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 …show more content…
The nurse found Mrs Smith to be tachypnoeic, her respirations were recorded as 24 breaths per minute it was observed as being fast and it appeared that her accessory muscles were being used. Mrs Smith’s pallor also appeared flushed and her saturations were documented as 93%. The nurse used the stethoscope to check for wheeze the patient’s lungs were clear and chest rise was symmetrical. Mrs Smith was commenced on 100% oxygen through a non-rebreathe mask, oxygen as an intervention is necessary as Creed & Spiers (2010) highlight ‘metabolic demand for oxygen throughout the body is hugely increased by sepsis and is essential to ensure the supply of oxygen is maximized’ .The nurse monitored the patient closely because in her confused state the patient may try to remove the oxygen mask.
An evaluation of Mrs Smith circulation was the next step carried out by the nurse, as in the breathing assessment Mrs Smith pallor was noted as being flushed and the patient appeared confused this could be associated with poor cardiac output. The nurse recorded the patient’s blood pressure using a dinamap it was measured at 88/50, it was then rechecked manually to ensure accuracy. The pulse was checked manually for rate and rhythm it was recorded as 98 beats per minute. Capillary refill was checked, was found to be normal.
The next step of the framework is disability. Mrs Smith’s conscious level was measured
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
Sepsis remains one of the most deadly diseases in the country. According to the literature, a majority of sepsis cases filter though the Emergency department. The diagnosis and treatment of sepsis are complex and the barriers to improving these things are even more intricate but the fact remains that improvement of sepsis care begins in the ED. Early recognition of sepsis using the SIRS criteria followed by multidisciplinary rapid response diagnostic testing and treatment are the keys to improvement of sepsis care in the ED.
This particular nurse practitioner (NP), Diana Hayes, seems like somebody who has done this job for decades; in reality she obtained her acute care NP (ACNP) degree in 2014, less than 2 years ago and got her advanced practice license in Tennessee the same year. Her current role working as an intensivist NP in the trauma unit at Vanderbilt Medical Center is part of a recently launched program that brought NPs into the care of the sickest patients in the hospital.
His skin was mottled with an increasing capillary refill time. Schmidt and Mandel (2008) suggest this is a sign of hypoperfusion as the skin is vasoconstricting due to the redirection of blood flow to the core organs.
The American Association of Critical-Care Nursing (AACN) is the largest nursing organization of a non-profit character in the world. It represents 500,000 nurses and their interests. The responsibility of these nurses is to provide health care services to the critically and acutely ill patients. Thus, the duty of the AACN organization is to give its members all the possible resources and knowledge, so that they could help critically ill clients become healthier. Therefore, I would like to join the AACN organization. To become a member of this particular organization I need to learn more about it by researching some questions.
The roal of public health nursing is to promote and protect the health of the population. This proactive approach does not limit their scope of practice to health concerns of individuals but also to developing and implementing programs and policies that help enhance the health of populations. The role of public health nurses is to focus on population centered care with the outcome of promoting health, preventing disability and disease, and improving the quality of life. An effective public health nurse is able to evaluate assessment data to define population diagnoses and set priorities accordingly. They can also serve as advocates for individuals and families in the population to develop policies, access resources, and protect their
Do you want to help save a life in the medical field but not do all the dirty work? Well being a nurse anesthetist is the perfect job for you. You get to be involved with the surgery and you don't need to even touch the insides of another person. Betty Horton, a experienced CRNA, says “Beings a nurse anesthetist is the best job you could ever have. It started my life off and made other things in my life accomplishable.” There are 170,400 jobs available to become a nurse anesthetist. That means there is 170,400 opportunities to help save someone's life. I believe that college is important in order to become a successful nurse anesthetist.
Hospice care is a model of care that focuses on relieving symptoms and supporting patients with a life expectancy of six months or less (Altshuler, 2013). For most nurses, caring for a dying elder (individual aged 65 years and above) is a discrete, time-limited experience that begins with first contact, often in a hospital, emergency room, or long term care facility, and ends with the death itself (Phillips & Reed, 2008).
The exact definitions, stratification, and approach to diagnosis of the sepsis spectrum has been a persistent, yet seemingly productive, endeavor for many years1,5,16. Multiple consortiums have addressed the approach to diagnosing sepsis. In 1992, a consortium, comprised of the American College of Chest Physicians and the Society of Critical Care Medicine, instituted the Systemic Inflammatory Response Syndrome (SIRS) criteria which established the fundamental screening tool for identifying individuals with an inflammatory immune response (Table 1)5. A patient exhibiting two or more of the SIRS criteria combined with the presence or suspicion of infection was the fundamental criteria for sepsis diagnosis5. Although this approach is of merit, it is too broad. Patients recovering from surgery or suffering from various non-infectious processes would meet the criteria for sepsis under SIRS17,18. An exhaustive list of exogenous and endogenous processes may generate a SIRS-inclusive response in the absence of infection18. A criteria with greater specificity was greatly needed.
The role of a family nurse practitioner is a fundamental portion of the future of healthcare. The role is clearly not as understood by other healthcare professionals as needed which results in the disagreement if the role of a family nurse practitioner is even required for primary care. As people are getting older, the need for medical professionals that can provide patient care to our ever growing population increases. The need for the role of family nurse practitioners will grow too. The role of the family nurse practitioner, the ability of the FNP to be able to transition into their role.
In this essay we are going to explore the connection between professional nursing practice and professional caring. I will outline the terms of professional nursing practice and what makes nursing a profession? I will describe the term of professional caring and the connection to the nursing practice and discuss the dilemma of care and cure. And also determine the importance of both in professional nursing practice.
Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of
A nursing diagnosis identifies an actual or potential response of a patient to a health problem (Jones 2009). Nursing diagnoses are important because they provide the foundation for the selection of nursing interventions (Walton 2008). This care plan is the concluding half to the initial care plan that identified nursing diagnoses and goals with the aim of promoting the holistic wellbeing, mental health, and independence of a 68 year old Mr. Bertoli who has returned home from hospital after experiencing a stroke. Particular emphasis will be placed on proposed interventions to achieve Mr. Bertoli’s healthcare goals and the provision of rationales. This is important to justify the significance of the interventions and indicate
This assignment will present a nursing care study of a patient on a cardiac ward. The patient will be referred to as Ann to maintain confidentiality (NMC, 2008). Ann’s consent was gained prior to starting this care study. The care study will be developed using the Nursing process and the Roper, Logan and Tierney model. These will both be outlined. The assignment will focus on the assessment process and one problem identified during the assessment and the nursing care which followed this.
Jane’s asthma was acute severe. Initially to alleviate some of Jane’s breathlessness she was sat up right in the bed and supported with pillows to improve air entry. Due to her low oxygen saturations she was placed on 40% oxygen via Hudson mask (BTS 2006), as Jane was mouth breathing the mask was the appropriate device to use to ensure adequate oxygenation (Walsh 2002). According to Inwald et al (2001) hypoxemia is frequently a primary cause in numerous asthma related deaths. By administering oxygen promptly, for acute severe asthma, serious hypoxemia