A 74-year-old male (Miles Smith) is brought into the Emergency Department after falling from a ladder while pruning tree branches (approximately 4 metres). He has left chest-wall tenderness,

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Case study 1

A 74-year-old male (Miles Smith) is brought into the Emergency Department after falling from a ladder while pruning tree branches (approximately 4 metres).  He was able to ambulate inside to call an ambulance and stated that the left side of his chest hurts when he breathes.  He has left chest-wall tenderness, a small amount of subcutaneous emphysema and a scalp laceration. He has a history of hypertension and takes warfarin for a past mitral valve replacement. His vital signs on arrival are HR: 64 bpm; RR: 26 bpm; BP: 140/80mmHG; SaO2: 94%; GCS: 15/15 (did not lose consciousness)

Question 1-

Identify 3 potential nursing interventions for this patient and what interventions you would prioritize and why. Ensure that you link this directly to the case study to support your findings from your assessment.

(250 words)

Question 2-

This patient has a differential diagnosis of a hemopneumothorax. Describe the pathophysiology of a hemopneumothorax and how you and the medical team would treat this. Your answer should include the difference between a pneumothorax and a hemopneumothorax.

(250 words)

Question 3-

This patient has received 5 mg IV morphine from the paramedics. The medical staff have prescribed a Ketamine infusion for this patient. Explain why Ketamine is used as an analgesic and induction agent. Your answer should include its indications, pharmacokinetics, and potential adverse effects it may have on a patient of this age and background. Your answer should include nursing considerations and what assessments and interventions you would do as a Registered Nurse caring for this patient.

(250 words)

Question 4-

The patient's son has telephoned the emergency department from interstate asking questions about the patient's condition. Would it be appropriate for nursing or medical staff to reveal medical information about a patient? Please ensure you make reference to the Registered Nurse Code of Conduct and Standards of Practice.

(250 words)

The A-E Assessment used throughout the unit is SKILL number 39-1 from the Fundamentals of Nursing Clinical Skills Workbook, 4th Edition; Rebeiro, G; Wilson, D; Fuller, S; (2021).

References in APA 7th edition

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