Myfirst patient is 89 years old. The past two temperature readingsrange at 104 F, with a BP of 140/40. The pulse rates at 115, withstrenuous breathing, and continued diarrhea for the past two days. Ihave to get rounds to the patient each day and determine thepriority.
Mysecond patient is a surgical operation that lasted for twenty hours.The patient is still unconscious with life supporting equipmentaiding to breathe and eat. Their pulse rate ranges to 100, and theirBP is normal.
Mythird patient suffers from sickle cell anemia. His hemoglobinelectrophoresis confirmed his SCD. The patient has anemia, frequentepisodes of pain, delayed growth, hand-foot syndrome, poor vision,pale skin, yellow tint on skin and whiteness of the eyes. Myresponsibility requires I lay out the priorities to take when caringfor the patients following a logical process that looks upon allneeds of the patients. My priorities range as follows for thepatients named above.
Theprincipal activity for each patient begins with the investigating andefficient working of the physiological factors. The airway,breathing, and circulation is among the top priorities for the threepatients (Gulanick, 2014). To start, I have to perform a check on thesecond patient who is still unconscious after the long surgery.Secondly, I have to check the breathing tubes and ensure that thepatient’s lungs do not expand from the air intake from therespiratory equipment (Gulanick, 2014). Additionally, I must takeconstant pulse rates displayed by the monitors in the room.
Mythird activity is moving to the room where the 89-year-old man lies.His breathing difficulties proof impaired gas exchange or ineffectivebreathing pattern which I have to report to the senior doctor. Theimmediate step is to place the senior man under breathing assistiveequipment to ease the hard work performed by the lungs that face arupture risk (Weiss, 2015). Evaluation, the success of the care plan,follows with comparing the former patient’s medical readings withthe current ones taken today. The risk for Altered nutrition lessthan body requirements is administered by initializing a feedingprogram to counter the weak signs of the patient. The hyperthermiarisk shown by the temp of above 100F is of huge concern, and medicalattention is paramount to regulate the temperate of the patienttowards normal (Weiss, 2015).
TheSCD patient receives a follow-up of the provided care plan of theimpaired gas exchange recovery process. The method works best as thepatient has symptoms relating to decreased oxygen transportationcapacity, reduced life of the abnormally structured RBC, and highsensitivity towards low oxygen tensions. The engagement involvesmonitoring the respiratory rate, the use of accessory muscles, depth,and are of cyanosis (White, 2013). The cardiac rhythm will beparamount as well as noting any absence or presence of adventitiousand breath sounds. Chest pain, fever, increased fatigue, sputumsecretion, breath shortness will help me detect the development ofacute chest syndrome that increases the heart workload and oxygendemand making the SCD worsen. I will assess the levels ofconsciousness to monitor the brain tissues’ levels of sensitivityto decreasing oxygen. More so, I will instruct the patient throughcoughing exercise to promote the aeration of the lungs (White, 2013).Drugs administration is paramount, and the prescribed drugs such asantipyretics will maintain a normal temperature for the patient toreduce the oxygen demands in metabolic processes. Such drugs lackaffective serum pH present in aspirin (White, 2013). Furthermore,administering antibiotics will subdue any pathogens detected in theSCD patient.
Doyou feel that the procedures followed in the prioritizationdiscussion above provide meaningful recovery leads for the patients?
Gulanick,M., & Myers, J. L. (2014). Nursing care plans: Diagnoses,interventions, and outcomes. Philadelphia: Elsevier/Mosby.
Weiss,S. A., & Tappen, R. M. (2015). Essentials of nursingleadership and management.
White,L., Duncan, G., & Baumle, W. (2013). Medical-surgicalnursing: An integrated approach. Clifton Park, NY: Delmar CengageLearning.Bottomof Form