Assignment Task

Scenario

Mrs. Sophie Joseph is an 85-year-old woman who was admitted to ED at 1800 with a history of unwitnessed fall. She was found on the floor by her son. She was unable to stand up. In ED she was found to be in excruciating pain. Her left leg appeared to be shortened and internally rotated. It was noted she had multiple bruising over her left arm and face and a 4 cm laceration to her left lower arm. She was administered intranasal Fentanyl 100 mcg by the Ambulance crew.

Her Vital Signs: BP – 157/77 mmHg, HR – 128

peats/min – Irregular, RR – 28/min, SpO2 – 99%

RA, temp – 37.2C

GCS – E3V4M6 = 13/15.

Regular Medication

Apixaban 2.5mg BD PO

Thyroxine 50 mcg Daily PO

Amiodarone 100mg Daily PO

Metoprolol 25 mg BD PO

Medications Administered in ED

Bupivacaine + fentanyl femoral block

Panadol 1 g PO

Diclofenac 50mg PO

Morphine 5 mg IV

Mrs. Sophie Joseph had blood taken. She had also done chest x-rays, which were NAD, and Left hip XRay which revealed neck of the femur.

A CT scan of her head has been ordered, which is yet to be done.

A — Allergies — Penicillin

M —- as mentioned above

P — Hypothyroidism, HTN, AF, IHD, multiple falls

L — Last ate around noon

E — Events — Does not remember events leading to the fall

The critical discussion paper should address the following issues:

1. What data deviate from normal findings, suggesting the need for further investigation?

2. What additional information should the nurse ask or question for?

3. Describe the patient’s presenting problemfocusing on the pathophysiological issues.

4. Identify 2 nursing diagnosis that needs immediate interventions and discuss the nursing management appropriate for the patient and evaluations of the nursing management plans presented in the literature.

5. Explain the pharmacokinetics of the prescribed medications in ED and their indications.

6. Discuss nursing management of the prescribed medication in ED, the adverse effects of the medications, contraindication, and side effects, with the age of the patient in mind, using evidence-based literature.

7. Describe in detail the information you would share with the patient and how you will educate the patient about the interactions and long-term effects of the regular medications of Mrs. Sophie Joseph after the acute problems are solved.