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Hypertension and depression Assignment

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NRSG258 2021
Assessment 1- Case Study

Incident: 72 yr old female Mrs Geraldine Berry sustained left fractured neck of femur (#NOF) and
laceration to her head 5cm while walking her dog. Tripped on an uneven pathway.
PMH: Hypertension and depression
Current Medications: Coversyl 5mg
Doxepin 25mg daily
Atorvastatin 40mg daily

SHx: Lives with elderly husband. Is the primary carer for elderly husband who has had a stroke
previously and is mildly impaired. Attends church every Sunday and is responsible for arranging
flowers for every Sunday service. She has started volunteering at the St Vincent De Paul’s Meals on
Wheels distribution centre two days a week. She lost two children 5 years ago in a car accident.
Geraldine is concerned who will look after her husband and their dog Nala. Geraldine and her
husband have no children or relatives nearby.

Current presentation

Day 3 post op left total hip replacement, increasing pain in hip unable to weight bear, pain score
currently 7/10. Geraldine has been prescribed oral tramadol tds, Ibroprofen prn, paracetamol prn, IV
Amoxicillin 1000mg tds and Clexane 40mg SC BD. Suture line on hip appears red and swollen.
Observations – 10am Day 3
Pulse Rate – 120
Respiratory rate – 22
Blood pressure – 120/80
Pain score – 7/10
Sa02 – 96%
Temperature – 39.1
BGL – 6.8 mmol/l
Glasgow Coma Score 15
Heat, pain and redness at suture site
Refusing to mobilise due to pain
NRSG258 Version 1 Feb 2021

  1. Using the CRC and the information presented about Geraldine, identify the
    abnormal cues, and discuss why these are considered abnormal (200 words)
  2. Using relevant literature, discuss the pathophysiology related to the two postoperative issues of concern from the abnormal cues you have identified in
    question one (500 words) (LO1, LO4).
  3. Using the template provided below, complete all the sections which include
    (200 words) (LO4, LO5):
    a. Identify the nursing goal for each identified issue/problem (2).
    b. List at least two nursing interventions for each issue/problem.
  4. Using relevant literature, provide a rationale for the listed interventions and
    discuss how the interventions will be evaluated (500 words) ( LO1, LO3, LO4,
  5. Identify 2 medications that were prescribed for the patient’s pre-operative
    condition. (Coversyl 5mg, Doxepin 25mg daily, Atorvastatin 40mg daily) used in
    this case study. Provide the mechanism of action, side effects correct dosage
    and contraindications for each medication. Explain how this might affect
    Geraldine in the post-operative period (400 words) (LO1, LO3, LO4, LO5).
  6. Using the Roper-Logan Tierney Model, identify one (1)
    potential cultural/biopsychosocial issue/problem and discuss how this will
    affect the patient post-operatively or on discharge (200 words) (LO3, LO2).
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