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APN105 Applying nursing practice

University: The London College

  • Unit No: 12
  • Level: High school
  • Pages: 20 / Words 4991
  • Paper Type: Dissertation
  • Course Code: APN105
  • Downloads: 757
Question :

 This assessment will cover the following questions:

  • Discuss provision of care to the number of patient which is based on the mutual understanding of their physical, psychological emotional and spiritual pattern which is based on various dimension.
  • What are the essential to build the positive thought for the future which is helpful for the development of positive outcome from the complication of health.
  • Identify signs of swallowing and breathing difficulties. Which nursing management strategies could be require to address the issues?
Answer :

Performance criteria, Knowledge evidence and Performance assessed


Student Name






Subject Code and Title

APN105: Applying nursing practice (A)

Unit(s) of Competency

HLTENN010 Apply a palliative approach in nursing practice

HLTENN013 Implement and monitor care of the older person

PC: Adjusted according to PC mapping

HLTENN013 - 1.8, 1.9, 2.1, 3.3, 4.3, 4.4, 4.5,  4.6.

HLTENN010 - 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 2.1, 2.2, 2.3, 2.4, 3.1, 3.2, 3.3, 3.4, 3.5,3.6, 4.1, 4.2, 4.3, 4.4, 4.5, 5.1, 5.2

PE: Adjusted according to module mapping

HLTENN013 - 1, 2,

HLTENN010 - 3, 4 , 5

KE: Adjusted according to question mapping

HLTENN013 -  2, 4, 5, 10, 13, 15, 17

HLTENN010 - 1, 2, 3, 4, , 10, 11, 12, 14, 15, 16, 17

Title of Assessment Task

Case Study

Type of Assessment Task

Case study with short answer questions


19 questions



Task Instructions

To complete the assessment, you must respond to a number of questions, which are based on the case study. These questions must be answered in full. When responding to the questions, please pay attention to the entire question being asked, as well as the prescribed word count, if provided. Use the correct medical terminology when answering all questions.

References are required in every answer box where indicated. In-text referencing can

also be used.

Reference bibliography is not required.

Case Scenario:

You are an Enrolled Nurse working in a residential facility. Mrs Hong has been a resident at your facility for 10 months. After the initial settling in period, which Mrs Hong found difficult due to her limited English and early dementia, she is now settled and has a good routine that she and her daughter are happy with. Mrs Hong's daughter, Yu Yang, visits her mother daily and assists with bringing in Asian food for Mrs Hong. At times however, Mrs Hong still finds it challenging to interact with other residents and staff and can become quite upset and distressed, especially if her daughter is late with her food.

Five months ago, it was noted that Mrs Hong had a deformity in her right breast. On examination it was determined that Mrs Hong had stage 3C breast cancer. Mrs Hong and her daughter, Yu Yang, were provided with information relating to the condition and the options available. They have decided to opt for palliative care. Mrs Hong does not want any active treatment and an advanced care directive has been completed with her instructions. In the last 2 days, Mrs Hong has shown signs of deterioration with her condition, is unable to eat or drink, and is confined to bed. She remains conscious at present and her daughter, Yu Yang, is with her for most of the day.

As part of your role, you are working with a Registered nurse to provide care for Mrs Hong considering her choices for palliative care.

Character Briefs reviewed:

Mrs Fei Hong:

Mrs Hong is a 70 year old lady of Chinese origin.

Mrs Hong's background includes: -

Comes from one child family, Chinese background

Speaks little English

Has no extended family

Came to Australia to help her daughter, Yu Yang, raise her son 19 years ago.

Is beginning to demonstrate signs of dementia

Interferes in parenting of twins

Dictates cooking must be Asian

Has hearing and sight impairment

Mrs Yu Yang McFarlane:

Mrs McFarlane is Mrs Hong's daughter. She is 38 years old and married to George McFarlane. She has a son, Jason, and 3 year old twins.

Mrs McFarlane's background includes: -

Came to Australian as a University student

Fell pregnant at the age of 19 - did not marry

Married George 5 years ago

Has 3 year old twins at home

One twin has developmental disorder

English language is good

Was/Is isolated with no extended family

Her issues will be those of isolated immigrant

Prefers to cook Asian food

Needed help with raising child and invited Chinese mother to Australia to help out

Mr George McFarlane:

Mr McFarlane has been married to Yu Yang for 5 years. He is 53 years old. Mr McFarlane is reliant on Yu Yang to complete all domestic duties as he is not self-sufficient. He is a long- haul truck driver and is often away for work. He earns good money.

Definition of Holistic care

Pain relief - pharmacological

Pain relief - non- pharmacological

Physical care

Nutritional support

Elimination  support

Social support

Social support

Cultural support

Religious support

Emotional support


Define the term ‘holistic care'

Provide examples of how you would provide holistic palliative care to Mrs Hong and her family in each of the following 10 aspects.  (word limit - 100 Words)




Assessment Criteria

Question 1


This is defined as the provision of care to the number of patient which is based on the mutual understanding of their physical, psychological emotional and spiritual pattern which is based on various dimension.

Codeine, fentanyl and so on.

Regular exercise and yoga.


In this, Mrs Hong used to eat take Asian food in which this is the major step which is taken in the care of palliative. So, as per this, diet must be provided in appropriate way which is helpful for the Mrs Hong

Essential to build the positive thought for the future which is helpful for the development of positive outcome from the complication of health.

Focus on the relationship make surrounding well and enjoy the life in such a way which used to create the situation of resilience, this is also a part of palliative care where the wellbeing is explored.

This is helpful to share the complication and consequence which may arise the issue for the health, the interaction and communication with healthcare staff is important.

This is kind of meditation which is helpful for the Mrs Hong to visualise the vibes of the spiritual term and create the positive aura. This is kind of holistic care which is appropriate and show the effect of proper palliative care.

Use to take proper approach towards the religious aspect.

In this, they used to take support from the loves ones or with their friend and relative.




Response: In this, Mrs Hong is used to show the condition which is outline some of the important document which used to provide the information which is associated with the client. In this, the patient used to state that she loves to walk and other activities which is helpful for care. Moreover, they use to eat Asian food.



Assessment Criteria

Question 2

What document would outline Mrs Hong's wishes for her care if she was unable to tell you?

What details might this document include?

Response: On the basis of belief and value, as nurse the main factor is providing quality of care which may helpful for the patient to provide the resilience and care while providing quality of care and providing quality of life.

PART A: Reflect on and outline your values, beliefs and attitude towards death and dying

In term of this, the value, belief and attitude which is associated with death and dying must be neutral and provide support with emotional aspect to people.

PART B: State how your beliefs and values may affect your provision of care to the client

In this, the value and support used to create obstacle for the number of time. In terms of client there are various aspect which used to create the diabolical view and bases which maintain the factor which filled with emotion and pain to loose someone.  

EXAMPLE- sometime while providing support the emotional breaches are occur.

EXAMPLE- used to take the emotional factor and related the situation with himself which can cause overthinking.


Assessment Criteria

Question 3

Reflect on and outline your values, beliefs and attitude towards death and dying - give an example.  

State how your beliefs and values may affect your provision of care to the client- give 2 examples.


References: review mapping

Standard 3

Code of Conduct

The main purpose of the standard is to provide the better and quality based care to the Mrs Hong which is helpful for the development of resilience and other which essential for the dying client. Moreover, the standard is used to provide direct and maintain the safe and clinical competent for the nursing practice.


Standard 3: set out the legal requirement which help to show the professional behaviour and conduct expectation for the nurse while any death is occur in the practice should be managed.


Assessment Criteria

Question 4

What is the scope of practice for an Enrolled nurse when caring for a dying client?

(Refer to the NMBA Enrolled Nurse standards for practice -especially Code Conduct 3.6- End of Life Care).

Describe how these standards and codes dictate the care ENs provide - give 4 points from the STANDARDS FOR PRACTICE and Codes of Conduct. (Word limit - 30 Words per point)



Assessment Criteria

Question 5

Identify physiological changes by body system that you may observe in a client who is dying- List two per system



Cardio- vascular

Heart beat become slow.

Symptoms of the hypertension is observed


Respiration rate become slow

Rate of bronchiole fraction is observed.


Excitatory neurotransmitter become slow  

Inhibitory neurotransmitter become slow.

Pain during urination

Yellow colour observed during urination


Congestion is also observed in some of the condition



Cause of reshuffle


Become slow and diverse

Have consequence with formation of slow energy rate.


Have tendency to being ill.

Can create complication with the though and feeling.

REFERENCE: href="https://palliativecare.org.au/" Home - Palliative Care, 2021


Assessment Criteria

Question 6

Provide examples of 3 members of the Multidisciplinary Team (MDT) and how each one will assist in providing holistic care to Mrs Hong and her family

NB. If including nurses please include specialist nurses - state their specialty).


MDT member 1: Psychiatrist

Role: They used to provide positive outcome by taking proper interaction with the client and provide effective and important scope for life.

MDT member 2: Specialist nurse

Role: They focus on the client complication and their recovery

MDT member 3: Medicine counsellor

Role: Provide medicine as per the need and requirement of patient as per taking concern which is part of holistic care.


Assessment Criteria

Question 7

Identify signs of swallowing and breathing difficulties. Which nursing management strategies could you use in each case?

b) Why is oral care important to consider in a client who is unable to eat or drink?


a)  Swallowing difficulty

· unable to eat and drink.

· Do not take food.

· Avoid eating and follow the liquid diet which is easily disintegrate.

Nursing management strategies x 2 (Word limit 15 words)

· Used to provide care based on the complication

· Take proper step for the care by analysing the condition of patient.

Breathing Difficulties

· During the diagnose of cancer.

· During the treatment of breast cancer.

· On the advance care of sign which is associated with cancer and dementia.

Nursing Management strategies x 2 (word limit 15 words)

Oral Care


Assessment Criteria

Question 8

Mrs Hong's breast tumour has developed into a malignant wound.

Explain what malignant means and describe how you would care for the wound.


The malignant wound is cancerous. As per this, they develop when the cell grows uncontrollably. If the cell continues to grow and spread, the disease which is become life threatening


Assessment Criteria

Question 9

What signs/ changes may you observe in Mrs Hong that may indicate that she has deteriorated further?

Who would you report these changes to?

Explain how would you support Mrs Hong's daughter as she witnesses her mother deteriorating?

She is avoided to take the treatment which is show the indication of deterioration. Because it can care barrier for the care. By providing information in the positive sense and providing quality of care to the Mrs Hong.

Explain how you would support Mrs Hong's daughter: -

In this, create a positive sense for the Mrs Hong and maintain the support with the emotional level to his daughter while sharing memories and their behaviour.



Assessment Criteria

Question 10

Mrs Hong is no longer conscious but is demonstrating signs of distress by groaning in pain. (Include also nonverbal cues of pain and distress).

What is the most appropriate Nursing tool to use and what else can you observe to assess Mrs Hong's pain?

Response: In this, the physical therapy and occupational therapy is play vital role when Mrs Hong do not take medicine.

· Numerical rating scale

· Visual analog scale

· Adult nonverbal pain scale


Assessment Criteria

Question 11

Split into two boxes

Mrs Hong is no longer conscious but is demonstrating signs of distress by groaning in pain- you have assessed Mrs Hong and decided to assist in decreasing Mrs Hong's distress.

What options for pain relief would you consider if Mrs Hong cannot take oral medications? (non-pharmacological treatment options)

Outline 4 methods used to administer pharmaceutical pain relief to Mrs Hong now she is unconscious and no longer able to swallow

Response: Reference:

Non -Pharmaceutical Pain relief

· Maintaining Mrs Hong airways for the better respiration.

· Maintaining fluid balance and manage the nutrition.

· Prevent the retention of urine.

B) Outline methods of pharmaceutical pain relief administration

· Topical administration

· Parental administration

· Intravenous administration

· Sublingual administration


Assessment Criteria

Question 12

Discuss and recommend 3 nursing daily living activities which will be required for Mrs Hong now that she is unconscious and no longer able to provide for her own self care needs. (consider activities of daily living that Mrs Hong can no longer do for herself)


1. bathing: As per this, they used to provide care for their bathing, they cannot take the bath due to the condition.

2. brushing: this is also applicable in the oral care.

3. medication: in this, they used to provide the drug and medicine at time.


Assessment Criteria

Question 13

You assess Mrs Hong and believe she has died.

What action should you take within your scope of an Enrolled Nurse?

Identify one legislation for the notification of a death in a healthcare facility in your state?

             In what circumstances should a death be referred to the coroner?


A.  as per this action which is performed by enrolled nurse in this condition is provide support and sympathy which is proper aspect to develop a sense of matter. In this, they are used to take possible management behalf of this to create the sense of empathy and sympathy to the number of way which help to maintain the resilience.

The coroners act 2009: This provide effective legislation which is imperative for the death of any patient which is explanatory in practice, as per this, the act is initiated which is essential to cause more and more need of this act.

B. Doctor did not treat the person during the last illness. Or the doctor did not see the patient for the situation which is associated within the 28 day before death


Assessment Criteria

Question 14

a) What care activities are undertaken once a person dies? Please list.

b) How would you maintain respect and dignity for a client when preparing their body after death (include one cultural or religious practice)?


· In this, there are various activities which is followed under the circumstance which used to play vital role in the development of activities. Moreover, they are used to focus on the various part which is helpful and used to maintain the quite elongation to follow the rule and regulation before the death. In this the autopsy is being imitated by taking various approach.

· Patient and their family have their confidentiality and self-respect which is appreciated all the time. With this honour the people requirements for the organ and tissue contribution. Provide the well-being and protection for the everybody who is comes into the interaction with the body. In this, some of the family member of close to the patient might want to assist with the personal care. Moreover, record all the personal care in the deceased care plan.


Assessment Criteria

Question 15

How does the care requirement change for a patient after death who:

Requires an autopsy

Wants to be an organ donor

(consider the legislative requirements for the care of a person after death who requires an autopsy or chooses organ donation)

Please complete the table



An Autopsy

Pt has chosen organ donation


There are two type of the autopsy a corner autopsy and hospital autopsy and this done by the legal reason about the case or cause of death.

Before they death they willingly follow some the paper work to donate organ.  

Reason 1

To verify the detail which is accountable and reason of death as per the law and act.

They use to create an understanding by donating their organ to beneficial for others.

Reason 2

To know the causes and time of death to verify that it is natural or any type of complication.

Have willingly want to donate organ for the other who have complication with their organ can use after the death for the public needs.

Consent requirement - who from

From the regulation and law

For the needy people who required organ transplantation.

Cause of death & signing death certificate

Natural or due to any complication

Show the significance of organ.

Chain of notification responsibility-




Nursing care

(3 for each)

· Used to provide quality of care of patient and provide all essential support.

· Focus on the requirement of patient

· Complete aspect of care and standard quality care.

· Used to take concern with nurse and doctor.


Assessment Criteria

Question 16

List three ethical and legal considerations for organ donation?


· Should be voluntary.

· Confidentiality and protection of donor and recipient data.

· Equitable opportunities and fairness allocation.


Assessment Criteria

Question 17

How would you provide support to Mrs Hong's daughter (Mrs McFarlane) after her death?

Outline 3 community services you could refer Mrs McFarlane to, to support her with grief and loss? One service from your local/home area.


Support for Mrs Mc Farlane

· Used to show sympathy

· In that situation be strong and brave to handle and hold the hand to provide support.

· Allow a person to talk about their concerns

Community services

1. Do not afraid and predominately ask for the help in which the grief can be isolating when a person start to feel like that only person in the world feeling which is appropriate and show the relevance of feeling in which they start to think.

2. Talk and ask help and show the need if the support is required, the family and friend are the basic need when the individual is loss something due the major factor.

3. try to focus on the work and live life in the happier way which is essential and play the role of activeness and so exercise and make a fitness streak among the body which help to provide positive core concept in body.


Assessment Criteria

Question 18

How would you support your own self-care after caring for a long term client who has died?

Provide 3 examples of ways you could take care of your own wellbeing


Supporting self- Care

By making change in the environment and distract from the thought of person.

· Used to change place.

· Busy with some activities.

· Join some of the classes which is make themselves busy for the longer.

Personal Wellbeing

1. To formulate the wellbeing, it is important to follow the concept of live healthy and eat healthy food which is appropriate and vital role in the development of wellness. This help to provide the effective exercise regularly and provide the good and effective drink such as juice and all. Moreover, avoid drug and alcohol which can cause more complication and affect the wellbeing.

2. In this, try to do and manage the healthy and good hygiene which is essential and used play vital role in development of individual resilience.

3.  As per this, try to do something which helps to provide happiness and meet friend and make new friend and engage with them and try to do activities which is interesting in order to create the wellbeing with friend.


Assessment Criteria

Question 19

What services are available which can assist you and your healthcare colleagues to debrief after a death in your workplace? (Provide 3 examples of general services available and how they can assist with debriefing and supporting healthcare professionals).

Please provide one example of a service in your local area.


General services

1. In this, they are used to show the encourage worker which is all about the current need which help to imply the worker advice, information and handout which is productive in practice and cause various complication.  

2. A critical incident is ant workplace which is show the events or the series which is show the sudden which can create the impact threatening or the protracted which may be an assaults, threat which show the condition which is important to know.  

3. The critical incident which is associated with the stress management can cause various complication in this, they can cause to show the aim which is show the emotional reaction which may results from the scope of involvement in an exposure which is unusual in workplace incident.

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