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APN108 Applying Nursing Practices (B) Assessment 1B: Case study Response Template ASSESSMENT 1B: Student Response Template Student Name Date Course HLT54115 Diploma of Nursing Subject Code and Title...

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APN108 Applying Nursing Practices (B)
Assessment 1B: Case study Response Template
    ASSESSMENT 1B: Student Response Template
    Student Name
    
    Date
    
    Course
    HLT54115 Diploma of Nursing
    Subject Code and Title
    APN108 Apply Nursing Practice (B)
    Unit(s) of Competency
    HLTENN006 Principles of wound management
HLTENN012 Implement and monitor care for a person with chronic health problems
    Performance criteria, Knowledge evidence and Performance assessed
    PC:
HLTENN006: 1.1, 1.2, 1.3, 2.1, 2.2, 2.3, 2.4, 2.5, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 4.1, 4.5, 5.1, 5.2, 5.6, 5.7, 6.1, 6.2, 6.3, 6.4, 6.5, 6.7.
HLTENN012: 1.1, 1.2, 1.3, 1.4, 1.5, 2.1, 2.2, 2.3, 2.4, 2.5.
    
    PE:
HLTENN006: 1
HLTENN012: 1
    
    KE:
HLTENN006: 2.1, 2.4, 3, 5, 6.1, 7, 8, 9.1, 9.7, 9.8, 10.1, 10.3, 10.4, 10.8, 11.1, 11.3, 11.4, 11.5, 11.6, 11.7, 11.9, 11.10, 12.1, 12.2, 12.3, 13.
HLTENN012: 1.5 a, b, c, d, e. 2.1, 2.2, 2.5, 2.7, 3.7, 4.1, 4.2, 4.6
    Title of Assessment Task
    Case Study
    Type of Assessment Task
    Case study with short answer questions
    Length
    10 questions with words limits of 300 – 750 per question.
    Submission
    Due by 11:55pm AEST Sunday end of Week 9 (module 5.1).
Task Instructions
To complete Assessment 1, Part B, you must respond to a number of questions based on the case scenario below. You are also required to complete a wound care assessment, develop a plan of care for the client and document using a clinical record on the assessment response template provided. These questions must be answered in full. When responding to the questions, please pay attention to the entire question being asked, as well as the prescribed word count, if provided. Use the co
ect medical terminology when assessing, reporting and recording data while answering all questions. Your answers should be reflective, analytical and based on critical assessments and the Enrolled Nurse standards for practice and Codes of Ethics for Nursing.
You will be assessed on the responses to the questions and will be deemed as either satisfactory or not satisfactory. ALL of the responses must be marked as satisfactory in order to pass the assessment. If your assessment is not deemed satisfactory, you will be re-assessed as per the THINK Education Assessment Policy for Vocational Education and Training (VET), before being awarded a Non Satisfactory mark for the assessment and the unit.
Case Scenario:
Mr George McFarlane is a 53 year old Caucasian Male, admitted to hospital after seeing his General Practitioner (GP) for an infected Left (L) toe, caused by a bliste
lesion, possibly from ill-fitting shoes. When Mr McFarlane realised there was a lesion present, he initially did not consider it serious and did not seek medical treatment straight away. After a week, the smell distu
ed him and he sought advice from his General Practitioner (GP) who prescribed oral antibiotics and stressed the importance of cleansing and changing the dressing on his wound regularly. Due to Mr McFarlane’s job which required being on the road for long hours at a time, these regular dressing changes did not occur. Subsequently, due to i
egular dressing changes, Mr McFarlane’s Methicillin-resistant Staphylococcus Aureus (MRSA) positive status and Type II diabetes, the lesion failed to heal and became larger and deeper. Mr McFarlane returned to his GP five (5) weeks later. The GP immediately refe
ed him to a specialist wound clinic. Investigations included a full blood count (FBC). The white blood cell (WBC) count was 17x 10⁹/L, predominantly neutrophils. The erythrocyte sedimentation rate (ESR) was 75mm/hr. An x-ray showed changes consistent with osteomyelitis.
Mr George McFarlane was admitted to hospital for surgical de
idement of his wound. A large amount of tissue was excised from his left foot, which resulted in amputation of all 5 toes. The wound was packed and placed on a suction wound dressing (negative-pressure wound therapy), to minimise the exudate at the wound surface and promote healing by granulation. Post-operatively, he initially did well. However, on the seventh day after surgery, he developed pyrexia and his diabetic control deteriorated. His left foot had swollen above the bandaging. The dressing was removed and there was tissue engorgement and cellulitis su
ounding the wound and evidence of necrosis (as shown in the photograph below).
Mr McFarlane has a Past Medical History (PMHx):
· Type ll Diabetes needing close management
· Osteoarthritis in L) Knee
· Peripheral Vascular Disease (PVD)
· Chronic Obstructive Pulmonary Disease (COPD)
· Methicillin-resistant Staphylococcus Aureus (MRSA) positive
· peripheral neuropathy
Social History (SHx):
· Second ma
iage
· Occupation - Long Haul truck drive
· ETOH (Alcohol) usage on a regular basis
· Smoker, averages 15/20 cigarettes per day
· Often consumes take away/ fast food diet as away from home regularly
Mr McFarlane’s cu
ent assessment consists of the following:
· BP 135/85
· RR 18
· SpO2 92% Room Air (RA)
· HR 89
· Temp 38.2oC
· BGL 13.8mmol
· U/A (Glucose ++, ketones+, protein +, SG 1010, PH 5)
· Pain score 7 at rest
· GCS 15
· Water low score of: 15 (High Risk)
        
Reference:
https:
www.gettyimages.com.au/detail/news-photo/amputation-due-to-diabetes-news-photo/ XXXXXXXXXX?adppopup=true
    TASK
    Assessment Criteria
    Question 1
    Discuss the physiological and biochemical process of normal wound healing. Include, in your answer, factors that impact wound healing.
(word limit XXXXXXXXXXwords)
    Response:
    TASK
    Assessment Criteria
    Question 2
    Discuss the nursing strategies required to minimise cross infection whilst conducting a wound assessment and implementation of a wound dressing.
Discuss in your answer:
a) The relevance of the client’s MRSA status, universal precautions and appropriate PPE to be considered for the client’s protection.
) Compliance with infection control practices and co
ect disposal of wound care products, including how hazardous waste are to be discussed.
c) How Aseptic Non Touch Technique (ANTT) and Hand Hygiene practices can prevent the introduction of new bacteria to the client.
(word limit XXXXXXXXXXwords)
    Response:
    TASK
    Assessment Criteria
    Question 3
    Discuss how Mr McFarlane’s chronic illnesses could impact on wound healing.
Include, in your answer, how the pathophysiology of Type II Diabetes, Peripheral Vascular Disease and peripheral neuropathy could delay/ hinder wound healing.
Discuss the differences in pathological terms between a venous ulcer, an arterial ulcer, a diabetic ulcer and a neuropathic ulcer.
(word limit 500 – 750 words)
    Response:
    TASK
    Assessment Criteria
    Question 4
    Explain the differences between a simple, complex and surgical wound.
In your response, consider the complications of healing with each type of wound.
Discuss the reason why some wounds are left undistu
ed for a longer period of time.
(word limit XXXXXXXXXXwords)
    Response:
    TASK
    Assessment Criteria
    Question 5
    What education should be provided to Mr McFarlane and his family in relation to his wound?
Consider in your answer:
a) Modes of transmission of infection
) Preventative strategies for other wounds
c) Wound care post discharge including evaluation of the condition of the wound and where to seek assistance if the wound deteriorates.
d) Possible psychological impacts of a chronic wound.
(word limit XXXXXXXXXXwords)
    Response:
    TASK
    Assessment Criteria
    Question 6
    What support networks could you suggest to assist and ease the difficulties for the client as well as family members? In your answer consider areas such as a holistic assessment and approach, and research what government health bodies are available to assist with financial assistance. Supply the Web Link for the government health bodies in your answer.
(word limit XXXXXXXXXXwords)
    Response:
    TASK
    Assessment Criteria
    Question 7
    Discuss appropriate pain management strategies for your client. Who, within the multidisciplinary team, could provide you with assistance with planning a pain management strategy?
Include, in your discussion, appropriate pain management and time frames to be considered prior to attending to the wound assessment and dressing. Discuss the role of the pain management team and the requirement to liaise with your RN/ Team leader as outlined in the Enrolled Nurse standards for practice.
(word limit XXXXXXXXXXwords)
    Response:
    TASK
    Assessment Criteria
    Question 8
    Wound Management Record
Discuss in the wound assessment the appearance of the wound (picture attached to case study), and the appropriate selection of the wound cleansing agent and cleaning technique; and wound products including primary and secondary dressings.
    Response:
    Think Hospital
    Wound Management Record
    WOUND MANAGEMENT RECORD
Allergies: NIL
    URN: XXXXXXXXXX
NAME: George McFarlane
    Dressing regime: Update regime when a change in client condition occurs
    Wound- Location,
And dimensions (width and length)
     Left foot diabetic ulcer and partial amputation (5 x toes)
    Wound bed description: % (epithelializing, Granulating, slough, necrotic, other)
    
    Su
ounding skin: (healthy, dry, discoloured, macerated, cellulitis, oedema, erythema, other)
    
    Infection: (suspected, confirmed, none, swab obtained, other)
    
    Exudate amount:
Nil, small, moderate, large.
    
    Exudate type: (serous, haemoserous, purulent, frank blood, other)
    
    Pain associated with wound
    Pre dressing scale 1 to 10:
Post dressing scale 1 to 10:
    Frequency:
    
    When:
    
    Cleansing agent:
    
    Cleansing method. (I
igation, N/Saline soak, ANTT swa
ing, shower, de
idement, keep dry, other).
    
    Primary Dressing:
    
    Secondary Dressing:
    
    Fixation:
    
    
    
    Refe
als and date: (diabetic education, dietician, vascular surgeon, wound CNC, prosthetic, podiatry, plastic surgeon, OT, other)
    
    Additional instructions:
    
    Refe
als and date: (diabetic education, dietician, vascular surgeon, wound CNC, prosthetic, podiatry, plastic surgeon, OT, other)
    
    Dressing Regime completed by:
    Date:
    
    
    
    
    
    
    
    Time:
    
    
    
    
    
    
    
    Signature, printed name, designation
    
    
    
    
    
    
    
    TASK
    Assessment Criteria
    Question 9
    Nursing Care Plan
Complete all areas of the Nursing Care Plan, mapping out nursing cares as appropriate for Mr McFarlane, taking in to account his cu
ent status as per the case study and the information you have discussed in your short answers. Apply appropriate nursing interventions for Mr McFarlane.
    Response:
    Think Hospital
    NURSING CARE PLAN
Answered Same Day Jul 20, 2021 HLTENN006 Training.Gov.Au

Solution

Tanaya answered on Jul 23 2021
144 Votes
APN108 Applying Nursing Practices (B)
Assessment 1B: Case study Response Template
    ASSESSMENT 1B: Student Response Template
    Student Name
    
    Date
    
    Course
    HLT54115 Diploma of Nursing
    Subject Code and Title
    APN108 Apply Nursing Practice (B)
    Unit(s) of Competency
    HLTENN006 Principles of wound management
HLTENN012 Implement and monitor care for a person with chronic health problems
    Performance criteria, Knowledge evidence and Performance assessed
    PC:
HLTENN006: 1.1, 1.2, 1.3, 2.1, 2.2, 2.3, 2.4, 2.5, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 4.1, 4.5, 5.1, 5.2, 5.6, 5.7, 6.1, 6.2, 6.3, 6.4, 6.5, 6.7.
HLTENN012: 1.1, 1.2, 1.3, 1.4, 1.5, 2.1, 2.2, 2.3, 2.4, 2.5.
    
    PE:
HLTENN006: 1
HLTENN012: 1
    
    KE:
HLTENN006: 2.1, 2.4, 3, 5, 6.1, 7, 8, 9.1, 9.7, 9.8, 10.1, 10.3, 10.4, 10.8, 11.1, 11.3, 11.4, 11.5, 11.6, 11.7, 11.9, 11.10, 12.1, 12.2, 12.3, 13.
HLTENN012: 1.5 a, b, c, d, e. 2.1, 2.2, 2.5, 2.7, 3.7, 4.1, 4.2, 4.6
    Title of Assessment Task
    Case Study
    Type of Assessment Task
    Case study with short answer questions
    Length
    10 questions with words limits of 300 – 750 per question.
    Submission
    Due by 11:55pm AEST Sunday end of Week 9 (module 5.1).
Task Instructions
To complete Assessment 1, Part B, you must respond to a number of questions based on the case scenario below. You are also required to complete a wound care assessment, develop a plan of care for the client and document using a clinical record on the assessment response template provided. These questions must be answered in full. When responding to the questions, please pay attention to the entire question being asked, as well as the prescribed word count, if provided. Use the co
ect medical terminology when assessing, reporting and recording data while answering all questions. Your answers should be reflective, analytical and based on critical assessments and the Enrolled Nurse standards for practice and Codes of Ethics for Nursing.
You will be assessed on the responses to the questions and will be deemed as either satisfactory or not satisfactory. ALL of the responses must be marked as satisfactory in order to pass the assessment. If your assessment is not deemed satisfactory, you will be re-assessed as per the THINK Education Assessment Policy for Vocational Education and Training (VET), before being awarded a Non Satisfactory mark for the assessment and the unit.
Case Scenario:
Mr George McFarlane is a 53 year old Caucasian Male, admitted to hospital after seeing his General Practitioner (GP) for an infected Left (L) toe, caused by a bliste
lesion, possibly from ill-fitting shoes. When Mr McFarlane realised there was a lesion present, he initially did not consider it serious and did not seek medical treatment straight away. After a week, the smell distu
ed him and he sought advice from his General Practitioner (GP) who prescribed oral antibiotics and stressed the importance of cleansing and changing the dressing on his wound regularly. Due to Mr McFarlane’s job which required being on the road for long hours at a time, these regular dressing changes did not occur. Subsequently, due to i
egular dressing changes, Mr McFarlane’s Methicillin-resistant Staphylococcus Aureus (MRSA) positive status and Type II diabetes, the lesion failed to heal and became larger and deeper. Mr McFarlane returned to his GP five (5) weeks later. The GP immediately refe
ed him to a specialist wound clinic. Investigations included a full blood count (FBC). The white blood cell (WBC) count was 17x 10⁹/L, predominantly neutrophils. The erythrocyte sedimentation rate (ESR) was 75mm/hr. An x-ray showed changes consistent with osteomyelitis.
Mr George McFarlane was admitted to hospital for surgical de
idement of his wound. A large amount of tissue was excised from his left foot, which resulted in amputation of all 5 toes. The wound was packed and placed on a suction wound dressing (negative-pressure wound therapy), to minimise the exudate at the wound surface and promote healing by granulation. Post-operatively, he initially did well. However, on the seventh day after surgery, he developed pyrexia and his diabetic control deteriorated. His left foot had swollen above the bandaging. The dressing was removed and there was tissue engorgement and cellulitis su
ounding the wound and evidence of necrosis (as shown in the photograph below).
Mr McFarlane has a Past Medical History (PMHx):
· Type ll Diabetes needing close management
· Osteoarthritis in L) Knee
· Peripheral Vascular Disease (PVD)
· Chronic Obstructive Pulmonary Disease (COPD)
· Methicillin-resistant Staphylococcus Aureus (MRSA) positive
· peripheral neuropathy
Social History (SHx):
· Second ma
iage
· Occupation - Long Haul truck drive
· ETOH (Alcohol) usage on a regular basis
· Smoker, averages 15/20 cigarettes per day
· Often consumes take away/ fast food diet as away from home regularly
Mr McFarlane’s cu
ent assessment consists of the following:
· BP 135/85
· RR 18
· SpO2 92% Room Air (RA)
· HR 89
· Temp 38.2oC
· BGL 13.8mmol
· U/A (Glucose ++, ketones+, protein +, SG 1010, PH 5)
· Pain score 7 at rest
· GCS 15
· Water low score of: 15 (High Risk)
        
Reference:
https:
www.gettyimages.com.au/detail/news-photo/amputation-due-to-diabetes-news-photo/151032672?adppopup=true
    TASK
    Assessment Criteria
    Question 1
    Discuss the physiological and biochemical process of normal wound healing. Include, in your answer, factors that impact wound healing.
(word limit 300 - 500 words)
    Response:
The physiological process of wound healing can be categorised in to four different phases. These phases include vascular response, inflammatory response, maturation and proliferation. The first phase is the vascular or homeostasis phase which begins at the very onset of the injury. The main objective of this stage includes stopping of the bleeding process. During this process the body’s repair system gets activated in association with the blood clotting system that builds a dam against the drainage of the blood (Atkin et al., 2020). This is the process by which the platelet come in contact with the collagen that causes activation as well as aggregation of platelets. The enzyme thrombin initiates the formation of fi
in mesh which helps in strengthening the platelet clumps forming a stable clot. In the second stage, the body activates its defensive or the inflammatory stage. This is phase where the body focuses on destroying the bacteria with the removal of de
is. Further, it also contributes in preparing a bed where the new tissues will start growing. Further, the white blood cells that are the neutrophils will enter the wound so that the bacteria are destroyed with the generation of a specialised cell called macrophages that continues cleaning the de
is (Gupta, Ga
iel, Lanti & Teot, 2016). The cells contribute in secreting the growth factors as well as the protein that helps in strengthening the immune system which facilitate in the repair of the tissue. In the third or the proliferation phase three distinct function occurs. This includes filling and complete solidification of the wound area, contraction of the margins of the wound and the epithelialization of the wound. The connective tissue develops new blood vessels with the epithelial cells migrating to the wound bed. This stage lasts for 24 days. Lastly in the maturation phase, the newly developed tissues start gaining flexibility and strength with the reorganisation of the collagen fi
es.
The factors that impact on the wound healing process includes:
a. Age of the patient: With the increase in age the capacity to healing decreases. In addition, with age there is an increase in como
idities. The epithelialisation becomes slower.
. The type of wound and its characteristics also impact on the healing process.
c. In case there is an infection at the site of the wound, the pathogen may take over the site of wound leading in the difficulty of healing as they create sore or lesion that required antibiotics administration (Kairinos, 2019).
d. Poor nutrition may provide insufficient resources for the healing of the wound.
e. Presence of chronic diseases like diabetes may slow down the healing process and at time need therapeutic intervention.
    TASK
    Assessment Criteria
    Question 2
    Discuss the nursing strategies required to minimise cross infection whilst conducting a wound assessment and implementation of a wound dressing.
Discuss in your answer:
a) The relevance of the client’s MRSA status, universal precautions and appropriate PPE to be considered for the client’s protection.
) Compliance with infection control practices and co
ect disposal of wound care products, including how hazardous waste are to be discussed.
c) How Aseptic Non Touch Technique (ANTT) and Hand Hygiene practices can prevent the introduction of new bacteria to the client.
(word limit 300 - 500 words)
    Response:
When assessing any granulating wound it is crucial that the practitioner note the volume, texture and colour of the granulation tissue. Often during the wound dressing there can be trauma as well as bleeding due to the fragile and thin capillaries that has developed. In such cases there are certain precaution that needs to be taken up by the professional so that the cross contamination can be avoided. According to CDC, one of the greatest sources of contamination often arises from lack of adequate hand hygiene that results in risks of the patient (Davies, Stephenson & Manners, 2019). This also leads to spread of germs and also developing resistance against the antibiotics. In addition to the hand hygiene it is crucial to utilise sterile gloves that reduces the hand contamination to 80% and also eliminate cross contamination, protecting the patient from infections.
Often the MRSA transmission takes place through the contact of contaminated hands, environmental surface and equipment (Everett, E., & Mathioudakis, 2018). The MRSA have the ability to proliferate and survive in different surface. This is the reason, often it is crucial that the medical professional handling wound of a MRSA resistant patient, to utilise the PPE (personal protective equipment) that includes gowns and gloves so that the contamination and colonisation of the bacteria can be prevented. According to the Standard Precaution protocols, it is important for the professional to regularly change the PPE after attending to the patient so that the contamination can be controlled from the infected patient. Proper selection and use of PPE are essential following the Standard precaution procedures.
Cleaning and proper disposal of the infected materials places an important role in the infection control. Some of the basic principles that are followed in infection control and disposal process includes, following a strict procedure of cleaning frequency with strict policies of utilisation of the disinfectant products. While following the cleaning protocols, it is crucial that the individuals needs to wea protective equipment following the Standard protocol. In addition, while cleaning, care should be taken there is...
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