Emergency Department Nursing Management

Running Head: EMERGENCY DEPARTMENT NURSING MANAGEMENT 1
ID number:
Unit code and title:
Title of assignment:
Name of Unit Coordinator:
Due date: Extension date (if applicable):
Word count: 1357

EMERGENCY DEPARTMENT NURSING MANAGEMENT
2
Table of Contents
Pathophysiological issues affecting the patient...............................................................................3
Pharmacology into practice.............................................................................................................4
Aspirin 300mg Po........................................................................................................................4
Morphine sulphate IV 2.5mg administered on.............................................................................4
Low molecular weight (LMW) heparin infusion.........................................................................5
Fentanyl 50mcg IV, x2 STAT doses............................................................................................5
Drug interactions.............................................................................................................................6
Nursing Management of Mr. Ferguson and the adverse effects of drugs used...............................6
Nursing interventions...................................................................................................................6
Management of adverse effects of the drugs...............................................................................7
Aspirin 300mg Po.....................................................................................................................7
Morphine sulphate IV 2.5mg administered on.........................................................................7
Low molecular weight (LMW) heparin infusion.....................................................................7
Fentanyl 50mcg IV, x2 STAT doses........................................................................................8
Evaluation of the Management Plans..............................................................................................8
Information to share with Mr. Ferguson..........................................................................................8
Conclusion.......................................................................................................................................9
References......................................................................................................................................10

EMERGENCY DEPARTMENT NURSING MANAGEMENT
3
Introduction
Mr. Ferguson, being 76 years old. He has a heavy chest and presents signs of high blood
pressure and his heart rate is abnormal. Ferguson has history of Angina, Non ST Elevated
Myocardial Infarction, hypertension, and hypercholesterolemia. He has sprayed x2 sprays of his
glyceryl trinitrate pump spray totaling 800mcg for his heavy chest but without help. Other
medications for the condition are aspirin, metoprolol, and rosuvastatin. He is fully conscious
with a GCS of 15. This study is a critical discussion paper related to the nursing management of
Mr. Ferguson’s addressing; the physiological processes through which the disease progresses and
the functional changes resulting from the disease, examines the drugs administered to alleviate
the patient’s deteriorating condition by analyzing the functioning of the drugs, the effects and the
expected results from the use of the drugs and his nursing care plan.
Pathophysiological issues affecting the patient
Mr. Ferguson is experiencing chest heaviness which has resulted in paleness, diaphoresis
and shortness of breath. His blood pressure is not within the normal range. Systolic pressure is
172 which indicates hypertension stage two while diastolic pressure is 86 which is within the
prehypertensive range. Hypertension experienced by the patient may be as a result of an angina
attack which had experienced in the past (Sanjay & Peter, 2014).His heart rate indicates that he
has tachycardia (from his hypertension). The patient’s blood oxygenation level is within the
normal range (Craig, 2013). The patient’s respiration rate is above the normal range which is
indicative that he is hyperventilating and is a sign of possible greater effects which need
monitoring.

EMERGENCY DEPARTMENT NURSING MANAGEMENT
4
Pharmacology into practice
As already discussed, Mr. Ferguson admitted to the hospital the medical team caring for
Mr. Ferguson varied his medication. The variation was indicative of the physiological changes
that had occurred in his body resulting in his ill health. The medication prescribed was intended
to reverse the physiological changes that had occurred.
Aspirin 300mg Po
Aspirin is administered orally as the patient is conscious as indicated by his 15/15 rate on
the Glasgow coma scale. Administration of aspirin is indicative of the patient’s chest pains
which can be relieved by aspirin which is an analgesic drug. It is also indicative of
cardiovascular problems which are alleviated by aspirin. (Lippincott nursing center, 2018). It has
a half-life of fifteen to twenty minutes after which it breaks down into salicylic acid which
remains in ones’ body for six hours (Electronic Medicine Compodium, 2013) (Karen & Terry,
2015). Aspirin works by reducing the action of enzymes in order to inhibit prosaglandins
synthesis and, thereby, performing its analgesic function.
Morphine sulphate IV 2.5mg administered on
The use of morphine sulphate indicates pain and respiratory depression which is line
with Mr. Ferguson’s chest heaviness and shortness of breath. It is used in relieving pain by
Patient Controlled Analgesia (PCA) (Electronic Medicine Compodium, 2013). Morphine is
broken down and absorbed mainly in the liver and undergoes fusion with glucuronic acid. The
drug acts on the Central Nervous System and smooth muscles. It increases smooth muscle tonus
especially pyloric sphincter, anal sphincter, lower esophageal sphincter and ileocecal sphincter.
Morphine is a depressant but it may at as a stimulant to certain parts of the CNS resulting in
nausea and vomiting. (Stitzlein, Opiods for pain management in older adults, 2017).