Mrs Chan is found lying at the bottom of her stairs by her daughter at 09:00 on 14/06/2016. Mrs Chan is dressed in a nightgown; the last thing she remembers is rushing to the toilet at about 10pm. She has no memory of falling, she recalls “waking up” on the floor feeling cold because she was incontinent and her night gown was wet. She was unable to get up due to a penetrating wound to her left leg from falling on a glass coffee table that has broken and become embedded in her upper thigh. She also has pain in her hip and pelvis. Her right leg is shorter than the left and it is internally rotated.
Mrs Chan’s past medical history includes:
• Urinary incontinence
• Compression fractures to her spine due osteoporosis
• Chronic pain
• Vitamin D
• Fentanyl patch
• PRN endone
Describe the initial assessment of Mrs Chan, including the following points in your answer:
(a) Describe the process of completing a primary survey on Mrs Chan
(b) List the specific assessments that would assist you to evaluate her penetrating injury.
Review the vital signs chart (attached pdf) and evaluate the following aspects:
(a) List each of the vital signs recorded at 06:30 in the table below:
List the vital sign
O2 Flow Rate
4 Hour Urine Output
(b) Complete the ADDS score for each vital sign recorded at 06:30 in the table below, then total the ADDS score.
O2 Flow Rate
4 Hour Urine Output
(c) List the abnormal signs and then describe the abnormality using correct terminology.
Mrs Chan is seen by the doctor, who documents her assessment as follows:
• 82 year old lady with confusion and hypothermia.
• Air entry R=L no adventitious sounds.
• Large laceration to her right thigh, glass remains imbedded in the wound.
• Right leg has obvious bone deformity – requires further investigation to evaluate possible fractures.
A chest, abdominal, pelvis and hip X-ray are to be completed. Intravenous normal saline 1L is prescribed to run over 4 hours
(d) Note the ‘Actions Required’ section of the ADDS chart and explain who should accompany Mrs Chan when she leaves the ward to go to the X-ray department. You would need to ensure that you confirm this with the RN.
Mrs Chan has been prescribed an IV solution of normal saline, which contains sodium chloride and water.
(a) Explain the following concepts related to body fluid compartments and intravenous fluids:
(i) Define the terms solute and solvent and how it relates to the prescribed solution
(ii) In your own words, explain what osmosis is and how it works in the three fluid compartments of the body
(iii) Why is Mrs Chan’s IV fluid an isotonic solution?
(iv) Why this solution is used to treat dehydration?
(v) Correctly match the terms listed below to either Active or Passive transport:
• No energy required
• Requires energy
• Sodium-potassium pump
Active Transport Passive transport
(vi) Describe the difference between hydrostatic pressure and colloid osmotic pressure (also known as oncotic pressure) in relation to transport of fluids across a capillary membrane.
Foundation An office by and large a room which give a space which business, administrative, or proficient exercises are led. An office building, otherwise called office square is a type of business building which contained spaces mostly assigned to be utilized for workplaces purposed. This examination will centers around the consultancy office. Consultancy office is an administration industry that giving master counsel in a specific field, for example, a business administration consultancy to their customers. Consultancy office, for example, bookkeeper office, legal advisor office and others are imperative for specialist these days. The advisor is master in a particular field and has a wide learning of the topics so they can furnish their customer with much helpful and educated supposition in regards to the related field. There are two sorts of office in the property market such reason assembled office structures and shop-workplaces. Reason assembled office structures are for the most part tall structure with in excess of ten stories and the building was simply utilized for workplaces purposed. Though the shop-workplaces for the most part low-ascent structures with a few story. It is a column of structures in which isolate shop-workplaces are connected together and it is inhabitant blend. The ground floor is utilized for the business such auto workshop and others, and for the upper floors is utilized for the workplace purposes. Shop-workplaces advancement was top picks by the workplace occupiers for most recent couple of years. It can be seen that the advisor office be situated in local locations since most recent couple of years. The motivation behind why they lease for shop-workplaces in the private as their work put is a result of the rental cost is considerably less expensive to contrast with the purposed manufactured office building. The workplace rental costs in prime working inside the city's business region have ascend because of the restricted supply of reason fabricated office building. Besides, there is likewise low support charges because of shop-workplaces typically required least upkeep and administration mind. As the organization might want to cut expenses by scaling down and migrating to more affordable workplaces, there could be higher interest for workplaces outside the principle business regions, similar to the shop-workplaces which is situated in neighborhoods. Issue Statements The request of office working in business locale territories is on the ascent. However, there is shortage of improvement arrive in Center Business District (CBD) make the ascended of office rental cost in the CBD regions. Along these lines, people groups these days move out from the CBD and discover an office working outside the CBD territories. Typically, office structures will be situated in CBD. Since the CBD manages most extreme availability through transport offices for clients and representatives and all the administration workplaces, monetary establishment and retails are situated inside the CBD territories which is significantly more comfort for the officers to play out their work errand. Today, there is a considerable measure of advisor office be leased an office at shop-workplaces part which is situated in local locations. In today scene, a mix of private and business has harmoniously converged as one substance. It was a live space as well as a work space for the people. They be situated in local location due to low rental value, low support expenses and possibly less clamor that make by the vehicles. There must convey some effect to the occupants once the expert office worked in neighborhoods. Local locations ought to be a place which having security and safe for the inhabitants. There would be more movement volume in the neighborhood if the expert office to be worked. What's more, what the issue is whether the expert office in neighborhood satisfactory? Essentialness This examination expects to look at the preferences and disservices of specialist office to be situated in local locations and furthermore the issues looked by the two inhabitants and office occupier in the chose local locations and furthermore to prescribe some adequacy measure to take care of the issue that looked by the both party. This examination will likewise intend to decide if the expert office is satisfactory to be situated in local locations and is it the open doors for advisor office to be situated in local locations. Destinations of Study There are three principle goals in this examination: To think about the area hypothesis of office improvement To recognize what is the focal points and weaknesses of expert office in local location for both chose occupants and office occupiers in Petaling Jaya zones. To decide the progression to be taken keeping in mind the end goal to enhance and take care of the issue that looked by the both chose inhabitants and office occupiers of the local location and furthermore the expert office. Extent of Study The extent of this examination concentrated on the chose specialist office which is situated in Petaling Jaya's local locations with a specific end goal to make sense of what are the points of interest and weaknesses of expert office in neighborhoods and how is the effect to the two occupants and office occupiers in the chose territory. The respondents of the poll overview sheets are the inhabitants of the chose local location and the workplace occupiers of the chose advisor office in Petaling Jaya regions. Input from the two occupants and office occupier can give a few thoughts that whether there is any points of interest that is truly advantage for the both party and whether there is any weaknesses that is truly should be progressed. Strategy All the applicable information identified with this examination are acquired through essential information and optional information. The essential information in this investigation will incorporate of examining, dispersion of polls and meetings. The respondents chose will be the two occupants and office occupiers who are living in the chose neighborhood inside Petaling Jaya regions through testing. For the meeting segments, respondents are focused to the workplace chiefs who are delegates of building proprietor's perspective and furthermore the occupants who are live inside the chosen neighborhoods. Through the reacts from the polls review sheet, the favorable circumstances and inconveniences of specialist office in local locations can be recognized. Other than that, the issue look by the both party can likewise be distinguish. The accumulation of optional information will be done through references of important books, diary, daily paper articles, gathering paper, magazines, daily paper and web looking and different sources. Structure of Study This examination comprised of five sections. Brief portrayals of the parts are as per the following:- Section 1 The section one will examine on the presentation for the examination. The primary part is in regards to the presentation of the examination. This part comprises of a straightforward presentation with a concise foundation of the investigation. Explanation of issue, explore destinations, extent of the investigation and procedure will be portrayed in this section. Part 2 Part two is examines on the writing survey about the exploration title. In this section, area hypothesis of office, administrations and offices, arranging and office advancement, area decisions of office, arrive utilize choice and neighborhood idea of the local locations will be talked about. Part 3 Part three displays every one of the contemplations identified with the technique and system that utilized as a part of social event the data required. The mix of quantitative and subjective research strategies is utilized to do this investigation. Moreover the testing technique, structure of survey and meeting guide is likewise talked about in this part. An exchange on respondents through meetings and polls overview will likewise be incorporated into this section. Section 4 Section four demonstrated the factual examination performed on the information acquired from the study sheets done bye the two occupants and office occupier. Other than that, the investigation on the focal points and impediments of specialist office in local location and furthermore the issue looked by the two occupiers will likewise be done by concentrate the data that accumulated through meetings and poll overview sheets and furthermore the optional information. The exploration answers from various gathering will be looked at. Part 5 Part five is the talk of the discoveries from the information got from the past section. The conclusion and proposals of this examination will be talked about in this part. It gives a review of the investigation along the ramifications of the examination, recommendations and finish of the entire examination. A few suggestions for the future examination will likewise be incorporated into this investigation.>GET ANSWER