In this essay, I am going to discuss the care given to
an acutely unwell patient, applying a nursing model to assess the patient’s condition
and meet their needs. The model that I have chosen is the Roper-Logan-Tierney
model for nursing. I will discuss the assessment of the patient’s condition and
relate this to the appropriate pathophysiology. I will also be exploring the
possible implications for my future nursing career. Lastly, I have changed the
name of this patient to comply with the Nursing and Midwifery Council (NMC
2015) by maintaining the confidentiality of the patient.
Alex is a 14-year-old male who has come into the ward
from Accident and Emergency (A&E) presenting with a left transverse fractured
tibia, the injury was sustained from playing football (X-Ray had confirmed the
facture). Alex has had plaster of Paris cast applied during A&E to make
sure there was no further damage was done. He has gone into theatre to have
rods placed into the tibia and another plaster of Paris cast will be applied.
Alex was admitted onto the paediatric ward for post-operative observation.
I first met Alex in the recovery room. On return to the
ward, Alex was awake but had a reduced level of consciousness due to the
effects of anaesthetics, he was also on 2L of oxygen with nasal prong to help
with breathing. As he was saturating 100% on air, he had been taken off oxygen.
Alex was on patient controlled analgesia (PCA) morphine via intravenous (IV)
during the surgery. Anti-emetic drugs was prescribed to the patient during the
surgery to treat post-operative nausea and vomiting.
Alex was on IV fluids pre-operative to maintain fluid as
he was nil by mouth (NBM). Alex post-operative observations were; temperature:
39.0 C pulse: 110 /minute, respirations: 24/minute, systolic blood pressure
(BP): 100mmHg and SpO2: 100% self-ventilating on air, capillary refill time was
12 years is;
temperature: 36.5ºC – 37.2ºC, pulse: 60-100/
minute, respiration: 15-20/minute, systolic blood pressure (BP): 100-120mmHg, the
normal SpO2 is >95.
Neurovascular observations were done on Alex; pallor –
pink, paresthesia – present, paralysis – good, pain – 7/10 (10 being most painful)
analgesia given to reduce the pain, pulse – strong, polar – warm, perfusion –