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 : develop a diagnosis based on the information you are provided in the case scenario. Then explain the nursing intervention/care you recommend to help manage the issue and identify a member of the Multi Disciplinary Team (MDT) who could assist; and finally state what outcome you expect from the action you proposed, using SMART goals (Specific, measurable, achievable, realistic and timely) Question 1 Based on the information received in the case study, you need to make a plan of care for George. Use the template below to outline the anticipated care for George for his post-operative period, considering your EN Scope of Practice. For question you need to: Specify four (4) nursing diagnoses or risk factors associated with the client’s current health presentations. (Consider manual handling, strict resting in bed, post-operative vital signs, pain score and management, neurovascular and wound monitoring, Type ll Diabetes requiring close monitoring, smoker, risk of post-operative complications, self-care needs. Reflect on Maslow’s hierarchy of needs) Record at least two (2) nursing interventions that could be applied for each diagnosis, these interventions must be in lines with current best practice standards. Specify at least one (1) member of the multi – disciplinary team who may be able to support your suggested interventions. Note at least one (1) expected outcomes that you would hope for as a result of each intervention. (Consider SMART goals when discussing outcomes) Nursing diagnosis Planning – (Nursing intervention) Multidisciplinary member to provide support Expected Outcome

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