Critical Thinking

Topics: Stroke, Atrial fibrillation, Vomiting Pages: 5 (1005 words) Published: June 20, 2013
CRITICAL THINKING SCENARIO

AN ASSIGNMENT ON
MRS. AUDREY SMITH

STD NAME : VIPIN ABRAHAM VARUGHESE GROUP : THIRD DUE DATE : 07/06/2013 STUDENT NO : 12185
INTRODUCTION

During my duty time at 1400 l had taken hand over about Mrs. Audry Smith,she is a 75 year old lady admitted to emergency department and she was diagnosed with fractured left NOF, soft tissue injury,brusng left shoulder and small hematoma to her left fore head,she was also scheduled surgery for arthroplasty- L hip after three hour

Nursing documentation
Identification data

Name : Mrs. Audrey Smith
Address : 440 Collins St. Melbourne Vic 3000
DOB : 31/12/38
Age : 75 years old
Diagnosis : Fractured left NOF (neck of femur)

Past Medical History
1 AF
2 Hypertension
3 L CVA -2008
4 NIDDM - 2OO8
5 GORD
6 Osteoporosis
7 Total hysterectomy – 1995
8 Depression -2011

Allergies
Bactrim.

Social history
1 Husband died in 2010.
2 One adult daughter sees infrequently.
3 Council home care once per fortnight.
4 Attends Senior Citizens once per week with her neighbor. 5 Social drinker.
6 Non-smoker x 25 years.

NURSING INTERVENTIONS

I. COMFORT AND SAFETY.

1. Assess the patient level of consciousness, the positioning of limb and spine ,site where the pain is experienced or patent feeling cold. 2. Provide pre-operative analgesia within prescribed limit. 3. If the patient is hypo thermic space blanket is employed to increased body temperature. 4. Monitor patient experienced nausea or vomiting either because of anesthetic use or head injury 5. To reduce the risk of further fall ensure the side rails in proper position. 6. Provide appropriate position change use of draw sheet and transfers. 7. It is important that injured area be kept as still as possible, if necessary support injured area with sling or brace 8. Keep the vomiting bowel near to the patent to reduce risk of retching or head to reach of vomiting bowel 9. Make sure that patient can able to use nurses call if patient need any help.

II. HYGIENE.
1. Ensure hand hygiene before and after attending patient . 2. A patient bath may be given at any time according to patient need and also provide back care to prevent further complication . 3. Clean the wound and dab a bit of antiseptic ointment to keep out jams and cover the wound with adhesive dressing . 4. Catheter care should be provided to prevent infection if any sign of infection immediately report to physician. 5. Strict standard of care and monitoring for IV site and exchanging peripheral site at lest every 72 hours according to INS standard

III. NUTRITION.

1. Increased fiber intake like daily addition unprocessed bran to make stool longer and softer. 2. Asses the patient signs and symptoms of dehydration and fluid aver load . 3. Assess the ability of swallowing and manage diet according to the patient swallowing capability . 4. Provide foods rich in vitamin C to enhance wound healing. 5. Provide foods rich in calcium and vitamin D to prevent further bone weakening. 6. Continue IV fluid till she can able to meet sufficient oral fluid intake intake

IV. ELIMINATION.

1. Monitor intake and output is a...
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