Scenario – Mr George McFarlane I: Mr
Scenario – Mr George McFarlane I: Mr George McFarlane is a 53year old Male. S: George has presented to hospital yesterday after he fell while getting out of his truck. The X-ray on admission showed that George has sustained a compound fracture of his right ankle, which required an open reduction and internal fixation (ORIF) to repair. Surgery was completed this morning and George has returned to the ward from the Operating theatres 2 hours ago. B: George’s past Medical History (PMHx) include: Type ll Diabetes needing close management. Records BGL daily Osteoarthritis in L) Knee Allergy to Penicillin Social History (SHx): Married for 5 years to Yu Yan, who is of Chinese heritage. She speaks English well. Has a 26 year old son from a previous marriage, who has depression and uses illicit drugs. The son visits occasionally. Lives with his wife and 3 year old twins from his current marriage. One twin has a developmental disorder. His 17 year old step son also lives with the family. Occupation: Long Haul truck driver, often isolated from family and friends as on the road and away from home due to work. Speaks to wife daily when away. ETOH (Alcohol) usage on a regular basis Smoker, averages 15 cigarettes per day Often consumes take away/ fast food diet as away from home regularly Sedentary lifestyle, often watches TV to cope with stress. Little to no exercise A: Mr McFarlane is 118kg and 180cm in height. Current vital signs Resp 26, O2 Sats 97% on room air (RA), BP 170/90, HR 110, Temp 37. R: Continue 2 hourly observations, including monitoring neurovascular observations and pain scores. Elevate right foot. Strict resting in bed until review by doctor tomorrow. Q1: While you are completing George’s post-operative observations, he states that he is feeling tight in the chest and a little breathless. A. Explain what you think might be happening to George. Provide a rationale for your response. (provide an explanation of what you think might be happening to George based on the symptoms he is describing.) treat it as heart attack until proven otherwise as per protocol) B. When you report the situation to the RN, they request that you record a 12 lead ECG on George , describe the steps in completing a 12 lead ECG (remember to include in your response dignity and privacy considerations) (Provide step by step instructions on how you would Do 12 lead ECG. In explanation, consider the client’s privacy and dignity.) Reference required. Q2: After completing the 12 lead ECG and review by the doctor, it is determined that George’s chest tightness is not cardiac related. The doctor has requested that you collect a sample of blood to determine what may be the cause of George’s symptoms. , describe the steps in completing venepuncture (remember to include dignity, privacy and safety considerations) Reference required. (Provide step by step instructions on how you would collect a sample of blood using venepuncture. In explanation consider the client’s privacy, dignity and any safety concerns for you and your client. ) Q3: George is for strict rest in bed after his surgery. Outline three (3) ways you could encourage George to remain as independent as possible while attending to his activities of daily living (ADLs) (Consider how you can encourage George to be independent in completing his ADLs while remaining resting in bed. Provide three (3) ways George could complete be independent.) Q4 : Other than an EN/ RN, name three (3) health care professionals found in a hospital setting that you might be able to refer George to for assistance with his current healthcare requirements and his previous comorbidities. For each professional, state how they could contribute to Mr. McFarlane’s care. Reference required. (you need to know what George’s issues are and the types of professionals who may be able to provide specialist advice or support for him. Ensure you outline how these health professionals can assist George.)
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