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Diploma of Nursing Assessment Task Five - Clinical Scenario 4

Running head: ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 1
Diploma of Nursing
Assessment Task Five - Clinical Scenario 4
Name: xxxxxxxxxxxxx
Student ID:
Analyse Health & respond to client information
HLT54115
Due Date: xx/xx/xxxx
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 2
TASK A
1. Define gastroenteritis.
Gastroenteritis is stomach inflammation caused by either viral infections or toxins from bacteria
2. What is Gastritis?
Gastritis is any group of conditions which lead to inflammation of the stomach lining.
3. Explain Mr Bate’s poor skin turgor in relation to his gastroenteritis.
Mr. Bate’s poor skin turgor is caused by dehydration or decreased intake of fluids.
4. How does his blood pressure reflect his illness? Why is it low?
A high blood pressure is a reflection of the illness but the severe dehydration is the cause of Bate’s
low blood pressure.
5. Provide two (2) signs /symptoms of gastroenteritis
Other Gastroenteritis signs are diarrhea and painful cramps in the tummy.
6. Describe the pathophysiology of multiple sclerosis
Multiple sclerosis is activated when immune cells attack the CNS
7. Provide two (2) signs/symptoms of Multiple Sclerosis.
Its symptoms are tissue damage and inflammation (Moorhead et al., 2014).
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 3
8. Define Rhabdomyolysis.
Rhabdomyololysis is a condition that leads to muscle tissue injury/breakdown thereby releasing
into the blood a damaging protein.
9. Name one group of medications that is prescribed to lower cholesterol and has this as
a side effect. What education should you give to your patient when commencing this
medication
Statins are recommended to lower cholesterol but may cause this condition. .Once the patient
notices this effect he/she should consult the doctor for a change of medication rather than stopping
taking the pills.
10. What is the medical term for black stools and what could it mean?
Melena is the medical term for black stool which means an oxidation of iron in hemoglobin.
11. What does ‘emesis’ mean? What does hematemesis mean?
Emesis is the action of vomiting while hematemesis is vomiting blood.
12. Explain the pathophysiology as to what would be happening to an individual that was
admitted to your ward with hematemesis and melena?
Hematemesis and melena occur due to the internal bleeding resulting from stomach tumors, ulcers,
radiation exposure etc.
13. What is the term used to describe skin colour and the sclera of the eyes becoming
yellow? What organ of the body is usually involved?
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 4
Yellowing of the skin color or sclera of the eyes is called jaundice and occurs due to liver problems
or blocked bile duct.
14. Give an example of a disease process that might cause this and explain why.
This may be caused by pancreatic cancer which blocks the bile duct causing bile retention in the
body (Brown et al., 2017).
15. Pruritus often accompanies this discolouration, what is pruritus?
Pruritus is severe skin itching associated with several disorders.
16. Explain what a Hiatus Hernia is and list two common symptoms the individual may
report.
Hiatus Hernia is a condition whereby stomach part pushes through the muscle of the diaphragm
indicated by heart burn, abdominal discomfort and chest pain (Roman & Kahrilas, 2014)
17. What does the acronym GORD stand for?
Acronym GORD stands for Gastro-esophageal reflux disease.
18. Complete three nursing care plans for Michael. Each plan must identify one patient
problem/issue, one goal and two courses of action you would take.
Nursing
Diagnosis
Goals
Intervention: rationale
Implementation
Evaluation
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 5
Diarrhea
Reducing the
rate of
dehydration
through and
ensuring he
has enough
water in the
body
● Advice Bate to
drink a lot of water
to reduce
dehydration and
proposing a diet
rich in fiber and
Iron like vegetables
and grains.
● Checking Bate’s
medical history of
consuming
contaminated food
or water.
Yes
Bate
demonstrate
that he
understands
the importance
of taking a lot
of fluids.
Additionally
ensuring Bate
drink six
glasses of
water daily.
Nursing
Diagnosis
Goals
Intervention:
Rationale
Implementation
Evaluation
Feeling pain
in the joints
and potential
fall.
Bate will not
feel any pain
during the
stay and in
future will
● Assessing the
condition of Bate’s
joint and tissue then
provide appropriate
medication that will
reduce pain like
Yes
The goal is
met by
following the
action plan of
providing
medication
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 6
have flexible
joints
aspirin and
ibuprofen.
● Encourage Bate to
engage in physical
activities to keep the
joints active.
for reducing
pain and
allowing to
have enough
rest.
Supervising
Bate while
doing some
exercise
without
experiencing
pain or fall.
Nursing
Diagnosis
Goals
implementation
Evaluation
Activity
intolerance
related to
inflammation
due to
colored stool.
Bate will not
produce any
colored stool
after the stay the
stool will be
normal.
Yes
Demonstrate
to Bate’s on
taking a
balance diet to
help in
digestion and
measure the
body weight.
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 7
Take the stool
for testing in
the laboratory
and see if it
has changed
color.
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 8
Task B.
1. What factors would have contributed to her developing osteoarthritis?
Factors that would have contributed to Carol’s osteoarthritis condition are; the bleeding condition
after the fall, her old age and her family history (Johnson & Hunter, 2014).
2. What education would you provide to an individual diagnosed with Osteoarthritis?
The education would include her engaging in regular physical activities and also instructing her to
reduce food intake to maintain a healthy weight.
3. Explain the pathophysiology of Parkinson’s disease and how it can contribute to falls.
Parkinson disease results from the gradual loss of brain cells in substantia nigra leading to a
decrease in dopamine hence loss of balance leading to possible falls.
4. What other symptoms might Carol have in relation to Parkinson’s disease?
Other symptoms include; tremor, stiff muscles and dystonia.
5. Besides monitoring the above vital signs what other observations should be
conducted? Explain why.
Other observations include taking the patient’s medical history to help know the progression of the
disease, observations of her speech and her memory level. This is because most of the Parkinson’s
disease patients experience a substantial reduction in olfactory and cognitive functions before the
motor challenges emerge (Shin & Habermann, 2017).
6. Carol starts to complain of a headache and is feeling nauseated. What do you think
could be happening?
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 9
Carol’s headache and nausea are due to the hyper-activation of the central dopaminergic pathways.
7. Complete three nursing care plans for Carol. Each plan must identify one patient
problem/issue, one goal and two courses of action you would take.
Nursing
Diagnosis
Goal
Intervention:
Rationale
Implementation
Evaluation
Potential
failure of not
being able to
move within
physical
environment
like mobility,
transfers and
ambulation.
Carol avoiding
the dangers of
immobility,
preventing
dependent
disabilities and
maintaining
mobility.
● Carol to use
safety measures
to aid her in
movement to
prevent potential
injury from fall.
Additionally
Carol performs
physical activity
without
assistance within
the limits of her
disease.
Yes
Carol is can
walk regular
paces without
stopping.
Likewise she
indicates a
sign of not
walking
without using
safety
measures and
as result no
injury occurs.
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 10
Nursing
Diagnosis
Goal
Intervention:
Rationale
Implementation
Evaluation
Activity
intolerance
related to
ineffectiveness
coping,
hopelessness
and fatigue
which causes
stress and
anxiety
Looking at the
level of
impairment and
assess how
carol copes
with abilities
and skill while
dealing with the
current
situations to
reduce
depression
● It would be of
importance to
educate Carol
about
depression
through feelings
expression.
● Provide
medication like
anti-depressant
drugs and
review their
adverse effects.
Yes
Carol can
verbally state
that she is
aware and able
to cope with
her feelings.
she is also able
to identify
effective
coping
behaviors and
their outcomes.
Nursing
Diagnosis
Goal
Intervention:
Rationale
Implementation
Evaluation
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 11
Bleeding
after fall
Reducing the
level of bleeding
after fall by
Carol due to as a
result of her old
age.
● Check Carol's
medical history
and to find out
whether the
disease is
hereditary and
provide
medication.
● Educate her on the
eating meals rich
in carbohydrates to
help her gain
energy.
Yes
Check her
body weight
and evaluate
the meals she
is taking
from
breakfast,
lunch to
dinner.
Verbally and
practically
affirmation
by warning
her in case
she is going
to fall.
8. Name an Allied Health Worker that you could include in this individuals care in
regard to her allergy and poor appetite. Explain their role.
I would include a dietician to help Carol deal with poor appetite and allergy. The dietician will help
her on how to manage diets to have significant weight change and guide her on appropriate food
preparation practices.
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 12
PART C
1. Briefly explain the pathophysiology of decompression sickness.
Decompression sickness is caused by the formation of inert gas i.e. nitrogen gas bubbles within
arterial gas embolism as well as within the body tissues (McCance & Huether, 2015).
2. What symptoms would you be looking for in an individual admitted to your ward who
had been deep sea diving?
An individual admitted in award after having been in deep sea diving may exhibit chest and
abdominal pains, fatigue as well as weak upper extremities (McCance & Huether, 2015).
3. List two forms of treatment.
The treatment of the DCI includes placing the patient on an oxygen mask to deliver high flow of
oxygen and IV fluids as well as recompressing the patient in a hyperbaric chamber (McCance &
Huether, 2015).
4. What is the recommended time between a dive and an individual flying?
The recommended time between a dive and an individual flying is 12-24 hours.
5. Can an individual prepare for flying into high altitudes? List two risk factors.
Flying into high altitude after diving is not recommended as it leads to DCI. The risk factors are
the cold water, long or the deep dives, hard exercise while at that great depth and rapid ascents
during the dive (McCance & Huether, 2015).
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 13
6. What symptoms would you educate Melony to look out for and what advice would
you give her when she arrives to the high altitude?
Melony should look for formation of bubbles near the joints which later leads to joint pains. Also
she should look for bubbles formation on her body tissues. While at high altitude Melony should
wear a pressure suit or be in a pressure cabin. In addition, she can wear an oxygen mask (McCance
& Huether, 2015).
7. Explain the difference in the signs and symptoms for Heat exhaustion and for Heat
Stroke
The symptoms of heat exhaustion are milder than those of heat stroke. For example, while heat
exhaustion is accompanied by a fever that does not exceed 104 degrees Fahrenheit the heat stroke
temperatures go over 105 degrees Fahrenheit. In heat exhaustion, the patient profusely sweats but
in heat stroke no sweating due to a high level of dehydration in the patient (McCance & Huether,
2015).
8. Define Hypothermia. List two signs and symptoms Melony might show if she became
very cold in Machu Pichu
Hypothermia is a condition of having abnormally very low body temperature due to the body losing
more heat than it can produce. Its signs and symptoms include; shivering, weak pulse, memory loss
and bright red cold skin (Pasquier, 2014).
9. Why should you never remove a penetrating object? What action should the guide
with her take?
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 14
The penetrating stick in Melony’s skin should not be removed as this will lead to a further damage
in her nerves and blood vessels. Rather, the guide should fasten the stick into the foot with a
bandage to prevent its further movements as she seeks medical intervention (Pasquier, 2014).
10. List the most common signs of a Benzodiazopine (sleeping tablet) overdose.
As a first responder what contact number in Australia should you ring for advise if
you suspect an overdose or poisoning?
The most common signs of benzodiazepine overdose are impaired balance, slurred speech, CNS
depression and ataxia. In case of suspect of poisoning or overdose in Australia, I should call 131126
or 000
11. After watching the video on Concussion, list four (4) of the common symptoms you
would need to look out for if Melony was to fall and sustain a head injury
If Melony was to fall and sustain head injury after taking the concussion, I would look out for loss
of consciousness, her repetition of phrases in her speech, dizziness and also nausea or vomiting
(www.youtube.com).
12. Define Blunt trauma.
Blunt trauma is a serious body injury which is caused by a collision with a blunt surface or being
hit by a blunt object.
ASSESSMENT TASK FIVE - CLINICAL SCENARIO 4 15
References
Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2017). Lewis's Medical-Surgical Nursing:
Assessment and Management of Clinical Problems. Elsevier Health Sciences.
https://www.youtube.com/watch?v=xvjK-4NXRsM
Johnson, V. L., & Hunter, D. J. (2014). The epidemiology of osteoarthritis. Best practice &
research Clinical rheumatology, 28(1), 5-15.
McCance, K. L., & Huether, S. E. (2015). Pathophysiology-E-Book: The Biologic Basis for
Disease in Adults and Children. Elsevier Health Sciences.
Moorhead, S., Johnson, M., Maas, M. L., & Swanson, E. (2014). Nursing Outcomes Classification
(NOC)-E-Book: Measurement of Health Outcomes. Elsevier Health Sciences.
Pasquier, M., Zurron, N., Weith, B., Turini, P., Dami, F., Carron, P. N., & Paal, P. (2014). Deep
accidental hypothermia with core temperature below 24 C presenting with vital signs. High
altitude medicine & biology, 15(1), 58-63.
Shin, J. Y., &Habermann, B. (2017). Nursing Research in Parkinson’s Disease From 2006 to 2015:
A systematic review. Clinical nursing research, 26(2), 142-156.

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