Reference no: EM133999815

Question

In this scenario you are a registered nurse, working in a ward at your local hospital. Gavin Jacobs is a 37-year-old man who has, since the age of 12 years, has had a profound acquired brain injury (ABI). This injury occurred during a major Motor Vehicle Accident (MVA) in which his father was killed. Gavin lives at home with his mother, Helen, who is 74 years old. Gavin is under a Disability Support package and disability support carers attend to his ADL's with Helen's support.

Recently Gavin underwent a surgical incision, drainage, and curettage of an infected pilonidal sinus. He was discharged back home after an overnight admission to hospital with a plan for follow up with a community nurse. Helen states she was informed Community Nursing would be coming to help with the wound dressing, but that no one ever made contact or came to their home.

Today, Gavin has been readmitted to your ward after Helen raised concern with their GP that the surgical site was not healing and appears to be deteriorating. You have completed a comprehensive assessment of Gavin. On assessment you note that Gavin is globally aphasic and non-communicative as a result of ABI. He requires full assistance for all Activities of Daily Living (ADL).

Gavin is fully dependent with mobility, compounded by severe contractures in his arms and legs. Helen tells you that he spends much of his day in a bed. Gavin is currently underweight. Helen tells you that he has been on the same PEG regime for many years, and that it has been a while since they have seen a Dietitian.

He receives nutrition via a Percutaneous Endoscopic Gastrostomy (PEG) feeding system. Gavin's lips appear dry.

Gavin is incontinent of both urine and faeces.

As you complete your assessment of Gavin, Helen tells you that she has been struggling with caring for Gavin recently, noting reduced mobility and changes to her fine motor skills due to osteoarthritis in her knees and hands. Helen explains that she recently saw an orthopaedic surgeon who told her she would benefit from bilateral knee replacements.

During your conversation with Helen, she starts to cry and states she is feeling very overwhelmed and upset that Gavin is back in hospital again.

Outstanding introduction that describes the content of the presentation.