Contribute to nursing care of a person with complex needs

This document provides knowledge questions and case study questions related to nursing care for a person with complex needs. It covers common disorders and conditions, diagnostic tests, nursing interventions, and steps for various procedures. The document also discusses referral options and resources available in community settings.

HLTENN005 - Contribute to
nursing care of a person with
complex needs

Contents
PART A-KNOWLEDGE QUESTIONS.........................................................................................3
1...................................................................................................................................................3
2...................................................................................................................................................5
3...................................................................................................................................................5
4...................................................................................................................................................5
5...................................................................................................................................................5
6...................................................................................................................................................5
7...................................................................................................................................................6
8...................................................................................................................................................6
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22...............................................................................................................................................10
23...............................................................................................................................................11
24...............................................................................................................................................11
PART B- CASE STUDY QUESTIONS.......................................................................................11
1.................................................................................................................................................11
2.................................................................................................................................................12
3.................................................................................................................................................12
REFERENCES..............................................................................................................................13
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PART A-KNOWLEDGE QUESTIONS
1.
Body system 6 common disorders Description of disorder
a. Musculoskeletal system Common disorders and
conditions:
Osteoporosis, leukaemia,
muscular dystrophy,
osteoarthritis, osteomalacia,
lordosis, scoliosis
Osteoarthritis: It is a form of
arthritis; it can affect joints
severely. In this bone get
cushioned (Pinkert and et.al.,
2018).
Muscular dystrophy: In this
muscles got weaken.
b. Skin Eczema, melanoma, Acne,
Rosacea, Hives, Sunburn.
Eczema: Colour of skin
changes to red, and becomes
dry.
Melanoma: Skin changes to
uneven shades, main cause of
cancer.
c. Cardiovascular system Myocardial infarction,
Haemophilia, coronary artery
disease, heart attack, aorta
disease, congenital HD, heart
failure.
Myocardial infarction: blood
flow reduces, heart attack
appears
Haemophilia: Genetic
disease, missing blood clots.
d. Respiratory system Emphysema, Pneumonia,
asthma, COPD, lung cancer,
bronchitis.
Emphysema: shortening in
breath, ruptured inner wall.
Pneumonia: Air sacs got
inflamed, got fill with fluid.
e. Gastrointestinal system Appendicitis, Irritable bowel
syndrome, acid reflux, Celiac
disease, Bowel Control
Problems, Colon Polyps.
Appendicitis: inflammation
of index, causes pain in lower
abdominal.
Irritable bowel syndrome:
Affects large intestine
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affecting and causing pain.
f. Ear Acute otitis media
Meniere’s disease
Ear Infections.
Ear Ringing
Hearing Loss.
Otitis.
Perforated eardrum.
Acute otitis media: painful
infection of ear, eardrum
affects.
Meniere’s disease hearing loss
and inner infection of ear.
g. Eye Cataract
Conjunctivitis
Diabetic Retinopathy.
Glaucoma.
Amblyopia.
Strabismus
Cataract: faded colours in
eyes
Conjunctivitis: inflammation
in transparent membrane.
h. Nervous system Guillain-Barre syndrome
Meningitis
Epilepsy
Motor neurone disease (MND)
Multiple sclerosis (MS)
Neurofibromatosis
Guillain-Barre syndrome:
nerves got attacked by
immune system.
Meningitis: fluid inflames,
causing fever. It can affect
health and well-being of the
patients.
I. Endocrine system Osteoporosis
Hypothyroidism
Cushing's syndrome
Addison's disease
Buffalo hump
Diabetes
Osteoporosis: body loses too
much bone. It becomes weak.
Hypothyroidism: affects
thyroid gland and in this
muscles as well as joints
become weak.
j. Urinary system interstitial cystitis, kidney
stones, kidney failure, urinary
tract infections, Diabetes
insipidus, chronic kidney
Diabetes insipidus: fluid
imbalance, large amount of
urine produces (Andersson
And et.al., 2018).
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disease. Interstitial cystitis: urination
frequently in small amount.
k. Reproductive system Endometriosis
Gonorrhoea
Uterine Fibroids.
Gynaecologic Cancer.
HIV/AIDS.
Interstitial Cystitis.
Endometriosis: painful
disorder includes pelvic pain.
Gonorrhoea: sexually
transmitted disease, causes
infertility.
2.
incentive spirometry assists in recovering lungs after the surgery. It is used to sustain the desire
flow which has been achieved. It provides information related to patient’s condition. The device
cannot be used for patient with dyspnoea.
3.
 Open mind-ness, can think outside the world.
 Assist in remaining well informed.
 Improved decision making power (Srulovici and Drach-Zahavy, 2017).
 Increases self confidence
4.
Critical thinking is a specific way for looking at certain aspects, problem solving is a skill to
solve issues, creative thinking is bringing new ideas and concepts to solve issues.
5.
ECG is used to detect the cardiac abnormalities. The 12 lead ECG has steps connecting the wires
into electrodes, V1 on right spectrum, V2 on left, V3 in midway, V4 at midclavicular, V5 at
anterior axillary, put it in mid axillary (Jasemi and et.al,, 2017).
6.
Common conditions and
disorders
Diagnostic tests
a. Stroke or a person showing signs of a
transient ischemic attack
MRI
b. Myocardial infarction EKG or ECG
c. Asthma Spirometry
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d. Diabetes mellitus RPG
e. Urinary tract infection Urinalysis
f. Colorectal cancer CT scan
g. Cervical cancer MRI
h. Osteoporosis BMD
i. Skin cancer Skin biopsy
7.
Conditions and disorders Nursing interventions (three specific
interventions)
a. Breast cancer Communication about early signs and
symptoms
Education about management of disease
Supporting psychologically.
b. Prostate cancer DEXA scan surgery at particular time
Managing the fertility and sexuality issues.
Providing assistance to patients.
c. Urinary tract infection Increasing the intake of fluid
Motivating patient to void in every 2-3 hrs
Palpating the bladder of client in every 3-4 hrs
d. Urinary retention Increasing consumption of juice
Increasing the intake of fluid
Managing the urine contradictions (Diab and
Ebrahim, 2019).
8.
The purpose of monitoring the oxygen saturation levels (SpO2) of a person is to check how well
the heart of patient is being working. It is used for those patients whose oxygen level can get
affected. It can be used in assessing the breathing difficulties and lung infections. For measuring
the oxygen saturation level, the finger must be placed properly on equipment, sitting still while
calculating the readings, positioning of carob effectively.
9.
 Avoiding the patient’s realisation of errors
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 Drawing tubes in sequence which is proper
 Using adequate containers for collection
 Mixing all the tubes properly
 Placing urine in biohazard bag.
 Delivering right specimen of urine to lab
10.
the steps involved in collecting a blood specimen from an adult patient includes the following:
 Collecting of equipment
 Preparing patient for test
 Making use of hand hygiene while collecting
 Filling the samples from lab
 Drawing the samples in order which is correct.
11.
the steps involved in assisting an adult patient to don anti-embolic stockings includes the
following:
 Measure to check the proper fit
 Powdering of skin
 Turning the stock inside and out
 Stretching and pulling of stock over the knee
 Analysing of skin colour
12.
the steps involved in caring for an adult patient with an intercostal chest drainage tube and
underwater sealed drains are as follows:
 In this all the tubes must get free from all the types of kinks, it must be analysed and
checked related to tubing beneath the patient. The fluid fill dependant loops need to be
prevented. The drainage must be promoted below the chest level of patients (Bragadóttir,
Kalisch and Tryggvadóttir, 2017).
13.
steps involved in emptying and changing an ostomy bag, includes the following.
 Choosing the time when stoma is not active
 Washing of hands while changing the ostomy bag
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 Removing of pouch
 Cleaning the skin which is surrounded around the stoma.
14.
the steps involved in emptying and changing a urinary drainage bag includes the following:
 Washing off hands well
 Cleaning the tip of drainage
 Closing of valve
 Reinserting of the tube
 Emptying of old bag
 Placing a towel under the connection of bag and catheter
 Placing of the bed on towel
 Replacing it with new one
15.
the steps involved in providing care of suprapubic catheter includes the following:
 keeping an eye upon the catheter site for a few times
 Washing the area which lies around catheter with a liquid soap.
 Making sure that cream, powder is not being used around site
 Applying of the bandages around site.
16.
the steps involved in inserting and removing indwelling catheters (IDC) for a male patient
includes the following:
 Carry an equipment for process
 Pouring of solution which is antiseptic
 Washing of the hands
 Covering of patients and collecting of vessel
 Making sure that penis is clean
 Inserting of the lignocaine gel
 Advancing of the catheter tip
 Urine needs to start flowing into vessel for collection
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17.
the steps involved in inserting and removing indwelling catheters (IDC) for a female patient
includes the following:
 Gently pulling the catheter inside female body out of the urethra
 Taking the breathes in control
 Making sure that catheter is not forced out
 Cleaning up
 Washing the hands off
18.
The steps involved in inserting and removing nasogastric tubes (NG) for an adult patient,
includes the following:
 Making sure that tip of NG tube is lubricated
 The NG tube is inserted inside the nostril gently
 Advancing of tube in desired length
 Analysing of the patient’s mouth
 Making sure that NG is secure.
19.
the steps involved in feeding an adult patient through nasogastric tubes (NG) using a syringe,
includes the following:
 Washing of hands
 Analysing the correct amount of formula and warming it to the desired temperature
 Checking placement of tube
 Clamping of tube
 Attaching the syringe for feeding the tube
 Pouring of formula into syringe
 Unclamping of tube
20.
steps involved in feeding an adult patient through percutaneous feeding tube (via feeding bag)
includes the following:
 Making use of the feeding syringe to go into the PEG tube
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 A 60 cc syringe is being attached to a feeding bag
 There will be a pull bag on plunger
 Injecting the mineral content inside the tube bag
The feeding tube is most useful when there is a troubled eating for the adult patient. It must be
used precisely and consciously.
21.
There are various referral options and resources available in community settings. The resources
can be used in managing the complex needs. In community settings there are various support
system available like GP’s who can monitor the health outcome of local public in an area. Other
referrals which is been available in community setting includes referring to a standardised
hospital, in this they also provide referral options to go for a better health care practitioner. The
resources which are available is educational materials on maintain the health aspects of local
communities are made available. The patient who requires more attention, so that their complex
needs can be fulfilled are also refer to better physicians. Family members of patients with
complex needs are also been communicated effectively about the issues which is being faced by
patient (Strandås and Bondas, 2018). All these resources are being made available to them. The
other referral program includes acute inpatient, GEM and Inpatient Rehab to RMH. All these
references can be made in community care services.
22.
There are various referral options and resources available in acute hospital care setting so that the
needs and demands of patients can be fulfilled. There are options like referring to acute and sub-
acute units. These units consist of specialised clinicians which supports in diagnosis like chronic
wound and chronic pain. Patient can also get refer to cognitive and dementia services. They can
also get refer to aged care assessment services. They can also get transfer to the community
support and prevention system. They can also get transfer to the transition care program. There
are also various resources that can be given by community care setting like X-ray machines,
resources for measuring the heart rate, respiratory rate blood pressure. Various health related
videos can also be get available to making patients educate about diseases. All these resources
are useful in managing the complex needs. In this they can also get other resources such as MRI
machined, ECG machine so that the issues faced by the patients can be analysed and also it can
get fulfilled.
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23.
A nurse can apply the isolation nursing practices in various ways. This nursing practice is
basically implied on that aspect where there is risk of spread of infection. In this practice nurse
needs to be get engaged by wearing gloves, maintain proper sanitisation, hand washing time to
time, decontaminating the equipment and making sure that they dispose of the clinical waste, so
that the infection is not spread. They should also make sure that patient is been stayed in an
isolated ward and also nurses must not meet anyone when they are treating an infected patient.
They must implement the isolated nursing practice. In this the precautions which is being taken
in isolation can act as barrier between germs and people. This type of practices assists in making
sure that the spread of germs is been prevented. This type of practice is useful for enhancing
well-being and health outcome of patient. Masks, goggles and shoes must be covered so that the
infection does not spread. Airborne precautions can also be taken so that germs do not float in air
and affect the other person. This isolated practice will assist in improvising well-being of other
people too as it is necessary.
24.
In dealing with health status of deteriorating patient various nursing interventions can be applied
negotiating, communicating and conflict resolution. In this the family members must be made
aware about the reasons because of which the health outcome of patient is been deteriorating. It
has also been analysed that in order to improve the family and nurse relationship effective
communication methods must be used. This will assist nurses in solving out disputes as well as
resolve conflict. Negotiation between nurses and family in the care setting environment can
assist in making family understood about the patients deteriorating conditions.
PART B- CASE STUDY QUESTIONS
1.
In this the health care providers will be engaged in removing down any type of kink which is
been seen in catheter. It can become blocked because of dysfunctions. The catheter must be
changed by nursing team only, by this way Russel’s catheter can be managed. The blockage can
be removed in the emergency department. Catheter must be cleaned so that no infection can be
spread. The blockage can be happened because of the bacterial infection. The educe encrustation
must be followed. The blockage must be cleared as this can lead to urine to be more alkaline.
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2.
Patients family has inappropriate behaviour towards nurses, this can be managed through
effective negotiation and communication. The care setting team should be involved in analysing
the need of family and must satisfy them.
3.
Nurses often recognize deterioration in patients through intuition rather than through routine
measurement of vital sign. In this they report signs and symptoms by which they can analyse the
condition of deteriorating client (Nolte and et.al., 2017). In this the negotiation must be used so
that the conflict can be resolved. They are bound to make use of effective communication to
make family members understand about the reasons for deteriorating health outcome and well-
being of patient. In this they are also been engaged in making use of the various negotiating as
well as other interventions, so that dispute cane be solved and conflict can be resolved.
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REFERENCES
Books and Journals
Nolte, A.G. and et.al., 2017. Compassion fatigue in nurses: A metasynthesis. Journal of clinical
nursing, 26(23-24), pp.4364-4378.
Andersson, Å. And et.al., 2018. Factors contributing to serious adverse events in nursing
homes. Journal of clinical nursing, 27(1-2), pp.e354-e362.
Pinkert, C. and et.al., 2018. Experiences of nurses with the care of patients with dementia in
acute hospitals: A secondary analysis. Journal of Clinical Nursing, 27(1-2), pp.162-172.
Jasemi, M. and et.al,, 2017. A concept analysis of holistic care by hybrid model. Indian journal
of palliative care, 23(1), p.71.
Srulovici, E. and Drach-Zahavy, A., 2017. Nurses’ personal and ward accountability and missed
nursing care: A cross-sectional study. International journal of nursing studies, 75,
pp.163-171.
Bragadóttir, H., Kalisch, B.J. and Tryggvadóttir, G.B., 2017. Correlates and predictors of missed
nursing care in hospitals. Journal of clinical nursing, 26(11-12), pp.1524-1534.
Diab, G.M.A.E.H. and Ebrahim, R.M.R., 2019. Factors leading to missed nursing care among
nurses at selected hospitals. American Journal of Nursing, 7(2), pp.136-147.
Strandås, M. and Bondas, T., 2018. The nurse–patient relationship as a story of health
enhancement in community care: A meta‐ethnography. Journal of advanced
nursing, 74(1), pp.11-22.
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