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NSB334 Integrated Nursing Practice

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Added on  2020-05-28

NSB334 Integrated Nursing Practice

   Added on 2020-05-28

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NSB334Integrated Nursing Practice 4Assessment Task 1 Workbook
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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 Simulation Bachelor of NursingPage 2 of 25
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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 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 BreastScreen 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 using 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. Bachelor of NursingPage 3 of 25
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NSB334 Integrated Nursing practice 4Complete the following workbook questions from your simulation including the clinical 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? Why would these signs and symptoms have occurred? Answer: Back pain: Mr Dwight might have been experiencing pain in the abdomen as indicated in the history. At times the symptoms of cancer might fail to show until it gets to spread to all the other parts of the body including the bones of the spine. Mr Dwight is experiencing pain in the abdomen a clear indication of discomfort at that part of the body. The pain is normally a discomfort 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[ CITATION Lou17 \l 1033 ].Loss of weight: As a result of the pain felt in the abdomen, Mr Dwight might have found minimal comfort in eating due to fear of bloating. Still, Mr Dwight might be taking a very low quantity of meals. Either of these results in limited nutrients into the body and hence loss of body weight. At other times, Mr Dwight might not just be feeling hungry hence decided to forego 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 the anatomy 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 the removal of the caecum, the hepatic flexure, the ascending colon, the first third of the transverse colon as well as a section of the terminal ileum together with fats and lymph nodes[ CITATION Gre131 \l 1033 ]. It is a treatment that is used for surgical treatment of malignant neoplasms of the right colon. Bachelor of NursingPage 4 of 25
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NSB334 Integrated Nursing practice 4The surgical procedure for hemicolectomy with the formation of a colostomy involves colostomy formation which is to form an opening or a stoma stitched to the outer surface of the 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, the skin surface will have both the downstream and upstream ends stitched to it. Bachelor of NursingPage 5 of 25
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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 bowel cancer compared to those younger than 50. With an increase in the age of an individual, the cell DNA damage tends to increase. The damage can result from some biological processes that are occurring the body of the individual or due to exposure to the risk factors[ CITATION Cha122 \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 of the family to another. In cases where one has the changed gene, risks of contracting bowel cancer become high at a point in the life of the individual. However, it is not clear which genes 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 the genetic conditions include MUTYH Associated Polyposis, Lynch syndrome and Familial Adenomatous Polyposis. The risk of developing bowel cancer among individuals with any of these 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 BGL be? Explain Mr Dwights BGL reading and the interventions in place to address his diabetes.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 individuals range between 3.9 and 5.5 mmol/L which is 70 to 100mg/dL. The mean normal level of blood 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 normal sugar level in adults which is 20mmol/L. in this regard, Mr Dwight could be suffering from moderate to severe high blood pressure symptoms[ CITATION Jen17 \l 1033 ]. Such symptomsmay include extreme thirst, flush, dry skin, blurred vision, restlessness, or difficulty to wake up. In case Mr Dwight’s body is producing little or no insulin at all, he could be suffering from either diabetes 1 or diabetes 2. Should that be the case, he could be having such symptoms as vomiting, rapid, depth breathing, pains in the belly, vomiting, weak pulse, false heart rate or even loss of appetite as well as a strong fruity breath smell. Some of these symptoms were noticed in Mr Dwight.Among the interventions that can be used to address Mr Dwight’s diabetes include eating food containing less calories, engaging in regular physical exercise in order to improve the sensitivity 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 blood sugar[ CITATION Jen17 \l 1033 ]. Bachelor of NursingPage 6 of 25
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