SOLVED109

CASE STUDY FOR WORKBOOK ASSESSMENT 2100 hours Johanna Crichton an 86-year-old female brought into the Emergency Department via Ambulance. It is 2100 hours in the evening and there has been hail, wind, and torrential rain since approximately 1830 hours as Perth has experienced a severe storm. Johanna is of Greek origin and does not speak English, only via her daughter who is coming to the hospital as soon as she can find a carer for her father. (Johanna is the primary carer for her husband Johan who has dementia). The paramedics state that Johanna was outside attempting to move the clothes off the clothesline when she tripped over the washing basket and appears to have a fractured hip. She was unable to get any assistance from her husband and daughter inside as they were unable to hear her calls for help over the loud rain. Johanna managed to drag herself across the ground and up to the house – an estimated 25 meters to raise the alarm. An ambulance was called, however, as she was unable to get up and her daughter was unable to assist, she remained on the ground until the Ambulance arrived. It is estimated that she was on the ground in poor weather conditions for an estimated 90 minutes. She is currently shivering on the ambulance trolley and has wet and soiled clothes on. Her vital signs are HR: 102 BP: 100/65 RR: 26 T: 35.3 degrees. The paramedics have placed bandages around her hips and knees to attempt to maintain alignment and have given her pain relief. She has a cannula in her right cubital fossa. There is an obvious shortening and rotation of the left leg and Johanna is shivering, grimacing, and calling out. She is in a distressed state. QUESTIONS: 1. Using the Safety and Quality Guidelines and a current Fractured Hip Clinical Pathway (supplied in LMS) describe how you will assess the following: a) Describe how will you initiate a transfer from the ambulance trolley to the emergency trolley to ensure Johanna remains comfortable and the transfer is done smoothly. b) Johanna’s clothing is wet, and she is signalling she needs to go to the toilet. Explain how you will remove her wet clothing and toileting Johanna. What are the nursing priorities of care and in your answer include: how this link to the guidelines and the clinical pathway in your answer. Note: Ensure you include the interprofessional team in the management of the transfer.
SCIENCE
HEALTH SCIENCE
NURSING

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