| Assessment Type: | |||
| Assessment Title: | 35822/02 Implement and monitor care for a person with diabetes case study | ||
| Date: | Student Name: | ||
| Cohort: | Open Colleges Student ID: | E |
| Attempt 1 In order to demonstrate competence in units of competency within the HLT54115 Diploma of Nursing a combination of assessment tasks must be completed to demonstrate an understanding of the underpinning knowledge and required skills as outlined in the National Training Package. The following 35822/02 Implement and monitor care for a person with diabetes case study assessment must be completed to form part of the evidence required to demonstrate the underpinning knowledge for: HLTENN025 Implement and monitor care for a person with diabetes HLTENN015 Apply nursing practice in the primary health care setting Timeframe: This assessment must be completed by week 66 in your timetable. Grading: Each assessment task will be graded Satisfactory (S) or Not Yet Satisfactory (NYS). A Satisfactory result in each assessment task must be attained to receive a competent outcome for the unit overall. For information regarding reassessment refer to the Student Handbook. “I affirm that all work submitted within is my true and original work unless otherwise credited” Student signature: Date ☐ If you have typed your name, please tick this box to acknowledge that by including your name in place of a signature above, it is deemed to be your signature for the purpose of this assessment Module 24 & 27 Implement and monitor care for a person with diabetes Apply nursing practice in the primary health care setting This is assessment 2 of 2. Deliverables/To do list: Complete the assessment coversheet by adding: Your full name Open Colleges Student ID Date Your Cohort (eg Feb 19) Affirm that the work submitted is your work, either by: Signing the bottom of the page (this can be an electronic signature) or Tick the affirmation box and type your name. Read the student instructions and complete all parts to this assessment. Before submitting all parts of this assessment into OpenSpace, ensure you read and follow the deliverables set out in this assessment. Save all documents using the naming convention: ‘Your Surname_your open colleges student number_assessment number.doc’. For example: “SMITH_E1234569_31135_01.doc.” Save a copy of this assessment for your own records and upload your assessment into OpenSpace using the relevant assessment upload link in this module. |
Instructions to the student
This assessment will comprise two (2) parts.
- Part A – Short answer knowledge-based questions relating to the Samuel Hardy
- Part B – Practical skills relating to caring for Samuel Hardy
This diabetes patient case study written assessment forms part of the assessible components for the diabetes and primary health care units. It includes a scenario of a patient with diabetes and is based on real patient with de-identified information to preserve their identity.
Part A – Short answer knowledge-based case study questions
You are required to read the case study background information on Samuel Hardy and use this information to answer the 10 questions relating to their care. The answers you provide should be related to the patient information provided and all rationales of care should relate to his specific needs.
You are to:
- Answer the questions from the perspective of a qualified Enrolled Nurse.
- Use correct anatomical and medical terminology in your answers.
- Reference your answers using the APA 6th Edition referencing standard.
Part B – Practical skills
The practical skills component of this assessment will take place in the clinical skills lab at a time advised by your educator. You will be required to print this assessment prior to attending campus.
During the simulation assessment, you are being assessed on your ability to provide nursing intervention to a patient with diabetic ketoacidosis. All skills to be completed must be completed to the standard outlined in:
Koutoukidis, G. and Stainton, K (2017). Essential enrolled nursing skills for person centred care. 7th Ed. Sydney: Elsevier Australia.
While you are not required to submit the individual skills checklists as part of this submission, the outcome of this skills session will depend on your completing the tasks to the required standard.
The skills will be simulated with another student representing the patient. During your practical skillsyour educator will ask and discuss with you your rationales for your nursing actions and ask clarifying questions as this will encourage you to think critically, problem solve, and identify the evidence that underpins your knowledge. They will also provide you with any assessment results you indicate are required for the patient.
Deliverables for this assessment
To gain a satisfactory result for this assessment, you will need to upload all the following documents into OpenSpace in one submission. Your OpenSpace assessment submission is to include:
- Your completed assessment coversheet
- Part A – Your completed responses to the short answer questions
- Part B – The completed practical simulation checklist attached to this assessment.
Once uploaded, your educator will assess your assessment submission and provide feedback to you on the Assessment Evidence Checklist attached to this assessment. You will be given either a Satisfactory or Not Yet Satisfactory result. If your result is Not Yet Satisfactory, you will be given a due date for resubmission and feedback indicating what areas need addressing to gain a satisfactory result.
Case study background information – Samuel HARDY
Samuel Hardy is an 18-year-old Jewish man from Israel admitted to your area for stabilisation of his blood glucose levels. He has had a chest infection recently causing his BGL to become dramatically elevated. He usually manages his diabetes well with the help of his family, as he was only diagnosed with Type 1 DM last year. His parents are a good support however he struggles at times trying to be ‘normal’.
Samuel lives with his parents and younger sister, who emigrated to Australia 4 years ago. He leads an active lifestyle and has a good group of friends since they were at high school together. He has a part time job as a barista in the local café as he is saving for his first car. He loves to play rugby and has training twice a week and games on the weekend. He has recently started smoking, and when asked why, he replied “because his friends were doing it”
Past Medical History Appendicectomy at age 12 Eczema Allergies Nil Known Medications S/C Novorapid 10 units TDS S/C Lantus 20 units nocte |
He has brought in his last 24 hours BGL readings.
| Previous Day Before breakfast – 9.8 mmol Before lunch – 11.6 mmol Before dinner – 18.5 mmol Before bed – 18.1 mmol | Today Before breakfast 20.2 mmol Before lunch 26.6 mmol |
He has had a 3-day history of fever, rigors, productive cough and general malaise. His BGL has steadily risen over this time.
Overnight he was complaining of polyuria, polydipsia and headache and a more productive cough causing him dyspnoea. His parents were concerned about his wellbeing and decided to present with him to the emergency department.
He also mentioned that he has had concerns regarding some weight gain since his diabetes diagnosis, despite no significant changes to his dietary intake or exercise habits.
| Observations on arrival to ED Pulse – 98 beats per minute Blood pressure – 105/65 mmHg Respirations – 22 breaths per minute Oxygen saturations – 96% on room air Temperature – 38.6 oC BGL – 29.8 mmol Chest Xray result Slight left lower lobe consolidation | Urinalysis Glucose +++ Ketones +++ Protein + pH 6.0 SG 1.015 |
After initial assessment in the emergency room he has been transferred to the ward for ongoing management.
He has deteriorated and continues to feel unwell, with polydipsia, polyuria, muscle cramps, nausea and general malaise.
Current Observations Pulse – 113 beats per minute Blood pressure – 115/60 mmHg Respirations – 28 beaths per minute Oxygen saturations – 96% on room air Temperature – 37.6 oC BGL – 32.3 mmol |
You note he has a sweet-smelling breath. You take your concerns to the RN and MO, who have diagnosed diabetic ketoacidosis. This is a medical emergency and needs attention immediately.
An infusion of insulin is commenced via a syringe driver pump and glucose infusion.
He needs hourly BGL monitoring with adjustments made to the insulin infusion according to these results. You will also test all urine for ketones.
Part A – Short answer knowledge-based case study questions
| Performance criteria | Record of results | ||
| Q1 | Explain the pathophysiological difference between types 1 and type 2 diabetes mellitus and gestational diabetes. | S | NYS |
| Student to add answer here | |||
| Q2 | Outline the pathophysiology of Diabetic Ketoacidosis (DKA). | S | NYS |
| Student to add answer here | |||
| Q3 | Briefly outline some the psychosocial issues faced by an 18-year-old who is a newly diagnosed type 1 diabetic. | S | NYS |
| Student to add answer here | |||
| Q4 | Discuss how diabetes can affect Samuel’s self-esteem and how the nurse could positively influence this? | S | NYS |
| Student to add answer here | |||
| Q5 | How does hyperosmolar hyperglycaemic nonketotic syndrome differ from diabetic ketoacidosis? | S | NYS |
| Student to add answer here | |||
| Q6 | During Samuel’s hospital stay, you are beginning to prepare his discharge, what are two potential health issues or complications related to his diabetes might he face after he is out of hospital? | S | NYS |
| Student to add answer here | |||
| Q7 | What are the clinical manifestations that Samuel would see should he develop the complication you identified in the previous question? | S | NYS |
| Student to add answer here | |||
| Q8 | It can be difficult with non-compliant diabetics to implement self-management programs for when patients are at home. Considering Samuel, what areas of risk exist that may cause difficulty to implement primary health care programs into his care at home? | S | NYS |
| Student to add answer here | |||
| Q9 | Excluding nurses, identify 3 other health care specialists that would be part of the interdisciplinary team that supports Samuel’s care after he is discharged. Include in your answer their role, and how they would specifically support him. | S | NYS |
| Student to add answer here | |||
| Q10 | As part of Samuel’s education regarding his diabetes, what health promotional information would you provide him on the following topics (include in your answer, the expected outcomes of the options you provide. | S | NYS |
| Exercise | |||
| Diet | |||
| Weight loss (weight management) | |||
| Smoking | |||
| Foot Care | |||
| Eye Care |
Part B – Practical simulation
For part B, you will be required to undertake nursing interventions related to Samuel’s care during his admission.
This will be conducted in the simulation lab, with another student taking on the role of Samuel.
During this session, your educator will provide you with the required assessment results, and you will be given the opportunity to both complete both Samuel’s assessment, and documentation related to his care.
| Part B – Practical simulation | Attempt: | |
| Satisfactory | Not Yet Satisfactory | |
| Did the student complete the following care interventions as per required standard? (refer to enrolled nursing skills for person centred care for required standards) Check BGL Check IV infusion rate and recalculated as ordered Check IVC for PIVAS / VIP score Calculate new insulin infusion rate as required by BGL result | ||
| Did the student Document all assessment outcomes correctly Document in progress notes with all care provided to Samuel. | ||
| Did the student explain the procedures and educate appropriately during the provision of nursing interventions? | ||
| Did the student maintain proper hand hygiene and infection control procedures during the provision of care? | ||
| Did the student maintain proper work health and safety requirements during the provision of care? | ||
| Educator’s comments | ||
| If work submitted by student was found ‘Not Yet Satisfactory’ advise what action that is required is: Resubmission required Date for resubmission Other | ||
| Educator Name: Date |
Assessment Evidence Checklist
The assessment evidence checklist is a record of your assessment activity outcome. Once you have submitted all parts of this assessment into OpenSpace, your educator will provide feedback and comments on this checklist and will provide a copy of this into OpenSpace once your assessment submission has been marked.
You have two attempts to complete the assessment. If you need to re-attempt the assessment task your educator will give you clear and direct feedback with revised submission dates if required.
| Student has completed and achieved all criteria for the assessment 35822/02 Implement and monitor care for a person with diabetes case study including providing all evidence which includes: | Attempt: | |
| Satisfactory | Not Yet Satisfactory | |
| Part A – Short answer knowledge-based case study questions Student has completed all 10 questions. Academic Integrity/ Plagiarism All the student’s work is original and sourced and referenced where appropriate. | ||
| Part B – Practical simulation Simulation checklist submitted | ||
| Educator’s comments | ||
| If work submitted by student was found ‘Not Yet Satisfactory’ advise what action that is required is: Resubmission required Date for resubmission Other | ||
| Educator Name: Date |
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