Reference no: EM133777486 , Length: word count:600

Care of the Person with an Acute Illness

Learning Outcome 1: Understand the pathophysiology and clinical manifestations of common acute presentations in the clinical setting.

Learning Outcome 2: Demonstrate a holistic approach to planning care for patients with an acute presentation.

Learning Outcome 3: Understand ethical and legal principles such as consent, privacy, open disclosure, and confidentiality.

Learning Outcome 4: Demonstrate proficiency in using a variety of risk assessment tools as outlined in the National Safety and Quality Health Services (NSQHS) Standards.

Assessment - Pre-operative Care Case Study Part

Assessment Task
This assessment is designed to further assess your knowledge of pre-operative nursing care. This assessment follows on from Assessment 1. From your analysis of the 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 a key 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 continue to examine the case study from Assessment 1. 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 principles 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:
Establish Goals
Take action

Instructions

To complete this assessment, you will need to examine and analyse the case study presented below and provide responses to the questions asked.
This assessment continues from Assessment 1 and now requires you to identify the appropriate nursing interventions and specific goals required for the patient problems identified in Assessment 1.

The case study is provided below for your further analysis.

Case study
Maria Russo 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 discovered by her neighbour.
Maria's medical history includes osteoporosis, prediabetes, and depression. She has recently been experiencing some orthostatic hypotension. She has no significant surgical history. Maria lives alone, her husband died 6 months ago. Her adult children live interstate.
Maria's current medications include Aspirin 75mgs daily, Citalopram 20mg, and Alendronate Sodium 10mg orally daily.
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 (irregular) Blood pressure: 104/70 mmHg Capillary refill: 2 seconds
Right leg shortened and externally rotated Right hip bruised and oedematous Right foot pink, cool, no paraesthesia or abnormal sensation, pedal pulse present.

Maria stated, "I can't remember what happened when I fell down. When I woke up on the ground, I could not get up."
Pain score: 5/10 on rest, 7/10 on movement Temperature: 35 C
Small laceration to right shoulder
Intravenous cannula inserted Cephalic vein Left arm Weight: 54 kgs Height: 174cm
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 to gain consent for surgery.
The Emergency Department is extremely busy, and Maria is positioned on a trolley in the corridor while she waits for the Registrar to come. Maria's neighbour, Francesco has arrived at the hospital and keeps asking you what is wrong with Maria and demanding to speak to the doctor. Maria is upset that she is going to require surgery and is worried about her pet dog, Bonnie, and who will care for her while she is in hospital.

Pre-operative Care Case Study Part II: 600 words
Surgical Consent: Discuss the Registered Nurse's role regarding informed surgical consent, confidentiality, and privacy in this scenario (120 words)

Pre-operative Care Short-term Goals:
Develop (4) short term goals to be achieved in the pre-operative period. These goals should relate to the problems identified in Assessment 1.
Discuss who must be involved in the development of these goals (80 words). What interdisciplinary professional may assist with achieving or setting the goal(s).
Nursing Interventions: Discuss the nursing interventions required to meet the identified goals and pre-operative patient problems (from Assessment
Provide a rationale(s) to support each nursing interventions (400 words).

Formatting
Use the Torrens Microsoft Word APA 7th Edition Template, which includes:
Title Page should be centred, bolded, and in title case and include the following items: 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, double spaced and a minimum of 2.5cm (1-inch) margins.

Structure
Headings to use for this assignment:
Surgical Consent
Pre-operative Short-term Goals (included in the table)
For each question, you should provide a brief separate heading, (please do not include the questions in the assessment).
Section 2: Pre-operative Short-term Goals must be presented in a table (see required table format above)
Ensure that your answers are concise and relate to the case study provided.

Referencing
(5) references are required for this assessment.
One of the references must be from one of your nursing course textbooks.
The other references must be related to the subject matter and not older than 7 years, including:
peer-reviewed literature
other credible sources: government documents, reports, publications, authentic webpages etc.
It is essential that you use appropriate APA style for citing and referencing research