CAP203 Care of The Person With an Acute Illness

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Assessment Task

This assessment is designed to assess your knowledge of pre-operative 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 preparation of a person for surgery. 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 integrate the information from analysis of the data provided, together with your knowledge of pathophysiology, clinical manifestations and legal and ethical considerations to the holistic nursing care of a person during the pre-operative period of an acute surgical admission. You will need to use the following processes from the clinical reasoning cycle to complete the assessment:

  • collect cues/information
  • process information
  • identify problems/issues

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 admitted to the Emergency Department via ambulance. Maria fell when watering her garden and was unable to get up. She was lying in her garden for 3 hours until her daughter came home from work and found her.

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.

She was administered Intravenous Morphine and inhaled Methoxyflurane by the paramedics.

Assessment data:

Airway: patent

Respiratory rate: 18 breaths/min    Oxygen saturation: 97% on room air

Heart rate: 90 beats/min     Blood pressure: 110/70 mmHg     Capillary refill: 2

seconds

Right leg shortened and externally rotated       Right hip bruised and oedematous

Right foot pink, cool to touch, no paraesthesia or abnormal sensation, pedal pulse present

Alert: orientated to time and place       Pain score: 5/10 on rest, 7/10 on movement

Temperature: 35 C

Small laceration to lower left leg

Blood glucose: 9 mmol/L

Intravenous cannula inserted Cephalic vein Left arm

X-rays reveal an Intertrochanteric fracture of the Right femur. Maria is seen by the Orthopaedic surgeon and is scheduled for an Open Reduction and Internal fixation (ORIF) of the fracture. She has been placed on the Emergency Operating List. The Registered Nurse has just administered Intravenous Morphine 2mg and the anaesthetist has been contacted to perform a femoral nerve block. The orthopaedic registrar will visit Maria in the next 10 minutes to gain consent for the surgery.

Maria is accompanied by Paulina, who is clearly upset about her mother's hospitalisation. Paulina informs you that she is so worried about how thin Maria is. She is also concerned that Maria has been falling frequently over the past few months, she purchased a walking frame for Maria but she rarely uses it. You note that Maria is upset that she is going to require surgery. She is worried about her garden and who will water it while she is in hospital.

Questions

  • After reviewing the information above, identify the assessment data/information/risk factors that would contribute to a diagnosis of a fractured neck of femur (100 words)?
  • Discuss the pathophysiology of osteoporosis and how this may have increased Maria's risk of sustaining a fracture (50 words).
  • Identify five additional assessments you would undertake to identify priorities for holistic person centred care in the pre-operative period. Provide a brief rationale for each (200 words).
  • Consider and briefly discuss any legal and ethical considerations relating to informed surgical consent, confidentiality and privacy from this scenario (200 words).
  • From your analysis of the data provided, identify four patient problems in the pre- operative period (50 words)

Formatting

  • A cover page must be included which includes; subject name and code, assessment number, student name, student number and word count
  • Present your assessment in 12-point font, Arial or Times New Roman, 5 line spaced and a minimum of 2.5cm margins.
  • Page numbers should be included in the footer along with student ID number

Structure

  • For each question, you should provide a brief separate heading (please do not include the questions in the assessment).
  • Ensure that your answers are concise and relate to the case study provided. Each question has been given an estimated word count to give you direction in the amount of information you need to
  • Bullet points can be utilised in your
  • You are not required to provide an introduction or conclusion for this assessment.

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