Case Study Analysis: Priorities and Interventions for a Critically Ill Patient

Running head: CASE STUDY ANALYSIS
CASE STUDY ANALYSIS
Name of the student
Name of the university
Author note

1CASE STUDY ANALYSIS
Introduction
The care process for terminally and critically ill patients are inclusive of influences
from patient’s surroundings, their habits, their past and present health complications and their
mental health conditions that eventually increases and decreases the healthcare complications
(Malbrain et al. 2014). Therefore, to treat such conditions nursing professionals prioritizes the
care process depending on which interventions are applied in the healthcare process and
effectiveness of those interventions brings improved patient outcomes. This paper would
discuss the case study of Mr. Smith, (70), who was admitted to the healthcare facility after
suffering from severe chest pain.
The primary aim of this paper is to implement the ABCDE framework to determine
the two primary priorities for the healthcare condition of the patient and then implement three
different interventions so that those two priorities could be addressed with evidence based
interventions. Finally, a discharge plan for the patient would be developed using the social
justice framework.
Primary priorities
As per Malbrain et al. (2014), application of ABCDE framework should be applied in
the care process for patients suffering from crucial healthcare professionals. This framework
is made up of Airway, Breathing, Circulation, Disability and Exposure. This process is
known as the systematic approach as it helps to conduct an immediate assessment and
identified priorities for the critically or terminally ill patients admitted in the HealthCare
facility (Steyerberg and Vergouwe 2014).
(A)- As per the case study, it was seen that Mr. Smith is suffering from exacerbation
in his chest and is suffering from Chronic Heart Failure. Further, as per his healthcare
observations bibasal coarse crackle, hacking cough and bilateral crackles observed.

2CASE STUDY ANALYSIS
Therefore, these issues indicated towards the respiratory disorders of the patient that lead to
healthcare complication.
(B)- In breathing condition, it was seen that the respiratory rate of patient was 24
BPM and the normal range of respiratory rate ranges from 12 to 20. Hence, the resultant
distress of respiratory condition was observed in the patient. Further, he was also observed
with shortness of breath and therefore as per Prowle, Kirwan and Bellomo (2014) he was
suffering from improper gas exchange associated concerns.
(C)- While determining the blood circulation of the patient, it was seen that his blood
pressure is high and the heart beat has also increased (105 beats per minute). Therefore, it
was noted that the blood circulation is suffering from hindrance due to which impaired blood
flow is observed. Further, as per Malbrain et al. (2014), patients suffering from congestive
heart failure, suffers from fluid accumulation in the smooth muscles of heart, kidney, liver
and other bodily organs. Therefore, the elevated blood pressure could the result of excess
fluid accumulation that affected the blood flow and increased the fluid volume.
(D)- Disability of the patient could be observed depending on the hypoxia condition
as he was unable to maintain his normal oxygen saturation level and the Sp02 was 92%,
whereas the normal saturation level in room temperature is 98%.
(E)- The patient information did not indicate towards any kind of exposure.
Therefore, from this above-mentioned assessment, it was identified that his two
healthcare priorities in this care management would be impaired gas exchange and excess
body fluid volume, due to which his distress enhanced and he was admitted in the healthcare
facility. The patient would be observed for his fluid intake and his water and minerals such as
sodium consumption would be controlled so that through his fluid and diet control, his
excessive body fluid could be reduced. Further, for impaired gas exchange, he would be

3CASE STUDY ANALYSIS
provided with external oxygen, breathing exercise technique and other management
techniques.
Interventions
First priority: increased fluid volume of the patient
Intervention 1: controlling mineral consumption
Pathophysiology
As per Malbrain et al. (2014) patients suffering from congestive heart failure are
affected with increased fluid consumption around their crucial bodily organs. In this aspect.
The pathophysiological changes due to which, excess bodily fluid occurs should be
mentioned. Due to the weakness of the lower ventricle heart muscles, the ventricles become
weak in pumping blood from the heart to the entire body and bodily organs (Parrinello et al.
2015). Due to this the oxygen and nutritional requirement of the organs affected. Due to this,
the bodily organs surrounded by smooth muscles starts accumulating fluids around them so
that their nutritional; requirements could be met. Hence, it could be one of the reasons the
patient has increased fluid consumption (Prowle, Kirwan and Bellomo 2014). Besides this, in
the case study, it was observed that the patient has increased his blood pressure and blood
pressure and it could be another reason for his increased fluid volume. As per Alt (2014),
while suffering from congestive heart failure, the heart rate and blood pressure increases so
that the increased and unmet requirement of blood of the person could be met. Hence, the
patient developed fluid accumulation around the bodily organs.
Management
While management of excess bodily fluid, for the patient, his fluid consumption and
the amount of minerals should be calculated (Stefánsson et al., 2015). Further, as per Ramirez
et al (2015), in such condition, the diet and fluid consumption of the patient should be