diabetes 1 (Autosaved)

Student Overall Assessment Record Sheet Qualification Code: Title HLT54115 Diploma of NursingUnit Code: Title HLTENN025 Implement and monitor care for a person with diabetesStudent Name Shovana ShresthaStudent ID AHI00000IHTerm and year 1st termDate 21/03/2019Assessment Items ResultS = SatisfactoryNS = Not SatisfactoryDNS = Did Not SubmitC = CompetentNYC = Not Yet CompetentAssessment 1 Underpinning Knowledge/Questions S NS DNSAssessment 2 Research Work/Project S NS DNSAssessment 3 Observation S NS DNSFinal Assessment Result for this unit C NYCStudent Declaration: I declare that the work submitted is my own, and has not been copied or plagiarised from any person or source. Signature: _shovana_____________________Date: 21 _/_03_/__2019__Feedback to StudentStudent Declaration: I declare that I have been assessed in this unit, and I have been advised of my result. I also am aware of my appeal rights.Signature: _shovana______Date: _21___/_03___/__2019________Assessor Declaration: I declare that I have conducted a fair, valid, reliable and flexible assessment with this student, and I have provided appropriate feedback.Signature: ________________________Date: ______/_______/______________Assessment DetailsQualification Code: Title HLT54115 – Diploma of NursingAssessment Type Assessment 1 Underpinning Knowledge/QuestionsDue Date 22/03/2019Location Castleargh street, SydneyTerm-Year 1st termUnit of CompetencyUnit Code/Title HLTENN025 Implement and monitor care for a person with diabetesStudent DetailsStudent Name Shovana Shrestha Student ID AHI00000IHFeedback to StudentRESULTS (Please Circle) SATISFACTORY NOT SATISFACTORYAssessor DetailsAssessors NameMae ShelAssessor SignatureDateAssessment 1 Underpinning knowledge questionsInstruction to Students:Answer the questions below in the spaces text box provided.Ensure all references are documented under each individual question.Answers are to be typed or for written submissions, use black or blue ink and ensure your name is attached to the responses.Case StudyGail is a 49-year-old Aboriginal woman. Gail spent her first 14 years at La Perouse Mission Church where many young Aboriginals girls were housed, she was isolated from her family and was not allowed to practice any cultural traditions. When she turned 14 she was placed in a “white folks” household where she worked for 4 years as the house maid. At age 18 she was able to leave her employment and worked most of her life in the kitchen of a small golfing club on the nearby coastline. Gail had 3 children to her husband who she met while working at the golf club.Gail discovered that she had diabetes 2 years ago because her father and two sisters had diabetes too, which appeared to be a hereditary disease in her family. She was strongly recommended by her sister – who is a nurse- to have a checkup which Gail did. Apart from her course of insulin (pill form), Gail also consumes alternative medicine, such as Barley Green Herb, as well as other bush medicine supplements.Yesterday Gail presented via ambulance to Prince Henry Hospital with breathing difficulties, blood pressure (95/55), temperature 38.6 and swelling in her lower limbs and hands. Gail also has a large ulcer which has small black area on it with a small amount of excrement. On admission and assessment Gail informs you that she has never smoked cigarettes or drunken alcohol and only consumes prescribed medication. Gail has a past history of high blood pressure for the last 5 years and poorly managed diabetes. Gail appears frail, unkempt and at times confused and disorientated.Gail’s breathing has become a little more difficult because of her anxiety levels at not seeing any familiar faces or family. She is very confused and upset. She is difficult to talk with and keeps saying she “let me go home”. She keeps try to remove the O2 cannula and attempting to get out of bed. She is refusing to take any fluids and her temperature is now 39 5 degrees.Read the above case study and provide a response to the questions below.List what needs to be holistically assessed for a person with a history of diabetes. (Min 300 words)We can take the patient Gail in the case study as our example for the assessment. The things that should be holistically assessed for a person with a history of diabetes are listed below:How and when did it start? Example: Gail had discovered diabetes 2 years ago as it is found to be hereditary diseases; father and two sisters.How is the patient coping with and complying with their medication regimen for diabetes?Example: Gail only has prescribed medication and also consumes alternative medication such as barley Green Herb and other bush medicine supplements.How is the patient coping with their self care and self management of the diabetes?Gail diabetes is poorly managed as per as case study.Did any of the family members have diabetes?Example: Gail father’s and two sisters had diabetes.Do they smoke, drink or take any recreational drugs?Example: Gail never smoke and drink.Does the patient have any allergies of anything?How is the medical condition of the patient?Example: Patient have breathing difficulties, blood pressure (99/55), temperature 38.6 C , swelling lower limbs and hands, large ulcer having small black area with small amount of excrement.Does client have any psychological issue that is related to diabetes?Gail stays upset, frail, unkempt, confused and disoriented. She is difficult to talk.How was the patient medical history?Gail has high blood pressure from past five years and is poorly managed balanced diet.Has the patient had any treatment or hospital admissions for complications of their diabetes in the preceding year?A day ago Gail was taken to Prince Henry Hospital by ambulance.Has the patient been otherwise well, or had any other illness of note over the preceding year for which they have consulted their GP or other healthcare services?Reference: Tidy, D. (2019). Assessment of the Patient with Established Diabetes. Patient. Retrieved from https://patient.info/doctor/assessment-of-the-patient-with-established-diabetesWhat situations during a holistic assessment might be ideal for providing patients with further information? (Min 50 words)What should you do if you identify a known diabetic in a drowsy unarousable state? (Min 50 words)When would you need to modify the clients care plan? (Min 50 words)The clients care plan should be changed :When there is any change in patient medical condition,When there is any change in medication,If the current interventions is not effective for patient,It needs to be modified after observing the patient is getting better or worsening or still same after implementing care plan.References: When does a nursing care plan need revision? | NANDA International Knowledgebase. (2019). Retrieved from http://kb.nanda.org/article/AA-00523/0/When-does-a-nursing-care-plan-need-revision.htmlWhat is the purpose of documenting any client uptake of services or health promotions? (Min 50 words)It is important to document the client uptake of services or health promotions :To ensure that patients receive care that is consistent with their preferences.It reduces moral distress among health care providers.To provide guidance to the family and reduce their decisional burden about whether they are following the client preferences.Reference: Up To Date. (2019). Retrieved from https://www.uptodate.com/contents/advance-care-planning-and-advance-directives#H37131055Discuss blood and urine tests associated with diabetes by completing the following table. (Min 300 words for table)Specimen Test Explanation and preparation for the testBLOODRandom Blood glucose level The testing of the blood sugar level at any time of the day is Random Blood Glucose level. The normal range of this blood test ranges from 70mg/dl-150mg/dl. It involves drawing of blood out from the veins by the means of an injection. We need to inform the doctor of any prior health condition or the intake of any steroid while doing this test. (2019) https://www.portea.com/…/random-blood-sugar-rbs-test-151HbA1c (glycosylated haemoglobin) It is the blood test of average blood sugar level, for the last 2/3 months that diagnosis and monitor diabetes. We don’t need to prepare anything for this test.Oral glucose tolerance test (OGTT) Oral glucose tolerance test: This test requires body to fast overnight. Drink sugary liquid which contain 75 grams of glucose. Blood test is done for next 2 hours. If the sugar level is less than 7.8mmol/L it is considered to be normal. If the range is between 7.8 to 11.0mmol/L it refers pre-diabetes. And, 11.1mmol/L or higher suggests diabetes. Reference:(“Type 2 diabetes – Diagnosis and treatment – Mayo Clinic”, 2019)URINE KetonesMicroalbuminglucose A ketone urine test measures the amount of ketones in the urine. The test kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones. Microalbumin urine test is a simple urine test and we don’t need any preparation for it.Glucose urine test doesn’t require any preparation for it. We can eat and drink whatever we like.(2019). Retrieved from https://www.webmd.com › Diabetes › Guide test, K. (2019). Ketones urine test: MedlinePlus Medical Encyclopedia. Retrieved from https://medlineplus.gov/ency/article/003585.htmMicroalbuminuria Test: Purpose, Procedure, and Results. (2019). Retrieved from https://www.healthline.com/health/microalbuminuria-test#preparationGlucose in Urine Test: MedlinePlus Lab Test Information. (2019). Retrieved from https://medlineplus.gov/lab-tests/glucose-in-urine-test/Case StudyYou are an EN who has been employed in the role of Diabetic educator in a local medical service that provides primary health care and supports the three surrounding Aboriginal and Torres Strait Islander communities of the North Coast of NSW.In your role you are responsible for assessment and monitoring; educating diabetic clients on the importance of self-management of diabetes; informing and liaising with diabetes care services and follow-up with multidisciplinary team.The need for a specific diabetic educator in the medical service was due to the increasing number of recorded diagnosed diabetics requiring health care. As part of your specialised training in Diabetes you are aware of the following:In 2012–13, around one in twelve (8.2%) Aboriginal and Torres Strait Islander people had diabetes mellitus and/or high sugar levels in their blood or urine. Aboriginal and Torres Strait Islander rates for diabetes/high sugar levels were between three and five times as high as the comparable rates for non-Indigenous people in all age groups from 25 years and over. Based on age standardised proportions, Aboriginal and Torres Strait Islander people were three times as likely as non-Indigenous people to have diabetes/high sugar levels (rate ratio of 3.3);Modifiable risk factors including diet, exercise, waist girth and smoking require culturally-appropriate educational interventions placed within a Medicare or otherwise public-funded avenue in order to be accessible to all Australian Aboriginal diabetic patients. The management of diabetes involves prevention or delay of complications, as well as detection and treatment of complications as they arise, thus necessitating a multi-disciplinary team approach to life-long patient care. Read the above case study and provide a response to the questions below.what are the underlying environmental and social factors contributing to diabetes in the Australian general population and specifically higher rates of diabetes experienced by Aboriginal and/or Torres Strait Islander people? (Min 100 words)Environmental andSocial determinantsAustralian population Environmental andSocial determinants Aboriginal and/or Torres Strait Islander people Modifiable risks Non-modifiable risks Provide a brief summary of diabetes care services in the Australian health care environment and sources of available funding for diabetes related services and specific resources for Aboriginal and Torres Strait Islander people with diabetes. (Min 100 words)Where would diabetic educators research current, relevant and accurate information on evidenced based best practice for diabetes care? (Min 100 words)Why is it important to provide and explain complex information about diabetes to clients, carers and family members relating to self-management and check their understanding? (Min 50 words)Part of your role in management of people with diabetes is to liaise with specialists and referring agencies. List the type of specialist you might seek a referral for and how you would liaise with these referring agencies. (Min 100 words)In your role of diabetic educator what should you teach clients in relation to self-management? (Min 100 words)Questions ChecklistHLTENN025 Implement and monitor care for a person with diabetesThe assessor needs to indicate whether they have conducted the questioning as written questions or as verbal questions by ticking the box below.Written Questioning Verbal QuestioningFor written questions, the assessor must provide the student’s original written responses.For verbal questioning, the assessor must provide dot points as a Maximum on the student’s responses.For details on how to conduct and contextualise this form of assessment, please refer to the questioning checklist explanation in the assessor guide.Student’s name: Assessor’s name: If questions are answered verbally, theassessor must write detailed answers in the sections provided below. The space below does not indicate the size of the answer anticipated. Keep typing and the space will expand. If answers are recorded separate to this document, they must be attached to the assessment documents. Satisfactory responseYes NoQ 1 List what needs to be holistically assessed for a person with a history of diabetes. (Min 300 words) Q 2 What situations during a holistic assessment might be ideal for providing patients with further information? (Min 50 words) Q 3 What should you do if you identify a known diabetic in a drowsy unarousable state? (Min 50 words) Q 4 When would you need to modify the clients care plan? (Min 50 words)Q 5 What is the purpose of documenting any client uptake of services or health promotions? (Min 50 words) Q 6 Discuss blood and urine tests associated with diabetes by completing the following table. (Min 300 words for table) Q 7 what are the underlying environmental and social factors contributing to diabetes in the Australian general population and specifically higher rates of diabetes experienced by Aboriginal and/or Torres Strait Islander people? (Min 100 words) Q 8 Provide a brief summary of diabetes care services in the Australian health care environment and sources of available funding for diabetes related services and specific resources for Aboriginal and Torres Strait Islander people with diabetes. (Min 100 words) Q 9 Where would diabetic educators research current, relevant and accurate information on evidenced based best practice for diabetes care? (Min 100 words) Q 10 Why is it important to provide and explain complex information about diabetes to clients, carers and family members relating to self-management and check their understanding? (Min 50 words) Q 11 Part of your role in management of people with diabetes is to liaise with specialists and referring agencies. List the type of specialist you might seek a referral for and how you would liaise with these referring agencies. (Min 100 words) Q 12 In your role of diabetic educator what should you teach clients in relation to self-management? (Min 100 words) Feedback to Student:Result Satisfactory Not Yet SatisfactoryAssessor’s Signature:Date: