In this assignment given the acuteness of the condition, a five-step Emergency Nursing Assessment Framework (EMNF) will be used to analyse the assessment data (Curtis, Murphy, Hoy, & Lewis, 2009), which would support the diagnosis of respiratory failure. This is a reasonable framework in this scenario since the events that are encountered are situational following the surgery and unexpected (Fry & Stainton, 2005)…
Download file to see previous pages...
Within the nursing process, use of the stated framework has been demonstrated to be effective as a contextualised framework relevant to emergency conditions. This framework consists of 5 steps of history taking, potential red flags, clinical examination, investigations, and nursing interventions (Curtis, Murphy, Hoy, & Lewis, 2009).
The inspection of his chest revealed intercostal muscle recession, and auscultation revealed diminished air entry at both bases of the lungs with crackles audible in the right base. The respiratory rate was higher than the baseline at 28 per min with deep and laboured breathing. His SpO2 was 89% on Hudson mask at 6 L of oxygen with elevation of PaCO2 to 54. All these information indicate that he was in acute respiratory failure (Delerme & Ray, 2008).
The clinical picture indicates that this alteration in respiratory function has occurred over a short period of time. This patient was at baseline hypoxaemic indicated by his need for supplemental oxygen to maintain his oxygen saturations above 95%. Given his age and potential blood loss due to fractured neck of right femur this is expected, although the history does not suggest any chronic respiratory disease at the baseline (Calverley, 2003). This is an important part of history since quite frequently such patients develop acute respiratory failure superimposed on a chronic pulmonary condition such as chronic obstructive pulmonary disease, which is common in elderly men of his age (O'Malley, Marcantonio, Murkofsky, Caudry, & Buchanan, 2007).
While initially 3 L of oxygen per min via nasal prongs ensured a 99% of SpO2 of 99%, postoperatively in 2 days' time, his condition deteriorated. The assessment while trying to reach a diagnosis must include an attempt to determine causes for such changes. Although high temperature of 38.5 degrees Celsius may contribute to higher rate of breathing, the laboured breathing and findings at auscultation strongly suggests respiratory failure, which is further confirmed by rise of PaCO2 to above 50 (El Solh & Ramadan, 2006). While a fall of PaO2 to below 50 is expected, given his oxygen supplementation, this may not occur always unless there is severe respiratory failure. As expected the pH is 7.30 which is less than 7.35 indicating respiratory acidosis along with oxygen destaturation indicated by SaO2 of 89%, which is below normal (Antonelli, Pennisi, & Conti, 2003). The X-ray picture confirms right sided basal consolidation and collapse, which may indicate an infective episode, which perhaps is the cause of this failure, since the other reason of overuse of PCA can be ruled out through the patient's statement.
Q2. The doctor initially prescribed two antibiotics. The later appearance of fever and concomitant respiratory failure due to consolidation and right sided pleural effusion leading to collapse indicated that this infection has been acquired in the hospital.
...Download file to see next pagesRead More
Cite this document
(“Emergency Nursing Assessment Framework Assignment”, n.d.)
Retrieved from https://studentshare.org/miscellaneous/1534121-emergency-nursing-assessment-framework
The present recessionary trend, coupled with uncertainty about the future also means that couples will tend to have few children and make lesser marriage commitments, which is worrisome for the people of coming generations. The current shortfall in medical care is expected to continue for some time, as it takes at least four to seven years for a medical graduate to become fully qualified and enter into professional life.
In developing budgets for clinical research, the first step is to list all the required resources and then categorize into direct costs, modified direct costs, indirect costs and total costs.
Direct Costs is defined as costs in a grant or contract that support a project/program including personnel, equipment, supplies, patient care costs.
Several researches claimed that the performance of employees and the workplace are dependent on the strategies that human resource management applies to the organisation. According to Savaneviciene and Stankeviciute (2010), there are no established human resource management practices to specifically measure its management, though the ability, motivation and opportunity (AMO) framework provides numerous situations that can help managers to apply its theories in order to effectively guide employees in increasing their performance.
Therefore the nursing practice constitutes of the interaction between people, health, environment and nursing. The practice entails face-to-face service, which is given to the patients in a population or even a community throughout the life term. The nurse-patient relationship takes place with the intention of reacting to the needs of the service whereby intensive care is the critical role in the nursing practice.
Various types of health hazards take place every minute around the globe. Among which stroke ranks third and considered as most life battling hazardous. (Cross, 2007, p.35) But stroke is preventable and treatable disease if proper care is taken. (Turner, 2008, p.32) This report is going to convey the role of a nurse within the stroke pathway.
They will meet the requirements of clause 6 of the Code of Professional Conduct: Standards for conduct, performance and ethics" (NMC 2004:13).
Stuart (2003) asserts that the differences in formal hospital ward environments and community learning environments are often overlooked.
According to the paper based on this case study, it is essential to identify the immediate priorities of care, how the patient would be triaged and why, provision of optimal care to the patient by services and support, and delivery of culturally appropriate care in the emergency room. The case study of the patient in the emergency care department is an example of the emergency care given to a youth belonging to a different culture, who is brought to the facility in a poor physical and mental condition as a result of unprovoked assault.
Emphasis is put on peace and cooperation, because, such, are essential for long term co-existence of humanity. Such elements to look for include, diplomacy, adherence to agreements and treaties, interstate cooperation, and economic activities. This paper presents