Unit - NSB334 Integrated Nursing Practice

NSB334
Integrated Nursing Practice 4
Assessment Task 1 Workbook

NSB334 Integrated Nursing Practice 4
Mr. Dwight Simulation
Setting the scene
Refer to your simulation documents
Epidemiology / pathophysiology of disease processes
The National Health Priority Area of Cancer Control was established with the aim of improving health outcomes
in this area.
The most common diagnoses for cancer in men are prostate (1 in 5 males), colorectal (1 in 11 males), melanoma
of the skin (1 in 13 males) and lung (1 in 13 males). For women, the most common diagnoses are breast (1 in 8
females), colorectal (1 in 16 females), melanoma of the skin (1 in 23 females) and lung (1 in 22 females).
Cancer screening programs have been large public health initiatives in this area aimed at reducing illness and
death resulting from cancer through an organised approach to screening. It would be of benefit for you to
research the three cancer screening programs of Breast Screen Australia, National Cervical Screening Program
and the National Bowel Cancer Screening Program to understand the importance of these programs and the
benefits obtained.
The World Health Organisation defines palliative care as:
‘An approach that improves the quality of life of patients and their families facing the problem associated with
life-threatening illness, through the prevention and relief of suffering by means of early identification and
impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
Your own values and beliefs about death and dying may impact on your interactions with a dying person, reflect
on your own self-awareness as an important strategy in palliative care nursing.
Now we shall step through the CRC in relation to Mr. Dwight’s’s case to prepare you
for the workbook assessment questions.
Assessment 1: SIM workbook: Summer semester 2 2019
Bachelor of Nursing NSB334 Page 2 of 19

NSB334 Integrated Nursing Practice 4
Based on your reading so far:
Gain an initial impression of your
patient
Consider Mr. Dwight’s situation, both socially and health wise. What
is your initial view of this patient and potential issues for him?
Answer:
The initial context shows as per the medical history that the patient
had been brought to the emergency care due to intense vomiting.
Considering the fact it can be a cause of an infection in the stomach
or intestine caused by the effect of stomach flu or due to obstruction
in the bowel system where the digested food have been obstructed
from passing. However, acid reflux can be another cause in which
the excess acid and bile might have disturbed the tract of food
passage (Unitypoint.org, 2020).
How has this changed between the acute admission and the palliative
care admission?
Answer:
Upon admission of Dwight, a thorough full body blood check up
was asked to be done which included cancer test as well. Upon the
diagnosis of cancer, it was asked for normal admission to be the
Assessment 1: SIM workbook: Summer semester 2 2019
Bachelor of Nursing NSB334 Page 3 of 19

NSB334 Integrated Nursing Practice 4
palliative care admission (Donaghey, Bernal, & Tuffrey-Wijne.,
2018).
Review current information
Gather new information
Recall knowledge (A&P, ethics,
law, cultural safety)
Consider the disease process and the assessment data you have been
provided with.
Answer: Current data provides with:
Complicated Left Ventricular Failure after the operation.
Diagnosis of type- II diabetes
Blood Pressure: 110/50, Body Temp.: 37 degree celcius
Respiratory Rate: 24 breaths per minute
BSL (Sugar Level): 22mol/L
Interpret data – what does it
all mean?
It is important to consider the
potential inter-relationships
between mental health, cardio
vascular, obesity,
musculoskeletal problems and
injury prevention.
What is your understanding of the cancer that Mr. Dwight presents
with?
Answer: Dwight was diagnosed with bowel cancer which is not that
common and also generally stays in the benign state. Generally, this
occurs in the small bowel, which is the small intestine, which
impacts in carrying the digested food from the stomach to the large
intestine with the absorption of fluids.
What is your understanding of the psycho-social effects for a patenit
and family faced with a diagnosis of cancer?
In almost any individual life, the fear and uncertainty of cancer
diagnosis will trigger an intense disturbance. A cancer diagnosis will
place a sense of security and orderliness for life at risk. While the
overwhelming majority of cancers are treatable, other people are
concerned about the stress, death and suffering of all cancers.
How does this change when a patient transitions into a palliative care
setting?
Assessment 1: SIM workbook: Summer semester 2 2019
Bachelor of Nursing NSB334 Page 4 of 19