EVALUATION OF MODELOD2

The nurse found Mrs Smith to be tachypnoeic, her respirations were recorded as 24 breaths per minute it was observed as being fast and it appeared that her accessory muscles were being used. Mrs Smith’s pallor also appeared flushed and her saturations were documented as 93%. The nurse used the stethoscope to check for wheeze the patient’s lungs were clear and chest rise was symmetrical. Mrs Smith was commenced on 100% oxygen through a non-rebreathe mask, oxygen as an intervention is necessary as Creed & Spiers (2010) highlight ‘metabolic demand for oxygen throughout the body is hugely increased by sepsis and is essential to ensure the supply of oxygen is maximized’ .The nurse monitored the patient closely because in her confused state the patient may try to remove the oxygen mask.

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

The Ventilatory threshold was reached at 5 minutes or stage 3 for patient 92 C. The ventilatory threshold is important because it indicates the point at which the blood lactate acid increases non-linearly. It indicates that there is an increase in the lactate acid level in the blood as well as the excess carbon dioxide (Kenny et al., 2015). The increase in carbon dioxide will stimulate chemoreceptors to increase ventilation. The ventilatory threshold is related to the anaerobic threshold which refers to the increase in carbon dioxide and indicates that the body has shifted towards anaerobic metabolism (Kenny et al., 2015).

hypotensive with a blood pressure of 82/44 mm Hg. His respiratory rate is 28 breaths/min

The new versus classic BPD features have changed over the years. The approaches to care, including surfactant administration, permissive hypercapnia, and noninvasive ventilation have changed. All these has increased the survival of low birth weight infants as before with classic BPD. The classic BPD was before surfactant and more management techniques, and inflammation and alveolar septal fibrosis. All these changes were associated with oxygen toxicity, infection, and barotrauma.

Using Functional MRI helps to visualize the brain functionality through local metabolism. In this technology it allows the researcher to measure and track the brain functions by discovering the correlated changes in blood flow. From this functional Mri when a brain function is acted out the flow of oxygenated rich blood is detected and highlighted on the specific location where the functionality came from on the brain.

his neurologic intensive care unit (NICU) stay, Y.W. was intubated and placed on mechanical ventilation, had a feeding tube inserted and was placed on tube feedings, had a Foley catheter to down drain (DD), and had multiple IVs inserted. He developed pneumonia 1 month after admission.

His Pulse ox of 94% reading is on the lower side, but still in normal range which indicated that there is less oxygen perfusion.

Even though the consequence of saline instillation on a ventilator patient in the acute care setting is pneumonia or the patient may become hemodynamically unstable, this practice remain contentious, the practice of this procedure will also decrease the oxygenation. (Ayhan, et al., 2015),

shortness of breath. Pain improved with sublingual Nitroglycerine and Aspirin given by EMS. On arrival to ED his blood pressure was 154/94, HR 70 bpm, RR 19 and SpO2 98% in room air. Heart, lung, abdominal and neurological examinations were unremarkable.

This scenario helped me understand the pathophysiologic process of pneumonia and decompensated shock and how they could possibly manifest in children. Since in our first simulation of the semester we learned different methods of assisting a patient in improving his/her breathing status I was better able to intervene and know what to do to improve our patient’s breathing status. However, I have never been exposed to a patient undergoing decompensated shock. Therefore, this time I was able to learn what to do in case a situation as such arises in the future on a real patient. Shock can be due to several reasons such as bleeding or severe dehydration. However, it was apparent in this case that the patient was not externally bleeding, but she was

The main priority for all the pediatric patient was to make sure they are getting enough air. They needed an open airway. Without an open airway nothing else matters. To help with the patients airways we monitored their O2 sats and if they were low we made sure to apply oxygen, and continue to monitor their sats. Once oxygen was applied we worked on

Our initial evaluation includes assessment of vital signs, assessment of the cardio-pulmonary status including work of breathing, breath sounds, perfusion, and pulses for circulatory assessment (Jevon, 2012, p. 193).  Assessment of consciousness, using the paediatric Glasgow Coma Scale (GCS) (ANZCOR, 2016), Level of consciousness using Alert, Verbal, Pain, Unresponsive scale (AVPU) (Jevon, 2012, p.194). Neurological observations, EDOES and CEWT to determine deterioration (PMH, 2013).

Blood gas analysis may be performed to determine if high concentration oxygen therapy is needed (Bush & Thomson, 2007). The management of fever would be a part of care plan when the infant is febrile due to infection (Axton & Fugate 2009).

Mrs. J. arrives at the emergency department with her 6 year old son, PJ, who has a history of Cystic Fibrosis (CF). He is febrile (101.7° F orally), BP 98/66, HR 122, RR 32 with the use of accessory muscles. Mother states PJ has, for the last five days, exhibited signs and symptoms of upper respiratory infection, runny nose, low grade fever, cough, and fatigue. He has lost 2 pounds over the past 5 days due to anorexia though he has not had vomiting. He weighs 36 pounds and height is 3’2”. Today, PJ became more lethargic and his fever was difficult to control with pyretics.