Epidemiology / pathophysiology of disease processes
The National Health Priority Areas of Obsesity, Diabetes Mellitus and Mental Health was established with the aim of improving health outcomes in all thes areas.
Excess weight, especially obesity, is a major risk factor for cardiovascular disease, type 2 diabetes, some musculoskeletal conditions and some cancers. As the level of excess weight increases, so does the risk of developing these conditions. In addition, being overweight can hamper the ability to control or manage chronic conditions.
The main factors influencing overweight and obesity are poor diet and inadequate physical activity. Increased energy intake from the diet without an increase in energy expenditure through physical activity will result in energy storage as fat and weight gain.
Diabetes is a chronic condition marked by high levels of glucose in the blood. The main types of diabetes are type 1 diabetes, type 2 diabetes and gestational diabetes. The prevalence of diabetes has been escalating over the last 3 decades, with rates tripling over this period—diabetes affected around 1.2 million people in 2014–15. Rates of diabetes are generally higher among males, the elderly, Indigenous Australians and people living in remote and socioeconomically disadvantaged areas. Type 2 diabetes is the most common form, and is largely preventable by maintaining a healthy lifestyle.
Mental illness comprises a wide range of disorders and varies in its severity. The effect of mental illness can be severe on the individuals and families concerned and its influence is far-reaching for society as a whole. Around 7.3 million Australians aged 16–85 (45% of that age group) will experience a common mental disorder such as depression, anxiety or a substance use disorder in their lifetime, according to the 2007 National Survey of Mental Health and Wellbeing. Estimates from the second National Survey of Psychotic Illness conducted in March 2010 suggest that almost 64,000 people have a psychotic illness and are in contact with public specialised mental health services each year.
Please write the answer directly under each question.
Green coloured texts are suggested structure of each answer.
WORK BOOK QUESTIONS
- Review patients background and history. MsRuby Pascal has multiple comorbidities including obesity, diabetes mellitus type 2 (DM2) and general anxiety disorder.Choose ONE comorbidity(Please choose DM2) and complete the following questions.
- Discuss the anatomy and physiology of the chosen comorbidity.(DM2)
(2 marks)
- Identify two (2) signs and/or symptoms of the chosen comorbidity.(DM2)Discuss how each sign and/or symptoms support the diagnosis of the chosen comorbidity. (DM2)
(4 marks)
Sign/symptom number 1, how does it support DM2 diagnose.
Sign/symptom number 2, how does it support DM2 diagnose.
- Identify two (2) lifestyle factors that may have impacted/influenced the chosen comorbidity (DM2). Justify your answer.
(4 marks)
Lifestyle factor number 1, how does it influence DM2.
Lifestyle factor number 2, how does it influence DM2.
- Ms Pascal acutely deteriorated in the first simulation scenario due to a pulmonary embolism.
- List four (4) signs and/or symptoms of a pulmonary embolism (PE).
(2 marks)
- Identify and discuss two (2) risk factors of the primary diagnosis and how they contributed to the acute deterioriation.
(4 marks)
Risk factor 1 of PE, how does it related to acute deterioration.
Risk factor 2 of PE, how does it related to acute deterioration.
- Review Standard 8 of the NSQHS. Identify and discuss two (2) risk factors that increase Ms Pascal’s risk of deterioration. Justify each risk with evidence.
(4 marks)
Risk factor 1 of PE, how does it related to Ruby’s deterioration.
Risk factor 2 of PE, how does it related to Ruby’s deterioration.
- During the second scenario, Ms Pascal requires anticoagulation therapy (she’s having Heparin). In relation to Ms Pascal’s clinical scenario.
- Discuss the role anticoagulants in the treatment and management of pulmonary embolism. (1 mark)
- Identify two (2) contraindications of anticoagulants.
(1 mark)
- Review Standard 4 of the NSQHS. Using the standard and relevant literature, list four (4) actions required of the registered nurse to ensure safety when managing and administering anticoagulants. (2 marks)
- Compare the difference between enoxaparin and warfarin.
(2 marks)
- Communication is an integral part of nursing, with an emphasis on person centred care.
- Identify two (2) communication strategies integral for person centred care.
(1 mark)
- Discuss and justify how each chosen communication strategy is important to Ms Pascal’s hospital admission.
(2 marks)
- Ms Pascal has been referred to a general practitioner and diabetes educator for discharge. Identify two (2) more interdisciplinary team members or teams who potentially would be involved in discharge or discharge planning for Ms Pascal. Justify their involvement in Ms. Pascal’s care demonstrating understanding of the team’s involvement in discharge care. Please write social worker and dietitian, why these two roles are involved, what can they do to Ruby.
(4 marks)
Questions directly related to Ms Ruby Pascal Admission to the Ward Scenario:
- Effective and accurate clinical assessment skills are imperative for the nurse working with Ms Pascal at all times. Identify and discuss (1) clinical priority (low oxygen saturation)for Ms Pascal who is rapidly deteriorating. Justify the priority with evidence.
- marks)
- From the identified clinical priority in the ward, state one (1) short term goal for Ms Pascal’s management using the SMART framework. (2 marks)
Short term goal can write increase oxygen saturation. Method: giving oxygen at xxx L/min (can use reference: Beasley, R., Chien, J., Douglas, J., Eastlake, L., Farah, C., King, G., … Walters, H. (2015). Thoracic Society of Australia and New Zealand oxygen guidelines for acute oxygen use in adults: “Swimming between the flags.” Respirology (Carlton, Vic.), 20(8), 1182–1191. https://doi.org/10.1111/resp.12620).
Please write this question in SMART format (Specific, Measurable, Achivable, Relevant and Time-bound), using following format. If not sure about SMART format, please google it, thanks.
SMART goal 1:
S-
M-
A-
R-
T-
- 9. Based on the short-term goal (increase oxygen satuation), state and describe (2) interventions (nursing, collaborative or pharmacological) which would assist to achieve Ms Pascal’s short-term goal.
Intervention 1 ( give oxygen), because …
Intervention 2 ( raise bed head to sit patient at xx degree), because…
(4 marks)
- Provide and justify two (2) methods of how you would evaluate the outcomes.
(4 marks)
TO BE RE-WRITTEN FROM THE SCRATCH
WORK BOOK QUESTIONS
- Review patient’s background and history. Ms Ruby Pascal has multiple comorbidities including obesity, diabetes mellitus type 2 and general anxiety disorder. Choose ONE comorbidity and complete the following questions.
- Discuss the anatomy and physiology of the chosen comorbidity. (DM2)
In the occurrence of diabetes type 2, it is due to a relative deficiency of insulin plus it is not the absolute deficiency. This suggests that the body is not in a position to reduce enough insulin to cater to its needs. Beta cell deficiency is prevalent plus the presence of peripheral insulin resistance(Stubbs, Vancampfort, De Hert, & Mitchell, 2015). (2 marks)
- Identify two (2) signs and/or symptoms of the chosen comorbidity.(DM2) Discuss how each sign and/or symptoms support the diagnosis of the chosen comorbidity.(DM2)
Sign/symptom number 1, how does it support DM2 diagnose.
Frequent urination. It is the abnormal amount of urine in the bladder which causes the person under the problem to have frequent urination all time(Stubbs, Vancampfort, De Hert, & Mitchell, 2015). A pregnant woman from her early time of frequency leads to the growth of the uterus the causing pressure to her exerted on the bladder.
Sign/symptom number 2, how does it support DM2 diagnose.
I have increased thirsty. Diabetes causes the building of excessive sugar in the body. The cause of the sugar then makes the kidney of work in excess to filter out the excess sugar. The outcome of the above symptom is frequent urination thus making the culprit feel thirsty therefore drinking more water(Takegoshi et al., 16). (4 marks)
- Identify two (2) lifestyle factors that may have impacted/influenced the chosen comorbidity. Justify your answer.
- Lifestyle factor number 1, how does it influence DM2.
Meal management and medication. A person affected by the diabetes mellitus 2 has a lifestyle which generally requires proper feeding. The person also needed proper medication to reduce the sugar level in the body.
Lifestyle factor number 2, how does it influence DM2.
Exercise daily. The person is the equipment for them to carry out the frequent exercise. The purpose of the exercise is to make sure that the person sugar level and the building is reduced to a healthy level(Stubbs, Vancampfort, De Hert, & Mitchell, 2015).
(4 marks)
- Ms Pascal acutely deteriorated in the first simulation scenario due to a pulmonary embolism.
- List four (4) signs and/or symptoms of a pulmonary embolism (PE).
Short of breath
Sudden, sharp chest pain(Takegoshi et al., 2016)
Rapid heart pain
Rapid breathing sweating(Takegoshi et al., 2016)
(2 marks)
- Identify and discuss two (2) risk factors of the primary diagnosis and how they contributed to the acute deterioriation.
(4 marks)
Risk factor 1 of PE, how does it related to acute deterioration.
Presence of right heart strain on echocardiogram- this makes the patients to be unable to withstand pulmonary artery pressure(Takegoshi et al., 2016).
Risk factor 2 of PE, how does it related to acute deterioration.
Elevated biomarkers- the patients are prone to suffer neuronal and axonal injury after HHI. The patients may experience bouts of chronic inflammation processes on the cells.
- Review Standard 8 of the NSQHS. Identify and discuss two (2) risk factors that increase Ms Pascal’s risk of deterioration. Justify each risk with evidence.
(4 marks)
Risk factor 1 of PE, how does it related to Ruby’s deterioration.
Substance abuse-instances of substance abuse like alcohol and tobacco usually increases the severity of high blood pressure t an individual suffering diabetes mellitus type 2(Takegoshi et al., 2016).
Risk factor 2 of PE, how does it related to Ruby’s deterioration.
Sleep apnea- an individual that has this condition increases the effects of his health on high blood pressure. T,…………………………………………………………………………………………………………………………………………………………………………………………………………………………………,…………………………………………………………………………………………………………………………………………………………………………………………………………………………………
National Health Priority Areas of Obsesity
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