Aim:

The aim of this assignment is for students to demonstrate an understanding of the theoretical knowledge to plan effective evidence-based, person-centred care for a client with an acute medical or surgical condition, as part of the role of the Registered Nurse.

This assignment addresses the following learning outcomes:

1. Develop a plan of nursing care for the person with an acute illness, identifying areas for collaboration with the family and other health disciplines;

2. Demonstrate reflective, evidence-based nursing practices for clients with acute medical/surgical conditions in a range of clinical settings, which is consistent with NMBA nursing standards;

3. Demonstrate the principles of reflective practice;

Task Description:

For this task you need to write approximately 1500 word essay in which you discuss the assessment of a post-operative client (Mrs Grace Potter; see below) and develop a comprehensive care plan to address the nursing care priorities including ONE priority which is EITHER Postoperative wound infection OR Post-operative deep vein thrombosis (DVT).

Task Instructions:

You MUST include the following information in your essay:

Introduction (approximately 100 words)

• Introduction should contextualise and identify the aim of the assignment.

Body (approximately 1300 words)

ESSAY WRITING_ ASSESSMENT

1. Discuss the risk factors and pathophysiology of the chosen health concern for Mrs Potter. (100 words)

2. List and discuss four (4) components of an initial post-operative assessment you (RN) would undertake for Mrs Potter. Provide a rationale for each assessment relating to Mrs Potter's conditions and justify with evidence-based literature. (300 words)

3. Identify TWO (2) priorities of nursing care to meet Mrs Potter's needs identified in your initial post-op assessment. Also provide a rationale for why these are a priority. One nursing care priority to be discussed must be DVT OR post-operative wound infection prevention. (50 words each priority)

4. Provide a comprehensive care plan to address the identified TWO (2) nursing care priorities. Use evidence-based literature to justify why each intervention is likely to be appropriate for Mrs Potter. (750 words)

5. Use Gibb's Reflective Cycle as a framework to demonstrate how you would reflect on the process of managing the chosen post-op potential health concern and what you have learnt from designing the plan. This section can be written in first person. (100 words)

Conclusion (approximately 100 words)

The conclusion should give a brief summary of the main points of the essay. [Approx. 100 words]

CLIENT SCENARIO:

Mrs Grace Potter is a 67- year old woman who presented with rheumatoid arthritis of the right hip. She has been a client of her local General Practitioner and has been medically managing her pain for the past 8 months. Due to worsening pain and decreasing mobility, Grace was referred to a surgical specialist and requires a total hip replacement (THR). Grace has a history of hypertension, hyperlipidaemia and poorly managed Type 2 Diabetes requiring oral hypoglycaemics.

Grace is widowed and lives alone, but has a son who lives nearby and is in regular contact. Grace lives in her own home, which has six steps at the front, and is usually able to do all her own activities of daily living (ADLs) and household work independently. Recently Grace has been having difficulty with her ADLs and with general mobility due to pain in her leg.

Grace has just returned to the orthopaedic ward post total hip replacement (THR) surgery. She has IV Normal Saline 0.9% running. She is drowsy but rousable and is complaining of pain
(rating 7/10). Her vital signs on arrival to the ward are: BP 145/70, HR 105bpm, temp 35.9 degrees, SpO2 99% on 8 litres of oxygen via a Hudson mask.

She has a dressing on her right hip that is intact, but there is a small amount of blood oozing out. She has a Redi-vac drain in situ that contains 50 mLs of frank coloured blood. She also has patient-controlled analgesia (PCA) in situ. A Charnley pillow (foam abduction pillow) is used. You have been allocated to care for Grace.