12.

  Nervous System Disorder

You witness a man drop to the floor unconscious in a shopping centre. On examination he is
stiff, having jerky spasmodic body movements, has bitten his tongue and passed urine
12.1
What is the most probable diagnosis?

The most probable diagnosis for an unconscious person with symptoms of stiffness, jerky
spasmodic movements ,tongue bite and urine passage is are of Epilepsy, or Tonic-Colonic
Seizure.

12.2
What is Status epilepticus?

Status epilepticus is a nervous system disorder where a seizure continues longer than 5 minutes
period and when many episodes of seizure occur together and the client does not recover
between seizures length.

12.3s
How you would manage the patient?
Keep the patient away from the harmful objects and obstructions, placing pillow, blanket,
jacket under person’s head. Calling the emergency help line is person is not already in hospital,
performing CPR if person is having difficulty in breathing.

17.  Mediation/ Negotiation
David is an alert and orientated 28 year old man with a terminal brain tumour. He has been sick
for a year intermittently, having gone through two operations and rounds of chemotherapy. He
has a Not for Resuscitation Order (NFR). David has agreed to the NFR order but his parents
say that they are not ready to accept that he is dying and that a miracle might occur to cure the
cancer. What are the mediation/ negotiation tasks to manage such situations? (30-60 Words)

Mediation provides a chance to calm down down the disagreements and struggles among
parties in an easy way. It lets the families and care givers to bring forward the opinions and
views they have without interrupting the patient health. NRF is a difficult situation fot the
families but negotiating with care givers can make them understand about the situation bit
better.

20.  Critical thinking, creative thinking and problem solving

Critical thinking, creative thinking and problem solving go hand in hand in nursing practice.
Nurses often use these skills to manage situations with clients, co-workers and self. What
nursing skill is demonstrated in the following scenarios a, b & c - Critical Thinking, Creative
thinking or Problem solving? And why? (20-40 words each)
20.1
A nurse takes vital signs of a dizzy client and finds the systolic blood pressure to be low. The
Nurse asks the client to stay in bed and elevates the foot end, checks the clients medication and
fluid balance charts and arranges an urgent medical review. The Nurse then keeps fluids ready
to be administered if prescribed following review.

Answer: (a) Critical thinking, as nurse analyzed and collected the data from patient by
communication and taking an action that solved the problem.

20.2
A Nurse Unit Manager (NUM) finds a way to improve storage space by relocating damaged
equipment to the workshops.

Answer: (b) Creative thinking, as it helps in finding unique solutions and generating creative
idea to do the task.

20.3
An Enrolled Nurse is addressing a client complaint. The Nurse comforts the client and
addresses their needs. Later the Nurse reports the incident to the RN and suggests ways to
address the issue.
Answer: In this case the nurse used critical thinking again, and used the skills and knowledge
from subjects and fields to give complete nursing help and dealt with change under stressful
situations.

21. Community services / Referrals

For continuing care in the community, various referral options are available. List 5 (five)
community referral options available for a client and briefly explain their functions as per the
given example.
What is their
Community services/ Referral options function?
Physiotherapist: Assess clients with mobility, respiratory or other issues
affecting ADLs and assist client with recovery / rehabilitation.

Counselors: providing healthy life options, and guidelines

Mental health Services: to provide mental support for depression

Drug Maintenance therapy: to help people in cooping from the drugs.

Community Health clinics: providing basic health facilities.

22.  Endocrine System
Briefly explain or define the following endocrine system conditions
22.1
Acromegaly:

Acromegaly is the imbalance in growth hormone (GH), it helps in growth process in early age
but in adults it cause sleep apnea syndrome, carpal tunnel syndrome and hypertension.

22.2
Addison's Disease:

Another name for Addison’s Disease is Adrenal Deficiency, this is a hormone disorder in wich
the necessary hormones are produced less in quantity. This disorder cause pain in joints,
swelling and severe fatigue

22.3
Cushing's Syndrome:

Abnormally high levels of cortisol hormone cause Cushing Syndrome, this disorder is also
known as hypercortisolism. One of the causes of this syndrome is oral usage of corticosteroid
medications. The person with this syndrome feels the weight gain and purplish stretch marks.

22.4
Grave's disease

Graves' disease is a type of autoimmune disease, in this the hyperthyroidism or overactive

thyroids occur. The immune system of body starts attacking the thyroid more thyroid hormone
then body’s need is produced.

22.5
Hypothyroidism:
The Hypothyroidism is the underactive production of thyroid hormone, it cause fatigue,
weakness, and major hair loss.