NSB334 Integrated Nursing Practice

Added on - 28 May 2020

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NSB334Integrated Nursing Practice 4Assessment Task 1 Workbook
NSB334 Integrated Nursing practice 4School of NursingASSESSMENT COVER SHEETStudent Name:Student No.:Unit Name: Integrated Nursing Practice 4Unit Code: NSB334Due Date:Lecturer’s/Tutor’s Name:Tutorial Day/Time:Assessment No.1Assessment Title:Collaborative Practice SimulationBachelor of NursingPage2of25
NSB334 Integrated Nursing practice 4Mr Dwight SimulationSetting the sceneRefer to your simulation documentsEpidemiology/pathophysiology of disease processesThe National Health Priority Area of Cancer Control was established with the aim ofimproving health outcomes in this area.The most common diagnoses for cancer in men are prostate (1 in 5 males), colorectal (1in 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 aimedat reducing illness and death resulting from cancer through an organised approach toscreening. It would be of benefit for you to research the three cancer screeningprograms of BreastScreen Australia, National Cervical Screening Program and theNational Bowel Cancer Screening Program to understand the importance of theseprograms 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 theproblem associated with life-threatening illness, through the prevention and relief ofsuffering using early identification and impeccable assessment and treatment of painand other problems, physical, psychosocial and spiritual.Your own values and beliefs about death and dying may impact on your interactionswith a dying person, reflect on your own self-awareness as an important strategy inpalliative care nursing.Bachelor of NursingPage3of25
NSB334 Integrated Nursing practice 4Complete the following workbook questions from your simulation including theclinical reasoning cycle:Gain an initial impression of your patientQuestion 1.Review Mr Dwight’s background and history. Mr Dwight has a history of bowel cancer.What two (2) signs and symptoms might Mr Dwight have had before his diagnosis? Whywould these signs and symptoms have occurred?Answer:Back pain: Mr Dwight might have been experiencing pain in the abdomen as indicated in thehistory. At times the symptoms of cancer might fail to show until it gets to spread to all theother parts of the body including the bones of the spine. Mr Dwight is experiencing pain inthe abdomen a clear indication of discomfort at that part of the body. The pain is normally adiscomfort or bloating that is experienced after taking a meal. This may lead to a reduction inthe food consumed by the patient and even culminate in loss of body weight[ CITATIONLou17 \l 1033 ].Loss of weight: As a result of the pain felt in the abdomen, Mr Dwight might have foundminimal comfort in eating due to fear of bloating. Still, Mr Dwight might be taking a very lowquantity of meals. Either of these results in limited nutrients into the body and hence loss ofbody weight. At other times, Mr Dwight might not just be feeling hungry hence decided toforego his meals. This would still lead to a significant drop in the weight of the body.Question 2:Mr Dwight has had a hemicolectomy with the formation of a colostomy. Discuss theanatomy and physiology of this condition and the surgical procedure?Answer:This is a condition in which the end of the ileum is dislodged out o the abdomen and stitchedonto the outer surface of the skin to form a stoma. Colostomy is another type of stoma whichcould be formed after a colectomy. It is achieved when there is any section of the large colonattaching to the small colon. An open hemicolectomy is a surgical process that involves theremoval of the caecum, the hepatic flexure, the ascending colon, the first third of thetransverse colon as well as a section of the terminal ileum together with fats and lymphnodes[ CITATION Gre131 \l 1033 ].It is a treatment that is used for surgical treatment ofmalignant neoplasms of the right colon.Bachelor of NursingPage4of25
NSB334 Integrated Nursing practice 4The surgical procedure for hemicolectomy with the formation of a colostomy involvescolostomy formation which is to form an opening or a stoma stitched to the outer surface ofthe skin. The procedure of the operation is as follow;A hole is made through the wall of the abdomenStitching the upper end of the colostomy (when making an end colostomy)Removal of the other end/ closing it by the use of a tapeThe surgeon may as well decide to form a loop colostomy. Under such a circumstance, theskin surface will have both the downstream and upstream ends stitched to it.Bachelor of NursingPage5of25
NSB334 Integrated Nursing practice 4Question 3:What two risk factors can lead to bowel cancer?Answer:Old age: People aged above 50 years are found to be at higher risks of contracting bowelcancer compared to those younger than 50. With an increase in the age of an individual, thecell DNA damage tends to increase. The damage can result from some biological processesthat are occurring the body of the individual or due to exposure to the risk factors[ CITATIONCha122 \l 1033 ].A family history of bowel cancer: Up to a third of bowel cancers can result from a variation orfault in one or more genes. The mutant genes can easily be passed from one generation ofthe family to another. In cases where one has the changed gene, risks of contracting bowelcancer become high at a point in the life of the individual. However, it is not clear whichgenes take part in the transmission of bowel cancer. Research has established that up to 5%of the cases of bowel cancer are directly associated with the genetic mutation. Some of thegenetic conditions include MUTYH Associated Polyposis, Lynch syndrome and FamilialAdenomatous Polyposis. The risk of developing bowel cancer among individuals with any ofthese conditions is high and may be diagnosed with the disease at tender ages.Question 4:Mr Dwights BGL on admission to the ED is 22 mmol. What level should a normal BGLbe? Explain Mr Dwights BGL reading and the interventions in place to address hisdiabetes.Answer:The normal blood sugar level is not static but fluctuates throughout the day in individuals.While fasting, the normal blood sugar level should for the case of non-diabetic individualsrange between 3.9 and 5.5 mmol/L which is 70 to 100mg/dL. The mean normal level ofblood glucose in the human body is approximately 5.5 mmol/L.Mr Dwight's blood sugar level reading is 22mmol/L. This is higher than the above normalsugar level in adults which is 20mmol/L. in this regard, Mr Dwight could be suffering frommoderate to severe high blood pressure symptoms[ CITATION Jen17 \l 1033 ]. Such symptomsmay include extreme thirst, flush, dry skin, blurred vision, restlessness, or difficulty to wakeup. In caseMr Dwight’s body is producing little or no insulin at all, he could be suffering fromeither diabetes 1 or diabetes 2. Should that be the case, he could be having such symptomsas vomiting, rapid, depth breathing, pains in the belly, vomiting, weak pulse, false heart rateor even loss of appetite as well as a strong fruity breath smell. Some of these symptomswere noticed in Mr Dwight.Among the interventions that can be used to address Mr Dwight’s diabetes include eatingfood containing less calories, engaging in regular physical exercise in order to improve thesensitivity of the cells to insulin, seeking medical intervention and avoiding both physical andmental stress as these release stress hormones which lead to a rise in the level of bloodsugar[ CITATION Jen17 \l 1033 ].Bachelor of NursingPage6of25
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