Ms Singh (Sangeeta) is a 69 year old retired secretary who lives ‘down the road’ from her daughter and grandchild. Her husband passed away 6 months ago and since then sheMs Singh (Sangeeta) is a 69 year old retired secretary who lives ‘down the road’ from her daughter and grandchild. Her husband passed away 6 months ago and since then she has become socially withdrawn; choosing to spend most of her time at home in the garden, or reading books.

She wears bilateral hearing aids and reading glasses. Other than a permanent colostomy (resulting from a large bowel infarction in 2005) she has had nil significant medical history to report. Ms Singh immigrated to Australia 20 years ago from India. English is her second language and she practices the Hinduism religion.

Last night Ms Singh was brought in by ambulance (BIBA) to the emergency department after her daughter found her on her bathroom floor. Ambulance staff report that she was found naked and unable to call for assistance for almost 18 hours. She was diagnosed as having had a cerebrovascular accident (CVA) with residual right (R) sided hemiplegia, dysphagia and dysphasia.
She is soon transferred to the acute medical ward where you work and is accompanied by her daughter (Nita) who is obviously quite distressed. Ms Singh appears quiet and drowsy. She is currently Nil by Mouth (NBM) whilst awaiting a speech therapist review.
Her vital signs on arrival are: T 36.9 degrees C; P 115; R 26; SpO2 94% and BP 170/95.

Answer the following:

1. A deficit refers to ‘a lack or impairment in mental or physical functioning’. Using the information from the case study, identify and define four (4) deficits that Ms Singh presented with (200 words).

2. After review by the speech pathologist, Ms Singh is no longer Nil by Mouth (NBM) and has been placed on a special (modified) diet.
A) Identify and give an example of each of the 3 (three) levels of modified foods and fluids that are recommended to clients with dysphagia (100 words).
B) Identify five (5) strategies used to assist the feeding of patients with hemiplegia and dysphagia (100 words – bullet points acceptable).

3. Assessing Mobilisation:
A) Identify six (6) factors that the nurse needs to consider before mobilising Ms Singh (100 words – bullet points acceptable).
B) What is the most suitable risk assessment tool used in this situation (and why)? (50 words)
4. As a result of the (R) sided hemiplegia, Ms Singh requires assistance to empty and change her colostomy bag. Outline the steps involved (for the nurse) to change her colostomy bag (100 words – bullet points acceptable). has become socially withdrawn; choosing to spend most of her time at home in the garden, or reading books. She wears bilateral hearing aids and reading glasses. Other than a permanent colostomy (resulting from a large bowel infarction in 2005) she has had nil significant medical history to report. Ms Singh immigrated to Australia 20 years ago from India. English is her second language and she practices the Hinduism religion.

Last night Ms Singh was brought in by ambulance (BIBA) to the emergency department after her daughter found her on her bathroom floor. Ambulance staff report that she was found naked and unable to call for assistance for almost 18 hours. She was diagnosed as having had a cerebrovascular accident (CVA) with residual right (R) sided hemiplegia, dysphagia and dysphasia.
She is soon transferred to the acute medical ward where you work and is accompanied by her daughter (Nita) who is obviously quite distressed. Ms Singh appears quiet and drowsy. She is currently Nil by Mouth (NBM) whilst awaiting a speech therapist review.
Her vital signs on arrival are: T 36.9 degrees C; P 115; R 26; SpO2 94% and BP 170/95.

Answer the following:

1. A deficit refers to ‘a lack or impairment in mental or physical functioning’. Using the information from the case study, identify and define four (4) deficits that Ms Singh presented with (200 words).

2. After review by the speech pathologist, Ms Singh is no longer Nil by Mouth (NBM) and has been placed on a special (modified) diet.
A) Identify and give an example of each of the 3 (three) levels of modified foods and fluids that are recommended to clients with dysphagia (100 words).
B) Identify five (5) strategies used to assist the feeding of patients with hemiplegia and dysphagia (100 words – bullet points acceptable).

3. Assessing Mobilisation:
A) Identify six (6) factors that the nurse needs to consider before mobilising Ms Singh (100 words – bullet points acceptable).
B) What is the most suitable risk assessment tool used in this situation (and why)? (50 words)
4. As a result of the (R) sided hemiplegia, Ms Singh requires assistance to empty and change her colostomy bag. Outline the steps involved (for the nurse) to change her colostomy bag (100 words – bullet points acceptable).