NRSG370: Jack Buun Presented to the Emergency Department - Nursing

Internal Code: MAS7479

Nursing Assignment:

Jack Buun, 69, femoral neck fracture post a fall Jack Buun presented to the emergency department (ED) via ambulance after a fall in his backyard, which lead him to twist and fall directly on the lateral aspect of his right hip. On examination, the paramedics reported his right leg to be shortened and externally rotated, and Jack was unable to get up and in a significant amount of pain. His wife Ethel found him and called the Ambulance. Jack has a past history of hypertension that is well controlled. Jack required emergency surgery under general anesthetic for his femoral neck fracture and underwent a hemiarthroplasty. You are called to the post-anesthetic recovery unit (PACU) to receive handover and are happy that he meets the discharge criteria of the hospital. You are told that Jack received the following intravenous medications for pain during and after his surgery:

• 20mg Morphine
• 100mg Tramadol
• 40mg Parecoxib
• 1g Paracetamol

Jack also received 0.625mg of droperidol in the PACU for nausea. On arrival to the orthopaedic ward you conduct further assessment as follows:

• Vital Signs: BP 145/80, HR 120, SpO2 96% on 2L via nasal prongs, Temp 37.1° Celsius, RR 10;
• Drowsy but rousable to voice commands;
• Pinpoint pupils;
• Neurovascular observations (Right Lower Limb): Cool, pale, touch present, movement
• present, capillary refill sluggish, dorsalis pedis present but thready; Pain 3/10.

You are the RN caring for Jack on the surgical ward.