- This topic has 23 replies, 22 voices, and was last updated 4 years, 1 month ago by
.
-
Posts
-
Collaborative Questions to Discuss for Charles Collins
Q1: Charles is happy to use the AF App you have recommended but is struggling to access it and has asked you to help him during his appointment.
What would you do?
1.Tell Charles he needs to contact the app developers
2. Offer to show Charles how the app works during the appointment. If it is accessible for Charles, provide the information in an alternative format.
3. Tell Charles that he needs to go home and practice with it and see if it is useful. At his next appointment if it is not working then you will change the plan.
Q2: Charles is keen to return to riding his bike but is unsure when or if he can do this now.
What would you advise?
1. Advise Charles not to continue riding as that has clearly caused too much stress on his heart.
2. Advise Charles to keep cycling straight away. If he does not then he will gain weight and having an increased BMI will be bad for his heart.
3. Advise Charles talks to the medical team and the senior nurses before undertaking this so that it is progressed and done at the right time.
Q3. Charles is concerned about his risk of stroke in the future. He asks you about the signs of a stroke.
What do you say?
1.Direct Charles to the following advice, Face – does your face look different on one side? Arms – can you raise your arms? Speech – is your speech slurred or different? Time to act – call 999, get help.
2.Advise that he has someone with him at all times that can see if he is acting differently.
3. Advise Charles that he will not have a stroke.
Q1 – I would choose option 2. Showing Charles how to use the app there and then will be beneficial to him as he can see it physically step by step. It will also be fresh in his mind for when he goes home and can tell his wife – this will be helpful as he will have a second pair of eyes helping him with it. However, I would also consider option 3 after having explained it to him as he does need to practice to get the hang of it. I also believe if the app isn’t working for him by the next appointment, then changing the plan is actually a good idea as there is no benefit trying something that isn’t tailored to the patient. With Charles being 65 he may not be great at technology regardless so there should be alternatives such as writing his observations down on pen and paper and bringing them for his next appointment.
Q2 – I would choose option 3 in regards to Charles returning to cycling straight away. The medical team and senior nurses will be able to advise him what is best. I can only tell him what I think and what medical advice is available – he also does have the option to refuse medical advice as he has capacity. However I do believe that senior staff members should be consulted in giving Charles a plan of when to begin cycling again and especially how often. They may suggest for example getting a lift to work 4 times a week and cycling once to ease himself (and his heart!) back in to the activity.
Q3 – I would advise Charles with option 1. As a nurse it is instinct to reassure the patient and tell them that ‘he will not have a stroke’ or ‘it is unlikely’ but this isn’t feasible as it can give them false hope and may not be true. Therefore, option 1 is the best in explaining to him what to look out for, also to explain this to his wife and relatives so that they know what signs to look out for too. Encouraging to call 999 if any of the symptoms are present is also a good idea as Charles will be reassured that help will is there if necessary.
Q1. Option 2, I will assist Charles with the app because he needs the “My app” to be able to monitor his health such as; blood pressure, pulse, temperature and oxygen saturation. If time permits I will show him how to seek technical help from the app or alternatively I can provide a hard copy information leaflet on how to use the app.
Q2. Option 3, I will advise Charles to seek advise from the medical team and senior nurses as he has not been able to use the app and he’s unsure if there are any changes to his health that is not visible at the moment.
Q3. Option 1, I will advise Charles to the direct helpline and assist him with the physical signs to look out for with the F.A.S.T approach, I will also relate the information to the senior nurse and document Charles concerns.
Q1 – option 2 – the app is a great tool for monitoring Charlses disease and it is in the best interest for him if we show him how to use it and offer an alternative if he can’t use it. IWe need that information and we need to make sure that cahrles has a means to record it.
Q2 – option 3 – we can refer charles for further advice if we do not have enough information if cycling at this stage in appropriate
Q3 – option 1 – it is i portnat to advise charles of the independent means he can take to assess himself and reduce his anxiety and option 2 is taking away his independence and with option 3 it is inappropriate to tell charles he will not have a stroke becasue that is always a possibility
Q1 – I would choose option 2 to check that the app would be beneficial to him, if he doesn’t know how it works he wont use it and would not have any results for the next appointment. This is also quicker than contacting app developers
Q2 – I would choose option 3 so that we are sure that it is the right time to return to exercise and if he should start gradually, have an exercise plan
Q3 – I would chose option 1 so that Charles is informed of the signs of a stroke. Cannot say he won’t have one as we don’t know and someone with him at all times is not feasible
Q1- I would choose 2, because Charles is struggling to access the AF app. I will help him to set up the app and give accessible information to let him understand how to use the app. I will recommend him an alternative way if he could not access the app, such as calling GP clinic for his next appointments or asking anyone in his family or friends to help him set up the app when he is at home.
Q2- I would choose 3, because Charles’s condition would require constant observation of his vital signs prior to any activity. I will recommend that he talk to the medical team and senior nurse before doing any physical or strenuous activities and not engage in any risky activities that may compromise his safety.
Q3- I would choose 1, because he is unaware of the signs of stroke, and I will demonstrate what to do in time of emergency. I will advise and explain to him that he could ask for help immediately once he feels that there are changes in his movement, if not able to raise his arms, has slurred speech, and if his face droops. If possible, to place himself in a comfortable safe position. Call 999 as soon as possible.
Q1: I would choose option 2 and offer to show Charles how the app works during the appointment and check it is accessible for him, providing the information in an alternative format if required.
Q2: I would choose option 3 and advise Charles talks to the medical team and the senior nurses before undertaking his bicycle rides so that it is progressed and not too much pressure on his heart.
Q3. I would choose option 1 and direct Charles to the following advice, educating him on the signs of a stroke, Face – does your face look different on one side? Arms – can you raise your arms? Speech – is your speech slurred or different? Time to act – call 999, get help. So that he is able to recognise the signs of a stroke so he can get urgent help if he is on his own.
Q 1. I would choose Option 2. The AF app includes more possibilities for monitoring additional vital signs, which is crucial for Charles; condition, so I would demonstrate how to use it. I’ll also provide him with more details or pointers on where to look for assistance if he gets stuck.
Q 2. Option 3: I would suggest that Charles consult with the senior nurse and the medical team before starting to exercise or engage in any risky activities.
Q 3. Option 1; I would direct Charles to FAST advice; (Face – does your face look different on one side? Arms – can you raise your arms? Speech – is your speech slurred or different? )
However, his family or those around him need to be trained to recognize the symptoms/ signs of stroke. Charles might be referred also to the Occupational Therapist to get more advice and support.Question 1 i will choose option 2. It is good to be able to show charles how to use the App in person and there we can see if that is something he will be able to do and if he finds it difficult and not something he will be able then a change of plan might be needed like looking for an alternative solution.
Question 2 option 3 I will advise charles to talk to the team and the senior before undertaking cycling as this need to be done at the right and not causing pressure to his heart
Question 3 option 1 I will reassure the patient and educate him on signs to look at for stroke and ask him to call 999 in the event he is unable to perform the following Face – does your face look different on one side? Arms – can you raise your arms? Speech – is your speech slurred or different? as this might be indication of stroke.
Q1. I would choose option 2 :which is offering to show Charles how to use the app,this will give him the opportunity to check is vital signs and also see if it can be provided in another format.
Q2. I would choose option 3 :I would suggest that Charles to speak to the medical team and the senior nurse so that it is progressed and done and the right time so that this will also be monitored.
Q3:I would choose option 1 :I would directs Charles to use the F.A.S.T advice which is Face-Does your face look different on one side?Arms-can you raise your arms?Speech -Is your speech slurred or different?Time to act fast-call 999 get help all this questions need to be asked in other to recognize the signs of stroke and so that he can get help fast.Q1. Option 2 I will go through the app with Charles step by step during the appointment. I would also look if there is a tutorial video/instruction book on how to use the app so he can follow instruction if he get stuck at home. I would ask him if there is someone at home that can help him with.
Q2. Option 3 I would suggest Charles talk to the medical team and the senior nurse they will need to take more observations to see if it is safe for him be undertaking risky activities
Q3 . Option 3 I would advice Charles to use F.A.S.T so he can recognise the signs and symptoms independently.
Q1 – I would choose option 2 as Charles is willing to learn how to use the app on his own and assisting him during the appointment is the best time to teach him to use the app as I can demonstrate how to use the app to him and he can visually learn as he’s been taught and not just trying to figure it out on his own. The app is important for him to be able to monitor his vital signs and he could be shown alternative ways to access the app if he continues to struggle.
Q2- I would choose option 3 and explain to Charles’s that because of his current medical condition and him requiring frequent monitoring of his vital signs,
I would suggest that he speaks to the medical team and senior nurse before undertaking this so that it is progressed and done at the right time for his safety.Q3. I would choose option 1 and direct Charles to the following advice explaining to him what the signs of a possible Stroke are; Face – does your face look different on one side? Arms – can you raise your arms? Speech – is your speech slurred or different? Time to act – call 999, get help. Explaining this to Charles would enable him know what signs to look out for in the future which could be beneficial to him and anyone around him.
Q1 – I would choose option 2 for it seems important for Charles to have access to the App as soon as possible. As a clinician I would like to know that all the equipment is in good working order and compatible with App before the end of the appointment.
Q2 – I would choose option 3, as Charles is currently undergoing assessment for AF, it would be vital to liaise with the medical team and senior nurse before undertaking strenuous exercises. Monitoring Charles with other experts, giving him advice on activities would reduce risk of symptoms worsening or causing permanent damage.
Q3 – I would choose option 1, this is a common procedure and is advertised on public health advert appeals for the lay public. I believe it would be simple and straightforward to direct Charles to the guidance in option 1 and ensure he understands fully.
Q1. Option 2: since Charles is happy to use the App i would offer him to help him access the app during the appointment. This will give Charles the chance to learn how to navigate the app better. I would also provide Charles information leaflet on the app or direct him to a website that has all the relevant in formation.
Q2. Option 3: I would advise Charles talks to the medical team and the senior nurses before undertaking this so that it is progressed and done at the right time. I would also explain the risk of putting too much pressure on his heart considering his condition.
Q3. Option 1: I would explain the risk of his condition which includes possible stroke. I would reassure Charles and explain the signs of stroke (Face – does your face look different on one side? Arms – can you raise your arms? Speech – is your speech slurred or different? Time to act – call 999). Acquiring this information will provide Charles with empowerment to deal with his condition better.
Q1 – I would choose option 2 however, option 1 & 3 seems to be good but can only be used after option 2. Option 2 explores the ethics of Beneficence in nursing because my action is guided by compassion and it also upholds the NMC code of prioritising the patients because I was interested in giving Charles the information in an alternative format (Responding to the preferences and concerns of patients).
Q2 – I would go with option 3. As stated clearly by the NMC Code that we should preserve safety. Identifying and working within the limit of your competence will improve both patient and public safety hence, Charles needs to speak to a senior as the decision is above my competence.
Q3 – I would choose option 1, because it is the option that captures what I should be doing as a nurse at that point. Option 3 should never be considered because reassuring a patient does not mean we should over promise.
Q1. Option2: Reason: Offer to show him how to use the App because the more knowledge he has the better. If this does not work I will suggest on something else if that could help. I would ensue that he understands what he is doing.
Q2. Option3: Reason: To discuss it with the medical team, gather all necessary information. Then, he can make an informed decision following from medical advice.
Q3. Option1: Reason: The more information he can access to the better for him. If he gets more information about his condition chances are that he will notice changes if it occurs and he will know when he needs medical attention.
Q1. I would choose option 2. This is because mobile apps such as the Atrial Fibrillation AF enables the detection of changes and management of AF, and also encourage self-management behaviour.
Q2. I would choose option 3. This is because physical activity such as bike riding prevents mortality as a result of cardiovascular disease. However, discussing with the medical team and senior nurses is essential to ensure Charles carries out PA safely.
Q3. I would choose option 1. This is because spotting the warning signs of a stroke increases the chances of survival and recovery.
Q1: Option 2: i would show Charles how to use the app during the appointment. Charles is more likely to engage with the information on the app if he has an understanding of how it works and feels confident in how to use it. This will lead to better management and reporting of his symptoms.
Q2: option two: I would advise charles to talk to the medical team.it would be outside of my competencies to offer advice on this matter and there for it could be negligent to suggest what to do. Advising Charles to talk to senior nurses and doctors would allow him to get specialized and evidence based advice on what to do and lead to better health outcomes.
Q3: option one: I would advice Charles on the symptoms of stoke. Knowledge is power and this will equip Charles with the skills to know what to do if he does start to experience any of the symptoms.Q1 – I would choose option 2 and offer to assist Charles with the ‘My AF’ app and demonstrate how to use it. I will make certain that Charles understands and is comfortable using the app, as it will promote his independence in monitoring his symptoms and tracking any changes in his AF.
Q2 – I would choose option 3 and I would advise Charles to consult with his medical team and senior nurses to ensure that it will not be harmful to his health due to cycling being a physical activity.
Q3 – I would choose option 1 and make sure Charles is aware of all the signs and symptoms of a stroke. I would also educate and equip Charles with information on how to respond and who to contact if he exhibits symptoms of a stroke.
Q1. Option 2: I’ll take him through the steps on how to use the App as well as print out a hard copy of the instructions and technical guide.
Q2. Option 3: I’ll advice Charles the medical team and senior nurses would give him the best advice that’ll be suitable for him due to his health.
Q3. Option 1: I’ll ensure Charles learns the signs (FAST)of imminent stroke and actions he take to act fast. Such as dialling emergency numbers for stroke.
Q1: I would choose option 2 because Charles will benefit from being shown how to use the app right there because he could see all the steps done. Also, advise him to tell his wife so that he’d have a second set of eyes to help him with that as well.
Q2: I would choose option 3 I would recommend to Charles that before beginning this, he consults with the medical team and senior nurses to ensure that this is transitioned well at the right time. I would indeed warn him about the dangers of putting more pressure on his heart, given his circumstances.
Q3: I would choose option 1 because he is unaware of the signs of stroke, and I will demonstrate what to do in time of emergency. I will advise and explain to him that he could ask for help immediately once he feels that there are changes in his movement, if not able to raise his arms, has slurred speech, and if his face droops. If possible, to place himself in a comfortable safe position. Call 999 as soon as possible.
Question 1: I will advise Charles to explore option 2: see how well he’s able to adjust to the App in person and take it forward.
Question 2: I will advice Charles to seek professional assessment on himself, recommend team leader and senior before embarking on circling. To avoid causing breakdown on his heart.
Question 3: I will look at exploring option 1: Creating awareness and reassuring the patient. Signs to watch out in stroke, abnormality in his speech or blood pressure that might put him in health hazard. In an emergency to dial 999 or 111 for quick intervention.
- You must be logged in to reply to this topic.
