AgentMetalSheep21
Assessment Task In this assessment, you will apply your knowledge…
Assessment Task In this assessment, you will apply your knowledge and understanding of postoperative nursing care. After analysing a case study you will answer a series of questions. Please refer to the Task Instructions for details on how to complete this task. Context The Registered Nurse plays an important role in the postoperative care of a person. This assessment provides you with the opportunity to apply theory to a clinical scenario. To complete this assessment you will need to apply clinical reasoning processes as you examine and analyse a case study. You will be required to analyse the data provided, research the surgical procedure and anaesthetic administered as well as post-operative nursing care principles. This information will then be used to discuss the holistic nursing care of the person during the post-operative period of an acute care admission.
Learning Outcomes This assessment addresses the Subject Learning Outcomes listed at the end of this document Submission. You will need to use the following processes from the clinical reasoning cycle to complete the assessment: ? process information ? identify problems/issues ? take action ? evaluate outcomes ? reflect on process and new learning Instructions.
To complete this assessment, you will need to examine and analyse the case study presented below and provide responses to the questions asked.
Case study Maria Romano is a 76 year old woman who sustained an Intertrochanteric fracture of the Right femur after she fell when watering her garden. She sustained a small laceration to her lower left leg when she fell. Maria’s Blood Glucose level on admission was 9 mmol/L. Maria’s medical history includes osteoporosis, glaucoma and she has recently been diagnosed with early dementia. She has no significant surgical history. Maria lives with her daughter Paulina and Paulina’s husband Sam. Maria’s current medications include Aspirin 75mgs daily, Alendronate Sodium 10mg orally daily & Latanoprost eye drops to both eyes nocte. Preoperatively, Paulina shared her concerns regarding Maria’s low weight and recent frequent falls. Maria has a walking frames but rarely uses it. Maria shared concerns about her garden and who will care for it while she is in hospital. Maria has undergone an Open Reduction and Internal fixation (ORIF) of the fractured Right Neck of Femur under Spinal and General Anaesthesia. Maria was nauseated in the Post anaesthetic care unit (PACU) and vomited a small amount of green fluid. IV Metoclopramide was administered with good effect. Post-operative surgical antibiotic prophylaxis and pharmaceutical and mechanical thromboprophylaxis are ordered. An intravenous PCA of Morphine is ordered together with regular Paracetamol.
The surgeon has ordered the drain tube to removed on Post-Operative day 2 (after review) Discharge is scheduled for post-operative day 5. Observations on return to the ward Airway: patent Respiratory rate: 16 breaths/min Oxygen saturation: 97% on room air Heart rate: 84 beats/min Blood pressure: 100/60 mmHg Capillary refill: 2 seconds Intravenous therapy Cephalic vein Left arm: Hartmanns solution 8 hourly Dressing to Right hip: Intact with small amount of bright red ooze on dressing Redivac drain tube in situ: patent – 200 mL of bright red drainage. Bromage score: 2 Dermatome level: L2 Right foot pale, cool to touch, pedal pulse present, slight paraesthesia in toes Graduated compression stockings in situ Alert: orientated to time and place Pain score: 1/10 on rest, 3/10 on movement Temperature: 36 C Maria sustains a skin tear to her lower right arm as you release the bed rails after transferring her to her room.
Questions 1. Discuss the elements of open disclosure that are required in this situation.
2. Identify four postoperative/anaesthetic problems or issues from the data presented. Briefly discuss the factors that pre-dispose Maria to these problems*
3. Discuss the nursing interventions that you would employ to prevent/manage the identified problems. Ensure a rationale is provided for each intervention*
4. Discuss how you would evaluate the effectiveness of these nursing interventions
Answers to questions 2, 3 & 4 must be submitted in a table (suggested format below) Patient problem Nursing intervention Rationale Evaluation
5. Reflect on what you have learnt from completing this case study and how this learning will inform your clinical practice
Referencing 10 references are required for this assessment. Use recent, relevant and reliable resources to complete this task. These should be peer-reviewed literature other credible sources (government documents, reports, publications, authentic webpages etc., related to the subject matter and not older than seven years It is essential that you use appropriate APA style for citing and referencing research.
