HLTENN005 TAFE Queensland: Case Study on Nursing Care of Patient

This case study presents the scenario of Ms. Sue Warral, a 50-year-old patient admitted for an abdominal hysterectomy due to stage II carcinoma of the cervix. The case details her medical history, including chronic asthma, hypertension, hypothyroidism, hiatus hernia, osteoarthritis, and a previous deep vein thrombosis (DVT). The assignment explores various aspects of her pre-operative and post-operative care, including medication management, necessary investigations like Urea & electrolytes (U & E), venepuncture procedures with infection control measures, risk factors for perioperative DVT and preventative measures like anti-embolic stockings, incentive spirometer usage and oxygen level monitoring. Furthermore, it assesses the patient's condition post-surgery based on vital signs and discusses appropriate actions based on an ADDS chart, covering critical aspects of nursing care for patients with complex needs. Desklib provides access to similar case studies and solved assignments.

Assessment Task
- Written
Student Name Student Number
Unit Code/s &
Name/s
HLTENN005 Contribute to nursing care of a person with complex needs
Assessment Type Written
Assessment Name Case study Assessment Task No. AT1
Assessment Due Date Date submitted
Assessor Name Marker:
Student Declaration: I declare that this assessment is my own work. Any ideas and comments made
by other people have been acknowledged as references. I understand that if this statement is found to
be false, it will be regarded as misconduct and will be subject to disciplinary action as outlined in the
TAFE Queensland Student Rules. I understand that by emailing or submitting this assessment
electronically, I agree to this Declaration in lieu of a written signature.
Student Signature Date
PRIVACY DISCLAIMER: TAFE Queensland is collecting your personal information for assessment
purposes. The information will only be accessed by authorised employees of TAFE Queensland. Some
of this information may be given to the Australian Skills Quality Authority (ASQA) or its successor
and/or TAFE Queensland for audit and/or reporting purposes. Your information will not be given to
any other person or agency unless you have given us written permission or we are required by law.
Instructions to Student General Instructions:
Size 12 font, open book
Word count 1,000 for Q1-16
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Assessment Criteria:
To achieve a satisfactory result, your assessor will be looking for your
ability to demonstrate the following key skills/tasks/knowledge to industry
standard:
http://training.gov.au/Training/Details/HLTENN005
Number of Attempts:
You will receive up to two (2) attempts at this assessment task. Should your
1st attempt be unsatisfactory (U), your teacher will provide feedback and
discuss the relevant sections / questions with you and will arrange a due
date for the submission of your 2nd attempt. If your 2nd submission is
unsatisfactory (U), or you fail to submit a 2nd attempt, you will receive an
overall unsatisfactory result for this assessment task.Only one re-
assessment attempt may be granted for each assessment task. For more
information, refer to the Student Rules.
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Submission details Insert your details on page 1 and sign the Student Declaration. Include this
template with your submission.
When you are answering your questions, type the answer below each
question. You may choose to put the question in bold format if you wish.
Please do not change the font.
Referencing requirements
You must use your own words to answer these questions (not a cut and
paste from a textbook or website) and APA style referencing should be
used, both in-text and in the form of a Reference List at the end of the
paper. Please note that assessments that contain plagiarism will be allocated
an unsatisfactory grade.
Please refer to the student rules for more information (see link below)
http://training.qld.gov.au/resources/about/pdf/tafe-qld-student-rules.pdf
Submission details
Once completed, you should then up load it the AS1 submission site on
CONNECT, ensuring that you follow the instructions carefully (there is an
instruction video on the screen). If you are experiencing difficulties
uploading your paper, contact your teacher before the due date.
If you are unable to submit by this date, you must ask for an extension in
writing at least 48 hrs before the due date. You can download an extension
request form on CONNECT. Requests for extensions inside this seven-day
deadline will not be approved unless you have a medical certificate.
 TAFE Queensland Learning Management System: Connect url:
https://connect.tafeqld.edu.au/d2l/login
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File Name
You should save this file in the following format (including the month and
year your course started. This enables your teacher to download your
assessments in alphabetical order:
Your Surname_group_Number of assessment
Example: Wilson_Apr 2015_AS1
If you are required to resubmit an assessment, please name your files as
follows:
Your Surname_resubmit_group_number of assessment
Example: Wilson_resubmit_Apr 2015_AS1
Instructions for the
Assessor
Assessors must hold current registration as a registered nurse with Nursing
and Midwifery Board of Australia”.
Note to Student An overview of all Assessment Tasks relevant to this unit is located in the
Unit Study Guide.
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Please answer all questions 1 – 32
Questions 1 – 16 relate to Ms Warral case study
Patient History
Name: Sue Warral
Age: 50
Ethnicity: Aboriginal Torres Strait Islander
Marital Status: Divorced from children’s father. Currently in a defacto relationship with James
Michaels (55)
Medical history: Chronic Asthma, hypertension, hypothryroidism, hiatus hernia, osteo arthritis
knee’s, smokes – 1 pack per week, alcohol - social
weight 95kg, height 160cm, BMI 37
Previous history of deep venous thrombosis
Occupation: Part-time reception duties at local primary school
Next of Kin: James Michaels Defacto husband
Dependents: 2 children (Rebecca 12yrs & Nathan 10yrs)
Family: Children visit their father every other weekend. Beryl’s mum and a sister live
nearby. The whole family gets together on a regular basis.
Interests: Socializing, gardening, reading
Ms. Sue Warral presents in your gynecological surgical unit for an abdominal hysterectomy tomorrow.
Ms. Warral has had three consecutive abnormal PAP smears in the past four months.
The patient states she has noticed an unusual vaginal discharge over the past six months. On further
investigation Sue was found to have stage II carcinoma of the cervix
She reveals to you she is anxious about the cancer and having young children to look after. She also
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confides that she is worried that her partner will still love her. Sue’s surgeon Dr Turner stated that they
would make a decision following the findings of the surgery regarding radiation therapy.
On admission to your ward, the day of surgery, you take Ms Warral vital signs;
BP 155/85, Pulse 88 bpm, temperature 36.6 ,respirations 18 , weight 95kgs
O2 sa 97%
Allergic to Penicillin
The patient gives you a list of her current medications.
Serevent – one puff twice daily
Salbutamol 1-2 puffs every 3 hours as needed
Metoprolol- 50mgs daily am
Thyroxine – 50mcgs daily am
Omeprazole 20mg daily am
Panadol osteo – two tablets TDS
You have been asked to prepare Ms Warral for theatre. Discuss the following procedures about the
patient’s history.
1. The patient has been fasting since 2400. Sue states she was not sure whether to take her morning
medications. State the reason why some of her prescriptions may be given, and some withheld on
the day of surgery. (50-100 words)
On the day of surgery, a patient is advised to alter some medication has it ensure she undergoes anesthesia
safely and it may delay the recovery after surgery. It is also necessary some medication taken to help
increase blood pressure which had been suppressed by anaesthesia and medicine for the patient. ...............
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2. Ms. Warral requires blood taken for a Urea & electrolytes (U & E) before surgery.
Discuss the rationale for this investigation & type of consent required. (50-100 words)
Urea and electrolytes show important information about the health of Ms. Warral such as the volume of
the blood and the PH level by regulating acid and base level in the blood.....................................................
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3. Discuss how you will perform a venepuncture on Ms. Warral using the vacutainer system, including
any infection control precautions you would take. Include rationale for actions. (procedure may be
written in list form. 100 – 150 words)
Before taking the venipuncture result, I have found out if she had ever had blood drawn before. If not, I
will explain to her the discomfort and prevent the anxiety of the patient (Loveitt). This procedure is
known as informed consent. In case she is concern about the test, I will have to explain to her that the
doctor has ordered further laboratory test to monitor the procedure. To prevent infection during this
procedure, a high level of hygiene should be kept. I will have to wear gloves, wash her hand with alcohol
to prevent disease, and after the test needles and tubes should be disposed of (Pang et al., 2018).................
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out if she had ever had blood drawn before if not I will explain to her the discomfort and prevent the
anxiety of the patient this procedure is known as informed consent if sh
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4. Discuss three (3) factors that make Ms. Warral at risk of perioperative deep vein thrombosis. (50-
100 words)
Age factor
Patient with older age are at risk of hypertension, postoperative dehydration and immobility are a risk
factor of DVT. Notably, this patient is usually associated with vascular sclerosis and higher blood
viscosity
Immobility
Due to her work has a receptionist in a local school lack of movement may lead her to a high risk of DVT.
Additionally, due to her surgery which is likely to prolong her bed rest, it may increase DVT.
Previous Risk Of The Same Illness
The previous occurrence of DVT from the health record of Ms. Warral it indicates she had been
diagnosed before with DVT which puts a high standard of getting the risk of DVT again.
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5. Mrs. Warral is to have anti-embolic stockings fitted to assist in the prevention of deep vein
thrombosis
Explain how to put anti-embolic stockings on a client (50-100 words)
Stocking prevents the patient from the risk of blood clotting. Before applying to stock, Ms warrant leg
should be measured using the fitting chart. One should insert the hand inside stocking as far as the heel. In
this light, on have to keep the hands inside the stocking and turn the stocking inside out. Finally, one
should pull the hose up and fit around the ankle and calf (Kato et al., 2016).................................................
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6. You complete the pre-operative ECG, as ordered.
 Looking at Lead 2 Please discuss PQRST and the method for calculating rate and determining
rhythm.
See :http://www.meddean.luc.edu/lumen/meded/medicine/skills/ekg/les1prnt.htm
 State the type of rhythm shown in the ECG below. The kind of rhythm is normal sinus rhythm
7. Ms. Warral is to use the incentive spirometer following surgery to prevent pulmonary
complications.
a. Discuss your explanation of how to use the incentive spirometer to your patient. (50-150 words)
Incentive spirometer helps patient lungs clear and helps the recovery process. Ms. Warral should sit on
the edge of bed help her hold incentive spirometer in an upright position. Place the mouth piece on her
mouth and make sure she seals her lips tightly around it (Higgins, Helm, Gould, & Kindel, 2018).
Additionally, make sure she breathes slowly, and as deeply as possible I would notice the yellow indicator
should reach the blue outlined area help her hold her breathe as possible and make sure she exhale slowly
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and allow the piston to fall to the bottom of the column. The process should be repeated after she can get
of bed safely and take frequent walk...............................................................................................................
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b. You are also asked to monitor Ms. Warral’s oxygen levels (Spo2) how would you do this
I would use pulse oximeter which contains a microprocessor and displays oxygen saturation will display
the monitor updates its calculation regularly to give oxygen saturation and pulse rate (Gautham,
Arulvelan, & Manikandan, 2016)....................................................................................................................
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Ms. Warral returns from theatre following abdominal hysterectomy & bilateral salpingo-oopherectomy.
She has insitu, a fentanyl PCA, oxygen 2l/min via nasal prongs, IV fluids, IDC – SD, bellovac drain &
vac dressing.
During the evening, you notice Ms Warrals’ bellovac drain has filled to 400ml. You observe her wound
& find a large collection of blood has formed under the vac dressing. In response to your questions she
has become increasingly drowsy & having trouble speaking.
8. Review the attached ADDS chart, make an assessment based on her vital signs & discuss the actions
you would initiate. Use the DRSABCD acronym as headings to explain your answer. (100 – 200
words
D
Checck if she has any danger
R
Ask her to breathe in deep
S
Call for help if needed
A
Check for any foreign object
B
Look if the wound has spread
C
Ask her if she is pain
D
Apply some nursing as soon as possible
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