Ingrid looks after her elderly aunt, who lives two hours’ drive away. Every Monday and Thursday, Ingrid drives to her aunt’s house, and spends the day with her, preparing meals, taking her to appointments and taking her on outings. She helps clean, maintain and organise her house, and just spends time with her. Her aunt, Seija, is 80, and has dementia. Generally, she is in good spirits, but she has difficult periods when she feels depressed and disorientated. Ingrid finds these days draining. Ingrid is happy to help her aunt, but after three or more years of being the sole carer for her aunt, she is beginning to feel the toll. Ingrid wants to study her masters in psychology, and asks her sister Maria to help with some of the care. Maria says she is too busy. Ingrid becomes more and more resentful. When Seija is having a bad day, Ingrid has little patience, and often leaves again after a couple of hours. She’s irritable at home and feels down a lot of the time. Her friends are concerned for her.

1) Identify at least two impacts that caring for her aunt have on Ingrid. (Approx. 30 words).

2. Seija relies on her family for support. Discuss how this impacts on the family. (Approx. 45 words)

3) Identify at least two services that could be appropriate referrals for Seija or Ingrid. (Approx. 30 words).

4) Why is it important to provide support to the carers like Ingrid? (Approx. 40 words).

5) Describe how respite care could support Ingrid. (Approx. 15 words).

Compare and contrast scabicides and pediculicides. This response should be at least 250 words in length

Mr.John confides in the nurse that his 86 year old mother was diagnosed with the same illness three weeks ago but did not exhibit all the symptoms he was experiencing and had to be kept in hospital for an extended period of time. Explain why his elderly mother did not possess his symptoms but was much more ill?

1) Surgical asepsis refers to the practices that keep objects and areas sterile (free from all living microorganisms). As such, surgical asepsis is crucial to minor office surgeries, as pathogenic microorganisms could enter the patient’s body and cause disease. Maintaining surgical asepsis is an essential responsibility of the MA. When does surgical asepsis come into play in a medical office? What are some specific circumstances when it is employed? What should be done if surgical asepsis is broken?

• What is your role as a student nurse during labor and delivery?

What do you think is the priority nursing problem of a parturient in labor?

1. Explain how the following factors can affect fecal elimination (having a bowel movement) and explain why? Personal habits, Diet, Fluids, Activity, Medications, Aging, Disability etc.
2. Explore the Personal Support Worker role on the interprofessional team when working with clients with elimination such as providing journals and descriptions. What could you put in the client’s elimination journal or diary?
3. Can the Personal Support Worker administer an enema or suppository? If your answer is no, then explain why not?
4. Discuss the importance of the Personal Support Worker monitoring intake and  output?

what is your preconception on Cultural Learning Reflection?

Case Study- Mobility Adaptive

You have been assigned to care for Mr. Rich Tilly, a 32-year-old admitted to your short-term rehabilitation unit after a lengthy hospitalization following a bike crash that occurred during a triathlon competition. He had sustained a closed head injury resulting in a 14-day coma but is now awake, alert, and oriented. He also had fractures to the right femur and tibia and right radius. The leg fracture sites were stabilized with external fixation devices providing skeletal traction. He has a fiberglass cast on his right arm extending from his hand to his elbow. He can bend the right elbow. He is permitted no weight-bearing on the right leg. Goals of his rehabilitation include reconditioning and independence in mobility and self-care activities.

1. Due to the prolonged recovery from his head injury as well as musculoskeletal compromise, Mr. Tilly is at risk for the hazards of immobility. Discuss the system changes you should be looking for during the admission assessment. Include both a subjective (how would the patient verbalize the problem) and the objective measurements (physical assessment data) of the potential system effects.

Mr. Tilly says to you during your morning assessment, “I just don’t know how I will ever recover from this—I can’t do anything for myself—I am so used to training every single day and now I can’t do anything I would call exercise. How can I get ready for all this rehab work?”

2. What type of exercise should be initiated with Mr. Tilly to regain muscle strength? Why?

3. Mr. Tilly wants to be able to help himself reposition in the bed telling you, “I am either stuck in one spot or sliding down in the bed. I want to be able to move myself instead of asking the staff to help me.” Keeping his injuries and treatment methods (external fixation and casting) in mind, what kind of positioning devices would be appropriate for him to use?

4. Discuss concerns with Mr. Tilly’s external fixator (skeletal traction). What are your priority assessments? How would you care for the site?

After completion of admission protocols the physician writes the following orders:

• OOB to chair for all meals, no weight-bearing to right leg

• May ambulate to bathroom with assistance, instruct in use of walker

4. . Mr. Tilly wants to get out of the bed as soon as possible. You sit him on the side of the bed but he complains of being “woozy and nauseated.” What is happening to him and how will you intervene?

5. How could you have assessed for the potential of this event occurring in this patient?

6. In consideration of the methods available to transfer patients out of bed, which method would be best to implement for Mr. Tilly at this time? Give a rationale for your decision.

7. Discuss the proper body mechanics that are imperative to safe patient care and transfers in any situation.

A week after admission Mr. Tilly is progressing slowly in his rehabilitation. He has verbalized frustration at his inability to ambulate freely. He states, “I just don’t know 264 Unit 4 | Supporting Physiological Functioning 2923_SE_Ch32_261-268 13/01/14 2:06 PM Page 264 if I am ever going to get better and some days don’t even feel like trying.” He has difficulty walking the required distances due to his musculoskeletal impairment and fatigue and has resorted to using a BSC instead of using the bathroom with assistance.

8. Formulate two nursing diagnoses, using a three-part format, that reflect the present issues being experienced by Mr. Tilly.

9. For each nursing diagnosis, identify the most appropriate outcomes for this patient. Develop an individualized goal for each that reflect the uniqueness of Mr. Tilly’s present situation.

10. Formulate three appropriate nursing interventions to facilitate the goals from above that are individualized to Mr. Tilly’s present health status.

11. At the sixth week of his recovery, the cast on his right arm is removed after diagnostic radiology shows that the fracture to the right radius has fully healed. The wrist and hand joints are very stiff and weak, and he is encouraged to move them as much as possible. Describe the aspects of range of motion of those joints that you should teach Mr. Tilly to do to facilitate a full return of function in that extremity.

Wrist:

Hand/Fingers:

12. Gaining strength in the arm has been a positive enforcer for his recovery. He asks you, “Why can’t I have a pair of crutches instead of that walker to help me get around?” Using an SBAR format, how would you address this with the physician?

13. Describe how you would teach Mr. Tilly to use crutches. What are the safety concerns you should address with him in the use of this modality?

research what outbreaks, disease, or pandemics have used the mitigation measure of Contact Tracing. After identifying those three outbreaks, write a three (or more) page paper that describes what type of infection was attempting to be contained, what patients were told to do to prevent the spread (if possible) the country(s) where the contact tracing occurred (for each), and what signs and/or symptoms patients or contacts were told to look for. This should be written using APA formatting

Roy’s Adaptation Model

Your closest friend has been diagnosed with breast cancer. Following surgery and chemotherapy she learned that the cancer has metastasized. She is single and has a daughter who is 6 years old.

Identify her adaptive needs in the physiological adaptive mode. What interventions would you provide?

Consider her possible adaptive needs in the self-concept mode. What possible interventions would you discuss with her?

What would be her needs in the interdependence adaptive mode? What possible interventions would you discuss with her?

Identify her adaptive needs in the role function adaptive mode. List an intervention you could offer to provide.

Mrs. Cass is an 87-year old African American client living in her own home. Her daughter lives nearby and is Mrs. Cass’s primary care giver. Mrs. Cass is a widow but has a few long-time friends who are concerned about her welfare. Due to mobility issues, they have difficulty making trips to visit her, limiting her socialization. She “gets by” financially, as she describes her situation. “I don’t have many needs, but my medication is expensive.”

Mrs. Cass suffers from pain related to bone cancer metastasis. As her nurse, you have been visiting her for several months in her home. You have noticed behaviors consistent with increasing pain. During your current visit, you ask Mrs. Cass to respond to a verbal rating scale by asking her to rate her level of comfort on a scale from 0 to 10, with 10 being the highest possible level of comfort. She rates her comfort at 2.

In past visits, she has expressed concern about her future, questions how long she will live, and whether she will have relief from her pain. You and her daughter will plan comfort measures for Mrs. Cass.

QUESTION

Based on the first case study, apply the Theory of Comfort in planning strategies to increase your client's level of comfort. Describe interventions to increase comfort in the   three areas of relief, ease, and transcendence within two of the four contexts (physical, psychospiritual, social, and environmental).