CAP203 Care of the person with an acute illness: Pre-operative care Case Study

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 an important 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:

• EstablishGoals
• Takeaction

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 on 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 Romano 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 her daughter came home from work and found her.

Maria's medical history includes osteoporosis, glaucoma and she has recently been diagnosed with early dementia. She has no significant surgical history. Maria lives with her daughter Paulina and Paulina's husband, Sam.

Maria's current medications include Aspirin 75mgs daily, Alendronate Sodium 10mg orally daily & Latanoprost eye drops to both eyes nocte.

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 Blood pressure: 110/70 mmHg Capillary refill: 2 seconds

Right leg shortened and externally rotated Right hip bruised and oedematous

Right foot pink, cool to touch, no paraesthesia or abnormal sensation, pedal pulse present

Alert: orientated to time and place Pain score: 5/10 on rest, 7/10 on movement

Temperature: 35 C

Small laceration to lower left leg

Blood glucose: 9 mmol/L

Intravenous cannula inserted Cephalic vein Left arm

X-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 in the next 10 minutes to gain consent for the surgery.

Maria is accompanied by Paulina, who is clearly upset about her mother's hospitalisation. Paulina informs you that she is so worried about how thin Maria is. She is also concerned that Maria has been falling frequently over the past few months, she purchased a walking frame for Maria but she rarely uses it. You note that Maria is upset that she is going to require surgery. She is worried about her garden and who will water it while she is in hospital.

Questions

• Discuss the Registered Nurse's role regarding the issues related to informedsurgical consent, confidentiality and privacy that were identified in Assessment 1 (120 words)

• Develop four short term goals to be achieved in the pre-operative period. Thesegoals should relate to the problems identified in Assessment 1. Discuss who must be involved in the development of these goals (80 words)*
• Discuss the nursing interventions required to meet the identified goals and pre-operative patient problems (from Assessment 1). Ensure that rationales are provided for these interventions (400 words)*

*Answers to Questions 2 & 3 can be presented in a table (see a suggested format below)

Formatting

• Acover page must be included which includes; subject name and code, assessment number, student name, student number and word count
• Presentyour assessment in 12-point font, Arial or Times New Roman, 5 line spaced and a minimum of 2.5cm margins.
• Pagenumbers should be included in the footer along with student ID number

Structure

• For each question, you should provide a brief separate heading (please donot include the questions in the assessment).
• Answers to questions 2 & 3 can be presented in a table (see suggestedformat below)

• Ensure that your answers are concise and relate to the case study provided.Each question has been given an estimated word count to give you direction in the amount of information you need to 
• Bulletpoints can be utilised in your 
• You are not required to provide an introduction or conclusion for this

Referencing

5 references are required for this assessment. Use recent, relevant and reliable resources to complete this task. These should be peer-reviewed literature other credible sources (government documents, reports, publications, authentic webpages etc., related to the subject matter and not older than seven years

It is essential that you use appropriate APA style for citing and referencing research. Please see more information on referencing here Academic Skills webpage

Submission Instructions

Submit your Case Study into Assessment 2 submission link in the Assessment section found in the main navigation menu of the subject Blackboard site. A rubric will be attached to the assessment. The Learning Facilitator will provide feedback via the Grade Centre in the LMS portal. Feedback can be viewed in My Grades.

Submit your assessment as a word document (not protected) and not a pdf.

Academic Integrity

All students are responsible for ensuring that all work submitted is their own and is appropriately referenced and academically written according to the Academic Writing Guide. Students also need to have read and be aware of Torrens University Australia Academic Integrity Policy and Procedure and subsequent penalties for academic misconduct. These are viewable online.

Students also must keep a copy of all submitted material and any assessment drafts.

Special Consideration

To apply for special consideration for a modification to an assessment or exam due to unexpected or extenuating circumstances, please consult the Assessment Policy for Higher Education Coursework and ELICOS and, if applicable to your circumstance, submit a completed Application for Assessment Special Consideration Form to your Learning Facilitator.