Marcia answers short

Question 1

Hospitals and other care institutions have a duty of care. List three (3) major areas that must be attended to?

Answer 1

• Safety of all employees, patient and visitors.
• Care of the patient
• Employee qualified personal in each department
• Have policies and procedures in place

Question 2

Discuss the principles of good pain management in the care of acute pain.

Answer 2

• Knowledge of analgesics, pathophysiology of pain.
• Formal patient assessment - Pain Scores.
• Prompt appropriate intervention.
• Evaluation of effectiveness of treatment.

Question 3

Explain the term white coat hypertension. Why is this important in your practice?

Answer 3

Elevated blood pressure in a clinical setting but not in other settings. It is believed that this is due to the anxiety some people experience during a clinic visit, hence alleviating anxiety reduces BP.

Question 4

Skeletal fractures or soft tissue injury of limbs can result in the development of compartment syndrome. Use the lower leg as an example
A) Explain what compartment syndrome is at a cellular level, and what factors contribute to the development of compartment syndrome?

Answer 4

• Compartment syndrome is a swelling inside the muscular compartment leading to decreased perfusion which in turn can lead to necrosis and muscle death. Increase in volume in compartment caused by bleeding, infiltration of intravenous fluid or post-traumatic or ischemic swelling.

Question 5

Skeletal fractures or soft tissue injury of limbs can result in the development of compartment syndrome. Use the lower leg as an example

B) Explain the signs and symptoms of compartment syndrome.

Answer 5

1. PAIN: That is persistent, progressive and unremitting, is out of proportion to the injury, exacerbated by touch, stretching & elevation.
2. PALLOR: The limbs may be a pale or dusky colour.
3. PULSELESSNESS: By the time a limb has become pulseless it is an orthopaedic emergency. The pulse may be absent or diminished.
4. PARAESTHESIA: As the nerves become ischaemic, paraesthesia may occur within the affected compartments.
5. PARESIS: Report feelings of weakness in limb or it’s extremities

Question 6

Skeletal fractures or soft tissue injury of limbs can result in the development of compartment syndrome. Use the lower leg as an example

C) What is the rational of all observation in the early detection of compartment syndrome?

Answer 6

Neurovascular assessment – blood supply to effected limb.
Physical assessment
Help detect any problems early and minimise further damage

Question 7

Health screening is an important act of Health promotion. Identify five types of screening tests used to assess health and wellbeing in practice?

Answer 7

	Pap smear test  > cervical area 
	Mammogram 
	Colonoscopy 
	Dermatological test  
	PPD test

Question 8

When is consent required to a patient and who can consent for a patient?

Answer 8

1. Surgery / anaesthesia
2. ECT
3. Radiological treatment
4. Any treatment which there is a procedural risk to the patient involved
   The patient can consent himself , parent and guardians may too.

Question 9

Neurological observations are an important nursing responsibility. A number of terms exist to describe abnormal finding which nursing are often are the first to observe.

a) Describe the features of a person who has decerebrate posturing.

Answer 9

Decerebrate: Upper extremities stiffly extended, adducted, internal rotation, palms pronated. Lower extremities stiffly extended, planter flexion; teeth clenched.

Question 10

Neurological observations are an important nursing responsibility. A number of terms exist to describe abnormal finding which nursing are often are the first to observe.

b) Describe the features of a person who has decorticate posturing

Answer 10

Decorticate: Upper extremities- flexion of arm, wrist, and fingers; adduction of arm tight against thorax.Lower extremities extension, internal rotation, planter flexion

Question 11

Describe the nursing care of a patient with a bowel obstruction. Where possible provide rational for your interventions/action.

Answer 11

•Monitoring for signs & symptoms of deterioration
*Pain & symptoms management
•Fluid balance monitoring *Monitor nutritional stats
•Administration of IV fluids and electrolytes
* Assess improvement I.e return of normal bowel sound
•Pain and symptom management
* Assessing & measuring NGT output
•Naso gastric tube
* Assess for decrease in abdominal digestion
• Emotional support increases comfort

Question 12

List three types of validity that researchers use to develop a good research instrument.

Answer 12

Continent, construct and predictive.

Question 13

Discuss the difference between the ischemic and haemorrhagic stroke.

Answer 13

Ischemic occurs due to lack of O2 supply to the brain caused by obstruction of a blood vessel due to thrombi or emboli
Haemorrhagic rupturing of a blood vessel in the brain due to increase intracranial pressure leading to brain cell death

Question 14

The acronym RICE is used in nursing. Explain what this means and whom would you apply it.

Answer 14

REST prevents additional injury and promote healing
ICE vasoconstriction reduces bleeding/ oedema & discomfort
COMPRESSION control bleeding, reduces oedema & provides support to the injured tissue
ELEVATION
It would be applied to treatment of Sprains and Strains

Question 15

Identify five (5) key areas in mental health care where issues of negligence have been highlighted.

Answer 15

Social
Psychosocial
Physical
Emotional

Question 16

Describe the risk factors and principle of prevention for the development of pressure ulcers.

Answer 16

Risk factors includes
Age, Immobility, Poor diet, Loss of bowel or bladder control, Loss of mental or sensory loss

Preventions 
PAC (post-acute care), Frequent repositioning, Pressure relieving equipment aids, changing incontinent aids frequently and patient education

Question 17

Describe the four (4) elements of negligence?

Answer 17

• A duty of care exist
• The act or failure to act fell below what is expected
• The act or failure to act was the direct case of damage
• The damage was reasonable foreseeable

Question 18

What is consent? What are the types of consents?

Answer 18

The consent is
Consent must be obtained when any health professional wishes to touch a patient.
The types of consents are
1. Implied consent: rolling up of sleeve for BP recording
2. Verbal consent: Adequate explanation and allow for questions
3. Written consent:
• Used for all major procedures
• Procedures with risk
• Experimental procedures