Scenario 1 A 34-year-old female patient came

Scenario 1 A 34-year-old female patient came to the hospital today at 9 am after a road side accident. She lost a lot of blood and was transfused 4 packed RBCs. The following are the details of her status as of 10 pm today. The patient suffered acute kidney injury secondary to hypovolemia. An IDC was introduced to monitor urine output. Name: Fatima Muhammad Age: 34 Sex: Female Diagnosis: Wedge compression of #L1 vertebra and # Rt.Superior Pubic Rami with no neurological deficit. BP: 100/60 mm of Hg Temperature: 99.2°F Pulse:97/min RR: 18/min SpO2: 97% Serum creatinine : 2.8 mg/dlFluid intake: 2000 ml Urine output:500 ml in urine bag with Foley’scatheter in place. The patient tells you that at the time of the accident, it was her Day 1 of menstrual cycle (period). She is very depressed and worried. She thinks she can never have a baby again. Q. a. Briefly explain the nursing interventions associated with the urinary system in this case. b. Identify at least six (6) nursing interventions associated with the reproductive system in this case. Scenario 2 Mr. A has a diagnosis of insulin dependent Type II Diabetes Mellitus. He is prescribed Insulin (10 units of mixtard 30/70 before breakfast and 6 units of mixtard 30/70 before dinner). He is also prescribed for PRN Actrapid 4 units if his BSL level is above 12 mmol/L. In case of hypoglycaemic episodes, Dr has recommended to treat hypoglycemia by giving 6 jelly beans or one glass of cordial juice. Check BSL again if still <4 mmol/L repeat interventions. If still <4 mmol/L ring 000. When you checked his blood sugar levels before breakfast it was 14 mmol/L. Q. Read the Nursing Diagnosis and the Objectives of Mr. A's Care Plan and outline the nursing care interventions you would perform on Mr. A, in the table below. Diabetes Care Plan Nursing Diagnosis Objectives Unstable blood glucose levels At Risk of Hyperglycaemic episode To maintain adequate blood glucose levels At risk of Hypoglycemic episodes To maintain blood glucose levels within the normal range. Scenario 3 Fatimah's cultural belief is that she should meet illness and death with patience, meditation, prayer and dignity. To Fatimah, her spiritual needs, privacy and modesty are paramount. Fatimah has a cultural dietary choice, including the need to avoid pork or medication that contains alcohol. Q. Identify at least four (4) nursing interventions you will undertake in order to demonstrate respect for Fatimah's dignity and cultural beliefs. Scenario 4 You are going to assist Mrs. C with a shower. Mrs. C recently experienced a road side accident and has a plaster cast on her fractured arm and fractured leg. She is still experiencing emotional trauma due to this intense accident. Mrs. C used to go to church every week. Due to her recent physical needs, she is no longer able to go which is making her more emotional. Mrs. C has no family who can look after her and fulfil her holistic care needs. Q. Taking into consideration her physical, emotional and psychosocial health care needs, briefly explain nursing interventions you will perform. Scenario 5 Mr. G has severe oedema in both his legs. His doctor prescribed antidiuretic to treat his fluid retention. His Doctor also commenced him on fluid restriction. After a week of commencement of antidiuretic (furosemide), Mr. G started experiencing severe hypotension as a side effect of the medication. Mr. G was very concerned and sad about his current condition and treatment. Q. a. Outline at least two (2) clinical signs you are observing in this scenario. b. Identify at least two (2) members of the healthcare team you should report/refer your findings to. c. Outline at least three (3) nursing interventions that you will implement for Mr G. d. Outline the information which you will include in progress notes regarding Mr G's symptoms, reactions and responses to the provided care management and medications. Scenario 6 Mrs. Smith was sitting in the lounge room with other patients. After 20 minutes you found your patient Mrs. Smith on the floor in her bedroom.Mrs Smith vaguely tells you that she had a bad fall and she cannot move her leg. You also note a big deep cut and blood on her head. Q. a. Briefly explain what your first response would be in this situation. b. Identify at least six (6) nursing interventions you should provide, including concern for the deteriorating patient. Scenario 7 Mrs. Gem is very particular with her medications. She remembers her medication as the number of meds she takes every time and their colour. She does not fully understand the action and reason of her medications. Today, you noticed that Mrs. Gem has experienced loose bowel movement three times. In collaboration with the RN you withheld her coloxyl-senna. When Mrs Gem noticed that you did not give her 2 brown tablets,she was not happy and was questioning you. Q. Identify how you would clearly explain the reasoning behind the specific decisions and actions taken to Mrs. Gem. Scenario 8 As an enrolled nurse you noticed that another enrolled nurse and a personal care assistant provided assistance to a client in transferring from shower chair to the wheelchair by using a lifting machine.You note that the care plan says to use a standing machine for this client. You question them about this and they reply that the resident was not able to stand up properly today and they had no choice but to use the lifting machine. You also note that the physiotherapist is not working this week. Q. a. Outline what nursing interventions are at odds here with an already prescribed course of action by physiotherapist. b. Identify who you would report and raise the issue with. c. Identify the referral you will make. d. Identify three (3) measures including change of organisation care process for further quality improvement in this scenario.

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