HLTENN043: Implement and Monitor Care for a Person with Acute Health Conditions

Assessment

Questions

1. CATSINaM:

CATSINaM is The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives.

• State the purpose of CATSINaM.
• List the (5) five priorities given in CATSINaM Strategic Plan 2023-2028

2. Aboriginal Health:

According to AIHW, there is a prevalence of certain health risk factors among Aboriginal and Torres Strait Islander people including obesity, alcohol consumption and smoking, dietary behaviours, and not meeting physical activity guidelines. These health risk factors increase the likelihood of a person developing a chronic disease or interfere with the management of existing conditions.

• Define Aboriginal Health
• Define Aboriginal Community Control in Health Services (ACCHO) according to The National Aboriginal Community Controlled Health Organisation (NACCHO)

3. Septic Shock:

• Explain the pathophysiology of shock
• List five (5) signs and symptoms of septic shock.
• Identify three (3) reasons a patient might be at higher risk of developing septic shock.
• List one (1) action an enrolled nurse should take immediately when a patient exhibits signs of septic shock? 

4. Dehydration:

Case Scenario: You are an Enrolled Nurse working in a surgical unit. A postoperative patient has been admitted following major abdominal surgery. The patient is showing signs and symptoms suggesting dehydration.

• Identify and explain three (3) key clinical indicators of dehydration that you might observe in this patient.
• Outline two (2) immediate nursing actions you would take to assess the patient's fluid status.
• Discuss one (1) possible complication of untreated dehydration in postoperative patients.

5. Assisted Ventilation:

• Define CPAP and provide an example
• Provide an example of one (1) acute and one (1) chronic condition that might benefit from CPAP.
• Explain how CPAP helps people with chronic conditions by describing its mechanism.
• Differentiate between BiPAP and CPAP.
• If someone with COPD needs help with breathing, would they do better with CPAP or BiPAP? Explain why.

6. PICC Lines:

• Define PICC, and provide an explanation
• Explain the structure and function of a midline catheter .
• Give one (1) difference between a PICC and an Intravenous Cannula.
• Describe how to care for and monitor patients with a PICC, including checking the insertion site and any signs of complications. Explain your scope of practice as a newly graduated EN in relation to this care.

7. Underwater Seal Drain (UWSD): Case Scenario:

Mr Jones is a 45-year-old male that has just returned to the ward post insertion of an intercostal catheter due to a haemothorax caused from a motor vehicle accident (MVA). An Underwater Seal Drain (UWSD) is insitu.

Explain the care and monitoring of an Underwater Seal Drainage (UWSD) system, making sure to address the following points:

• Monitoring and observing an UWSD system
• Describing the purpose of the three chambers in an UWSD drainage system
• How often to conduct checks
• Explain what bubbling and swinging indicate in an USD, including what you would expect to see and what would cause concern.
• Observing the patient and the intercostal catheter site
• Identifying the emergency equipment at the bedside in case of issues like dislodged tubing.

 8. Post- amputation Patient:

Identify three (3) nursing considerations when managing a post-amputation patient.

Brief Summary of Assessment Requirements

This assessment evaluates the student’s foundational nursing knowledge and clinical understanding across a broad range of Indigenous health, acute care, chronic disease management, and essential nursing interventions. The assessment is structured into eight question-based sections, each targeting specific theoretical knowledge and applied nursing practice relevant to the role of an Enrolled Nurse (EN).

Key pointers covered in the assessment include:

• Understanding national Aboriginal and Torres Strait Islander health organisations and frameworks (CATSINaM, NACCHO, ACCHO)
• Knowledge of Aboriginal health definitions and health risk factors
• Recognition and management of acute clinical conditions (septic shock, dehydration)
• Understanding of assisted ventilation methods (CPAP and BiPAP)
• Safe management of vascular access devices (PICC and midline catheters)
• Monitoring and emergency management of Underwater Seal Drain (UWSD) systems
• Nursing care considerations for post-amputation patients
• Application of scope of practice for a newly graduated Enrolled Nurse

The assessment requires clear definitions, clinical reasoning, identification of risks, nursing actions, and patient safety considerations, demonstrating both theoretical knowledge and practical nursing application.

Academic Mentor’s Step-by-Step Approach

The academic mentor guided the student through a structured and supportive step-by-step learning process, ensuring each assessment requirement was clearly understood and accurately addressed.

Step 1: Interpreting the Assessment Questions

The mentor began by breaking down each question to clarify:

• What was being asked (definition, explanation, listing, or clinical application)
• The expected depth of response
• Alignment with enrolled nurse competencies and scope of practice

This helped the student avoid irrelevant content and focus directly on marking criteria.

Step 2: Indigenous Health and Cultural Safety (Questions 1 & 2)

The mentor guided the student to:

• Clearly state the purpose of CATSINaM and accurately list the five strategic priorities (2023–2028)
• Use authoritative sources (AIHW, NACCHO) to define Aboriginal Health and Aboriginal Community Controlled Health Organisations (ACCHOs)
• Emphasise cultural safety, self-determination, and community-led healthcare

The mentor ensured respectful language and culturally appropriate terminology were used throughout.

Step 3: Acute Care Knowledge – Septic Shock (Question 3)

For septic shock, the mentor:

• Explained the pathophysiology of shock using a simplified physiological flow (infection → systemic inflammation → poor perfusion)
• Guided the student to correctly identify signs, symptoms, and risk factors
• Clarified the immediate action within EN scope, such as escalation of care and vital signs monitoring

This reinforced clinical prioritisation and patient safety.

Step 4: Clinical Scenario – Dehydration (Question 4)

Using the postoperative case scenario, the mentor helped the student:

• Identify observable clinical indicators (e.g., poor skin turgor, low urine output)
• Link indicators to physiological causes
• Outline immediate nursing assessments
• Discuss complications relevant to surgical patients

This step strengthened clinical reasoning and scenario-based application.

Step 5: Assisted Ventilation (Question 5)

The mentor supported the student to:

• Define CPAP and BiPAP clearly
• Compare their mechanisms and clinical uses
• Apply reasoning to determine which mode is more suitable for COPD patients
• Demonstrate understanding of acute vs chronic respiratory support

This ensured both conceptual understanding and applied clinical decision-making.

Step 6: Vascular Access Devices – PICC Lines (Question 6)

The mentor guided the student to:

• Define PICC lines and midline catheters accurately
• Compare PICCs with IV cannulas
• Describe care, monitoring, and complication signs
• Clearly explain EN scope of practice, including escalation responsibilities

This reinforced safe practice and professional accountability.

Step 7: UWSD Case Scenario (Question 7)

For the UWSD scenario, the mentor helped the student:

• Systematically explain monitoring, chamber functions, and expected observations
• Interpret bubbling and swinging
• Identify patient and equipment safety checks
• Recognise emergency preparedness requirements

This ensured a logical, comprehensive response aligned with acute care standards.

Step 8: Post-Amputation Care (Question 8)

The mentor encouraged concise, focused responses covering:

• Pain management
• Infection prevention
• Psychosocial support and mobility considerations

This demonstrated holistic nursing care.

Outcome Achieved

Through structured academic mentoring, the student successfully produced:

• Clear, accurate, and well-organised responses
• Correct application of nursing knowledge within EN scope
• Strong clinical reasoning across acute and chronic care topics
• Culturally safe and evidence-based understanding of Indigenous health

Learning Objectives Covered

The assessment and mentoring process addressed the following learning objectives:

• Application of foundational nursing knowledge to clinical scenarios
• Understanding of Aboriginal and Torres Strait Islander health frameworks
• Recognition and management of acute deterioration
• Safe use and monitoring of medical devices
• Clinical decision-making and escalation of care
• Professional accountability and scope of practice awareness

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