1. After assessing the patient and reading Lewis’s Medical-surgical Nursing pages 1584 to 1586…

1. After assessing the patient and reading Lewis’s Medical-surgical Nursing pages 1584 to 1586 (complications of fractures) what condition do you think the patient is experiencing? 2. Based on the information provided in the scenario, what do you think is causing the condition you have identified? 3. Who will you inform about the changes in Miley’s NV status? Research the condition in your Lewis’s Medical-surgical Nursing (p1584 -1586) and list the treatment required and state the reasons these interventions are required. 4. Miley’s cast is split which relieves the condition. Miley is 64 years old, what age related changes in the muscular system could impact her recovery or lead to future problems, please list. 5. What age related changes occur in the bones related to slowing of cellular metabolism? 6. Briefly discuss the following age related physiological changes of Miley’s developmental stage: Musculoskeletal, renal, gastrointestinal (GI), cardiovascular (CV) and psychosocial, cognitive and spiritual development. 7. You need to undertake Miley’s routine observations, including her neurovascular observations. When you ask for consent, Miley does not seem to understand what you are asking. Would you proceed? Explain you answer. 8. In this situation what type of consent is required for non-invasive procedures? 9. When trying to gain consent you realise that it is your communication with Miley that is inhibiting gaining consent. What could be inhibiting your communication with Miley and why? Identify at least 3 factors that could be effecting your communication given Miley’s scenario. 10. What strategies could you use to improve on this interaction/communication with Miley? Ensure you address each individual inhibiting factor you identified 11. Later in the shift Miley’s daughter, Lucy comes to visit and is very anxious about her Mother’s condition. Lucy speaks English well and while she is explaining her mother’s situation she begins to cry at the bedside. Lucy is tells you a lot of information about her Mother’s life. A history of abuse from Miley’s late husband and that Miley has no money to pay her bills. Lucy is holding her Mother’s hand while she speaks and she is very upset. After reading pages 177-179 of Foundations of Nursing which discusses therapeutic communication skills, how do you think the use of the following skills will help ensure good communication with Lucy and her Mother? What therapeutic communication skills could you utilise to encourage effective communication with Lucy and explain why you would use the skills you have identified. 12. Why is the development of trust important? 13. Would the use of social conversation work in this situation 14. Would you use active listening when listening to Miley’s daughter Lucy and please explain your answer? 15. After all the difficulties communicating with Miley you realise that there are many constraints to your communication with her including your understanding of her Greek culture. The RN gives you this document https://www.health.qld.gov.au/multicultural/health_workers/greek.pdf Identify at least 3 cultural considerations you would need to understand to provide effective care to Miley regarding her culture and discuss how this would affect your behaviour and interactions. 16. You share the information about Miley’s past history with the RN who then asks Miley if she would like to speak with the social worker. What is the role of the social worker? 17. You are showering Miley and another client’s bell starts ringing. You leave Miley in the shower while you go to answer the bell. When you return Miley has been burnt by hot water as she was unable to move away from the water and she is also unable to reach the nurse call bell. In relation to Miley’s incident explain why you as an EN owe Miley a duty of care? 18. The injury Miley has sustained has been caused by negligence. What is negligence and have you breached your duty of care? 19. Assault and Battery is considered an intentional tort. Is this statement true or false? True OR False 20. Write a brief definition of defamation and explain how they could impact a client. 21. What isvicarious liability?

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