Ann Buinda is an Aboriginal female (identifies
Ann Buinda is an Aboriginal female (identifies as she, her) aged 55yrs who lives in St George QLD and is admitted to a Brisbane hospital for a right knee replacement. Ann is accompanied by her niece Joanne who is 22yrs old. Ann suffers from osteoarthritis and uses 2 walking sticks to mobilize. She has treated her pain with over-the counter medications including paracetamol and ibuprofen. Ann is also a Type 1 insulin dependent diabetic and admits she is not always compliant with a diabetic diet. You ask Ann how she would like to be addressed and she says to call her Ann, Ann speaks her local Aboriginal language and English, Joanne also speaks English. Ann is very quiet and looked scared. Joanne has indicated to you that Ann is feeling quite anxious coming into hospital and being away from her community. As the Enrolled Nurse doing the admission documents you have taken a base line set of Observations and noted the following. BP 170/100 PR 90 regular RR 22 To 36.4 SpO2 98% on room air BGL 10.4 mmol Weight 66 kg Height 152 cm GCS (Glasgow coma scale) = 15 Identify the purpose of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM)………………………………………………………………………… According to the Nursing And Midwifery Board Code Of Conduct For Nurse’s, Identify four (4) aspects of culturally safe and respectful practice that you as the Enrolled Nurse can acknowledge to help Ann feel less anxious. …………………………………………………………………………………………. Answer the following questions in relation to the assessment data in the Case Scenario for Ann. Q.3 Ann’s blood pressure (BP) is 170/100. What artery is the blood pressure cuff placed over What is the generally accepted normal range for Systolic and Diastolic blood pressure in an Adult? Is Ann’s blood pressure reading within normal range? What is the correct terminology of high blood pressure? Q.4 Ann’s pulse rate is 90 and regular. What artery do you normally feel for when taking a person’s peripheral pulse When taking a person’s pulse what are you assessing What is the normal range for adult pulse rate? Is Ann’s pulse rate within normal range? Q.4 Ann’s respiratory rate is 24. How do you count respiration rate on a person What is the normal range for respiratory rate in an adult? Is Ann’s respiratory rate within normal range? What is the correct terminology for low respirations? Q. 5 Ann’s temperature is 36.4. How would you take a person’s temperature using a Tympanic thermometer What is the normal range for adult temperature? Is Ann’s temperature within normal range? Identify two (2) other sites you can take a temperature reading from Q.6 Ann’s oxygen saturation (SpO2) is 98% on room air. If you are placing an oxygen sensor probe on a patient’s finger, what must you assess first to ensure that the site is appropriate What is the normal range for oxygen saturation? Is Ann’s SpO2 within normal range? Q.7 Ann’s Blood Glucose Level (BGL) is 10.4 mmol. When using a Blood glucose meter device, what site on a person’s body is usually used to take a blood sample and why What is the normal range for blood glucose levels? Is Ann’s BGL within normal range? Q.8 Ann’s Glascow Coma Scale (GCS) = 15. When performing a neurological assessment using the GCS, what six (6) areas do you assess and why Is Ann’s GCS normal and why? Q.9 Using the following formula calculate Ann’s BMI: BMI = kg/m2 Ann’s BMI = Is this normal? …………………………………………………………………………………………. Q. 10. Neurovascular Observation a. What areas on the body would you include for Ann when doing a Neurovascular assessment? ………………………………………………………………………………… b. What are you assessing (looking for) when palpating the pulses of the popliteal, posterior tibial and dorsalis pedis? ………………………………………………………………………………… c. What are you assessing (looking for) when palpating the extremities? ………………………………………………………………………………… Q. 11. As part of your admission assessment on Ann you are to check for bowel sounds – please answer the following questions. Gastrointestinal and Bowel sounds a. State two (2) inspections that are performed when assessing a patient’s abdomen………. b. What are bowel sounds?…………………… c. State the equipment to be used to Auscultate a patient’s abdomen when checking for bowel sounds?……………………….. d. What sounds would u normally expect to hear?…………………………………………………………….. e. What maybe the problem if no bowel sounds are heard …………………………………………… Q. 12 As part of your admission assessment on Ann you are to complete a skin assessment – please answer the following questions. Skin assessment a. Identify four (4) factors that are important to consider when assessing the integumentary system (skin)…………………………………………………………………………………. b. How would you assess the skin turgor on Ann, and state what is normal / abnormal? ………………………………………………………………………………… Later in the shift Ann presses her call button, when you respond you notice that Ann is grimacing and is rubbing her knee. Her Niece explains that Ann is a lot of pain but doesn’t like to say anything. You are required to conduct a pain assessment. You will be using the PQRSTU tool to assess Ann’s pain. Q. 13 Outline three (3) nursing actions you as a EN could provide for Ann’s pain. (ensure these are relevant to her stay in hospital) ………………………………………………………………………………………… Q.14 You are employed as an Enrolled Nurse in a community health service with a high proportion of Indigenous individuals and families. Your service is focused on providing culturally safe care that acknowledges the diversity of cultural needs among different Indigenous language groups. Q- Provide two (2) principles of cultural safety that you would find helpful when working in this setting.
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