HLTAAP002 Practical Case Study: Confirming Physical Health Status

This HLTAAP002 case study presents three scenarios focusing on confirming a patient's physical health status, particularly in the context of an Enrolled Nurse's responsibilities. The first scenario involves Mr. Frank Hardy, a patient with hypertension and a cerebrovascular accident, requiring the student to analyze vital signs, understand the pathophysiology, define the scope of practice, and identify potential risk factors. It requires an understanding of the roles of different healthcare professionals like dieticians, physiotherapists, and general practitioners in Mr. Hardy's care. The subsequent scenarios require similar analysis and application of knowledge related to patient assessment, care planning, and communication within a healthcare team. The assessment includes questions on various aspects of patient care, reporting hierarchies, and the impact of medical and social history on patient health, aiming to evaluate the student's competency in confirming physical health status and providing appropriate care as an Enrolled Nurse.

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
Student Name: Student ID:
Group: Date:
Type of Assessment
This summative assessment will enable your Assessor to make a judgement of competency based on the submission of
your completed assignments against the requirements of this unit of competency.
Assessor Instructions
The Assessment Benchmark developed for each unit of competency is the evidence criteria used to judge the quality of
performance (i.e. the assessment decision-making rules). Assessors must use these benchmarks to make a judgement on
whether competency has been achieved and to determine if the participant has performed to the standard expected to
meet the unit requirement and learning outcomes. Competency results for each unit are recorded in the Record of
Assessment Form.
Reasonable Adjustment
Careers Australia will allow flexibility in relation to the way in which each unit is delivered and assessed based on the
student’s requirement. The following are the reasonable adjustments for this unit:
Trainer/Assessor must select which of the following is suitable for this unit and DELETE rows that are not
applicable
Reasonable Adjustment for this unit College Based On-Line Delivery
The assistance of a Learning Support Teacher for LLN issues 1 1
Modifications to physical environment, e.g. Wheelchair access 1 1
Changes to course design, e.g. Instead of written assessment task – change to verbal
questioning & assessor to write the answers 1 1
Changes in lecture schedules and arrangements, e.g. Relocating classes to an accessible
venue 1 1
Modifications to computer equipment in the computer lab 1 1
Provision of information or course materials in accessible format, e.g. A textbook in
braille 1 1
Supply of specialised equipment or services, e.g. A note taker for a student who cannot
write 1 1
Assessment Coding
Assessment of this program of study is based on competency-based principles.
S = Satisfactory
NS = Not Satisfactory
Students who fail to perform satisfactorily for the assessment in the prescribed date may be assessed as ‘not
satisfactory’. You are required to be assessed as ‘Satisfactory’ on completion of Assessments assigned by your
assessor for this unit of competency.
Re-assessment
Any re-assessment is conducted as soon as practicable after you have been informed of the requirement to be re-
assessed and have been given the opportunity to be re-trained and assimilate the training. You are re-assessed in only
the areas assessed NS. It is at the assessor/s discretion to re-assess the entire assessment should it be demonstrated an
overall understanding of this unit has not been achieved. Students that are assessed ‘satisfactory’ after re-assessment of
areas deemed NS will achieve competency for this assignment.
I acknowledge the assessment process has been explained and agree to undertake the assessment. I am aware of Careers Australia’s appeals
process, should the need arise. I also understand that I must be assessed as ‘satisfactory’ in all parts of the assessment to gain a competent
result for this unit of competency. I declare that the work contained in this assessment is my own, except where acknowledgment of sources is
made. I understand that a person found responsible for academic misconduct will be subject to disciplinary action (refer to student handbook).
Student Signature: __________________________
Date:
______
Assessor use only
Assessor Comment/Feedback:
Assessor Name: _________________________ Assessor Signature: _____________________________
Date: _________________ Result: Satisfactory/Not Satisfactory
Office use only:
Results entered by: Date: Skills Centre:
19th January 2017 Page 1

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
ASSESSMENT: Practical – Case Study
S/NS result given. A satisfactory result must be attained.
STUDENT INSTRUCTION:
This case study has three (3) scenarios and twenty five (25) associated questions. Please read the three (3)
scenarios carefully and answer ALL of the questions. Use the correct medical terminology when answering
questions.
All of the assessment is to be completed on this word document, saved and submitted via the online portal
within the unit on blackboard.
MARKING CRITERIA:
Sections Questions
Case study 1 Q 1-9
All must be answered correctly to attain a satisfactory
result
Case study 2 Q 10-17
All must be answered correctly to attain a satisfactory
result
Case study 3 Q 18-25
All must be answered correctly to attain a satisfactory
result
Reference text:
Waugh, A & Grant, A 2014,
Ross and Wilson, Anatomy and Physiology in Health and Illness, 12th edn, Churchill
Livingstone Elsevier Australia, NSW.
Clarke, L, Gray, S, White, L, Duncan, G & Baumle, W 2016,
Foundations of Nursing – Enrolled/Division 2 Nurses,
Cengage Learning, Australia.
19th January 2017 Page 2

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
Case Study 1
Scenario 1 – Mr. Frank Hardy (Questions 1-9 refer to this scenario)
Mr. Frank Hardy has been in hospital for three (3) days. He was admitted because of high blood pressure
(hypertension) and a possible stroke (cerebrovascular accident). After further investigations during his
admission, it has been identified that Mr. Hardy has had a cerebrovascular accident affecting his left side.
After reviewing Mr Hardy’s chart you find that he has a significant medical and social history:
Medical History:
 Age: 68 years old
 Current smoker, with a fifty year history of smoking 30 cigarettes daily
 Weight: 135kg
 Height: 180cm
 Hypertension
Social History:
 Mr Hardy is a widow (1 year ago) and lives alone
 There are no children or current support systems
 Mr Hardy has no current services in his home (such as home help, meals on wheels)
Mr. Hardy is currently reluctant to mobilise due to a mild weakness in his left side. Mr Hardy has been
seen by the physiotherapist and given a walking stick to aid with his mobility. He appears to be very
quiet and not willing to engage with staff. He has declined hygiene cares since admission three (3) days
ago. When you review Mr Hardy’s care plan you note that the following cares need to be completed:
 Hygiene cares
 Assist with mobility
 Observations
In relation to the above scenario, please answer the following nine (9) questions regarding Mr. Hardy’s
care both in and out of the hospital and your role as the Enrolled Nurse (EN) providing care for Mr.
Hardy.
1. Mr Hardy has ‘hypertension’ which means high blood pressure.List the parameters for a ‘normal’blood
pressure range and the ranges for hypertension.
2. You have performed vital signs on Mr. Hardy, they are;
 BP135/ 90mmHg, RR 26bpm, P 95bpm, T 40oC.
If the observations listed below are considered the normal for adults, identify which of these observations
are variations from normal levels that have the potential to cause problems with Frank’s health.
T: 36.2 – 37.3oC
P: 60 – 100bpm
RR: 16 – 24bpm
BP: 120/80mmHg
19th January 2017 Page 3

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
3. The term pathophysiology explains the processes and functioning within the body which result in the
signs and symptoms of a disease/s. The ‘relationship’ between body systems is the contributing factor/s
that work together in our bodies to try and maintain homeostasis. Explain the relationship between Mr
Hardy’s respiratory rate and temperature.
As observed from the above reports, it can be observed that Mr. Hardy’s respiratory rate as well as his
body temperatures are found to be high. The relationship between these two parameters is essential for
the maintenance of equilibrium or homeostasis within the body. During the onset of any disease, as
observed in his CVA, which will lead to inflammatory responses, Mr. Hardy’s body temperature will rise.
To cope up this change in an attempt to maintain equilibrium, his respiratory rate will also increase
simultaneously, as observed, which will hasten the regulatory organ functioning in his body to achieve
homeostasis. Hence, the relation between Mr. Hardy’s respiratory rate and temperature is essential for
the maintenance of equilibrium, since body temperature has been documented to be an independent
determinant of the rate of respiration. 1
4. Identify your scope of practice in this situation. List your role responsibility in comparison to a
Registered Nurse (RN) role.
As an enrolled nurse the major role would be to assist the Registered Nurse in helping Mr. Hardy carry out his
activities of daily living an hygiene. The additional role of enrolled nurse would be monitor Mr. Hardy for the
presence of any changes to his health, and report the same to the Registered Nurse immediately. The
Registered Nurse possesses enough competency to administer medications to Mr. Hardy. Hence, the enrolled
nurse must engage in the same, by first learning from the registered nurse and assisting her thereafter. In the
absence of the registered nurse, the enrolled nurse’s scope is to carefully assist Mr. Hardy in his mobility and
hygiene, and report the associated progress reports to the registered nurse. 2
5. As an Enrolled Nurse, identify the reporting hierarchy that you would follow in order to ensure that this
information is relayed appropriately.
1 Kotas, Maya E., and Ruslan Medzhitov. "Homeostasis, inflammation, and disease susceptibility." Cell 160, no. 5 (2015):
816-827.
2 Arrowsmith, Victoria, Margaret Lau‐Walker, Ian Norman, and Jill Maben. "Nurses' perceptions and experiences of work
role transitions: A mixed methods systematic review of the literature." Journal of advanced nursing 72, no. 8 (2016): 1735-
1750.
19th January 2017 Page 4

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
6. Explain and discuss the following three (3) health care professionals’ scope of practice/role in the care
and management when referred to Mr. Hardy.
 Dietician
 Physiotherapist
 General Practitioner (GP)
 Dietician: The dietician would play a key role in the management of M r. Hardy’s hypertension and
deteriorating cardiovascular health through the administration of an appropriate diet plan. A diet rich
in sodium and saturated fats have been documented to cause hypertension and cardiovascular
diseases such as atherosclerosis and the resultant stroke. Hence, the dietician would play a key role in
Mr. Hardy’s recovery through recommendation a low fat, antioxidant rich, high fibre diet. 3
 Physiotherapist: It has been observed that Mr. Hardy is encountering weakness on his left side, which
is resulting in difficulties in mobility. Hence, the physiotherapist will play a key role in the improvement
of mobility by administering physiotherapeutic procedures in Mr. Hardy, such as massages or
stretching will lead to reduced stiffening and enhanced ability to move. 4
 GP: The general practitioner’s role in the care of Mr. Hardy would include the development of a care
plan for him, to be followed by nurses and other professionals involved in his treatment. Further, the
GP may also be involved in obtaining any referral services for Mr. Hardy if needed. The GP would also
play a key role in imparting health education to Mr. Hardy for the purpose of maintaining optimum
health outcomes even after treatment. 5
7. Mr. Hardy has a significant medical and social history. From the case study list four (4)
potentialfactorsthat could have been responsible for the CVA (stroke). In your answer ensure that for
each factor you provide a brief explanation of how/why it could have impacted on Mr. Hardy’s current
condition.
1.
2.
3.
4.
3 Petroni, Renata, Michele Di Mauro, Settimio F. Altorio, Silvio Romano, Angelo Petroni, and Maria Penco. "The role of
bariatric surgery for improvement of hypertension in obese patients: a retrospective study." Journal of Cardiovascular
Medicine 18, no. 3 (2017): 152-158.
4 Oakley, Caroline, and Carol Shacklady. "The clinical effectiveness of the extended‐scope physiotherapist role in
musculoskeletal triage: A systematic review." Musculoskeletal care 13, no. 4 (2015): 204-221.
5 Jose, K., A. Venn, M. Nelson, F. Howes, S. Wilkinson, and D. Ezzy. "A qualitative study of the role of Australian general
practitioners in the surgical management of obesity." Clinical obesity 7, no. 4 (2017): 231-238.
19th January 2017 Page 5

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
5.
8. A functional deficit is a sign or a symptom associated with an illness in a body system or a variation from
normal. These functional deficits can also be identified as potential risk factors when performing an
intervention. Mr. Hardy has several of these risk factors. Using correct medical terminology, list two
(2)potential deficits associated with Mr Hardy’s CVA.
Mr. Hardy has several risk factors of paralysis of the face ,arm or leg on either or both sides of the body,
Difficulty speaking and understanding ,Dizziness loss of balance and an unexplained fall ‘ loss of vision ‘ sudden
blurring and decreased vision in one or both eyes. Headache has severe and abrupt start or unexplained
change in the pattern of headaches. The two main deficits associate with CVA include the following6:
1.Ischaomic:- Caused due to a thrombus which is defined as the formation of clot in blood vessels that
supply the brain .It can also be caused by embolus ,association with when a clot travels from the
heart and block the arteries in the brain.
2. Haemorrhagic:- Caused due to aneurysm or the formulation an outpouch in the artery, further
leading to its rupturing and associated haemorrhage. One of the most prevent symptoms associated
with this deficit is weakness, as observed in Mr. Hardy.
9. As per organisational policy you are taking blood from Mr Hardy for his routine tests. When finished you
note that you leave his arm with a large contusion (bruise). Identify the term used to describe
complications that are caused by treatment from healthcare professionals.
The term iatrogenic is used to describe the complications that are caused by treatment from healthcare
department. For treatment of the above complication, that is the bruise, the nurse must elevate the injured
section during the application of ice, while keeping Mr. Hardy in a lying down or sitting position. The elevation
of the section above the area of the heart helps in the reduction of swelling. The nurse must then gently
massage the area in order to enhance blood flow and decrease pain. 7
End of section one
6 Pandit, R., Mary Mathews, and Shashikala Sangle. "Assessment of neurological deficit among cerebrovascular accident
patient in selected hospital." Int J Health Sci Res 7 (2017): 221-6.
7 Shah, Viraj M., and Reena Nayar. "Iatrogenic iliac arteriovenous fistula with aortic pseudoaneurysm formation post
lumbar (L4-L5) laminectomy and pedicular screw fixation." Korean journal of anesthesiology 69, no. 3 (2016): 305.
19th January 2017 Page 6

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
Case Study 2
Scenario 2 – Mrs. Heather Bishop (Questions 10-17 refer to this scenario)
Mrs Heather Bishop is aneighty (80) year old womanwho is living in the residential aged care facility you are
working in. Before meeting her you quickly review her chart for her medical and social history:
Medical History:
 Weight 50Kg
 Height 170cm
 80 years old
 Menopause at 38yrs of age
 Osteoporosis
Social History:
 Widowed (10 years ago)
 1 Daughter that visits regularly
She is mobile with a walking frame and supervision, however has had difficulty hearing lately. Mrs Bishop is
orientated and alert, and she has no cognitive deficits. As Mrs Bishop walks to the shower, she states that
she is ‘dizzy’andloses her grip on her walking frame. She falls on her right side, you call for help, make her
comfortable and take a set of observations;
 BP: 110/60mmHg, T: 36.5oC, P: 100bpm, RR: 28bpm
You are assisted by colleagues to move her back to the bed, then the resident doctor arrives. The doctor
diagnoses a fractured hip, at the neck of femur (NOF). Mrs Bishop is transferred to a hospital for further
treatment and investigations.
10. If the observations listed below are considered the normal parameters (range) for adults, identify
Heather’s abnormal observations.
T: 36.2 – 37.3oC
P: 60 – 100bpm
RR: 16 – 24bpm
BP: 120/80mmHg
As observed from the given handover of Heather an upon comparison to normal parameter values, it
can be observed that Heather’s blood pressure is abnormally low and her respiratory rate is
abnormally high. While her body temperature seems normal, her pulse is projected to be at the
upper limit of the normal range.
11. Consider Mrs Bishop’s recent hearing loss. Identify and briefly explain thepathophysiology of the
degenerative ear condition that commonly causes hearing loss.
19th January 2017 Page 7

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
12. Mrs Bishop has a significant medical and social history. From the case study list four (4) potential risk
factors that could have been responsible her osteoporosis.
Risk factors for osteoporosis include the following: 8
1. Mrs. Bishop’s old age is a considerable risk factor for her osteoporosis. This is due to the fact that an
individual achieves the highest levels of bone density till the age of 30, after which there is gradual
decline. This reduction puts the aged individual at increased risk of osteoporosis.
2. It can also be observed that Mrs. Bishop has a low body weight in relation to her height, which puts
her at an increased risk for osteoporosis. Underweight individuals possess bones of low density than
individuals possessing a normal weight.
3. Menopause, which Mrs. Bishop has encountered, is key risk factor in the development of
osteoporosis. Menopause results in the reduction of levels of oestrogen, which further leads to
increase in the activity of osteoclasts – or cells responsible causing bone loss or resorption. Hence the
disrupted equilibrium of osteoblastic and osteoclastic activity due to menopause, results in bone loss
and osteoporosis.
4. It is noted that Mrs. Bishop is a female which also increases her risk. Females have less bone density
and thinner bone structures as compared to males, hence increasing the risk of osteoporosis.
13. Discuss the pathophysiology of osteoporosis and relate this to Mrs Bishop’s fractured Neck of Femur
(#NOF).
14. Mrs Bishop must have a surgical repair of her fracture; this means some care will be referred to other
health carers. Explain and discuss the following three (3) health care professionals’ roles,within the
multidisciplinary team in regards to Heather’s care and management whilst in hospital.
 Orthopaedic Surgeon
 Physiotherapist
 Radiologist
 Orthopaedic surgeon: The orthopaedic surgeon appointed for the care of Mrs. Bishop, will play a key
role in operating and performing surgical repair of her hip fracture. Along with the performance of
8 Chen, J-F., T-T. Cheng, S-F. Yu, Y-C. Chen, C-Y. Hsu, H-M. Lai, F-M. Su, BY-J. Su, and W-C. Chiu. "THU0478 Before
and after menopause, osteoporosis risk factors are different in women with rheumatoid arthritis." (2018): 448-448.
19th January 2017 Page 8

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
orthopaedic surgery, he will also engage in educating Mrs. Bishop and her daughter on care and
management of osteoporosis after treatment. 9
 Physiotherapist: The role of the physiotherapist will be to enhance the mobility of Mrs. Bishop prior
to and after surgery, through physiotherapeutic procedures such as massages, stretching or
resistance training which will reduce her pain and stiffness and allow her to move with ease. 10
 Radiologist: The role of the radiologist would be to engage in imaging the affected areas of Mrs.
Bishop, that is her hip, prior to and after treatment, which will allow the registered nurse and other
professionals to view, identify and diagnose her condition effectively. 11
15. A functional deficit is a sign or a symptom associated with an illness in a body system or a variation from
normal. These functional deficits can also be identified as potential risk factors when performing an
intervention. Using the correct medical terminology identify two (2) main functional deficits in Heather’s
body systems necessitating nursing care and or monitoring.
The two main functional deficits in heather’s body systems requiring nursing care and monitoring are reduced
peripheral vision due to changes in eye, and disturbance in sleep due to possibility of pain caused from
fractured hip.
16. You assess Heather’s reported pain level and note that it is a 9/10 and she is not due for medication.
This is an abnormal result and potentially a very serious issue. Consider your scope of practice as an
ENand within organisational requirements. Identify the reporting hierarchy that you would follow in
order to ensure that this information is relayed swiftly and action taken.
9 Bender, Jay S., and Eric G. Meinberg. "Fragility Fracture Programs: Are They Effective and What Is the Surgeon’s
Role?." Current osteoporosis reports 13, no. 1 (2015): 30-34.
10 Cullen, C. M., M. Phelan, S. Harney, and J. Ryan. "FRI0617-HPR An Audit of The Role of A Clinical Specialist
Physiotherapist in Rheumatology Triage." (2016): 1277-1277.
11 Gunn, Andrew J., Mark D. Mangano, Garry Choy, and Dushyant V. Sahani. "Rethinking the role of the radiologist:
enhancing visibility through both traditional and nontraditional reporting practices." RadioGraphics 35, no. 2 (2015): 416-
423.
19th January 2017 Page 9

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
17. Mrs Bishop is ordered a high dose of a strong pain killing medication to be given orally. Consider your
basic pharmacology and pharmacokinetics in Mrs Bishop’s situation. List three (3) factors specific to Mrs
Bishop that may affect therapeutic levels.
Factors affecting therapeutic levels: 12
1. Mrs. Bishop’s old age would be a key factor which would reduce her compliance to the therapy
provided to her.
2. Mrs. Bishop’s widowed status could also be a key factor which would result in her lack of
compliance to treatment, since it has been documented that individuals with their spouses
support exhibit greater compliance to treatment.
3. Mrs. Bishop’s gender can be a key factor which would influence her therapeutic levels since
females have been documented to display greater compliance to treatment.
End of section two
Case Study 3
Case study 3 – Mrs Jane Trenton (questions 18-25 refer to this scenario)
Mrs Jane Trenton is an 85 year old woman who has just returned to the residential care facility from a ten
(10) day hospital stay for dehydrationcaused by gastroenteritis (vomiting and diarrhoea).
You review her chart and find the following:
Medical History:
 Weight 65 Kg
 Height 150 cm
 Age 85 yrs. old
 Urinary incontinence
Social History:
 Partner in care also in facility (different area, dementia ward)
 Five (5) children in different states
 Enjoys social activities at the facility
On admission you perform a full integumentary assessment and vital signs as per organisational policy. Her
vital signs are;
12 Yap, Angela Frances, Thiru Thirumoorthy, and Yu Heng Kwan. "Systematic review of the barriers affecting medication
adherence in older adults." Geriatrics & gerontology international 16, no. 10 (2016): 1093-1101.
19th January 2017 Page 10

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
 BP 110/80mmHg, P 65bpm, R 20bpm, T 36.5oC
 UrinalysispH- 5, SG-1010, Glucose- Neg, Ketone- Neg,Protein- Neg, Leukocytes- Neg, Blood (RBC’s)-
Neg
On inspection of Jane’s skin you find an area oferythema (dark red in colour) that does not blanch (go white)
when gently pressed. The area, over her left hip is raised but the skin remains intact. This appears to be a
pressure injury. Jane appears to be in some pain as you move her and gently touch the red area. Mrs
Trenton is not usually independently mobile and requires assistance for transfers and a wheelchair to move
around in. When in bed she needs to be frequently turned to prevent pressure injuries.
In consultation with the RN you dress the area to prevent further pressure and Jane’s care plan
documentation is adjusted to reflect 2nd hourly turns. You ensure that Jane has a clean,dry continence pad
on before settling her into her chair.
18. The following are considered normal values for urinalysis:
 pH 4.6- 8, SG-1.015- 1.030, Glucose- Neg, Ketone- Neg, Protein- Neg, Bilirubin- Neg, Nitrites- Neg,
Leukocytes- Neg, Blood (RBC’s)- 2-3HPF (Clarke et al, 2016)
Identify which of Mrs Trenton’s urinalysis results are considered a variation of normal and a potential
risk for poor skin integrity.
Upon comparison it can be observed that Mrs. Trenton’s urine’s specific gravity level is abnormally low,
which indicates dehydration. The presence of dehydration puts one at a risk for poor skin integrity. 13
19. The skin is the largest organ in the body and has a surface area of 1.5 -2m2 in an adult. Identify four (4)
functions of the integumentary system.
20. When functioning normally the skin comprises of three layers, the epidermis, dermis and subcutaneous
tissue. Mrs Trenton has a pressure injury that threatens to progress into her dermal layer. Identify four
(4) structures found in the dermis.
1.
2.
3.
4.
21. Pressure injuries can be caused by different factors. In Jane’s case the cause was likely to be pressure
from decreased mobility whilst in hospital. Identify two (2) other potential risk factors for Jane that
could be responsible for her pressure injury.
The two factors include: 14
13 Wilson, Mary. "Incontinence-associated dermatitis from a urinary incontinence perspective." British Journal of
Nursing27, no. 9 (2018): S4-S17.
14 Beeckman, Dimitri, Aurélie Van Lancker, Ann Van Hecke, and Sofie Verhaeghe. "A systematic review and meta‐
analysis of incontinence‐associated dermatitis, incontinence, and moisture as risk factors for pressure ulcer
19th January 2017 Page 11

STUDENT
Practical– Case Study
HLTAAP002 Confirm Physical health status
1. The first key risk factor which is responsible for her pressure injury is her age, since old age people find
it difficult to move on their own resulting in ulcer development.
2. The second risk factor responsible for her pressure ulcer is her condition of urinary incontinence which
results in damage to the skin in the form of reddened areas which blanch upon application of pressure.
22. Mrs Trenton is 85 years old. As people age their bodies change and normal function can be
compromised. Explain the degenerative changes that occur to the skin as a result of ageing.
23. In order for wounds to heal certain conditions need to be met both locally and systemically. Identify two
(2) local and two (2) systemic conditions that would delay wound healing.
Local15
1. Dessication or lack of hydration delays wound healing since a dry environment would lead to
dehydration of the cells of the affected area, leading to their death.
2. Maceration: Presence of urinary incontinence can delay would healing due to its negative effect on
the skin integrity of the affected individual.
Systemic16
1. Old age or aged individuals display greater delaying in the wound healing process, due to the delayed
metabolic and immunological functioning associated with ageing.
2. Obesity also delays wound healing since a in overweight individuals, blood supply is delayed
due to excessive accumulation of adipose tissue in the individual.
24. Mrs Trenton is ordered medication to help with pain (such as paracetomol), to be given orally. Consider
your basic pharmacology and pharmacokinetics in Mrs Trenton’s situation. List three (3) factors specific
to Mrs Trenton that may affect the therapeutic dose being reached.
development." Research in nursing & health 37, no. 3 (2014): 204-218.
15 Eming, Sabine A., Paul Martin, and Marjana Tomic-Canic. "Wound repair and regeneration: mechanisms, signaling, and
translation." Science translational medicine 6, no. 265 (2014): 265sr6-265sr6.
16 Zhao, Pan, Bing‐Dong Sui, Nu Liu, Ya‐Jie Lv, Chen‐Xi Zheng, Yong‐Bo Lu, Wen‐Tao Huang et al. "Anti‐aging
pharmacology in cutaneous wound healing: effects of metformin, resveratrol, and rapamycin by local application." Aging
cell 16, no. 5 (2017): 1083-1093.
19th January 2017 Page 12