CAP203Careof thepersonwithanacuteillness:Pre-operativecare Case Study

AssessmentTask

This assessment is designed to further assess your knowledge of pre-operativenursing care. This assessment follows on from Assessment 1. From your analysis ofthe case studyyouwillanswer a seriesof questions.

PleaserefertotheTaskInstructionsfordetails onhowtocomplete thistask.

Context

The Registered Nurse plays an important role in the preparation of a person forsurgery. This assessment provides you with the opportunity to apply theory to aclinical scenario. To complete this assessment you will need to apply clinicalreasoning 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 providedtogether with your knowledge of pathophysiology, clinical manifestations and legaland ethical principles to the holistic nursing care of a person during the pre-operativeperiodofan acutesurgical admission.

You will need to use the following processes from the clinical reasoning cycle tocompletetheassessment:

• EstablishGoals
• Takeaction

Instructions

To complete this assessment, you will need to examine and analyse the case studypresentedbelowandprovide responsestothe questionsasked.

This assessment continues on from Assessment 1 and now requires you to identifythe appropriate nursing interventions and specific goals required for the patientproblemsidentified inAssessment1.

Thecasestudyisprovided belowforyourfurtheranalysis.

Casestudy

Maria Romano is a 76 year old woman admitted to the Emergency Department viaambulance. Maria fell when watering her garden and was unable to get up. She waslying in her garden for 3 hours until her daughter came home from work and foundher.

Maria's medical history includes osteoporosis, glaucoma and she has recently beendiagnosed with early dementia. She has no significant surgical history. Maria liveswithher daughter Paulina andPaulina'shusband,Sam.

Maria's current medications include Aspirin 75mgs daily, Alendronate Sodium 10mgorallydaily&Latanoprost eyedropstobotheyesnocte.

She was administered Intravenous Morphine and inhaled Methoxyflurane by theparamedics.

Assessmentdata:

Airway:patent

Respiratoryrate:18breaths/min Oxygensaturation:97%onroomair

Heartrate:90beats/min Bloodpressure:110/70 mmHg Capillary refill: 2seconds

Rightlegshortenedandexternallyrotated Righthipbruisedandoedematous

Rightfootpink,cooltotouch,noparaesthesiaorabnormalsensation,pedalpulsepresent

Alert:orientatedtotimeandplace Painscore:5/10onrest,7/10onmovement

Temperature:35C

Smalllacerationtolowerleft leg

Bloodglucose:9mmol/L

IntravenouscannulainsertedCephalicveinLeftarm

X-rays reveal an Intertrochanteric fracture of the Right femur. Maria is seen by theOrthopaedic surgeon and is scheduled for an Open Reduction and Internal fixation(ORIF) of the fracture. She has been placed on the Emergency Operating List. TheRegistered Nurse has just administered Intravenous Morphine 2mg and theanaesthetist has been contacted to perform a femoral nerve block. The orthopaedicregistrar willvisitMariain thenext10minutesto gainconsentforthesurgery.

Maria is accompanied by Paulina, who is clearly upset about her mother'shospitalisation. 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 fewmonths, she purchased a walking frame for Maria but she rarely uses it. You notethat Maria is upset that she is going to require surgery. She is worried about hergardenand who willwater it whileshe is inhospital.

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 beinvolvedin thedevelopment ofthese goals (80words)*
• Discuss the nursing interventions required to meet the identified goals and pre-operative patient problems (from Assessment 1). Ensure that rationales are providedforthese interventions(400words)*

*AnswerstoQuestions2&3canbepresentedinatable(seeasuggestedformatbelow)

Formatting

• Acoverpagemustbeincludedwhichincludes;subjectnameandcode,assessmentnumber,studentname,studentnumberand wordcount
• Presentyour assessmentin12-pointfont,Arial or Times NewRoman,5linespacedand aminimumof2.5cmmargins.
• Pagenumbersshouldbeincludedinthefooteralongwith studentIDnumber

Structure

• For each question, you should provide a brief separate heading (please donotincludethequestions intheassessment).
• Answers to questions 2 & 3 can be presented in a table (see suggestedformatbelow)

• 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 directionintheamountofinformation youneed to
• Bulletpointscanbeutilisedinyour
• You are not required to provide an introduction or conclusion for this

Referencing

5 references are required for this assessment. Use recent, relevant and reliableresources to complete this task. These should be peer-reviewed literature othercredible sources (government documents, reports, publications, authentic webpagesetc.,relatedtothesubjectmatter and notolderthan seven years

ItisessentialthatyouuseappropriateAPAstyleforcitingandreferencingresearch.Pleaseseemore informationon referencinghereAcademicSkillswebpage

SubmissionInstructions

Submit your Case Study into Assessment 2 submission link in the Assessmentsection found in the main navigation menu of the subject Blackboard site. A rubricwillbeattachedtotheassessment.TheLearningFacilitatorwillprovidefeedbackviatheGradeCentreintheLMSportal. FeedbackcanbeviewedinMyGrades.

Submityourassessmentasaworddocument(notprotected)andnotapdf.

AcademicIntegrity

All students are responsible for ensuring that all work submitted is their own and isappropriately referenced and academically written according to the Academic WritingGuide.StudentsalsoneedtohavereadandbeawareofTorrensUniversityAustralia Academic Integrity Policy and Procedure and subsequent penalties foracademicmisconduct.Theseareviewable online.

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

SpecialConsideration

To apply for special consideration for a modification to an assessment or exam dueto unexpected or extenuating circumstances, please consult the Assessment Policyfor Higher Education Coursework and ELICOSand, if applicable to yourcircumstance, submit a completed Application for Assessment Special ConsiderationFormtoyour LearningFacilitator.