Coversheet and Feedback for Assessments

This document provides information about the coversheet and feedback requirements for assessments. It includes the declaration, assessment requirements, and student responsibilities. The document also explains the process of attaching the coversheet and feedback document to electronic files.

Coversheet and Feedback
Please attach this coversheet and feedback document to every assessment submitted. If
submitted in Moodle, the student must sign and scan and attach to the electronic file.
UNIT
CODE
UNIT
TITLE
Qualification
Code
Qualification
Title
Task Number Task Name
Student ID
Number
Student
Name
Student Declaration
I hold a copy of this assessment which can be produced if the original is lost/damaged.
I have been advised of the assessment requirements, including reading and understanding the
information in the Student General Information of this document.
I have been made aware of my rights and responsibilities as a student and have read the
student handbook.
This assessment is my original work and no part of it has been copied from any other source
except where the due acknowledgment is made.
No part of this assessment has been written for me by any other person, except where such

Coversheet and Feedback
Please attach this coversheet and feedback document to every assessment submitted. If
submitted in Moodle, the student must sign and scan and attach to the electronic file.
UNIT
CODE
UNIT
TITLE
Qualification
Code
Qualification
Title
Task Number Task Name
Student ID
Number
Student
Name
collaboration has been authorized by the assessor concerned.
I have not previously submitted this work for this or any other program/unit.
I have not allowed this work to be copied by another person.
I give permission for this work to be reproduced, communicated, compared and archived for
the purpose of detecting plagiarism.
I give permission for a copy of my marked work to be retained by UOW College for review
and comparison, including review by external auditors
Note: UOW College will hold a copy of this completed form and relevant completed task for
6 months.

Coversheet and Feedback
Please attach this coversheet and feedback document to every assessment submitted. If
submitted in Moodle, the student must sign and scan and attach to the electronic file.
UNIT
CODE
UNIT
TITLE
Qualification
Code
Qualification
Title
Task Number Task Name
Student ID
Number
Student
Name
I declare that I agree to the above statements:
Signed Date
Assessor to complete
Task outcome
1st Submission Date:
2nd
Submission
Date:
☐ Satisfactory
☐ Not
Satisfactory
☐
Satisfactory
☐ Not
Satisfactory

Coversheet and Feedback
Please attach this coversheet and feedback document to every assessment submitted. If
submitted in Moodle, the student must sign and scan and attach to the electronic file.
UNIT
CODE
UNIT
TITLE
Qualification
Code
Qualification
Title
Task Number Task Name
Student ID
Number
Student
Name
Assessor Signature Date: Date:
Feedback to student
1st Submission
2nd Submission

Coversheet and Feedback
Please attach this coversheet and feedback document to every assessment submitted. If
submitted in Moodle, the student must sign and scan and attach to the electronic file.
UNIT
CODE
UNIT
TITLE
Qualification
Code
Qualification
Title
Task Number Task Name
Student ID
Number
Student
Name
ELEMENT ONE: Identify impact of acute health problems on a person, family or carer
Case Study One:1/7/2018
1100: Nadia Canssino is a 76-year-old NESB lady admitted to your ward from Accident and
Emergency. Nadia is able to understand a small amount of English and lives with her daughter.
Nadia presented with a Bowel Obstruction which may require surgery in 2 days if it does not

resolve on its own. Nadia’s observations on admission to your ward are Temperature 36.7, Pulse
98, BP 156/89, Respiration 22, Oxygen Saturation 96% on Room Air, Weight is 43kgs. Nadia is
complaining of abdominal pain on arrival to the ward and requests pain relief.
1300: Nadia is to remain NBM with IV fluids over 6 hours for hydration. Intravenous Catheter
(IVC) is in-situ to the left arm, the site is NAD. A nasogastric tube is in-situ for free drainage and
4th hourly aspiration. IDC in-situ and is draining adequate amounts of urine every hour. Nadia
remains NBM Nadia’s IDC and Nasogastric hourly output is as below:
IDC N/G
1300 25mls 100mls
1400 20mls
1500 30mls
1600 32mls
1700 20mls 250mls
1800 40mls
1900 5mls
2000 10mls 100mls
1645: Nadia complains of a painful red and swollen left arm and the IVC is removed at 1700.
The Doctor attempts to insert another IVC for Nadia however after 4 attempts the doctor decides

that Nadia will need a PICC line inserted but is unable to organize it until tomorrow. Therefore,
Nadia has no IVC access until tomorrow.
2000: Nadia complains of feeling unwell, she looks pale and clammy. Observations T 38.6, P
120, BP 100/55, Respiration 25, Oxygen level 92% room air. A critical review is called for
Nadia.
2030: Temp 38.5, P 130, BP 92/50, Respiration 26, O2 Sats 89% 4 litres nasal prongs. Nadia is
continuing to deteriorate, and you need call for emergency response for her (as per organization
procedures) as her level of consciousness is decreasing.
Use CASE STUDY ONE provided to answer the following questions: -
Question 1.1.1
Define and describe the aim and characteristics of acute care
Acute care is one among the branches of secondary health care which mainly deals with
patients requiring active and short-term treatment as a result of severe injuries, urgent medical
conditions or recovering from surgery. The main aim of acute care is to ensure that the patients
in acute conditions receive critical care in order to survive the acute conditions. This branch is
uniquely characterized by patients diagnosed with short but serious conditions resulting from
accidents and emergency. The patients are also physiologically unstable, critically ill and highly
vulnerable to complications.
Identify and explain briefly 1 (one) acute health problem relating to Nadia.
The Bowel Obstruction suffered by Nadia can be categorized as an acute health problem.
From the explanation in the case study, the disease has been presented to require a quick

response in terms of surgery (2 days) if it does not resolve by its own and that short duration is a
characteristic feature of acute health problems.
What should be included in the preliminary health assessment?
 Inspection- Nadia will be examined and inspected at the various parts of her body for
normal shape, colour and consistency. This will help in alerting the healthcare providers
on the problems she might be having
 Palpation- the examiners will use their hands to tap on Nadia’s body. This will help in
listening to her heart, neck, abdomen or the lungs in order to identify problems she might
be having
 Auscultation- this is a physical examination technique which will be used to listen unto
Nadia’s lungs, heart, abdomen or neck to identify any problems which she might be
undergoing
 Neurologic examination- this will entail assessing Nadia’s cranial nerves, motor function
and sensory function.
List three (3) the actual and potential health issues for Nadia
 Crohn's disease
 hypernatremia
 Edema
List 2 (two) other health team members are involved in the care of Nadia and describe their roles
 Neural Surgeons- responsible in diagnosing and carrying surgery on Nadia
 Intensive care unit- responding to Nadia’s condition when under emergency

Question 1.2.1
List and describe 2 (two) factors you would include in the pre-operative care education of Nadia.
Your answer must include the potential physical and psychological impacts of acute health
problems on daily living activities
 Pain management- after the surgery, Nadia is expected to undergo a lot of pain before
recovery. She, therefore, needs to be prepared psychologically for that and how to
manage the condition.
 Physical restrictions- there are some of the duties which Nadia used to perform on her
own like cleaning utensils but the condition after surgery won’t allow her to perform
them. She, therefore, needs to be informed about the consequences of being involved on
those activities on her health.
For the two factors listed above how would you explain these issues to Nadia’s family?
First of all, I would explain to the family members on the reason behind Nadia’s pain and
how it’s an unavoidable circumstance to her. For instance, the issue of surgery I would inform
them that undergoing painful conditions by surgery patients is normal and that the pain won’t
last forever. I would also enlighten them on how to help her contain such moments. As far as
being restricted from vigorous physical activities is concerned, I would explain to them about the
consequences of her being involved in some of the physical activities like farming, cleaning or
carrying heavy luggage she used to be undertaking before.
Question 1.3.1

Define Pathophysiology: Pathophysiology is the study of disorders in physiological processes
which are associated with diseases or injuries.
List four (4) of Nadia’s acute health issues
 Bowel Obstruction
 Crohn's disease
 hypernatremia
 Edema
Briefly define and describe the Pathophysiology of the four (4) acute health issues you identified
for Nadia
 Bowel Obstruction- Faecal impaction as a result of large, hard mass of stool getting stuck
in Nadia’s digestive tract and which can't be eliminated in the normal way
 Crohn's disease - an inflammatory bowel disease which will cause inflammation of
Nadia’s digestive tract
 hypernatremia – an electrolyte problem if the hydration being administered to Nadia fails
and the serum sodium concentration value exceeds 145 mmol/L
 Edema- a swelling on Nadia’s body which will be caused by excessive fluid trapped in
her tissues if the hydration process fails
ELEMENT TWO: Contribute to planning care for a person with acute health problems
Question 2.1.1

Using the ISBAR format describe the information you would hand over to the registered nurse?
ISBAR
I Introduction- I will identify Nadia to the Nurse (her name and her local
location) then give the nurse the reason as to why i called
S Situation – I will give Nadia’s age and gender
Then her status as per the time of calling which can be
A) Stable or
B) Unstable
B Background –give Nadia’s relevant details like her problems and her
clinical history
A Assessment –I will put it all together at this point by explaining Nadia’s
current condition, risks, and needs
R
Recommendation – I will give recommendation on her transfer/ review
treatment
Using the ISBAR format describe the information you would hand over to another member of
the healthcare team. (Your handover must have key differences to the previous question)
ISBAR
I Introduction- I will identify Nadia (her name and location) then give the
reason as to why I called

S Situation – I will give Nadia’s age and gender
B Background –give Nadia’s relevant details like problems
A Assessment –Explaining Nadia’s current condition, risks, and needs
R
Request – I will give my request on how I think Nadia can be assisted.
Question 2.2.1
Using the A-H format document what you would enter into her record at 2030.
 her heart rate
 her blood pressure
 her breathing and respiration
 her pain management and nausea
ELEMENT THREE: Perform nursing interventions to support the health care of a person
with acute health problems.
Case Study TWO

0700: Nadia is required to go for emergency surgery due to a Bowel perforation. Due to her heart
condition, the Surgeon is unsure of which anesthetic will be best suited for her and asks for an
Anaesthetic review.
1500: Nadia returns to the ward post Bowel surgery she is awake and orientated to time and
place. IVF in-situ via right PICC line, IDC draining concentrated urine. N/G tube is to remain in
situ and is draining small amounts of bile colored fluid. Nadia also has an epidural infusion for
pain at a rate of 8mls/ hour which is keeping her comfortable. Abdominal wound is covered with
a small dressing, nil visible ooze.
25/7/2018
3 weeks after surgery Mrs. Cassino remains in hospital. Her abdominal wound has broken down
due to poor nutrition and requires daily packing. The Doctors are now requesting Nasogastric
feeding for her as she is severally underweight and malnourished. A fine bore Nasogastric
feeding tube is inserted by the Registered nurse and an X-Ray has confirmed correct placement
of the tube. The Doctor has confirmed the nasogastric placement and is happy for feeding to
commence via the NG tube. The doctor asks you to commence Nasogastric feeds on Nadia.
Nadia is not happy having a nasogastric tube as she finds it uncomfortable and thinks that people
are looking at her, due to the tube in her nose and a bag of nasogastric feeds being attached. You
notice that Nadia is constantly pulling at her nasogastric tube, as she wants it out. You find Nadia
in bed lying flat, the tape on her nose has been dislodged and her NG feed is still being

administered. She is having difficulty in breathing and her chest sounds moist. A set of
observations reveal BP 165/90, P 130, RR 28, O2 Sats 92%.
26/7/2018
Due to the poor nutritional state of Nadia, the Doctors are requesting that Nadia is to be
discharged with continuing Nasogastric feeding next week. As the Enrolled nurse, you need to
provide education and training to Nadia and her daughter to ensure patient safety after discharge.
You are also responsible for organizing discharge planning for Nadia.
Use case study TWO to answer the following questions 3: - Emergency scenario – deteriorating
patient with a compromised airway
Question 3.1.1
Explain in detail the steps to manage a compromised airway.
 Ensuring the airway management preparation is done properly
 Placing the patient in an optimal position to open an airway
 Ventilating the patient using long inspiration times
 Positioning the patient for direct laryngoscopy and endotracheal intubation
Question 3.2.1
Describe and discuss enteral feeding. Your answer must include:

Enteral feeding is any feeding that utilizes gastrointestinal (GI) tract to ensure all of the
caloric requirements of a person are met. It is used to feed patients who don’t meet the adequate
oral food intake basics or who cannot eat and drink safely.
Two (2) Nursing interventions related to enteral feeding
 Gastrostomy tube feeding can lead to pulmonary aspiration which can only be responded
to, by a trained nurse
 Patients under enteral feeding need a supplemental free-water flush to maintain hydration
Two (2) examples of different types
 Gastrostomy Feeding
 Jejunostomy Feeding
Question 3.3.1
Using CASE STUDY TWO, and particularly in relation to Nadia’s deteriorating condition. List
and describe in order of importance the five (5) key priorities and how you would modify your
nursing care to address these needs.
 Medication
 Nutrition
 Response
 First aid
 Safety
Question 3.4.1

List and discuss five (5) key topics you would you include when educating Nadia and her family
to promote the understanding that the health care being given is to regain optimal health
outcomes?
 Nutrition
 Medication
 Dressing wounds
 Caregiving
 First Aid giving
Question 3.5.1
Describe and discuss two (2) types or examples psychological support and care that Nadia may
require due to the impact of her acute health issues.
 Counselling
 Teaching them on how to cope
 Teaching them on how to adapt
Question 3.6.1
Once you have accepted care hand-over on Nadia onto your ward, List the initial assessments
that needed to be undertaken on Nadia
 physiological assessment
 psychological assessment

 sociological assessment
Nadia may need hourly clinical observations, list the necessary observations required.
Her heart rate, blood pressure, respiratory rate, oxygen saturation, temperature,
respiratory effort and capillary refill time
ELEMENT FOUR: Contribute to pre- and post-operative nursing care of a person.
Use the case study 2 to answer the following questions 4 (Pre and post-operative care)
Question 4.1.1
Contribute to pre-operative nursing management of the person for specific surgical procedures.
Provide a brief explanation as to how you would prepare and educate Nadia/family before
surgery:
 By assuring them that the process is going to be successful and totally controlled for
safety purposes
 Enlightening them on some of the basics necessary before surgery like to stop drinking
and eating for some time, use of antithrombotic stockings and the purpose of signing the
consent form
 Enlightening them on the use of anesthetics to ensure that the process of surgery is
painless
 Assuring them that even after the surgery, the patient will be fully taken care of by
specialist until she recovers.
Question 4.2.1

The following are some of the potential post-op complications that may occur after surgical a
procedure. Define and explain each term:
Shock- it is a severe drop in the blood pressure leading to a dangerous reduction in blood
flow in the whole body
Hemorrhage - it is excessive bleeding that may follow after surgery at the body part where
the surgery was done.
Deep Vein Thrombosis- it is a condition resulting from a blood clot in one or more deep
veins at the area where surgery was done
Wound Infection- it’s the wound that results from a surgery especially a surgery that involves
incision or skin cut.
Question 4.3.1
What is your role in caring for Nadia post anesthesia? Your answer must describe the key
observations and the key clinical priority post anesthesia.
 Monitoring her heart rate
 Monitoring her blood pressure
 Monitoring her breathing and respiration and
 Helping her manage pain and nausea
Question 4.4.1

Mobilization is an important part of a patient’s recovery process, depending on circumstances,
describe three (3) strategies will you put in place/undertake to help Nadia in regaining optimal
health after surgery?
 Ensuring that she follows her appointments
 Inspecting her incision regularly
 Ensuring that she eats and drinks properly
 Advising her on how to carefully cough and sneeze
Question 4.5.1
What is post-operative pain management? List and explain two (2) types of pain assessment tools
you may use in assessing Nadia’s pain
Post-operative pain management is a pain management approach which aims at
minimizing patient’s discomfort, facilitate initial mobilization and functional recovery to prevent
acute pain which develops into chronic pains.
Tools
 Verbal rating scales
 Pain Assessment Tools
Some of the common policies on postoperative pain management are
 Organizational preoperative education
 Organizational preoperative pain management planning,
 Use of pharmacologic and non-pharmacologic modality policies
References

Crisp, J.; Douglas, C.; rebeiro, G.; Waters, D.; Potter, P.; Perry, A.G.; Stockert, P. and Hall,
A.M.; 2017, Potter and Perry’s Fundamentals of nursing, 5th edition, Elsevier, Australia.
Levett-Jones, T.; Harvey, N. and Burton, T. 2017, Skills in Clinical Nursing Pearson Australia.
Student Workbook - HLTENN011 – Implement and monitor care for a person with acute health
problems
Tollefson, J 2012, Essential Clinical Skills for Enrolled/Division 2 Nurses, 2nd edition, Cengage
Learning, Melbourne.
Marieb, E 2010, Essentials of human anatomy and physiology, 10th edition, Pearson/Benjamin
Cummings, San Francisco.
Mosby 2009, Mosby’s dictionary of medical, nursing and allied health dictionary, 8th edition,
Mosby/Elsevier, St Louis, Missouri. (Or any other medical dictionary)
Brown, D, Edwards, H, Seaton, L & Buckley, T 2015, Lewis’ medical-surgical nursing:
assessment and management of clinical problems, 4th edition, Elsevier, Australia.
Funnell, R, Koutoukidis, G & Lawrence, K 2009, Tabbner’s nursing care: theory and practice,
5th edition, Churchill Livingstone, Australia.
Links
www.http//training.gov.au/Training/Details/hltenn011 Companion Volume implementation
guides are found in VETNet
www.https://vetnet.education.gov.au/Pages/TrainingDocs.aspx?q=ced1390f-48d9-4ab0-bd50-
b015e548570

http://www.schn.health.nsw.gov.au/_policies/pdf/2006-8239.pdf Guideline: Cardiopulmonary
Resuscitation and Equipment
http://www.cec.health.nsw.gov.au/patient-safety-programs/adult-patient-safety/between-the-
flags/clinical-emergency-response-systems Between the Flag - Clinical Emergency Response
System (CERS)