Q1 Regular Neurological observations will be necessary for this…

QuestionQ1 Regular Neurological observations will be necessary for this…Q1 Regular Neurological observations will be necessary for this patient, discuss the rationale for undertaking these observations. S NYS Betty is a 72-year-old English lady who lives with her partner Malcolm in their own 2-bedroom house.  Betty has two daughters who visit regularly, and she cares for one of her grandsons on Tuesdays and Thursdays while his parents are working.    Betty presented to her GP following a 12hr history of ‘droopy eye’ which is diagnosed as ptosis.   On neurological examination, the GP noted that her L) pupil was sluggish to respond to light and she was hypertensive 172/98mmHg on assessment.  Neither of these symptoms were present in Betty’s past medical history so suspecting a neurological event.  The GP sent Betty to the local hospital for an MRI and further investigation by the neurological team. Now in the hospital, Betty complains of a sudden intense headache with visual disturbance, neck stiffness and nausea.  Past medical history  Hypertension, diagnose 20 years agoHypercholesterolaemia diagnosed 20 years ago L) TKR, 10 years ago Osteoarthritis Psoriasis diagnosed 55 years ago L) Leg DVT, post TKR  Vital signs  Pulse: 115 beats per minute BP:172/98 mmHgRespirations: 26 breaths per minuteTemperature: 38.4oC  Current medications include: PO Ibuprofen 400mg QID PO Panadol Osteo 650mg TDS PO Simvastatin 40mg nocte PO Trandolapril 4mg Daily Celestone Ointment applied to Psoriatic patches TDS PRN  Part A – Short answer knowledge-based case study questions        Q2 Discuss the likely changes you would expect to see in Betty’s neurological and vital signs when her condition deteriorates?  Explain the pathophysiology.   S NYSStudent to add answer here         Q3 List three (3) priorities of your immediate care for a rise in intracranial pressure.   S NYSStudent to add answer here          Case study scenario update Betty deteriorates and is found unconscious 2 hours following the commencement of her headache.  The MRI scan confirmed she has had a ruptured cerebral aneurysm leading to a large subarachnoid haemorrhage on the R) side of her brain.  The plan is for surgery to evacuate the haematoma and repair the aneurysm. An indwelling urinary catheter will be inserted during surgery.  Malcolm, Betty’s partner becomes very distressed about Betty’s sudden deterioration.  He is anxious and starts to request additional information in a loud manner.    Q4 How would you explain to Malcolm the pathophysiology of an aneurysm? Include in your response concepts of mediation, negotiation or conflict resolution.   S NYSStudent to add answer here         Q5 When answering Malcolm’s questions, explain how you would demonstrate the concepts of mediation, negotiation or conflict resolution.  S NYSStudent to add answer here          Q6 Outline the procedure for the application of anti-embolic stockings and the rationale for their use for this patient.  S NYSStudent to add answer here         Q7 Discuss your scope of practice in relation to the care of the deteriorating patient within the interdisciplinary health care team.   S NYSStudent to add answer here                 Q8 Using the care plan below, outline the nursing care and rationale for the management of an unconscious patient and include preoperative care. Provide three (3) actual or potential problems with at least one (1) nursing intervention, rationale and evaluation of the goal for each problem you identify.Actual / Potential Problem / Nursing Diagnosis (problem) Expected outcome / Goal Nursing implementation/ InterventionWhat the nurse would do Rationale Evaluation                                                    S NYS    Scenario update Day 2 Post-op 2 days postoperative, Betty is recovering well and has some residual L) leg weakness.  She has been mobilising short distances with x1 assistance and a 4-wheel walking frame.  She is tolerating a ward diet with free fluids and the doctor has requested her Indwelling Urinary Catheter to be removed.    Q9 Discuss how you can encourage Betty to maintain her own independence, taking in to account her physical, emotional and psychosocial needs.  S NYS NEEDS ENCOURAGEMENTPHYSICAL    EMOTIONAL    PSYCHOSOCIAL         Q10 Discharge planning commences on admission.  Research three (3) support services Betty might need on discharge and discuss how three (3) members of the interdisciplinary health care team may assist in her recovery at home.  S NYSALLIED HEALTH TEAM MEMBER SUPPORTS                       Health ScienceScienceNursingHLT E1224Share Question

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