Problem
Scenario - Mr George McFarlane
I: Mr George McFarlane is a 53year old Male.
S: George has presented to hospital yesterday after he fell while getting out of his truck. The X-ray on admission showed that George has sustained a compound fracture of his right ankle, which required an open reduction and internal fixation (ORIF) to repair. Surgery was completed this morning and George has returned to the ward from the Operating theatres 2 hours ago.
B: George's past Medical History (PMHx) include:
1) Type ll Diabetes needing close management. Records BGL daily
2) Osteoarthritis in L) Knee
3) Allergy to Penicillin
Social History (SHx):
1) Married for 5 years to Yu Yan, who is of Chinese heritage. She speaks English well.
2) Has a 26 year old son from a previous marriage, who has depression and uses illicit drugs. The son visits occasionally.
3) Lives with his wife and 3 year old twins from his current marriage. One twin has a developmental disorder. His 17 year old step son also lives with the family.
4) Occupation: Long Haul truck driver, often isolated from family and friends as on the road and away from home due to work. Speaks to wife daily when away.
5) ETOH (Alcohol) usage on a regular basis
6) Smoker, averages 15 cigarettes per day
7) Often consumes take away/ fast food diet as away from home regularly
8) Sedentary lifestyle, often watches TV to cope with stress. Little to no exercise
A: Mr McFarlane is 118kg and 180cm in height. Current vital signs Resp 26, O2 Sats 97% on room air (RA), BP 170/90, HR 110, Temp 37.
R: Continue 2 hourly observations, including monitoring neurovascular observations and pain scores. Elevate right foot. Strict resting in bed until review by doctor tomorrow.
When you go and check on George you find that he has fallen out of bed. On initial assessment he is unresponsive.
a. Outline your immediate response to this situation. (Outline your immediate response to discovering that George has fallen out of bed and is unresponsive)
George regains consciousness very quickly and explains to you that he was trying to get up to go to the toilet. After the doctor and RN have examined George and determine that there are no significant adverse outcomes from his fall, you assist him to return to bed.
II. Outline your nursing interventions for George after his fall.
Reference required (Describe two nursing interventions/care you would provide to George now that he is stable and safely back in bed after his fall.)
George is due for discharge from hospital tomorrow. Outline three referrals and/ or community resources that you could provide to George to assist him after discharge.
(You need to consider what care George may continue to require on discharge and provide three health professional referrals and/ or community resources that you could provide to George so that he receives the ongoing care required.)