Reference no: EM133508648

Mrs Smith is a 76-year-old woman and lives in an Aged Care Facility. She was brought to emergency 2 days ago for management of respiratory distress and decline in health due to COVID.

Situation

Mrs Smith has COVID and has sustained a fall last night.

X-Ray of Right shoulder, hip and MRI Brain has been done.

Observations

Mrs Smith sustained a fall last night in the hospital as she was attempting to get out of bed to the toilet. The fall was unwitnessed. She landed on the floor on her right side and could not get up. During the routine rounding, the night nurse found the patient lying on the floor. The night nurse conducted assessments and patient stated there was no loss of consciousness.

Mrs Smith weighs 106kg and was experiencing severe pain on movement post fall. Two staff members used the Hoverjack and Hovermatt to transfer patient to the bed. Upon further assessment, Mrs Smith complained of headache and swelling on the Right side of forehead was noted. GCS is 14 and she is alert but slightly confused. Mrs Smith currently has trouble mobilizing right arm and 5X5 cm bruise on the Right shoulder is observed.

Background

Mrs Smith has been living in aged care for 10 years. She has hearing impairment (uses bilateral hearing aids), loss of sight in right eye and impaired vision the left eye (wears glasses). Mrs Smith has hypertension (high Blood Pressure) and Diabetes, both being managed with medication. She suffers from urinary incontinence (urge incontinence). She has joint pain due to gout and decreased mobility due to hip surgery 6 months ago. She ambulates using frame under direct supervision of staff. She has aphasia due to Alzheimer's disease.

Assessment

Vital Signs:

Pulse rate: 76 bpm, (Normal 60-100bpm)

Respiration: 19 bpm, dry cough, runny nose, (Normal 12-20 bpm)

Saturation: 97% (Normal >95%)

Blood pressure: 118/ 76 (Normal 120/80)

Temp: 37.5°C (Normal Range 36.5°C-37.5°C)

Blood glucose level: 5.5 mmol/L (Normal)

Recommendation

Mrs Smith is reviewed by ortho specialist and will be reviewed by physiotherapist on the ward. Results are awaited for X-Ray of Right shoulder, hip and MRI Brain. Strategies to prevent further falls during current admission are placed.

Diagnosis: Mrs Smith has COVID-19. X-ray of hip and Right shoulder indicates no fracture. MRI doesn't indicate any abnormalities.

After reading the case study carefully, please answer the following questions based on the diagnosis given.

Question 1. Based on case study, identify three barriers to therapeutic communication and discuss in detail communication strategies you would implement to overcome each identified barrier to provide person-centred care to Mrs Smith. *(300 words)

*Discuss Minimum 2 strategies under each barrier considered

Question 2. Briefly discuss the components of Neurological Assessment for Mrs Smith (Physical Assessment Only) (200 words)

Question 3. Briefly discuss the components of Neurovascular Assessment (upper limbs only) for Mrs Smith. (Physical Assessment Only) (200 words)

Question 4. Briefly discuss the relevant musculoskeletal assessment for Mrs Smith. (Physical Assessment Only)