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HLT54115 Diploma Of Nursing

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  • Course Code: HLT54115
  • University: Australia Institute Of Business And Technology
  • Country: Australia


Nursing assessment is the first stage of the nursing process. State four reasons why a nursing history is performed on admission?

Explain why it is important to involve your client and/or their family whilst conducting nursing assessments?

What is meant by holistic care?

What is a holistic assessment?




Nursing history is performed at the time of admission in-order to understand the patient’s past medical illnesses which serves as a guide for the patient care. It helps to understand about their cultural values and beliefs so as to plan care based on it. It helps us to understand about the present signs and symptoms so as to plan care based on the patient’s needs. It helps the nurses to provide more appropriate care directly based on their features. Moreover, it helps nurses to develop therapeutic communication with patients as well as relatives, which helps to render a complete holistic care to the patient (Douglas, 2012). By understanding the physiological, psychological, spiritual, cultural and social aspects of patient, nursing assessment can be framed accurately allowing the nurses to plan appropriate patient- centered care.   

Nursing assessments should be conducted directly in patient by observing him/her so as to identify patient needs and problems. Collecting the history directly will give an accurate and more appropriate subjective data. Involving family in nursing assessment will help them to understand the patient’s problem as well as to gain cooperation from them throughout the nursing care. This will help the nurses to plan apt nursing care to both the patients (problems) as well as for family coping.   

Holistic care is the total or complete care rendered to the patient. This involves addressing not only the physiological and psychological needs of client but also their sociological, spiritual, developmental as well as cultural needs (Douglas, 2012).

List 4 points relating to the documentation guidelines that you must comply with when recording any information.

The documents should be clear, legible, concise, accurate and appropriate. Date and time should be written on every document in order to avoid bias. The involved nurses should document for her/ him not by others. Overwriting or erasing should never be done. Only the facts should be entered. 

You are asked to take vital signs on a client. State 4 indications to complete vital signs

1). Vital signs should be assessed at the time of admission of the clients in a hospital or health care facility. 2). Assessed as routine process in a health care organization according to the doctor’s order or institutional policy. 3). Before and after a surgery or diagnostic (invasive) procedures. 4). Before, during as well as after administering medications to patients that could affect cardio-vascular, temperature- control measures or respiratory functions.      


Match the appropriate term with the correct temperature range


37.5 – 39.0 0C


36.2 -37.5 0C



35.0- 36.0 0C

It is recommended to take a confused person’s temperature via the oral route

Answer: False


Because the confused patient may bite down the thermometer. 



is an abnormal pulse rate greater than 100 beats/minute

List 4 factors that affect body temperature

1). Age  

2). Increased exercise or physical activity

3). Hormonal changes

4). Stress level

When taking a client’s pulse, what 3 characteristics must be assessed?

The rate, rhythm, strength and equality of the pulse should be assessed.

List the 4 most common sites for taking a pulse measurement.

1).Radial- assessed on the thumb side of forearm or wrist

2). Apical- assessed on 4th to 5th inter-costal space at mid- clavicular line (left).

3). Ulnar- forearm’s or wrist’s ulnar side

4). Carotid- palpated along the sterno-cleidomastoid muscles’ medial edge in neck (Douglas, 2012).   

The term for a pulse rate below 60 beats per minute is a Bradycardia

When taking a client’s respirations, what 3 characteristics must be assessed?

Respiratory rate- by observing the number of full respirations (inspiration and expiration) in a minute

Respiratory rhythm- involves determination of breathing pattern by observing the chest/ abdomen  

Ventilatory depth- is determined by observing the degree of chest wall movement or excursion (Douglas, 2012).

A normal respiratory rate for a child is 20- 30 breaths per minute.

List four factors which may affect pulse oximetry

The light from external sources may interfere with the ability of pulse oximetry in processing reflected light (Lewis, 2013)

Patient movement may interfere with light processing.

Intravascular dyes can absorb light similar to deoxyhemoglobulin and can lower oxygen saturation artificially.

Carbon monoxide (from smoke inhalation) can elevate SPO2 artifically by absorbing light as like oxygen. 

List the normal range of pulse oximetry in a healthy adult.

Normal range is from 95 to 100 percent in adults.


Define systolic blood pressure (SBP)

It is the maximum pressure that is exerted by the blood on the vessel walls at the time of ventricular systole (when the left-sided ventricle forces blood into aorta). The normal range of SBP in healthy adults is 90- 140 mmHg (Douglas, 2012).

Define diastolic blood pressure (DBP)

It is the minimum pressure exerted by the remaining arterial blood at the time of ventricles relaxation, just before the commencement of left-sided ventricular contraction. The normal range of DBP in healthy adults is <90 mm/Hg (Douglas, 2012).

An elderly client has a blood pressure of 184/102.  

The elderly client has stage- 3 Hypertension as his/her systolic BP is above 180 mmHg and diastolic BP is above 100 mmHg. It shows that the client is at an increased risk fro developing myocardial infarction and stroke and hence the nurse should notify this client’s blood pressure to senior staffs and physician for further management.  

A client has a urinary tract infection.  The client will have an increased level of White Blood cells present in his urine.

Outline the normal characteristics of urine.

Color                         : Pale yellow to deep amber. When the urine quantity

                                    increases, the color will be pale while if the urine quantity        

                                    decreases, the color will be deep yellow  

Odor                          : mostly odorless

Urine-Volume            : 750 to 2000 mL/ 24 hr

pH                             : 4.5 to 8.0

Appearance              : clear without deposits  

Specific- gravity        : 1.003 to 1.032

Osmolarity-urine       : 40 to 1350 mOsmol/ kg

Uro-bilinogen            : 0.2 to 1 mg/ 100 mL

WBCs                       : 0 to 2 HPF  

Leukocyte- esterase : Nil

Protein                      : Nil or trace

Bilirubin                    : <0.3 mg/ 100 mL

Ketones                    : Nil

Nitrates                     : Nil

Blood                        : Nil

Glucose                    : Nil

The medical term for shortness of breath is


A client’s blood glucose level prior to breakfast was 3.1mmol/l. Result is

It indicates that the client is in hyperglycemic state as his/ her fasting glucose is less than that of the normal glucose level of 3.89- 6.66 mmol/L  

The correct formula to calculate the body mass index (BMI) is which of the following

BMI is a simple index that is used to measure weight relating to height of a person. It is used to calculate the obesity, overweight or underweight of a person. It is the best method as compared to the traditional height- weight measurement. It is measured by dividing weight (Kg) by height (meter- squares) of a client.

BMI= weight (Kg)/ height*2 (m2). The BMI of less than 20 indicates underweight and above 35 indicates overweight of a person (Park, 2017).

A client with a BMI of 33.4 is considered to be

Obese Class- I grade with moderate risk for co morbidities as cardiovascular diseases, diabetes and hypertension.

Blood glucose target ranges may differ depending on age, duration of diabetes and medications.  Normal level is

Fasting glucose (blood) levels: 70 to 120 mg/dl or 3.89 to  6.66 mmol/L

Post- prandial blood glucose levels: 110 to 140 mg/dl i.e. less than 7.8 mmol/L  

Erikson’s eight stages of development




Oral- Sensory Stage (from birth to one year)

Baby will understand that things as well as persons exist even if they can’t visualize them. Here trust develops.

Musculo- Anal Stage

(1 to 3 yrs)


Child will learn to become self sufficient in their daily activities such as eating, toileting, running and talking. Or else may doubt their abilities.

Locomotor- Genital Stage

(3 to 5 yrs)


Child will try to take adult-like activities but at times over-stepping their limits may cause guilt.

Latency Stage

(6 to 11 yrs)


Child will learn to be competent as well as productive but sometimes may feel inferior if something went wrong.

Adolescence Stage

(12 to 18 yrs)


Adolescents will figure out themselves as ‘Who am I?’ but sometimes confused about their roles to play.

Young Adult Stage (19 to 35 yrs)


Young people seek friendship and love with other person but at times may become isolated.

Middle adult Stage (40 to 65 yrs)


Middle adult will be productive and perform needful work, but may become stagnant at times.

Maturity Stage (65 till death)

Older people will make sense of their lives Or despairing at goals that was not achieved.


Outline the specific assessment technique(s) you would use to assess the following clients:

A client who has fallen and is suspected of having a head injury

The important part of assessment involves performing GCS score assessment, neurological status assessment as well as determination of CSF leak. In GCS scoring, eye opening and best verbal along with best motor response should be graded. The highest grade is 15 and lowest grade is 3 (Lewis, 2013). 


A client who is dyspneic

Standard spirometry should be used to assess the level of dyspnea. Dyspnea can also be graded by using Borg- category- ratio scale from 0 to 10 to note the level of shortness of breath encounter by the client. 

A client with diabetes

Regardless of types of diabetes, the client should be diagnosed by ruling out if

  • Fasting glucose: more than 126 mg/dL or 7.0 mmol/ L
  • Random sugar:  >200mg/dL or 11.1 mmol/ L
  • Two hours- glucose tolerance test:  >200mg/dL

A client who is complaining of pain on micturition

Complete urinalysis should be done to rule out the causative organism for urinary tract infection as pain in micturition mostly occurs due to UTI both in males and females.

A person who has a plaster cast on their arm post a recent fracture

Peripheral pulses (distal pulse) should be checked once in 2- 4 hours to assess the blood flow to the arm as the plaster cast may obstruct the blood flow.

A fluid balance chart has been ordered for Mr. Leech (UR 0123456789) DOB: 30/06/1949. Complete FBC on the following page below using the following information:

0730 hrs — orange juice 150 mL, milk 140ml

1350 hrs — cup of tea 250 mL, water 100 mL

1030 hrs — cup of tea 180 mL

1430 hrs — voided 250 ml

1115 hrs — water 120 mL

1630 hrs --- vomited 150ml, bile stained fluid

1230 hrs — cup of tea 120 mL jelly 200 mL

1800 hrs --- Bowels open – loose, approximately 100mls

1230 hrs — voided 150 mL urine


The Total intake for the day is


The total output for day is


Is Mr Midler in a positive or negative fluid balance?


Mr Midler is in a positive fluid balance

What can a urinalysis reveal?

Urinalysis is used to assess the overall health of a person;  to diagnose a medical illness or disorder (urinary tract infections, renal disorders, diabetes and hypertension) and to monitor a medical condition. Pregnancy testing as well as drug screenings was also done through urinalysis. 


Provide a definition for the following terms


It is a condition in which a person’s heart rate is below 60 beats per min


It is a condition in which the respiratory rate is more than 20 breaths per minute.


It is a bluish discoloration of the skin due to decreased oxygenation of tissues. It could be central or peripheral cyanosis.


It is a condition in which the blood pressure drops below 90/60 mmHg

Provide a definition for the following terms


It is condition with yellowish discoloration of the skin, eyes, tissues, as well as body fluids due to the deposition of bile pigments


Pallor indicates pale color of a person’s skin which may be caused by diseases, emotional stress, shock, use of stimulants and/or anaemia, that results in decreased oxyhaemoglobin causing visible pallor in the skin eye (conjunctivae) and mucous membrane.


Turgor also called as skin turgor is the degree of elasticity of a person’s skin. Assessing skin turgor helps to determine the dehydration, or fluid status in a person.


It is a smaller reddish/ purple colored spot (1–2 mm) on the skin that occurs due to minor bleeding from damaged capillaries.

When completing a nursing assessment, data that is the client’s perception, ideas and sensations is known as

Subjective data

Holistic assessment is practiced in nursing to provide foundations for client based on the nursing process. Through this holistic care assessment along with therapeutic communication and history collection (objective & subjective data), the staff-nurses will be able to render efficient client- centered care.

3 characteristics of a Glasgow Coma scale

  • Eye opening
  • Best verbal- response
  • Best motor- response 

Part A


Admission assessment of a 4 year old with vomiting and diarrhea

The child should be assessed for his appearance (unwell), altered responsiveness, decreased urine output, pallor or mottled skin and colder extremities. The child should be categorized under dehydration grading to know the extent of dehydration from no clinical symptom to clinical dehydration and shock (Lewis, 2013).

Part B

While undertaking the nursing admission, you note that the General Practitioner has stated in the referral that the child is allergic to a medication, however the Medical Officer has written up a stat dose.  What are your actions?

Notify the concerned medical officer immediately about the patient’s allergy. Then raise mplement computer alerts for particular drug allergy. Wear the patient with medical bracelet indicating teh drug’s name. Then add the data to the PCEHR.

Discharge care plan for Mrs. Marjorie, 83 year old who underwent hip replacement.

Discharge plan for Mrs. Marjorie should include the entire course of care given to the patient, medications to be taken with dose, frequency and route, physical activities (mild/ moderate), diet restrictions along with follow-up instructions (Douglas, 2012). 

Part A

You have just completed a blood pressure measurement of your client. It was 185/105. List the steps you would take;

If the patient is found to be severe hypertensive, I will make the patient to lie down on the bed. I will check BP of the patient every 15 minutes. I will inform to the concerned staff nurse and then to the physician for further management.  I will raise the side rails of the bed to enable safety so as to prevent patient fall.

Part B

List 2 likely causes of this high reading

This could be due to any previous history of cardiovascular, renal diseases or hypertension. It could be due to decreased venous return due to ageing process. 

Health education for Jess, 19yrs male with asthma

Jess should be educated about the anatomy and physiology of the respiratory system. He should be instructed about deep breathing and coughing and diaphragmatic exercises, method of using inhalers and peak flow meter and the importance of taking regular medications (Lewis, 2013).  

Milestone- 7 month old Zoe

I will explain her that mile stones can vary a little between children and it cant be similar in all children, except in few variations were the milestone is greatly varied causing developmental delay. The stages of development may vary to some extent but not to a greater extent.

Mrs Joan Smith is a 61 year old lady (UR 333666) was admitted to your ward for day surgery.

Document the following admission observations accurately on the graph observation chart provided.

1400 hrs T – 36.7, P – 100, R – 22, B/P – 140/90.

Weight is 68 kg

Urinalysis reveals a ph  of 8.0, positive for leucocytes and SC 1015



Douglas, C. (2012). Potter and Perry’s Fundamentals of Nursing- Australian version. (4th edition). Elsevier: St. Louis, Missouri

Lewis, S.M., Heitkemper, M. M., & Dirksen, S.R. (2013). Medical Surgical Nursing: Assessment and Management of Clinical Problems. (9th ed.). Missouri: Mosby.

Park, K. (2017). Park’s Textbook of Prevention and Social Medicine. (24th ed.). Jabalpur:   m/s Banasardidas Bhanot. 

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