Kristy Parkes is a 35-year-old woman who owns and runs a large cattle farm with her husband in outback central Queenslan
Posted: Thu Mar 31, 2022 7:59 am
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. (800 words
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. (800 words