Nursing Management

Students are required to submit a critical discussion paper related to the nursing management of Mrs. Jane Smith’s case study below, with the support of literature. Scenario: Mrs. Jane Smith is an 80-year-old woman who was admitted to ED in 1730 with a history of unwitnessed fall. She was found on the floor by her son. She was unable to stand up.  In ED she was found to be in excruciating pain. Her right Leg appeared to be shortened and internally rotated. It was noted she had multiple bruising over her right arm and face and a 4 cm laceration to her right lower arm. She was administered intranasal Fentanyl 100 Mcg by the Ambulance crew. Her Vital Signs: Bp – 147/77 mmHg, HR 112/mt – Irregular, RR – 24/min Spo2 – 99% RA, temp; 37.2 GCS – E3 V4M6 = 13/15. Mrs. Jane Smith had blood taken. She chest x-rays, which was NAD, and Right hip XRay which revealed # neck of femur. She CT scan of her head has been ordered, which is yet to be done A – Allergies – Penicillin M – as mentioned above P – Hypothyroidism, HTN, AF, IHD multiple falls L – Last ate around noon E – Events – Does not remember events leading to the fall   The critical discussion paper should address the following issues: What data deviate from normal findings, suggesting the needs for further investigation? What additional information should the nurse ask or question? Describe the patient’s presenting problem focusing on the pathophysiological issues. Identify 2 nursing diagnosis that needs immediate interventions and discuss the nursing management appropriate for the patient and evaluations of the nursing management plans presented in the literature. Explain the pharmacokinetics of the prescribed medications in the ED and their indications. Discuss nursing management of the prescribed medication in ED, the adverse effects of the medications, contraindication, and side effects, with the age of the patient in mind, using evidence-based literature. Describe in detail the information you would share with the patient and how you will educate the patient about the interactions and long-term effects of the regular medications of Mrs. Jane Smith.                             The critical discussion paper should address the following issues: 1. What data deviate from normal findings, suggesting the need s for further investigation? 2. What additional information should the nurse ask or question? 3. Describe the patient’s presenting problem focusing on the pathophysiological issues. 4. Identify 2 nursing diagnosis that needs immediate interventions and discuss the nursing management appropriate for the patient and evaluations of the nursing management plans presented in the literature. 5. Explain the pharmacokinetics of the prescribed medications in the ED and their indications. 6. Discuss nursing management of the prescribed medication in ED, the adverse effects of the medications, contraindication, and side effects, with the age of the patient in mind, using evidence-based literature. 7. Describe in detail the information you would share with the patient and how you will educate the patient about the interactions and long – term effects of the regular medications of Mrs. Jane Smith after the acute problems are solved. 

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