Case Scenario: You are an Enrolled Nurse working as part of
Case Scenario: You are an Enrolled Nurse working as part of the…Case Scenario:You are an Enrolled Nurse working as part of the Aged Care Assessment team (ACAT). On your shift today a new client is being assessed for short term respite, with the plan to transition to longer term respite if suitable for the client and the family. You are visiting the client in their home, along with a Registered nurse.As part of your role, you are working with a Registered nurse to assess the client and to develop a plan of care appropriate for the client with both short and long term objectives and goals. Character Briefs:Mrs Fei Hong: Mrs Hong is a 70 year old lady of Chinese origin. Mrs Hong’s background includes: -Comes from one child family Chinese backgroundSpeaks little English Has no extended family Came to Australia to help her daughter, Yu Yang raise her son 19 years ago.Is beginning to demonstrate signs of dementia Interferes in parenting of twinsDictates cooking must be Asian Has hearing and sight impairment Mrs Yu Yang McFarlane: Mrs McFarlane is Mrs Hong’s daughter. She is 38 years old and married to George McFarlane. She has a son Jason and 3 year old twins.Mrs McFarlane’s background includes: -Came to Australian as a University studentFell pregnant at the age of 19 – did not marry Married George 5 years agoHas 3 year old twins at home One twin has developmental disorderEnglish language is goodWas/Is isolated with no extended family Her issues will be those of isolated immigrantPrefers to cook Asian foodNeeded help with raising child and invited Chinese mother to Australia to help out Mr George McFarlane: Mr McFarlane has been married to Yu Yang for 5 years. He is 53 years old. Mr McFarlane is reliant on Yu Yang to complete all domestic duties as he is not self-sufficient. He is a long- haul truck driver and is often away for work. He earns good money. Mrs McFarlane has found it increasingly difficult to care for her mother at home and is seeking short term respite for her mother with the possibility of long- term care. Both Mrs McFarlane and Mrs Hong are in attendance for the assessment. 1 Below is a list of body systems- complete the following: -Sensory functionCardiac functionRespiratory functionNeurological functionMusculoskeletal functionGenitourinary functionEndocrine functionrenal functionskin integrityList 2 age related physiological changes for each systemDiscuss how these identified changes can affect the client’s ability to perform activities of daily living. Age-related Physiological changesGive two examples Effect on ADLs (client’s daily functioning)Give one exampleSensory Function Cardiac Function Respiratory Function Neurological Function Musculoskeletal function Genito-urinary Function Endocrine Function Renal Function Skin Integrity Function REFERENCE: TASK Assessment Criteria 2 How would you assess the client for any of the identified physiological changes listed above? List 5 nursing assessment tools that would be used to identify age-related changes.Response: Assessment 1 Assessment 2 Assessment 3 Assessment 4 Assessment 5 REFERENCE: TASK Assessment Criteria 3 a)Outline how age can affect the metabolism and excretion of medications in the renal and hepatic systems. b)Why is it important for an EN to know the functions of body metabolism when caring for elderly patients Response: REFERENCE:a) b)TASK Assessment Criteria 4 Explain in understanding of the following aging theories: -biological theorypsychosocial theorydisengagement theorysocial exchange theorywear and tear theoryactivity theory Response: biological theory- psychosocial theory- disengagement theory- social exchange theory- wear and tear theory- activity theory REFERENCE: TASK Assessment Criteria 5 Three stereotypes required: -Discuss three common stereotypes of aging. How might stereotyping affect the way care is provided to an older person?Response: REFERENCE 1.a) Stereotype b) Care provision 2.a) Stereotype b) Care provision 3. a) Stereotype b) Care Provision TASK Assessment Criteria 6 How would the rights or dignity of an older person be affected by these stereotypes? Please provide an example.Response: TASK Assessment Criteria 7 Identify types of elder abuse and possible signs for each one. Created a table for a Matching Type test (3 columns: verbal abuse, Financial abuse, physical abuse)b) What are all health professional’s mandatory responsibilities in this circumstance?c) How would you, the EN, advocate for an older client if you observed elder abuse? What will be your immediate actions as an EN in terms of reporting and referrals to appropriate MDT? Elder abuse type Physical signGive example Behaviour changeGive exampleA. Verbal Abuse B. Financial abuse C. Physical Abuse D. Sexual abuse E. Social Abuse F. Emotional Abuse/ Neglect TASK Assessment Criteria 8 What signs might Mrs Hong demonstrate physically, emotionally and mentally which may indicate to you that she is feeling stressed about her current situation. How might you respond and include Culturally sensitive responses? Response: PhysicalA.B. EmotionalA.B. MentalA.B. REFERENCE TASK Assessment Criteria 9 List 2 possible signs and symptoms which may indicate that Mrs Hong is developing dementia?Response: 1. 2. REFERENCE: TASK Assessment Criteria 10 How would you approach Mrs Hong differently if she was demonstrating signs of dementia with agitation or challenging behaviours? What nursing interventions would you consider?How might these interventions differ for Mrs Hong’s culture and age? Please explain and give 2 examples.Response: A. B. C. 2 Examples:c.1c.2 REFERENCE TASK Assessment Criteria 11 Describe 3 possible impacts on Mrs Hong if she will be admitted to short or long – term residential care?Response: 1. 2. 3. REFERENCE: TASK Assessment Criteria 12 Name 3 emotional impacts on Mrs McFarlane if she was to admit her mother to long -term residential care? (Consider the holistic picture of the patient and family).Response: 1. 2. 3. REFERENCE:TASK Assessment Criteria 13 List 5 home care/ support services that Mrs Hong and Mrs McFarlane could consider if they decided to stay at home rather than use long- term residential care. Include one service that would meet Mrs Hong’s cultural requirements. (Considerations should also be made for cultural and religious beliefs and how and what to include in an Advanced Care Directive). Response: 1. 2. 3. 4. 5. REFERENCES: TASK Assessment Criteria 14 What information can you give to Mrs Hong and Mrs McFarlane about advanced care directives (ACD)? IncludingWhere to get information about ACD How to complete an ACD /Who can assist them in completing an ACD? What can be included in ACD. (Include cultural and religious considerations).N.B- Reference and provide your own state’victoria australia s legislation for advanced care planning when providing information. Response: Where can the family get information about ACD ? How will the family complete an ACD? Who can assist? What can Mrs Hong and her family include in ACD? REFERENCES: TASK Assessment Criteria 15 List 5 sources of education and necessary information that Mrs Hong and Mrs McFarlane would need when making a decision about short and long -term options for residential care? (This might include implications to Mrs Hong and Mrs McFarlane if admitting to a long term residential facility including cost, legal requirements/ documents requiring completing)Discuss two possible health promotion activities which could be provided to Mrs Hong. (Consider the aging process, her hearing and sight difficultiies and limited English)Response: a)1. 2. 3. 4. 5. b)1. 2. REFERENCES: TASK Assessment Criteria 16 After examining and assessing Mrs Hong, write a care summary for Mrs Hong using a Body Systems documentation approach suitable to inform the MDT and other nursing staff.Include in your summary: -ADLs-her ability to provide self-care and any possible limitationsany identified physiological, emotional or mental issues which will require specific nursing care (including early dementia).Response of Mrs Hong and her daughter to possible admission to residential facilityInformation and interventions provided to Mrs Hong and her daughterNursing interventions discussed relating to Mrs Hong’s culture, hearing and vision impairment & poor English(Care Summary relating to Q 16Response: DATE;TIME:NURSING:INTRODUCTION: CARDIOVASCULAR: RESPIRATORY: NEUROLOGICAL & PAIN: NEUROVASCULAR STATUS: METABOLISM: GASTRO -INTESTINAL: ADLS SKIN INTEGRITY WATERLOW/BRADEN PSYCHOLOGICAL: DISCHARGE PLANNING: (Interventions provided, outcome/evaluation and plans for future management) NAME & DESIGNATION: SIGNATURE: Health ScienceScienceNursingHLTAAP 003Share
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