Morgan Jones Case Study - Student RN on Placement at the Local Multi Purpose Centre - Nursing Assessment Answer

Assessment Task:

Morgan Jones Case Study Nursing Assessment Answer

Task
In this assessment, you are required to compose answers related to the following case scenario. Each answer is required to be written in an academic format and be supported by a minimum of two (2) current (within a 5-7 year age limit) peer-reviewed sources.

The Scenario:
You are a student RN on placement at the local Multi-Purpose Centre, where today you have been allocated to the emergency ward. Your facilitator has advised you that there is a patient being brought in by ambulance and advises you that together you will be involved in the initial assessment and care of the patient.

Ambulance Handover to medical and nursing staff in the Emergency ward:
Morgan Jones, 30 yr. old female, the driver of a car travelling approximately 80 km/hr on the highway, was involved in a rear-end collision with another car, which stopped suddenly to avoid hitting a kangaroo. Morgan was wearing a seat belt, and all airbags were deployed. Morgan was removed from the car by paramedics, airway patent, talking in mostly, complete sentences, The paramedics placed a hard collar to stabilise spine, Morgan reports no loss of consciousness at scene, however Morgan reports may have hit her head on the steering wheel, has a small graze on the left side of her forehead, which has been dressed with non-adherent dressing.

Morgan has expressed that she has mid-sternal pain and has reported this pain as 8 out of 10, where airbag hit and/or the seatbelt tensioned against her sternal area. The patient is unable to take a deep breath, and her respiratory rate is 22 and shallow.

Observations 5 minutes prior to arrival at hospital: BP 135/85mmHg, P 92 bpm, Sao2 94% room air, Respiration Rate 22 bpm, Temperature (via the ear) 37.2 degree celcius.

Clinical focus:
Your clinical facilitator asks you to stand back and observe the multidisciplinary team interact as a primary assessment is conducted. After the primary assessment has been completed, you will be asked to take on a role in the care of the patient.

During this time, Morgan is assessed by the doctor; a radiographer has undertaken investigative radiological views of chest, head, and abdomen. Morgan has been diagnosed with a fractured sternum. Morgan has been advised that she will be admitted to the general ward of the hospital overnight for observation, pain relief and assessment by the physiotherapist.

Question One:
You have been asked to conduct a comprehensive nursing assessment on Morgan, including considerations of Morgan’s psychosocial history. During your discussion with Morgan, she becomes distressed and tells you she needs to get her son from school. Morgan tells you she usually rings her husband at 2.45pm to remind him to collect their son from school. Morgan also asks you what happened to the occupant of the other car.

• Suggest who in the multidisciplinary team you could contact to assist Morgan with her identified psychosocial issues. Include in your answer the nursing care considerations in regards to sharing patient information you would have prior to contacting these teams. (LO1)

Question Two:
Morgan has been diagnosed with a fractured sternum; the physiotherapists have asked you to be involved in educating Morgan on the use of an incentive spirometer.
Discuss how you would educate Morgan, as to why she requires incentive spirometry and how she should use the equipment including how often. (LO2 & 4)

Question Three:
Morgan has been ordered oral Paracetamol 1 gram every six hours. Paracetamol is considered a simple analgesic.

A) In the drug cupboard, you locate Paracetamol 500mg tablets, calculate the dose you would administer to Morgan (show your calculations).

B) Outline the pharmacokinetics and the pharmacodynamics of the drug, and identify two (2) adverse reactions and two (2) nursing precautions relevant to the administration of Paracetamol to Morgan. (LO6).

Question Four:
You have been asked to provide bedside handover to the next shift; you are required to use the modified ISBAR table below and complete a handover that you would provide to nursing staff. For this question, dot points are acceptable. (LO3)

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