Energy Calculations: Use activity factors for MSJ
In: Nursing
Describe why you think access to health care (i.e., insurance coverage) is a social determinant of health. Provide at least one concrete example.
In: Nursing
A young mother of a 4 year old child expresses concern regarding the milk her child is drinking. The family purchases milk with WIC (Women Infant Children) government assistance.
“I am not allowed to purchase organic milk” she states. The mother goes on to explain “I heard regular cow’s milk has hormones in it and I am worried about giving it to my child.”
How would you respond to this mother? Would it be prudent for her to forgo her WIC coupons to purchase organic milk, almond milk or soy milk instead? Think about what your answer would be before proceeding with the questions.
Discuss:
Step 3 Post Your Initial Response including the following:
How would you respond to this mother? Would it be prudent for her to forgo her WIC coupons to purchase organic milk, almond milk or soy milk instead? Use facts from the text with digestion, absorption, and how the cells make protein in the body.
In: Nursing
Please describe your level of self awareness for emotional intelligence. What experiences have prepared you for your emotional intelligence?
2. In your current or past work setting, have you seen instances of unethical behavior? How would you react to these behaviors now that you are studying this issue?
3. What is your level of commitment to excellence in your professional role?
In: Nursing
Mrs. S, a 63-year-old patient who suffered a myocardial infarction last year, is in the cardiac rehabilitation center for follow up after suffering from fatigue and shortness of breath; she complains of a “fluttering” feeling with her heartbeat and she has an occasional productive cough. Mrs. S normally does not struggle with nighttime urination, but for the past month, she has to get up to use the bathroom 2-3 times per night. She has gained 5 pounds in the past week.
Mrs. S’s physician believes that she has developed congestive heart failure after having an MI last year. Which test would most likely be used to confirm the presence of CHF?
The nurse performs a physical assessment on Mrs. S and checks her respiratory rate while listening to her lung sounds. If Mrs. S has CHF, what signs would the nurse most likely notice when performing a respiratory assessment?
After diagnostic testing, Mrs. S is diagnosed with congestive heart failure. Her physician prescribes oral Lasix for her to take every day to help with some of her symptoms and assists her with starting a program through cardiac rehabilitation where she can exercise on a routine basis and continue to be monitored by health professionals.
What types of tests would this patient undergo that would diagnose heart failure?
How does Lasix help with congestive heart failure symptoms?
What information should the nurse include with teaching Mrs. S about taking a diuretic medication, such as Lasix?
In addition to regular exercise, what other types of lifestyle changes should Mrs. S implement to control her symptoms of heart failure?
Mrs. S has started taking Lasix and continues with cardiac rehabilitation. She lost the recent weight gained and is able to walk a little further than before when using the treadmill. She also does not get up as often during the night to use the bathroom when she takes her Lasix first thing in the morning. However, Mrs. S still complains of a fluttering feeling in her chest and her blood pressure readings have been elevated. Her last BP was 140/88 mm/Hg. The physician orders Captopril 50 mg po tid and has her come back to the clinic in 2 more weeks.
What type of drug is Captopril?
Why would this type of medication be prescribed for a patient with heart failure?
What information is most important for the nurse to give this patient when using this medication?
How would Mrs. S know if her medications are working to control her heart failure?
What is a primary nursing diagnosis for Mrs. S and why?
In: Nursing
In: Nursing
In: Nursing
James is a 52-year-old black male who comes to the clinic for a checkup for his diabetes. He tells the doctor that he has noticed that his feet have been getting numb and cold, causing him annoyance and irritation. The pulses in James’ feet are faint and they are pale in color. James is diagnosed with vascular insufficiency secondary to consequences of his diabetes
In: Nursing
In: Nursing
Certificate III IN INDIVIDUAL SUPPORT
CHCCOM005: Communicate and work in health and community services
CHCLEG001: Work legally and ethically
ASSESSMENT TASK 2: CASE STUDIES
CASE STUDY 1: NORNI AND JIM
Norni and Jim talked frankly about ageing and death long before either of them reached old age. They both agreed that they did not want to be kept alive artificially and that they would like to refuse treatment when they no longer had a good quality of life.
When Jim entered residential aged care, he specified his wish which was recorded on his file. His wife had a medical power of attorney for him so that she could make decisions about his treatment if he was not able.
After a period of time his health worsened. He no longer knew his wife and suffered pain and discomfort. He suffered many chest infections.
After one particularly bad chest infection, Norni spoke to Jim’s doctor and said that she no longer wanted his chest infections to be treated with antibiotics. The doctor knew Jim’s wishes and agreed that this was what he would have wanted.
His next chest infection was his last. He died peacefully and with dignity.
One of the personal care workers was heard to say in the staff room, ‘I can’t believe the doctor didn’t give Jim antibiotics. He would have been alive now if he had. That’s malpractice! His wife probably just wanted his money quicker.’
1. How has the personal care worker breached ethical requirements?
2. What would have been the ramifications if Jim had been given antibiotics against the instructions of his wife?
3. How did the personal care worker’s values differ from those of Norni, Jim and the doctor?
4. What action should be taken by the person who heard the personal care worker’s comments?
Norni is very sad after her husband’s death. She confides in you that she misses him terribly. She is glad that he is finally at peace but is also struggling with her decision to refuse treatment. She knows that is what Jim wanted but wishes he was still with her. She tells you that she can’t sleep at night and does not feel like eating at all. She thanks you for the care that you provided to Jim in his last weeks of life.
5. What would you say to comfort Norni?
Norni is so thankful to you for all the support you have given to Jim and her that she presents you with Jim’s gold watch and says she wants you to have it. It is old and looks very valuable.
6. Would it be a conflict of interest to accept this gift? Explain your answer.
7. What would you say to Norni, regards to the gift she has offered?
CASE STUDY 2: MAYA
Maya is an Aboriginal lady from the Kimberley region. She lives in a small, remote community but has recently entered an aged care facility as she is seriously ill with cancer. She is not expected to live more than a few months. The closest aged care facility that could take her was four hour’s drive from her home. The facility has only one male Aboriginal worker, Benny. The rest of the personal care workers are all female non-Aboriginal people. Most of the residents at the facility are not Aboriginal.
Maya does not settle well into the facility. She does not eat the food unless it has been brought to her from her family. She likes to chat with Benny and tells him that he is the only one who understands how she feels about being so far away from home. She will not let Benny assist her with tasks such as dressing and bathing, however, as he is male. She often refuses to shower.
Other residents have complained that Maya is rude and often ignores them, and never looks them in the face. They also say she is dirty and they do not want to associate with her.
1. What issues does Maya face regarding communication with staff?
2. What issues does Maya face in communication with other residents?
3. What assistance can Benny give to other staff to assist them to communicate with Maya?
4. Is Maya being rude when she doesn’t look people in the face when talking to them? Explain your answer.
Benny explains the process that will happen when Maya is near death. Various members of her family will gather to be with her. On her death they will conduct a smoking ceremony to purify the room and remove bad spirits. The body will then be taken back to her homeland to be buried.
The health and safety officer say that he understands this is Maya’s custom, but the smoking ceremony cannot be undertaken in her room. This would set off the smoke detectors and other residents may complain about the smoke. He suggests they do the smoking ceremony when her body is back at home. Benny rolls his eyes and walks out of the room in disgust.
5. What are Maya’s rights to the smoking ceremony?
6. List two things that Benny can do to support Maya to ensure that her rights are met.
7. List three things that Benny and the health and safety officer should do to resolve their differences.
CASE STUDY 5: HERRIOT
You are working in a community health service which is run in conjunction with a youth ‘drop-in’ program known as Youth in Front. Herriot Malini is a 14-year-old girl who has been attending the program for some time. Herriot has a mild intellectual disability with sub average intellectual functioning and lack of social skills. Herriot has a reputation for dishonesty including telling lies and stealing from others.
You have noticed lately that she has been withdrawn and subject to fits of temper. When you ask her if she is okay, she tells you that no, she is not okay and how would you feel if your mother’s boyfriend kept feeling you up?
As you talk to Herriot, she discloses that her mother’s boyfriend has touched her sexually on several occasions when her mother has been at work. She has now moved in with her grandmother to get away from him. Her mother went crazy when she found out she was living with Grandma and when she told her why she called her a ‘lying little b***h’.
She tells you that she wants the man locked up so he can’t hurt her anymore, but she also tells you that she would be much too scared to talk to authorities about what has happened.
Herriot also says that her mother has no rights over her because she is not her real mother but only a guardian because her mother died when she was a baby.
1. What legislation covers the protection of children against abuse in your state?
2. Herriot has a reputation for lying. Does this mean you should decide whether or not she is telling the truth before reporting the allegation? How may the code of ethics assist you with this decision?
3. Where can you find information about how to deal with allegations of client abuse inside and outside of your organisation?
4. What guidance does a code of ethics give in relation to confidentiality in this case?
5. Is Herriot right when she says her mother has no rights because she is not her real mother?
6. You realise you will need to report this to your supervisor. When should you do this and what would you do if your supervisor was not available?
7. What communication and interpersonal techniques would you use when talking with Herriot?
8. You may have personal values that conflict with those of Herriot’s family. How would you deal with this?
ASSESSMENT TASK 3 - ROLE PLAYS:
ROLE PLAY 1: HERRIOT AND THE CARE WORKER:
This role play is a continuation of Case Study 5 from Assessment Task 2.
In this role play your assessor will play the role of Herriot. Herriot is going to tell you some things.
You will need to take notes about what Herriot says to you, as you will need to discuss her situation with your supervisor in Role Play 2.
As part of this role play you should:
▪ Listen to what Herriot has to say. Use verbal and non-verbal communication techniques to show Herriot your concern, show respect, and to make sure you have understood her correctly
▪ Respond appropriately to what Herriot tells you
▪ Ask for permission to take notes
▪ Explain what you will do with the information that Herriot has given you.
Your assessor will refer to the following checklist when observing your performance:
▪ Demonstrate effective communication skills?
▪ Check understanding and demonstrate empathy and respect?
▪ Respond appropriately?
▪ Respect the confidentiality of the disclosure?
▪ Explain duty of care to client and mandatory reporting requirements?
ROLE PLAY 2: HERRIOT'S CARE WORKER AND THEIR SUPERVISOR:
This role play is a continuation of Role Play 1 above.
In this role play your assessor will play the role of your supervisor, Ian.
You need to give Ian a verbal report of what Herriot told you. You can refer to your notes during this discussion. You will need to talk about what further action should be taken.
Ian will ask you questions.
As part of this role play you should:
▪ Provide a full, accurate and non-judgmental verbal report of what Herriot has disclosed.
▪ Detail your own responsibilities in this situation.
▪ Describe what actions should be taken next by your organisation, including timeframes.
▪ Listen to your supervisor’s instructions and confirm that you have understood what you need to do and what timeframes you have to do it in.
Your assessor will refer to the following checklist when observing your performance:
Comply with legal and ethical responsibilities to report suspected child abuse?
Correctly identify breaches of legislation that have occurred to Herriot?
Communicate effectively using verbal and non-verbal techniques to provide clear, accurate and easily understood advice of what has occurred?
Demonstrate a non-judgmental approach?
Use industry terminology effectively?
Confirm that your message has been understood correctly?
Listen to instructions and clarify their meaning?
Respond appropriately to instructions and questions?
Clarify timelines for carrying out instructions?
Communicate in a timely manner and in line with workplace instructions?
Role play 3: Jenienne
You are to role play a telephone conversation with Jenienne. She is the daughter of a potential client of your residential aged care facility.
Jenienne is concerned about her father’s rights within the home and the type of care that they will receive. She is also concerned about how information is kept (both electronically and in hard copy) and who will have access to her father’s information.
Your assessor will play the role of Jenienne.
Your assessor will refer to the following checklist when observing your performance:
Demonstrate knowledge of legal and ethical obligations relating to confidentiality?
Demonstrate knowledge of how information is securely maintained?
Demonstrate knowledge of who can access client information?
Demonstrate knowledge of how electronic and hard copy records are maintained securely?
Use effective telephone techniques?
Use effective communication skills – both verbal and non-verbal?
Explain information clearly and confirm understanding?
Listen to requests, clarify meaning and respond appropriately?
Agree on any follow-up actions?
ROLE PLAY 4: ELANA
There are two parts to this task:
1. Role playing a discussion with Elana about the storeroom.
2. Answering a set of verbal questions related to this scenario.
You have been asked by your supervisor to clean out the storeroom – it has become a workplace hazard. Nothing has been sorted and there is stuff all over the floor.
You are a little concerned because your supervisor has told you to ask Elana to assist you. You know Elana hates doing jobs like this – and the last time you worked with her, she basically told you to get lost!
Your assessor will play the part of Elana. You must ask her to assist you with the storeroom, and try to avoid a conflict. Ian, your supervisor, has asked you to get this done immediately because it is a health and safety hazard.
Following the role play, you will need to answer a set of verbal questions.
Your assessor will refer to the following checklist when observing your performance:
Use effective communication to avoid and resolve a potential conflict situation?
Explain workplace instructions to a colleague?
Negotiate timeframes with a colleague?
Demonstrate a collaborative and motivational approach?
Use appropriate, non-confrontational, body language?
In: Nursing
Discuss the functional relationship between the Respiratory System and the other body systems. How does medical terminology help you make sense of this?
PS: reponse should be at least 200 words
In: Nursing
Case Study #3:
Mr. Wilson, a 51 y.o. male patient, is admitted to the Intensive Care Unit in critical condition after a Case motor vehicle accident. He presented unconscious and is therefore unable to make his own medical decisions. The family of this patient provided a detailed formal advance directive which indicated that in the event of a traumatic injury such as this one, where the outcome is uncertain, the patient would consent to aggressive medical intervention in an attempt to stabilize and determine the severity of his injury. Life-sustaining interventions were therefore pursued.
After a myriad of test and a set of neurologic assessments were performed, it was determined that an anoxic brain injury occurred, and it was not clear whether the patient would ever regain consciousness. The team needed some time to clearly establish a diagnosis, and the family members were kept informed of any progress that was made.
Several weeks passed as the patient stabilized, and the health care team was finally confident that the patient had met the criteria for being in a Persistent Vegetative State, a diagnosis that was presented to the family. According to the advance directive, if the patient were ever in a situation where their continued existence would be in such a state, he would want all life-sustaining intervention withdrawn, and be allowed to die. The family (spouse is no longer in the picture, 18 y.o. daughter, 20 y.o daughter, and 14 y.o. son) are presented with this formal diagnosis of PVS and are willing to continue to assume the responsibility of SDMs. The 14 y.o. son is adamant that his father is a ‘fighter’ and demands the team continue to ‘do everything possible’ and provide the most aggressive care they can. The 18 y.o. daughter agrees with the son, but the 20 y.o. daughter wants to respect her father’s wishes and refuse further life-sustaining measures.
Questions:
In: Nursing
Case Study #1:
A 75-year-old healthy male was working on the roof of his house when he slipped and fell 10 ft. to the ground. He was knocked unconscious. When the paramedics arrived, he was awake but confused. His vital signs were stable (e.g., Glasgow Coma Scale [GCS] score of 14). He was immobilized with a C-collar and backboard and taken to the ED. Shortly after arrival in the ED he became more confused, then sleepy. His GCS score decreased from 14 to 10. The attending emergency physician was concerned that perhaps the patient had a significant head injury and was in the process of arranging for a CT scan when the patient’s wife arrived. The patient’s condition continued to deteriorate, to a GCS score of 8. The emergency physician prepared to intubate him, but when she discussed this with the patient’s wife, the wife became upset and stated that her husband had a “living will,” which specifies that, if he became critically ill, he would not want any resuscitative interventions, including intubation.
Questions:
In: Nursing
Q3 Case study: Peter Smith, a 19 year old university student, was suffering from influenza and visited his local GP. He said he began to feel unwell two days earlier and his condition had worsened since with an acute onset of a sore throat(pharyngitis). On examination the following observations were made: Fever of 38.9 degrees C, Runny nose, Sneezing, Enlarged anterior cervical lymph nodes (lymphadenopathy) Peter’s throat was observed to have the following signs: Redness, Swollen, Having a patchy covering of yellow-white exudate over his tonsils The doctor prescribed phenoxymethylpenicillin 500 mg twice per day for ten days.
Question: Given that influenza is caused by a virus, why was Peter prescribed an antibiotic?
In: Nursing
Q5. Case study: Peter Smith, a 19 year old university student, was suffering from influenza and visited his local GP. He said he began to feel unwell two days earlier and his condition had worsened since with an acute onset of a sore throat(pharyngitis). On examination the following observations were made: Fever of 38.9 degrees C, Runny nose, Sneezing, Enlarged anterior cervical lymph nodes (lymphadenopathy) Peter’s throat was observed to have the following signs: Redness, Swollen, Having a patchy covering of yellow-white exudate over his tonsils The doctor prescribed phenoxymethylpenicillin 500 mg twice per day for ten days.
Question: Explain why antibiotics are not effective against viruses.
In: Nursing