NRSG258: Principles of Nursing: Surgical Written Assignment Help
Question
NRSG258: This Principles of Nursing: Surgical Written Assignment for Australian Catholic University is a case study-based assessment. The student is provided with a surgical case study for a patient named Maisie Wilson based on which the student is supposed to answer certain questions. Through these answers, the student should analyze the clinical notes provided for the patient and demonstrate an understanding of nursing interventions related to surgical patient care. The student is required to write an essay answering the four questions mentioned in the task file. These questions relate to the pre-surgical challenges for the patient, investigations needed before the surgery, legal consent required, elaboration of two of the chosen medications, and lastly the biopsychosocial aspects that might influence the patient and her family.
Solution
The case study revolves around Maisie Wilson, 74, who was presented to the ED after an 8-hour fall at home. It was reported that she suffered a facial laceration and reported left hip pain. The ED notes indicated a need for spinal precautions. Her husband was present with her and her family was notified of all the necessary evaluations.
The solution incorporates a comprehensive essay providing an analysis and discussion of Maisie’s surgical case study. Our experts have written a well-structured essay elaborating on all four questions in detail.
The solution begins with a brief introductory paragraph to orient the reader to the case study and the aim of writing this essay.
Globally, the risk of fall is very high in geriatric patients, with a higher prevalence in females. Maisie, a 74-year-old female, was admitted to the emergency department via ambulance at 1620 hrs after a fall at home. She had a laceration to her left eyebrow and reported severe pain (6/10) to her left hip and (4/10) to her head. On assessment of Maisie’s injury, she was referred to the orthopedics department as she needed an open reduction and internal fixation of her fractured hip joint.
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The next paragraph provides an answer to the first question in this Written assignment based on a surgical case study. Here, our experts have remarked on all six of the pre surgical risks which Maisie is likely to face. Here, we have provided only a snippet of this total section written by our experts.
It is necessary to undertake an assessment of the preoperative risks before any surgical procedure. This helps to guide presurgical interventions and acute postsurgical care, thereby improving the prognosis of the patient (Skrejborg et al., 2019). Firstly, Maisie’s age itself is attributable to postoperative complications, hence a potential preoperative risk. This is because with increasing age, immunity of the body declines and comorbidities increase. Comorbidities lead to frailty that causes pathologic deterioration of physiologic systems. This makes Maisie vulnerable to intraoperative and postoperative complications. Assessments like the frailty index can be performed to assess the age-related risk factor (Amrok & Deiner., 2014). To assess the severity and intensity of Maisie’s fall, a general assessment like the Comprehensive Geriatric Assessment (CGA) can also be performed (Garrard et al., 2022). Secondly, Maisie has a history of osteoporosis, which leads to low bone density and an increased risk of fracture fixation complications like fixation failure (Goldhahn et al., 2010). This will lead to a poor prognosis. Hence, osteoporosis is a pre-surgical risk factor in Maisie’s case.
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Next, our experts have highlighted the aspects of legal consent which becomes necessary in such a critical surgical case. In addition to a comprehensive discussion of all the important concepts of consent related to legislation, Maisie’s situation is also assessed with respect to whether she can consent for her surgery or not.
Masie was admitted to the emergency department (ED) with a hip fracture. According to Lamont et al. (2019) any assessment or investigation must not be performed without obtaining an informed legal consent. Therefore, obtaining a legal consent from Maisie was mandatory before 4performing her assessment, investigation and surgery.
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In the following section, the experts have identified two medications which are deemed appropriate for Maisie’s case. Here, the answer written by our experts also demonstrate knowledge regarding the administration, side effects, appropriate dosage for the present case. You can read an elaboration of one of the medications below:
Maisie was feeling nauseated and it was triggered by neurotransmitters like serotonin which acts on the receptors located centrally in the area postrema and peripherally at the vagus nerve. Therefore, she was administered ondansetron (Griddine & Bush., 2022). Ondansetron is an antiemetic drug sold under the name “Zofran”, which is effective against nausea and vomiting. It will relieve Maisie’s symptoms by antagonizing the 5-HT3 serotonin-receptors present centrally and peripherally. While administering any drug in Maisie’s case, it’s necessary to analyse its side effects that the drug may have on her condition due to her age and comorbidities (Griddine & Bush., 2022). Firstly, administering ondansetron intravenously in Maisie’s case may cause arrhythmia, QTc prolongation, and alter her heart rate (HR) and blood pressure (BP). Secondly, Maisie may also experience side effects like headache, malaise, constipation, dizziness, and fatigue, elicited due to the drug. (Griddine & Bush., 2022). The dosage of ondansetron must be regulated. Hence it was very necessary to give the correct recommended dosage to Maisie that is 4 mg intravenously (Diana., 2020). Also, before administration of any drug, its contraindications must be taken in consideration to prevent any unnecessary metabolic response to the drug. Therefore, Maisie’s history related to medication and known allergies must be performed in order to rule out any chance of hypersensitive reactions.
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This paragraph delves into the last question for the Written Assignment based on a Surgical Case Study. This section discusses biopsychsocial aspects in detail, while also considering a holistic understanding for Maisie and her family members.
There are various biological and psychosocial factors like anxiety, depression and loss of selfconfidence that may affect Maisie and her family after the accident (Kenny et al., 2017). As per the Roper-Logan-Tierney (2000) (RLT) Model of Nursing, firstly, maintaining a safe environment is necessary to prevent accidents, but Maisie is unable to maintain a safe environment as she is disoriented and immobilized. She will need supervision and assistance by her family members to eliminate the safety hazards and maintain a safe environment for her. Secondly, Maisie was feeling anxious and attempted to move even after precautions were explained. This indicates the need for additional psychological support to relieve her anxiety and make her feel safe (Holland & Jenkins., 2019). Maisie’s husband is anxious and concerned, as her husband keeps blaming himself for her condition even after assurance. Hence, he must be kept informed and updated on her hospital care. Maisie has a responsibility of being a wife, mother and a grandmother, her condition may affect her ability to function normally in these family roles and change family dynamics.
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Lastly, a brief conclusion provides a summary of the entire essay.
This essay analysed Maisie’s case study by implementing critical thinking and clinical reasoning. Firstly, it identified and evaluated the preoperative risk factors such as age and comorbidities as well as the investigations required prior to surgery.
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