharged

home where appropriate with the consent of the client and their significant others.
A12

Q13 List 3 common sites where cancer develops.
A13

Q14. What is the principle of bed rest?
A14

Q15 Describe you management and care of your patient, 20 year old male with a diagnosis of Ulcerative Colitis. He has just returned to your care from Operating Theatre following a Colonoscopy.
A 15

Q16 Define Chronic Renal Failure
A 16

Q. 17
a) Identify key considerations in regard to cultural and religious issues when caring for clients requiring extended or rehabilitative care.
b) Discuss how a client’s dignity and privacy are maintained.
c) Write a paragraph on nursing considerations that would be significant to a client, their
family/carer/significant other.
A 17

Q 18 Discuss the Enrolled nurses role and responsibilities in accordance with professional, legal and organizational requirements.
A18

Q19. How, when and to whom would you (EEN) report changes in a client’s condition?
A19

Q 20. Scenario
Your patient is a 68-year-old Indigenous male, Tom Jones, who presents with a decubitus ulcer on his sacral area and increasing shortness of breath. He has a history of chronic obstructive pulmonary disease. He tells you his current medications are as follows: Ventolin 1ml and Atrovent 1ml – 4 times a day via home nebuliser. Vitamin B tablet x 1 daily.
He lives with his partner of 20 years in rented accommodation. He has a son from a previous marriage who lives interstate that he hasn’t seen for 5 years. He doesn’t talk to him on the phone because he can’t hear that well.
Tom and his partner, Sally, drink a 2 litre cask of wine each day and both smoke a packet of cigarettes a day between them. They receive the aged pension. Sally mostly does the housework, shopping and cleaning as Tom usually ‘doesn’t feel up to it’. Recently Sally has been ‘out of sorts’ with arthritis in her hands and knees, so they have been eating mostly tinned food as it is easy to prepare. Until now they have both refused services saying “we’ll manage”. Tom admits he is frightened of falling because he tires easily has problems walking steadily and “never know what to
grab on to”. Tom required 4 days of bed rest.
He was discharged home with services of home care for cleaning, a follow up appointment in wound clinic, a nurse going out to assist with showering and attending wound care and meals on wheels and a GP appointment.
On admission (at 10 a.m.) the patient is anxious, appears unkempt and has a pungent body odour.
Observations on admission to ward:
BP 140/90 Pulse 96 Respiration’s 26
Temperature 38.2c SaO2 91% on room air
Urinalysis: Leucocytes ++, Blood +
Height: 178cms
Weight: 58kgs
Peak flow reading: 150
Observations on discharge:

BP 130/80 Pulse 86 Respiration’s 20
Temperature 36.2c SaO2 98% on room air
Urinalysis: NAD
Height: 178cms
Weight: 62kgs
Peak flow reading: 350

You are required to:

1. Reflecting on your knowledge of the normal anatomy and physiology of the lungs explain the
   pathophysiological changes related to COPD
   Answer
2. Based on the information in the scenario briefly discuss Toms actual problems and how they may
   be impacting on his activities of daily living (assess holistically). Include in your answer
   Behaviours/life style choices which may have contributed to the development of the chronic illness.
   Answer
3. Based on the information in the scenario, list 5 potential problems for Tom (assess holistically)
   Answer
4. A key consideration of how successful outcomes will be for a client and their significant others is
   the understanding they have of their own illness or condition. As an enrolled nurse how could you
   confirm the clients understanding or their presenting and underlying conditions
   Answer
5. Briefly discuss Tom’s observations. Are they within normal range and what do the variations
   indicate to you. Who do you report the observations to and where do you document your findings.
   On the documentation paper work provided: record observations on appropriate chart following
   legal requirements for documentation. Write a legally compliant progress note entry based on the
   admission.
   Answer
6. List 5 nursing interventions you could deliver during Tom’s hospitalization based on your
   assessment. List the members of the health care team who may participate in the development of
   the care plan.
   Answer
7. You have identified that Tom needs education on how to use his nebulizer effectively.
   a) Identify any physical or mental problems that may hinder the communication
   process with Tom?
   (b) In your own words, briefly, describe step by step the procedure for using a nebulizer.
   Answer
8. A key consideration of how successful outcomes will be for a client and their significant others is

the understanding they have of their own illness or condition. As an enrolled nurse how could you
confirm the clients understanding of their present and underlying conditions?
Answer

1. (a) Briefly describe the discharge process
   (b) Identify 3 community based services that could assist Tom to rehabilitate.
   (c) Do you require the clients consent to refer to services?
   (d) What equipment might help this client to remain independent at home?
   Answer
   (a)
   (b)
   (c)
   (d)
2. Tom was on bed rest for 4 days. What are the risks/complications of prolonged bed rest and
   what are the nursing procedures that can be undertaken to prevent them? (Word count 500)
   Answer
3. What support if any can be offered for Sally as Carer for Tom?
   Answer
4. Discuss the discharge process and requirements required for Tom to be discharged
   Answer
5. Complete the designated paper work
   Patient profile/Discharge check list
   General observations sheet
   Peak flow meter chart
   Progress notes admission entry and discharge entry

Discharge notification for patients
Patient discharge check list
Write a care plan: minimum of 5 nursing diagnosis – goals, interventions, evaluation and rationale.
Include one activity of daily living, and remember to consider your clients psychological and social
needs and demonstrate respect for your client’s dignity and self-involvement.