10198 – Case Studies for Professional Discussion Table of Contents Overview of Case Studies...

hi i have attached the file i don't need references I need the context as per the case and rubric attached. there are diagonise and cases in next page


10198 – Case Studies for Professional Discussion Table of Contents Overview of Case Studies .................................................................................................................................................. 1 Case study 1 ...................................................................................................................................................................... 2 Case study 2 ...................................................................................................................................................................... 3 Case study 3 ...................................................................................................................................................................... 6 Case study 4 ...................................................................................................................................................................... 7 Case study 5 ...................................................................................................................................................................... 8 Overview of Case Studies. The following case studies will be used to assess students for the second assessment - Professional Discussion. Students will be allocated one of the scenarios at random on the day of the assessment by the marker. Where there are two scenarios related to a case study, only one scenario will be examined. For example: If allocated to the scenario of a person experiencing, or at risk for, impaired skin integrity the student will not be required to also outline to care of a person experiencing impaired elimination during the assessment. Students are encouraged to prepare for the assessment throughout the semester by completing the modules as guided by the marking rubric. Case study 1 • A person experiencing impaired oxygenation (Acute shortness of breath). • A person during a perioperative episode of care (Post-operative phase). Case study 2 • A person experiencing impaired tissue perfusion (Acute chest pain). Case study 3 • A person experiencing impaired tissue perfusion (Acute confusion). • A person with, or at risk for, an acute infection (Surgical Site Infection, Sepsis, and Antimicrobial Stewardship). Case study 4 • A person experiencing fluid imbalance (Bleeding, and Acute decrease in blood pressure). Case study 5 • A person experiencing, or at risk for, impaired skin integrity (Pressure injury prevention, and Invasive device management). • A person experiencing impaired elimination (Abdominal pain in the postoperative phase). 2 Case study 1 You are working a morning shift on the Orthopaedic Surgical Ward as a Registered Nurse (RN). Introduction Bob is a 59-year-old male, day 2 post right total hip replacement. You are walking towards Bob’s room to take routine vital signs when the visitor that was in with Bob comes rushing out for the room and heads straight to you saying that they are “worried about Bob, he seems really short of breath and not quite right…please come quickly”. You enter Bob’s room and note that the bed is in a supine position and Bob is holding onto each of the side rails in an attempt to sit upright. Situation Bob experienced a short episode of post-operative delirium which has now resolved. Since the surgery Bob has been experiencing significant acute pain issues at the surgical site and is under the care of both the orthopaedic surgical team and the Acute Pain Service. As a result of the delirium and ongoing pain issues, Bob has not been up out of bed since prior to the surgery. Yesterday the Acute Pain Service increased the bolus dose on the Fentanyl PCA with the view of commencing Bob’s physiotherapy regime this afternoon. During the morning round the Surgical team have confirmed that the plan is for mobilisation as tolerated this morning with a physiotherapy review this afternoon, Bob had expressed to you that he was worried that it might make the pain worse. Background Medical History • Osteoarthritis o Usually takes Panadol® Osteo TDS Social History • Bob is a current smoker and a social drinker, o Bob tells you “that he usually has a few too many drinks on the weekend after golf”. • Bob lives by himself in Queanbeyan and is estranged from family. Assessment Airway • Patent Breathing • Spontaneous effort • Sp02 85% on room air • Strong productive cough. Circulation • Dual Heart sounds • Peripheral pulses thready, regular • Cap refill >3 secs. • NIBP 128/62 (84) mmHg (usual SBP 120mmHg) • HR 123/min. • Tympanic Temperature 37.7°C Disability • GCS 15 (E:4, V:5, M:6) • Restless/Unsettled • Blood Glucose Level 5.4 mmol/L • States to have mild feeling of nausea. Exposure • Pale and diaphoretic • Cyanosis to lips and peripheries • IV Cannula to right cubital fossa. o Plasma- Lyte 148 infusion continues at 100ml/hr. • Dressing to surgical site intact. • Haemoserous fluid to drain o approx. 100mL in total o 5mL since last hour • IDC insitu, draining >0.5ml/kg/hr, straw coloured urine. • Pain at surgical site 6/10, o PRN Paracetamol charted. 3 Case study 2 You are the registered nurse receiving handover, from an ambulance crew, for a new patient admitted to your ward. Introduction Aaron is a 48-year-old male, transferred by ambulance from work. Situation Whilst at work today Aaron experienced severe nausea and vomiting, followed by a syncopal episode. Noting the events Aaron’s colleagues promptly called an ambulance, explaining to the call operator that Aaron appeared to be “greyish in colour and sweaty”. During the ambulance transfer: • An IV Cannula was inserted to his right cephalic vein • Aaron experienced sudden onset, sharp central chest pain, scored 5/10 on examination. o No other changes to his vital signs were observed. • 12 lead ECG was performed, showing