Assessment 2 Weighting 30%
Written case study essay with headings (including ELP assessment) 1800 word count (+/-10
• Develop an appropriate response to the acute nursing needs of a diverse range of clients.
• Utilise evidence based practice to identify and problem solve the needs of patients.
Assessment instructions:
Dave Sawyer (DOB: 24/10/1991) is a FIFO worker who lives near Collie. Dave has just completed his rotation of night shifts and flown straight home for his R&R days. Dave decided to go into the nearby bush to collect wood for his indoor fire, as he was low on wood and the weather is cold. Whilst using his chainsaw, the chainsaw cut through one of the pieces of wood, and Dave didn’t take his finger off the trigger in time, resulting in a jagged 10cm long, deep laceration to his right calf, running parallel with his tibia.
Dave went to ED, and on arrival Dave’s observations were: T-36.7oC, HR-89bpm, RR-20pm, BP-139/68mmHg, O2-95% RA, pain score 9/10. Dave was given opioid analgesia for his pain, the wound dressed, and he was reviewed by the ED doctor. It was arranged for Dave to undergo surgery for debridement and skin flap to repair the laceration. Dave is allergic to elastoplast (causing pruritus and welts), is not on any medications, and has no other medical problems.
You are looking after Dave on his return to the ward post-operatively at 11:45hrs. Doctor’s post-op orders are for routine observations, dressing to stay intact for 72hrs, keep leg elevated, and neurovascular observations four-hourly. He is awake and alert, and he has a dressing on his right calf, with minimal sanguineous ooze evident. Dave’s observations on return to ward are: T-36.1oC, HR-66bpm, RR-16pm, BP-109/71mmHg, O2-95% RA, and pain score 2/10. Dave was given prophylactic Cefoxitin 2g IV during surgery. Dave’s anaesthetist has prescribed Paracetamol 1g IV/PO 6 hourly, Ibuprofen 200-400mg PO TDS, Tramadol SR 100mg PO BD, and Cefoxitin 2g IV/ IM 6 hourly for 2 further doses. IV Compound Sodium Lactate 1L is running at a six-hourly rate into Dave’s left arm.