Consider the patient situation Kristy Parkes is a 35-year-old woman who owns and runs a large cattle farm with her husba

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Consider the patient situation Kristy Parkes is a 35-year-old
woman who owns and runs a large cattle farm with her husband in
outback central Queensland. Together she and her husband have a
3-year-old son, Sam. Yesterday Kristy was thrown from her horse
whilst mustering cattle. She landed on her right side and hit her
head. She was not wearing a helmet. Her husband witnessed the event
and rang for help and Kristy was air lifted to Brisbane Hospital, 2
hours away by the care flight rescue team. On arrival to hospital
her X-rays showed she has fractured her pelvis in 2 places on the
right side, and her head CT scan shows some right sided cerebral
contusions. Kristy is intermittently confused. She remembers her
horse bucking and her falling off but does not remember the events
after her fall. She remains sometimes confused to place and time.
Her spine and neck have been radiologically cleared and she has no
neck pain. Kristy has no other medical history. She has been
administered intravenous (IV) morphine for her pain and is waiting
for surgery which is scheduled for tomorrow to repair her fractured
but stable pelvis. Her husband has had to remain at home to care
for their son and to continue to manage the family property.
Question 1: Using the Roper Logan Tierney (RLT) model of nursing
discuss the biological, psychosocial, spiritual and cultural
factors Kristy and her family may be experiencing following her
accident and injury. (500 words) Question 2: Explain the legal
concepts of consent, the doctrine of necessity and enduring
guardianship/NOK. Discuss how these legal considerations may or may
not apply to Kristy’s situation. (200 words) Question 3 Kristy now
has a valid consent for her surgery tomorrow. In preparing Kristy
for surgery, outline three (3) preoperative nursing actions that
are required and explain why they are required as part of her care.
(300 words) NRSG258 202230 Case Study continues… It is now the
following day. Kristy has been transferred from theatre recovery to
the ward post operatively following a 3-hoursurgery to repair her
fractured pelvis. The recovery nurse hands over to you that
Kristy’s surgery went well. There was a small amount of blood loss
of approximately 400mls intraoperatively. She received 500mls of
fluids intraoperatively and has been commenced on IV normal saline
(NaCl 0.9%) fluids in recovery, of which the first bag is currently
running. She had fentanyl, propofol and midazolam during the
procedure and a dose of IV fentanyl was also administered in
recovery for her pain. Upon arrival to the ward, you conduct an
assessment of Kristy and find the following: • Kristy is a little
drowsy but easy to rouse,she is orientated to person, however
confused to time and place. • Kristy is moaning that she “feels
sick”. • Her vital signs are as follows: pain score is 7/10; BP
105/74mmHg; PR 95bpm, regular; RR 15bpm; SpO2 97% on 4L O2 via
nasal prongs (NP); T 35.8°C • BGL is 6.5mmol/L. Her lower limb
assessment reveals the following: bilaterally cool feet, slightly
pale skin colour, and cap refill to both feet are 3 seconds. She is
able to move both feet and can slightly bend her knees on the bed.
She denies any numbness or pins and needles to both lower
limbs/feet. • Kristy has a honeycomb long Opsite dressing to her
right hip. The dressing is clean, dry and intact. Kristy is to
remain on strict bed rest until the physiotherapist reviews her
tomorrow. Question 4: Identify three (3) abnormal cues in Kristy’s
post-operative nursing assessment. For each of these cues, discuss
the pathophysiological or pharmacological factors that has resulted
in these abnormal findings.