Thinkabel

yes please. its something like the assessment you will do for this patient if say this patient has been transferred to your ward. thx

Scenario - Compound fracture Mr X is a 40 year old man, who lives alone, except for Truddy (his cat), in a three storey terrace house. He and a two other friends went on a skiing holiday in the Highlands of Scotland. While skiing, he fell and sustained a compound fracture to his right tibia and fibula. One friend stayed with him on the mountainside, while the other alerted the emergency services, who arrived quickly. The paramedic team applied a clean dressing over the open wound and splinted his leg. In the air ambulance, Mr X was given intravenous Morphine analgesia as he was in severe pain. One of his friend did mention to the paramedic staff that X does suffer from a peptic ulcer for which he has omeprazole twice daily, amoxicillin 500 mg three times daily, metronidazole 400 mg three times daily and aluminium hydroxide 500 mg four times daily and as required. He smokes approximately 20 cigarettes and drinks three cans of lager daily. On arrival at the accident and emergency department, the named nurse recorded his observations and they were within normal range. The duty orthopaedic doctor examined Jonathan and ordered an X-Ray of his right leg which confirmed that he had fractured his tibia and fibula. A clean dressing was reapplied to the open wound and it was decided to admit Mr X to the ward for surgery later that day, for an external fixation of his right leg.

names in this scenario are pseudonyms Mrs DAY is a 58 year old married woman with 2 adult children. She has a part-time teacher in a school, but spends a large part of each day looking after her elderly mother who suffers from rheumatoid arthritis and is unable to move around. Her husband is a bus driver and both her children are at university. Mrs DAY was diagnosed with cancer of the left breast 4 years ago for which she had surgery with axillary clearance. Adjuvant radiotherapy was also given. At this time 4 axillary nodes were found to contain cancer and Mrs DAY was prescribed 4 courses of epirubicin and CMF chemotherapy (cyclophosphamide, methotrexate and fluorouracil) and subsequently tamoxifen 20 mg which she has been taking ever since. She was feeling well until a few weeks ago, when she experienced pain in her back; this has since increased in intensity. Her husband took her to see her GP and after a physical examination decided to refer Mrs DAY to the hospital. On arrival to the hospital, Mrs DAY was seen by the physician in the A/E department who decided to admit her for investigations. A bone scan revealed extensive metastatic cancer in the lumbar spine and a chest X-ray showed pulmonary metastases. The doctors informed Mrs DAY of the metastases and prescribed a course of paclitaxel chemotherapy with herceptin. Mrs DAY agreed to the treatment but is frightened at the thought of having chemotherapy and is devastated to hear that the tumour has returned. Her major worry is how she is going to cope with looking after her mother.