NSB335 Integrated Nursing Practice


Your Task:

Use the Clinical Reasoning Cycle on the following pages to review the nursing priorities in relation to the care of Ethel.

Question 1: 

What type of arthritis do you think that Ethel has? Provide a rationale for your answer linking to pathophysiology. 

Question 2: 

Nurses need to understand the indications for and actions of medications they administer and make clinical decisions to ensure safe medication administration.

a) Donepezil is a commonly used medication to treat mild to moderate dementia caused by Alzheimer’s disease.  Briefly describe the mode of action (pharmacodynamics) of Donepezil.

b) Discuss the nursing considerations for patients taking Donepezil and the education you would provide to the patient/family.                                                                                   

c) Name one (1) side effect of Donepezil and state how you would assess Ethel for this? (1 mark)                   

d) Ethel takes non-steroidal anti-inflammatory drugs (NSAIDs). What is the risk for her with also taking Telmisartan? What advice can you give to reduce this risk and what monitoring should occur?

Question 3: 

Review knowledge on types of dementia as it is important to understand the type of dementia that Ethel has.

Ethel has been diagnosed with Alzheimer’s dementia. 

Outline briefly the basic pathophysiology of Alzheimer’s’ dementia.      

When the family first became concerned about Mrs Simpson’s cognitive status, they visited her GP. You will do a further examination of mental status.  There are many cognitive tools available that you might use to assess mental status.  

b)Name and justify one (1) cognitive test that would be applicable to use for Ethel.  

c)Name three (3) other tests (not cognitive) a doctor might order to determine a diagnosis of Alzheimer’s dementia and explain briefly why. 

Question 4: 

After reviewing NSQHS standard five, answer the following questions related to safety and comprehensive care

a)Ethel is at increased risk of injury while in hospital. Name three (3) reasons why.                                                                                                      

b)Discuss two (2) interventions that you would implement to help Ethel avoid injury while she is in hospital. Justify your answer using evidence beyond the NSQHS standard.                 

Question 5: 

Ethel is having a total knee arthroplasty. Her granddaughter asks what this means. Provide a suitable explanation for her of this surgical procedure.