1. Comfort, rest and sleep are important factors in an individual's life. Answer the following questions. 1.1 Identify four (4) factors that promote comfort, rest and sleep. 1.2 Identify four (4)...

1. Comfort, rest and sleep are important factors in an individual's life. Answer the following questions.

1.1

Identify four (4) factors that promote comfort, rest and sleep.

1.2

Identify four (4) factors that impede comfort, rest and sleep.

2. Answer the following questions related to Activities of daily living.

2.1

Define activities of daily living.

2.2

List five (5) basic activities of daily living.

3. Using proper aids to assist a client with their ADLs makes the activity safe and simpler for the clients. In the table given below, some scenarios are given. Choose the aids that would help you with assisting the client in the scenario. Also briefly state at least one easy way to assist the client to maintain safety, privacy and simplicity.

3.1

A client has right sided hemiplegia. Client needs to wear a shirt

3.2

A client has difficulty feeding himself due to chronic osteoarthritis in wrist and knuckles.

3.3

Client has Parkinson's disease moderately affecting his mobility. Client needs to get up from his bed and stand

3.4

Client is old and had a recent fall. He finds it hard to walk by himself.

4. A 67 year old lady with history of stroke and left sided hemiplegia is admitted in your unit. She also has a history of type 2 Diabetes mellitus and acute renal failure (now resolved). She is having a second degree pressure sore in the sacral area. She is incontinent with urine and continent with faeces. She has upper dentures and lower row of own teeth. She uses bilateral hearing aids and glasses. She is on regular pain relief tablets and still has occasional pain in her right leg and gets headaches very often which is usually relieved by Paracetamol.
Current reason for admission is lethargy and acopia at home. Family found the client confused at times and not attending to hygiene and grooming by self as she used to do before. You are assigned to provide comprehensive care to her. Answer the following questions.

4.1

Mention four (4) purposes of hygiene and grooming.

4.2

Enlist
four (4)
contributing factors of pressure injury.

5. With reference to the previous question, what are the actual/potential nursing care needs of your client? (in 30-40 words each).

5.1

Mobility and transfers

5.2

Elimination needs

5.3

Comfort and sleep

5.4

Nutrition needs

5.5

Oral hygiene

5.6

Personal hygiene and grooming

5.7

Falls prevention

5.8

Pressure injury prevention

5.9

Prevention of deconditioning

6. Urinary incontinence is one of the most chronic health problems and can be intractable and ongoing.

Specify
two (2)
examples each for the following treatment strategies of urinary incontinence.

6.1

Behavioural technique

6.2

Pharmacologic technique

6.3

Mechanical treatment

7. Urinary incontinence is one of the most chronic health problems and can be intractable and ongoing.

7.1

68 year old Janice complaints of urge incontinence. Janice is a slow walker and uses a 4 wheeled walker for ambulation. Janice had a fall while trying to get to the toilet to urinate. What aids could be used to assist Janice with toileting? How can we make Janice's environment safe to avoid falls?

7.2

82 year old Bob is under palliative care. Bob is bed bound. Bob has functional incontinence of urine and faeces. This makes him highly susceptible to pressure injuries, macerations and skin breakdown. Also, it would be very uncomfortable for client. What aids could be used to assist Bob with toileting comfortably?

8. You find a 63 year old female on the floor of the living room who is not arousable. Describe the initial steps of resuscitation (in 30-40 words each).

8.1

Dangers

8.2

Responsiveness

8.3

Send

8.4

Airway

8.5

Breathing

8.6

Defibrillation
• Use of Automatic external defibrillator

9. Mrs. Alice, a known case of asthma has recently been admitted into the unit where you work. Recently she fell at home and sustained a hipbone fracture. She is having severe pain in the hip and groin area which makes it difficult to walk. From your observation she seems severely malnourished. Answer the following question based on the scenario

9.1

Identify
ten (10)
actual and potential nursing interventions that can be provided to Ms. Alice to reduce pain (in 80-120 words)

9.2

Describe the nursing care to manage the respiratory problems related to chronic asthma.(in 30-40words)

9.3

Describe
four (4)
nursing interventions to improve the nutritional status of Alice (in 100-150 words)

10. With reference to the previous question, mention
four (4)
nursing interventions each to prevent the following complications of immobility( in 20-30 words)

10.1

Pressure injury

10.2

Constipation

10.3

Contractures

10.4

Chest infection

11. Mr. William, 85 years old male client is living in a long-term care facility. He is having progressive dementia over the past seven years and is unable to care for himself independently due to cognitive decline. He has got visual and hearing impairment.
Identify actual and potential nursing interventions to improve the self-care ability of Mr. William in relation to the following (in 50-60 words)

11.1

Cognitive decline

11.2

Sensory deficits

12. Good clinical handover and case meetings are vital to protect patient safety. Briefly describe the recording and reporting requirements for comprehensive clinical handovers and case meetings (30-40 words).

13. Mr Roy was admitted under your care with community acquired pneumonia. As part of the treatment regime IV Benzyl penicillin infusion was commenced. Minutes after commencement, client complained of shortness of breath and itching all around the IV cannula. On examination, you find that the client has wheeze, is short of breath and has raised red rashes developing on the arm, face and neck. SBP is low, patient is tachycardic, respiratory rate is 32, oxygen saturation is 85% on room air.

13.1

What is possibly wrong with Mr Roy? Rationalise your answer.

13.2

Describe how would you respond in this situation as an enrolled nurse(40-50 words).

14. You are posted in a post-operative unit to take care of the clients after surgery. Answer the following questions

14.1

Describe how to perform deep breathing and coughing exercise of a patient after surgery (40-50 words)

14.2

Enlist four (4) measures for maintaining a safe environment for the patients

15. Episodic care is health care provided to a client during an episode of illness. The main focus of this model of care is to treat the immediate issues of the client. This model of care is proven to have lot of risk factors as it lacks continuity of care and does not consider holistic care.

Give below are a list of situations where episodic care is commonly sought. Write at least 2 related risk factors for each situation.

15.1

86 year old client admitted from a nursing home with UTI and delirium.

15.2

6 month old baby is admitted with diarrhoea and vomiting

15.3

A client with delirium is posted for abdominal surgery.

15.4

Client was admitted with pathological fracture in the lower legs and is bed bound. Recovery time is expected to be more than 2 weeks

15.5

A client with BMI of 38 is admitted for treatment of chronic back and knee pain. Client needs assistance with mobility and transfers due to pain.

15.6

A client is admitted with Depression and weight loss for investigation. Client has lack of appetite and is non complaint to previous therapeutic interventions

16. Answer the following multiple choice questions on oral hygiene and provide rationale for your choices.

16.1

While caring for dentures, which of the following statements are WRONG? Select
3 (three)
answers.

Dentures should be stored in labelled denture cup with cool water if not being used

All surfaces of dentures should be brushed properly

A small break or chip in the denture is ok. We have to report only major damages

Use of detergent on dentures are not advised

While cleaning, it is ideal to place the dentures in a sink half filled with water and without a lining surface

Dentures must be soaked in commercial denture solution daily

16.2

Rationalise your choices in previous question.

16.3

Which of the following statements are WRONG in relation to oral care? Select
3 (three)
answers.

Regular flossing is recommended for health teeth and gums

Mouthwashes should be free from alcohol, hydrogen peroxide and sodium bicarbonate

Using lemon and glycerine for oral care is good for oral cavity

Best way to moisturize oral mucosa is by using mouthwash twice daily

Mouthwashes with alcohol available from pharmacy is good to kill unwanted bacteria in mouth that causes halitosis

16.4

Rationalise your choices in previous question.