Complete the following table identifying any three key presenting features or clinical manifestations

Questions:

Part A

1. Complete the following table identifying any three key presenting features or clinical manifestations (signs and symptoms) of each of the following chronic diseases or health conditions.

Chronic diseases or chronic health conditions Any three major presenting features or manifestations

  • Chronic asthma
  • Chronic obstructive pulmonary disease
  • Chronic pain
  • Chronic renal failure
  • Congestive heart failure
  • Diabetes insipidus
  • Diabetes mellitus
  • Eczema
  • Bladder incontinence
  • Motor neurone disease
  • Severe traumatic brain injuries (neurological injury)
  • Long term unconscious or coma
  • Osteoarthritis
  • Parkinson’s disease
  • Rheumatoid arthritis
  • Middle cerebral artery (MCA) stroke
  • Systemic lupus erythematosus (SLE)
  • Chronic back pain
2. Answer the following questions based on the Working with People with Chronic and Complex Health Care Needs Core Standard for Nurses, practice package and appraisal document.
a)Briefly describe in your own words the purpose of this Standard.
b) Identify five issues nurses need to consider when supporting a person with dysphagia.
c) Identify three factors a nurse must consider when managing a person with faecal incontinence.
3. Answer the following questions based on the Person Centred Health Care Assessments and the Development of Health Care Plans Core Standard for Practitioners, practice package and appraisal document.
a) Briefly describe the purpose of this Standard.
b) Identify five different uses of health assessment.
4. Briefly describe the clinical features distinguishing a permanent tracheostomy from a temporary tracheostomy.
5. Complete the following table briefly describing various concepts and models of chronic health care in your own words.

Various concepts and models of chronic health care Description

  • Chronic disease continuum
  • Five key strategic objectives of the Chronic Diseases and Health Promotion Department (World Health Organisation)
  • Innovative Care for Chronic Conditions Model
  • Six elements of the Chronic Care Model
  • Purpose of the National Strategic Framework for Chronic Conditions
  • Nine national health priority areas agreed by the Australian Health Ministers’ Advisory Council
6. Provide three examples each for social, emotional, physical, psychological and financial impacts of chronic disease on a person.
7. List five common sites for cancer development.
8. Identify five (5) life variables that have an impact on the health and well-being of a person.
9. Complete the following table briefly describing various strategies to address and manage chronic diseases.

Various strategies to address and manage chronic diseases Description

  • Four strategies to prevent chronic diseases
  • Four treatment strategies used to address and manage chronic diseases
  • Five principles of person-focused nursing practice
  • Five examples of recommended practices for person-focused nursing practice
  • Four strategies to assist a person with chronic disease to maintain positive life roles
  • Five strategies to enable changes in a person’s behaviour over time
  • Five stages of change to establish readiness for attitudinal and behavioural change
  • Palliative care and domains of palliative care that must be undertaken as a strategy to address and manage chronic diseases
10. Complete the following table briefly describing rehabilitation strategies, techniques and equipment used for chronic health conditions.

Various rehabilitation strategies, techniques and equipment used for chronic health conditions Description

  • Five focus areas of physiotherapy in managing chronic conditions
  • Aim of occupational therapy in rehabilitation
  • Role of hydrotherapy in rehabilitation
  • Four advantages of the use of Pilates in rehabilitation
  • Four advantages of massage in rehabilitation
  • Role of art therapy in rehabilitation
  • Four advantages of music therapy in rehabilitation
  • Five considerations when choosing a wheelchair, scooter or walking aids for a person with chronic disease
  • Three considerations when choosing a prosthesis for a person with chronic disease.
11. List five community based care services that are available in Australia for individuals with a need for restorative or rehabilitation care.

Part B – Case Study

Case Study Scenario 1:

Assume that you are working as an EN in a stroke unit. Sherly, 48 years, is admitted with middle cerebral artery stroke and is recovering well. She is due to be discharged tomorrow.

Sherly has severe paresis and sensory loss of left extremities, uncoordinated movements and slurred speech.

Sherly requires restorative care and is anxious about her future life.

She requires a wheel chair to move around.

Sherly is a migrant with permanent residency in Australia. She has limited knowledge and understanding of resources that she could utilise in managing her condition.

  1. Identify and briefly describe any three (3) specific community based care services that are available for Sherly to ensure a coordinated service approach to provide her with rehabilitation care.

Case Study Scenario 2:

Mrs Melisa Carfi, a 65-year-old female patient with Type 2 diabetes mellitus, was admitted in your health care facility with a non-healing foot ulceration. Prior to admission, Melisa’s diabetes was managed with metformin. Upon admission, subcutaneous insulin with a diabetic diet was initiated along with oral anti-diabetic agents to achieve optimal blood glucose control.

  1. Provide a list of four (4) specific questions you would ask Melisa in order to seek information to confirm her understanding of the condition and its impact.
  1. What specific information will you give to Melisa if you are to provide health education on dietary management and physical activity with the goal of losing weight?

Case Study Scenario 3:

Mr David Ventor, 76 years old, has Type 2 Diabetes Mellitus, hypertension and a history of a Transient Ischemic Attack x 3 months ago. Mr Ventor’s wife passed away a month ago.

A community enrolled nurse visiting Mr Ventor’s home noticed the kitchen in an unhygienic condition with leftover food including pizza, juice and ice cream cartons.

The enrolled nurse observed that Mr Ventor was upset and teary when talking about his health status and the demise of his dear wife.

The community RN is due to visit Mr Ventor next week.  At the previous visit, there were no unusual activities to be noted or cause worry in relation to Mr Ventor.

Mr Ventor’s son moved in with him a week ago. His son is unemployed and an alcoholic. He was not at home during the visit.

The enrolled nurse asked Mr Ventor how supportive his son was in addressing his father’s needs.  Mr Ventor didn’t reply and stared away with teary eyes.

Mr Ventor was unwell with a cough and chronic back pain.

The enrolled nurse convinced Mr Ventor to seek medical support. An ambulance was called and Mr Ventor was transferred and admitted to a medical ward in the hospital for further evaluation and management.

  1. Identify and discuss the current contribution of community agencies and professionals in supporting Mr Ventor, referring to the scenario provided.
  1. Identify and discuss the level and type of contribution and support made by Mr Ventor’s son in managing his health condition and current situation.
  1. How effectively did the enrolled nurse respond to variations in Mr Ventor’s needs?
  1. Mr Ventor’s blood sugar level was observed to be high (14 mmol/dL). Mr Ventor was not complying with diabetic diet requirements. How should the enrolled nurse respond to these variations and Mr Ventor’s changing needs? Briefly describe a coordinated service approach required for Mr Ventor in this situation.
  1. Discuss strategies you could implement to actively involve Mr Ventor in the development of approaches to self-manage his condition.
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