Case Study Of Hip Replacement Care

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As the Australian population ages, nurses will play an important role in caring for older adults in the hospital setting. This demographic shift will mean that that nurses will care for adults over 65 more than any other patient group (Van Leuven, 2012). It is important for nurses to take the opportunity to think critically about the specific complex needs of older Australians and ensure they are practicing in a way that is safe, considered best practice and is aimed at bringing the patient back to health. This Essay, using the case study of Mr Dwight Simons will describe to the reader how a general nurse will care for a confused patient who has undergone total hip replacement surgery (THR) in an eight hour shift. In doing so this essay will …show more content…
The PQRST (Provocation, Quality, Region, Severity, and Time) tool is viewed as the gold standard in assessing, managing and documenting a patient’s level of pain (reference). After the nurse has established that Mr Simons pain has been managed a secondary survey should take place. It has been identified in the scenario that Mr Simons is confused, for this reason the nurse should ensure that he feels as safe and orientated as possible before beginning the assessment. Jarvis (2012) recommends that a nurse introduce themselves, explain what they are going to do and gain consent to perform the assessment. Literature recommends the use of a head-to-toe assessment as a secondary survey, as a systematic approach allows the nurse to gain a holistic understanding of the patient’s health in a relatively short amount of time with a low risk of missing any particular area (Boudreaux, 2014). Clarke (2014) recommends a secondary survey start with …show more content…
According to Chan (2011) the most common causes of confusion are; dementia, depression and delirium. Given Mr Simons has just had a THR, has a Fentanyl PCA running and his age it is possible that he is suffering with delirium (reference). Literature indicates that delirium is a common experience for older patients postoperative, with incidences reported as high as 61% (Russell-Babin & Miley, 2013). Delirium can be the presenting result of various underlying issues, including; dehydration, electrolyte imbalance, infection, medication or a head injury (Bush & Lawlor, 2015). Moreover, predisposing factors such as age and a history of depression can increase the risk of postoperative delirium (Russell-Babin & Miley, 2013). A nurse should aim to identify the underlying and predisposing factors that may be causing Mr Simons confusion and assist in treating the cause. An appropriate nursing intervention would be to collect a urine specimen through his IDC and test it with a dip stick for signs for of infection (reference). Neurological and integumentary assessments, as discussed previously can help to identify dehydration and neurological issues. Lastly, a history of psychosocial issues, such as depression relating to the death of his wife may be obtained by speaking to his next of kin. To promote Mr Simons physical safety, a nurse should ensure that his bed is low with the rails up and that he can easily

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