The goal of this case study is for you to identify the role of the Registered nurse in the appropriate assessment and management of an individual experiencing health alterations when access to healthcare is suboptimal or compromised.
Mr. Smith is a 70yr/old male who presented to his GP at 10am today with an exacerbation of his CHF. He was complaining of chest pain that is pleuritic in nature, SOB, weakness, fatigue, a hacking cough with bilateral bibasal coarse crackles.
Meds: atorvastatin 20m Mane, frusemide 20 mg mane, Metoformin XR 1000mg BD
Past illnesses: hypercholesterolaemia, MI, angina, hypertension, Increased BMI 34, T2DM
Last meal: 7am (3hrs ago), bacon eggs, sausages toast and hash browns
Events leading up to presentation: walking/gardening on his farming property 3 hours away from the nearest hospital
His vital signs are a Temp 36.8, GCS 15, HR 105, NiBP- 170/90, Sp02- 92%, RR 24. Initial ECG displayed new abnormalities and initial bloods showed a negative troponin of TNI: 0.02. He was given his regular meds & 5mg IV morphine, 1gm paracetamol which reduced his pain to 2/10. PIVC insitu R) ACF- patent.
Step 2: Based on your assessment of the case study, identify2 health care priorities for your patient. Refer to the ABCDE framework to justify your decision.
Step 3: Identify interventions (no more than 3 and at least one for each priority problem) to manage each priority. Provide a rationale for each intervention that refers to pathophysiology, as well as a discussion of related nursing care.
Monitoring such as completing vital signs, telemetry and fluid balance charting is not an intervention. An intervention needs to effect a pathophysiological change. These may be nursing considerations
Step 4: Outline and Discuss appropriate discharge planning for this patient that aligns with the social justice framework
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