Question One

Medical Surgical Nursing 92438, 92454, 92450 Assessment task 3: Reflection Paper Guidelines Intent: This assessment is designed to develop students’ reflective practice to improve their self-awareness and professional competence through critically thinking. This guided critical reflection can evaluate students’ ability to critically think and inform their future clinical practice. Objective(s) This assessment task addresses subject learning objective(s): B, C, D, E and G This assessment task contributes to the development of graduate attribute(s): 1.1, 1.2, 1.4, 3.1, 4.2, 4.3. 5.1, & 5.3 Weight: 30% Due date: Wednesday 3 rd. June 2020 by 5pm Length: 1500 word limit +/- 10%, excluding references Task: Students will produce a written response in short answer format using the Gibb’s (1988) reflective cycle and supporting literature to reflect on how their education during Nursing studies prepares them to respond to COVID-19? The students will be asked to address the following components: Description (outline what happened and describe the role of nurse) Describe your understanding of COVID-19 and its impact? Describe the role of the nurse in this context? Feelings (demonstrate an awareness of your own feelings and identify the reasons behind them) Describe your feelings about entering the health workforce during the outbreak of a pandemic. Evaluation (describe what was good and/or bad about your learning and experience) Reflect on how the knowledge and skills developed during your Nursing studies is relevant to COVID-19 and if there are gaps in your learning. Analysis (examine the elements of your experience using evidence-based literature) Analyze the relevance and utility of the knowledge and skills you have learned during your Nursing studies that relate to COVID-19

Conclusion (Using the Gibbs reflective Cycle and other evidence-based literature describe how the knowledge and skills developed during your Nursing studies can be used to make a positive contribution to the community). Consider how you can use the skills and knowledge that you have acquired during your Nursing studies to contribute to patient care, treatment and the public response to COVID-19. Referencing the Faculty of Health uses the UTS Harvard referencing guide or the American Psychological Association (APA) 7th referencing style for in text referencing and production of a reference list. Please refer to the following links for guidance on these referencing styles: https://www.lib.uts.edu.au/sites/default/files/attachments/page/InteractiveHarvardUTSGui de.pdf https://www.lib.uts.edu.au/help/referencing/apa-referencing-guide Further information: Please note your Coursework Assessment Policy Manual and Student Disclaimer: You are not permitted to use or replicate previous assessment or use this assessment in your future studies.

Question Two

Susan Brown, his usual personal care assistant, has returned from holidays and finds Jun-Wei is still not out of bed. It is now 09h00, this is not normal behavior for Jun-Wei. Susan notices that he is very wheezy and seems unable to manage his puffer. He says he thinks he has a cold. Susan helps him to get ready for the shower and he manages to wash himself with much more effort than usual. He says he is not hungry and doesn’t want to go out today. He seems sad.

The organization has procedures that state the following:

• Client personal information is recorded on a personal details form.

• All client information goes into the client’s file that is locked in the filing cabinet in the staff office.

• Client progress notes are to be updated by every staff member at the end of each shift.

• Money spent is to be recorded in the petty cash records in the finance folder in the staff office.

• Changes in clients’ needs or health are to be reported as soon as possible, by phone, to the area manager.

• Incident reports are to be completed if a client is put at risk or puts themselves at risk.

Case study (questions 17–24)

Read this case study, then answer the questions that follow.

Margaret is a 75-year-old woman living in an aged care facility for residents with low-care needs. Margaret had polio as a young child and has one shortened leg requiring a built-up shoe. She also now has arthritis in her hands, back, hips and knees, which is making movement, transfers and balance difficult and painful. Margaret also has emphysema and requires oxygen via nasal tubes, medication via a nebulizer, tablets for her arthritis and she receives injections.

Following is a list of supports outlined on Margaret’s care plan.

Washing:

Margaret can sit on a shower chair and independently wash the top half of her body, including genital area. She requires assistance to wash feet, legs and hair.

Margaret must be supervised and may need direction when stepping in and out of shower and transferring in and out of the shower chair.

She needs full assistance with drying herself, as she becomes breathless.

Dressing/undressing:

Margaret needs assistance with dressing and undressing as she has difficulty moving and becomes breathless with exertion. She must have a built-up shoe on her left foot.

Grooming:

Margaret likes to direct her own grooming and can do her make-up independently. She needs assistance with drying and styling her hair.

Nail care:

Margaret needs regular monitoring and treatment for ingrown toenails and corns. She takes care of her fingernails independently.

Oral hygiene:

Margaret has upper dentures and requires assistance to clean these and to open lids of cleaning fluid and containers.

Mobility:

Margaret uses a four-wheeled walker at all times

Transfer:

Margaret requires direction to use handrails and chair arms, to transfer in and out of chairs.

Toileting:

Margaret can use the toilet independently but wears incontinence padding due to difficulty getting to the bathroom in time, which results occasional leakage.

Question Three

Assessment 1 Underpinning knowledge questions

Case scenario 1:

George has come into the acute ward after his wife stated that he had some episodes of obstructive sleep apnea. George has been placed on a continuous positive airway pressure (CPAP) machine.

Provide a response to the following questions based on this case scenario.

1. Describe the potential physical and psychological impacts of obstructive sleep apnea on a person’s health status. (Min 100 words)

• List 3 risk factors for a person developing obstructive sleep apnea and how a CPAP machine can assist with sleeping. (Min 100 words)

Risk factors:

• Excessive weight
• Family history

• George does not tolerate the CPAP machine and the specialist suggest that they change to Bilevel positive airway pressure (BiPAP) machine. What is difference between CPAP and BiPAP? (Min 50 words)

Case Scenario 2:

Debbie is 30-year-old women admitted to the acute ward after having a spinal anaesthetic for surgical repair to a laceration of her chest cavity after a motor vehicle accident. Debbie is 30 weeks pregnant, has a right intercostal catheter and UWSD to treat a haemothorax, is on oxygen therapy and has a PICC line to maintain fluids and deliver medications.

• The changes in a woman’s physiology during pregnancy present special challenges to the trauma team, what are they?

Research: Changes in woman’s physiology during pregnancy and relate it to the scenario (issues to the trauma team)

Example:

• Laboratory tests need be read with an understanding that values or levels will be slightly different in the 3rd trimester of a pregnant woman compared to a non-pregnant woman

• If a chest tube is indicated, place tube 1–2 intercostal spaces above usual fifth intercostal space landmark due to raised diaphragm

• Describe nursing management and monitoring of a person with an intercostal catheter and underwater seal drainage system and possible complications of this treatment. (Min 200 words)

• Intercostal catheter insertion site checked for signs of infection and wound dressing according to organizational policy and procedures.
• Check the tubing…
• Check Underwater seal drainage observe for….
• Check for

• The anesthetists used a spinal anaesthetic for Debbie during surgery; why are the following listed types of anaesthetic used for different presenting health conditions? Complete table below.

• What pain management strategies and nursing care actions could you use to promote Debbie’s post-operative comfort? (Min 100 words)

Case Scenario 3:

A patient is admitted post-operatively after a general anesthesia to the acute ward. The patient is a little drowsy but slowing becoming more alert but is unable to communicate with you due to having a procedure for a tracheostomy.

Patient’s vital signs are: T38.9, R 16, P 85, BP 115/85; GCS 13

oxygen saturation 99%; Humidification 30%

• What are the most common postoperative complications from general anesthesia that nurses need to be aware of? (Min 50 words)

• Nausea and vomiting
  •    

(Give at least 8-10)

• What are some of the physiological changes that occur when a person has a tracheotomy? (Min 50 words)
  • Loss of voice

1. What are the clinical indicators of the need for suctioning of a tracheostomy tube? (Min 20 words)

1. What are the clinical indicators of the patient’s tracheostomy stoma site that need reporting to RN? (Min 50 words)

1. Describe some communication methods when speech is not possible due to a person having a tracheostomy. (Min 50 words)

1. How would your priorities and modify nursing interventions for a person with a tracheostomy in consultation with RN?? (Min 100 words)
2. Maintaining airway – briefly describe, suctioning,
3. Prevent infection –
4. Communication - strategies

1. What type of risk assessment would be carried out to make a determination of the of patient’s stability on their feet prior to allowing them to ambulate post operatively after days of bed rest?

Research project 3 Individual work

The assessment task will be to view the following image of an acute care environment and research the equipment in the image to provide a brief description. Use the table below to list the equipment and brief description.