fb
$20 Bonus + 25% OFF
$20 Bonus + 25% OFF
Securing Higher Grades Costing Your Pocket? Book Your Assignment at The Lowest Price Now!
Add File

Error goes here

NRS312 Essential Nursing Care: Managing The Deteriorating Patient

tag 0 Download11 Pages / 2,552 Words tag Add in library Click this icon and make it bookmark in your library to refer it later. GOT IT

Question:

Clinical Case Study

John Smith - 81-year-old retired farmer, married to Jean. They are both physically and socially active within the community.

Phase 1 – On Presentation

At 0600hrs this morning John rolls his tractor down a 6 M embankment and is not found until 0930

Jess goes looking for him and finds him at semi-conscious and calls an ambulance.

On arrival at Emergency Department:

Obs: RR 28, SpO2 90% RA. GCS15, BP122/64, HR94 sinus rhythm, T36.4 tympanic. Abrasions across left side of chest extending around to middle of his back. Extensive bruising to left hip and around to left buttock. Unable to weight bear, no shortening of legs, constant sharp pain 8/10 in left upper thigh and into left hip region.  Also complaining of left sided chest discomfort 3/10 under his rib cage. HNPU.

Treatments given: FiO2 6L Hudson, 20G IVC in R cubital fossa with NS at 200ml/hr. 250ml bolus given on route. IVI Morphine 2mg stat at scene at 1020hrs and repeat 2mg Morphine on route at 1030hrs. Left hip and buttock pain now 6/10 and chest discomfort 1/10.

PH- non-smoker, ETOH 3-5/ week. Reading glasses and hearing aids. He is 180cm tall and weighs approximately 104kg. John has a medical history of GORD and TIA 2 years ago. John’s regular medications are Zantac and Clopidigril.

Phase 2 – On Assessment – Clinical Review Activated

You commence your nursing assessment of John and note the following:

John’s is speaking in short sentences, breathing is shallow but with symmetrical rise and fall of the chest. Breath sounds on auscultation normal but he is tender to touch. There is grazing over left side of the chest.

Peripheries are a dusky pink colour and now cool to touch with a capillary refill <4 seconds. Pt states pain in L hip as 6/10 at rest and 10/10 on movement. Normal sensation in all limbs. Grimaces in pain on abdominal palpitation.

Vital signs : RR26, SpO2 92% 6L Hudson, BP 96/50, HR120 sinus tachycardia, T35.9. GCS=14. PEARTL size 4. BGL 6.0 mmols.

You initiate a clinical review.

A clinical review is attended and the medical team has provided the following plan:

  • For urgent abdo CT
  • Surgical consult and NBM.
  • Maintain systolic BP >100mmHg if <100 for rapid response
  • Insert IDC

Phase 3 – Rapid Response

A Left CVAD inserted. Maintenance fluid 200mls/hr

John becomes confused with a GCS 11, BP 92/54, HR134, RR 30 SpO2 88% 6L Hudson mask. PEARTL size 4. Cap refill is 4 seconds – cool extremities.

A rapid Response is activated

Phase 4 – Resuscitation

John continues to deteriorate as his BP falls to 52/25, HR 144.

Cardiac monitor then alarms demonstrating pt in VT.

CPR is commenced and the ALS team attach him to an AED.

Patient is delivered 200joules for a shockable rhythm with no effect.

Adrenaline IV is administered.

Second shock delivered and reverts to SB with multifocal VEB’s.

Obs: BP 72/48, HR 89 sinus arrhythmia. Two minutes later John’s vital signs are BP 99/64, HR 82 Sinus Rhythm, RR 14, SpO2 88% Non-Rebreather mask and a GCS 14.

Task

You are to examine the case study and identify what was happening for the patient, clinically, in each of the "Between the Flag" phases.

Include in your discussion the importance of:

  • knowing and identifying the four phases highlighted in the 'Slippery Slope' for the patient in the case study; and
  • patient safety from the perspective of a Registered Nurse.
Download Sample Now

Earn back the money you have spent on the downloaded sample by uploading a unique assignment/study material/research material you have. After we assess the authenticity of the uploaded content, you will get 100% money back in your wallet within 7 days.

Upload
Unique Document

Document
Under Evaluation

Get Money
into Your Wallet

Total 11 pages, 1 USD Per Page

Cite This Work

To export a reference to this article please select a referencing stye below:

My Assignment Help. (2020). Essential Nursing Care: Managing The Deteriorating Patient. Retrieved from https://myassignmenthelp.com/free-samples/nrs312-essential-nursing-care-managing-the-deteriorating-patient.

"Essential Nursing Care: Managing The Deteriorating Patient." My Assignment Help, 2020, https://myassignmenthelp.com/free-samples/nrs312-essential-nursing-care-managing-the-deteriorating-patient.

My Assignment Help (2020) Essential Nursing Care: Managing The Deteriorating Patient [Online]. Available from: https://myassignmenthelp.com/free-samples/nrs312-essential-nursing-care-managing-the-deteriorating-patient
[Accessed 25 October 2021].

My Assignment Help. 'Essential Nursing Care: Managing The Deteriorating Patient' (My Assignment Help, 2020) <https://myassignmenthelp.com/free-samples/nrs312-essential-nursing-care-managing-the-deteriorating-patient> accessed 25 October 2021.

My Assignment Help. Essential Nursing Care: Managing The Deteriorating Patient [Internet]. My Assignment Help. 2020 [cited 25 October 2021]. Available from: https://myassignmenthelp.com/free-samples/nrs312-essential-nursing-care-managing-the-deteriorating-patient.


Are you one of those students who have no idea how to write an annotated bibliography? There is nothing to ashamed about it. However, it is essential to have detailed knowledge of the different bibliography format before writing an assignment. In case, you are not able to procure the required information, you should ask the experts at MyAssignmenthelp.com for authentic annotated bibliography format. Over 5000 qualified and experienced writers provide day long service to help you achieve exemplary grades in the assignments. They are aware of the different annotated bibliography styles like Chicago, Vancouver etc.

Latest Nursing Samples

NR510 Leadership And Role Of The Advanced Practice Nurse

Download : 0 | Pages : 9

Answer: Introduction Advanced Professional Nurses (APNs) consist of nurses who are registered with proper training and have the required certificates that help them give healthcare skills in their place of work. APNs are very important since they make sure that those who need their attention are well attended to with accordance of each person’s needs (Sheer & Wong, 2008). The scarcity of healthcare experts, there is a reason to set ...

Read More arrow Tags: Australia Bakersfield Management University of New South Wales Masters in Business Administration 

CNA741 Foundations Of Mental Health Nursing Theory 2

Download : 0 | Pages : 14

Answer: Introduction Electroconvulsive therapy (ECT) is the deliberate inducing of a modified generalized seizure in an anaesthetized patient under medically-controlled conditions to produce a therapeutic effect (Kavanagh & McLoughlin, 2009). To achieve this, an electric charge is passed through the brain between two electrodes that are placed on the scalp of the anaesthetized patient. Electroconvulsive therapy is used to cause changes in...

Read More arrow Tags: Australia Surry Hills Medical Healthcare University of New South Wales 

NUR2107 Person Centered Mental Health Care

Download : 0 | Pages : 9

Answer: Introduction In Australia, the MHN reports that most cases of chronic mental illness are due depression: either socially or economically associated (Reich, 2015). Also, the bipolar condition and schizophrenia disorder have been on the increase up to the early 2000s after which the federal government is liaising with the MHN, and the state governments intervened through regulation of Medicare safety net and Medicare Levy (Dzipora and A...

Read More arrow Tags: Australia Clayton Management University of New South Wales Masters in Business Administration 

ITC542 Internetworking With TCP/IP

Download : 0 | Pages : 3

Answers: 1. The advantages of larger MTU is: They are appropriate for handling the transfer of the larger amount of the data that is set over the longer distance. There is no major fragmentation important for fast delivery and few lost datagrams. The advantages are for small MTU: With good transferring of the time sensitive data like the audio or the video. The suit for the multiplexing. 2. CSMA/CD is set with the operations wi...

Read More arrow Tags: Australia Brunswick Management industrial relations in Asia-pacific region  University of New South Wales Masters in Business Administration 

NURS11159 Introduction To Nursing

Download : 0 | Pages : 7

Answer Introduction The The results of the Gallup’s Annual Honesty and Ethical Standards poll (DEC20, 2016) showed that nursing the most trusted profession for the 15th year all way. Trust is a firm belief, of the character, strength or truth of someone of something according to Merriam-Webster (1828). For a person to be trusted by anyone, he must have portrayed a particular character, trait, or individual strength. The character is also ...

Read More arrow Tags: Australia Randwick Management University of New South Wales Masters in Business Administration 
Next

5% Cashback

On APP - grab it while it lasts!

Download app now

*Offer eligible for first 3 orders ordered through app!

ribbon
callback request mobile
Have any Query?