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Original Question
I WANT IN-TEXT CITATIONS AND REFERENCES AND NO PLAGIARISM PLEASE Scenario: Luke Parker, a 23-year-old male sustained an injury during his AFL tryouts. He was diagnosed with a comminuted fracture of the shaft of his Right tibia. He underwent an Open Reduction and Internal Fixation (ORIF) with Interlocking Intramedullary nailing and bone grafting. The rehabilitation protocol involves strict immobilization for 6 weeks after surgery. The doctor has also advised him to quit smoking. Below is a picture of his postoperative X-ray. Always being an avid footy fan, he is depressed that he has to lay in bed for a long time and cannot play anymore. He and his family are orthodox Christians. His father explains to him that God has better plans for him. Now take a look at the timeline of events that occurred that day. 10:00 am- Pt shifted to OR room 12:00 noon – Pt shifted to recovery 12:30 pm – Pt shifted to the post op ward where you work. Vitals at the time of clinical hand over: BP: 110/70 mm of Hg Temperature: 36.7`C Pulse: 90/min Respiratory rate: 16/min Oxygen sat: 97% of SpO2 on RA Drain: 30 ml, dark red GCS: 14/15 The PACU nurse mentions that the following drugs have been administered before shifting: Inj Amoxicillin 500mg IV at 12:25 pm Inj. Metoclopramide 10mg IV stat at 12:25pm Inj. Morphine 2mg IV stat 12:20 pm Vitals at 12:45 BP: 100/70 mm of Hg Temperature: 36.7`C Pulse: 112/min Respiratory rate: 10/min Oxygen sat: 89% of SpO2 on RA Drain: 30 ml, dark red GCS: 12/15 1. Identify risks and likely impacts the surgery has on Luke’s ADLs. What healthcare is required here? 2. Identify the problems/signs and symptoms that Luke has in the following aspects, and work with Luke and his father to plan strategies/interventions to address all of those problems, using the template below. Ensure the strategic care planning is appropriate to Luke’s needs including: – Physical – Emotional – Spiritual and/or Religious – Psychosocial aspects Nursing Care Plan Template Problems/signs and symptoms Physical: Emotional: Spiritual and/or Religious: Psychosocial Needs: Planned strategies/interventions 3. (a) When and how do you raise issues of concern about Luke’s deterioration? b) How would you communicate all deterioration concerns to the relevant healthcare staff? 4. Determine the interventions you should take to manage Luke’s deterioration, and provide the rationale for your decision based on principles of contemporary, evidence-based practice and risk assessment 5. Given that Luke’s leg is now immobilised in a Plaster of Paris Cast, state at least five (5) aspects of Luke’s legs you would assess to determine his neurovascular status of the limb 6. The best practice includes undertaking the risk assessments and providing relevant nursing interventions to minimise those risks and prevent harm or an adverse effect occurrence. Describe what risk assessments and relevant interventions you would undertake to care for a patient with a POP Cast like Luke, and explain briefly the rationale for your practice. 7. If you find a discrepancy between the prescribed plan of care and the nursing care plan, what should you do and with whom should you consult? 8. State three (3) measures that you would use including working with Luke and his father to review and evaluate whether the planned nursing care meets Luke’s needs.
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