Simulation Laboratory Activities

Introduction to Ms. Ruby Cheng

Ms.Cheng is a 21 year old woman who injured her right knee whilst on an overseas holiday. She has had ongoing pain, especially when exercising. She has been referred by her GP to an Orthopaedic Surgeon.

Dr. Alverez (Orthopaedic Specialist Surgeon) has met with Ruby and they discussed her options for treatment including surgery to repair the damage to her knee. Ruby has decided to go ahead with the surgery. She has been scheduled for admission to the Sydney Orthopaedic Private Hospital next week.

Past Medical History

• Appendecectomy aged 17
• Fractured Left wrist aged 19

Social History

Ruby is a university student studying economics at Sydney University. She lives in university accommodation. Her parents also live in Sydney. Ruby is employed part-time as a waitress at the local Chinese restaurant. Ruby enjoys reading and plays competitive tennis.

Hospital Admission Day

Ruby has been admitted into hospital and now awaits her surgery. Her surgery has been scheduled for 1600hrs. She is having a Right Total Knee Reconstruction. Ruby is given some patient education by the CNS on her ward regarding the surgery and what to expect post-op. She gave her detailed instructions on the use of PCA and reassured her that she will have further instructions when she returns to the ward after the surgery. Ruby’s parents are in attendance giving support to Ruby.

Post-op

The operation was successful and Ruby is progressing well. She has returned to the ward with a wound drain x 1, IV fluids and instructions to commence PCA.

Her current observations are:

• HR: 76 BP: 110/58 RR: 14
• SpO2: 99% on room air
• Temp: 36.0 degrees Celsius
• Neuro-vascular obs: Capillary return to right foot toes < 1 sec
• Colour - pink
• Foot and leg cool to touch
• Sensation-present

Simulation Laboratory Activities

It is now 0740hrs, you have been assigned to care for Ruby this shift. You are required to attend to the following activities:

• Commence PCA
• Attend post-op observations including neuro-vascular
• Give IMI antiemetic as ordered
• Write nursing report
• Complete Multidisciplinary Careplan (MDCP)