Student Name Binta bah Student Number 4101568315
Unit Code and Name HLTAAP002 – Confirm physical health status
HLTAAP003 – Analyse and respond to client health information
Assessment Type Written
Assessment No. AT2 Assessment Date
Assessment Name Workplace Simulated Activity – Short and long answer questions
Assessor Name Date Submitted
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Instructions to Student General Instructions:
Read the workplace simulated scenarios on the following pages and answer the questions related to the information provided in each case study scenario. Please review the marking criteria for this assessment to ensure you are providing the required information in your answers.
All parts of each question are to be answered.
This is a clustered assessment for units HLTAAP002 and HLTAAP003.
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This is an open book assessment.
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Academic and research misconduct
APA 6th edition style in-text referencing must be used throughout and a reference list submitted with the assessment. Students must use their own words to answer the questions. Assessments that use, reproduce or adapt the work or ideas of another person without due acknowledgment will be graded as unsatisfactory and considered academic misconduct. For more information, refer to the Student Rules.
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Instructions for the Assessor The student must demonstrate key skills and knowledge identified in the marking criteria for this assessment task.
Note to Student An overview of all Assessment Tasks relevant to this unit is located in the Unit Study Guide.

CASE STUDY 2
Miss Walker is a 46-year-old female who has been admitted with shortness of breath over the last two days which has got progressively worse. She has no other significant past medical history. Her RR is 26 and her SpO2 is 93%. The doctor orders a chest X-ray which shows consolidation of fluid on his right lower lung. The doctor diagnoses right lower lobe pneumonia.
1. Relate the diagnosis of pneumonia to the two stages of respiration - external respiration and gas transport. Include the following in your answer (min 150 words).
Describe what occurs during normal:
a) External respiration.
External respiration is the formal term for gas exchange. It describes both the bulk flow of air into and out of the lungs and the transfer of oxygen and carbon dioxide into the bloodstream through diffusion. While the bulk flow of air from the external environment happens due to pressure changes in the lungs, the mechanisms of alveolar gas exchange are more complicated. The primary three components of external respiration are the surface area of the alveolar membrane, the partial pressure gradients of the gasses, and the matching of perfusion and ventilation.
Once inside the lungs, the respiratory gases (oxygen and carbon dioxide) diffuse across the respiratory membrane.
This involves oxygen uptake and carbon dioxide unloading from haemoglobin (in red blood cells) - this takes place in the lungs.
The oxygen diffuses rapidly from the alveoli into the blood; the carbon dioxide moves in the opposite direction.
Source: Boundless. “External Respiration.” Boundless Anatomy and Physiology. Boundless, 21 Sep. 2016. Retrieved 01 Oct. 2016 from https://www.boundless.com/physiology/textbooks/boundless-anatomy-and-physiology-textbook/respiratory-system-22/gas-exchange-211/external-respiration-1033-446/
b) gas transport.
The Molecular oxygen is poorly soluble in blood and only 1.5% is dissolved in plasma. The remaining 98.5% must be carried through haemoglobin, with up to four oxygen molecules reversibly bound to a molecule of haemoglobin transportation of gases throughout the body takes place in the bloodstream through the action of the cardiovascular system (heart and blood vessels), as can be seen in the adjacent image.
Oxygenated blood leaving the lungs flows back to the heart via the pulmonary veins and is then pumped to the rest of the body from the left ventricle via the aorta and its branches .
The amount of haemoglobin (Hb) in the blood determines its oxygen carrying capacity.
Increases in CO2, H+ ions or temperature will also decrease the ability of O2 to bind to Hb.
This in turn leads to a decrease in performance as less O2 means less production of energy through aerobic metabolism.
As the oxygen rich blood reaches the capillaries gas exchange occurs, oxygen is delivered to the tissues and de-oxygenated blood (loaded with CO2) leaves the tissues of the body and flows back to the heart where it is pumped to the lungs via the pulmonary arteries.
Once CO2 is transported to the lungs it diffuses out of the capillaries into the alveoli and exhaled out of the lungs
(Source: Marieb. 2015.)
c) Explain the differences between external respiration and cellular respiration? Include at least three (3) points
Internal respiration is the exchange of respiratory gases that occurs between the systemic blood and the tissue cells.
Oxygen unbinds from haemoglobin and diffuses across the blood vessel membrane, into the surrounding tissues; carbon dioxide travels in the reverse direction.
.
Internal respiration is the gas exchange between the systemic blood and tissues. External respiration is the gas exchange between the lungs and blood. External respiration occurs in the lungs where oxygen diffuses into the blood and carbon dioxide diffuses into the alveolar air
External (physiological) respiration is the process of oxygen (in air) flowing into cells, coupled to the opposite flow of carbon dioxide from cells into the air. Simply put, breathing — via lungs, gills (fish/molluscs), and tracheoles (insects).
Internal (cellular (biochemical)) respiration is the process of converting “food energy” — primarily glucose — into ATP “energy tokens” (which can be used by the cell “as needed”), primarily through ATP synthesis, via oxidative phosporylation (in mitochondrion organelles) and by glycolysis (in the cell cytosol

least three (3) points
Internal refers to exchanging oxygen and carbon dioxide with the blood.
Cellular is an energy making process whereby the cell produces ATP from glucose and other organic monomers
Internal respiration: gas exchange occurs between the cytoplasm and the extra cellular fluid (ECF) External respiration: gas exchange between the alveoli sacs (the lungs) and the blood
External respiration refers to gas exchange across the respiratory membrane in the lungs.
Internal respiration refers to gas exchange across the respiratory membrane in the metabolizing tissues, like your skeletal muscles, for example.
Cellular respiration is a set of metabolic reactions and processes that take place in the cells of organisms to convert biochemical energy from nutrients into usable energy in the form of ATP.
Describe the steps involved in homeostasis of respiratory rate including the following aspects in your answer (min 150 words):
a) Name the 2 respiratory gases detected in the blood?
Blood Gas Analysis
Blood gas analysis, also called arterial blood gas (ABG) analysis, is a test which measures the amounts of oxygen and carbon dioxide in the blood, as well as the acidity (pH) of the blood.

Arterial blood gases (ABG) are a blood test using arterial blood to measure the oxygen status and acid-base balance of the blood
Arterial blood gases (ABGs) are an important routine investigation to monitor the acid-base balance of patients.[1] They may help make a diagnosis, indicate the severity of a condition and help to assess treatment. ABGs provide the following information:
• Oxygenation
• Adequacy of ventilation
• Acid-base levels
(Source: Kaufman. 2012.)
b) Briefly explain respiratory acidosis and alkalosis?

Respiratory alkalosis occurs when the levels of carbon dioxide and oxygen in the blood are not balanced. Your body needs oxygen to function properly. ... This causes the pH of the blood to rise and become too alkaline. When the blood becomes too acidic, respiratory acidosis occurs
c) Where is the respiratory control centre located?

The respiratory center (RCs) are located in the medulla oblongata and pons, which are parts of the brainstem. The RCs receive controlling signals of neural, chemical and hormonal nature and control the rate and depth of respiratory movements of the diaphragm and other respiratory muscles
d) Why would Miss Walker have an increased respiratory rate due to pneumonia?

Her RR is 26 and her SpO2 is 93%.
References list
Forbes, H. (2013). Vital Signs. In J. Crisp, C. Douglas, & G. Rebeiro (Eds.), Potter and Perry's Fundamentals of Nursing (4th ed.). Chatswood. Elseveir
Crisp, J., Taylor, C., Douglas, C., & Rebeiro, G. (Eds.) (2013) Potter & Perry's Fundamentals of Nursing 4th ed. Sydney, Australia: Elsevier
The doctor prescribes oxygen at 6l via a Hudson mask. Identify what impact administration of oxygen will have. Include in your answer:
e) How does administration of supplementary oxygen help to maintain homeostasis?

f) What impact will this have on the respiratory rate?

g) What impact will this have on the SpO2?


CASE STUDY 3
Mrs Nguyen is a 71-year-old female who has presented at the medical clinic for her annual health assessment.
Answer the following question related to Mrs Nguyen’s health care:
2. The RN asks you to perform a urinalysis test.
a) Explain how you would prepare for a urinalysis test? (min 50 words)
wash my hand explain the procedure to the Mrs Nguyen pee) sample is collected, it's put into a centrifuge — a special machine that separates the liquid in the urine from any solid components that may be present, such as blood cells, mineral crystals, or microorganisms. Any solid materials are then viewed under a microscope.
b) You physically assess the urine; what signs would you expect if a UTI was present? List at least two (2).

c) What symptoms could Mrs Nguyen be experiencing if she has a UTI? (min 50 words)

d) A urine test is then ordered for culture and sensitivity. Describe what each of these tests are evaluating and how the results relate to medication prescription. (min 50 words)

e) Explain how Mrs Nguyen’s age could impact on her urinary system function? (min 50 words)


CASE STUDY 4
Mrs Thompson is a 79-year-old patient who has been admitted to hospital following a fall at home the previous evening. She fell while climbing the stairs and was found on the floor this morning by a neighbour. She has a wound to her right arm and a painful left hip. Mrs Thompson has a past medical history of Type 2 diabetes, hyperlipidaemia and hypertension and wears glasses for reading.
Mrs Thompson lives alone as her husband has recently moved into a residential nursing home, she does not have any family who live close by but occasionally her neighbour pops in to visit her at home.
4. When Mrs Thompson is admitted to hospital, she is found to have mild hypothermia.
a) Explain what hypothermia is and what might have caused this in her case. (min 50 words)

b) Define homeostasis and then describe what occurs in the body to regulate body temperature. Identify at least 4 changes that occur and explain why these maintain homeostasis. (min 150 words)


5. You are asked to clean the wound on Mrs Thompson’s arm.
a) Explain the structure and the function of the skin and the problems associated with a break in the skin such as this wound. (min 300 words)

b) You notice that Mrs Thompsons skin appears thin and like ‘tissue paper’. Explain what may have caused this. (min 50 words)

6. Explain what 2 diabetes is. (min 150 words).
In your answer, include:
a) the body system/s and organ/s affected

b) possible causes

c) risks
d) treatments

7. Define hyperlipidaemia and explain the associated risks and causes of this condition. In your answer identify the roles of high density lipoprotein (HDL), low density lipoprotein (LDL) and triglycerides. (min 150 words)

8. Mrs Thompson wears reading glasses, explain degenerative changes in the eye and how this may have resulted in the need to wear glasses. (min 50 words)

9. Later in your shift, you find Mrs Thompson crying. She tells you that she has been crying a lot lately and feeling sad since her husband was admitted into residential care. Explain psychological health as it relates to Mrs Thompson and who you could refer Mrs Thompson to. (min 50 words)

Insert Reference List on following page