Assessment of the Geriatric Patient with Multisystem Failure

I and my colleague systematically assessed the patient using rapid assessment (ABCDE) and observation of vital sign. ABCDE mean assessing patient Airway, Breathing, Circulation, Disability and Exposure. Vital signs consist of blood pressure, pulse temperature, and respiration rate. They are essential basic observation that provides information on which clinical decisions are based and for identifying when any nursing or medical intervention is required according to Lina and Barbara (2008 p59).

After assessing the victim?s airway, now you should check for breathing. To check for breathing, place your ear over the mouth looking toward the chest. This will allow you to listen for air movement, feel for air movement on your cheek, and look for chest rise. If the victim is breathing adequately, you should roll him or her on their left side. By doing so this puts them in the recovery position and permits him or her to breathe adequately. This also prevents aspiration if the victim vomits. If the victim is not breathing, give two breathes, watching for chest rise. Give breathes over a second, wait a second, then give another breathe. While doing so, you should not hyperventilate the victim.

I returned to the recovery ward, my patient was still hypertensive and tachycardic and I felt by assessing her non-verbal signals of communication that she was still in great discomfort. After 15 minutes of no improvement I returned to theatre to see the anaesthetist, I explained that I was not happy with the patient’s level of pain and requested that he come to the recovery ward to assess the patient. He reluctantly came to the recovery ward and after spending a few minutes assessing the patient agreed that she was in an unacceptable level of pain and prescribed a further 5mg of morphine which I duly gave to the patient in 2.5mg increments. After this the patients heart rate and blood pressure decreased to pre operative levels, she seemed to be more relaxed and eventually fell asleep. After a further period of time spent continually reassessing the patient and when I was satisfied she was comfortable and haemodynamically stable I discharged the patient back to the ward.

Any of these issues have the potential to extend the patients length of stay in the hospital. The restraints have the potential to make the patient more agitated, thus increasing his risk of injury. Understanding the nursing-sensitive indicators can greatly contribute to a better outcome for all patients.

Vital observations were carried out efficiently, they were recorded every 15 minutes and a cardiac monitor was attached to continuously monitor for any deterioration. As a student nurse I assisted by recording vital observations using NEWS and assessing consciousness by using the Glasgow coma scale to ensure there were no signs of brain trauma (Le Roux, Levine and Kofke, 2013). In line with the NMC, my mentor supervised and countersigned my observations (NMC, 2011b). I promoted good patient safety as deterioration would be recognised early and appropriate care provided. Throughout the treatment process I witnessed and provided person centred care. Nursing and medical staff continuously checked patient comfort and obtained consent for treatment being provided.

One you should wash your hands if there is a place close by, if there is not a place close by use hand sanitizer, two put on gloves, having a sanitary field could help keep you and the patient safe, three checking the could help the EMS or know how long they have been out and what to do if the patient worsens, four you would do a primary survey which would be checking the circulation, airway, and breathing, (CAB) for short. Call EMS and begin CPR if needed, five you should ask them if they have a headache, dizziness, feel sick to their stomach, or lack of their surroundings, six have them repeat a series of numbers, recite the months backward, remember three words or objects for five minutes. You could do the Romberg test and tandem gait test which would be increasing their activity level for a little bit, have them run a short distance do five pushups without getting a headache or feeling dizzy, seven if they are unable to perform any of the above

Ms. Sunshine immediately was placed on oxygen, sitting upright, an IV infusing, had blood work sent for numerous labs, including cardiac markers, had a chest x-ray and an electrocardiogram (EKG) performed. A clinical nurse leader is able to teach patients and patients regarding health promotion, disease prevention, or disease management (American Association of Colleges of Nursing, 2011). It is important to understand the pathophysiology behind disease processes in order to help facilitate better outcomes for Ms. Sunshine.

Dr. Jackson called back around 4:40 a.m. and ordered supplemental oxygen, blood work, and diuretic, and to maintain the patient’s oxygen saturation reading above 94 percent. Around 5:30 a.m., the patient’s respiration was still labored with 36-40 breaths per minute. Obeyesekere once again suctioned the patient that brought the patient’s oxygen saturation level at 95 percent. Meanwhile, at 5:30 a.m.,

According to Burchum and Rosenthal (2016), “The nurse is obligated to administer opioids with discretion in an effort to minimize abuse” (p. 275-276). This can be difficult if the nurse does not use objective data and instead uses past experiences or their own judgement of the pain the patient is experiencing.

This can include cases of perceived “pain-seeking” patients or “frequent flyers”. It can be difficult to treat those we see as trying to “use the system” for pure personal gain equally to those we may see as “truly ill”. It is important to remember to treat everyone in the same manner. Another important provision is provision 3. This provision states, “The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.” This means that nurses must always do everything thinking of the patient’s best interest first. This includes making sure they are fully informed before signing any consents for procedures and questioning any orders that may seem inappropriate for said patient. It is the nurse’s job to be the patient’s advocate and to always provide a safe environment for the patient.

The nurse will assist Mrs. Thomas in achieving optimal pain control. The nurse will interact with Mrs. Thomas more than any other practitioner. The nurse will have to continuously assess Mrs. Thomas pain control. Due to Mrs. Thomas’s advance stage in her illness her pain control needs will vary depending on her level of conscious and the disease process. Keeping Mrs. Thomas’s level of pain to a level where Mrs. Thomas can still maintain her functional ability will be an ongoing struggle. Too little or too much pain medicine will prevent Mrs. Thomas in participating in activities.

Like a perfect automaton, the nurse proceeds to measure vital signs and note her findings with as little human interaction with you as is possible. After the nurse has completed her tasks, you must wait until the doctor pops his head in, nurse's records in hand. The doctor then proceeds to ask you some variation of the stock doctor question: "What seems to be the problem today?"

Mrs. Mavis is a Palliative patient who is receiving comfort measures in her nursing care. It is important to evaluate the effectiveness of her pain

at the time of your visit. We have divided the DGA in two parts, each with three

In order to make sure that the victims airway is open,place your hand on the victims forehead and two fingers on their chin and tilt the head back slightly to open the airway.Look, listen, and feel for breathing. Get close enough to the victims face to listen if victim can breath by putting you ear close to the victims mouth. At the same time ,look if victims chest is rising up.Do that for ten seconds.If you do not feel the victims breath, or cannot see the chest rising after ten seconds, continue to the next step.