Competency-Based Assessments
1
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Develop a ten-minute presentation that outlines the stages of the bowel elimination process.
Sarah, a 32-year-old parent, is concerned about her infant’s bowel habits. Her daughter, Emma, is 8 months old and has been experiencing occasional constipation since she started transitioning to solid foods a few months ago, which causes Emma to become upset when she has difficulty passing stool. Sarah questions if she needs to increase Emma’s fiber intake. Although Emma is not on any prescription medications, Sarah remembers the iron-fortified formula she switched Emma to recently might be contributing to the constipation.
2
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Identify the developmental, individual, and medication factors presented in the scenario.
3
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Outline a comprehensive plan for addressing Emma’s constipation.
4
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Consider potential challenges or barriers to implementing the plan.
5
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Discuss the importance of monitoring Emma’s progress and scheduling follow-up appointments with her pediatrician to assess the effectiveness of the interventions.
Mr. Smith, a 68-year-old patient, was admitted to the hospital with complaints of severe diarrhea for the past two days. He has a history of irritable bowel syndrome (IBS) and is currently taking medications for hypertension and diabetes. On assessment, the nurse notes that Mr. Smith appears lethargic, with dry mucous membranes and decreased skin turgor. His vital signs reveal a heart rate of 110 bpm, blood pressure of 100/60 mm Hg, respiratory rate of 22 breaths per minute, and temperature of 99.2°F (37.3°C). Laboratory results are as follows: serum sodium (Na+): 130 mEq/L (normal range: 135–145 mEq/L); serum potassium (K+): 3.2 mEq/L (normal range: 3.5–5.0 mEq/L).
6
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What are the potential causes of Mr. Smith’s electrolyte imbalances based on his clinical presentation and laboratory results?
7
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How does diarrhea contribute to the development of electrolyte imbalances such as hyponatremia and hypokalemia?
8
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Discuss the relationship between dehydration and altered vital signs, including tachycardia, hypotension, and tachypnea, in patients with gastrointestinal issues like severe diarrhea.
9
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What nursing interventions would you prioritize to address Mr. Smith’s dehydration and electrolyte imbalances?
10
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How might Mr. Smith’s underlying conditions, such as irritable bowel syndrome, hypertension, and diabetes, influence his response to treatment for dehydration and diarrhea?
Mrs. Suarez, a 70-year-old female, is admitted to the hospital with complaints of fecal incontinence. During the admission assessment, the nurse listens carefully to the patient’s report of symptoms and then observes the following clinical manifestations:
- Mrs. Suarez reports experiencing frequent episodes of involuntary stool leakage, particularly during routine activities such as walking or standing up from a seated position.
- Upon inspection, the nurse notes evidence of stool staining on Mrs. Suarez’s undergarments and bedding.
- Mrs. Suarez expresses embarrassment and frustration over her inability to control bowel movements, stating that it has significantly affected her quality of life and social interactions.
- During toileting assistance, the nurse observes urgency and difficulty in controlling bowel movements, with Mrs. Suarez expressing a sense of urgency and discomfort just before accidents occur.
- Physical examination reveals skin irritation and redness in the perianal area, indicating potential skin breakdown caused by prolonged exposure to fecal matter.
11
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Identify the clinical manifestations of fecal incontinence observed in Mrs. Suarez.
12
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Discuss potential nursing actions or interventions to address Mrs. Suarez’s clinical manifestations.
13
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Explore the effect of fecal incontinence on Mrs. Suarez’s physical and emotional well-being and discuss strategies for providing holistic care and support.
14
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Reflect on the importance of maintaining Mrs. Suarez’s dignity and autonomy while providing care and support for her fecal incontinence.