Case Studies on Ivy Knowles, Agnes Anderson, and Tom Brown

Read case studies on Ivy Knowles, Agnes Anderson, and Tom Brown. Explore the complexity of care, thoracic injury, respiratory assessment, risk on floor overnight, acute kidney injuries, and more. Find solutions to nursing concerns and interventions.

Case Studies
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Case Study 1: Ivy Knowles
Complexity of care:
There is a lady named Ivy Knowles recently meet with an accident with a motor vehicle
which was moving ta 60kph speed and she get restrained with the head collision. Due to tgis she
get chest injury, right hand fractured and right knee injury. She was taken to hospital with the
help of ambulance where on admitting her to hospital she was provided with medication such as
irbesartan of 75mg and propylthiouracil 25mg mane as well as 50mg nocte in order to revive her
on the normal condition so that she can get prepare with further treatment. The case of this old
lady Ivy Knowles is very serious as she is having a bad medical history where she si having
several health issues, which make it difficult to treat them as due care is required to be consider
for treatment exert to them by doctors. She is already suffering from high blood pressure,
thyroid, her left knee is already replace, cancer treatment was done previous, she also have an
eye issues i.e. Cataracts and bones are also not working appropriately as they are weak and
brittle. So, there is lots of complexity in providing care and treatment to the lady due to such
history as it may leads to critical situation to her. Therefore, for tackling her situation effectively
it was decided to firstly study the case thoroughly then move to treatment and for this a normal
check-up is done while taking her to eth emergency department and from this check up it has
been found that the Respiratory rate of lady is 32, HR is 95, oxygen saturation is around 82%,
temperature is 35.5* and GCS shows 14. Hence, her treatment require doctors or nurses to have
due attention and care while treating her as the medical history and current health condition is
not good at present which make this case more complex.
Thoracic injury:
The ivy Knowles get thoracic injury which si basically a injury which is caused due to
some accident where the reparation, blood circulation or both get disrupted from normal
situation. Due to this accident she is having a thoracic pain on the log roll, addition to this she is
having a bilateral swelling and also get injury in her right knee due to accident so she is having a
sever pain in right knee too.
Respiratory assessment:
The respiratory assessment is also done where its rate is recorded as 32 which is very high as
compare to normal RR which is consider in between 12 to 16 breaths per minute.
Optimising oxygenation: -
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As the lady is having the oxygen rate down the normal rate, she require a oxygen mask as below
85% oxygen rate can put the organs in danger. In this adjust the machine and set the flow rate of
oxygen in meter so that it can be adjust to the normal rate.
Allied health role:
The medical staff in this case are required to perform minor procedures like suturing of
laceration, splinting of fracture, first aid, medication, diagnosis etc. The medical staffs are
responsible for performing this action and responsible for assisting the doctors in providing
appropriate treatment.
Pain assessment:
Effective pain assessment practices is very crucial in order to provide better care to
patient by determining the kind of treatment they require. There are several tools that can be used
fro pain assessment such as Wong baker pain scale which shows several faces ranging from
happy face at 0 to crying face 10 to rank the pain rate. Other than this another scale NRS can be
used to rank the pain such as no pain, mild, moderate, sever etc.
Pelvic binder role:
It is used by the doctor in order to stop bleeding of the patient to take her into normal situation.
The pelvic binder is a device which is used to compress the pelvis of the patients having pelvic
fracture in order to stop the flow of blood.
Role of intraosseous:
It is used to directly injecting the marrow of bones which provide a non-collapsible entry point
in systemic venous system. This will support in providing fluid and medication when intravenous
access is not available or not feasible.
Spinal immobilization: -
It is referred to the spinal motion restriction which is a practice that emergency medical services
personnel uses in order to maintain the normal anatomical alignment and restrict the motion of
the spinal cord.
Roel of documentation:
The documentation plays a significant role in medical field as it help in providing better care
while considering the legal norms and standards. With the help of arranging proper
documentation, this information can be used to communicate about the health of patient with
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other health care personnel for better treatment, ensure appropriate reimbursement, record the
CMS hospital quality indicator and help in reducing the risk management exposure.
Roel of professional care : -
The professional care plays a significant role in enhancing the access as well as quality of health
care for population. These all help in providing the essential services which promote health,
prevent disease and deliver the health care servi8ces to people in more efficient manner.
As per the above mentioned information it has been found that the patient is suffering
from Thoracic injuries which brings three major concern in term of nursing such as monitoring
respiratory status, chest tube drainage and supportive care.
Case 2: Agnes Anderson
Risk on floor overnight exposes Agnes
Mrs Agnes Anderson fall last two days ago when she was stepping down to the stairs on
last 3 step which was very much dangerous to her as she is having a long medical history due to
range of health issues. Though she fall over carpet but still the accident was very much severe as
when she fall on the floor she don’t even able to stand up by her own. This was the major issues
as it creates a huge risk to her health. As when she fall she get multiple traumatic injury over her
leg, right arm, distal radical facture along with the dorsal angulation, a non-displaced fracture of
C3, multiple of broken rips and ulna styloid fracture. Due to all these injuries the risk to her
health get increase when she doesn’t stand up after the accident, as she was a diabetic person so
that bleeding was continue which make her body weak. Other than this the fractures that she got
at several places make her body stiff which even get more harder to the mobile, but if she get
stand up and may call for help then the situation will not get that much worsen. But due to her all
night spent over the carpet she get several issues RR moved to 30 which make difficult to cool
down the breath and blood pressure, HR moves to 128 which is very much high, BP was about
99 etc.
Acute kidney injuries: -
Due to this accident Mrs Agnes also get a acute kidney injury i.e. a sudden kidney failure
or damage that happen overnight after her fall from stairs. This is so because due to lack o
treatment the blood flow was imbalances which causes a build up of waste product within the
blood which in turn make it difficult for the kidney to keep right balance of fluid in body.
Role of intervention in palliation:
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The palliation care is considered to be a most crucial intervention that are taken by
medical staffs in order to improve the life quality of patients that are facing life threatening
illness, by providing relief to treatment of the pain. By adopting these interventions Mrs Agene
can be provided with the relief from the pain which she was tolerating from two days which
support a lot in making her recover from the other injuries too which was the result of this
accident.
Optimising the oxygenation-HFNP
Due to this accident the respiratory rate of breath per min get increased which affected
her respiratory system and due to her past medical history of suffering from COAD diseases
make it difficult to breath appropriately as it block the airflow and other than this it also affected
the heart function by disturbing the blood pump. Hence it required the ventilation treatment to
the lady for oxygenation optimisation where the Agene will be provided with appropriate oxygen
by diffusing it passively through the alveolus to the pulmonary capillary where it get into the
haemoglobin and get dissolved within the plasma. This in turn help in transport the oxygen to
lungs to the peripheral tissues and make it function appropriately to make sure that women get
recover from such issues which is making her treatment difficult.
Role of allied health workers
The main role of allied health workers in this case is to assist the doctors by perform
appropriate diagnosis of past history of the patients as well as present situation of the lady in
order to provide detailed information about the case to doctor. Other then this they are also
responsible to provide basic treatment to the Agene at the time of her admission to the hospital
so that she get some relief from her pain by getting normal medication treatment and make her
prepare for the treatment from doctor.
Advocating for patient:
The allied health workers are consider to be the advocate for the patients as they are the
one who first person to recognise about the issues or problem of the patients and frequently serve
as a safety net to them. There sense of patient care is consider to be the best patient care
accountability which add value and quality to the treatment that patients get.
Roel of supportive fellow staff:
The role of supportive fellow staff members are responsible to make all the instruments
and resources available so that patients get delivered with best treatment on timely manner. ither
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than this they are also responsible for performing a basic check for the patients like blood flow,
RR, oxygen, pulse etc.
Importance of documentation
The documentation before or after the treatment is very much crucial for the health
practitioners. This is so because it help in arranging all the essential information regarding the
health of patients under a format for further reference while providing treatment. Additionally, it
can also be used to consult with other health care experts so that best possible treatment can be
exert to them. Along with this it also keep the heath care service provide away from any kind of
legal issues by presenting all their statement regarding the consequences of particular treatment.
As per the above-mentioned case of Agene it has been found that she was suffering from
a sever issues as she get delayed in getting a proper treatment over injury as well as damages on
timely manner as she stayed whole night over the floor after accident. So in this case the major
nurse concerns are nurse must focuses toward stabilising the patient by providing them
immediate treatment that can get back to the normal situation i.e. normalising the blood flow,
stop the bleeding and body fluids before providing nay kind of standardised treatment. The
second concern of the nurse is to provide patient with airway, breathing and circulation treatment
by providing them with oxygenation, ventilation and perfusion. The third concern is to provide
the supporting care to the patient while it is being treated by the doctor.
Case 3: Tom Brown
The Tom Brown was travelling with the car and hit by another car accidently where he
get a motor vehicle collision at the rate of 100km/hr and after this accident he got stuck in
confinement for around 2 hours and also get his right forearm deformity and facial injury. The
accident was very much serious that causes several injury and damage to the patient. Among
them the major issues which patient get confront while accident is that the hit among car was so
hard that he enrooted with the large brown vomits as well as his SBP also get dropped to 145
mmHg to 110mmHg and the respiratory rate get higher i.e. up to 28 per min.
From this accident while admitting the patient to the emergency department diagnosis of
his situation was performed where it is found that he may have a abdominal injury as he had 4
vomits and, it is also assumed that he may have the pelvic fracture, right forearm fracture etc. In
addition to this, due to his previous medical history he is suffering from the IHD which usually
block the coronary arteries which in turn limit the blood flow to the heart and due to this accident
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the respiratory rate of the patient get increased to 28 breaths per min which consider to be 16-18
breath as normal rate. This in turn creating a pressure for blood flow but due past disses of IHD
and high blood pressure make it difficult to make the patient back to the normal situation for
providing them with eth father treatment.
Additionally, it has been found from the secondary survey that the patient has blood in
both the nose, neck was also injured. But the oxygen flow was normal at the time of patient
admission and there is not any kind of abnormality is detected from eth diagnoses. Other than
this there is no pain of palpation and no injury to legs. Hence this make it clear that the situation
is not much worsen he can easily recover with better medication and treatment and only have
certain injury in abdominal and neck, along with a fracture in right forehand.
So, in this case the major point of concern in nursing is firstly to perform stabilisation
when the patient get arrive to the hospital or picking them up at the accident place. In this the
EMTs or nurses are responsible yo provide Tom with the attention and care by providing first aid
to stop the bleeding, wipe off all the blood spread out on the body, arranging proper evacuation
and calming down the patient. After that the next concern of the nursing staff is to identify about
the patient if having any kind of the life threatening issues so that they can diagnoses earlier
which make available with adequate information that are required to provide appropriate
treatment to the patient. These issues mainly related with the respiratory, cardiovascular and
neurological system and if such issues involve then proper arrangement of machines and tools to
provide them with better treatment. The third concern of the nursing staff in such case would be
making the body of patient relaxed by controlling and calming down all the functions in order to
prepare them for final ED treatment by providing proper assistance. This mainly includes
asserting the aggressive fluid therapy and also proper medication should be provided to recover
the patient from the abdominal issue he has after accident due to which he get with vomits as it
make difficult to provide treatment until get in control the medication wont work properly for
rest of the body.
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