Type: Written Assessment
Length: 1000 words (+/-10%) excluding reference list
Aim
The aim of this assessment is to demonstrate your understanding of the nursing roles within the perioperative and postoperative care of a patient experiencing an acute musculoskeletal alteration in health requiring surgical intervention. You will apply your understanding of the perioperative and postoperative nursing roles to the care of a patient. You will also apply your understanding of the role of the registered nurse in early recognition of deteriorating and sepsis in the treatment and care of a person in an acute care environment. Completion of this assessment will allow you to deepen your understanding of these concepts and the multifaceted and varied role of the registered nurse in the delivery of care.
Scenario
Matt, a 14-year-old boy, suffered an open fracture involving the tibia and fibula of the right leg while riding his quad bike on his family property in rural New South Wales. An aeromedical retrieval was required. Matt and his father were transferred by helicopter to the nearest regional facility. Upon arrival, Matt was treated in the Emergency Department (ED), where he was stabilised. Imaging was undertaken, confirming the need for surgical management. He was then transferred from ED directly to theatre for emergency surgery for an open reduction and internal fixation (ORIF).
• Explain the role and actions of the ED nurse when transferring Matt from ED to theatre? What information should be included when communicating during transfer of care and why?
Matt’s immediate post-operative phase and recovery is uneventful, and he is transferred to the paediatric unit. Upon transfer to the unit Matt is commenced on regular prophylactic Cefazolin. Within 20 minutes Matt complains of an itch at the site of his IV and across his body.
• What nursing actions may assist you in recognition and management of Matt’s deterioration?
On day two of admission during dressing change, it is noted that there is an unusual amount of ooze with some redness and swelling around the surgical site. A swab is taken and sent to the laboratory. Within 4 hours, the results return, indicating a gram-positive bacterium. Further blood tests are requested for a full septic screen.
• Briefly discuss the role and nursing actions undertaken by the Registered Nurse when caring for Matt and how will these assist in identifying sepsis?
Matt will be transferred to a rural and remote hospital in the nearest town and will require referrals to multidisciplinary teams.
• What considerations need to be made when organising Matt’s transfer to the local rural facility and eventual discharge?
