rr Cet (ermal Mrs Roberta Blackwood - attempted suicide Read this description of a patient who was admitted to Accident and Emergency (A&E) when she took an overdose of paracetamol along with alcohol. Then read her A&E admission form which was completed when she arrived: When Roberta Blackwood was admitted to ABE, she was sitting up, though she was.a little vague and sleepy. She responded to verbal commands and was able t transfer herself from the ambulance trolley to the casualty trolley. Roberta's breath smelt af alcohol. However, there were no signs that she had vomited. Base-line functions were recorded on the admission form thus: Base-line functions Breathing Circul: Pulse rate BF 92/min 105/65 mmHg Colour Skin Lip ok pink Roberta was accompanied in the ambulance by her aunt, Mrs Judith Smart. The patient had telephoned her aunt an hour earlier telling her what she had done and asking her to take care of her baby.ED ever 047 enctisn ror wunsina At the time the admission form was completed, Roberta was very withdrawn, avoided looking at people and would not speak. Later, however, after some counselling by an AGE staff nurse, she began to talk more openly. Roberta has a baby. She is unskilled and unqualified and her husband works as a labourer. Roberta often visits a local pub with her aunt, who is her best friend, Her husband is out most evenings and when he returns, she says, he is usually drunk and aften aggressive. She dreads her husband coming home at night but, though he is fairly rough with her, he has not beaten her up. Roberta said she felt unable to cope with the situation at home. She said thar the baby cried a lot and was very demanding and that she was not getting much sleep. Roberta is very anxious about the involvement of the Social Services and worries in case they will take her baby away. Her parents arrived soon after she did and her father showed he was tated at hit daughter's actions. Her husband so far has not visited. n, the patient was: a, unconscious, b. conscious and alent. c. awake but drowsy. EB on admission, the patient: a. had been sick. b, had not been sick c, was sick. EE the patient: a. came alone, b, came with her baby. ¢, came with a relative. EB Her base-line functions show that the patient: a. is not coughing. b. cannot cough. ¢. has no cough. the patient is: a. worried about the Social Services. b. anxious to see someone from Social Services ¢, worried for the Social Services KB the patient's father is: . a, sympathetic. b. indifferent, ¢. antagonistic EB the patient says: a. she has too much. b, there’s too much for her. ¢. things are too much for her.uns KonertA suitwo05 =aTréMerED suo ED MEDICAL INFORMATION et aol Uy Name: Prefers to be addressed Relevant medical history Roberts Blackwood as: Robbie Feeling depressed/weepy ‘over period, has baby 3 Address: months - ¢/o aunt ~ on consulted GP-= no medication preseribed, 14 Hardeastle Terrace, Ch Other persons important to patient: husband Medical diagnost risk oF hepatic failure due Wham to contact in emergency: to ingestion of 12.5 g 45 abov paracetamol/risk of respiratory depression due DOB: 20.780 Tel: 0112: 765432 to drinking unknown amount aleohol Primary nurse: ASN Jane Smallweed Allergies: penicillin Reason for admission: overdase - 25 paracetamol tabs (approx) + gin. Patient's feelings and expectations related to present illness: Patient's understanding of admission: Patient is aware ofdangers & poss. risks & will patient embarrassed by admission - unresponsive co-operate with stomach wash-out but not unco-operative ‘Nurse's Initial impression (physical and sock Source of assessment: Patient is conscious but drowsy, uncommunicative patient/aune (Judith Smart} aceompanying & avoids eye contaet, poss. poor relationship with husband (reported by aunt) - says, ‘unable to cope Family's understanding of admission: ‘with new baby’ Husband &parenes inks Attractive, slim young woman — not dirty oF untidy, Drugs taken at home: admits to use of this Patient Assessment Record is completed? (Some statements may he true but you don’t know for sure.) . Robbie is the patient's husband, The patient was given too many paracetamol. The patient is out cold. rhe patient is violent. Information comes from the patient's aunt The patient is unhappily married, The husband knows about his wife's admission, . Robbie uses unpreseribed drugs. The patient has been to see her family doctor, No one is available 10 take care of the baby. The overdase will cause respiratory depression reeasse reeESD eveeroar enous roe nunsing The following is part of Roberta Blackwood’s Patient Assessment Record written out in full sentences. Put these words into the gaps in the text (some of them can be used more than once): at, to, in, on, of, ago, ary, some, about, since, with, though. Roberta Blackwood took an overdose ....... 25 paracetamol and drank comm Sin. She did not respond ..... Stall... first but later spoke coos HEF PFOBLEMS soso Home, She had a baby three months and has been feeling depressed ....... then, She is not getting ..... Wi her husband and she says she is unable to cope ........ the new baby. She uses cannabis .......... help her sleep and _.. she has been in touch with her GP he did not preseribe medication, Roberta has agreed ..... co-operate with staff over a stomach wash-out because she understands the danger she The following sentences are taken from Roberta Blackwood’s Patient Assessment Record. Choose, from a, b and c, which is the nearest in meaning to the underlined phrase: Reason for admission “The patient has overdosed on 25 paracetamol tablets and an. unknown wantity of alcohol.” a, The patient didn’t know she was drinking alcohol. b. Hospital staff don't know how much she has drunk. c. The patient has mixed her drinks and so staff don't know exactly what she has b drinking Patient's understanding of admission “The patient is embarrassed by her admission.’ a. The patient is embarrassing. b. The patient is shy . The patient is ashamed of herself Medical diagnosis ‘There is a risk of hepatic failure due to the ingestion of 12.5 g of paracetamol.’ a. There is 2 danger that the liver will malfunction, b. Liver failure creates risks. c. A [ailed liver is dangere Relevant medical history ‘The iene hy, n feeling we over Tiod of a. The patient occasionally feels depressed b, She has always been depressed ¢. The patient has been feeling depressed for a w Nurse's initial impression ‘The patient is conscious but drowsy. a. The patient is sleepy b. The patient is asleep, ¢. The patient is unaware of any