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
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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 …show more content…
A strict fluid balance chart should be continued and any adverse assessment findings should be documented and reported. Secondary complications that occur in patients who have undergone a THR include; infection, pulmonary complication and venous thromboembolism (VTE). It should be a priory of the nurse to implement prophylactic strategies that will not only assist Mr Simons in returning to health as soon as possible, but to avoid secondary problems that may deteriorate his health further. Strategies suggested by Burscough & Smith (2009) employed to prevent secondary infections associated with hospital stays include; five moments of hand hygiene, aseptic techniques for catheter and wound cares and administering all antibiotics prescribed by the medical team. Pulmonary complications are the leading cause of mortality and mobility for postoperative patients, common severe complications include; pneumonia, a lobular collapse, pneumonitis and respiratory insufficiency (Bergin et al., 2014). To help prevent these complication and achieve effective inspiration an incentive spirometry deceive should be given to Mr Simons and the nurse should educate him how and why to use it when he is in a pain
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 …show more content…
A strict fluid balance chart should be continued and any adverse assessment findings should be documented and reported. Secondary complications that occur in patients who have undergone a THR include; infection, pulmonary complication and venous thromboembolism (VTE). It should be a priory of the nurse to implement prophylactic strategies that will not only assist Mr Simons in returning to health as soon as possible, but to avoid secondary problems that may deteriorate his health further. Strategies suggested by Burscough & Smith (2009) employed to prevent secondary infections associated with hospital stays include; five moments of hand hygiene, aseptic techniques for catheter and wound cares and administering all antibiotics prescribed by the medical team. Pulmonary complications are the leading cause of mortality and mobility for postoperative patients, common severe complications include; pneumonia, a lobular collapse, pneumonitis and respiratory insufficiency (Bergin et al., 2014). To help prevent these complication and achieve effective inspiration an incentive spirometry deceive should be given to Mr Simons and the nurse should educate him how and why to use it when he is in a pain