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Essay on Deteriorating Patient

   

Added on  2021-05-31

11 Pages3105 Words1021 Views
Running head: DETERIORATING PATIENT 1Deteriorating PatientNameInstitution

DETERIORATING PATIENT2Deteriorating PatientIntroductionDue to their altered psychological conditions, critically ill patients are at a huge risk of experiencing deteriorating health conditions if the appropriate nursing interventions are not applied. An appearance of abnormal vital signs could be the initial indications the patient’s health is deteriorating and the vital signs may start showing after several hours in a gradual manner (Considine & Currey, 2015). The nurse should be able to identify, observe, and assess these psychological abnormalities to enable them in developing the best care plan and ensuring the patient safety. According to Creed & Spiers (2010), failure to address these abnormalities andhealth deteriorations could escalate the patient’s condition into a critical state that may, unfortunately, lead to death. The nurses normally apply the between the flags system to intervene in the in situations of clinical deterioration of a patient’s health condition. This system may be described as a safety net for patients in most of the healthcare facilities (Pain et al., 2017). The aim of its design is to prevent an unnoticed deterioration of patients and to ensure that the patients get the best care in case of deterioration. This helps in improving the quality of care and ensuring patient safety. In the intervention to prevent patient deterioration, there exists a slippery slope diagram that has four phases of intervention (Hughes, Pain, Braithwaite & Hillman, 2014). The phases include prevention, clinical review, rapid response and advanced life support. In this essay, we will discuss the four phases of the slippery slope, and identify what happens in each of the phases. Additionally, the essay addresses the safety of the patient from the perspective of a registered nurse.

DETERIORATING PATIENT3Phase 1: PreventionFrom the observation presented in the scenario, it is clear that John’s condition is deteriorating. According to between the flags a normal respiratory rate of adults should be between 12 to 20 breaths per minute. John’s respiratory rate, however, is 28, which could be an indication of respiratory distress. A 90% SpO2 may be an indication of a decrease in perfusion and a blood pressure of 122/64 is a sign of an elevated blood pressure. Also, the abrasion on the left side of his chest extending around to the middle of his back and chest discomfort may be an indication of chest injury or damage to the heart valve. Further, an extensive bruise on the left hip and around to buttock, unable to weight bear, constant sharp pain in the upper thigh and hip region may be an indication of fracture NOF. These abnormal vital signs may be associated with John’s pain that may establish from chest injury or fracture NOF. The management of pain in elderly is very important, as John is 81 year old, because usually elderly patients amplified with anxiety and stress, therefore due to this challenge their conditions may further deteriorate. Initial pain assessment, an appropriate and timely pain management for trauma patients is vital because it can induce severe complications that may leadJohn to further deteriorate (Brown, Edwards, Seaton & Buckley, 2017). Therefore, pain management in trauma patients is an important part of the systemic approach to trauma. Brown et al. (2017), further ascertain that the complication of pain includes problems with ventilation, perfusion abnormalities due to muscle splinting, increased myocardial workload, decrease in the risk of pulmonary embolism and decreased gastrointestinal motility as John has a medical historyof GORD.

DETERIORATING PATIENT4Several complications of the respiratory system such as pneumothorax, atelectasis and respiratory failure may be caused by inadequate ventilation as a result of an injury to the chest (Unsworth, Curtis & Edward, 2015). Injury to chest and pain causes hypoventilation in the patient characterized by shallow and fast respirations like in John’s case. This will lead to impaired gas exchange in the lungs, where the level of alveoli is perfused (Unsworth et al., 2015). Management of pain also aids in decreasing incidence of chronic pain, Post-traumatic stress disorder, shortens the length of hospital stay, lowers costs, and ultimately reduces the rate of morbidity and mortality.Additional assessment such as an ECG to detect any abnormalities in the heart due to the injury as John is experiencing chest discomfort. Also closely monitoring the vital signs especially respiratory rate and the spo2 level is important for John to prevent the development of further complications. Monitoring these vital signs will help to determine which treatment protocols to follow, confirm feedback on treatments provided, and provide critical information needed to make life- saving decisions and when to make a met call (Mok, Wang & Liaw, 2015). Monitoring respiratory rate and the spo2 level will help to decrease the respiratory distress and risks of developing hypoxia. Phase 2: Clinical ReviewDuring this phase, John's condition is further deteriorating. He is going down in clinical review phase according to slippery slope diagram. He is speaking in short sentences, has shallowbreaths and he is tender to touch. Additionally, he has dusky pink peripheries that are cool to touch with a capillary refill of greater than four seconds. He also experiences pain during the palpitations of the abdomen. Pain 10 out of 10 on the left hip when moving may indicate

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