Scenario 1
Mrs Chan is found lying at the bottom of her stairs by her daughter at 09:00 on 14/06/2016. Mrs Chan is dressed in a nightgown; the last thing she remembers is rushing to the toilet at about 10pm. She has no memory of falling, she recalls “waking up” on the floor feeling cold because she was incontinent and her night gown was wet. She was unable to get up due to a penetrating wound to her left leg from falling on a glass coffee table that has broken and become embedded in her upper thigh. She also has pain in her hip and pelvis. Her right leg is shorter than the left and it is internally rotated.
Mrs Chan’s past medical history includes:
• Urinary incontinence
• Osteoporosis
• Compression fractures to her spine due osteoporosis
• Chronic pain
Regular medications:
• Fosamax
• Vitamin D
• Calcium
• Fentanyl patch
• PRN endone
Question 1.
Describe the initial assessment of Mrs Chan, including the following points in your answer:
(a) Describe the process of completing a primary survey on Mrs Chan
(b) List the specific assessments that would assist you to evaluate her penetrating injury.
Question 2.
Review the vital signs chart (attached pdf) and evaluate the following aspects:
(a) List each of the vital signs recorded at 06:30 in the table below:
List the vital sign
Respiratory Rate
O2 Saturation
O2 Flow Rate
Systolic BP
Heart Rate
Temperature
4 Hour Urine Output
Consciousness
(b) Complete the ADDS score for each vital sign recorded at 06:30 in the table below, then total the ADDS score.
ADDS Score
Respiratory Rate
O2 Saturation
O2 Flow Rate
Systolic BP
Heart Rate
Temperature
4 Hour Urine Output
Consciousness
Total ADDS
(c) List the abnormal signs and then describe the abnormality using correct terminology.
Further Information
Mrs Chan is seen by the doctor, who documents her assessment as follows:
• 82 year old lady with confusion and hypothermia.
• Air entry R=L no adventitious sounds.
• Large laceration to her right thigh, glass remains imbedded in the wound.
• Right leg has obvious bone deformity – requires further investigation to evaluate possible fractures.
A chest, abdominal, pelvis and hip X-ray are to be completed. Intravenous normal saline 1L is prescribed to run over 4 hours
(d) Note the ‘Actions Required’ section of the ADDS chart and explain who should accompany Mrs Chan when she leaves the ward to go to the X-ray department. You would need to ensure that you confirm this with the RN.
Question 3
Mrs Chan has been prescribed an IV solution of normal saline, which contains sodium chloride and water.
(a) Explain the following concepts related to body fluid compartments and intravenous fluids:
(i) Define the terms solute and solvent and how it relates to the prescribed solution
(ii) In your own words, explain what osmosis is and how it works in the three fluid compartments of the body
(iii) Why is Mrs Chan’s IV fluid an isotonic solution?
(iv) Why this solution is used to treat dehydration?
(v) Correctly match the terms listed below to either Active or Passive transport:
• No energy required
• Osmosis
• Endocytosis
• Requires energy
• Diffusion
• Sodium-potassium pump
Active Transport Passive transport
(vi) Describe the difference between hydrostatic pressure and colloid osmotic pressure (also known as oncotic pressure) in relation to transport of fluids across a capillary membrane.
Sample Solution
Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell.
In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.
God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.
Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.
To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.
References
Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.
Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.
Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.
