Medical Surgical nursing

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#Assessment 2 Case Study Students will be able to demonstrate active engagement in critical reflection on their ability to undertake appropriate assessment(s) and maintain holistic perspectives and cultural awareness through the theoretical examination of a particular nursing specialty case study focusing on the delivery of nursing care, using the clinical reasoning cycle framework and the evidence. Due date: 26 th August, 2017 18:00hrs Weighting:40% Length and/or format: 1600 words +/-10% Case study format Jack Buun, 69, femoral neck fracture post a fall Jack Buun presented to the emergency department (ED) via ambulance after a fall in his backyard, which lead him to twist and fall directly on the lateral aspect of his right hip. On examination the paramedics reported his right leg to be shortened and externally rotated, and Jack was unable to get up and in a significant amount of pain. His wife Ethel found him and called the Ambulance. Jack has a past history of hypertension that is well controlled. Jack required emergency surgery under general anaesthetic for his femoral neck fracture, and underwent a hemiarthroplasty. You are called to the post anaesthetic recovery unit (PACU) to receive handover, and are happy that he meets the discharge criteria of the hospital. You are told that Jack received the following intravenous medications for pain during and after his surgery: • 20mg Morphine • 100mg Tramadol • 40mg Paracoxib • 1g Paracetamol Jack also received 0.625mg of droperidol in the PACU for nausea. On arrival to the orthopaedic ward you conduct further assessment as follows: • Vital Signs: BP 145/80, HR 120, SpO2 96% on 2L via nasal prongs, Temp 37.1° Celsius, RR 10; • Drowsy but rousable to voice commands; • Pinpoint pupils; • Neurovascular observations (Right Lower Limb): Cool, pale, touch present, movement present, capillary refill sluggish, dorsalis pedis present but thready; • Pain 3/10. You are the RN caring for Jack on the surgical ward.

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