Order DescriptionReferencing will be APA, QUT style. Also about the referencing boundary its written in case study.
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1
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Written Assignment
Le
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t
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:
2
,
2
00
w
o
r
d
s
(
1
0%)
W
e
i
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h
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:
50
%
Lea
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O
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c
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As
sessed:
1
, 2, 3 & 5
Case Scenario
Mr
George
Jensen
, a
65
–
year old male,
was brought into Emergency Department with an open fracture of his right tibia and fibula
after falling from his roof while clearing the gutters.
The follow
ing data were obtained on his admission:
Objective Data
Past Med
ical Admission History
Social History
Weight 12
2 kgs
Height 190 cms
BMI 33
Diminished peripheral pulses
eGFR 78
mls/min/1.73m
Hb 11.3gms/dl
BP 155/100
HR 110
Diagnosed with type 2 diabetes mellitus 2 years
ago
–
on oral hypoglycaemics
Hypertension
Current Medications
:
Glibenclamide, 5mgs
, Mane
Captopril, 50mgs
,
BD
Simvastatin 40mgs, Nocte
,
Rantidine 150mgs, BD
Aspirin 75mgs, Mane
Has 3 children
and an
ex
–
wife
who live
out of state
;
Has been working as a real estate
agent 20hrs/wk.
Consumes
15units of alcohol/day
Smokes 20 roll
–
up cigarettes per
day for last 10 years
.
He was taken to theatre as an emergency case where he had an open reduction and external fixation of his fractures
.
He has returned to your ward
at
5.30am post
–
operatively.
You have arrived on the morning shift to find
:
ASSESSMENT DATA
His r
ight leg is cool to touch;
Pain Score is 7 on a scale of 1
–
10;
Fracture
site and pin sites
have
serous ooze
with
notable swelling of his
right
leg;
Blood glucose level of
17
mmols/ltr
;
His
post
–
operative
vital signs are
currently
, HR 107BPM, BP 104/55mmHg, temp 37.9°C Axilla, SaO
2
95%, FiO
2
6
ltir
es via Hudson mask, Resp rate 24
BPM
;
Hartmans solution running at 125mls/hr via
triple lumen central line situated in the right internal jugular.
Insulin and dextr
ose infusion running at 2mls/hr (2 units/hr)
;
Urine output via a Foley IDC is >1ml/kg/hr and dilute.
Applying your knowledge and understanding of Type 2 Diabetes, fractures and hypertension, you are asked to write an
academic essay applying the following
principles throughout your discussion:
1.
Explain
,
the
pathophysiology
of Mr J
ensen
’
s post
–
operative hypovolemia
and how
some
of
his post
–
operative
assessment
data might have contributed to this
.
In addition explain how the body might
compensate
for this
physiologically
(
a
p
p
r
o
x
i
m
a
t
e
l
y
8
0
0
words)
.
2.
Identify Mr
Jensen’s
actual
PRIORITY
problems
. Justify each problem based on the data collected from Mr
Jensen’s
assessment
data
(approximately 4
00 words)
.
3.
For each problem identified, describe
one (1)
nursing
goal for his care
(approximate
ly 200 words)
.
4.
Choose
two (2)
of the identified goals, and justify, with a synthesis and an analysis of
the
evidence
–
based
literature,
nursing
interventions
with rationales
to assist in ac
hieving the id
entified goals. (approximately 8
00
words)
.
ASSIGNMENT TIPS
The most important thing you must consider for this assignment is that it is sequential. This means you cannot answer the
questions out of sequence, the assignment won’t make sense to the marker if you attempt to do this. For exa
mple to answer Q3
you should have answered Q2 first and so on.
Q1:
Is asking you to consider how the stress of the operation might affect
his blood pressure
.
Q
2
:
I
s
a
s
k
i
ng yo
u to consider the
most important problems
–
remember
ABCDE.
Q3
:
Is asking you to identify patient centred nursing goals for the prob
lems you have identified from Q2
–
I would strongly urge
you to review the
PowerPoint on Goal Setting
as to how to write a c
oncise patient centred nursing goal.
Q4
:
Is asking you to only pick 2 of those nursing goals (any 2 the choice is yours) and using the literature provide an evidenced
–
based rationale as to why these interventions are appropriate in this case.
Minimum 20 re
ferences;
Can use books as references but maximum of 5 and must be no later than 5 years old;
Can use reputable medical/nursing based websites
–
5 maximum;
Can reference journal articles up to 10 years old;
The assignment is a case study so can use questio
n and answer format
–
no need for introduction and conclusion;
APA referencing as per QUT referencing policy.
