Management Of The Acutely Ill Adult

Through basic observations, health professionals are able to evaluate the performance of an individual’s health status. In relation to Casey, it is noted in her Observation Chart that in the time span of two hours the patient’s health status had changed from being relatively normal (to the patient) to an increased respiratory rate, heart rate and temperature as well as a decrease in blood pressure. It is also noted that the patient has a score of 8 in the pain scale (compared to the score of zero two hours previously), relating to the lower abdomen. Programs such as Between the Flags acknowledges the fact that the early recognition of deterioration of patients can reduce harm to patients through designing and implementing systems which provide a structural response in the event of a deteriorating patient, such as Rapid Response and Clinical Review. There are two phases involved in the rapid response, which includes the afferent phase and the efferent phase. The afferent phase focuses on the overall monitoring and recognising the deteriorating patient whereas

The aim of this assignment is to critically discuss the nursing assessment individualised care and nursing interventions of the acutely ill patient. The patient discussed developed severe sepsis due to a urinary tract infection and her condition deteriorated during the recovery process in the nurse’s care. Lovick (2009) defines sepsis ‘as a known or suspected infection accompanied by evidence of two or more of the SIRS criteria’. SIRS is outlined as a ‘systemic inflammatory response’ consisting of two or more of the following symptoms ‘temperature >38 degrees Celsius or 90 beats per minute, respiratory rates greater than 20 breaths per minute and white blood count higher than 12,000 cells per microliter or lower than 4000 cells per

And at the center of the care. Medication that has been given to the individual has to also be reviews as it may have reached its time limit this means that they might become immune to it like some antibiotics people can become immune to so that this drug will not be affective. Checks have to be done to make sure that the medication is still effective and is working correctly and the patient isn’t suffering any side effects. If there are side effects occurring or the individual has become immune to their medication there will be investigations in to which alternative medication can be given to them that won’t react the same. Scans and x-rays may need to be repeated by the people that have put together the care strategy this is done so that if anything has changed that the individual Is getting care for or physic then this can be assessed again if they need this level of care and it can be changed, or on the other hand if the case has gotten worse and they symptoms are worsening then this also can be looked at and things can be done so that the individual is receiving the right care.

In the first step of the Tanner (2006) model nurses use their personal knowledge and experience to notice whether the patient requires attentions based on their expectations and looking at environment of the patient. Therefore, for an experience nurse it is easier for them responding to the similar situation if she or he revisit because the knowledge is already there through experience. In the case of Mr Devi, assessment will perform using systematic assessment based on the ABCDE approach (Airway, Breathing, circulation, Disability and Exposure). The ABCDE approach is an evidence-based practice widely accepted and used by all the members of a multidisciplinary team (MDT) to assess an acutely ill patient (Harrison and Daly 2011). First, life-threatening

As Jane was presenting with a symptom of a life threatening event it was important that treatment was immediate. Priority was initially made from assessment of the airways, breathing and circulation, level of consciousness and pain. Jane’s respirations on admission were recorded at a rate of 28 breaths per minute, she looked cyanosed. Jane’s other clinical observations recorded a heart rate of 105 beats per minute (sinus tachycardia), blood pressure (BP) of 140/85 and oxygen saturation (SPO2) on room air 87%. It is important to establish a base line so that the nurse is altered to sudden deterioration in the patient’s clinical condition. Jane’s PEWS score (Physiological Early Warning Score) was 4 and indicated a need for urgent medical attention (BTS 2006). Breathing was the most obvious issue and was the immediate priority.

In a sudden illness the nurse in charge should be informed for advice whether the doctor or paramedics should be called other staff members should be made aware in case this

Hello everyone. My name is John Smith. I am a RN here at the Hospital and I am the Director of Nursing Informatics. As I’m sure all of you know to be successful in the care of our Patients you have to work as an interdisciplinary team and timely COMMUNICATION is key! As you can see I have capitalized communication to emphasize how important it is. As a Nurse on the unit a big part of communication is reporting a patient’s condition after you have

With the health care system changing so rapidly, it is important that nurses are autonomous. It is necessary, as patient advocates, that we understand the cause and effect of all entities involving our patients. Critical thinking and making the correct judgment call clinically is vital. A patient situation which comes to mind is an 86 year old female, weighing 50kg, Vital Signs: Blood Pressure: 80/50, Heart Rate: 102 (Sinus Tachycardia), Respirations:

The issue of consistency is raised when discussing how to ensure assessments are comprehensive, complete and that the data is recorded using the same guidelines as other nurses. To enable consistency of assessment, the same nurse should be taking the observations of a patient for the duration of a shift (Moore, 2007). This ensure that the interpretation of results don’t differ each time the vital signs are done. It also allows the nurse to detect subtle changes in the patients state that may not have been written down. For example, in most clinical environments the respiration rate is recorded as just a number, and the rhythm, degree of effort, quality of breathing and evidence of wheezing or other abnormal breathing sounds are not recorded. The rate may stay the same over a period of time while other aspects of respiration may change, and this is something that a nurse is more likely to notice if they have assessed that patient before. During handover, a nurse should tell the next nurse looking after their patients how they took observations and detail what tools they used to ensure consistency is maintained.

The focus for the general care nurse outside of the ICU is to be able to recognize sepsis and to initiate appropriate interventions in an appropriate amount of time. Nurses need to facilitate the transfer of the patient to an ICU as urgently as possible. Once sepsis is suspected, it is important to closely monitor patients for signs and symptoms of progression with increasing frequency of assessments. While awaiting transfer of a patient to the ICU

This essay will now analyze the nursing intervention that requires for the acutely ill patient to prevent an exacerbation of chronic obstructive pulmonary disease. The nurse carried out an initial assessment of a full history, taking in consideration that the patient was over 35 years of age who has been, or still is, a cigarette smoker, with vascular related diseases and had symptoms of breathlessness on exertion, chest tightness, wheezing, coughing, sputum production especially in the morning and chest infection (Currie 2009). A physical examination was done to check the patient respiration rate, depth and rhythm, blood pressure, pulse, temperature and oxygen saturation (Lynes 2007). The acutely ill patient’s respiration was between 30-34 breaths per minute, blood pressure 580/98, pulse 110 beat per minute and saturation levels 80-82%. Increase respiration indicates that the patient was in fear, pain and anxious. Anxiety causes stimulation of sympathetic nervous activation which forces bronchioles

John was a 76 year old gentleman returning to an orthopaedic ward following a total hip replacement under general anaesthetic. The agreed care plan was to regularly monitor John’s vital signs over the next several hours in accordance with local hospital resuscitation trust policy (2012) and the National Institute

The case I will discuss comes from the Journal of General Internal Medicine and is as follows: the patient is an 80-year-old woman who suffers from nonresectable lung cancer and has been diagnosed with lobar pneumonia. Other conditions present are: hypertension, diabetes, chronic renal insufficiency and severe degenerative joint disease. While improvement was seen with initial treatment, the patient suffered worsening hypoxemia, level of consciousness obtunded, and developed acute renal failure. Thus, the only means to prevent death was intubation with

More recently, early warning systems have been developed in an effort to recognise the at-risk patient who may be deteriorating

The patient on which the care plan will be assessed will be a 72 year old female, May Watters who I assisted in the care of during clinical placement in the Emergency Department (ED). May Watters is a pseudo name to ensure confidentiality to An Bord Analtrais standards (ABA 2000). May was brought in by ambulance which was called by her husband Jimmy. May was brought into the ED for Diarrhoea and Vomiting 5/7 days and generally unwell and weakness and non productive cough. Mays’ husband who is her next of kin was concerned about her deterioration