Implement to prepare audrey for her surgery

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Reference no: EM131274927 , Length: word count:2500

Critical Thinking Scenario

Mrs. Audrey Smith is a 75 year old female who arrived to the Emergency Department at 1045. She was found lying on the kitchen floor by a neighbour at 0925 and an ambulance was called immediately. Mrs. Smith stated that she had tripped over her dog.

Mrs. Smith has been diagnosed with a fractured left NOF (neck of femur), soft tissue injury and bruising to her left shoulder as well as a small haematoma to her left forehead. She is oriented to time, place and person. She is eye opening to commands and is able to understand and perform what is asked of her, for example when asked to perform deep breathing and coughing exercises, she responds to the instructions appropriately. GCS is 14. Neurological observations are ordered hourly.

Audrey. (preferred name), is transferred to your ward at 1400 with an IVT and IDC in situ. She is alert but anxious and speaks frequently about her dog, Rufus. Audrey is concerned that there will be no-one to care for him when her neighbour goes back to work. Surgery for arthroplasty - L hip is scheduled for 1700.

Patient Details

Name: Mrs. Audrey Smith
Address: 440 Collins St.
Melbourne Vic 3000
DOB: 31/12/38
Age: 75

Past Medical History
AF Hypertension
L CVA - 2008 T2DM - 2008
GORD
Osteoporosis
Total hysterectomy - 1995
Depression - 2011

Medication History

Digoxin 62.5 mcg OD
Warfarin 2 mg OD (INR result 2.0 in ED) Coversyl 5 mg OD
Vitamin D 1,000 units OD
Metformin 500mg BD (BSL 5 @ 1200) Esomeprazole 40 mg OD
Efexor 150 mg OD
Caltrate 600 mg OD Mylanta 15-30 mls prn

Allergies

Bactrim

Social History
Husband died in 2010
1 adult daughter who lives in Queensland & sees her mother infrequently Council home care once per fortnight
Attends Senior Citizens once per week with her neighbour
Past history
Social drinker
Non-smoker (25 years)

Nursing Assessment
Slight right-sided weakness
Chronic constipation
Mild to moderate urinary incontinence
Anorexia
Early morning wakening

You reassure Audrey that you will do your very best to meet her needs.

The Task

BASED ON THE SCENARIO YOU WILL:

1. Admit the patient using critical thinking skills interventions related to Audrey's: to assess and prioritise nursing

- Safety
- Hygiene & Comfort
- Nutrition
- Elimination
- Activity levels
- Psychosocial needs

All interventions must be accompanied by a relevant explanation.

2. Provide an explanation of the 8 diagnoses referred to in Mrs. Smith's past medical history. Indicate how they affect the care that you provide to Audrey.

3. Use critical thinking skills to discuss each of Audrey's prescribed drugs using the following criteria:

- Indications for use

- Nursing implications

- Indicate how they affect Audrey and the care that you provide to Audrey

4. Discuss the specific nursing actions you will implement to prepare Audrey for her surgery and explain your reasoning.

5. Discuss the immediate nursing interventions you will implement when Audrey returns to the ward at 2000 and explain your reasoning.

6. Mrs. Smith is to be discharged 10 days post-op. She will be admitted to a fast track rehab facility. Describe 4 nursing interventions you will implement to prepare Audrey for this transition and explain your reasoning.

Reference no: EM131274927

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Reviews

len1274927

11/12/2016 5:07:30 AM

6 Discharge planning demonstrates contextualised conclusions and strategies 4 Conclusion: 4 Case study format is adhered to utilising proper headings and clear and concise information. 4 Grammatical style/spelling/ sentence structure 4 6 Critical thinking skills are demonstrated in a systematic and logical manner. Citing and referencing is consistent with APA style Demonstrates use of appropriate/current literature. 6 80

len1274927

11/12/2016 5:07:21 AM

1 Introduction: 4 Interpretation, analysis, reasoning, explanation and relevance of nursing problems and interventions. Prioritisation is evident. 15 5 2 Definitions of diagnoses are accurate and demonstrate understanding of pathophysiology 4 3 Drug therapy is discussed using reasoned conclusions that are appropriate to the care of the patient 8 4 Pre-operative care is discussed using appropriate prioritisation. reasoning and relevance to the patient 8 5 Post-operative care is discussed using appropriate prioritisation, reasoning and relevance to the patient 8

len1274927

11/12/2016 5:07:00 AM

Critical Thinking Criteria • Communication is effective and provides a clear explanation of all points • Accurate interpretation of data • Inductive and/or deductive reasoning is used to identify relevant information • Conclusions are appropriate to the care of the patient • An explanation of why or how care is delivered demonstrates adequate contextual reasoning • Refer information back to Audrey • Utilisation of contemporary resources and clinical guidelines

len1274927

11/12/2016 5:06:48 AM

Presentation of Written Assignment: Please follow these guidelines; • Submit via email to the address specified on Assessment Timetable Timeline. • Late submissions will incur a 10% penalty for each day that it is late • Word process your assignment and use Arial 10 font and double space • Cite and reference according to the APA Referencing Guide • Failure to cite and reference will result in a Not Yet Competent (NYC) • A pass mark of 65% must be attained • Students must write in third person • Students must adhere to a 2,500 word limit. In calculating the number of words for the purposes of enforcing the word limit, 10% over the word limit will be granted, to cover headings and in-text citations • Work judged in excess of 10% as stipulated, will be returned for rewriting and re-submission and can only attain the pass mark, subject to assessment criteria • Utilise a case study format using headings provided, which will include an introduction and conclusion. Do NOT use essay format. • Demonstrate critical thinking by identifying priority nursing interventions

len1274927

11/12/2016 5:06:27 AM

• This cover sheet must be =law and attached to each Assignment. • This cover sheet must be signed, STUDENT NAME Surname: Date Group Started: /20 Group: ONE TWO THREE (circle appropriate group) Student ID Number (if known) Assessment Task: Due Date: „,„„/ ,,,,,,,,, /20,,.., Date Submitted: / /20..... Student Email: Student Mobile: Statement of Authorship: This assignment is my original work and no part of it has been copied from the work of another student or from any other source except where due acknowledgement is given. *I have a photocopy or electronic copy of this work which can be submitted if the original is lost or damaged. *No part of this assignment has been written for me by any other person

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