NUR5111: Nursing - Mr George Case Study Assessment Answer

Mr. George Case Study Assessment Answer

Mr. George Case Study

1. Mr. George is a 69-year-old male
2. Mr. George has limited English language.
3. He lives at home with his wife
4. He has 3 children, aged 42, 40 and 38.

• Steven was brought to ED four days ago, following a fall in his daughter’s garden. An x-ray revealed a fractured left neck of femur.
• Steven underwent an ORIF three days ago in theatre.
• Steven has a wound dressing on his left hip at the surgical site.

• Steven has not previously walked with an aid. He now ha a pickup frame, supplied by the physiotherapist.

• Mr. George’s children are concerned about their father’s deteriorating health and feel he should go into a nursing home. Mr. George has refused to discuss this. His wife has refused all services stating it is ‘her duty to care for her husband’ though she admits she is exhausted in caring for him.

• History of hypertension, osteoarthritis, asthma, atrial fibrillation, hypercholesterolemia, heart failure.
• Allergic to a penicillin (anaphylaxis)
• Increasing episodes of confusion over the past 2 months
• Periodic functional urinary incontinence last few weeks
• Occasional episodes of aggression
• Medications
•  Perindopril 4mg man
• Frusemide 40mg mane
• Cholecalciferol 1000 IU mane
• Digoxin 125mcg mane
• Seretide 250/25 2 puffs BD
• Simvastatin 40mg Nocte
• Oxycodone SR 10mg BD
• Oxycodone IR 5mg TDS PRN
• Salbutamol inhaler MDI 2 puffs PRN

• You receive a handover from the nurse on night duty. The night duty nurse states that Mr. George didn’t sleep much and has been restless, often shouting out.
• The physiotherapist has authorised mobility over short distances only (toilet and back) with a pick-up frame and assistance x 1. Mr. George has been refusing to ambulate however and has been requiring a sling lifter for all transfers.
• Vital signs at 2230hrs (beginning of night shift): NUR5111

• The nurse requests that you evaluate the effectiveness of the 0630 analgesia as she hasn't had a chance to get back to him.
• The physiotherapist has encouraged mobility over short distances to tolerance.
• The nurse requests you have Mr George’s PRN oxycodone increased as he has required all three does over the past two days.
• It is 0730 and you have received handover on your patient. You go in to see Steven lying in the bed, moaning and clutching his chest. There is a strong smell of urine. He does not respond to your enquiries just stares at you for a moment then continues to moan. He is flushed and tachypnoeic.

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