Hltenn 007 AE CS 3of5 PDF

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Hltenn 007 AE Case Study take home assignment 3of5...

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Case Study Assessment Criteria Unit code, name and release number HLTENN007 Administer and monitor medicines and intravenous therapy (1) Qualification/Course code, name and release number HLT54115 Diploma of Nursing (1)

Student Details Student number 446818902

Student name Kevin Lee

Assessment Declaration 

This assessment is my original work and no part of it has been copied from any other source except where due acknowledgement is made.

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No part of this assessment has been written for me by any other person except where such collaboration has been authorised by the assessor concerned.

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I understand that plagiarism is the presentation of the work, idea or creation of another person as though it is your own. Plagiarism occurs when the origin of the material used is not appropriately cited. No part of this assessment is plagiarised.

Student signature and date

Document title: HLTENN007_AE_CS_3of5 Resource ID: HCS_18_023_HLTENN007_AE_CS_3of5

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Version:

20191010

For queries, please contact: Health, Wellbeing and Community Services SkillsPoint Crn MacQuoid Street & Buttle Street QUEANBEYAN NSW 2620

© 2019 TAFE NSW, Sydney RTO Provider Number 90003 | CRICOS Provider Code: 00591E This assessment can be found in the: Learning Bank The contents in this document is copyright © TAFE NSW 2019, and should not be reproduced without the permission of the TAFE NSW. Information contained in this document is correct at time of printing: 29 September 2020. For current information please refer to our website or your teacher as appropriate.

Document title: HLTENN007_AE_CS_3of5 Resource ID: HCS_18_023_HLTENN007_AE_CS_3of5

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Assessment Instructions Table 1 Assessment instructions

Assessment details

Instructions

Assessment overview

The objective of this assessment is to assess your knowledge and performance as would be required to show your ability to complete and manage tasks in this unit, manage any contingencies in the context of your job role.

Assessment Event number

3 of 5

Instructions for this assessment

This is a case study assessment and it will be conducted as a take home assessment. You should use your reference text, learning notes and other reputable resources and internet sources when completing this assessment. This document is in 6 parts: Part 1: Case study scenario 1 and short answer questions Part 2: Case study scenario 2 and short answer questions Part 3: Case study scenario 3 and short answer questions Part 4: Case study scenario 4 and short answer questions Part 5: Case study scenario 5 and short answer questions Part 6: Assessment feedback.

Submission instructions

On completion of this assessment, you are required to upload it or hand it to your teacher for marking. Ensure you have written your name at the bottom of each page of this assessment. It is important that you keep a copy of all electronic and hardcopy assessments submitted to TAFE and complete the assessment declaration when submitting the assessment.

What do I need to do to achieve a satisfactory result?

To achieve a satisfactory result for this assessment all questions must be answered correctly. If you do not achieve 100% you will be provided with feedback and asked to resubmit responses to those questions you answered incorrectly within two weeks, unless otherwise agreed with the Head Teacher where there are extenuating circumstances.

What do I need to provide?

Computer and/or pens and paper, internet access if submitting assessment online, ability to print or email completed assessment, calculator, learning notes, student ID.

Document title: HLTENN007_AE_CS_3of5 Resource ID: HCS_18_023_HLTENN007_AE_CS_3of5

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Assessment details

Instructions

Assessment overview

The objective of this assessment is to assess your knowledge and performance as would be required to show your ability to complete and manage tasks in this unit, manage any contingencies in the context of your job role. Optional recommended textbook: Freshwater, D and MaslinProthero, S.E. (2013) Blackwell’s Nursing Dictionary, 2nd Edition, Blackwell Publishing Ltd, Sydney.

What will the assessor provide?

Prescribed textbooks: TAFE NSW. (2017). Medication Administration for Nurses. Orange: VETRes. Koutoukidis, G, Stainton, K. & Hughson, J. (2017) Tabbner’s Nursing Care (7th ed.) Elsevier, Chatswood Computers with online learning platform and resources, printed copy of assessment, reading lists, policies or guidelines, key documents and templates, assessment guidance and feedback.

Due date

Teacher/Assessor to complete as per assessment schedule.

Time allowed

It should take about 8 hours to complete this assessment.

Assessment feedback, review or appeals

Appeals are addressed in accordance with Every Students Guide to Assessment.

Document title: HLTENN007_AE_CS_3of5 Resource ID: HCS_18_023_HLTENN007_AE_CS_3of5

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Specific Task Instructions You are required to complete short answer responses to the questions relating to following five (5) case study scenarios. Once completed you should submit these to your assessor for marking. The instructions and the criteria in each case study scenario will be used by the assessor to determine whether you have satisfactorily completed this assessment. Use these instructions and criteria to ensure you demonstrate the required knowledge.

Document title: HLTENN007_AE_CS_3of5 Resource ID: HCS_18_023_HLTENN007_AE_CS_3of5

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Part 1: Case Study Scenario 1 and Short Answer Questions Read the case study scenario below, then complete your written responses to the questions in the spaces provided in this document. The required answer length varies and is indicated with each question. You may also find it helpful to review the following website on Visual Infusion Phlebitis Score: vipscore.net Case study scenario 1: Mr Ethan Black, 76 years, has been admitted to the hospital with gastroenteritis. He is prescribed IV antibiotics to be given 6 hourly via a burette and has a litre of intravenous fluids in progress to maintain hydration. He has a peripheral intravenous cannula insitu, inserted one day prior. His IV therapy is running through an IV pump infusion device – a volumetric pump. Mr Black is concerned about the side effects of the antibiotics he has been prescribed for his gastroenteritits. Short answer questions: 1. Describe the Visual Infusion Phlebitis Score (VIPS) monitoring system and how you will use it to monitor Mr Black’s IV cannula. (minimum 100 words, maximum 150 words)

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(VIPS) is a very popular tool for monitoring infusion sites. All patients with an intravenous access device in place must have the IV site checked at least daily for signs of infusion phlebitis. (VIPS) determines the appropriate discontinuation of (PIVC) by evaluation of the (VIPS) score. The subsequent score and actions taken must be documented. The cannula site must also be observed when: bolus injections are administered, IV flow rates are checked or altered, and solution containers are changed.

2. The infusion pump alarms and you notice swelling at the IV site. Identify at least three (3) appropriate courses of action the enrolled nurse should take. (minimum 15 words, maximum 30 words) The three courses of actions are: ask patient’s pain level along the path of the cannula, check redness and swelling around the site, and notify RN in charge.

3. Identify five (5) elements that should be included on the intravenous additive label when his antibiotics are in progress either via a burette or IV piggyback, tandem. (minimum 25 words, maximum 50 words)

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The elements that should be included on the IV additive label are: Patient name, MRN, DOB, medication details, diluent, date and time, check for signatures.

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4.

Explain three (3) reasons why parenteral medication should only be drawn up immediately prior to use regardless of the patient’s situation and medication order. (minimum 15 words, maximum 30 words)

The three reasons why parenteral medication should be only be drawn up when applying are to maintain a sterile environment for medication, maintain a safe practice and accuracy, as well as keep an optimal medication efficacy prior to use.

5. Age is a consideration in the calculation of medication doses, particularly for older patients like Mr Black. Explain why dosage calculations for geriatric and also paediatric patients need careful consideration. Provide at least three (3) reasons for each. (minimum 50 words, maximum 100 words) Dosage calculations for geriatrics and paediatric patients need careful consideration is important when administrate medications. Factors need to be considered such as minimise the risks of overdose a patient, as they are vulnerable groups of people. In addition, monitor medication strength for safety precaution also needs to be considered as well as monitor and observe the side effects and symptoms from the medication.

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6.

Explain three (3) factors that need to be taken into consideration when administering medication to older patients like Mr Black and also taken into consideration for the very young. (Minimum 150 words, maximum 250 words).

The three factors that need to be taken into consideration when administering medication to older patients and for the younger ones are drug contradiction, effectiveness, and re-evaluation of medications being given. Drug interaction – monitor medication contradiction, observe the side effects from the medication. Communicate well with the patient and monitor their progress. Ineffectiveness of drug – monitor body function from accumulated drugs over time, observes patient’s body size and composition, fluid intake, and skin integrity. Re-evaluation of medication – observe patient’s physical condition and reevaluate their status to check whether medication is appropriate to be given or need to be ceased.

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7. What course of action would you take if Mr Black said he refused to have his IV antibiotics anymore.(minimum 50 words, maximum 100 words) The course of action for Mr Black is to educate the patient regards to why medication prescribed by the doctor is necessary. If the patient still refuses to take the medication, documented on EMR and notify RN and inform Doctor.

8. The doctor advises that Mr Black needs electrolyte replacement. Describe six (6) signs and symptoms that Mr Black would demonstrate if he was experiencing an electrolyte imbalance that would need to be recorded and reported to the RN/doctor. (minimum 75 words, maximum 150 words) The six signs and symptoms that Mr Black would demonstrate if he was experiencing an electrolyte imbalance that would need to be recorded and reported to the RN/Doctor are: - Irregular and fast heartbeat - Fatigue, feel lethargic - Convulsions and seizures - Nausea and vomiting - Diarrhoea and constipation

Document title: HLTENN007_AE_CS_3of5 Resource ID: HCS_18_023_HLTENN007_AE_CS_3of5

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9. If Mr Black receives electrolyte replacement, how would you evaluate its effectiveness? Provide four (4) nursing evaluations and the rationale. (Minimum 50 words, maximum 100 words). Fluid balance – Hypervolemia and Hypovolemia Check excess fluid volume and deficient fluid volume Potassium (k) imbalances – Hyperkalemia and Hypokalemia Sodium (Na) imbalances – Hypernatremia and Hyponatremia Magensium (Mg) imbalances – Hypermagnesemia and Hypomagnesemia Calcium (Ca) imbalances – Hypercalcemia and Hypocalcemia Nurse Interventions Monitor vital signs as well as central venous pressure, if available. Weight client daily and observe for sudden weight gain. Note presence of neck and peripheral vein distention, along with pitting edema, and dyspnoea. Monitor intake and output. Note decreased urinary output and positive fluid balance on 24-hour calculations. Monitor infusion rate of parenteral fluid closely; may use infusion pump as necessary. Rationale Monitor tachycardia and tachypnoea, hypertension, elevated CVP. One litre of fluid retention equals a weight gain of one kilogram (2.2 pounds). Check signs of cardiac de-compensation and heart failure Decreased renal perfusion, cardiac insufficiency, and fluid shifts may cause decreased urinary output and edema formation. Rapid fluid bolus or prolonged excessive administration potentiates volume overload and risk of cardiac de-compensation.

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Part 2: Case Study Scenario 2 and Short Answer Questions Read the case study scenario below, then complete your written responses to the questions in the spaces provided in this document. The required answer length varies and is indicated with each question. Case study scenario 2: Mr Adam Watson, 32 years, has been admitted to the hospital with pancreatitis. He is nil by mouth (NBM) and has been commenced on intravenous (IV) fluids 1000 mLs over 8 hours. He has been written up for metoclopramide 10 mg, IV 6hrly prn for his nausea and vomiting. Short answer questions: 1. The safe administration of medications is one of the nurse’s most important responsibilities. Explain the relationship between pharmacodynamics, pharmacokinetics and pharmacotherapeutics when administering Mr Watson his metoclopramide? What individual factors influence pharmacokinetics and pharmacodynamics? (minimum 100 words, maximum 150 words) Pharmacodynamics is the study of how a drug affects an organism. This includes the pharmacological response and its duration and magnitude observed, relative to the medicine concentration at an active site in the organism i.e. the study of a medicine’s effect and the mechanisms of action. Pharmacokinetics is the study of how the organism affects the drug. It influences the decided route of administration for a specific medication. The amount and frequency o each dose and its dosing interval. Both, together influence dosing, benefit, and adverse effects.

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2. You give Mr Watson a dose of IV metoclopramide for his nausea and vomiting. How long will it take for the onset of action? (maximum 20 words) The onset of action is 1-3 minutes following IV administration, pharmacological effects persist for 1-2 hours. It takes 10-15 minutes for IM administration, onset of action.

3. Describe the therapeutic use of metoclopramide for Mr Watson’s nausea and vomiting and the effect of this drug on the body. (minimum 15 words, maximum 30 words)

Metoclopramide is within the Prokinetic class. It works by speeding the movement of food through stomach intestine. It is used to prevent both nausea and vomiting from surgery and chemotherapy.

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4. Why might Mr Watson be given an electrolyte replacement? (minimum 50 words, maximum 100 words) Mr Watson has lost significant amount of fluid due to nausea and vomit, and he is nil by mouth. Given electrolyte replacement to the patient for some fluid balance and prevent dehydration.

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5.

Two minutes after administering a second dose of 10 mg metoclopramide to Mr Watson he complains of shortness of breath, a feeling of light headedness and nausea.

Identify and explain Mr Watson’s reaction. (Minimum 50 words, maximum 100 words)

Mr Watson is showing the side effects of medications that need medical attention. Unfortunately, there is no antidote for the medication’s side effects, it takes 24 hours to wash off. Documented and reported to the RN/Doctor, and review on the medication dosage.

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Part 3: Case Study Scenario 3 and Short Answer Questions Read the case study scenario below, then complete your written responses to the questions in the spaces provided in this document. The required answer length varies and is indicated with each question. Case study scenario 3: Kelly Brown, a 53 year old female with a history of congestive cardiac failure, is on your ward. You are working with a registered nurse and the RN is in the room with you while you are dispensing a medication to Ms Brown. You have been told in handover that this medication has been discontinued, but when dispensing and talking with the RN you forget this. You administer the medication to Ms Brown and observe her taking it. You go back to the chart and realise that you have administered the discontinued medication. Short answer questions: 1.

Identify five (5) essential actions following a medication error incident. (minimum 50 words, maximum 100 words)

Report – the incident to the RN/supervisor Documentation – on the MRN Follow up – meeting to discuss the outcome Prevention – Re-evaluation and reflect the incident IINS – report to the committee

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2. Ms Brown is ordered furosemide (frusemide). Why is furosemide (frusemide) used to treat cardiovascular disorders? (minimum 30 words, maximum 75 words) Furosemide used to treat cardiovascular disorder by reducing the extra fluid in the body, thus prevent edema.

3. (a). When monitoring the effects of furosemide (frusemide) on Ms Brown, identify three (3) signs and symptoms of hypervolemia that you would report and record for each of the three (3) body systems listed in the table below. (minimum 20 words, maximum 50 words)

Cardiovascular System

Respiratory System

Nervous System

1. edema – feet, ankles, 1. shortness of breath wrists and face

1. blurred vision

2. discomfort – causing 2. lungs - fluid cramp, headache, stomach

2. dizziness

bloating

3. High blood pressure – 3. Nausea and vomiting excess

fluid

in

3. Headache

the

bloodstream

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(b). List four (4) complications of untreated hypervolemia.

Untreated hypervolemia can cause several compli...