Case Studies of the Older Person for Implement and Monitor Care of the Older Person

Knowledge Assessment Task
U N I T
C O D E HLTENN013 U N I T
T I T L E Implement and monitor care of the older person
Qualification
Code HLT51445 Qualification
Title Diploma of Nursing
Task Number 1 of 3 Task Name Case studies of the older person
Description of assessment task to be completed ☐ Additional content attached
• This is one of three assessments you need to complete to be deemed competent in this unit.
• You are required to answer questions after reading three (3) aged related health scenarios provided by the assessor that are typically
seen in the elderly population, and provide written responses to the accompanying questions.
• You are required to consider and analyse the health information and the clinical presentation of three older people in the case studies
provided to reach an accurate conclusion on possible nursing interventions related to their care.
• This assignment will allow you to provide evidence of researching (but not limited to):-
o disease processes,
o management of diseases,
o families,
o environment,
o care settings,
o legal and ethical issues,
o pain management,
o documentation,
o safety,
o understanding of the ageing process,
o Nursing Professional Standards.
• The emphasis of these scenarios is developing a sound understanding of aged related issues and health problems, identifying any
variations from normal and responding accordingly within a health care setting.
• The scenarios are based on real people (written and provided by the assessor which is incorporated into this assessment).
• You will be assessed against criteria listed in the marking guide
• This assessment will be completed in your own time and location throughout the units scheduled timetabled timeframe
Conditions of assessment
• This is an individual task. Youmay only receive minimum guidance from your assessor during the assessment. All responses listed
must be completed satisfactorily to the standard required.
• You must be assessed by a qualified assessor who holds a minimum Certificate IV in Training and Assessment (TAE4011).
• There is no minimum or maximum time allowed to complete this assessment. It is up to your discretion; however must be submitted
by the due date (see Unit Outline).
• Assessment will take place out of class, in your own time and location of your choice.
• You will be assessed according to the criteria listed in the marking guide.
• Learning material delivered throughout the unit will assist you to research further and guide you to complete the written assignment
(see Moodle).
• Include links or reference of any websites or books referred to throughout this assessment (no more than five (5) years old).
• You must submit via password protected University website (MOODLE) by the due date in the relevant section. By submitting via
MOODLE, you agree that in lieu of signing the student coversheet, you agree that all your responses provided are the product of your
own work. This will support the authenticity of the evidence.
• It is expected all documents will be completed electronically, however, if this is not possible, make alternative arrangements for
submitting the assessment with the assessor.
• You must save a copy of your work and be responsible for your own time management.
• Valid extension requests must be discussed with the teacher and approved by the teacher/course coordinator at least three days prior
to the due date.
• Late submissions other than those approved will be assessed and regarded as a resubmission.
• Your responses are to be typed directly under the questions on the document supplied. Your work must be well presented, using
industry preferred language, with accepted medical abbreviations (if applicable).
• No marks or grades are allocated for this assessment task. The task will be resulted as Satisfactory or Not Satisfactory.
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
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Knowledge Assessment Task
U N I T
C O D E HLTENN013 U N I T
T I T L E Implement and monitor care of the older person
Qualification
Code HLT51445 Qualification
Title Diploma of Nursing
Task Number 1 of 3 Task Name Case studies of the older person
• VET students are entitled to two (2) assessment attempts for each assessment task within a unit enrolment period in accordance with
Federation University Australia Statue 5.3.
• Students will be assessed according to the criteria listed in the marking guide.
Suggested resources (but not limited to) for the student to use are below.
 Australian Government, Department of Health and Ageing, http://www.health.gov.au/
 Kozier and Erb’s Fundamentals of Nursing
 LemoneMedical Surgical Nursing
 Australian Government: http://www.australia.gov.au/
 World Health Organization: http://www.who.int/en/
 Human Rights: Ageism - http://www.humanrightsactionplan.org.au/nhrap-blogs/ageism-is-a-human-rights-issue
 Osteoporosis Australia: http://www.osteoporosis.org.au/about/about-osteoporosis/what-is-it/
 MIMS online (via Federation University Library web link)
 Alzheimer’s Australia
• You must complete and sign the attached coversheet and submit it with your work.
Duration of assessment/ when assessment is due
This assessment will be given to you within two (2) weeks of the beginning of the unit.
This assessment should be worked on progressively throughout the delivery of the unit (see current timetable).
You should begin working on this assessment immediately and submit on or before the due date (see unit outline)
Material and resource requirements
Student to provide Assessor to provide
Stationary
Class notes / textbooks relevant to topic as per booklist
Location of your choice to complete assessment
Computer / internet access
Class notes to assist with assessment via password protected site
MOODLE
Assessment task accessed via password protected site MOODLE
Library access / IT access (during opening hours)
Teacher assistance by appointment
Submission details
• You must submit via password protected University website (MOODLE) by the due date in the relevant section.
• All work is to be typed
• Save your document under SURNAME, Initial, Student number, AT1 and upload into the Task 1 assessment MOODLE link
• By submitting via MOODLE, you agree that in lieu of signing the student coversheet, you agree that all your responses provided are
the product of your own work. This will support the authenticity of the evidence.
Satisfactory completion of assessment
To successfully complete this assignment you must:
• Answer all questions correctly and appropriately.
• Submit this assessment task by the due date according to the instructions above.
Additional information
Glossary of terms for clarification in case studies:
Warning: Uncontrolled when printed! The current version of this document is available from our website.
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Knowledge Assessment Task
U N I T
C O D E HLTENN013 U N I T
T I T L E Implement and monitor care of the older person
Qualification
Code HLT51445 Qualification
Title Diploma of Nursing
Task Number 1 of 3 Task Name Case studies of the older person
• LIST provide a number of connected items or points (often expressed onebelow the other)
• OUTLINE highlight main features without going into detail
• EXPLAIN give supported reason for; interpret meaning
• IDENTIFY name the issues, show
• EVALUATE look at reasons for and against and draw conclusions
• JUSTIFY provide reasons for a decision, viewpoint
• DISCUSS look at reasons for and against
• DESCRIBE give details using examples to illustrate
• RATIONALE explain reasons why
• RELATE make or show connections, relationships and associations
• STATE express a position clearly
• SUMMARISE give a concise account of the main points of something, omitting details
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Knowledge Assessment Task
Questions ☐Additional question sheet attached
Eg. With diagrams, photographs etc.
Case Study 1
John Arthur Shaw is a 76-year-old man.
John lived in inner Sydney until 2011 when he & his life partner Malcolm moved to a small farmlet near Ararat, where they ran a
variety of small animals including chickens, sheep & alpacas. They also had John’s horse Micah which he bought when they
acquired the farmlet. John’s most recent history of employment up until retirement was teaching disabled children to ride horses. He
had worked in this role for 11 years. Prior to that he worked in a racing stable as a strapper.
John’s family live in the Ararat area. He has a good relationship with his twin brother Peter & elder sister Meredith, but has a very
strained relationship with his youngest sister Kristine. Brother Peter & sister Kristine do not communicate with each other at all. This
poses some difficulty with communication with the family. Peter has John’s enduring power of attorney and his sister Meredith has
his financial power of attorney.
John’s life partner Malcolm died 3 months ago & it became obvious that John was far more dependent on Malcolm than was realised
by his family. Malcolm had taken over managing John’s medications with the help of a Webster Pack from the community
pharmacist. Malcom also assisted John with his showering, dressing, cooked all the meals and maintained the home.
John’s GP has recently retired & his new GP does not know him very well.
John was admitted to residential care shortly after Malcolm’s death. On admission John was noted to have some shortness of breath
on exertion, his blood pressure was slightly elevated at 135/90, he also complained of recent indigestion after meals. John has lost 5
kg in weight in the last three (3) months and is becoming more unsteady on his feet, requiring the furniture to hold onto as he moves
around. John also had a medical history of cardiac failure.
John is noticeably forgetful and becomes distressed when he cannot find Malcolm & wants to go home to see his animals. John has
not has not made any effort to join in with residents or staff in the facility & keeps to his room. He is often found in a tearful state.
There is no past history of depression noted in his medical file.
It is also noted that John has a past history of cancer of the throat that has been in remission for the past five (5) years. He
sometimes has swallowing difficulties & choking episodes in relation to this. John suffers from recurrent mouth ulcers, and is
currently being treated for thrush. John has upper & lower dentureswhich he is unable to care for independently.
John has very dry skin, and his skin tears very easily.His skin shows evidence of past skin cancer removal, although there is no
official record of this located in his medical file. He also has frequent episodes of senile purpura on his arms.
John is able to manage his shower under supervision, but is unable to dress himself without assistance. His oral care is attended to
by the staff.
Malcolm cooked all of their meals, providing John with a soft diet. John is sometimes non-compliant with his diet, and particularly
with his fluids. He especially hates thickened fluids. John has been assessed by the speech pathologist as continuing to require the
soft diet andthickened fluids.
Johns’ medications are as follows:
 Lanoxin PG 1 tab daily (check pulse). (62.5mcg daily)
 Lasix 20 mg mane
 Nilstat drops (Dose: 1ml QID)
 Bonjela mouth gel:
 mane, after oral hygiene after breakfast, and
 nocte, after oral hygiene before settling for the night
•
Please note: The tablets in Johns’ medication chart are crushed & mixed in apple puree.
After reading John’s story, please answer the following questions
1 Question: Identify three (3) common stereotypes or myths associated with ageing.
Answer: Old age, (dementia, sick, dying) Depression
Unfortunately theOld age Ageist stereotypes are persistent in our culture.
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Knowledge Assessment Task
Some of the myths and stereotypes associated with ageing include:
1. Dementia affects only the older people- This is a common myth about the senior people, whereas the reality is
though most people with dementia are over 65 years of age, but, a small number of people who are in the age
group of 40-50 are also likely to develop dementia.
2. Older aged people are depressed- While, many finds that aging is depressing, the reality is seniors are among the
happiest person provided that are surrounded by their family members and receive love and care.
3. All older people are sick and unwell- It has been seen that the majority of old people are active and healthy. “In 2011
only 6% of people aged 65 and older lived in nursing homes (67%) and retired or aged care facilities (25%)”.
2
Question: Identify two (2) potential impacts these myths or stereotypes may have that can adversely impact on the older
person.
Answer:missed diagnosis and care can be a big impact on johns health
Since, John’s pharmacist doesn’t know him well and not unaware of his forgetful state therefore, it could be difficult for
both of them to deal with. If John misses diagnosis and treatment due to his forgetful nature it can have an adverse
impact on hishealth.
3
Question: Reflecting on the myths and stereotypes you identified previously, discuss your own values, attitudes and
beliefs towards ageing and the older person.
Answer:Older people are often considered to be an economic burden to the society whereas the reality is older people
make contribution to the economy. It is believed that older people are only affected with dementia whereas people of
age group between 40-50 are also susceptible to dementia. It is also believed that old people are depressed because of
their old age, but studies have shown that they are the happiest person. Happiness is followed by a Shape curve with
lowest age at 40 and then grows eventually with age.
4
Question: With your own values and beliefs, how might you ensure (within your scope of practice) your values are not
enforced onto others?
Answer: We all have our own principles, views and behaviors as natural humans, which we have evolved throughout our life. Our
family, friends, society and interactions all add to our understanding of who we are and how we look at the world. Nurses,
working as community workers often work with sensitive individuals and/or individuals who can live a culture that society
considers is distinct or inappropriate. To provide a service that meets the needs of target groups and helps them feel empowered
as community services workers, nurses need to be aware of their personal values, beliefs and attitudes and be prepared to
accept the professional values of industry and not impose one's own ideas on the patients.
5 When considering the normal physical changes associated with ageing, each body system is directly affected.
Question: Identify and discuss these changes for the systems below that relate directly to John.
(What is happening to John’s body and why is it happening? (Look at the pathophysiology)
 Integumentary – increased skin dryness, due to decrease sebaceous gland activity, which explains the john’s high risk of skin
tears and skin dryness.
 Sensory/perceptual – decreased sense of taste, reduced saliva which has resulted in john with having dry mouth, as John is
struggling with swallowing this could indicate why Johns poor diet intake.
 Cardiovascular/Respiratory - reduced cardiac output and stroke volume, increase in diastolic and systolic blood pressure,
john
 Gastrointestinal – delayed swallowing time, this results in alterations in swallowing mechanism, indigestion
 Urinary/Renal- incontinence, dehydration
 Immunological/ Oncological disorders- Immune system becomes less effective, which can result in resistance to infectious
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Knowledge Assessment Task
diseases
Answer:
 John is prescribed with Bonjela mouth gel can have side effect such as skin dryness and that is why his skin often
tears.
 Lanoxin has side effects including loss of appetite, slows down heart rate thereby increases cardiac output and
stroke volume and reduces systolic blood pressure.
 Since he had throat cancer, he has lost appetite and has a slow mechanism of metabolism.
6
Question: Identify two (2) common side effects for Lasix and two (2) common side effects of Lanoxin.
Answer: Do not answer.
7
Question: Considering Johns circumstances, identify two (2) potential psychosocial considerations that may impact
John’s family and/or carers.
Answer: Adjusting to moving in to residential aged care facility, remaining in contact with family members
8
Question: Identify two (2) common side effects of each medication that John is taking.
Answer: Lasix – dehydration, nausea Lanoxin – dizziness, fast pounding or irregular heartbeat.
• Lanoxin PG 1 tab daily (check pulse). (62.5mcg daily)- Loss of appetite, anxiety.
• Lasix 20 mg mane-itching or rash, weakness (Healthdirect.gov. (2019).
• Nilstat drops (Dose: 1ml QID)- Nausea or vomiting, stomach pain.
• Bonjela mouth gel-skin dryness, tongue or throat swelling.
9
Question: Who would you report your concerns to about the information you have learned regarding John’s medication
and common side effects? (Excluding the doctor). How would you report your reporting actions?
Answer: RN on duty or Nursing unit manager, document in progress notes.
10
Question: Identify one (1) nursing intervention can you provide to John to assist with his dehydration?
Answer: encourage fluids
 Nurse should encourage patients to drink small amounts of fluid throughout the day gradually, rather than
drinking a large quantity at once.
 Nurse should not give coffee, alcohol or high protein drinks, particularly in large quantities since they have a
diuretic effect that can lead to a greater loss water from body.
 Foods that are has high amount of water like fresh fruits, and dairy products must be given to patients to meet the
daily water requirement.
11
You are about to assist John with his morning hygiene. You have read the care plans provided regarding John’s care, however, you
would like to determine Johns understanding of the care provided by staff.
Question: Identify and provide an example of two (2) open ended questions you would ask John in determining his
abilities and limitations in ADL’s? (Try to understand and ascertain what John thinks/believes he needs assistance for).
Answer: How much assistance do you need with showering? How can I assist with your hygiene
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