Patient Assessment and Care Case Questions
Patient Assessment and Care Case Questions
Patient Assessment and Care Case Questions
Assessment Task 2 Student UNIT CODE UNIT WMTLLU806A TITLE Qualification 10512NAT Code Task Number Assessment 2 Assess and manage patients with lower leg ulceration related to circulatory insufficiency Qualification Graduate Certificate in Wound Title Management Task Name Clinical Case Review Description of assessment task to be completed • • • • • • This is one of fourassessment tasks students need to successfully complete to be deemed competent for this unit. This assessment contributes 40% of the total graded assessments for this unit. Marks will be scaled appropriately. To complete this assessment task student must answer a series of short answer questions based on simulated clinical cases. The assessment task is based on the clinical cases for this unit of competency presented on moodle. Students will receive feedback and allocated mark for each question. . You must achieve an overall mark of Satisfactory across all sections to be deemed satisfactory in this assessment. Conditions of assessment • • • • • This assessment activity is in the form of an open book written assessment completed out of class.
The clinical cases and questions will be available for the assessment period. You must upload their responses to the assessment questions to moodle as a word document according to the assignment submission instructions. If you receive an unsatisfactory mark will be required to complete a second assessment. The second assessment will be based on the alternative clinical case. You must adhere to the Graduate Certificate level requirements for referencing resources used and demonstrating the skills for research by using contemporary reference sources. Assessment Dates Please refer to moodle for the assessment availability and due date. Instructions to students • • • • • Refer to the assignment instructions on moodle. Respond to each of the questions on a separate word document. Use the suggested word allocation as a guide. You may use dot points or bullets to list items in your answer. References where included must be completed using the Harvard author date system according to institutional policy. Your mark and feedback will be returned via moodle. Warning – Uncontrolled when printed! The current version of this document is kept on the William Light Institute website. Authorised by: Academic Director Smartfutures Pty Ltd ABN 31 127 177 637 T/A The William Light Institute Original Issue: Draft Document Owner: Academic Director Smartfutures Pty Ltd ABN 31 127 177 637 T/A The William Light Institute Current Version: Draft 26/08/2021 Version: Draft Page 1 of 2 Assessment Task 2 Student The following 6 questions relate to the Unit 6 Clinical Case: Mrs Robina No Estimated words (approx) Question Grade allocated The Following 4 questions relate to 1 100 How would you classify the aetiology and features of Mrs Robina’s leg wound? Give justification for your selection. Satisfactory/Not Yet Satisfactory 2 200 Describe the physiologicalalterations in the normal vascular and lymphatic supply contributing to the risk of wounding and poor wound healing evident in Mrs Robina’s assessment.
Satisfactory/Not Yet Satisfactory 3 200 Describe the key elements which you would include in Mrs Robina’s comprehensive wound management plan and the time frames for review. Satisfactory/Not Yet Satisfactory 4 300 Describe your rationale for any compression therapy used in Mrs Robina’s treatment plan. Discuss the evidence for any therapies would you employ and the physiological effects and side effects of each. Satisfactory/Not Yet Satisfactory 5 200 What specific patient education would you provide to Mrs Robina regarding care of her wound and reducing her risk of further injury? Satisfactory/Not Yet Satisfactory 6 100 Describe the likely psychosocial effects of Mrs. Robina’s wound. Discuss how you would incorporate strategies which enhance wellbeing into your treatment plan Overall result 4 marks Satisfactory/Not Yet Satisfactory Warning – Uncontrolled when printed! The current version of this document is kept on the William Light Institute website. Authorised by: Academic Director Smartfutures Pty Ltd ABN 31 127 177 637 T/A The William Light Institute Original Issue: Draft Document Owner: Academic Director Smartfutures Pty Ltd ABN 31 127 177 637 T/A The William Light Institute Current Version: Draft 26/08/2021 Version: Draft Page 2 of 2 Graduate Certificate in Wound Management WMTLLU806A: Assess and manage patients with lower leg ulceration related to circulatory insufficiency Case Study Mrs Robina is a 78 year old female who is refereed to your wound management outpatient clinic by her local doctor for assessment of a wound on her right leg. She first presented to her local doctor two weeks ago but the wound has failed to heal. Past Medical History: She describes her health as good. She takes
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no medication She developed varicose veins in both her legs after her third pregnancy. She had stripping and ligation of veins in her legs 40 years ago however the varicose veins have returned. Her legs have been getting swollen in the evening for approximately the last 5 years.
This has increased over the last 8 months with increased swelling throughout the day. She complains of leg pain when standing for long periods of time. This is relieved when she sits down and puts her leg up. She does not remember ever having a wound on her leg which did not heal. She has never smoked. Patient demographics: Height 170cm Weight 82kg Social history: Mrs Robina lives at home with her husband. She is actively involved as a volunteer in her local community including serving at the community shop one afternoon per week. Her husband has chronic illnesses including heart disease and arthritis which restrict his mobility. Mrs Robina is responsible for the shopping and food preparation and all household chores. She drives a car and regularly is required to transport her husband to medical appointments. They have three adult children, with one living locally with two young children. Recently the wound on her leg has made prolonged standing difficult so she has had to limit her level of activity including reducing her hours of community service which she is disappointed about. Nutrition Mrs Robina states that she aims for a healthy balanced diet and cooks meat, grain and vegetable based dishes for herself and her husband. She states that as she has gotten older that she finds that her appetite for meat has decreased and has found herself eating smaller portions than her husband. She tries to eat three meals a day, however finds that a small snack at lunch time is sufficient on most days. Warning – Uncontrolled when printed! The current version of this document is kept on the William Light Institute website. Authorised by: Academic Director Smartfutures Pty Ltd ABN 31 127 177 637 T/A The William Light Institute Document Owner: Academic Director Smartfutures Pty Ltd ABN 31 127 177 637 T/A The William Light Institute Current Version: 23/06/2016 Page 1 of 4 Graduate Certificate in Wound Management WMTLLU806A: Assess and manage patients with lower leg ulceration related to circulatory insufficiency Case Study Wound History She says that the wound occurred when she knocked her leg on a piece of wood in the garden a couple of month ago. Initially it was a small laceration, approximately 4 cm long which she covered with a bandage.
During the ensuring period it has increased in size and started to produce large amounts of exudate. She says the exudate is sometimes offensive and soaks through her clothing frequently during the day especially when she is working at the shop. She saw her local doctor two weeks previously and was advised to cover the wound with gauze and a crepe bandage and has recommended changing it every day. Upon review the wound had failed to improve so referral for further opinion was indicated. She says the wound is not painful but her legs feel heavy and ache at the end of the day. Assessment and Physical Examination Mrs Robina arrives unaccompanied to the wound management clinic. She is alert and mobile but walks unaided with a moderately pronounced limp. She admits feeling ‘generally unwell’ for the last few days. Vital signs are as follow: Blood Pressure 130/95 Heart Rate 86 Temperature 38.4C Physical Examination revealed the following: There is mild oedema to the lower leg and the skin is dry and scaly with some reddish brown pigmentation over the ankle region extending to the lower leg. There is some indentation of the skin in the area where the crepe bandage had been wrapped around. There is evidence of varicose veins over the calf and thigh on the right leg. The wound is over the medial aspect of the lower leg it is covered with a gauze dressing and a bandage. Some of the dressing has adhered to the wound bed. There is evidence of serous exudate on the gauze which has soaked through the bandage, and the bandages are slightly malodorous. There is some erythema to the skin surrounding the immediate peri-wound area. The surrounding skin is also dry and scaly and the texture of the skin changes from soft to a more firm texture around mid to distal calf. Capillary refill time is less than 2 seconds. Dorsalis pedis pulse is able to be palpated. Posterior tibial not assessed due to the location of the wound. The ankle brachial pressure index is 0.96 in the right leg, with DP and PT pressures greater than 120 mmHg. Warning – Uncontrolled when printed! The current version of this document is kept on the William Light Institute website. Authorised by: Academic Director Smartfutures Pty Ltd ABN 31 127 177 637 T/A The William Light Institute Document Owner: Academic Director Smartfutures Pty Ltd ABN 31 127 177 637 T/A The William Light Institute Current Version: 23/06/2016 Page 2 of 4 Graduate Certificate in Wound Management WMTLLU806A: Assess and manage patients with lower leg ulceration related to circulatory insufficiency Case Study Blood Results The following blood results represent her biochemical and cellular markers on presentation to the wound management clinic. Pathology C-Reactive Protein White Cell Count Neutrophil Count Monocytes Count Haemoglobin (Hb) Platelet Count Sodium (Na) Potassium (K+) Chloride Albumin Urea Creatinine Total Protein Result 50 10.8 7.4 0.8 128 210 141 3.3 99 29 7.1 98 64 Normal Range