• April 7th, 2016

Med-Surgical Assignment

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Task description: 1. Consider the following client scenario: Ruby Kuān ɡǔ, a 75 year old woman, presents to the ED via ambulance from an aged care facility, with a history of having a fall in the shower. Miss Kuān ɡǔ is unable to put weight or pressure on her left side hip and has shortening of the left leg. She smokes 10 cigarettes a day, has no allergies and takes Perindopril (Coversyl) 4mg. She states that she has severe 9/10 pain on her left side surrounding the hip and groin region and there is notable bruising of the left hip area. On arrival to ED, Miss Kuān ɡǔ is mildly febrile (temperature 37.8 C), and has the following vital signs: BP 140/ 70, HR 100 bpm and a GCS of 15. Intravenous fluids (N/Saline @ 125 mls/hr) have been commenced and a Penthrox (Methoxyflurane) stick has been given for pain by QAS prior to her transfer to hospital. Her BMI is 40, and her skin is slightly clammy and tissue paper thin. The Waterlow Pressure risk assessment score is 16. Following open reduction and internal fixation for repair of #NOF (neck of femor), Miss Kuān ɡǔ is to be admitted to the surgical ward for post – operative pain management and continuous intravenous fluid rehydration and antibiotics. 2. Choose one of the topics listed below. 3. Search the literature for at least five recent [less than five years old] research journal articles or systematic review papers related to the topic you have selected. 4. Summarise key points from those sources in a table (exemplar shown below). 5. Use the APA 6 Referencing style and the School’s assignment formatting guidelines https://sites.google.com/a/griffith.edu.au/nursing-writing-and-referencing-guide/ 6. Write an essay of 1500 words in length that addresses the questions listed in your chosen topic. Use current evidence to support your discussion on the topic. 7. Refer to the marking criteria to see how many marks are allocated to each section and to get further information on the assignment structure. 2 TOPICS: Choose ONE A. POST OP INFECTION – WOUND SITE MRSA (methicillin-resistant Staphylococcus aureus)  What is the pathophysiology of post-operative MRSA infection development in a client with Ms Kuān· ɡǔ’s risk factors (in other words what might go wrong to cause a MRSA wound infection and why)? Support your claims with relevant literature.  From your analysis of the literature you have reviewed in your table, discuss and justify your plan to· prevent a post-operative MRSA infection in this client (ie. Make a case for what is best practice based on your reading, and provide supporting evidence to back it up).  Compare any conflicting views you find in the literature and construct an argument for what you think is· best practice in this particular situation.  Discuss the education that may be needed for the client.·  Discuss any inter-professional collaboration that may be required to prevent pressure injury in this client.· B. DVT (DEEP VEIN THROMBOSIS)  What is the pathophysiology of DVT development in a client with Ms Kuān ɡǔ’s risk factors (in other· words what might go wrong to cause DVT and why). Support your claims with relevant literature.  From your analysis of the literature you have reviewed in your table, discuss and justify your plan to· prevent DVT in this client (ie. make a case for what is best practice based on your reading, and provide supporting evidence to back it up).  Compare any conflicting views you find in the literature and construct an argument for what you think is· best practice.  Discuss the education that may be needed for the client.·  Discuss any inter-professional collaboration that may be required to prevent DVT in this client.·

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