Assignment Case Study: Mildred

Mildred is a 78-year-old lady who resides in a residential home that is warden supported. Mildred lives independently with home care support for cleaning and shopping. Mildred has a history of alcoholic dependence and was diagnosed with the onset of dementia 2 years prior to the death of her husband George. Mildred has deteriorated over the past year and has periods of lucidity and periods where she is confused and disorientated.

Presenting complaint: Mildred tripped and fell whilst in the residential home and has a colles’ fracture of the left wrist.

PMH – Hypertension, alcoholic.

Medication- Ramipril 2.5mg OD, Omeprazole 20mg OD,

Family history- mother died of cardiac disease

Social history- Retired nurse, smoked since age 15, 20- 30 cigarettes, and still smokes when given the opportunity. George, Mildred’s husband died 2 years ago, she has 1 son who is married with 2 children.

Mildred attends the local Catholic church on a Sunday.

General health – Previously fit and well and living independently with home care support.

Mildred is one hour post op following open reduction internal fixation of her Colles’ fracture. Your supervisor handover to you on Mildred’s return to the ward includes the following ABCDE information:

Airway – patent, placed in lateral position, talking when prompted.

Breathing – RR= 8, SpO 2 94%, on oxygen- simple mask on 6l/min, respirations shallow.

Circulation- BP 90/55, HR 96, CRT 3 secs, dry mouth and has not passed urine post-surgery.

Disability- mildly disorientated, Mildred is aware she has had an operation and back on the ward. Not taken regular drugs this morning. Pethidine 25mg IV and Cyclizine 50mg IV given in recovery.

Exposure – temp = 36 o C, dressing in-situ on left wrist- fingers warm to touch.

The task: a scenario-based 2500 word essay

From your chosen scenario, discuss the factors that influence holistic person-centred assessment exploring the key principles and values that underpin adult nursing practice.

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