logo

Clinical Practice Assignment

   

Added on  2021-04-17

14 Pages4826 Words158 Views
AA 5.1 - ASSIGNMENT (Clinical Practice 2)Common DisordersName:Date:

Body SystemCommon DisorderCardiovascular SystemAcute Coronary SyndromeRespiratory SystemAsthmaMusculoskeletal SystemLimb Injury (Lower leg fracture)Endocrine SystemDiabetes (Hypoglycemia)Digestive SystemGastrointestinal bleedingUrinary SystemUrinary Calculi (Renal Colic)Reproductive SystemEctopic pregnancyIntegumentary SystemBurns (Body)Nervous SystemStroke/ Transient Ischemic AttackFor each ‘Common Disorder’ in the table – complete:1.Cause of the Disease/ Injury:The underlying pathophysiological cause of the condition, includingwhereappropriate; the physicalcausesRisk factors associated with disease, or signs and symptoms of diseaseRefer to:QAS Clinical Practice Guidelines (CPG), Some diseases(gastrointestinal bleeding & renal colic) will require external research 2.Assessment:Including the Clinical Features (signs and symptoms) Assessment of the patientRefer to: QAS Clinical Practice Manual – Clinical Practice Guidelines

3.Management:The treatment plan, including procedures (skills) and pharmacology (drugs) foryour scope as an Advanced Care ParamedicIndicate ‘cautions’ and ‘contraindications’ for drugs being usedIdentify possible requirements for assistance from higher levels of care(Critical Care Paramedics)Refer to: QAS Clinical Scope of Practice QAS Clinical Practice Manual – Clinical Practice GuidelinesQAS Clinical Practice Manual – Drug Therapy Protocols4.Impact of Management:What are the short term, and/or long term impacts the management andtreatment for this patient may have on the patient for both the procedures andpharmacology that may be provided at your level? (eg Adverse effects andtheir causes)Refer to: QAS Clinical Practice Manual – Drug Therapy ProtocolsAdditional information:When locating signs and symptoms – refer toQAS Clinical Practice Guidelines toassistFor ‘Risks Factors’ associated with disease – refer to QAS Clinical PracticeGuidelinesWhen searching QAS Clinical Practice Guidelines – not all diseases have specifictreatment guidelines. Where there is no specific guideline, refer to the region, orsigns and symptoms related to the compliant. An example would be ‘AcuteAppendicitis’ – there is no specific pre-hospital treatment for this disease, however itdoes fall into the category of an ‘Abdominal Emergency’, same as ‘Acute BowelObstruction’ and many more.When completing the section on ‘Management’ useQAS Clinical Practice Guidelinesto assist.For ‘Pharmacology – cautions and contraindications – refer to QAS Drug TherapyProtocols.

Acute Coronary Syndrome:1.Cause of the Disease/ Injury:Acute coronary syndrome is caused due to the buildup of the fatty deposits on the walls of the coronary arteries and the blood vessels delivering nutrients to the heart muscles. When these plaques ruptures or splits the blood clot is formed. The clot prevents the flow of the blood to the heart muscles. Due to the low supply of the heart muscles the cells of the heart muscles can die, resulting in damage to the muscle tissues causing conditions like myocardial infarction. If cell death does not occur and there is still inadequate oxygen in the heart muscles. This causes the impairment of the heart muscles resulting in unstable angina.2.Assessment:Diagnosis of acute coronary syndrome can be done by the symptoms like chest pain, hurt burn, tightness, dyspnea (shortness of breath), dizziness, lightheadedness. Once the life threatening symptoms have been identified an ABCDE approach can be taken to assess thesymptoms.Airway- It is to be ensured that the airway is patentBreathing- assessing the oxygen saturation, respiratory rate Circulation- rhythm and volume, capillary refill, blood pressure, general color.Disability- Establishing the conscious level using Glasgow coma scale Exposure- Monitoring of the temperature and external abnormal signs.The assessment- A normal 12 Lead ECG within 10 minutes, assessment of vital signs3.Management:Oxygen, Aspirin, GTN, Antiemetic (Preferred narcotics for ACS).Pre-hospital fibrinolysis administration includes Clopidogrel, Tenecteplase and Enoxaparin. Dosage- > 18 years- 600 mg, swallowed with a small quantity of water, 15-48% of thepatients display a very poor platelet inhibition response to clopidogrel. Hence for theselected patients, ticagrelor can be given. QAS officers are not allowed to provideclopidogrel to the pediatric patients.Dosage- 30 mg (loading dose) to be administered within 15 minutes, intravenously Maintenance dose- 1mg/kg single dose that should not exceed 100mg.Contraindications- reaction to clopidogrel, active bleeding, and patients contraindicated forthe fibroninolysis administration in the prehopital period.4.Impact of Management:Side effects: Hemorrhage.Side effects of Enoxaparin include hemorrhage and thrombocytopenia. Lower rates of morbidity would be found. The nitroglycerins work by relaxing the blood vessels of the body thus increasing the blood flow in the coronary arteries and the amount ofoxygen that arrives to the heart muscles and thus reduces the work load that heart requires to produce against them and oxygen it uses. The analgesics would reduce the work of breathing, reduce anxiety and would alleviate breathlessness.

End of preview

Want to access all the pages? Upload your documents or become a member.

Related Documents
Acute Coronary Syndrome Management
|11
|2575
|61

Mortality Reduction With Use of Oral Beta-blockers in Patients with Acute Coronary Syndrome
|7
|2004
|36

Oxygen Therapy for Acute Coronary Syndrome
|9
|2235
|410

Health Variation Question 2022
|11
|2794
|16

Pharmacology and Practice Scenarios
|24
|5259
|123

Nursing, Clinical Scenario Assignment
|15
|2983
|215