HLT54115 Nursing

Questions

1. List five chronic aged related health problems. Explain the impact of multiple diagnosis in iden*ingand prioritising care of older clients in health care settings.

2. Discuss the importance of oral hygiene for a partial or fully edentulous cbents. Explain the care of soft tissues, dentures and dental prosthetics.

3. What are the external factors and common stereotypes associated with aging and how does it adversely impact the older person?

4. List the roles and responsibilities of an EN while providing care for a deceased person.

5. List five functional assessment tools for assessing older clients.

6. List the limitations and legal ramifications of the following restraints: Restraints Limitations

Ramifications	Limitations	Legal ramifications

1. Physical Restraint
2. Chemical Restraint
3. Psychological restraint

7. List few legal and ethical issues associated while caring older clients with the list of considerations to address such issues.

8. Briefly discuss about Aged care Act and Carers recognition 1997 act. Include mandatory reporting laws.

9. Briefly discuss AC Fl and ResCare QA with its role in residential aged care.

10. List some physical triggers of aggression and challenging behaviours among older clients in aged care. Describe how an EN can use techniques of distraction and behaviour modification to address and manage such behaviours.

11. Explain in your own words the following theories of ageing:

a. Biological Theory

b. Psychological Theory

c. Disengagement Theory

d. Social Exchange Theory

e. Wear and tear Theory

f. Activity Theory

12. Discuss the normal physiology of ageing process and its relation to the disease process with respect to each of the following systems.

a. Sensory

b. Cardiac

c. Neurological

d. Mu sculoskeletal

e. Genitourinary

f. Endocrine
g. Integumentary
h. Cancer disorders

13. As an EN, how do you provide support and comfort for th e grieving family practice?

14. Statement A: An Enrolled nurse should considerown values, attitudes and beliefs towards ageing while caring for the olderperson.

Statement B: An Enrolled nurse should monitor own performance to ensure all interventions are conducted appropriately and within scope of practice of the enrolled nurse.

a. Statement A is correct and Statement B is incorrect

b. Statement B is correct and Statement A is incorrect

c. Both are correct

d. Both arc incorrect

15. What is complementary therapy? Give 2 examples of complementary therapies in nursing practice.

16. Briefly outline the Code of ethics for nurses in Australia and the code of professional conduct for nurses (Nursing and Midwifery Board of Australia)

17. Describe the Aged Care risk classification system .

Answers

1. Chronic problems associated with old age

Diabetes, Cardiovascular diseases, arthritis, hypertension and Parkinson’s disease.

Impact of multiple diagnosis in identifying care for patients

It interferes with their quality of life and ability to perform tasks. It is also associated with increased rates of functional decline and mortality. There is increased risk associated with visits to physicians, prescriptions, home health visit, own expenses and cumulative health care expenditure.

2. Importance of oral hygiene for partial or fully edentulous clients.

Oral hygiene involves proper cleaning of teeth regularly. The importance of oral hygiene is to prevent buildup of plague and tartar. This prevent dental carries, periodontal disease and decreases incidence of halitosis (Van Der Weijden, & Slot, 2011).

Care of soft tissues, dentures and oral prosthestics

Use a clean soft toothbrush and water to clean dentures. Ensure that tongue, palate and gums are cleaned morning and night with a soft toothbrush before dentures are inserted, ensure regular visit of dentist to check mouths soft tissue (Bissett, & Preshaw, 2011).

3. External factors and stereotypes associated with aging and how it impact older person.

Life style for example, alcohol consumption, stress, poor diet and lack of exercise causes stiffness and cardiovascular diseases. Some medications contribute to aging and hormones essential for aging process is under genetic control. Growth differentiation hormone factor 11 are determined by genetics and blood levels of this hormone decreases with time causing aging (poggioli et.al, 2016).

4. Roles and responsibilities of en in providing care for deceased person

Immediate care with the family; at no time should the family be rushed. Prepare the family to enter the environment of deceased valuables and ensure that personal effects are documented and given to nominated next of kin. Engage social worker early to assist the family. Involve pastoral care if the hospital has pastoral care service, special rituals such as washing and draping of the body.

5. Functional assesment tools for assessing older patients

i. Self-care. This checks if the patient has any need of assertive for walking or need any assistance for daily activities for example grooming, toilet use, feeding or bathing.

ii. Fall assessment Tool. Check if there has been any history of fall within the last 12months if there is difficult in walking or balance (Moyer, 2012).

iii. Incontinence which checks on patient’s elimination of urine rate and amount.

iv. Impaired vision to checks visual acuity by Snellen chart.

v. Impaired hearing – asses hearing abilities of patient.

vi. Depression. Feeling of being hopeless, as the patient if he has had a feeling of hopelessness for the past 2weeks.

vii. Oral health. Checks if the patient has any oral discomfort for example chewing problem or difficulty in cleaning teeth.

Restraints	Limitations	Legal ramifications
Physical restraints	Violate patient dignity and patient autonomy ceases	Basic human right Privacy and safety
Chemical restraints	Loss of memory and increased dependence	Medication control
Psychological restraints	When someone has metal disorder it’s hard to use	Basic human right ,privacy and safety

8. Legal and ethical issues associated with caring older clients

Beneficence. This is caring for them in such a way that they will benefit.

Non –maleficence. Do not harm. Treat them with great care.

Autonomy. enabling the existence and feeling of freedom of choice and self-governance.

Informed consent before any treatment is given.

9. Role of acfi and rascareqa in residential area

ACFI is used to measure the level of each resident need based on activities of daily living. its role is to allocate Australian government subsidy to residential aged care providers. RAScareQA is an objective to figure out the face and content validity of the residential care quality. Its role is to address and determine quality of care and get information about what services are offered (Australian Institute of Health, 2012).

10. Physical triggers of aggression and challenging behaviour among clients in aged

Drug therapy, illness, fear, depression triggers aggression and challenging behaviors.

Enrolled nurse can manage such factors by introducing exercise and activities such as baking classes or cooking which will engage the client’s thoughts and hence distracting them from aggression or other behaviors. This may involve working in groups, i.e, group therapy (Heathcote, Chia, & Hibberd, 2011).

11. Theories of aging

a) Biological theory. Aging is as a result of sequential switching on and off of certain genes.

b) Psychological theory. Mutual withdrawal process whereby the older adults willingly slows down by retiring as expected by the community.

c) Disengagement theory. This theory brings out the fact that aging is certain to happen. It comes naturally and no one opposes adults to withdraw from society.

d) Social exchange theory: states the stability and change of exchanges among individuals across life span.

e) Wear and tear theory: states that aging is through deteriorative process that operate in organized manner

f) Activity theory: Aging occurs as a result of older adults staying active and maintaining social interaction.

12. Normal physiology of aging in relation to disease process

1) Sensory: Changes in sensory system occur especially on hearing, peripheral sensation, smell, taste and vision. This influence their quality of life.

2) Cardiac: Deposit of aging pigment and heart cell muscle degenerate.

3) Neurological: brain and spinal cord lose nerve cells and weight.

4) Musculoskeletal: loss of bone density, bones become fragile and joints become weak.

5) Genitourinary: muscle changes and can affect bladder control.

6) Endocrine: hormone receptors become less sensitive.

7) Integumentary: skin become thinner and more easily damaged.

8) Cancer disorders: older people are likely to develop cancer.

13. How to provide comfort for a grieving family.

Nurse should normalize grief, console the family members that what they are going through is normal and there is no right way for one to grieve, they need to be encouraged to identify and express their feelings.

14. Both are correct

15. Complementary therapy

They are used alongside medical treatments prescribed by doctor. They include mind and body practices and massage therapy (Lindquist, Tracy, & Snyder, 2018).

16. Code of ethics for nurses in australia and code of professional

Code of professionals for nurses in Australia include nurses guide to practice and competent manner. Members must perform professional duties in ethical manner with honesty, appropriate skills and good faith. Members to act promptly in service of client. Members should not wrongly present professional qualifications and to operate within limits of qualifications. Member should not disclose client’s confidential information in order to build community’s trust and confidence and enhance dignity. Nurses to respect the dignity, culture, ethnicity and beliefs of people (Council, 2013.

17. Aged care risk classification

Most of the risks that are faced by aged care industry has to do with complex medical conditions and potential for important errors to be made by staff for example nutritional and fluid intake errors or incomplete fall protection while care is being delivered by trained care givers.

References

Australian Institute of Health. (2012). Residential Aged Care in Australia 2010-11: A Statistical Overview (No. 36). AIHW.

Bissett, S., & Preshaw, P. (2011). Guide to providing mouth care for older people. Nursing Older People (through 2013), 23(10), 14.

Council, S. A. N. (2013). Code of ethics for nursing practitioners in South Africa. Pretoria: South African Nursing Council, 3-5.

Heathcote, J., Chia, S. H., & Hibberd, J. (2011). Group and individual work with older people: a practical guide to running successful activity-based programmes. Jessica Kingsley Publishers.

Lindquist, R., Tracy, M. F., & Snyder, M. (Eds.). (2018). Complementary & alternative therapies in nursing. Springer Publishing Company.

Moyer, V. A. (2012). Prevention of falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. Annals of internal medicine, 157(3), 197-204.

Van Der Weijden, F., & Slot, D. E. (2011). Oral hygiene in the prevention of periodontal diseases: the evidence. Periodontology 2000, 55(1), 104-123.

Poggioli, T., Vujic, A., Yang, P., Macias-Trevino, C., Uygur, A., Loffredo, F. S., … & Gonzalez, E. (2016). Circulating growth differentiation factor 11/8 levels decline with age. Circulation research, 118(1), 29-37.

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HLT54115 Nursing

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