Scenario 1 Mrs Heather Bishop is a 59 year old mother of 5 children; she has been admitted to your ward after her husband expressed concerns for her health. She presented with the following symptoms:  Tiredness – even after rest and especially after a meal  Occasional blurred vision  Increased thirst  Frequent urination On entering her room you introduce yourself and ask if, before you admit her, she would like the hot lunch that has just arrived. Heather tells you that she has gained a lot of weight over the past 2-3 years and worries that it is the weight gain that is making her so tired all the time. Her weight has begun to impact upon her mobility levels as well. You notice on speaking to Heather that her breath smells of acetone (like nail polish remover). She declines the lunch, stating that she isn't hungry and just wants to rest. You have been instructed by the shift coordinator to takes Heather's admission observations and perform a ward test urinalysis and a blood glucose level (BGL) blood test. Heather informs you she had her BGL tested 2 years ago and it was elevated then, but she had not returned to her GP for a follow up. You perform the observations including the blood and urine tests and find the following results: T – 37.1 HR – 72bpm RR – 18 BP – 175/95 BGL = 17.2mmol/L Ward test urine results: Urine specimen has a sweet fruity smell which is unusual. Large amount of ketones Positive for protein ++++ QUESTIONS: 1. If the observations listed below are considered the normal parameters (range) for adults, identify and list Heather's abnormal observations? (1 mark) T: 36.2 – 37.3 degrees Celsius HR: 60 – 100bpm RR: 16 – 24bpm BP: 120/80mmHg Blood glucose Level (BGL) normal range 4-8mmol/L Ward urinalysis: a normal urine specimen would not smell fruity and would have no ketones or protein in the urine. 2. In relation to Mrs Bishop's admission observations, identify the reporting line you would follow to notify of her abnormal results. (1 mark) 3. Given Mrs Bishop's recent weight gain, her 2 year reported history of high blood glucose levels, her symptoms on admission and her observations, what do you consider to be her condition? (1 mark) 4. Discuss the inter-relationship between Mrs Bishop's 2 year history of hyperglycaemia (elevated blood glucose) and the impact that would have on the following body systems: (see template provided on separate sheet). (5 marks) 5. Identify and briefly explain the role of three (3) health professionals who would be involved i n Mrs Bishop's care. (100 words or less) (3 marks) 6. List two (2) contributing factors that may have impacted upon the development of Heather's condition – Type ll Diabetes (2 marks) 7. The term pathophysiology explains the processes within the body that result in the signs and symptoms of a disease. In relation to Heather, what caused her elevated blood glucose levels and what occurred as a result? (Explain why Heathers breath smelt like acetone and her urine showed large amounts of ketones) (200 words or less) (5 marks) 8. Summarise two (2) main functional deficits (signs and symptoms of illness) in Heather's body systems necessitating nursing care and or monitoring (50 words or less). (2 marks) 9. Within your scope of practice as an EN, outline two appropriate nursing interventions that would be indicated in this scenario (20 words or less). (1 mark) 10. Identify two health care professionals within the multidisciplinary team who need to be consulted in regards to Heather's care. Summarise the roles they play and include how their roles differ to the EN role (150 words or less).