[PDF] Executing a Project Assignment

Added on - 24 Apr 2021

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Foot InfectionContentsIntroduction...........................................................................................................................................1RECOMMENDATION.........................................................................................................................7
1Conclusion.............................................................................................................................................8REFERENCES......................................................................................................................................8IntroductionThe biggest part of the heath profession in health care setting is nurse. They utilisejudgements and reasoning for taking decisions in terms of patient’s care. On the broader scalenursing profession understands intuitive reasoning as the expert’s hint. Thompson et al., 2010approximated that nurses that is employed in health centres shall take a mean of single results
2per 10 min. In patients safety agenda decision making plays a very crucial role (Yang, 2009).This report illustrates clinical reasoning cycle to give a clinical decision regarding diabeticfoot’s infection. This may occur due to acute or chronic skin’s compromise, outerneuropathy, arterial insufficiency or the mixture of all these. Around 20% of diabetic patientswith ulcer in foot may have inadequate peripheral atrial supply, approximately half of themhave peripheral neuropathy and about 30% will showcase all.The writer chooses this issue in the present clinical practicum because there are largenumbers of clients having foot infection in the heal care settings especially diabetic patientshaving this problem. Adding to this, patients are exposed to danger situation. The majorobjective of this paper is to develop a clinical decision utilising the clinical reason cycle. Italso illustrates about the essentiality and the appropriate stages to take proper decisions. Itwill also be supporting the condition which is faced by HAAD after which certainrecommendations shall be provided.Diabetic Foot infectionClinical reasoning is said to be as the reasoning that is utilised by the nurses and other staffsto gather cues, information processing, reach to a conclusion of the situation or issue,implement, plan, analyse results, learn and reflect prom the process. During the process itconnected the way of thinking in respect to care of patients, ability to think critically and withexperience and practice clinical reasoning changes to natural skill. Adding to this, clinicalreasoning is a crucial skill since it provides positive results for the clients; empower efficientmanagement in complex situations and bifurcates among things that need instant attentionand what not. Writer utilises process of clinical reasoning that is described as dynamicprocess which moves in clockwise direction begins at 12:00. It is crucial and advantageouscycle in decision making since the nurses can go forward and back before taking action orreaching decision or evaluating the results. It is also essential since it contains 8 steps thatassist in understanding and work through every step instead of making approximationsregarding problems of patients and starting intervention. It also gives a framework for thenurses intervention with sufficient consideration and planning (Levett-Jones etal.2010,p.516:Hoffman 2007).Scene
3Mr M has an age of 55 years. In his left ankle she was diagnosed with foot infection. In hisinterrogation with doctor she said that she was knows about the infection. She understood itas a simple wound that will be healed by time. That is why she ignored it for about a week.After few days she noticed that wound got larger, it did not healed and there was severe painwhich impaired his movement. Underlining that she is diabetic from past 15 year and havingfamily history of diabetic mellitus. She also had cholesterol. Her doctor suggested her 4antibiotics and 4 analgesic and swelled left leg at the time of getting admitted. Their plan wasto do inspection, swab wound care, dressing and mobilisation.Etiology and Epidemiology of diabetes foot ulcerDiabetes is accumulation of metabolic disease categorised by hyperglycemic outcomes fromlack of insulin secretion, action or both. Blurred vision, weight loss, polydipsia and polyuriaare the symptoms of Hyperglycemia. Problem of diabetic foot has an influence of thepatient’s life’s quality which may result in depression and decreases movement. It also hasfinancial angle with it (American Diabetes Association, 2014a). Moreover, diabetic foot ulceris caused by peripheral neuropathy, outer arterial disease that lead to gangrene and necrosis,infection and osteomyelitis (NICE, 2011).1.Patients ConditionGood morning, my name is Noor, I am RN from ED. Today Mr. M was diagnosed with thewound infection at the age of 55. The infection is mild and is present in the left ankle. Shevisited ER at 23:00 pm. Her condition is that she was hit by the thrown rock at the floorwhich she hit by mistake. His ankle got ruptured from where continuously blood was comingout for half an hour. He just wrapped it up for the week with a towel without cleaning it up.The wound become painful and the situation got worst as she exclaims it to be the worst painof his life. She arrived at ER in lot of pain and the legs were swelled. She receives anantibiotic levofloxacin 500 mg and IV and acetaminophen 1000mg IV. Wound got dressedwith silver cell and gelonet it was wet, swelled and 1 inches in breadth, 3 inches in length andfresh blood cells release at the time of dressing.Vitals of his like blood pressure was 130/81, temperature 36.1C, oxygen saturation was 99% ,his pain score was 5 and she was depressed with his respiratory rate of 20/min. Her bloodsugar was 270mg/dl, 4thhurly blood checking was done. Mr. M is in sliding scale utilisinginsulin aspart 2 unit fixed dose and 2-10 unit unfixed. Her attributes are 71 kg in weight, 163cm in height and having BMI of 26.72. Mr M lab’s outcome was ordinary except HDL low33 mg/dl and LDL high 189 mg/dl. She is under atorvastatin 40 mg and asked for repeatingof her lipid profile. She does not have allergy from medicine or food.After receiving the patients hand over from ED nurse, me and my preceptor introduceourselves to Mr. M and we started the assessment. Formal admission process to the ward wasdone by us that involved risk assessment, physical assessment and history taking.
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