Nursing Assignment: Observation, Abuse Indicators, Care Plan, and Body Processes

This nursing assignment covers various topics such as observation at a client's home, indicators of abuse and neglect, importance of acknowledging roles in care plan, negative impact of caring role, types of family structures, changes in life of person with support needs, service delivery philosophy, legal and ethical requirements of a carer, assessment of client needs, and body processes. It includes case studies and recommendations for each scenario. The assignment is relevant for nursing students and covers various courses and universities.

Nursing Assignment 1
Nursing Assignment
by
Course:
Tutor:
University:
Department:
Date:

Nursing Assignment 2
Table of Contents
QUESTION1: Observation at a client’s home...........................................................................3
QUESTION 2: Indicators of abuse and/or neglect....................................................................4
QUESTION 2: Importance of acknowledgement of the roles of all people involved in the care
plan of a person..........................................................................................................................6
QUESTION 3: ways in which the caring role can have a negative impact on families, carers,
and friends..................................................................................................................................6
QUESTION 4: Types of family structures and effects on person with support needs..............6
QUESTION 5: Changes or transitions in the life of a person with support needs and their
effects on families and carers.....................................................................................................7
QUESTION 6: Service delivery philosophy and models of my organization (Care-full
Service Delivery).......................................................................................................................7
QUESTION 7: Policies and Procedures of Care-full services for carers and families..............8
QUESTION 8: Legal and Ethical Requirements of a carer.......................................................8
QUESTION 1: assessment of the needs of clients and their carers and families......................8
QUESTION 7: Body processes and their importance..............................................................12
QUESTION 1: Class sessions on human body and its healthy functioning............................12
QUESTION 1: Supporting ones independence and well-being...............................................15
QUESTION PC 5.2: Importance of understanding the necessary workplace documents.......15
QUESTION PC 5.4..................................................................................................................15
QUESTION 1: evidence/ details of communication at three different work situations..........16
QUESTION PC 1.1:.................................................................................................................17
QUESTION PC 1.3..................................................................................................................17
QUESTION PC 2.3: seeking feedback from client with disability.........................................18
QUESTION PC 3.3: Dialogue on success strategy.................................................................19
QUESTION PC 3.4..................................................................................................................19
References................................................................................................................................22

Nursing Assignment 3

Nursing Assignment 4
QUESTION1: Observation at a client’s home
My supervisor assessed my observation of the client’s home which was home to an elderly
man.
My responsibilities included:
 Assess the suitability of the home to the elderly man
 Examine security protocols, if at all they are there
 Ascertain potential hazards and risk in the room
 Recommendations on how to minimize any potential risks
 Effectiveness of the smoke alarm
Security protocols at the clients homes
 All windows and doors are lockable and should be locked most of the times
 Keep a phone nearby
 Use the installed peephole in case of doubt
 Do not leave a spare key accessible
 Ensure that the home is well lit and motion sensor lights are installed and working
 Use an alert necklace or bracelet in case the phone is not reachable
Potential hazards in the room/to the client
 Too high cabinets
 Sharp utensils that break easily
 Furniture that is not easy to stand up from after sitting
 A small pet that gets below the feet
 Throw rugs
Potential risks to myself

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 Obstructed pathways
Hot to minimize these risks in this situation
Risks such as throw rugs can easily be eliminated. The furniture needs restructuring and be
made to the height and comfort of the client. The obstructed pathways just need a thorough
re-organization of the items in the house and elimination of the unnecessary items. The small
pet can only be substituted with a bigger pet.
The smoke alarm is averagely effective, however, I can make recommendations that the fire
safety system be assessed after every month to ensure that it is effective.
Limitations on my visit
 The client wanted me to fix the ineffective smoke alarm and yet I don’t have the
capacity to do so
 The client also wanted me to re-arrange the room to eliminate the obstructed pathway
Aspects of my care were person-oriented and I was able to empower and give the dignity of
risk to the client in various ways. I empowered the client by encouraging him and ensuring
that the room gave him the necessary comfort and ease. I also gave the client a dignity of risk
by assessing any potential risks and hazards in the room and making necessary
recommendations.
QUESTION 2: Indicators of abuse and/or neglect
Physical abuse
 Bruises
 Burns or scalds
 Fractures or broken bones
 Bite marks (Cooper, Selwood, and Livingston, 2008).

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Sexual abuse
 Fear responses to flashbacks of the assault
 Fear of whether it is possible to ever feel safe again
 Feelings of guilt (Austin et al., 2008)
 Loss of interest in sex (Rosen, Lachs, and Pillemer, 2010)
Psychological abuse
 Reluctance to talk publicly
 Avoiding eye or verbal contact with care provider
 Hopelessness
 Fear (Alonso, Manso, and Sánchez, 2012)
Emotional abuse
 Loss of self-esteem or confidence
 Social withdrawal or loss of interest
 Depression
 Headache (Glaser, 2009)
Financial abuse
 Abnormal use of credit cards
 Missing money from accounts
 Lack of basic necessities like food at home
 Missing possessions (Manthorpe and Samsi, 2012)
QUESTION 2: Importance of acknowledgement of the roles of all people involved in the
care plan of a person
It is crucial to acknowledge the roles of all people involved in the care plan of a person
because they are the ones who have a one on one experience or encounter with the client and

Nursing Assignment 7
therefore will provide information that is important on which specific support needs are
required.
QUESTION 3: ways in which the caring role can have a negative impact on families,
carers, and friends
i. Isolation. The demands of the role of caring can hinder carers and families from being
involved in normal participation of family and community activities and employment
(Bramble, Moyle, and McAllister, 2009).
ii. Invisibility. It is possible that the carer attending to persons with disability or illness
to focus so much on the patient to the extent of forgetting their individual care
iii. Low quality of family relationships among the care givers because of the high care
giving demands
iv. Lack of bonding between the client and their families and friends due to isolation
(Williams et al., 2010).
v. Depression amongst the family members and friends due to the separation
QUESTION 4: Types of family structures and effects on person with support needs
i. Nuclear family
Nuclear family may have an effect on a person with support needs because of the already
established bond amongst the family members
ii. Single parent family.
A single parent family affects the individual in need of support because of the limited
financial resources which only come from a single person (Cunningham, 2014).
iii. Extended family.

Nursing Assignment 8
An extended family affect the person with support needs because this structure is often
characteristic of financial difficulties thus may not be able to cater for the expenses of care
giving but instead will prefer to stay together in the same house
QUESTION 5: Changes or transitions in the life of a person with support needs and
their effects on families and carers
i. Inability to move or perform basic tasks. This will significantly affect the family and
carer because the individual will appear like a burden to the family
ii. Sense of isolation. The individual with support needs will feel isolated and thus
become depressed leading to other health problems, and this will psychologically
affect the family and friends
iii. High demands of care with increase in age may be too strenuous for the carer thus
affecting the quality of care offered the client. This will further affect the quality
health of the patient
QUESTION 6: Service delivery philosophy and models of my organization (Care-full
Service Delivery)
The Care-full Service deliver model offers a framework for palliative care service providers
(primary and specialist) to jointly offer services for the advantage of patients and families
The Model aims at attaining cohesive, co-operative, excellent quality palliative care service
delivery in all its branches and to ensure that there is complete access to patients through:
 Comprehensive evaluation of the palliative care needs of the patients
 Minimizing duplication
 Clarity in roles
The model appreciates that:
 Persons suffering from sicknesses that limit life should individually be attended to
from the specialists’ care-full service delivery according to their unique needs.

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 Most of the patients are offered primary care-full services without having to go
through the specialist service
QUESTION 7: Policies and Procedures of Care-full services for carers and families
Procedures
 Client accident incident reporting and investigation
 Abuse and neglect of a client
 Food handling
 Standard of service provision
 Supporting and reporting client behaviours of concern
Policy
 Client health checks
 Clients human rights and freedom from abuse and neglect
 Cultural security for clients
 Disability aged care entry and exit criteria
QUESTION 8: Legal and Ethical Requirements of a carer
i. Privacy and confidentiality. This provides guidelines on how to collect, use, and
disclose any personal information about the clients
ii. Disability discrimination act and racial discrimination act. disability discrimination
act prohibits the discrimination of people based on their disability whereas the racial
discrimination act offers prohibitions on discriminating one on the basis of colour
QUESTION 1: assessment of the needs of clients and their carers and families
Elderly
Profile information
Age: 78 years

Nursing Assignment 10
Name: Eliphas White
Family structure: Extended family
Current medication and their purpose
Eliphas white is currently undergoing medication for osteoporosis to strengthen his bones and
enable him to walk
Summary of medical history
The client has been sick for the past 15 years and has been under medication. The major
diseases that have affected him in his old age or for the past 15 years include diabetes and
osteoporosis
Present physical abilities
Can only for short distances when aided
Poor eyesight
Home safety problems
No one is available to take care of the client, all family members are busy with work and
school
Need of carer
The patient requires constant needs of a carer
Recommendation: the client should be assigned a carer for home care nursing and the house
remodelled to suit the situation. Alternatively, the client can be taken to a care centre
Client with physical disability
Profile information

Nursing Assignment 11
Age: 20 years
Name: James Clark
Family structure: Nuclear family
Current medication and their purpose
James Clark is currently under no special medication since his condition is permanent or
inborn
Summary of medical history
The client has not been ill for the last two years, except for psychiatric services that are
offered to him on monthly basis
Present physical abilities
The client can only move using his wheel chair due to disabled legs
All other major organs are appropriately functional
Need of carer
The patient requires more of counselling services and part time carer
Client with intellectual disability
Profile information
Age: 20 years
Name: Edith Whimsy
Family structure: Nuclear family
Current medication and their purpose

Nursing Assignment 12
Edith is currently undergoing medication to improve her intellectual and cognitive abilities
Summary of medical history
The client has been suffering from intellectual disability since birth but has been improving
Present physical abilities
The client can accomplish all physical activities except for those that require aggressive
mental involvement
Need of carer
The patient should be provided with a psychiatrist and a specialist in intellectual disabilities
QUESTION 2: Strength-based approach in assessment of care relationships
My client is Mr Richard aged 66 years and is living alone since the death of his Wife who
they had been married for 20 years.
Problems encountered
The client became emotional when asked of his past and thus could not offer detailed
information regarding how he feels currently
The client had signs of depression and financial mismanagement but was unwilling to open
up. The neighbours were very much willing to help the old man but he wanted to live lonely.
Strength based solutions applied
Several factors were considered when preparing for the assessment: the following questions
were asked in accordance to the legal duties for the Care Act
 What is to be considered to ensure the assessment is successful?
 How to ensure that a strength based approach is factored in
 Who will be engaged in the assessment

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 What is the impact of the assessment on the client, carer and family?
I also ensured that the assessment was proportionate and appropriate
The eligibility of the assessment were determined and the outcomes recorded
QUESTION 7: Body processes and their importance
i. The circulator and respiratory systems. This is in charge of blood transportation
throughout the body thus supplying the necessary nutrients to all body organs for
effective performance (Sonenshine and Roe, 2013).
ii. Acid-balance. This is a homeostasis process through which the body controls the
amounts of acids and bases in the blood thus ensuring that the body doesn’t suffer
from toxicity due to high or low acid and base levels (Kohan et al., 2011).
iii. Regulation of body temperature. This is also a mechanism through which the body
regulates its temperature by producing heat or releasing excess heat. This prevents
conditions such as loss of consciousness or breakdown of the central nervous system
(Nakamura, 2011).
QUESTION 1: Class sessions on human body and its healthy functioning
Importance of maintaining a healthy body
 Increase well-being. A healthy body keeps the metabolism working effectively and
increased energy with less pains.
o A healthy body can be maintained by taking healthy diet such as enough
vitamins, minerals, dietary fiber that is required by all body processes
 Minimize injuries and infections. A maintained healthy body has a strong immune
and thus is not easily overwhelmed by infections (King et al., 2009).

Nursing Assignment 14
 Maintain weight. A healthy body will have the appropriate weight thus preventing
diseases associated with over or under weight
Importance of sleep
 Inadequate sleep leads to weight gain. Studies show that short sleep duration is a risk
factor for obesity (Cappuccio et al., 2008). The impact of sleep on weight gain is
mediated by factors such as hormones and motivation to exercise (Di Milia,
Vandelanotte, and Duncan, 2013).
 Adequate sleep increases concentration and performance. Adequate sleep boosts brain
functions such as cognition, concentration and productivity (Killgore, 2010).
Human muscular and skeletal system
Source: (Watkins, 2009)

Nursing Assignment 15
Source: (Watkins, 2009)

Nursing Assignment 16
QUESTION 1: Supporting ones independence and well-being
I support the WHS manager, cleaner, and watchman at my workplace to enhance their
independence and well-being in the following ways:
i. Recognizing and supporting individual differences
 By recognizing and respecting each person’s social, cultural and religious
differences
 By regarding the individual’s needs, stage of life, abilities and inabilities when
offering support activities
ii. Promote independence
 By helping the individual to ascertain and acknowledge their personal
strengths and capacity of self-care
 Help the people to find out opportunities to use their strengths
iii. Support well-being
 By fostering and encouraging daily life habits that promotes healthy lifestyle
QUESTION PC 5.2: Importance of understanding the necessary workplace documents
 To help in knowing what is expected and how to behave at work and
performance
 To know a framework for decision making
 To protect me from breaches of legislations
Find Attached in Appendix 1: Referral Assessment Form
QUESTION PC 5.4
A client by the name Edwin Johns has visited with us at 9:20 am requesting to personally see
Mrs Ruth. The client looks distressed and agitated and have requested a quick response.

Nursing Assignment 17
Please you can consider his request of allowing Mrs Ruth to attend the client in the visitors’
private room promptly. Much regards.
QUESTION 1: evidence/ details of communication at three different work situations
To my supervisor
I communicated to my supervisor about an assignment of client assessment report and the
possible recommendations I made to the families and carer. This communication was
important as it was to be examined by my supervisor whether it met the organizational
reporting standards
To a nursing intern
I communicated to the intern on the work instructions and timeframes. These included roles
and responsibilities such as attending to specific needs of clients and compiling reports on the
same in time in accordance to organizational policies and procedures.
To a social worker
Communications were made to the social worker on the specific homes of the elderly that
needed needs assessment within one week. The needs assessment was to be done based on
company policies and procedures
The communication skills used
 Listening
 Non-verbal communication such as eye contact, hand gestures
 Clarity and concision
 Empathy
Communication techniques used
 Determine the objective of communication

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 Examining the receiver
 Select the appropriate communication tool
QUESTION PC 1.1:
Strengths
Adaptability
Interests
Solving problems
Preferences
Training
Abilities
Teamwork
Support requirements
Availability of resources
Suggested suitable activities
Training, community work to offer solutions to problems, need assessments.
QUESTION PC 1.3
Summary of client’s preferences and needs
 Training
 Availability of necessary resources
We have chosen with the client on working with communities to offer solutions to existing
problems

Nursing Assignment 19
Requirements
 Participation resources: printing of survey materials, printing of official tags
 Programs: meeting with the local leadership to promote the agenda
 Agencies: local community leadership, county security team
 Transport services: two 4WD trucks
 Aids and equipment: camera, microphones,
QUESTION PC 2.1: Community events
 Provision of health check-ups for the community. This activity doesn’t meet the
preferences of the client because he prefers to provide solutions to problems not just
offering services
 Suggestion of best methods of water preservation. This activity meets the preferences
of the client who is interested in offering solutions to existing challenges in the
society
 Security measures for the community. This activity meets the preferences of the client
who is interested in offering solutions to existing challenges in the society
QUESTION PC 2.3: seeking feedback from client with disability
I would approach this task by first ensuring that the method of feedback collection is
accessible by the disabled persons and that it doesn’t discriminate.
I will cover topics on quality of service delivery, recommendations for any changes, and likes
and dislikes of the client on organizations services.
Questions on feedback will include:
 How do you rate the quality of services offered to you within a scale of 1 to 5
 Are you happy with our carers? Why?
 Which recommendations can you make to the organization for better services

Nursing Assignment 20
QUESTION PC 3.3: Dialogue on success strategy
Worker: I see the success strategies are more effective
Supervisor: Oh, that is good news
Client: at least there is improvement. But still there is more to be done on the number of
carers assigned to each client
Supervisor: Ok, client. Why do you say that?
Client: the number of carers is under estimated because some clients’ needs more time of the
carer thus affecting the quality of service delivery to other patients
Worker: Ok, dear client. That is noted and I have included it as part of my recommendation
in the monthly report. This is attributed to the rise of serious cases of elderly clients that were
admitted this week into our care centre
Client: Ok, that’s fine
Supervisor: Well, that will be acted upon. Thanks and good day
Client and worker: Thanks, you too
QUESTION PC 3.4
An example of an instance when I would be limited in addressing an issues when conducting
an assessment of a senior’s home for health suitability and then I find a problem with client’s
smoke alarm system. This is beyond my limitation because I am a practicing nurse and what I
can only do is to ascertain the workability of the smoke alarm but cannot repair it since it is
not in my field. I would instead call the relevant department at work to come and address the
issue conclusively.
QUESTION 1: Support for people living with dementia in a residential home setting
Senior with dementia

Nursing Assignment 21
Caring for the client with Dementia using the person centred approach will be accomplished
by:
 Providing a selection of food at mealtimes. This is done by asking what the client
would like to eat or show images to assist. If this fails, the client can be given that
which he always likes
 Emphasizing on little things because they mean a lot. For instance, choosing the type
of watch or tie to put on will develop a sense of control
A child with dementia
 The child should be treated with dignity
 The carers and family should be conversant with his likes and dislikes, preferences
and tastes
 Considering his individual personality and opinion
QUESTION 3: Person centred approach Review
While dealing with the clients I maintained person centred approach by
 Ensuring that the older person was at the centre of all discussion
 Ensured that the discussion was inclusive and accessible
 Consideration of personal priorities and strengths
I worked continually to improve the older client by focusing on the strengths already
mentioned by him and leading him to still become positive about life
I used a range of oral communication skills such as maintaining eye contact, active listening
and speaking clearly.
I recognized that the cabinets were too high for the client to reach and thus noted down and
made recommendations for remodelling the furniture.

Nursing Assignment 22
I could improve the performance of the discussion by first meeting the carer or close family
members for more detailed information about the client’s tastes and preferences
Steps on areas on improvement
i. Conduct a client assessment with the help of the family members
ii. Attend oral communication seminars
iii. Undertake basic training on risk identification and arrest
Examples of AAC to help people with disability to reach their personal goals
i. Pictures
ii. Symbol communication boards
QUESTION 1: Demonstrative/Role playing activity
My behavioural support plan for the student
i. Identify problem behaviours of the student
ii. Observe and record behaviour
iii. Analyse the collected behaviour on data
iv. Implement intervention strategy
v. Evaluate the intervention
Use a disruptive behaviour frequency chart to record the time, day and occurence of the
behaviour
QUESTION 3: Response to adverse behaviour
My response to an adverse behaviour by the client will involve the use of an ABC chart as
shown below:

Nursing Assignment 23
Date/
Time
Antecedent
(Explain what occurred before
the behaviour)
Behaviour
(Describe what the
client is actually
doing. Describe
where it occurred,
who was in the
room, and how long
did the incident
occur)
Consequence
(Describe the
outcomes of the
behaviour)
QUESTION 2: Individualised behavior support plan
Depending on the details of a client provided by the tutor. You should first shortlist the needs
of the client. The support for this client will be the solutions to the needs. Measure to prevent
the adverse behavior will involve ways in which you can prevent the behavior from taking
place again (but the measures must not contravene the basic rights of the client). The ways in
which you can react if the adverse behavior re-occurs is through brainstorming on preventive
measures.

Nursing Assignment 24
References
Alonso, M.B., Manso, J.M.M. and Sánchez, M.E.G.B., 2012. Indicators of psychological
abuse associated with the length of relationships between couples. Anales de
Psicología/Annals of Psychology, 28(3), pp.772-779.
Austin, S.B., Roberts, A.L., Corliss, H.L. and Molnar, B.E., 2008. Sexual violence
victimization history and sexual risk indicators in a community-based urban cohort of
“mostly heterosexual” and heterosexual young women. American Journal of Public
Health, 98(6), pp.1015-1020.
Bramble, M., Moyle, W. and McAllister, M., 2009. Seeking connection: family care
experiences following long‐term dementia care placement. Journal of clinical
nursing, 18(22), pp.3118-3125.
Cappuccio, F.P., Taggart, F.M., Kandala, N.B., Currie, A., Peile, E., Stranges, S. and Miller,
M.A., 2008. Meta-analysis of short sleep duration and obesity in children and
adults. Sleep, 31(5), pp.619-626.
Cooper, C., Selwood, A. and Livingston, G., 2008. The prevalence of elder abuse and
neglect: a systematic review. Age and ageing, 37(2), pp.151-160.
Cunningham, H., 2014. Children and childhood in western society since 1500. Routledge.
Di Milia, L., Vandelanotte, C. and Duncan, M.J., 2013. The association between short sleep
and obesity after controlling for demographic, lifestyle, work and health related factors. Sleep
medicine, 14(4), pp.319-323.
Glaser, D., 2009. Emotional abuse. Child Protection, p.64.
Killgore, W.D., 2010. Effects of sleep deprivation on cognition. In Progress in brain
research (Vol. 185, pp. 105-129). Elsevier.

Nursing Assignment 25
King, D.E., Mainous III, A.G., Carnemolla, M. and Everett, C.J., 2009. Adherence to healthy
lifestyle habits in US adults, 1988-2006. The American journal of medicine, 122(6), pp.528-
534.
Kohan, D.E., Rossi, N.F., Inscho, E.W. and Pollock, D.M., 2011. Regulation of blood
pressure and salt homeostasis by endothelin. Physiological reviews, 91(1), pp.1-77.
Manthorpe, J. and Samsi, K., 2012. ‘Inherently Risky?’: personal budgets for people with
dementia and the risks of financial abuse: findings from an interview-based study with adult
safeguarding coordinators. British Journal of Social Work, 43(5), pp.889-903.
Nakamura, K., 2011. Central circuitries for body temperature regulation and fever. American
journal of Physiology-Regulatory, integrative and comparative Physiology, 301(5),
pp.R1207-R1228.
Rosen, T., Lachs, M.S. and Pillemer, K., 2010. Sexual aggression between residents in
nursing homes: literature synthesis of an underrecognized problem. Journal of the American
Geriatrics Society, 58(10), pp.1970-1979.
Sonenshine, D.E. and Roe, R.M. eds., 2013. Biology of ticks(Vol. 2). Oxford University
Press.
Watkins, J., 2009. Structure and Function of the Musculoskeletal System-2E. Human
Kinetics.
Williams, J.K., Skirton, H., Paulsen, J.S., Tripp‐Reimer, T., Jarmon, L., McGonigal Kenney,
M., Birrer, E., Hennig, B.L. and Honeyford, J., 2009. The emotional experiences of family
carers in Huntington disease. Journal of advanced nursing, 65(4), pp.789-798.

Nursing Assignment 26
Appendices
Appendix 1: Aged Care Assessment Referral form