SAQA All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.
SOUTH AFRICAN QUALIFICATIONS AUTHORITY 
REGISTERED UNIT STANDARD: 

Maintain physiological homeostasis in the acutely ill patient 
SAQA US ID UNIT STANDARD TITLE
252161  Maintain physiological homeostasis in the acutely ill patient 
ORIGINATOR
SGB Nursing 
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY
-  
FIELD SUBFIELD
Field 09 - Health Sciences and Social Services Curative Health 
ABET BAND UNIT STANDARD TYPE PRE-2009 NQF LEVEL NQF LEVEL CREDITS
Undefined  Regular  Level 7  Level TBA: Pre-2009 was L7  10 
REGISTRATION STATUS REGISTRATION START DATE REGISTRATION END DATE SAQA DECISION NUMBER
Reregistered  2018-07-01  2023-06-30  SAQA 06120/18 
LAST DATE FOR ENROLMENT LAST DATE FOR ACHIEVEMENT
2024-06-30   2027-06-30  

In all of the tables in this document, both the pre-2009 NQF Level and the NQF Level is shown. In the text (purpose statements, qualification rules, etc), any references to NQF Levels are to the pre-2009 levels unless specifically stated otherwise.  

This unit standard does not replace any other unit standard and is not replaced by any other unit standard. 

PURPOSE OF THE UNIT STANDARD 
This qualification will enable the nurse to function as a clinically focused, service orientated, independent registered professional nurse, who is able to render comprehensive care across all spheres of health, as determined by the appropriate legislative framework. The qualifying learner will apply evidence-based research to enhance nursing practice.

This unit standard will recognise the essential knowledge and skills required to monitor physiological factors and maintain homeostasis in the acutely ill patient.

People credited with this unit standard are able to:
  • Assess and diagnose the physiological status of the acutely ill patient.
  • Monitor the acutely ill patient for the development of potential complications.
  • Implement evidence-based nursing interventions for disturbances in physiological homeostasis.
  • Monitor and evaluate patient response to interventions. 

  • LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING 
    The credit calculation is based on the assumption that learners are already competent in terms of the following outcomes or areas of learning when starting to learn towards this unit standard:
  • Anatomy and physiology of all human body systems related to the maintenance of homeostasis.
  • Assessment of client.
  • Management of activities of living. 

  • UNIT STANDARD RANGE 
    Specific range statements are provided in the body of the unit standard where they apply to particular specific outcomes or assessment criteria.

    The following scope and context applies to the whole unit standard:
  • The Nurse functions within the scope of practice of a professional nurse as formulated by the SANC. 

  • Specific Outcomes and Assessment Criteria: 

    SPECIFIC OUTCOME 1 
    Assess and diagnose the physiological status of the acutely ill patient. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    The acutely ill patient is accurately assessed in terms of the key processes of physiological homeostasis, in accordance with established procedures. 
    ASSESSMENT CRITERION RANGE 
    Processes include:
  • Peripheral perfusion; haemodynamic status; cardiac function; oxygenation; pulmonary function; renal function; fluid balance.
     

  • ASSESSMENT CRITERION 2 
    Information on the patient's physiological homeostasis is obtained from appropriate observations, diagnostic tests and other forms of assessment, applied in accordance with established procedures and protocols. 
    ASSESSMENT CRITERION RANGE 
    Information includes:
  • Observations: vital signs; pressures; skin colour, oedema, circumference.
  • Diagnostic tests: blood gasses, other blood tests; urine tests; X-rays; lung function tests; sputum tests; body fluid cultures.
  • Other assessment: neurological tests; Glasgow coma scale; Electrocardiograms.
     

  • ASSESSMENT CRITERION 3 
    Information is gathered and accurately interpreted to assess the different areas of function in accordance with established procedures and protocols, and generally accepted medical practice. 

    ASSESSMENT CRITERION 4 
    The physiological functioning compromised by the illness is accurately identified and the intervention selected is appropriate in terms of the available data and knowledge of the underlying disease. 

    ASSESSMENT CRITERION 5 
    The intervention is monitored to ensure that it achieves the expected short term support and balance. 

    SPECIFIC OUTCOME 2 
    Monitor the acutely ill patient for the development of potential complications. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    The acutely ill patient is accurately monitored for potential complications due to the illness, in accordance with established procedures and protocols. 
    ASSESSMENT CRITERION RANGE 
    Monitoring includes:
  • Haemodynamic; respiratory; fluid and electrolytes; acid-base balance; blood chemistry, haematology; mental state and/or potentially dangerous or self-destructive behaviour.
     

  • ASSESSMENT CRITERION 2 
    The acutely ill patient is accurately monitored for response to treatment, both desired and undesired, in accordance with established procedures and protocols. 
    ASSESSMENT CRITERION RANGE 
    Treatment includes:
  • Medication; non-pharmacological treatment modalities.
     

  • ASSESSMENT CRITERION 3 
    The acutely ill patient is accurately monitored for the development of complications due to immobility, in accordance with established procedures and protocols, and best nursing practice. 
    ASSESSMENT CRITERION RANGE 
    Monitoring includes:
  • Regular assessment of condition of pressure areas; regular assessment of joint mobility; regular assessment of air entry and chest x-rays; assessment for constipation and/or faecal impaction; assessment for urinary stasis and urinary infection; assessment for deep vein thrombosis; assessment for the effects of sensory verload/deprivation.
     

  • SPECIFIC OUTCOME 3 
    Implement evidence-based nursing interventions for disturbances in physiological homeostasis. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    Intravenous fluids are commenced and managed to bring about fluid and electrolyte balance as required to achieve physiological homeostasis. 

    ASSESSMENT CRITERION 2 
    Parenteral feeding is managed to ensure that patients with long term illnesses received the high protein, high fat intra-venous fluids required to support the healing process. 

    ASSESSMENT CRITERION 3 
    Other forms of fluid replacement therapy are managed according to established procedures and protocols. 
    ASSESSMENT CRITERION RANGE 
    Replacement includes:
  • Blood; plasma; albumin.
     

  • ASSESSMENT CRITERION 4 
    Artificial airways and mechanical ventilation is managed to keep smaller airways open and maintain respiration, according to established procedures and protocols. 
    ASSESSMENT CRITERION RANGE 
    Artificial airways include:
  • Tracheotomies; ventilators; CPAP breathing mask.
     

  • ASSESSMENT CRITERION 5 
    Peritoneal dialysis is managed to support the renal excretion function in accordance with established procedures and protocols. 

    ASSESSMENT CRITERION 6 
    The purpose of, and principles underpinning each intervention, are accurately described and explained. All nursing interventions are administered under highly aseptic conditions, according to established procedures and protocols. 

    ASSESSMENT CRITERION 7 
    Prescribed medical treatment is correctly implemented, according to established procedures and protocols. 
    ASSESSMENT CRITERION RANGE 
    Medical treatment includes:
  • Medication - oral and/or parenteral; administration of drugs via continuous intravenous infusion; administration of inhaled medication; nursing care of invasive monitoring devices.
     

  • ASSESSMENT CRITERION 8 
    Records of each intervention are accurate, complete and available to authorized personnel. Records provide sufficient detail to enable the nursing team to maintain effective care and/or treatment. 
    ASSESSMENT CRITERION RANGE 
    Records include:
  • Time of hook up to machines; changing lines; medication administered; patient response; test measurements.
     

  • SPECIFIC OUTCOME 4 
    Monitor and evaluate patient response to interventions. 

    ASSESSMENT CRITERIA
     

    ASSESSMENT CRITERION 1 
    Decisions on the frequency of monitoring and evaluation of the patient are appropriate in terms of the patient's condition, available data and own professional judgement. 

    ASSESSMENT CRITERION 2 
    Significant variations from normal homeostatic physiological function are promptly and correctly diagnosed, in accordance with established procedures. Variations are individualized in terms of the patient's history. 

    ASSESSMENT CRITERION 3 
    The situation is assessed, analysed and evaluated at appropriate intervals to ensure that care can continue at present levels, and under own supervision. Where care is beyond own scope of competence, referrals are prompt and to appropriate health professionals. 

    ASSESSMENT CRITERION 4 
    Longer term assessment and analysis establishes the effectiveness of the treatment in bringing about the planned and anticipated change. Reports on treatment effectiveness are accurate and helpful to those charged with prescription of care. 


    UNIT STANDARD ACCREDITATION AND MODERATION OPTIONS 
    Accreditation Options:
  • Providers of learning towards this unit standard will need to meet the accreditation requirements of the relevant ETQA.

    Moderation Option:
  • The moderation requirements of the relevant ETQA must be met in order to award credit to learners for this unit standard. 

  • UNIT STANDARD ESSENTIAL EMBEDDED KNOWLEDGE 
    The following essential embedded knowledge will be assessed through assessment of the specific outcomes in terms of the stipulated assessment criteria. Candidates are unlikely to achieve all the specific outcomes, to the standards described in the assessment criteria, without knowledge of the listed embedded knowledge. This means that for the most part, the possession or lack of the knowledge can be directly inferred from the quality of the candidate's performance. Where direct assessment of knowledge is required, assessment criteria have been included in the body of the unit standard:
  • Application of the principles of physiological homeostasis.
  • Application of evidence based practice to manage acutely ill patients. 

  • UNIT STANDARD DEVELOPMENTAL OUTCOME 
    N/A 

    UNIT STANDARD LINKAGES 
    N/A 


    Critical Cross-field Outcomes (CCFO): 

    UNIT STANDARD CCFO IDENTIFYING 
    Identify and solve problems and make decisions using critical and creative thinking.
  • Note: Identifying and implementing health care solutions implies problem-solving and effective decision making. 

  • UNIT STANDARD CCFO WORKING 
    Work effectively with others as members of a team, group, organisation or community.
  • Note: Health care provision is team based. 

  • UNIT STANDARD CCFO ORGANISING 
    Organise and manage themselves and their activities responsibly and effectively.
  • Note: Implementing health care to achieve homeostasis requires effective organisation. 

  • UNIT STANDARD CCFO COLLECTING 
    Collect, analyse, organise and critically evaluate information.
  • Note: Central to monitoring and evaluation components. 

  • UNIT STANDARD CCFO COMMUNICATING 
    Communicate effectively, using visual, mathematical and/or language skills in the modes of oral and/or written presentations.
  • Note: Core competence - gathering, analysing data; reporting. 

  • UNIT STANDARD CCFO SCIENCE 
    Use science and technology effectively and critically showing responsibility towards the environment and health of others.
  • Note: Used in assessment and monitoring as well as implementation of interventions. 

  • UNIT STANDARD CCFO DEMONSTRATING 
    Demonstrate an understanding of the world as a set of related systems by recognising that problem-solving contexts do not exist in isolation.
  • Note: Body as a system; part of the broader health care system. 

  • UNIT STANDARD ASSESSOR CRITERIA 
    N/A 

    REREGISTRATION HISTORY 
    As per the SAQA Board decision/s at that time, this unit standard was Reregistered in 2012; 2015. 

    UNIT STANDARD NOTES 
    Notes to Assessors:

    Assessors should keep the following general principles in mind when designing and conducting assessments against this unit standard:
  • Focus the assessment activities on gathering evidence in terms of the main outcome expressed in the title to ensure assessment is integrated rather than fragmented. Remember we want to declare the person competent in terms of the title. Where assessment at title level is unmanageable, then focus assessment around each specific outcome, or groups of specific outcomes.
  • Make sure that evidence is gathered across the entire range, wherever it applies. Assessment activities should be as close to the real performance as possible, and where simulations or role-plays are used, there should be supporting evidence to show the candidate is able to perform in the real situation.
  • Do not focus the assessment activities on each assessment criterion. Rather make sure the assessment activities focus on outcomes and are sufficient to enable evidence to be gathered around all the assessment criteria.
  • The assessment criteria provide the specifications against which assessment judgements should be made. In most cases, knowledge can be inferred from the quality of the performances, but in other cases, knowledge and understanding will have to be tested through questioning techniques. Where this is required, there will be assessment criteria to specify the standard required.
  • The task of the assessor is to gather sufficient evidence, of the prescribed type and quality, as specified in this unit standard, that the candidate can achieve the outcomes again and again and again. This means assessors will have to judge how many repeat performances are required before they believe the performance is reproducible.
  • All assessments should be conducted in line with the following well documented principles of assessment: appropriateness, fairness, manageability, integration into work or learning, validity, direct, authentic, sufficient, systematic, open and consistent.

    The following particular issues should be taken into consideration when assessing against this unit standard:
  • The SANC guidelines are used as a reference for integrated assessment.
  • Formative Assessment: A variety of assessment strategies and/or approaches integrating theory and practice must be used. These could be tests, assignments, projects, demonstrations or clinical assessments or any other applicable method.
  • Summative: This could take a form of oral, written and/or practical assessments as agreed to with the relevant ETQA.

    Definition of Terms:
  • Terms have been clarified as far as possible through the use of range statements. 

  • QUALIFICATIONS UTILISING THIS UNIT STANDARD: 
      ID QUALIFICATION TITLE PRE-2009 NQF LEVEL NQF LEVEL STATUS END DATE PRIMARY OR DELEGATED QA FUNCTIONARY
    Core  59257   Bachelor of Nursing  Level 7  NQF Level 08  Reregistered  2023-06-30  As per Learning Programmes recorded against this Qual 


    PROVIDERS CURRENTLY ACCREDITED TO OFFER THIS UNIT STANDARD: 
    This information shows the current accreditations (i.e. those not past their accreditation end dates), and is the most complete record available to SAQA as of today. Some Primary or Delegated Quality Assurance Functionaries have a lag in their recording systems for provider accreditation, in turn leading to a lag in notifying SAQA of all the providers that they have accredited to offer qualifications and unit standards, as well as any extensions to accreditation end dates. The relevant Primary or Delegated Quality Assurance Functionary should be notified if a record appears to be missing from here.
     
    NONE 



    All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.