Analyse & Respond To Client Health Infomation Essay

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Analyse & Respond To Client Health Infomation Essay

Q1) Diabetes Type 2 is the most common form of diabetes where the pancreas can still produce insulin however the body loses the ability to use the insulin it produces effectively, this is called insulin resistance, (“Type 2 diabetes”, 2018). Cells don’t respond to insulin and the pancreas does not produce enough insulin for the body’s increased needs. If the insulin cannot do its job, the glucose channels do not open properly. Glucose builds up in the blood instead of getting into cells for energy. Type 2 diabetes results from a combination of genetic and environmental factors. Although there is a strong genetic predisposition, the risk of developing type 2 diabetes is significantly increased with factors that may be related to lifestyle choices including high blood pressure, high cholesterol and insufficient physical activity. Analyse & Respond To Client Health Infomation Essay.

Q2) Poor blood circulation or loss of sensation due to diabetes-related nerve damage means that pressure on the skin goes unnoticed resulting in pressure ulcers. This also links back to Percy’s past medical history of peripheral neuropathy. It is the inability of the damaged skin to repair itself normally that result in ulceration.

Q3) Percy’s BGL recorded 2. 7 mmol/l. This means his hypoglycaemic. I would get him to drink a soft drink or something with sugar in it. Then I would continue to check his BGL over the next 5 hours.

Q4) Percy’s wound is red and leaking fluid because it’s infected. Diabetes reduces the blood circulation to and around the wound site. A lack of circulation in the extremities can result in a reduced supply of oxygen and nutrients to the body tissue and nerves, which is necessary for healing. Over time, nerves in these areas may become damaged, decreasing the sensation of pain, temperature and touch, making patients vulnerable to injury.

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Q5) Endocrinologist An endocrinologist is a medical specialist who is trained to diagnose and manage diseases that affect the glands and the hormones. An endocrinologist aims to restore hormone balance within the body’s systems. Endocrinologists commonly treat and provide expert advice on the management of diabetes. Die titian A dietician will work with the patient to develop a personalised healthy eating plan to suit their lifestyle, their type of diabetes and individual health needs. Analyse & Respond To Client Health Infomation Essay. They can educate on how to read food labels, modify recipes and even how to order at restaurants to make healthier choices. Exercise physiologist/physiotherapist An exercise physiologist/physiotherapist can help to determine the appropriate exercise/activity plan for the patient individually suited to their needs and lifestyle. They will assist in increasing mobility and comfort.

Case Study two – Neurological and urinary disorders

Q6) Urinary Tract Infection due to positive levels in protein, nitrates and blood.

Q7) Risk factors for urinary tract infection include

duration of catheterization – insertion
aphasia – patients inability to speak makes it harder for her to alert physicians of burning sensation and pain when voiding
CVA – stroke severity, depressed conscious level increased post-void residual urine volume

Q8) “Fever is generally defined as a temperature above 38 degrees, and occurs when the hypothalamus increases the core body temperature in response to an infection” (Musselman & Saely 2013). Febrile temperatures operate as a systemic alert system that promotes immune surveillance during challenge by invading pathogens, (Koutoukidis, Stainton & Hughson, 2017)

Q9) TIA (Transient Ischaemic Attack) – occurs when the blood supply to the brain is blocked temporarily. When the blood supply is stopped, the brain cells in the area start dying, and you experience signs that something is wrong, (“Transient ischaemic attack (TIA) — Stroke Foundation – Australia”, 2018). The signs and symptoms are similar to that of a stroke however they disappear within a short time and are often only present for a short time. After a TIA the risk of having a stroke is higher and often acts as a warning sign. CVA (Cerebrovascular Accident) – often referred to as a stroke. A stroke is a sudden loss of cerebral circulation, which causes cerebral infarction. Analyse & Respond To Client Health Infomation Essay. The sudden death of some brain cells due to lack of oxygen when the blood flows to the brain is impaired by blockage or rupture of an artery to the brain. An embolic stroke occurs when a blood clot that forms elsewhere in the body breaks loose and travels to the brain via the bloodstream. When the clot lodges in an artery and blocks the flow of blood, this causes an embolic stroke.

Q10) Neurologist: This doctor is a specialist trained to treat disorders that affect the brain, spinal cord, and nerves, such as: Cerebrovascular disease, such as stroke. Speech Therapist: This professional helps you relearn language and communications skills. Speech therapists also help you deal with swallowing problems and develop alternative ways of communicating. Physiotherapist: uses exercises and physical manipulation of your body to help restore movement, balance and coordination. Physiotherapists can help you relearn movement skills, such as walking, sitting, lying down and switching from one type of movement to another. Case Study three – Respiratory, genetic and reproductive disorders

Q11) ‘Cystic fibrosis is inherited as an autosomal recessive condition’, (“Cystic Fibrosis – What is CF”, 2018), this means a child can only have the disease if both parents are carriers. Carriers have no symptoms; however they do carry a genetic change referred to as a “mutation” that may be passed on to future generations. Because Madeline’s parents are both carriers there is a 1 in 4 (25%) chance that both passed on the non-functioning gene, (“Cystic Fibrosis – What is CF”, 2018).

Q12) Cystic fibrosis causes the mucus that coats the bronchial tubes to become so thick and sticky that the cilia are unable to sweep the germs and other particles up and out of the lungs. The trapped bacteria lead to frequent, serious infections and permanent lung damage.

Q13) Most men with cystic fibrosis are infertile because of a blockage or absence of the sperm canal, known as congenital bilateral absence of the vas deferens (CBAVD). The sperm never makes it into the semen, making it impossible for them to reach and fertilize an egg through intercourse. The absence of sperm in the semen can also contribute to men with CF having thinner ejaculate and lower semen volume. Analyse & Respond To Client Health Infomation Essay.

Q14) Madeline will experience exacerbation of respiratory and other disease symptoms, requiring intensified treatments, if she decides to fall pregnant. Normal pregnancy is associated with significant respiratory, cardiovascular and metabolic changes. Although healthy women usually adjust easily to these changes, they may impose a considerable strain for women whose physiology is already severely compromised with cystic fibrosis.

Increased risk of pulmonary infection
Decreased pulmonary function
Increased oxygen consumption

Q15) Pulmonologist: managing the care of chronic respiratory diseases is one of a pulmonologist’s main duties. Pulmonologists also coach their patients on management of their illness, by making lifestyle changes or learning coping strategies to minimize their reliance on medications.

Respiratory Therapist: performs pulmonary function tests to measure the air flow and volume in your lungs. Assists with pulmonary therapies, which are designed to clear mucus (sputum) out of your lungs, control bacteria and reduce the inflammation of your airways. These therapies involve airway clearance techniques (ACTs) and inhaled or nebulized medications.

Physiotherapist: Physiotherapy management is a key element of care for people with cystic fibrosis. The lungs make mucus to help defend against germs. Cystic fibrosis changes the mucus, making it thick and hard to clear. Brisk percussion of the chest wall helps to break up and dislodge mucus, so it can be more easily coughed out of the body.

Mrs Chan has been bought in by ambulance following a fall at home, where she fractured her hip. She believes she fell around 10pm last night, and was unable to get up to seek help. Her daughter found her still on the floor this morning at 6.00am and called the ambulance. Analyse & Respond To Client Health Infomation Essay.

Mrs Chan’s past medical history includes:

Urinary incontinence
Osteoporosis
Compression fractures to her spine due osteoporosis
Removal of a Stage II melanoma in 2006

Regular medications:

Fosamax
Vitamin D
Calcium
Fentanyl patch

PRN endone

Question 1

When Mrs Chan is admitted to hospital, she is found to have mild hypothermia.

Explain what hypothermia is and at least three factors that may have caused this in her case.

Define homeostasis and name the three components that make up any biological homeostatic control mechanism

Describe at least four different changes that would occur in Mrs’s Chan’s body to regain temperature homeostasis.

Further Information:

Mrs Chan had a Stage II melanoma removed in 2006 and the tissue was sent to pathology for testing. The pathology report came back stating the tumour showed signs of dysplasia.

Question 2.

The four major types of cellular adaptation are hypertrophy, hyperplasia, metaplasia and dysplasia. Briefly describe each of these types of cellular adaptation

Define atrophy

What does the term ‘surgical insult’ mean?

Question 3.

Part of the ENs role is to assist in referring clients care to the appropriate people within a multi-disciplinary team.

List six (6) different professions that may be part of a multi-disciplinary team.

Which part of the team has the role of interpreting test results in order to formulate a diagnosis?

Why does the EN need to know the purpose of blood collection?

Can an EN disclose pathology results to their client? Give a reason for your answer. Analyse & Respond To Client Health Infomation Essay.

Scenario 2 – Mr Marconi

Mr Marconi is a 76-year old man who has hypertension, hyperlipidaemia and congestive heart failure. He is brought in to the Emergency department at 06:00. On arrival, Mr Marconi states that he has chest pain when breathing in, he is coughing up yellow phlegm and he feels exhausted. His left arm has a shallow wound that Mr Marconi said he got while weeding his garden two days earlier.

His vital signs include:

Respiratory Rate: 28 bpm (shallow with pain on inspiration)
SaPO2: 91% (2L O2)
Blood Pressure: 105/70 mmHg
Pulse Rate: 105 bpm
Temperature: 38.9 degrees C
BGL: 4.5mmol
Weight: 78 kg
Height: 174 cm

His current medications include Atenolol, Ramipril and Lipitor.

He has no known allergies.

Question 4.

Describe the process of coronary artery atheroma formation – include the following in your answer:

Describe the steps of atheroma formation:

Name three factors that trigger endothelial inflammation:

How do high and low density lipoproteins contribute to atheroma formation?

What is the role of macrophages in relation to atheroma formation?

The patient is taking Atenolol and Ramipril. Describe in simple terms (that a patient could understand) how these two medications work in treating ischaemic heart disease.Analyse & Respond To Client Health Infomation Essay.

Question 5.

You are asked to clean the wound on the patient’s arm.

Explain the structure and the function of the skin and the problems associated with a break in the skin such as this wound.

You notice that the patient’s skin appears thin and like ‘tissue paper’. Explain what may have caused this.

Question 6.

The patient wears reading glasses. Explain degenerative changes that occur in the eye as we age and how this may have resulted Mr Marconi’s need to wear glasses.

Scenario 3 – Mrs Thompson

Sarah Thompson is a 65 year old woman who presents to her GP clinic for an annual check up. She was diagnosed with Type II Diabetes Mellitus (T2DM) in 2009:

Weight: 95kg

Height: 164cm

BMI 36

Mrs Thompson also has hyperlipidaemia and hypertension, and she is taking Metoprolol and Rosuvastatin daily.

Question 7.

Discuss Type 2 diabetes – include the following in your answer:

What body systems and/or organs can be affected by T2DM?

Name five risk factors for developing T2DM:

Describe appropriate treatment for a patient such as Mrs Thompson who has T2DM

Which part of the cell makes ATP (adenosine triphosphate) needed for cellular energy

What is required to ensure a cell remains healthy?

Question 8.

Define hyperlipidaemia and explain the associated risks and causes of this condition. In your answer identify the roles of high density lipoprotein (HDL), low density lipoprotein (LDL) and triglycerides.

Scenario 4 – Miss Walker

Miss Walker is a 46-year-old female who presented to the emergency department with shortness of breath which has got progressively worse over the last two days. She has no other significant past medical history.

RR: 26

SpO2: 93%.

The doctor orders a chest X-ray which shows consolidation of fluid on his right lower lung. The doctor diagnoses right lower lobe pneumonia.

Question 9

Relate the diagnosis of pneumonia to two stages of respiration – external respiration and gas transport. Analyse & Respond To Client Health Infomation Essay.

Describe what occurs during normalexternal respiration.

Describe what occurs during normalrespiratory gas transport. Discuss how O2 and CO2 are transported in the blood

Differentiate between pulmonary ventilation, internal respiration and cellular respiration.

Briefly explain what respiratory acidosis and respiratory alkalosis are:

Question 10

Describe the steps involved in homeostasis of respiratory rate – include the following in your answer

Name two (2) respiratory gases detected in the blood?

Where is the respiratory control centre located? What is the stimulus that causes the respiratory control centre to increase respiratory rate?

Why would the patient have an increased respiratory rate if they are suffering from pneumonia?You need to explain the physiology behind why having pneumonia causes increased respiratory rate

How does administration of supplementary oxygen help to maintain homeostasis of respiration?

What impact would the administration of supplementary O2 have on the patient’s respiratory rate? What impact would the administration of supplementary O2 have on the patient’s SpO2?

Question 12

Later in your shift, you find the patient crying. She tells you that she has been crying a lot lately and feeling sad since her husband asked her for a divorce. Explain psychological health as it relates to the patient and who you could refer them to. Analyse & Respond To Client Health Infomation Essay.

Scenario 5 – Mrs Nguyen

Mrs Nguyen is a 75 year old woman who is bought into the GP clinic by her daughter Rosemary. Mrs Rosemary says that her mother has complaining of painful urination and her mental state has become confused over the past 24 hours.

The RN asks you to perform a urinalysis test.

Question 13

Explain how you would prepare for a urinalysis test?

You assess the results of a urine dipstick test – list two (2) signs would you expect if a UTI was present?

What symptoms could the patient be experiencing if she has a UTI?

A urine test is then ordered for culture and sensitivity. Describe what each of these tests are evaluating and how the results relate to medication prescription.

Explain how the patient’s age could impact on the urinary system?

Mrs Nguyen also has had some dental problems, and lets you know that she is getting dentures in the next month or so.

Question 14.

List five (5) oral health diseases

What is the term used to describe people with teeth and without teeth

During assessment, Rosemary shows you Mrs Nguyen’s medication webster pack. She is concerned that there are three days of medications missing and she thinks that her mother may have forgotten that she had taken her pills and took another dose.

The medication list on the webster pack lists the drugs as:

Serepax: 10mg at night

Metoprolol: 50 mg twice per day

Aspirin: 100mg in the morning.

Metforman: 500mg BD

List three (3) body systems that may be affected by the accidental ingestion of these medications.

Scenario 6 – Peter Jackson

Ruth and Michael Jackson have been trying to have a baby for the past five years. In November 2016, Ruth gives birth to a son, Peter. 48 hours after birth, Peter undergoes the standard neonatal screening test, which helps to identify those infants at risk of rare, but serious medical conditions such as phenylketonuria, hypothyroidism and cystic fibrosis.

Peter is found to have cystic fibrosis (CF), an autosomal recessive condition that affects mostly the lungs, but also the pancreas, liver, kidneys and small intestine.

Question 15

Discuss difference between having the disease of CF compared to being a carrier of CF from a genetic perspective.

Further Information:

At three months, Ruth and Michael take Peter to the paediatrician for a follow up. The paediatrician notes FTT (failure to thrive) on Peter’s medical record. Analyse & Respond To Client Health Infomation Essay. She explains to the Jackson’s that this means Peter has poor weight gain, and that he will need a high calorie diet and enzyme supplementation for the rest of this life.

Explain how CF causes failure to thrive and how this may impact on Peter’s biological maturation

Why does Peter need a high calorie diet and pancreatic enzyme supplementation?

How does CF contribute to malabsorption of nutrients in a teenager?

Further Information:

Ruth is worried about Peter’s future and how long he is likely to live.

What is the life-expectancy of a patient with CF, compared to a non-CF patient? How has current treatment affected this, compared to a patient diagnosed with CF twenty years ago?

You are talking to Ruth during a routine visit to the GP. She says that her husband Michael has taken up scuba diving. Ruth doesn’t understand much about scuba diving and is concerned that her husband may be injured, leaving her to care for Peter.

List three (3) common emergencies experienced by divers.

Answer:

Scenario 1 – Mrs Chan

1.

When Mrs Chan is admitted to hospital, she is found to have mild hypothermia.

Explain what hypothermia is and at least three factors that may have caused this in her case.

Hypothermia refers to a condition where the body loses more heat than it produces result in a state of abnormally low temperatures.

In her case, the causes would have been:

Lying on the floor for a long period increases the rate of loss of heat
A removal of melanoma can alter the thermoregulatory mechanisms of the skin hence its inability to respond to decreased temperatures
The use of fentanyl, an opioid, has an effect on the central thermoregulatory centres in the brain and is associated with hypothermia, (Yoo, Lee& Suk, 2015). Analyse & Respond To Client Health Infomation Essay.

Define homeostasis and name the three components that make up any biological homeostatic control mechanism.

It refers to the continuous attempt of the body to maintain a constant internal environment

Components of a homeostatic control mechanism include:

Sensor
Control centre
Effector

Describe at least four different changes that would occur in Mrs’s Chan’s body to regain temperature homeostasis.

Shivering which increases muscle contraction to generate heat. It is a centrally mediated mechanism in the thermoregulatory centre (Werner, 2018).

The erector Pilli muscle will contract causing the hair to stand erect maintaining the air along the surface which is warm lowering the rate of diffusion

Vasoconstriction to shunt blood away from the body surface reducing the rate of loss

Increased metabolism in the liver to generate more heat through exothermic reactions. Heat resulting from theses reactions is distributed to other parts

Decreased rate of sweating to decrease the rate of heat loss through the skin.

Further Information:

Mrs Chan had a Stage II melanoma removed in 2006 and the tissue was sent to pathology for testing. The pathology report came back stating the tumour showed signs of dysplasia.

2.

The four major types of cellular adaptation are hypertrophy, hyperplasia, metaplasia and dysplasia. Briefly describe each of these types of cellular adaptation

Hyperplasia refers to an increase in the number of cells in a tissue. For example, the increase in cells in breast tissue in puberty due to hormonal influence.

Hypertrophy refers to an increase in the size of the cells in a tissue or organ which results in a general increase in its size. For example, hypertrophy of the cardiac muscle of the left ventricle in stenosis of the aorta. Analyse & Respond To Client Health Infomation Essay.

Metaplasia refers to an abnormality in cellular differentiation. An irreversible change where an adult cell type is replaced by another adult cell type. For example, a change from columnar epithelium to stratified squamous epithelium in the respiratory epithelium of cigarette smokers

Dysplasia refers to an abnormality in cellular development. There is an abnormal cell proliferation which is usually non-neoplastic for instance an increase in the number of epithelial layers. There are also some cytology changes in the cells that differ from the normal cells. For instance, loss in the basal cell polarity.

Define atrophy

it refers to the shrinkage of a cell due to the loss of cellular substance resulting in the decrease in size of a tissue or the organ. May result from factors such as decreased work load, diminished blood supply or loss of innervation.

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What does the term ‘surgical insult’ mean?

It refers to the physiological response of the body following stress inflicted on the body due to a surgical procedure. It is usually a multisystem approach producing a particular outcome. They all produce an additive effect.

3.

Part of the ENs role is to assist in referring clients care to the appropriate people within a multi-disciplinary team.

List six (6) different professions that may be part of a multi-disciplinary team.

General practitioner

Practice nurses and Community health nurse

Psychiatrists

Physiotherapists and occupational therapists

Dieticians

Social workers

Health educators

Which part of the team has the role of interpreting test results in order to formulate a diagnosis?

The general practitioner is usually the first contact with the patient. They take history, examine and order for tests to confirm a diagnosis.

In the case of a mental illness, a psychiatrist will make the diagnosis and interpret the tests.

A nursing diagnosis is done and the care plan formulated.

Why does the EN need to know the purpose of blood collection?

In order to collect it in the right specimen bottle for a particular intended test. For example, blood for hemogram would be differently collected than that for a coagulation screen.

In order to send it to the right laboratory for testing and confirmation of diagnoses.

Can an EN disclose pathology results to their client? Give a reason for your answer.

No.

Pathology results can only be well interpreted be the doctor who requested the test. The doctor is only one in the best position to disclose them since after taking a history and making the examination, they can make a meaningful diagnosis. Analyse & Respond To Client Health Infomation Essay.