Case Study Essay
Case study Essay
Length: – 1800 words
Sally with Talipes who has had TendoAchilles lengthening
Sally is a 4 month old baby girl with unilateral talipes equinovarus (TEV) and congenital hip dysplasia. Serial plasters in hospital began since day three of her birth and today she is admitted to the day surgery unit for left Tendo Achilles lengthening and plaster cast application. Following surgery Sally has returned to the ward with an intravenous cannula in her right hand and a plaster of paris cast encasing her left lower leg and foot. The focus of this essay is Sally’s two priority nursing problems, which are post surgery pain related to Tendo Achilles lengthening and the plaster cast application, and secondly peripheral tissue integrity related to pressure from the cast (Ackley, Ladwig,2010). The essay will cover the two priority nursing interventions for both of these problems, what is involved in implementing these interventions, what should be considered when implementing these interventions, and the expected outcomes when evaluating the efficacy of the interventions.
Sally’s first priority nursing problem is post-surgery pain R/T Tendo Achilles lengthening and plaster cast application (Ackley, Ladwig, 2010). Sally’s pain is evidenced by her observed grimacing and crying with continuous lifting of her legs off the cot mattress and her Mother’s subjective statement “I can’t seem to settle her, she doesn’t even want to breastfeed she’s so distressed” (Browne, et. al., 2007; Hockenberry & Wilson, 2011). When attempting to measure pain in infants the FLACC Pain Tool is popular for children less than 3yrs old, as it is a behavioural observational scale of Face, Legs, Activity, Crying, and Consolability scored from 1-10 not requiring self-report (Hockenberry & Wilson, 2011). Sally’s FLACC pain scale is scored as an 8/10 because her face shows quivering of chin and or a clenched jaw, whilst her legs are kicking and drawing up with restless or arching
Length: – 1800 words
Sally with Talipes who has had TendoAchilles lengthening
Sally is a 4 month old baby girl with unilateral talipes equinovarus (TEV) and congenital hip dysplasia. Serial plasters in hospital began since day three of her birth and today she is admitted to the day surgery unit for left Tendo Achilles lengthening and plaster cast application. Following surgery Sally has returned to the ward with an intravenous cannula in her right hand and a plaster of paris cast encasing her left lower leg and foot. The focus of this essay is Sally’s two priority nursing problems, which are post surgery pain related to Tendo Achilles lengthening and the plaster cast application, and secondly peripheral tissue integrity related to pressure from the cast (Ackley, Ladwig,2010). The essay will cover the two priority nursing interventions for both of these problems, what is involved in implementing these interventions, what should be considered when implementing these interventions, and the expected outcomes when evaluating the efficacy of the interventions.
Sally’s first priority nursing problem is post-surgery pain R/T Tendo Achilles lengthening and plaster cast application (Ackley, Ladwig, 2010). Sally’s pain is evidenced by her observed grimacing and crying with continuous lifting of her legs off the cot mattress and her Mother’s subjective statement “I can’t seem to settle her, she doesn’t even want to breastfeed she’s so distressed” (Browne, et. al., 2007; Hockenberry & Wilson, 2011). When attempting to measure pain in infants the FLACC Pain Tool is popular for children less than 3yrs old, as it is a behavioural observational scale of Face, Legs, Activity, Crying, and Consolability scored from 1-10 not requiring self-report (Hockenberry & Wilson, 2011). Sally’s FLACC pain scale is scored as an 8/10 because her face shows quivering of chin and or a clenched jaw, whilst her legs are kicking and drawing up with restless or arching