ROLE-TAKING

223143219

LENIENT ANELE NKALA

STUDENT NO: 223143219

NAME(S) & SURNAME: LENIENT ANELE NKALA

ROLE-TAKING ASSIGNMENT

1. Patients often turn to their religious and spiritual beliefs when making medical
decisions.
i. Many patients’ religious beliefs tend to conflict with medical
recommendations thus is important to consider a patients’ religion. In the
case of Mr X Ntini, being a Rastafarian, he may be hostile towards western
medicine and be reluctant to use drug treatment for fear it will contaminate
the body.
ii. As religion plays a role in patients’ life, it is the duty of a medical
professional even students to respect the patients’ views and beliefs by
remaining open-minded and flexible and to seek the patients’ good by
persuading them to follow medical recommendations.
2. Nursing Diagnosis:
i. Headaches related to head injury as evidenced by patient verbalizing the
pain.
ii. Dizziness related to head injury evidenced by observation and patient
verbalizing
iii. Anxiety related to head injury evidenced by patient verbalizing
3. Patient has BP of 145/85, which is abnormal, and above the normal ranges.
According to Bates Nursing guide to physical examination under classification of
normal and abnormal blood pressure, Mr X Ntini’s BP indicates that he has stage
1 hypertension (HBP). The likely reason Mr Ntini has an elevated BP would be
the family history as his father has a history of hypertension and is on treatment.
Another likely reason would be the area of sport Mr Ntini is in, rugby is a sport of
endurance, strength, and dynamic motion, both systolic and diastolic pressure
rises during action thus increasing the blood pressure to increase cardiac output.
Mr Ntini was in a ruby match when he sustained the injury thus this reasoning
may also be a cause of his elevated blood pressure. Both scenarios may be likely
true.
 Respiration and Temperature were in the normal ranges; no abnormalities
detected, Haemoglobin and Haemoglucotest (HGT) were also within the normal
ranges; no abnormalities detected. No abnormalities detected in urinalysis.
4.
i. a) Allergies: The patient is allergic to fish, thus there must not be any fish
in the patients’ food. If the patient does eat fish, it will cause the patient to
undergo stress and will likely cause unnecessary complications
ii. Diet: The patient is under strict vegetation diet; the patient does not eat
meat nor meat related foods. Respecting the patients’ diet regardless of
medical recommendation is important.
iii. Medical alert band: This identifies the patient, their allergies, medical aid
details, implanted medical devices as well notifying the healthcare team of
any medical directions. It is essential in allow the team to administer the
best care possible without affecting the patients’ health and condition.
5. The patient does have the potential to be suffering from hypertension. According
to the family history Mr Ntini’s father has a history of hypertension and is on
treatment thus increasing the likelihood of Mr X Ntini to suffer from hypertension
due to genetics or the common environment and factors that increase the risk.
6. Acromioplasty is a surgical procedure that involves the shaving away of part of
the shoulder bone called the acromion.
7. An okapype/hookah/hubbly is a water pipe used to smoke specially made
tobacco. The tobacco usually comes in different flavours, such as mint, cola or
cherry etc. The main difference between okapype smoking and cigarette smoking
is that in a typical 1-hour okapype smoke, users may inhale 100-300 times the
amount of smoke they would inhale from a single cigarette. This okapype smoke
contains even deadlier substances such as toxins, tar, and even carcinogens.
8. There is the Professional Nurse and Midwife, the General Nurse, and the
Auxiliary nurse
9.
i. Neurological system: Patient is conscious, no problems detected. Patient
is well-oriented, no problems detected. Patient has occasional dizziness
likely caused by the head injury. The trauma may have affected the inner
ear canals cause balance to be distorted. There were no problems in the
 patients’ auditory and visual function. No other problems with the
neurological system.
ii. motional status: Patient is feeling anxious. Mr Ntini may be feeling
anxious about their right shoulder, as there was a surgery done on the
same shoulder before and now the same shoulder is injured, the patient
may feel this will stop them from playing rugby in the future. No other
problems with emotional status.
iii. Pain: There is a problem in pain, the patient indicated to have a headache
in the right side of the skull (site) and pain radiating to the right shoulder,
likely caused by the injured right shoulder. No other problems in pain.
iv. Respiratory system: There is a problem in the respiratory system, patient
has mild cough and itchy throat. No other problems in the respiratory
system
v. Musculo-skeletal system: No problems in mobility, patient can move by
themself. There is a problem in joint movement, tenderness of the right
shoulder upon abduction of the right arm. No other problems in the
musculoskeletal system.
10. The doctor’s orders were to admit the patient, ensure the patient in vegetarian
diet, do GCS bi – daily, bed rest, medication as well as physiotherapy. My role as
a 1st year nursing student is to make sure the patient is admitted to the ward and
has a file. I need to ensure that patient is comfortable in the ward and in their
room. I need to ensure that the patient receives their meals in the morning and
afternoon and to ensure there is no meat or fish in the food. I also need to make
sure the patients’ vital signs are done and recorded in the observations chart. I
need to make sure that the GCS is done daily to monitor conscious, visual, and
auditory function for any abnormalities that may rise in the patients’ stay in the
ward. I need to also ensure that the patient is resting in bed and that they do not
partake in any strenuous activity that may later affect the body. Monitoring the
patient in the ward would also allow for doctors to observe any signs of
deterioration or improvement. I also need to ensure that the patient takes their
medication in the morning, afternoon, and night (for night staff). If ever the patient
does not want to take medication I would then report to the sister in charge or any
sister in the ward and record in the patient progress that patient refused
medication. As a 1st year student, I’d also need to ensure the patient is seen by
 the physiotherapist to note any signs or deterioration or improvement in the
patients’ mobility and musculoskeletal system.
11. The doctor prescribed Paracetamol 500mg (2 tablets) to be taken 3 times daily as
well Ung methyl Sal to be applied to the right shoulder. The paracetamol acts as a
pain reliever used to treat mild to moderate pain. Ung methyl Sal is used to for
temporary relief of minor ached and pains caused by bruising or tenderness. (The
rest of this question is ambiguous in that the words “give medication” can
mean a lot of things, I will however explain both scenarios that came to
mind when I read it). As a 1st year nursing student, I am not allowed to prescribe
medication (give medication) in the ward as I have no background in
pharmacology nor do I have training in prescribing medication. If I do prescribe, I
may very well prescribe the wrong medication causing unnecessary problems.
However, as a 1st year nursing student I am allowed to help with the patients’
medication by handing it over to them to drink (give medication).
12. Care plan

Name: Xola Ntini

Ward: 2A
Hospital: Livingstone Hospital

Database Date Nursing Intervention Signature

Blood pressure – 145/85 1. Identification band
Pulse – 89 2. Call bell
Temperature – 36,8 3. Safety
Weight – 85kg 4. Do 4 hourly vital signs
Diet – does not eat meat 5. Report and record abnormal
findings
Allergies – Fish 6. Give medication as prescribed
7. Encourage adequate fluid intake

8. Encourage bed rest and sleep

9. Maintain hand hygiene by doing
20-30 second handwashing
 10. Do rapid sponging when patient
presents with raised
temperature

13.
i. Initial entry: 24-year-old male patient admitted to the ward presenting with
head injury, injured right shoulder and symptoms of headache, dizziness, mild
cough, and itchy throat. Seen by Sr M Maduba and Dr XYZ. Medication was
prescribed and administered. Vitals signs: BP 145/85, Pulse: 89, Temp: 36.8,
Haemoglobin: 14gm%, Haemoglucotest: 5.0 mmol, Urinalysis: Ph-7, SG-1000.
Condition of patient appears stable.
ii. Interim entry: GCS done, and results recorded, no abnormalities detected
iii. Assessment entry: Patient had breakfast, showed no signs of nausea or
vomiting. Patient however did not finish food and felt full after a few bites.
iv. Evaluation entry: Patient conditions drastically improvement over the past 4
days, current condition appears stable, and patient is now able to walk without
a prosthetic.
v. Crisis entry: Patient came in with sharp protruding object inside the eye, pain
medication administered, reported to sister ABC of the patients’ condition.
vi. Transfer entry: Patient to be transferred to Port Elizabeth Provincial Hospital
for further care and treatment. Transfer conducted by sister ABC.
14. Accurate documentation is an important way to communicate to other members of
the healthcare team how the patient is progressing and responding to
interventions. Document must be comprehensive and accurately reflect the health
status of the patient., accuracy is achieved by recording information precisely. Full
and accurate records can protect the nurse if allegations of poor or negligent care
are made. Sparse detail and abbreviations can make the meaning unclear and
open to misinterpretation if used in court of law
15.
15.2 Essential care/Bed bath:

Bathing is an essential part of hygiene. It includes washing of the body and

removing worn out and dirty clothing. Due to COVID-19 infection it is vital that all
nurses observe the infection control policies and adhere to it. I will close open
windows and draw screens. I will then place Mr. Ntini in a comfortable position,
semi fowlers, high-fowlers position. I will then ask Mr Ntini if he needs anything
prior to starting. I will place the necessities near the patient

Since the patient is conscious, I must support him. I will offer the patient a bedpan
to urinate and empty his bladder. I will then undress the patient and cover him
with a sheet. I will first check the temperature of the water and ask the patient to
do so as well. I will expose only parts of the body that I will wash. I will wash the
patients’ face, ears and neck using soap only on the patients’ request. I will then
wash the arms from hand to shoulder. I will massage pressure areas lastly rinse
the patients’ hands in basin and dry the hands. I will repeat this process for the
chest and abdomen, the legs as well as the patients’ feet.

15.2 Mouth Care:

Mouth care is an essential part of oral hygiene. It includes brushing and flossing
of the teeth. Due to COVID-19 infection it is vital that all nurses observe the
infection control policies and adhere to it. I will then place Mr. Ntini in a
comfortable position, semi fowlers, high-fowlers position. I will then ask Mr Ntini if
he needs anything prior to starting. I will place a linen saver on his chest to
prevent spilling of water on the patients’ body that may cause discomfort. I will
place the necessities near the patient, such as the acceptor bag that will be
attached to the bed.

Since the patient is conscious, I must support him. I will use mouth prop and bite
blocks. Once mouth is open, I will use a soft toothbrush with toothpaste and brush
the upper and lower teeth back and forth in a circular motion to ensure all dental
cavities are being removed. I will use water and give the patient to rinse and spit-
out. I will use a swab to wipe the area around the mouth for excess water or
toothpaste. After that I will observe for signs of any abnormalities and allow the
patient to identify any form of discomfort during the procedure. I will discard all
used apparatus, remove gloves, and do handwashing. I will then put the patient
back into a comfortable position, do health education to patient regarding the
importance of oral. In the recording of the notes, I will then give a clear description
of any abnormalities noted as this will assist in the proper management of the
patient’s condition in terms of medication to be altered or to be ordered to resolve
abnormalities.

FEEDBACK
The assignment was difficult. There were some questions I did not understand
what they there asking such as question 15. However, there were some questions
where I was confident in my answering. Question 11 gave me a scare, as the
context of “give medication” meant two things two me – one meant prescribing
medication the other meant helping to give the patient medication. So instead of
trying to explain one I explained both. Question 7 was informative, I had this
notion that okapype was not dangerous – however, as I researched more, I
learned that an hour of smoking okapype is much more destructive compared to
smoking a single cigarette. Question 10 was as it meant describing the activities
that I as a 1st year nursing student do in the hospital and having had experience in
Term 3 it was much easier to answer this question.