What are the general nursing problems for patients undergoing major orthopaedic surgery?
What do you anticipate may be post-operative complications for this gentleman given his co-morbidities?
Synthesize all information that has been collected and processed.
You need to consider Ivan’s priority problems and any actual or strong potential problems he may experience while in hospital, based on your assessment of him and your knowledge of the pathophysiology of his presenting condition and co-morbidities.
Consider the pre-operative, acute post-operative and recovery phase.
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As a nurse, what are your desired outcomes for Ivan?
Now you have identified his problems, you need to identify your goals of care for each problem using the SMART acronym.
What action/interventions will you do?
The next step is to consider what you will do and ensure your nursing interventions suit the context and are evidence based.
Assess the effectiveness of actions
Now think about your interventions and how you will evaluate them.
What have you learned from this experience?
Now consider what you have learnt and what you need to follow up with.
References:
AIHW, (2018), Australia’s health 2018, Retrieved 4/12/18 https://www.aihw.gov.au/reports/australias-health/australias-health-2018
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Workbook Questions
Complete the following questions in the provided template following the instructions in your task booklet.
• Do NOT replicate the questions, just identify by number.
• You must attempt all questions, incomplete papers will be asked to resubmit
• References must be provided – remember no reference provided = 0 marks.
• Include a reference list at the end.
• Word count is up to 2000 words; responses beyond this will not be marked.
• You will be awarded 10 marks (total) for academic writing and quality of references and reference formatting- see CRA in your task booklet.
1. Mr Jankovic has presented with severe osteo-arthritis requiring a hip replacement. Discuss briefly the pathophysiology of obesity and its link to Ivan’s arthritis. (2 marks)
2. When you watch the pre-operative videos, what communication issues do you observe? Critically analyse the situation and consider both the patient and the nurse perspective and what may have contributed to this? (4 marks)
3. Explain the importance of the pre-operative checklists and how these link to patient safety and the NSQHS standards? (2 marks)
4. State 3 risks to Mr Jankovic linked to his obesity pose when having a General Anaesthetic? Support your answer with contemporary literature. (3 marks)
5. You realise that Ivan has been given incorrect medication. He received the medication for the person in the next bed and has incorrectly received
• Metformin 500mg
• Gliclazide 5mg
• Aspirin 100mg
• Omeprazole 20mg
What are your immediate responsibilities as an RN to ensure Ivan’s safety? (1 mark)
What responsibilities do you have in regard to medication administration? Discuss this incident with relation to 2 of the NSQHS Standards. (4 marks)
6. Ivan becomes very confused and a little aggressive in the immediate post-operative period. He does not have a history of dementia or confusion. This is quite distressing for his wife, Marla.
Discuss what is happening here in relation to the case study patient and outline briefly 2 key areas of nursing management linking to the evidence.
(4 marks)
7. Effective and accurate clinical assessment skills are imperative for the nurse working with Ivan at all times. State 3 priority nursing problems and justify for Ivan in the acute post-surgical phase. Following left total hip replacement. Phrase your problem statements as “Problem related to cause” (3 marks)
8. For each problem state a goal in SMART format.
(no reference required for this response) (3 marks)
9. For each problem above, state 2 nursing interventions to address these and briefly justify. These interventions can be independent or collaborative. (6 marks)
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10. Based on the clinical priorities of care and short-term goals, state 2 means you would use to evaluate the outcomes of each intervention.
Justify with links to the evidence to support your answer. (6 marks)
11. Ivan is having difficulty voiding post-operatively. He is demanding to get out of bed post his hip replacement. He passes 120mLs into the urinal with difficulty. What further two assessments should you perform and state 2 nursing actions that may assist him? (4 marks)
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