The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:
communication strategies that underpin assessment and communication with the person and other health professionals, including:
appropriate modes of communication for the information being provided
range of interviewing skills
information technology and health technologies to capture clinical data for responsive coordination and dissemination to relevant members of the interdisciplinary health care team
factors for consideration when communicating with people with:
communication-related disabilities
mental health conditions
pharmacological and alcohol addiction or misuse
adverse behavioural responses to unfamiliar environments
person under stress due to situations to themselves or others such as trauma, death and life threatening situations
advanced concepts underpinning human maintenance systems including immunity and homeostasis imbalance causing physical changes associated with:
acidosis/alkalosis
diabetes (hypoglycaemia, hyperglycaemia)
nutirition and hydration/dehydration
cancer treatment
thermostasis (thermoregulation)
infections
poisoning
sepsis
clinical assessment techniques and tools used in a head-to-toe physical body examination:
inspection – uses of the sense of sight to identify specific characteristics of the individual
palpation – utilises use of the sense of touch to determine physical signs.
percussion – use of tapping on an individual's body to evaluate location and density of underlying structures.
auscultation – listening to sounds created by the body using stethoscope
processes for the neurological examination of the sensory function and motor responses including:
cranial nerves
inspection, looking for subtle weakness e.g. tremors, pronator drift
gait abnormalities including scissors, spastic, stoppage and waddling
stance including posture, lordosis, kyphosis and scoliosis
muscular response and muscle strength
dermatomes and related spinal nerves
peripheral neuropathies
sensory function testing: light touch, pain sensation, temperature, proprioception and tactile localisation
stereognosis and graphaesthesia
Romberg test
deep tendon reflexes including how to position a person and use of reflex hammer and comparing left and right side responses
superficial reflexes such as abdominal and cremasteric reflexes
processes for respiratory system examination including
respirations – breathing effort, chest pain associated with breathing, movement of the rib cage for symmetrical or diaphragmatic breathing pattern
auscultation – systematic approach to determine if underlying lung tissue is filled with fluid, air or solid material checking lung fields for bilateral adventitious noises
percussion sounds including:
resonant: heard over the lung fields - air filled spaces- very hollow sound
tympany: heard over the gut area- duller sound- like tapping on a watermelon
dull: heard over bony areas- little transmission of sound
processes for checking heart sounds including:
aortic, pulmonic, Erbs Point, tricuspid and mitral heart sounds
Sound1 represents closure of the atrioventricular (mitral and tricuspid) valves during the beginning of systole
Sound 2 represents closure of the semilunar valves (aortic and pulmonic) valves during the end of systole and beginning of diastole
processes for chest and abdomen examination including:
inspection – described by location (quadrant) visible abdominal masses, and the movement of the chest and abdominal wall
auscultation (for abdomen auscultation is before palpation and percussion) – detection of normal and altered bowel sounds in abdomen, bubbling; rubbing; grating; crackling or vascular bruits
palpation and percussion – depth of palpation (superficial or deep) using the fingertip or flat of the hand for examination of the abdomen for crepitus of the abdominal wall, for any abdominal tenderness, rebound tenderness or for abdominal masses
processes for peripheral vascular system examination including:
inspection – colour of limbs (including when legs are hanging over the edge of the bed), hair loss, ulcers, scars and muscle wasting, lateral side foot and in-between toes
upper limb pulse – subclavaian, carotid, brachial, radial, ulnar and capillary refill time
lower limb pulse – aorta, femoral, popliteal, posterior tibial, doralis pedis and anterior tibial
palpation of the amplitude of arterial pulses bounding, brisk diminished, absent or unable to palpate
checking peripheral pulse and apical pulse for consistency
Allens test to determine patency of the radial and ulnar arteries
processes for skin, hair and nails examination including:
colour, texture, turgor, warmth, moisture distribution, the presence of any lesions or scars
clubbing of the nail beds can be indicative of pulmonary disease
reduced hair distribution on the lower legs can be indicative of cardiovascular disease (check with individual if they use hair removal treatments)
effects of intrinsic factors (such as age, health) and extrinsic factors (such as environment, medications) on person’s condition
how to interpret common blood test results and their meanings as indicators of a health condition or illness including:
Albumin
Arterial Blood Gas (ABG)
Blood Sugar Level (BSL), haemoglobin A1C
Blood Urea Nitrogen (BUN)
Calcium
Cardiac Enzymes (CE)
Cholesterol
Coagulation Studies (Coags)
Erythrocyte Sedimentation Rate (ESR)
Electrolytes (EUC) (Sodium/Potassium/Chloride Urea/Creatinine)
Full Blood Count (FBC)
High-Density Lipoprotein (HDL)
Iron
Low-Density Lipo-protein (LDL)
Magnesium
Phosphorus
Triglycerides
Thryoid Stimulating Hormone (TSH)
Uric acid
how to recognise subtle changes in a person’s condition through knowledge of a person’s patterns of responses and comparing responses over periods of time
principles for recognising a deteriorating patient and raising issues of concern about a person’s deterioration
socio-economic, physiological, emotional and physical variables related to clinical presentation of a person.