Nursing Assessment and Management of Diabetic Ketoacidosis and Lower Respiratory Tract Infection in

The Nurse's Role and Purpose of Assessment in the Nursing Process

Alex is a  year old student in his first year at university, has been admitted to the medical high dependency unit (HDU) from the emergency department (ED) for ongoing monitoring and nursing management with diabetic ketoacidosis (DKA), dehydration and a lower respiratory tract infection. Alex has type 1 diabetes, diagnosed at the age of and is managed with a combination regime of a rapid acting insulin, novarapid pre-meals and a long acting insulin, insulin glargine nocté.

His flatmate Zenat called an ambulance when she found him unresponsive that morning. She reported that Alex has been unwell for the past two days with flu like symptoms, fever, cough, joint pains and loss of appetite, but refused to attend the campus surgery. Alex is drowsy but responding to verbal commands. He is currently on oxygen.

He has had an intravenous infusion of sodium chloride 1L which was infused over an hour in ED. Currently running now is an infusion of sodium chloride 0.9% with potassium chloride 1L to be infused over 2hours. The I.V fluids are running concurrently with a continuous fixed rate intravenous insulin infusion (FRIII) of Actrapid 50units/50mL normal saline at 0.1units/kg/hr started in the ED. Alex weighs 75kg according to his health records so the infusion is set at 7.5units/hr. The medical team also want him to continue with is long acting insulin regime of insulin glargine 24units nocté . A urinary catheter was inserted in the ED and has currently drained.

Your work will need to be submitted anonymously for anonymous marking. do not put your name or student id.

Word count plus or minus 10%. If your work is significantly under it will demonstrate that your work is superficial and as such not meeting the Los at the depth required to pass. For work that is over, that content will not be considered for marking

The essay will need to address learning outcomes of the module.

You will need to have a clear introduction that informs the marker of the content of your essay, which should then follow through to the conclusion. This is an academic essay and will need to be written in an objective manner using appropriate academic language.

The essay will need to explain the nurse’s role and purpose of assessment as part of the nursing process, identifying the assessment framework appropriate for an acutely ill patient. You will also need analyse the assessment framework being utilised to assess the patient in the scenario with a clear rationale for the assessment framework.

You will then need to discuss and analyse the actual assessment with rationale of the patient in the scenario utilising the information that you have been presented with in the scenario.

The immediate interventions to manage the patient will need to be discussed and analysed using supporting literature. The nurses role in the context of the episode of care need to be explicit as well.

The essay will need to demonstrate knowledge and understanding of the relevant pathophysiology and also physiological concepts for the scenario which you will need to apply in the context of the assessment, interventions and nursing management.

You will need to discuss all aspects of pharmacology that apply in the scenario with regards to rationale for the drugs and i.v fluids being used, pharmacokinetics & pharmacodynamics and the nurses role. This must be applied in the context of the information presented in the
scenario about the patient.

A conclusion that summarises the content of the discussion in the essay.

Throughout the essay your discussion will need to be supported with evidence from appropriate nursing literature and text; show application of module content and demonstrate safe practice and care.

You will need to reference using the Harvard referencing system for Middlesex University