Respiratory Essay

Adequate qualified medical staff must be present in all critical care areas caring for mechanically ventilated

2. An 56-year-old established patient presents to her doctor's office with chest pain and shortness of breath. The doctor orders an ambulance to take the patient to the ED to be checked out. From the ED the patient is admitted for some

Throughout my clinical rotation, the only concern for this patient was pain management and discomfort from the chest tube site. The patient was given Ketorolac for a pain of 4/10 using the numeric pain sale. The patient was also at risk for pneumonia and pressure ulcers from immobility and not coughing/deep breathing. Nursing interventions were getting the patient up to the chair and using the incentive spirometer ten-times per hour. Another concern was SOB and fatigue with activities.

On the early morning of August 17, 2002, James C., a patient in one of the wards under the supervision of Ellen Hughes Finnerty, RN, went into respiratory depression. Between 3:00 and 4:00 a.m., Ann Mugi, the patient’s primary nurse, sought the assistance of a respiratory therapist, Hiran Obeyesekere, to help her care for the patient. As Obeyesekere suctioned the patient airway, Mugi called the service of the patient’s primary care physician, Dr. Jackson, to report the changes in the patient’s respiratory status, e.g., respiratory rate of 40 breaths per minute and low urine output.

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),

A patient that requires mechanical ventilation is typically suffering from acute respiratory failure. This can be from either complication of COPD or spinal cord injuries. Depriving the body from oxygen can be fatal to the brain and other vital organs. Mechanical ventilation assists the patient in breathing while the patient is unable to breath on their own.

The incident happened on Nov 21st, 2017. The patient has sleep apnea and a health history of chronic bronchitis (no episode in recent 2 years). Her respiration rate was 16 and all lung fields were clear upon auscultation. After I took the patient’s vital signs, I noticed that her oxygen saturation was low (83%). Then, I notified the nurse and asked the patient to do take some deep breath. After that, we put her on 2L of oxygen and her oxygen saturation went up to above 90s. However, the patient had a bladder control problem (was incontinent), so I took the oxygen off because she went to the toilet for around 4-5 times in an hour. However, I forgot to monitor her O2 saturation right away. Instead, I checked her oxygen saturation after she finished her dinner, and it dropped to 86%. The instructor showed me how deep breathing exercise can help the patient increase her oxygen level quickly. I notified the nurse and we put the patient on 2L of oxygen, but again I forgot to check her oxygen saturation right away. Instead, I checked her oxygen around 7pm later.

The patient manifested signs of respiratory distress precipitated by a pneumonia and bronchiolitis infection. A.D was on 0.5 liters of oxygen via nasal prongs with an oxygen saturation reading of 94%. On prior days without the supplemental oxygen, she was desaturating to below 92%, “ high flow rates generate continuous positive pressure in the airways that could help reduce the work of breathing in bronchiolitis and decrease the need for more invasive respiratory support” (Casey, 2015, p. 24). The patient had a respiratory rate of 42 breaths per minute and the normal respiratory rate for a 13month old as stated in Perry et al. (2013) ranges between 20-40 breaths per minute. Also, the patient had a heart rate of 158 beats per minute and the

On Monday, November 11, 2015, a 79-year-old female was brought to the emergency department (ED) of Fairview Southdale via ambulance for myocardial infarction (MI). A few hours prior to the ambulance arriving, the patient was experiencing chest discomfort, shortness of breath, and upper abdominal pain. At that time, she called her son who then went to her house to check on her. Her son made the decision to call 911. Minutes after the paramedics arrived, the patient went into cardiac arrest. The patient had previously expressed to her family that she wanted to be “do not resuscitate” (DNR) to her family, however, upon cardiac arrest her son told the paramedics that he wanted all measured taken to resuscitate her. Cardiopulmonary resuscitation (CPR) was initiated with a Lucas device and the patient was deemed rapid transport. In route to the ED, the patient was in ventricular tachycardia and ventricular fibrillation. An automated external defibrillators (AED) was used to shock her 3 times in route and 1 dose of epinephrine was given. She was intubated with a 7.0mm endotracheal tube (ETT) to protect her

From there we can continue to monitor the patient’s condition. Oddly enough, s/s of hemodynamic instability are surefire ways to determine if the patient sustained any unintentional injuries during the procedure. If we are unlucky enough to get a patient who sustained such an injury unbeknownst to whoever placed the device, we will know because the patient will most likely have diverted from his/her pre/post baseline. SOB, diminished lung sounds, and drop in SaO2 are all s/s of pnuemothorax. If a vessel is punctured, pulses will be thready, heart rate will be rapid, pressure will be lower, and breathing will most likely be heavy and labored. Effort required to breathe will undoubtedly increase (due to increasing pressure) and a pale/dull complexion will also manifest if blood continues to escape from the vascular system into the thoracic cavity. If we take too long to notice these symptoms, and shame on us if we do, the patient will show s/s of hemorrhagic shock including critically low blood pressure, loss of consciousness, and

Case :- A 17-year-old female presents to her local hospital 's E.R. at 7:45 in the morning on a school day. She appears apprehensive and uncomfortable. She winces and splints her chest to the right side when she coughs. She is examined by the attending resident.

Cristina the RT placed patient on transport vent. RN left with the patient while Cristina pushed the 840 vent. RN reported that the patient began Brady and desaturating she started bagging the patient. RT called to the bedside IR and RT made sure vent was functioning correctly. High peak alarm was displayed. Patient’s procedure was cancelled and the patient returned to bedside. Clinical specialist Raven and Manager Laura notified transport vent was taken to out of service sent to BIOMED. Breina ran a service check in which found that the high pressure alarm was malfunctioning. Brena communicated via email and verbal with Risk, director of respiratory to inform them of the situation. Transport Vent sent to company for service.

- Patient is afebrile, meaning "no fever". No signs of infection. This eliminates answer choices: Acute fibrinous pericarditis and Endocardial fibrosis.

At the start of her admission, Mrs. J is going through many complications throughout most of her systems. I would follow the rules of ABC and control her respiratory problem first. Mrs. J has an oxygen saturation of 82% and is probably going to continue dropping. She will require oxygen first, possibly a nonrebreather mask. The symptoms she is facing is of a person going through acute heart failure which includes shortness of breath, coughing/wheezing, weight gain, swollen ankles, rapid heart rate,

Before transporting the patient to the ED, the priorities intervention are establishing airways, supplying oxygen, at least one large-born IV line, and cover the wound to prevent infection. For burns, it is important to assess the patient with ABCDEs (airways, breathing, circulation, disability, and examine) first, then later obtain a history, completion of the total body system assessment, initial fluid resuscitation, and psychosocial support. Once the patient is transport to ED, 100%-humidified oxygen is administrated and that patient is encourage coughing out any secretion. In severe case like T.J, it may necessary to remove secretions by bronchial suctioning and administer bronchodilators and mucolytic agents. Fluid resuscitation should be administered right away to support circulatory function and tissue perfusion. Any delay with fluid can cause ischemia, organ dysfunction, and organ failure. Lactated Ringers can give IV fluid in the central venous access for large burn like the patient T.J. Once respiratory and circulatory statuses are established, the patient should be assessed for cervical spine and/or head injury along with eyes are examined for promptly for injury to the corneas. It is important to pay close attention to the patient temperature to