nursing care examine essay

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The goal of this nursing jobs care examine is to demonstrate that, like a student health professional, the copy writer is capable of developing and delivering the abilities needed for evaluating and addressing each individual patient’s care requirements. Included in these types of set of expertise, is the ability to develop essential thinking, decisive decision making plus the ability to think about events to be able to become a better health care provider. The sufferer in which the writer will discuss was based on an 83 year old guy, pseudonym Mr.

Scott who had been admitted into accident and emergency via a referral from his doctor presenting with exacerbation chronic obstructive pulmonary disease (COPD) with a history of congestive heart failure (CCF). On admission to car accident and crisis Mr. Scotts’ team required arterial bloodstream gases, purchased a pulmonary function checks and a chest Xray.

Prior to the exacerbation of Mr. Scotts’ condition he frequently attended a cardiac medical center due to becoming a long term patient of congestive cardiac inability and also attended pulmonary function clinic intended for tests (pulmonary function tests).

Through these treatment centers Mr. Jeff was informed on his prescription drugs and current condition. In admission of Mr. Scott, the writer decided to utilize the frameworks Roper Logan and Tierney (2000); Orem’s Self Care Structure (1995) and Gibbs (1988); which incorporates each device of assessment known as, prepare, implementation, analysis, educate and reflection. Making use of the above frames, an improvement of Mr. Scotts’ current excitement of chronic obstructive pulmonary disease (COPD) was noticed to have recently been resolved and a new analysis of Mr. Scotts’ attention was developed.

The chosen tool of expression used is known as the Gibbs cycle of reflection. The writer applied this tool in order to evaluate the sufferer care. The rationale behind this is to attempt to grasp reflection so as to apply this kind of to every day practice, thus improving being a student nurse. The Gibbs cycle involves a description of the incident, feelings and thoughts experienced and also evaluation and analysis from the incident, findings and plan of action (Gibbs, 1988). According to Barnett (2005) using a instrument of representation, to give a merchant account of activities in the clinical setting can aid the nurse to examine and explore their feelings regarding affected person care.

Key body

Eighty three year old Mister. Scott was admitted to accident and emergency having a referral coming from his general practitioner, presenting having a recurrent higher respiratory tract contamination and a history of exacerbation of chronic obstructive pulmonary disease (COPD) and congestive cardiac disease. Due to his history of serious obstructive pulmonary disease (COPD), Mr. Scott was sent for a breasts x beam to assess the deterioration of his lung area due to his condition. (Alexander et approach. 2009) Content admission in to accident and emergency, Mister. Scott was sent to St . Pat, Thomas, Johns’ ward where the copy writer was operating at the time as a student registered nurse.

The copy writer found, when assessing Mr. Scott, that he resided alone, nearby, was a widower of ten years and had two daughters who have also existed near by. Although Mr. Jeff had many concerns, he also had a good online social network such as the support of as well as a home help deal of 6 hours per week, which included foods on wheels. The local public health nurse also called to determine Mr Scott on a cultural capacity. At present the main health issues which faced both Mr. Scott and his family were; the deterioration of his dyspnoea, relevant to his chronic obstructive pulmonary disease; pressure ulcers, due to developing pressure ulcers while in clinic in prior years and anxiety from both Mister. Scott fantastic family because of the unknown. Reassurance was given and so they were discussed what attention he was to receive.

Issue # 1 Inhaling and exhaling.

The key characteristic of chronic obstructive pulmonary disease (Barnett, 2009) is experiencing breathlessness. Being out of breath, short of breath for most individuals can be the two a stressful and frightening encounter, which can increase anxiety levels. In previous studies, males predominantly more than women were found to be affected by chronic obstructive pulmonary disease (COPD); but also in a recent research carried out by Meilan et ‘s. (2007); studies have found that cases of chronic obstructive pulmonary disease (COPD) will be increasing in women world wide. The attention Mr. Scott received was split in two, short term and longer term care; both of that have been constantly re-evaluated to maximise productivity and quality of treatment.

As part of the short term care strategy the copy writer ensured which the bedside was set up with suctioning equipment help ready for potential complications. To avoid complications, one example is tachypnoea (rapid breathing) which is found to become an early sign of respiratory system distress (Jevon and Evens 2001); the golden general guideline, depth and rate of breathing was monitored and recorded effectively (Jevon, 2010). Further lowering the risk of issues occurring, Mr. Scott was encouraged to sit up within a semi fowler position while enduring deep breathing exercises allowing him to breathe with greater ease and comfort. The rationale at the rear of this was supported by a study completed by Duggan et al. (2005).

The long term target was to make certain that an air saturation level between 88%-94% is preserved (Alexander ou al 2009). To keep an eye on oxygen saturations levels, a pulse oximeter was put on Mr. Scott’s finger. The explanation for this is to detect fresh air absorption of haemoglobin (Plaice &Graham, 2000). A study carried out by Groeben (2003) shows that applying high concentrations of oxygen to people with chronic obstructive pulmonary disease (COPD) will decrease the respiratory drive, resulting in respiratory depression. This kind of finding offers rationale to why a minimal flow of oxygen healing is given to individuals with long-term obstructive pulmonary disease (COPD). Humidification was added to Mr. Scotts’ air therapy to warm and moisten the gas (Jevon and Ewens 2001) endorsing secretions whilst enhancing sufferer comfort (Woodrow 2005). The explanation for this is the fact oxygen may dehydrate revealed membranes in the upper respiratory tract.

Issue #2 Pressure ulcers.

According to Lawrence ainsi que al (2010), every person’s skin changes with time, this can be a normal technique of ageing. With this modify comes a decrease in their elasticity and turgor, therefore with grow older one has to make certain vital proper care of skin has in an attempt to prevent skin breakdown. Due to Mister. Scott as an elderly guy of 83, the article writer was concerned with skin sincerity. A tool known as the water low score utilized in order to measure the likelihood of Mr. Scott expanding any pressure ulcers during his be in the hospital (Whiteing 2009). As Mr. Scott had developed pressure ulcers in a previous experience, he would have an elevated chance of a re-occurrence. In an attempt to prevent this example the article writer requested that Mr. Jeff be nursed on an air mattress. (Stafford and Brower 2009). Issue #3 safety and delerium

Anxiety is an emotional state influenced simply by past experience, which exists at a given point in time using a level of depth related to a future perceived threat (Passer and Smith 2007) The provision of information is really important to the individual as research from, Biswajit et approach. (2009) has demonstrated that an informed patient with a good understanding of their condition decreases anxiety. Harvey (2002), advise shared control in patient-practitioner interactions for the reason that patients successfully participate in handling important events. After liaising with Mister Scott’s’ medical team concerning his anxiety, a low dose of Alprazolam brand name Xanax 5mg, was charted and given in an attempt to relieve his anxiety. Alprazolam reduces anxiousness within people (De Witte, et al 2002).

Health care administered

In admission to the ward Mister. Scotts’ medical team ordered pulmonary function tests. These tests know what type and extent of restriction the patient is going through (Alexander et al 2009); furthermore indicating any increase/decrease in their condition (Daly 2009). Arterial blood vessels gasses were checked to be able to determine the quantity of O2 to be administered lowering the risk of hypoxia. The rationale for taking arterial bloodstream gases was going to determine the bloods Ph and the T-MOBILE levels moving within the blood. (Alexander ou al 2009). A sputum sample was also gained from Mr Scott and sent to the lab for traditions and awareness testing to trace which bacterias is present inside the sputum to be able to treat chlamydia (Gray ou al 2008). Through reflection the article writer recalled that oedema might be present in the reduced extremities second to Mr. Scotts history of congestive heart failure and chronic obstructive pulmonary disease (COPD) and recorded the findings.

The rationale for this was that, Mr. Jeff suffered with congestive cardiac inability which elevated the risk of expanding oedema while in accommodement, putting increased pressure on functioning bodily organs (Morley et al. 2009). During the authors assessment of Mr. Scott it appeared that having been suffering from an abrupt onset of dyspnoea, (laboured breathing). Using critical thinking, the writer administered oxygen therapy at more twenty four percent and right away informed Mr. Scotts’ group on his state. The rationale lurking behind administering low dose T-MOBILE is due to the simple fact that the hypoxic drive may be decreased simply by administering a huge dose of O2 bringing about respiratory inability and the worsening condition of the sufferer, (Simmons ainsi que al. 2004). Using the Gibbs reflection routine, the article writer believes pupils should be under constant guidance in order to obtain the knowledge of administering T-MOBILE to people diagnosed with chronic obstructive pulmonary disease.

The medical crew looking after Mister. Scott prescribed an antibiotic called Tazocin (4. 5grams three times a day) to get given intravenously. The rationale pertaining to administering this antibiotic was to attempt to deal with any disease that the sufferer may have developed. Also approved for Mister. Scott was obviously a steroid and bronchodilator. The explanation for charting a anabolic steroid and bronchodilator was that, they are really found to decrease inflammation up way as well as open up the airway (Greenstein et ing 2009). As a result of Mr. Scotts’ condition he was a long term user of dental Corticosteroids. Research (Walters et al. 2008) have shown that, corticosteroids decrease the need for added medical remedy while, also shorting clinic stay.

Upon previous representation (Gibbs 1988) as a student nurse, the writers’ know-how developed because of reflection coming from previous sufferer care. The writer knew that due to Mr. Jeff being on steroids, his glucose levels needed to be inspected once a day concerning ensure it stayed in the normal selection. The rationale in back of monitoring Mr. Scott’s’ blood glucose once a day was due to the side effects that are straight related to the administration of corticosteroids. Such side effects will be as oral cavity ulcers, weight gain and elevated skin thinning (mayoclinic. com). The article writer encouraged Mr. Scott to rinse his mouth area out with water content administration of oral anabolic steroids to reduce the development of oral ulcers or a candida infection of the mouth, (Greenstein et approach 2009).

The Roper, Logan, Tierney (RLT) 2000 breastfeeding framework helped the article writer in focusing upon the care examine. This model includes key elements such as social status, environmental factors in addition to the physical/ emotional factors which will influence people in their daily lives (Roper et approach 1991; the year 2003, Newton 1991). This model is manufactured adaptable to the patient and not for the person to adapt towards the model of nursing; so that it allows the nurse to care for each patient on an individual level (Roper ou al 2000).

Nursing can therefore end up being defined through this model when it comes to helping visitors to prevent, minimize, solve or perhaps cope with concerns (actual or potential) when ever relating to those activities of daily living, (Roper ainsi que al. 1990).


Although the Roper Logan and Tierney’s’ model of nursing covers a holistic view, a model known as the Orem’s Self Proper care Framework in accordance to Fawcett (1995) concentrates on the people’s self maintenance and control through a type of action generally known as self-care. This model could be seen as beneficial to Mister. Scott like a patient whom has been diagnosed with chronic obstructive pulmonary disease as a main part in maintaining good health is a great understanding/ conversation, knowledge and education showing how to take care of ones’ personal (Eva ainsi que al. 2009).

The aim of this kind of piece of work was to assemble while using the tools of assessment a person care plan. This was to be drawn up with the patient and the writer hence the system of treatment would be of an individual position. The article writer also was executed to demonstrate that with critical thinking and decisive decision making the patient involved received treatment when needed.

While the article writer worked on the ward mentioned a strong therapeutic relationship have been built among patient and student registered nurse, this allowed the patient to feel at ease when ever asking concerns regarding his condition enabling the article writer to educate the sufferer at a greater understanding. Upon Mr. Scott’s discharge he expressed a much better understanding of his knowledge about his condition, he also believed that in the event that or if he experienced another exacerbation he’d not truly feel as stressed and be better able to cope with that. Hearing this as a scholar nurse the writer felt that it experienced enhanced specialist development for even more nursing practice.

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