Federation University: HLTENN013 Knowledge Assessment Task - Nursing

This document presents a completed knowledge assessment task for the HLTENN013 unit, "Implement and Monitor Care of the Older Person," within a Diploma of Nursing program. The assessment requires the student to analyze three case studies of elderly individuals, addressing various health concerns and social situations. The student is tasked with identifying and evaluating common stereotypes associated with aging, discussing their personal values and beliefs regarding the elderly, and outlining potential impacts of these stereotypes on older individuals. The assignment also requires the student to interpret the provided case study information, considering the patient's medical history, current condition, and medication regime to identify potential nursing interventions. The student must answer questions related to each case study, demonstrating an understanding of aged-related health issues, disease management, and the application of nursing principles to provide appropriate and effective care. The scenarios incorporate elements of disease processes, management of diseases, families, environment, care settings, legal and ethical issues, pain management, documentation, safety, understanding of the ageing process, and Nursing Professional Standards. The assignment aims to develop a sound understanding of aged related issues and health problems, identifying any variations from normal and responding accordingly within a health care setting.

Knowledge Assessment Task
U N I T
C O D E HLTENN013 U N I T
T I T L E Implement and monitor care of the older person
Qualification
Code HLT51445 Qualification
Title Diploma of Nursing
Task Number 1 of 3 Task Name Case studies of the older person
Description of assessment task to be completed ☐ Additional content attached
• This is one of three assessments you need to complete to be deemed competent in this unit.
• You are required to answer questions after reading three (3) aged related health scenarios provided by the assessor that are typically
seen in the elderly population, and provide written responses to the accompanying questions.
• You are required to consider and analyse the health information and the clinical presentation of three older people in the case studies
provided to reach an accurate conclusion on possible nursing interventions related to their care.
• This assignment will allow you to provide evidence of researching (but not limited to):-
o disease processes,
o management of diseases,
o families,
o environment,
o care settings,
o legal and ethical issues,
o pain management,
o documentation,
o safety,
o understanding of the ageing process,
o Nursing Professional Standards.
• The emphasis of these scenarios is developing a sound understanding of aged related issues and health problems, identifying any
variations from normal and responding accordingly within a health care setting.
• The scenarios are based on real people (written and provided by the assessor which is incorporated into this assessment).
• You will be assessed against criteria listed in the marking guide
• This assessment will be completed in your own time and location throughout the units scheduled timetabled timeframe
Conditions of assessment
• This is an individual task. Youmay only receive minimum guidance from your assessor during the assessment. All responses listed
must be completed satisfactorily to the standard required.
• You must be assessed by a qualified assessor who holds a minimum Certificate IV in Training and Assessment (TAE4011).
• There is no minimum or maximum time allowed to complete this assessment. It is up to your discretion; however must be submitted
by the due date (see Unit Outline).
• Assessment will take place out of class, in your own time and location of your choice.
• You will be assessed according to the criteria listed in the marking guide.
• Learning material delivered throughout the unit will assist you to research further and guide you to complete the written assignment
(see Moodle).
• Include links or reference of any websites or books referred to throughout this assessment (no more than five (5) years old).
• You must submit via password protected University website (MOODLE) by the due date in the relevant section. By submitting via
MOODLE, you agree that in lieu of signing the student coversheet, you agree that all your responses provided are the product of your
own work. This will support the authenticity of the evidence.
• It is expected all documents will be completed electronically, however, if this is not possible, make alternative arrangements for
submitting the assessment with the assessor.
• You must save a copy of your work and be responsible for your own time management.
• Valid extension requests must be discussed with the teacher and approved by the teacher/course coordinator at least three days prior
to the due date.
• Late submissions other than those approved will be assessed and regarded as a resubmission.
• Your responses are to be typed directly under the questions on the document supplied. Your work must be well presented, using
industry preferred language, with accepted medical abbreviations (if applicable).
• No marks or grades are allocated for this assessment task. The task will be resulted as Satisfactory or Not Satisfactory.
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 1 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
U N I T
C O D E HLTENN013 U N I T
T I T L E Implement and monitor care of the older person
Qualification
Code HLT51445 Qualification
Title Diploma of Nursing
Task Number 1 of 3 Task Name Case studies of the older person
• VET students are entitled to two (2) assessment attempts for each assessment task within a unit enrolment period in accordance with
Federation University Australia Statue 5.3.
• Students will be assessed according to the criteria listed in the marking guide.
Suggested resources (but not limited to) for the student to use are below.
 Australian Government, Department of Health and Ageing, http://www.health.gov.au/
 Kozier and Erb’s Fundamentals of Nursing
 LemoneMedical Surgical Nursing
 Australian Government: http://www.australia.gov.au/
 World Health Organization: http://www.who.int/en/
 Human Rights: Ageism - http://www.humanrightsactionplan.org.au/nhrap-blogs/ageism-is-a-human-rights-issue
 Osteoporosis Australia: http://www.osteoporosis.org.au/about/about-osteoporosis/what-is-it/
 MIMS online (via Federation University Library web link)
 Alzheimer’s Australia
• You must complete and sign the attached coversheet and submit it with your work.
Duration of assessment/ when assessment is due
This assessment will be given to you within two (2) weeks of the beginning of the unit.
This assessment should be worked on progressively throughout the delivery of the unit (see current timetable).
You should begin working on this assessment immediately and submit on or before the due date (see unit outline)
Material and resource requirements
Student to provide Assessor to provide
Stationary
Class notes / textbooks relevant to topic as per booklist
Location of your choice to complete assessment
Computer / internet access
Class notes to assist with assessment via password protected
site MOODLE
Assessment task accessed via password protected site
MOODLE
Library access / IT access (during opening hours)
Teacher assistance by appointment
Submission details
• You must submit via password protected University website (MOODLE) by the due date in the relevant section.
• All work is to be typed
• Save your document under SURNAME, Initial, Student number, AT1 and upload into the Task 1 assessment MOODLE link
• By submitting via MOODLE, you agree that in lieu of signing the student coversheet, you agree that all your responses provided are
the product of your own work. This will support the authenticity of the evidence.
Satisfactory completion of assessment
To successfully complete this assignment you must:
• Answer all questions correctly and appropriately.
• Submit this assessment task by the due date according to the instructions above.
Additional information
Glossary of terms for clarification in case studies:
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 2 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
U N I T
C O D E HLTENN013 U N I T
T I T L E Implement and monitor care of the older person
Qualification
Code HLT51445 Qualification
Title Diploma of Nursing
Task Number 1 of 3 Task Name Case studies of the older person
• LIST provide a number of connected items or points (often expressed onebelow the other)
• OUTLINE highlight main features without going into detail
• EXPLAIN give supported reason for; interpret meaning
• IDENTIFY name the issues, show
• EVALUATE look at reasons for and against and draw conclusions
• JUSTIFY provide reasons for a decision, viewpoint
• DISCUSS look at reasons for and against
• DESCRIBE give details using examples to illustrate
• RATIONALE explain reasons why
• RELATE make or show connections, relationships and associations
• STATE express a position clearly
• SUMMARISE give a concise account of the main points of something, omitting details
Page left blank intentionally.
Please continue on the following page
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 3 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
Questions ☐Additional question sheet attached
Eg. With diagrams, photographs etc.
Case Study 1
John Arthur Shaw is a 76-year-old man.
John lived in inner Sydney until 2011 when he & his life partner Malcolm moved to a small farmlet near Ararat, where they ran a
variety of small animals including chickens, sheep & alpacas. They also had John’s horse Micah which he bought when they
acquired the farmlet. John’s most recent history of employment up until retirement was teaching disabled children to ride horses. He
had worked in this role for 11 years. Prior to that he worked in a racing stable as a strapper.
John’s family live in the Ararat area. He has a good relationship with his twin brother Peter & elder sister Meredith, but has a very
strained relationship with his youngest sister Kristine. Brother Peter & sister Kristine do not communicate with each other at all. This
poses some difficulty with communication with the family. Peter has John’s enduring power of attorney and his sister Meredith has
his financial power of attorney.
John’s life partner Malcolm died 3 months ago & it became obvious that John was far more dependent on Malcolm than was realised
by his family. Malcolm had taken over managing John’s medications with the help of a Webster Pack from the community
pharmacist. Malcom also assisted John with his showering, dressing, cooked all the meals and maintained the home.
John’s GP has recently retired & his new GP does not know him very well.
John was admitted to residential care shortly after Malcolm’s death. On admission John was noted to have some shortness of breath
on exertion, his blood pressure was slightly elevated at 135/90, he also complained of recent indigestion after meals. John has lost 5
kg in weight in the last three (3) months and is becoming more unsteady on his feet, requiring the furniture to hold onto as he moves
around. John also had a medical history of cardiac failure.
John is noticeably forgetful and becomes distressed when he cannot find Malcolm & wants to go home to see his animals. John has
not has not made any effort to join in with residents or staff in the facility & keeps to his room. He is often found in a tearful state.
There is no past history of depression noted in his medical file.
It is also noted that John has a past history of cancer of the throat that has been in remission for the past five (5) years. He
sometimes has swallowing difficulties & choking episodes in relation to this. John suffers from recurrent mouth ulcers, and is
currently being treated for thrush. John has upper & lower dentureswhich he is unable to care for independently.
John has very dry skin, and his skin tears very easily.His skin shows evidence of past skin cancer removal, although there is no
official record of this located in his medical file. He also has frequent episodes of senile purpura on his arms.
John is able to manage his shower under supervision, but is unable to dress himself without assistance. His oral care is attended to
by the staff.
Malcolm cooked all of their meals, providing John with a soft diet. John is sometimes non-compliant with his diet, and particularly
with his fluids. He especially hates thickened fluids. John has been assessed by the speech pathologist as continuing to require the
soft diet andthickened fluids.
Johns’ medications are as follows:
 Lanoxin PG 1 tab daily (check pulse). (62.5mcg daily)
 Lasix 20 mg mane
 Nilstat drops (Dose: 1ml QID)
 Bonjela mouth gel:
 mane, after oral hygiene after breakfast, and
 nocte, after oral hygiene before settling for the night
•
Please note: The tablets in Johns’ medication chart are crushed & mixed in apple puree.
After reading John’s story, please answer the following questions
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 4 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
1
Question: Identify three (3) common stereotypes or myths associated with ageing.
Answer: Old age, (dementia, sick, dying) Depression
Unfortunately theOld age Ageist stereotypes are persistent in our culture.
Some of the myths and stereotypes associated with ageing include:
1. Dementia affects only the older people- This is a common myth about the senior people, whereas the reality is
though most people with dementia are over 65 years of age, but, a small number of people who are in the age
group of 40-50 are also likely to develop dementia.
2. Older aged people are depressed- While, many finds that aging is depressing, the reality is seniors are among the
happiest person provided that are surrounded by their family members and receive love and care.
3. All older people are sick and unwell- It has been seen that the majority of old people are active and healthy. “In 2011
only 6% of people aged 65 and older lived in nursing homes (67%) and retired or aged care facilities (25%)”.
2
Question: Identify two (2) potential impacts these myths or stereotypes may have that can adversely impact on the older
person.
Answer:missed diagnosis and care can be a big impact on johns health
Since, John’s pharmacist doesn’t know him well and not unaware of his forgetful state therefore, it could be difficult for
both of them to deal with. If John misses diagnosis and treatment due to his forgetful nature it can have an adverse
impact on hishealth.
3
Question: Reflecting on the myths and stereotypes you identified previously, discuss your own values, attitudes and
beliefs towards ageing and the older person.
Answer:Older people are often considered to be an economic burden to the society whereas the reality is older people
make contribution to the economy. It is believed that older people are only affected with dementia whereas people of
age group between 40-50 are also susceptible to dementia. It is also believed that old people are depressed because of
their old age, but studies have shown that they are the happiest person. Happiness is followed by a Shape curve with
lowest age at 40 and then grows eventually with age.
4
Question: With your own values and beliefs, how might you ensure (within your scope of practice) your values are not
enforced onto others?
Answer: We all have our own principles, views and behaviors as natural humans, which we have evolved throughout our life. Our
family, friends, society and interactions all add to our understanding of who we are and how we look at the world. Nurses,
working as community workers often work with sensitive individuals and/or individuals who can live a culture that society
considers is distinct or inappropriate. To provide a service that meets the needs of target groups and helps them feel empowered
as community services workers, nurses need to be aware of their personal values, beliefs and attitudes and be prepared to
accept the professional values of industry and not impose one's own ideas on the patients.
5 When considering the normal physical changes associated with ageing, each body system is directly affected.
Question: Identify and discuss these changes for the systems below that relate directly to John.
(What is happening to John’s body and why is it happening? (Look at the pathophysiology)
 Integumentary – increased skin dryness, due to decrease sebaceous gland activity, which explains the john’s high risk of skin
tears and skin dryness.
 Sensory/perceptual – decreased sense of taste, reduced saliva which has resulted in john with having dry mouth, as John is
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 5 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
struggling with swallowing this could indicate why Johns poor diet intake.
 Cardiovascular/Respiratory - reduced cardiac output and stroke volume, increase in diastolic and systolic blood pressure,
john
 Gastrointestinal – delayed swallowing time, this results in alterations in swallowing mechanism, indigestion
 Urinary/Renal- incontinence, dehydration
 Immunological/ Oncological disorders- Immune system becomes less effective, which can result in resistance to infectious
diseases
Answer:
 John is prescribed with Bonjela mouth gel can have side effect such as skin dryness and that is why his skin often
tears.
 Lanoxin has side effects including loss of appetite, slows down heart rate thereby increases cardiac output and
stroke volume and reduces systolic blood pressure.
 Since he had throat cancer, he has lost appetite and has a slow mechanism of metabolism.
6
Question: Identify two (2) common side effects for Lasix and two (2) common side effects of Lanoxin.
Answer: Do not answer.
7
Question: Considering Johns circumstances, identify two (2) potential psychosocial considerations that may impact
John’s family and/or carers.
Answer: Adjusting to moving in to residential aged care facility, remaining in contact with family members
8
Question: Identify two (2) common side effects of each medication that John is taking.
Answer: Lasix – dehydration, nausea Lanoxin – dizziness, fast pounding or irregular heartbeat.
• Lanoxin PG 1 tab daily (check pulse). (62.5mcg daily)- Loss of appetite, anxiety.
• Lasix 20 mg mane-itching or rash, weakness (Healthdirect.gov. (2019).
• Nilstat drops (Dose: 1ml QID)- Nausea or vomiting, stomach pain.
• Bonjela mouth gel-skin dryness, tongue or throat swelling.
9
Question: Who would you report your concerns to about the information you have learned regarding John’s medication
and common side effects? (Excluding the doctor). How would you report your reporting actions?
Answer: RN on duty or Nursing unit manager, document in progress notes.
10 Question: Identify one (1) nursing intervention can you provide to John to assist with his dehydration?
Answer: encourage fluids
 Nurse should encourage patients to drink small amounts of fluid throughout the day gradually, rather than
drinking a large quantity at once.
 Nurse should not give coffee, alcohol or high protein drinks, particularly in large quantities since they have a
diuretic effect that can lead to a greater loss water from body.
 Foods that are has high amount of water like fresh fruits, and dairy products must be given to patients to meet the
daily water requirement.
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 6 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
11
You are about to assist John with his morning hygiene. You have read the care plans provided regarding John’s care, however, you
would like to determine Johns understanding of the care provided by staff.
Question: Identify and provide an example of two (2) open ended questions you would ask John in determining his
abilities and limitations in ADL’s? (Try to understand and ascertain what John thinks/believes he needs assistance for).
Answer: How much assistance do you need with showering? How can I assist with your hygiene
12
Question: Identify two (2) possible nursing interventions for John that you would consider implementing regarding
personal hygiene and activities of daily living. Provide a rationale for your response.
Answer: Medication – if John is having trouble with pain this could potentially decrease pain levels and be more comfortable for john
with attending personal hygiene.
13
After spending time with John and performing his ADL’s, you become aware that the details of his care plan require some
modifications, or are not the same as the abilities he had when with him, (i.e, unable to stand in the shower, unable to dress
himself, unable to perform oral hygiene, unable to shave himself, etc.).
Question: When implementing changes to a persons’ care, and in this situation, Johns’ care, what are the correct
processes that you must follow?
Answer: assess patients care needsunder direction of RN
14
Too often, oral care is overlooked when caring for all patients, and constitutes unprofessional care.
John’s oral health is linked to his overall general health and well-being, in fact, as are all patients in our care.
Question: Identify three (3) factors related to oral health that specifically affect John. Provide a rationale for your answer,
linking your response to overall heath. (You may need to review his scenario to answer this question).
Answer:
 Poor oral hygiene can contribute to mouth ulcers.
 John is having difficulties to maintain dentures.
 He also has poor nutrition which contributes to ill-fitting dentures.
You have completed all care for John at this point during your shift, and are happy that you provided person centred, professional,
high level care to John. At this point, you have handed over important information to the person in charge, and have documented
the care and/or concerns you have had.
Your next patient is now waiting for you.
Please continue on the following page
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 7 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
Case Study 2
Violet Maria Lucio is a married 70yearold Italian lady. She has (four) 4 married children and five (5) grandchildren, who all live in
Queensland.
Violet lived at home (with her husband Leo) until 6 months ago when she was admitted to permanent care, following a 2-week
respite admission to enable her husband to have some minor surgery. Leo and Violet have been married for 45 years. Violet’s
husband visits daily and takes her home every Saturday after lunch for the afternoon, bringing her back to the facility after the
evening meal.
Staff have reported concerns with regard to her safety during these visits, as she noticeably smells of semen when her personal
hygiene is completed following her return. Violet shows no obvious evidence of distress following these visits home.
Violet was known as a strong & vibrant lady. She has been an active member of a service club in her local area. Her past
employment was providing domestic care: house cleaning etc., as this was the only form of employment her husband would allow.
She was active in this employment until six years ago, when it became evident that there was an obvious decline in her ability to
function in this role. On one occasion she placed her client’s vacuum cleaner out in the shed & it was not found for several weeks.
She also scorched several of another clients’ business shirts when completing the weekly ironing without mentioning it to her clients.
Violet thought nothing of it.
Quite often staff have found Leo closed off to any form of communication regarding Violets’ care. He doesn’t participate in any
dialogue with staff, only responding with a grunt or a nod of his head to acknowledge staff. He does not answer direct or indirect
questions. Staff have tried a variety of communication techniques: all to no avail.
Violet has a medical diagnosis of:
- Pick’s Disease
- Osteoarthritis (OA), (most notable in her hands and shoulders)
- Type 2 diabetes (T2DM)
- urinary and faecal incontinence
- hearing andvision impairment (often does not wear hearing aids or glasses)
Violet is unable to verbalise her needs or wants (due to Pick’s disease and reverting to Italian language), and it is difficult to know
just how much she understands when being spoken to.
Often Violet exhibits extreme restlessness and some agitated behaviours, such as pacing. If she is not pacing or fiddling, Violet
constantly runs from one end of the facility to the other. She repetitively tries to open external doors, and constantly perspires. Staff
find itchallenging to ensure adequate diet & fluid intake due to her constant physical activities.
Violet has a legal restraint order specific for a table and chair for meal times only. Her daughter Louisa is adamant she wants her
mother to be restrained in the chair for longer periods of time to ensure she is “rested”. Violets arms & legs never stop moving during
the meal restraint time. She also rocks back & forward in the chair, moving it along the floor.
Showering, personal hygiene and continence management also present a problem with her constant restlessness & pushing to get
moving.Staff are concerned for the safety of the other frail residents, as Violet pushes people out of her way when running from one
end of the facility to the other.
Violet sleeps well once settled in bed, although the settling takes some time as she keeps getting out of bed.
Muscular rigidity is evident when first rising in the mornings. Her shoulders (most noticeably her right shoulder) are very painful first
thing in the mornings.
Violet’s BGL’s vary between 4.0mmol/L and 6.4mmol/L. They are often much higher when she returns from her afternoon out with
her husband.
Violet’s weight is 56 kg and Violet is 176cm tall.
Violet eats a soft diet; she eats very quickly, and is very restless at meal times. Two (2) meals are provided for her at each mealtime
as per the dieticians’ orders to assist in maintaining energy and weight.
Violets medication includes the following:
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 8 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
 Panadol-Osteo SR 665mg (2 tabs TDS).
 Metformin 500mg mane &nocte
She takes these whole. Staff need to be vigilant to ensure they are all ingested as she has previously been observed spitting these
out.
15
When considering the normal physical changes associated with ageing, each body system is directly affected.
Question: Identify and discuss these changes for the systems below that relate directly to Violet. (What is happening to
Violet’s body and why is it happening? (Look at the pathophysiology).
 Musculoskeletal
 Gastrointestinal
 Urinary/Renal
 Reproductive
 Endocrine
 Cognitive/Neurological
- Answer:
- Musculoskeletal: Violet has osteoarthritis in her hands and shoulders, which means that she suffers from an active
degradation of articular cartilage.
-
- Gastrointestinal: Violet has been observed to eat her meals fast and suffers from faecal incontinency that might lead to
abdominal pain and discomfort. Thus, to decrease the probability of diarrhoea, nausea and gas in the bowel, she has been
allotted a soft diet plan.
 Urinary/Renal: Inconsistency in urination, she is diabetic. Reproductive: She is 70 years old and has crossed her prime reproductive years. But, after her home visits to her husband,
she has been found to smell of semen. Endocrine: In a diabetic patient the body is unable to respond effectively to insulin, which can also result in higher than
normal blood glucose levels. Medications for type 2 diabetes include those which help to increase insulin sensitivity, those
which stimulate the pancreas to release more insulin and other medications which inhibit the release of glucagon.
 Cognitive/Neurological: She has Pick’s disease which is a neurodegenerative disease.
16
Question: Identify two (2) potential psychosocial considerations as a whole for Violet, taking into account her physical age
related changes.
Answer: Potential Psychosocial Considerations-
1. Violet is suffering from pick’s disease which is a sort of Alzheimer-like dementia, but much less so. It affects parts of the
brain which control emotion, conduct, personality and language. The disease is also a type known as frontotemporal
dementia FTD or frontotemporal lobar degeneration FTLD. Pick's disease has traditionally been a set of neurodegenerative
diseases that show signs of frontal and temporal lobe dysfunction. A distinguishing feature of the disease is tau protein
build-up in neurons that accumulate in soft silver, spherical aggregations called "pick bodies".
2. She was facing language and thought challenges, efforts to distance themselves from the family, behavioral changes,
unreasonable anxiety, irrational fears, compulsive buying disorder (CBD or oniomania), poor social behavior regulation (i.e.
etiquette breaches, vulgar language, lack of tact, disinhibition, perception), passivity, low motivation (aboulia), inertia,
overreaction and Overacting.
17
Question: Identify at least four (4)) common possible aged related side effects of the medications Violet is taking?
(Minimum of two (2) for Metformin & minimum of two (2) for Panadol-Osteo).
Answer: Metformin - Heartburn, stomach pain Panadol osteo – Nausea, constipation
18 Question: What is the nature of Violet’s dementia and how does her dementia typically present clinically?
Answer: A type of Alzheimer-like dementia, but much less prevalent. They affect components of the brain which are
emotional, behavioral, personal and language controlled. This is also a sort of disease recognized as FTD or FTLD. A
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 9 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
distinguishing feature of the diseased condition is the development of tau proteins in neurotic aggregations, which
accumulate into a silver-staining and spherical aggregation called "pick bodies". Typically, Pick's disease has been a
group of neurodegenerative diseases with signs of frontal and temporal lobe disorder. The use of "Pick's disease as a
clinical treatment is now more frequently known as frontotemporal dementia by experts.
19
Considering Violet’s medical conditions and nursing interventions that staff are performing, Violet is becoming incontinent of bowel
and bladder more frequently.
Question: Identify 2 continence management strategies to support Violet (excluding catheterisation).
Answer: Aids to support incontinence- While urinary incontinence is common in the elderly population, it can still be
improved or managed effectively through efficient therapy choices. These recommendations include lifestyle activities
and behavioural therapies to be carried out on their own, as well as environmental changes that improve access to the
toilet.
Toileting schedule program- Timed voiding is frequently used with older adults suffering from cognitive impairment,
generally at specified times (e.g. 1:00, 16:00, 19:00, and so on). There are no efforts to make the elderly person aware of
urinary incompatibility or attempt to restore invalid habits.
20
Question: Identify and describe four (4) nursing interventions or strategies for managing Violets’ dementia as a
progressive neurological condition.
Your response must consider distraction and behavior modification strategies.
Answer: validation therapy: in simple terms, validation should be used to reduce Violet’s erratic display of behavior.
Validation will help Violet in sharing her distresses with the nurse. The nurse will be acknowledging her emotions and
feelings which will help Violet understand the feel good nature of the nurse.
Aromatherapy: this will help Violet evoking pleasurable emotions and reduce the display of aggression. Melissa balm and
lavender are the two most common oils which are used for giving aromatherapy to the patients who are suffering from
dementia.
21
As you know Violet reasonably well, you have been asked to assist with the development of a care plan for Violet that includes time
with the lifestyle staff, who is new to the facility.
Question: Identify four (4) activities that you could suggest that would be appropriate for Violets. You must consider
gender, cultural background, age,and dementia. Please also consider Violet’s possible likes and dislikes? Provide a
rationale for your response.
• Answer: Exercise and physical activity.
• Reminisce about their life.
• Engage them in their favourite activities.
• Go in and out.
• Explore nature.
• Read their favourite books.
22 Question: Identify three (3) important environmental aspects you would need to consider to maintain Violet’s physical,
social and emotional state when providing care. Provide a rationale for your response.
Answer:
1. Exercise and physical activity- Exercise and physical activity can have many benefits for persons with dementia. It
can help control sleep and avoid restlessness and insomnia at night. It can also help maintain a good mood and
reduce the risk of depression.
2. Reminisce about their life- In people who live with dementia, long term memory often remains stronger for longer.
It can be great to engage them in discussions or activity about their life.
3. Go out and about- Dementia people often speak of boredom or not being able to get out, so this can be a great
route to meet this need and to have varying stimulus.
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 10 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
23
How staff respond and communicate to people living with dementia can have profound effects on a person’s wellbeing.
Violet’s ability to communicate verbally is declining significantly.
Question: Identify four (4) barriers to effective communication that are relevant to Violet. Include strategies to overcome
these barriers in your response.
Answer:
1. Language barriers.
2. Cognitive impairment therefore difficult to understand what the nurse says.
3. Problem interpreting whatever said.
4. Unable to understand and comprehend.
24
You believe that you are doing everything correctly and appropriately for Violet, and are providing high quality, professional person
centred care. However, when you try to involve Violet in your planned activities, Violet has no inclination to do so and begins to
become distressed, displaying behaviours such as verbal abuse, physical agitation, and displays some risk-taking behaviours
(wandering into unsafe areas, removing items from walls, etc.).
Question: Discuss how you would manage this situation.
Answer: experiencing such behaviours are common for a nurse who is taking care for a mentally challenged person.
These symptoms can be controlled by letting the patient indulging in activities that distract them from such violent
memories. The patient should be encouraged to talk more to share their fears and worries to let themselves feel
relieved. This will help the patient in comforting and reducing the erratic behaviours.
25
Question: List 4 potential triggers for behaviours of concern.
Answer: Pain, anxiety over a bad past, visualization of a similar memory in the present time and hyper sexuality.
26
Violet’s family come to visit as often as they can, however, they are finding it challenging to cope with her changing behaviours and
moods when they visit, and find understanding their mother’s condition difficult. The staff who work with dementia sufferers often use
many reputable services within the community to assist in working and understanding dementia.
Question: Taking into consideration the impact on staff and family of complex issues and conditions surrounding Violet,
where might family and staff receive support and information, including training?
Answer: There is a National Dementia Foundation present in all the states of Australia to help the families and the staffs of
people suffering from dementia. It helps the people getting aware of the impact of the illness dementia and identifying
relevant strategies for the appropriate care for the patients.
27 You have heard some staff say they would like to restrain Violet as she is becoming physically aggressive when her ADL’s are
attended to (as her dementia progresses), and that by restraining Violet, this would stop her from going into unsafe areas, and the
risk of causing harm to others and herself would be eliminated.
Question: Identify a current definition of restraint that is applicable to nursing.
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 11 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx

Knowledge Assessment Task
Answer: device or action that interferes with a person’s ability to make a decision or which restraints their free movement
28
Question: Identify what is meant by:
- Physical restraint – the intention to restrict a person’s voluntary movement or behaviour by a device or removal of
mobility aid, or physical force.
- Chemical restraint - being medicated to control behaviour when no medical condition is identified
- Psychologicalrestraint / Aversive treatment practices –unpleasant physical, sensory or verbal stimuli in an attempt
to reduce undesired behaviour
- Environmental restraint – limiting a person to a particular environment
Answer:physical restraint: bounding Violet in a wheelchair.
Chemical restraint: Violet takes the medicines but has a tendency to spit it out.
Environmental restraint: restraining Violet to some areas in the facility to caution other patients from harm.
29
Question: Discuss six (6) alternatives to restraint
Answer: minimize or prevent harm, high low bed, provide specific activities and programs to meet Individual needs, use
alarm systems, address physical triggers provide distraction
30
Question: Can we legally restrain Violet for longer periods as per Louisa (the daughters) request?
Provide a rationale for your answer and relate it to Violet’s daughter’s request.
Answer: legally we are not to restrain violet and will need to be discussed with daughter that under guidelines it is not
recommended.
31
As part of Violets care you and your colleagues are providing, many assessment documents (or tools) have been completed during
her admission.
Question: Identify three (3) nursing assessments you would consider using in consultation with a registered nursein
regards to Violets’ care and condition, in particular, if/when her condition deteriorates rapidly.
Link the assessments to the appropriate documentation / charts (tools).
Answer: behaviour assessment, food and balance chart.
Page left blank intentionally.
Please continue on the following page
Warning: Uncontrolled when printed! The current version of this document is available from our website.
Authorised by: Deputy Vice-Chancellor, Learning and Quality Original Version: 30/06/2014
Document Owner Deputy Vice-Chancellor, Learning and Quality Current Version: 27/02/2017
Page 12 of 22 CRICOS Provider Number 00103D Review Date: 01/07/2015
Version Number: 6 /tmp/9118160365732725455.docx