Analysis Essay - Rural Accident - Emergency Department - Waiting Room - Nursing Assessment Answer

Analysis Essay - Rural Accident - Emergency Department - Waiting Room - Nursing Assessment Answer 

Assessment Task:

The case study:
Elenor is a 16 year old who attended the rural accident and emergency department (ED) complaining of lower abdominal pain. Accompanied by her mother, Elenor was initially triaged by the registered nurse (RN), who recorded her vital signs, which were within normal parameters, and a pain score of 3 out of 10. The RN also tested her urine and no abnormalities were detected, hence, Elenor was asked to sit in the waiting room with her mother until she could be seen by a medical officer. At that point a number of people were admitted to the ED as a result of being injured in a motor vehicle accident (MVA) involving a number of cars and a motorcyclist, therefore Elenor was kept waiting. The motorcyclist had major head, leg and chest injuries whilst the other patients had a number of significant but not so critical injuries. Elenor and her mother were informed by the nurse of the accident and that there may be a delay but they also noticed how short staffed the department appeared to be, therefore did not want to complain. Elenor was called through to the treatment area of the ED four hours after her initial presentation, where a doctor commenced her examination. By this time her pain score had increased to 5 out of 10, and her vital signs were indicative of her discomfort. Prior to completing his examination the doctor was called to attend to one of the patients in the MVA who was deteriorating. Unfortunately, the cause of Elenor’s abdominal pain at this point was unknown but as he left the doctor ordered her to be kept nil by mouth (NbM), to have intravenous (IV) fluids, pain relief and a full blood count. The RN explained the treatment and the plan of care in full to Elenor and her mother, following which she commenced IV fluids and organised for a full blood count to be done along with continued monitoring of Elenor’s vital signs. However, Eleanor declined pain relief advising that she may be pregnant and that she did not want her mother to know. The nurse did however, inform the doctor who ordered an urgent ultrasound scan, confirming pregnancy but no fetal heartbeat. Elenor subsequently haemorrhaged heavily vaginally, and the doctor ordered more blood specimens for haemoglobin (HB) group and hold in preparation for surgery to evacuate the remaining uterine contents, at which time her mother advised that she and Elenor were Jehovah’s Witnesses. Consent for surgery was gained but on the way to the operating theatre Elenor stated that she was happy to consent to receive blood products if necessary and the doctor was informed. During the operation Elenor lost a significant amount of blood and the doctor ordered a blood transfusion to save her life. In theatre, nursing staff assisted the doctor to complete the blood transfusion. Following the procedure, Elenor was transferred to recovery area and then to a ward. Her mother was angry and aggressive towards the nurses when she discovered that her daughter had a blood transfusion in progress.

Case study analysis assignment brief:
The case study analysis essay word limit is 2000 (plus or minus 10% as per the School of Nursing & Midwifery Undergraduate Assignment Guidelines). All words are calculated towards the word limit except for the title page, direct quotes and end-text references. If you write less or more than this, penalties will apply. If you write less, it is unlikely you will have covered all aspects of the assignment. The assignment brief is structured under the same headings as the marking rubric, please consider both documents carefully as you construct your essay.

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