You need to assess, plan, prioritise and provide care for Mr Simons who has just undergone a total hip replacement to treat a fractured neck of femur of his right leg.
You are a registered nurse working on an Orthopaedic ward. Mr Dwight Simons, 67 years, isbeing transferred to you from the Emergency Department via operating theatres. You need toassess, plan, prioritise and provide care for Mr Simons who has just undergone a total hipreplacement to treat a fractured neck of femur of his right leg.Mr Simons waited in the Emergency Department 12 hours for surgery. Prior to this he waslaying where he fell, on the floor at home, for 18 hours before help arrived. Mr Simons is asemi-retired pharmacist and has been working 3 days per week. His wife died earlier this yearand he now lives alone.On arrival to your ward, Mr Simons is confused but otherwise in a stable condition. He hasan IV cannula in situ right lower arm, with IV Normal Saline running at 40mls/hr and aFentanyl PCA. There is approximately 200mls left in the IV bag. His GCS is 14 and hispupils are equal & reactive. His blood pressure is 137/78 mmHg, his pulse is 87 bpm and heis afebrile at 36.6 degrees. The surgical incision is dressed with minimal strikethrough. Thereare 2 Belovac drains that are patent and draining from the incision site- a total of 500mlsemptied in operating theatres. His integument is otherwise intact but you notice a large bruiseand swelling on his (R) temple – the theatre nurse explains that his head was bumped duringthe transfer from the operating table to his bed. His IDC is patent and draining a strongyellow coloured fluid.Mr Simons is awake but appears confused. He is able to remember his date of birth butcannot recall why he is in hospital or what day it is. He keeps trying to sit up even though hehas been frequently reminded not to. He keeps dropping his PCA button and asking staff tocall his wife to come and pick him up.Task: Your task is to write an essay of 2000 words in which you explain the decisions youwould make in assessing, planning and prioritising the care of Mr Simons. You are to assumeyou are the Registered Nurse assigned to care for him for the duration of an 8 hour shift. Inthe essay you need to:1) Identify & prioritise the nursing care of Mr Simons2) Describe, prioritise and provide a rationale for the nursing assessments you willundertake3) Describe, prioritise, and provide a rationale for the planned care of Mr Simonsthat demonstrates client centred care Ensure that you use relevant academic literature to support the decisions you wouldmake in order to provide an evidenced-based approach to the nursing assessmentand nursing care
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