Apprenticeship Learning Log

Date of Learning: 18^th of September 2024

Time: 09:30 – 16:30

Title of learning activity: Reflection – Induction & welcome week

 

Diary of Learning activity

ePortfolio – Explored learning platform, logging into ePortfolio for posting daily learning logs, self-directed learning, e-certificates, essays and assignments.

Artificial intelligence (AI) – open discussion on AI, its contribution/application in building essays.  We are reminded to maintain integrity and refrain from relying on AI in our work.

Anatomy and Physiology (A & P) – Introduction to anatomy and physiology.  The aim is to provide an overview of the body’s systems, types of cells and the concept of homeostasis.

 

Learning in class today:

2024.25 Understanding health and illness across the lifespan – CNR020C111A

• Introduction to A&P: Systems, Cells and Homeostasis (Understanding Health and Illness)

Aim of the session:

To provide an overview of body systems, types of cells, information on homeostasis and how the body maintains homeostasis

Familiarise with common anatomical terms, locations/positions (directional terms)

Learning outcomes:

• Anatomical position

Standing upright

Forward facing

Arms at the side

Palms forward

Feet parallel

• Positional terms – body parts are described relative to other parts

Superior – toward the top or head region

Inferior – toward the bottom or feet

Anterior or Ventral – towards the front of the body

Posterior or Dorsal – towards the back of the body

Medial – closer to the midline

Lateral – farther from midline

Proximal – body part is closer to the point of attachment than other body part

Distal – body part further from point of attachment than other body part

Superficial – closer to the surface

Deep – deeper in the body

• Body cavities and regions

Learning using body cavities to help organise the different organs and organ systems provides a useful way for breaking down information into more manageable components.  Body cavities represent fluid filled spaces which house and protect the major internal organs

Dorsal body cavity – cranial & vertebral cavity

Ventral body cavity – thoracic, abdominal & pelvic cavity

Distal – in anatomy, distal means a part of the body is farther away from the centre of the body than another part, e.g., the hand is distal to the shoulder

Proximal – means situated nearest to the point of attachment or origin

The abdomen is divided into 4 quadrants – right, left, upper, lower

The abdomen is sub-categorised in 9 regions – right hypochondriac region, epigastric region, left hypochondriac region, right lumbar region, umbilical region, left lumbar region, right iliac region (where the appendix is located), hypogastric region, left iliac region

• Regions of the body

Head, neck, trunk, upper limbs, hands, lower limbs, feet

• Leads of organisation

Organisation in anatomy refer to the hierarchy within biological systems, starting from cellular level, to tissue level, organ level, organism level.

Each level as follows:

1. Chemical level – the smallest layer of structural organisation, the body is made up of various chemicals.  Different chemicals combine to form the various molecules found in the human body.  Atoms combine to form molecules. E.g., Adenosine triphosphate (ATP – is the source of energy for use and storage at the cellular level; used for various cellular functions including transportation of different molecules across cell membranes, and other functions include supplying energy required for muscle contraction, neurotransmission, DNA and RNA synthesis), oxygen, carbon dioxide, hydrogen.  The importance of electrolytes – electrolytes are chemicals that conduct electricity when dissolved in water.  They regulate nerve and muscle function, hydrate the body, balance blood acidity and pressure, and help rebuild damaged tissue.
2. Cellular level – cells are the smallest units of the living organisation and are the building blocks of the human body.  The human body develops from a single cell, the zygote, a fertilised egg cell that results from the union of a female gamete (egg, or ovum) with a male gamete (sperm).  In the embryonic development of humans and other animals, the zygote stage is brief and is followed by cleavage, when the single cell becomes subdivided into smaller cells.
3. Tissue level – collections of similar cells grouped together to perform a specific function.  Tissues consist of similar types of cells.  E.g., nervous tissue, muscular tissue, epithelial tissue, connective tissue
4. Organ level – structures that operate to perform a specific function; and consist of two or more types of tissue, which enable them to perform a specific role or function.  E.g., the heart, lungs, liver, kidneys, the skin
5. Organ system level – a group of organs that work collaboratively to perform specific functions.  E.g., the skeletal system, the muscular system, the circulatory system, the respiratory system, the nervous system, the endocrine system, the digestive system, the urinary system, the reproductive system
6. Organism level – a living form where all the other body structures function to bring life to the organism.  E.g., humans, mammals, reptiles

The human cell structure and it cell components – DNA and genes, the cell membrane and transport

Passive transport is the movement of molecules across a cell membrane without the use of energy.  It occurs when molecules move from an area of high concentration to an area of low concentration, which is known as moving down a concentration gradient.  There are several types of passive transport:

Diffusion – small nonpolar molecules, like oxygen and carbon dioxide, move through the membrane by diffusion

Osmosis – water molecules move through a semi-permeable membrane from an area of high water concentration to an area of low water concentration

Facilitated diffusion – large, insoluble molecules, like glucose or amino acids, move through the membrane with the help of carrier proteins or pores in the membrane

Active transport – the process of moving molecules across a cell membrane from an area of low concentration to an area of high concentration,  This process is against the concentration gradient and requires energy.  Examples of active transport:

The uptake of glucose by the epithelial cells in the small intestines and the uptake of ions from soil water by roots hair cells in plants

Sodium-potassium pump – a transport of protein that moves sodium out of cells and potassium into cells.  This process helps nerve cells transmit nerve impulses

The smallest structures capable of performing activities essential for life.  Cells are made up of molecules.  E.g., muscle cells, nerve cells, blood cells

• Homeostasis/haemodynamic

The body’s many functions, beginning at cellular level, operate as to not to deviate from a narrow range of internal balance, a state known as dynamic equilibrium, despite changes in the external environment.  Those changes in the external environment alter the composition of the extracellular fluid surrounding the individual cells of the body, but a narrow range must be maintained to stave off death of cells, tissues, and organs.  In short, the purpose of homeostasis is to maintain the established internal environment without being overcome by external stimuli that exist to disrupt the balance.

2 physiological responses:

• Shivering and arrector pili muscle – shivering is a remarkable thermogenic response in homeothermic animals, including humans, that involves rapid, repeated skeletal muscle contractions leading to heat production through the inefficiency of ATP utilisation.  Shivering maintains homeostasis when the body gets too cold by generating heat.
• The erector pili muscle, also known as the arrector pili muscle or pilomotor muscle, is a hair-supporting dermal tissue and a king of smooth muscle in the skin that causes hair to stand, and maintain the warmth of the mammalian body through erecting hairs.

5 essentials for survival:

1. Water
2. Oxygen
3. Nutrients
4. Normal body temperature
5. Normal blood pressure

 

Characteristics of life:

1. Movement
2. Respiration
3. Sensitivity
4. Growth – increase in the size or number of cells
5. Reproduction
6. Excretion
7. Nutrition

 

With the help of reading material on MOODLE, information will help me familiarise myself with the clinical terms above towards assessment (mock & exam) in February 2025.  Additionally, knowledge of terms and general functions will, in my role as a student nursing associate, support patients with their health and well-being, and to identify and document patient’s clinical information (body maps including pressure sores and wounds, compromised skin integrity, pain sites & locations) appropriately.

In the course of my duties and responsibilities at work, while performing physiological measurements, I was able to identify a mild muscular spasm in the left hypochondrial region alongside pain scoring system, and other chest discomfort the patient was experiencing.  Upon recording detailed information, clinician was able to initiate further investigation (ECG) to establish primary risk or indication of heart failure.

 

Assignment for home:

To complete online questionnaire on VARK

To upload care certificate on ePortfolio

Check session resources on MOODLE, module outline and learning outcomes.

Essential reading – anatomy book list on MOODLE

Self-directed learning and research – definition and difference between “acidotic”, “alkalotic” – acidosis and alkalosis are conditions that occur when the body’s pH levels are abnormal:

• Acidosis occurs when the body’s pH levels drop below 7.35, indicating too much acid in the body’s fluids.  Symptoms include fatigue, confusion, nausea and vomiting, headaches, increased breathing rate and depth, seizures, and coma.

 

• Alkalosis occurs when the body’s pH levels rise above 7.45, indicating too much base in the blood.  Symptoms include irritability, weakness, cramping, muscle twitching, muscular spasms, fatigue, confusion, tremor, tingling and numbness, abnormal heart rate (arrhythmia), and seizures

 

• Why is dangerous to administer oxygen to a COPD patient?

Oxygen therapy can be dangerous for patients with chronic obstructive pulmonary disease (COPD) if not properly prescribed and monitored.

NICE (2016) Quality statement 6: Emergency oxygen during an exacerbation (a sustained worsening of a person’s symptoms from their stable state beyond usual day-to-day variations and is an acute onset, commonly reported symptoms are worsening breathlessness, cough, increased mucus production, and a change in the colour of the mucus) – people receiving oxygen for an acute exacerbation of chronic obstructive pulmonary disease (COPD) have their oxygen saturation levels maintained between 88% and 92%.

During an exacerbation, people with COPD may experience a worsening of gas exchange in the lungs, which can lead to low blood oxygen levels.  Emergency oxygen is often given during the treatment of an exacerbation, either in the community, during transfer to hospital in an ambulance  or while being assessed at hospital.

In some people, uncontrolled oxygen therapy may reduce the depth and frequency of breathing, leading to a rise in blood carbon dioxide levels and a fall in the blood pH (acidosis).  Controlled oxygen therapy must therefore be administered by a delivery device and at a flow that helps the oxygen saturation to be maintained between 88% and 92%.

 

KSBs addressed:

K1: Understand the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and how to fulfill all registration requirements

K4: Understand the principles of research and how research findings are used to inform evidence-based practice

K10: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

S1: Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements

S2: Keep complete, clear, accurate and timely records

S5: Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018)

S17: Protect health through understanding and applying the principles of infection prevention and control, including communicable disease surveillance and antimicrobial stewardship and resistance

S24: Perform a range of nursing procedures and manage devices, to meet people’s need for safe, effective and person-centred care

S35: Accurately undertake risk assessments, using contemporary assessment tools

S36: Respond to and escalate potential hazards that may affect the safety of people

S44: Access, input, and apply information and data using a range of methods including digital technologies, and share appropriately within interdisciplinary teams

B1: Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care

S2: Keep complete, clear, accurate and timely records

S30: Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed