Q1. Identify (8) eight important assessments and/or forms you should perform and/or fill out as part of the admission. (This is to exclude name, age, and address.) 100 to 150 words Admission date: Record the full date of admission to hospital Admission time: Use the 24-hour clock to record the time of admission. Times are between 0000 (midnight), which is the start of the day, and 2359, which is the end of a day. Admission number: Record the admission number from the admission register (allocated automatically by the system (HBCIS) and it known as the episode number. Chargeable status: When admitted to a hospital, an eligible patient must elect either to be a public or private patient. Paper hospital: Record the chargeable status of patient using one of the following codes; Code Description 1 Public 2 Private shared 3 Private single Ineligible for Medicare: A patient who ineligible for Medicare does not have access to free hospital. Queensland Public hospitals are to provide Medicare ineligible patients with a choice to be treated as a public or private patient. Different fees apply. Incident Date (HBCIS only): The date on which the injury, accident or illness associated with the episodes of care occurred. Source of Referral/transfer (admission source): The source of referral/transfer indicates the referral point of a patient immediately before they are admitted either formally (hospital admission) or statically (type of episode change). Recording the source of referral/ transfer are identified by special codes. Care Type: Refers to the nature of treatment/care provided to a patient during an episode of care. Transferring from facility: The facility number must be recorded when the hospital receives a transferred patient for ongoing care. Ref: (Data Collections unit Queensland Health, Manual of Instructions and procedures for Reporting of QHAPDC Data, 2012) Q2. In your health assessment of Mrs Akimoto, name four (4) physiological things do you need to assess for each of the following areas: 100 to 150words A. Respiration Acidaemia: state in which the pH of the blood falls below 7.35 (normal=7.35-7.45) Atelectasis: collapse of lung tissue with consequent reduction in gas exchange. Hypercapnia: increased the amount of carbon dioxide in arterial blood. Hypoxaemia: Insufficient oxygen content in arterial blood. B. Pulse Body temperature Heart Rate or pulse Respiratory Rate Blood Pressure C. Neurological status Level of consciousness – a key indicator to brain function (response from client/patient by soft verbal contact then loud verbal contact if no response, gentle touch then a mildly painful stimulus if not responding). Orientation of the client/patient – client able to respond to simple questions and personal information. Assess motor response – single response commands to client, if unable to obey, apply painful stimulus and watch response. Assess pupillary activity – Determining size of pupil, pupil shape is determent to indicate abnormality, reactivity to light is also assessed and response is recorded as brisk, sluggish or fixed. Q3. Identify four (4) hazards/risks in the operating theatre to the patient and/or staff. 50 to 100 words All staff that is part of the surgical team has to familiarize them with the OSHA Guidelines in the exam room. While working in the operating room, you as a nurse should follow correct procedures to avoid getting injured or sometimes being subjective to other dangers while on theatre duty. The following hazards can occur: Physical Hazards – Injuries that can include electric shocks, pricks, burns, cuts and falls. These injuries could happen due to accidental cuts, shock or burn using surgical equipment (electrical), laser equipment, hitting of heads against overhead lights, wet floors causing slipping and falling. Biological Hazards – Medical staff accidently getting in contact of patient’s blood or body fluids. Diseases like HIV and Hepatitis can also be carried over to staff if they sustain a cut or a prick from any sharp operating instruments. Chemical Hazards – There is always a possibility that Anaesthetic instruments/tools can malfunction during operating process. Anaesthetic gases seep out through leaks in the connective tubing and expose to all working in the operating room. There is also a chance that disinfectants, cleaning and sanitising agents can cause sickness or injury if exposed to medical staff. Health Hazards – Medical professionals who spend lots of time standing and hunching over operating table can cause orthopaedic complications including spinal and disc problems. Stress also plays a mental health problem including anxiety, depression and burnout. Ref: (Timmons, B., Houston Chronicle, Occupational Hazards in Operating Room, 2015) Q4. What are 2 common types of skin prep use in surgery? Povidone Iodine – This antiseptic agent kills a range of Gram positive and Gram negative bacteria, fungi and viruses. Iodine is slowly released by the povidone and kills bacteria rapidly having no residual effect. This antiseptic agent is inactivated by organic material and can only be applied onto clean skin. Alcohol – A range of Gram positive and Gram negative bacteria, viruses and fungi are killed by the use of alcohol. Although it has little residual effect, it reacts and kills quicker than Chlorhexidine gluconate or Povidone Iodine. Ref: (Young, J., Custodian Director, Centre for Health Care related infection, Skin Prep, Dec 2012). Mrs Akimoto has an uneventful operation and recovery in PACU. She returns to your ward. Q5. List 10 observations / assessments / information you need to receive during handover from the PACU nursing staff on Mrs Akimoto’s return to the ward. (excludes Vital Obs).