Examination ticket number 11

Certification of professional activity

PM02. Participation in medical diagnostic and rehabilitation processes

MDK _ 02.01. “Nursing care for various diseases and conditions”

MDK 02.02. “Fundamentals of Rehabilitation”

Specialty_ 060500 “Nursing”

GBOU SPO VO “Kovrov Medical College” Considered and approved at the meeting of the CMC “___” _____________. Approved by Deputy Director for SD ___________Nakhaeva N.P. “___”____________G.

Tasks for students

Assessed competencies PC2.1, PC 2.2, PC 2.3, PC 2.4, PC 2.5, PC 2.6, PC 2.7. PC 2.8

Conditions for completing the task the practical task is performed in the classroom using material resources, taking into account the requirements for labor safety when performing a medical service

Task completion time_ 30 minutes

Task number 1. Task

Instruction:

Read the assignment carefully.

Task completion time – 10 minutes

A 48-year-old man with a diagnosis of stomach cancer is being treated in the oncology department.

Complaints of vomiting, weakness, lack of appetite, aversion to meat food, weight loss, severe pain in the epigastric region, belching, bloating. The patient is adynamic, depressed, comes into contact with labor, withdrawn, experiences a feeling of fear of death.

Objectively: the condition is severe, the temperature is 37.9 0 C, the skin is pale with an earthy tint, the patient is sharply emaciated, palpation in the epigastric region reveals soreness and tension in the muscles of the anterior abdominal wall. The liver is dense, painful, tuberous, protrudes 5 cm from under the edge of the costal arch.

Tasks

1. Identify the patient’s problems;

2. set goals

3. Make a nursing care plan for the priority problem, with the motivation for each nursing intervention.

4. Educate the patient’s relatives in caring for cancer patients.

5. Demonstrate the technique of administering a nutrient enema.

6. Counsel the patient and his environment on the use of medicines

7. Complete the required medical documentation

Task number 2. Task

Instruction:

Read the assignment carefully.

Task completion time – 10 minutes

The patient is in the surgical department for an appendectomy. Operated 3 days ago. Postoperative course without features. However, by the evening of the 3rd day, the temperature rose to 37.8°C, malaise, chills, and throbbing pains in the area of the postoperative wound appeared. When examining the postoperative suture, edema, redness are noted, 3 sutures have erupted.

TASKS

1. Identify the patient’s problems;

2. set goals

3. Make a nursing care plan for the priority problem, with the motivation for each nursing intervention.

4. Explain to the patient the nature of the complication,

5. Explain to the patient the possible causes of the complication.

6. Remove the stitches from the wound.

7. Complete the required medical documentation

Task number 3. Task

Instruction:

Read the assignment carefully.

Task completion time – 10 minutes

A 30-year-old patient was admitted for inpatient treatment in the gynecological department with a diagnosis of uterine fibroids with hemorrhagic syndrome.

Complaints about heavy and prolonged menstruation, general weakness, dizziness. In the surrounding space is oriented adequately. The woman is restless, nervous, makes contacts, but expresses fear about the upcoming operation.

Objectively: consciousness is clear, position in bed is active. The skin is clean, pale, pulse 80 beats per minute, blood pressure 110/80 mm Hg. Art. The abdomen is soft, painless, participates in the act of breathing.

Tasks

1. Identify the patient’s problems;

2. set goals

3. Make a nursing care plan for the priority problem, with the motivation for each nursing intervention.

4. Teach the patient how to take hormonal drugs.

5. Conduct conversations with the patient in order to convince her of a successful outcome of the surgical intervention

6. Have conversations about providing a diet high in protein, vitamins, micronutrients

7. Prepare a set of tools for diagnostic curettage.

8. Complete the required medical documentation

Ticket number 11 (sample answer)

Task #1

Patient problems

Real: pain in the epigastric region, weakness, lack of appetite, weight loss, belching, flatulence, vomiting, fear of death, fear for the future of loved ones.

Potential: deterioration of the patient’s condition associated with the development of acute cardiovascular failure, gastric bleeding and peritonitis.

The priority problem of the patient: severe pain in the epigastric region.

Objectives: short-term and long-term reducing the intensity of pain from the day of admission to the time of discharge, adaptation to the state of one’s health.

Plan Motivation
1. Provide the patient with peace, increased attention, sympathy. To create psychological comfort.
2. Monitor compliance with bed rest. To create physical peace.
3. Provide the patient with a high-calorie, easily digestible, varied diet rich in proteins and vitamins. To increase appetite, improve digestion.
4. Organize feeding the patient in bed. To reduce weight loss and to compensate for the loss of protein and vitamins, to maintain the body’s defenses.
5. Help the patient with physiological functions and hygiene procedures; carry out the prevention of bedsores; change bed and underwear in a timely manner. To maintain hygiene conditions and prevent complications.
6. Ensure regular ventilation of the room and regular cleaning. To prevent possible complications.
7. Control temperature, body weight, pulse, blood pressure, stool, appearance of urine. For early diagnosis and timely emergency care in case of complications (cardiovascular insufficiency, bleeding).
8. Provide emergency care for vomiting and gastric bleeding. To prevent aspiration of vomit.
9. Train relatives in caring for cancer patients. For the prevention of bedsores, infectious complications, aspiration of vomit.

Evaluation: the patient will notice an improvement in well-being, the intensity of pain will decrease. The goal has been reached.

The student demonstrates the right level of communication with the patient and his relatives, explains the rules for caring for cancer patients in an accessible way.

The student demonstrates the technique of administering a nutrient enema on a phantom.

The student completes the required medical documentation

Task #2

The real problems of the patient:

– throbbing pain in the area of the postoperative wound;

– temperature increase;

– redness and swelling of the edges of the wound;

– violation of the integrity of the skin (postoperative wound).

Priority problem : throbbing pain in the area of the postoperative wound due to suppuration.

The goal is short-term : the patient will reduce pain, signs of inflammation in the postoperative wound.

Plan Motivation
1. M / s will call a doctor. To receive appointments
2. M / s will treat, as prescribed by the doctor, the skin around the wound. To prevent the spread of inflammation
3. M / s, as prescribed by the doctor, will treat the edges of the wound with alcohol-containing antiseptics, remove the stitches, apply a bandage with a hypertonic solution. To ensure the outflow of pus from the wound
4. M / s will provide observation of patients (pulse, respiratory rate, temperature, blood pressure). To monitor the general condition of the patient
5. As prescribed by the doctor, will provide a course of anti-inflammatory therapy. To relieve signs of inflammation and detoxification.

Evaluation: throbbing pain in the postoperative wound disappeared, signs of inflammation decreased. The goal has been reached.

The student explains to the patient the nature of the complication, its possible causes.

The student demonstrates the removal of sutures on the model.

The student completes the required medical documentation

Task #3

Patient problems

Real problems: heavy, prolonged periods; general weakness; dizziness; fear of an upcoming operation;

Potential problems: bleeding, infertility; anemia; violation of the functions of neighboring organs.

Priority problem: heavy and prolonged menstruation.

Short term goal : Reduce menstrual flow.

Long-term goal: The patient will be free from bleeding complaints by the time of discharge.

Plan Motivation
1. Giving the patient a horizontal position To improve the blood supply to the brain
2. Applying cold to the lower abdomen For effective treatment
3. Conducting a conversation about providing nutrition with a high content of protein, vitamins, microelements To compensate for the loss of protein and increase the body’s defenses
4. Educating the patient to prepare for diagnostic curettage For the prevention of postoperative complications
5. Conducting a conversation about the correct intake of iron supplements To reduce bleeding
6. Conducting a conversation with the patient in order to convince her of a successful outcome of the surgical intervention To create a favorable preoperative psychological climate
7. Monitoring the appearance and condition of the patient For early diagnosis and timely provision of emergency care in case of complications

Evaluation: the patient notes a significant improvement in her condition. The bleeding has stopped. The goal has been reached.

The student demonstrates training in taking hormonal drugs and finds out if she understood his explanation correctly.

The student demonstrates the preparation of a sterile table and lists the necessary tools for diagnostic curettage of the uterine cavity: sterile cotton balls, gloves, a bottle of 70% alcohol and formalin, tweezers, a spoon-shaped mirror, bullet forceps, Hegar dilators, 2 curettes.

The student completes the required medical documentation

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