Assignment Task
Case Study
Osteoporosis and anaphylactic shock Jade, a 60-year-old female, is admitted to the surgical ward following an emergency left femur open reduction and fixation (ORIF). She is currently on analgesia, as well as prophylactic antibiotics and anticoagulant. Jade received an antibiotic ten minutes of ago. You find her unresponsive and initiate a code blue. Upon carrying out vital observations, Jade is tachycardic and profoundly hypotensive at 65/25 mmhg. She has a bilateral wheeze on auscultation, swollen tongue and lips, as well as hives. She is given IV adrenaline and hydrocortisone for a suspected anaphylactic reaction.
Past medical history
Osteoporosis
Wrist fracture post fall
Hypercholesterolemia
Subjective data
Lactose intolerance
Two glasses of wine every evening
Smoker: 7-10 cigarettes per day
Sedentary lifestyle-fast food several times a week and lack of exercises
Post-menopause-not on any HRT
Osteoporosis treatment-noncompliant at times
BMI 30
Medications
Clexane 40 mg SC OD
Paracetamol 1g PO QID
Fentanyl 500 microgram in 50 mLs Na Chloride (Patient controlled IV administration), 20 microgram bolus with 10-minute lockout time (not used in the last two hours)
Cephazolin 2g IV TDS
Atorvastatin 40mg PO OD
The following is to be addressed in your presentation.
1. Pathophysiology
Discuss the pathophysiology of anaphylactic shock. Include in your answer the pathophysiological changes that have contributed to Jade’s clinical manifestations.
2. Pharmacology
Identify which drug likely caused the anaphylactic reaction, to include its mechanism of action, normal dosage, ADR’s and any specific nursing consideration. (DO NOT USE TABLES)
Discuss the two drugs used to manage the anaphylactic reaction. Include in your discussion the mechanisms of action, normal dosage, ADR’s and any specific nursing considerations. (DO NOT USE TABLES).
3. Specific Nursing Care
Discuss the nursing intervention during the code blue and after stabilisation of Jade.
4. Discharge education
You identify that Jade has knowledge deficit regarding osteoporosis. Identify the osteoporosis risk factors that Jade may have, and briefly provide her with specific discharge education.
Specific assignment instructions
The aim of this case study presentation is to provide an opportunity for you to apply your new knowledge of specific disease pathophysiology, diagnosis, and treatment (pharmacological, non-pharmacological, nursing, and allied health professional interventions) to a “real life” clinical scenario.
