Posted: February 2nd, 2022

NRSG258 2021 Assessment 1- Case Study
Incident: 72 yr

NRSG258 2021 Assessment 1- Case Study
Incident: 72 yr old female Mrs Geraldine Berry sustained left fractured neck of femur (#NOF) and laceration to her head 5cm while walking her dog. Tripped on an uneven pathway.
PMH: Hypertension and depression Current Medications: Coversyl 5mg
Doxepin 25mg daily
Atorvastatin 40mg daily
SHx: Lives with elderly husband. Is the primary carer for elderly husband who has had a stroke previously and is mildly impaired. Attends church every Sunday and is responsible for arranging flowers for every Sunday service. She has started volunteering at the St Vincent De Paul’s Meals on Wheels distribution centre two days a week. She lost two children 5 years ago in a car accident. Geraldine is concerned who will look after her husband and their dog Nala. Geraldine and her husband have no children or relatives nearby.
Current presentation
Day 3 post op left total hip replacement, increasing pain in hip unable to weight bear, pain score currently 7/10. Geraldine has been prescribed oral tramadol tds, Ibroprofen prn, paracetamol prn, IV Amoxicillin 1000mg tds and Clexane 40mg SC BD. Suture line on hip appears red and swollen.
Observations – 10am Day 3
Pulse Rate – 120
Respiratory rate – 22
Blood pressure – 120/80
Pain score – 7/10
Sa02 – 96%
Temperature – 39.1
BGL – 6.8 mmol/l
Glasgow Coma Score 15
Heat, pain and redness at suture site Refusing to mobilise due to pain
NRSG258 Version 1 Feb 2021
Questions
1. Using the CRC and the information presented about Geraldine, identify the abnormal cues, and discuss why these are considered abnormal (200 words) (LO4).
2. Using relevant literature, discuss the pathophysiology related to the two post- operative issues of concern from the abnormal cues you have identified in question one (500 words) (LO1, LO4).
3. Using the template provided below, complete all the sections which include (200 words) (LO4, LO5):
a. b.
Identify the nursing goal for each identified issue/problem (2). List at least two nursing interventions for each issue/problem.
Problem Goal Interventions 1.
2.
4. Using relevant literature, provide a rationale for the listed interventions and discuss how the interventions will be evaluated (500 words) ( LO1, LO3, LO4, LO5).
5. Identify 2 medications that were prescribed for the patient’s pre-operative condition. (Coversyl 5mg, Doxepin 25mg daily, Atorvastatin 40mg daily) used in this case study. Provide the mechanism of action, side effects correct dosage and contraindications for each medication. Explain how this might affect Geraldine in the post-operative period (400 words) (LO1, LO3, LO4, LO5).
6. Using the Roper-Logan Tierney Model, identify one (1)
potential cultural/biopsychosocial issue/problem and discuss how this will affect the patient post-operatively or on discharge (200 words) (LO3, LO2).
NRSG258 2021 Case Study
Mrs Geraldine Berry, 72, had a left neck of femur (#NOF) fracture and a 5cm laceration to her head while walking her dog. I tripped on a bump.
Current Medications: Coversyl 5mg
25mg Doxepin
40mg atorvastatin
SHx: Husband is elderly. Her elderly spouse has suffered a previous stroke and is moderately affected. Attends church every Sunday and arranges flowers for every service. She now volunteers twice a week at St Vincent De Paul’s Meals on Wheels distribution center. They died in an automobile accident 5 years ago. Geraldine worries about her husband and their dog Nala. Geraldine and her spouse don’t have kids or relatives.
Currently shown
Today is day 3 post-op left complete hip replacement with growing discomfort and incapacitation. Geraldine is on oral tramadol tds, Ibroprofen prn, paracetamol prn, IV Amoxicillin 1000mg tds, and Clexane 40mg SC BD.
10am – Observations
120 bpm
RH – 22
120/80
7/10 for pain
96 % Sa02
39.1
6.8 mmol/l
Coma Glasgow 15
Heat, pain, and redness at suture site Painful movement
NRSG258 Feb 2021
Questions
1. Identify the abnormal signals and explain why they are abnormal using the CRC and information about Geraldine (200 words) (LO4).
2. Discuss the pathophysiology of the two post-operative concerns of concern indicated in question one (500 words) (LO1, LO4).
3. Complete the following sections (200 words) (LO4, LO5):
a. b.
Determine the nursing aim for each issue/problem (2). For each issue/problem, list two nursing interventions
Problem Goals 1.
2.
4. Explain the rationale for the mentioned initiatives and how they will be assessed (500 words) ( LO1, LO3, LO4, LO5).
5. Indicate the patient’s pre-operative drugs. Used in this case study: (Coversyl 5mg, Doxepin 25mg, Atorvastatin 40mg). Indicate the drug’s method of action, adverse effects, dosage, and contraindications. Explain how this may affect Geraldine’s recovery (400 words) (LO1, LO3, LO4, LO5).
6. Identify one Roper-Logan Tierney model (1)
• Discuss the patient’s post-operative or discharge cultural/biopsychosocial issues/problems (200 words) (LO3, LO2).

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