FON SOLVED PAPER UHS (2007)

(MADE BY: AMEER UMAR KHAN)

Answer Key
Q1 :
Patient Care
A nurse is a caregiver for patients and helps to manage physical needs, prevent illness, and treat health conditions.
To do this, they need to observe and monitor the patient, recording any relevant information to aid in treatment
decision-making.

Patient Advocacy
The patient is the first priority of the nurse. The role of the nurse is to advocate for the best interests of the patient and
to maintain the patient’s dignity throughout treatment and care. This may include making suggestions in the treatment
plan of patients, in collaboration with other health professionals
 Planning of Care
A nurse is directly involved in the decision-making process for the treatment of patients. It is important that they are
able to think critically when assessing patient signs and identifying potential problems so that they can make the
appropriate recommendations and actions.

Patient Educationand Support

Caregiver. As a caregiver, nurses are expected to assist the client’s physical, psychological,
developmental, cultural and spiritual needs

Communicator. Communication is very important in nursing roles. It is vital to establish nurse-client relationship.
Nurses who communicate effectively get better information about the client’s problem either from the client itself or
from his family.

Teacher. Being a teacher is an important role for a nurse. It is her duty to give health education to the clients, families
and community.

Counselor. A nurse may act as a Counselor. She provides emotional, intellectual and psychological support. She
helps a client to recognize with stressful psychological or social problems, to develop and improved
interpersonal relationship and to promote personal growth

Client Advocate. A nurse may act as an advocator. An advocator is the one who expresses and defends the cause
of another or acts as representative.

Change Agent. As a change agent, oftentimes a nurse change or modify nursing care plan based on her
assessment on the client’s health condition. This change and modification will only happen when the intervention/s
does not help and improve a client’s health.

Leader. Nurse often assumes the role of leader. Not all nurses have the ability and capacity to become a leader

Manager. As a Manager, a nurse has the authority, power, and responsibility for planning, organizing, coordinating
and directing work of others.

Q2
5 Proven Strategies to Prevent Patient Falls

1. Make it easy to identify high-risk patients. ...

Cardiovascular Increase in stroke volume (SV); increase in heart rate (HR); increase in
system cardiac output (Q); increase in blood pressure (BP)

Respiratory system Increase in breathing rate; increase in tidal volume

Cardio-respiratory
Increase in oxygen uptake; increase in carbon dioxide removal
system

Energy system Increase in lactate production

Muscular system Increase in temperature of muscles; increased pliability; muscle fatigue

Q4

What Is Maslow’s Hierarchy of Needs?

In order to better understand what motivates human beings, Maslow proposed that human needs can be organized into a
hierarchy. This hierarchy ranges from more concrete needs such as food and water to abstract concepts such as self-fulfillment.
According to Maslow, when a lower need is met, the next need on the hierarchy becomes our focus of attention.

These are the five categories of needs according to Maslow:

Physiological

These refer to basic physical needs like drinking when thirsty or eating when hungry. According to Maslow, some of these needs
involve our efforts to meet the body’s need for homeostasis; that is, maintaining consistent levels in different bodily systems
(for example, maintaining a body temperature of 98.6°).1

Maslow considered physiological needs to be the most essential of our needs. If someone is lacking in more than one need,
they’re likely to try to meet these physiological needs first. For example, if someone is extremely hungry, it’s hard to focus on
anything else besides food. Another example of a physiological need would be the need for adequate sleep.

Safety

Once people’s physiological requirements are met, the next need that arises is a safe environment. Our safety needs are
apparent even early in childhood, as children have a need for safe and predictable environments and typically react with fear or
anxiety when these are not met. Maslow pointed out that in adults living in developed nations, safety needs are more apparent
in emergency situations (e.g. war and disasters), but this need can also explain why we tend to prefer the familiar or why we do
things like purchase insurance and contribute to a savings account.

Love and Belonging

According to Maslow, the next need in the hierarchy involves feeling loved and accepted. This need includes both romantic
relationships as well as ties to friends and family members. It also includes our need to feel that we belong to a social group.
Importantly, this need encompasses both feeling loved and feeling love towards others.

Since Maslow’s time, researchers have continued to explore how love and belonging needs impact well-being. For example,
having social connections is related to better physical health and, conversely, feeling isolated (i.e. having unmet belonging
needs) has negative consequences for health and well-being.2
 Esteem

Our esteem needs involve the desire to feel good about ourselves. According to Maslow, esteem needs include two
components. The first involves feeling self-confidence and feeling good about oneself. The second component involves feeling
valued by others; that is, feeling that our achievements and contributions have been recognized by other people. When
people’s esteem needs are met, they feel confident and see their contributions and achievements as valuable and important.
However, when their esteem needs are not met, they may experience what psychologist Alfred Adler called “feelings of
inferiority.”

Self-Actualization

Self-actualization refers to feeling fulfilled, or feeling that we are living up to our potential. One unique feature of self-
actualization is that it looks different for everyone. For one person, self-actualization might involve helping others; for another
person, it might involve achievements in an artistic or creative field. Essentially, self-actualization means feeling that we are
doing what we believe we are meant to do. According to Maslow, achieving self-actualization is relatively rare, and his
examples of famous self-actualized individuals include Abraham Lincoln, Albert Einstein, and Mother Teresa.

Q6

Purpose of bed bath:

Removal of bacteria from the skin.

 Confinement in bed increases perspiration, and bacterial growth is stimulated by moisture.

Relaxation effect on the patient.

Stimulation of blood circulation to the skin, respirations, and elimination.

Maintenance of joint mobility.

Improvement of the patient’s self-image and emotional and mental well-being.

Providing the nurse with an opportunity for health teaching and assessment.

Providing the nurse with an opportunity to give the patient psychological support.

The process of building rapport may begin during the initial bath.

The bath aids in the development of the therapeutic nurse-patient relationship as the patient has the nurse’s undivided attention.
 Q7 five contradictions to the use of heat applications are:

 Dermatitis.
 Deep vein thrombosis.
 Peripheral vascular disease.
 Open wound.
 Skin sensation impairment (e.g. some diabetic patients)
 Severe cognitive impairment (e.g. dementia patients)
 Thrombophlebitis

Q8 Types of enema

Enema is classified into evacuant enema and retained enema.

Simple evacuant enema

Medicated evacuant enema

Cold enema
Retained enema is classified into

Stimulant enema

Sedative enema

Emollient enema

Anesthetic enema

Nutrient enema

Simple evacuant enema

Simple evacuant enema is used to remove fecal materials and gaseous distension. It is also used to clean the bowel and rectum before investigations,
surgeries and child birth. Soap water or normal saline are used usually for simple evacuant enema. The amount of the solution used is variable
depending on the age of the patient / client and temperature of the solution. For adults 500 – 1000 ml solution is used, for children 250 – 500 ml and for
infants <250 ml is used generally.

Medicated evacuant enema

Medicated evacuant enema is used to administer medications through the rectum. Ther are different types of medicated evacuant enema. They are

Oil enema

Astringent enema
 Purgative enema

Anti-helminthic enema

Carminative enema

Oil enema

Oil enema is used to soften the fecal matter. Oil enema is used in following conditions

 Severe constipation

 After surgeries to rectum and perineum to prevent injury to sutures

After oil enema simple evacuant enema is performed to remove the softened the stool matter. The solutions used for oil enema are olive oil, castor oil
and sweet oil.

Astringent enema

Astringent enema is used to reduce the inflammation, bleeding and mucous discharge in colon. Astringent enema is used in following conditions

Colitis

dysentery
The solutions commonly used in astringent enema are 2% silver nitrate solution, tannic acid and alum.

Purgative enema

Purgative enema is used to improve the peristalsis to empty the bowel.

Anti-helminthic enema

Anti-helminthic enema is used to kill the intestinal parasitic worms. Soap water enema is performed before anti-helminthic enema is performed. The
solutions used in this enema are hypertonic saline solutions.

Carminative enema

Carminative enema is called anti-spasmodic enema. It is used to remove the gaseous accumulation in abdomen. It acts by increasing the peristaltic
movement of intestines. Solutions commonly used in this enema are milk and molasses, asafetida in soap water and terpentine.

Cold enema

Cold enema is used to reduce the body temperature during high fever and heat stroke.
 Hypothermia and abdominal cramps are common complication of cold enema.

Stimulant enema

Stimulant enema is used in shock, collapse and in some poisoning cases. The solutions used are black coffee / brandy. Black coffee is prepared in
300ml water with tea spoon of coffee powder

Sedative enema

Sedative enema is used to induce sleep or sedation. Paraldehyde, potassium bromide, chloral hydrate are the main drugs used with the solution of
sedative enema.

Anesthetic enema

Anesthetic enema produces anesthesia in the patient. The drug avertin is used for anesthetic enema. The dose of avertin is 150 to 300 mg per kg

Q9
Decubitus ulcers are an open skin wound sometimes known as a pressure ulcer, bed sore, or pressure
sore. A decubitus ulcer forms where the pressure from body the body's weight presses the skin against a firm
surface, such as a bed or wheelchair. Pressure cuts off the blood supply to the skin and injures tissue cells

Four stages of pressure ulcers

 Stage 1 sores are not open wounds. The skin may be painful, but it has no breaks or tears. The skin appears reddened and does

not blanch (lose colour briefly when you press your finger on it and then remove your finger). In a dark-skinned person, the area

may appear to be a different colour than the surrounding skin, but it may not look red. Skin temperature is often warmer. And the

stage 1 sore can feel either firmer or softer than the area around it.

 At stage 2, the skin breaks open, wears away, or forms an ulcer, which is usually tender and painful. The sore expands into deeper

layers of the skin. It can look like a scrape (abrasion), blister, or a shallow crater in the skin. Sometimes this stage looks like a blister

filled with clear fluid. At this stage, some skin may be damaged beyond repair or may die.

 During stage 3, the sore gets worse and extends into the tissue beneath the skin, forming a small crater. Fat may show in the sore,

but not muscle, tendon, or bone.

 At stage 4, the pressure injury is very deep, reaching into muscle and bone and causing extensive damage. Damage to deeper

tissues, tendons, and joints may occur