Recognise signs of deterioration in a patient

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Reference no: EM133656463

Implement and monitor for a person with acute conditions

Assessment - Transitional Gap Assessment

I: Suraj is a 22-year-old male, DOB 24.9.2001, URN 001212, admitted to your ward via emergency following an MVA.
S: He has sustained a complicated fracture to his left (L) humorous, fractured ribs 5/6 (L) side, severe soft tissue damage to his (L) thigh, whiplash to his neck and multiple bruises and small lacerations.
B: Suraj was riding home on his push bike when he was hit by a slow-moving car. He was wearing a helmet and states no loss of consciousness (LOC). He has no significant medical Hx, takes no medications, and has Nil Known allergies.
A: Last observations 15 mins ago - BP 120/80, PR. 78, and RR. 16, T. 36.6, O2 Sats 100% with 2L O2 via nasal specs (96% on RA). His airway is patent, breathing is shallow, neurovascular obs to (L) arm NAD, and He is alert and awake with a GCS of 15, pupils 3-4. BGL 5.1 mmol/L. PQRST pain assessment - 3/10 (L) arm & 5/10 chest pain, analgesia last administered 15 mins ago. He has numerous small lacerations to his (L) side. He has been to radiology and his X-rays are available electronically.
R: The medical team request 2/24 observations, IV fluids running as ordered, leave splint to (L) arm insitu, for insertion of IDUC, analgesia as per chart, bloods to be collected as per pathology chart, sequential compression to be applied to (R) leg. Suraj is to remain fasting and on bed rest until surgery.
Suraj is a nursing student, has a part time job, and lives with friends, all his family reside in India. He has only been in Australia two months.

Question 1

An hour after his return, Suraj complains of feeling nauseous and has 7/10 pain in his ribs /chest.
For the following nursing diagnosis, provide
Two (2) nursing interventions (within your scope as an EN.)
For each intervention discuss the desired outcome
For each intervention, outline how you will evaluate if the intervention was successful
Nursing diagnosis:
Post-operative nausea related to GA
Increased pain in (L) side chest related to fractured ribs
You must provide a reference for your answer.

Question 2 Describe in your own words, how you would
a) Recognise signs of deterioration in a patient

b) Manage the escalating care of a patient
You must provide a reference for your answer.

Question 3

For each of the following interventions, outline two (2) types of nursing care, you could provide, within your EN scope of practice, specific to that intervention. See example provided below.
Changing a colostomy bag.
Removal of an indwelling urethral catheter.
Care of a suprapubic catheter.
Insertion of a nasogastric tube.
Removal of a nasogastric tube.
Care of a drain e.g., Bellovac Drain
Delivering a PEG feed.
Commencing a Nasogastric tube feed
Applying isolation procedures

Question 4 Identify 3 (three) considerations for Suraj's discharge

Reference no: EM133656463

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