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Code: NUR5111
Mr. George Case Study Assessment Answer
Assignment Task: NUR5111
Mr. George Case Study
Mr. George is a 69-year-old male
Mr. George has limited English language.
He lives at home with his wife
He has 3 children, aged 42, 40 and 38.
Situation NUR5111
Steven was brought to ED four days ago, following a fall in his daughters garden. An x-ray revealed a fractured left neck of femur.
Steven underwent an ORIF three days ago in theatre.
Steven has a wound dressing on his left hip at the surgical site.
It is due to be changed this shift. NUR5111
Steven has not previously walked with an aid. He now ha a
pickup frame, supplied by the physiotherapist.
Mr. Georges children are concerned about their fathers deteriorating health and feel he should go into a nursing
home. Mr. George has refused to discuss this. His wife has refused all services stating it is her duty to care for her husband though she admits she is exhausted in caring for him.
History of hypertension, osteoarthritis, asthma, atrial fibrillation, hypercholesterolemia, heart failure.
Allergic to a penicillin (anaphylaxis)
Increasing episodes of confusion over the past 2 months
Periodic functional urinary incontinence last few weeks
Occasional episodes of aggression
Medications
Perindopril 4mg man
Frusemide 40mg mane
Cholecalciferol 1000 IU mane
Digoxin 125mcg mane
Seretide 250/25 2 puffs BD
Simvastatin 40mg Nocte
Oxycodone SR 10mg BD
Oxycodone IR 5mg TDS PRN
Salbutamol inhaler MDI 2 puffs PRN
You receive a handover from the nurse on night duty. The night duty nurse states that Mr. George didnt sleep much and has been restless, often shouting out.
The physiotherapist has authorised mobility over short distances only (toilet and back) with a pick-up frame and assistance x 1. Mr. George has been refusing to ambulate however and has been requiring a sling lifter for all transfers.
Vital signs at 2230hrs (beginning of night shift): NUR5111
o
Respiratory rate: 19
o
T37.7C
o
Pulse rate: 88, irregular
o
Blood pressure: 130/80
o
Sp0
2
95% room air
o
Pain score: 6/10 L) hip
The nurse requests that you evaluate the effectiveness of the 0630 analgesia as she hasnt had a chance to get back to him.
The physiotherapist has encouraged mobility over short distances to tolerance.
The nurse requests you have Mr Georges PRN oxycodone increased as he has required all three does over the past two days.
It is 0730 and you have received handover on your patient. You go in to see Steven lying in the bed, moaning and clutching his chest. There is a strong smell of urine. He does not respond to your enquiries just stares at you for a moment then continues to moan. He is flushed and tachypnoeic.
Mr. Georges pain has been an issue and the nurse states that he has required two doses of IR Oxycodone overnight. One at 2230 and another dose at 0630 for hip pain. Mr. George could not rate this pain but was clearly uncomfortable. NUR5111
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