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NURSING ADULT WITH COMPLEX NEEDS EXAM LATEST UPDATE 2025-2026|Qs WITH CORRECT As|100% PASS
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White blood cells normal count 4.5 to 11.0 × 109/L Normal area for ileostomy stoma to be formed Right illiac region Stoma stool consistency would expect type 7 loose and watery DM range 4-7mmol
Blood gas- PH 7.35- 7. Blood gas- PaC 4.7-6.0 kPa Blood gas- p 10.5 to 14.0 kPa Blood gas- base excess -2.5 to +2.5 mmol/L Blood gas-Calculated bicarbonate 22 to 30 mmol/L Risks with oxygen Dry oral mucosa
tachycardia and decreasing depth of breathing Hypernatermina high sodium (na) hyponatermina low sodium (na) hypokalaemia low potassium (k) hyperkalaemia high potassium (k) Clinical judgement model (tanner, 2006) Based on - Benner (1982) From Novice to Expert. American Journal of Nursing 82(3): p402-
Guidelines for surgery NBM No eating or drinking 6 hours prior to surgery & no water 2 hours before surgery Morphine typical side effects
of limb or organ, for fixation of many fractures and for relief of pain or other distressing symptoms. Normally within hours of decision to operate. EXPEDITED (NCEPOD) Patient requiring early treatment where the condition is not an immediate threat to life, limb or organ survival. Normally within days of decision to operate. ELECTIVE (NCEPOD) Intervention planned or booked in advance of routine admission to hospital. Timing to suit patient, hospital and staff. Emergency anaesthesia Two main problems -Hypovolaemia> bleeding -risk of aspiration
types of anaesthetic GA- General anaesthetic - Sedation - TIVA( Total Intravenous Anaesthesia) - TCI (Target Controlled Infusion) LA- Local anaesthetic Regional anaesthetic sepsis 6
reference for clinical judgement Tanner (2006) Think Like a Nurse: A Research-Based Model of Clinical Judgment in Nursing. Journal of Nurse Education. (Tanner, 2006) reference for sepsis in trust Sepsis Trust (2017) [available online] sepsis.org Temperature range 36.1-38. temperature scoring 1 35.1-36. 38.1-39. temperature scoring 2
temperature scoring 3 <35. oxygen saturations normal above 96% oxygen saturations scoring 1 94-95% oxygen saturations scoring 2 92-93% oxygen saturations scoring 3 <91%
Heart rate scoring 1 41- 91- heart rate scoring 2 111- heart rating scoring 3 <
Question example: Dannys alterted body image write a nursing diagnosis has an ileostomy
danny is experiencing a disturbed body image related to his emergency tempoary ileostomy as evidenced by inability to look at his ileostomy site writing a person centred goal/ objectives for first care priorty (5 marks) using assessment skills indentify whats wrong i.e. pain: pain score willl improve to a tolerable level of 4/10 over next 2 hrs principles from writing a person centred SMART GOAL Specific- WHO is involved, WHAT do I want to accomplish Measureable- Can you track progresss/ measure the outcome Attainable- Ensure that the goal is possible (no out of reach) Relevant- Is the goal worth while to meet your needs
-critical evaluate the provided research and known national guidelines to promote evidence-based practice -systhesis this information and your own knowledge to create response to the patients problem sodium (na) values 135- potassium (k) 3.5-5. calcium (ca) 9- Magnesium 1.8-
chloride (Cl) 96- phosphorus 3.0-4. magnesium (mg) 1.3-2.1 mEq/l AKI Reversible, Raised creatinine >26umol/l normal creatinine 0.7-1.2umol/l Care plan frame work clinical judgement model tanner 2006
33 mark essay points (responding) part 3
