Nursing and Acute Care

This document discusses nursing and acute care, specifically focusing on respiratory concerns. It covers the importance of a focused assessment, symptoms indicating worsening health condition, and immediate interventions for shortness of breath. References are provided for further reading.

Running head: NURSING AND ACUTE CARE
NURSING AND ACUTE CARE
Name of the student
Name of the university
Author note

1NURSING AND ACUTE CARE
Answer 1
While working with patients suffering from critical health conditions, it is important
for the nursing and healthcare professionals to implement an accurately focused assessment
so that the complete identification of healthcare complication of the patient could be
achieved. In the healthcare process of Jenifer it was seen that she is suffering from sinus
tachycardia with elevated blood pressure and heart rate. This heart rate and blood pressure
remains elevated throughout the day and hence a detailed focused assessment so that her
complication related to her breathing complication should be conducted for accurate
intervention implementation.
I would first perform hand hygiene, patient identification with MRN number and then
after checking the room contact precautions I would provide the patient with an idea of the
process that would be conducted. After this, I would ask the patient for her health history,
smoking habit and any environmental exposure so that from her previous health condition,
nay idea about her current health complication could be drawn (Rogers et al., 2014). Further,
her chest configuration and symmetry would be checked and her respiration rhythm, pattern
and rate would be checked (McIver et al., 2015). Further, by checking her O2 saturation
would be done with a pulse oximeter so that her accessory muscles and its breathing pattern
could be understood. Besides this, her anterior and posterior lung would be auscultate so that
any adventitious sound or breathing sound could be assessed. All these assessment would be
conducted by complying with the organisations policy and ethical code of conduct. Hence,
this will be the focused assessment of respiratory concern of patient (Rogers et al., 2014).
Answer 2
After conducting the focused assessment, a series of symptoms would be obtained
that would indicate towards the worsening health condition of Jenifer. As per Jary et al.
(2014), the SpO2 level or oxygen saturation condition is very crucial and in such condition as
the percentage of SpO2 determines the amount of oxygen carried in the blood. Hence, for
example, if the SpO2 level is 98%, then it is mentioned that each of the red blood cells are
carrying 98% oxygen. Hence, the low percentage of SpO2 (73-74%) would indicate that her
red blood cells are unable to collect enough oxygen and hence, her health condition is
deteriorating (Baria et al., 2014). Hence, she should be provided with oxygen immediately so
that accurate oxygen saturation could be achieved. Besides this, while auscultate the lungs, if
crackling sound is observed, then it could indicate to the chronic obstruction in the airway

2NURSING AND ACUTE CARE
due to which the patient would suffer from shortness of breath and coughing and hence, this
should be treated with effective intervention (Baria et al., 2014). Further, it was seen that the
patient is suffering from chronic respiratory condition and due to this, she could suffer from
Chronic Obstructive Pulmonary Disorder (COPD) (Liu et al., 2015). Hence this should also
be taken care of while providing effective care to the patient.
Answer 3
As the nurse has witnessed that the patient Jennifer is suffering from shortness of
breath, the nurse should be able to maintain a fowler position so that the lung could be
provided with enough space and ability to accumulate air or oxygen through breathing.
Further, as per Frownfelter (2014), it is the responsibility of the nursing professional to
maintain an upright head position to the patient so that her lungs could expand properly and
then increase the concentration of oxygen in the body. The second priority for the nurse
would be developing and conducting the lung assessment by conducting the SpO2
concentration, pulse rate as well as respiratory rate so that her health complications could be
assessed in routinely manner and with deterioration of her health complication, she could be
provided with effective interventions (Patel & Bahna, 2015). Further, the patient should be
provided with oxygen through Hudson mask so that oxygen concentration could be increased
in her body (Patel & Bahna, 2015). Further, as mentioned by Duchesne et al. (2015), if the
patient developed severe shortness of breath and any of the above- mentioned interventions
are unable to provide improvement to her health condition, then the nursing professional
should provide her with two puffs of corticosteroids or inhalers so that immediate relief in the
obstruction in airway could be provided and her health complication could be relieved.
Therefore, these would be the immediate and rapid action that any nursing professional
would implement while [providing effective care to patients that has developed shortness of
breath (Yang, 2015). Further, if the health condition worsened, a general physician would be
asked to visit her and provide effective intervention for her shortness of breath condition.

3NURSING AND ACUTE CARE
References
Baria, M. R., Shahgholi, L., Sorenson, E. J., Harper, C. J., Lim, K. G., Strommen, J. A., ... &
Boon, A. J. (2014). B-mode ultrasound assessment of diaphragm structure and
function in patients with COPD. Chest, 146(3), 680-685. DOI:
https://doi.org/10.1378/chest.13-2306
Duchesne, G. M., Woo, H. H., King, M., Bowe, S. J., Stockler, M. R., Ames, A., ... & Millar,
J. (2017). Health-related quality of life for immediate versus delayed androgen-
deprivation therapy in patients with asymptomatic, non-curable prostate cancer
(TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-
blinded, phase 3 trial. The Lancet Oncology, 18(9), 1192-1201.DOI:
https://doi.org/10.1016/S1470-2045(17)30426-6
Frownfelter, D. (2014). Facilitating ventilation patterns and breathing
strategies. Cardiovascular and Pulmonary Physical Therapy-E-Book: Evidence to
Practice, 352. Retrieved from: https://books.google.co.in/books?
hl=en&lr=&id=L8vsAwAAQBAJ&oi=fnd&pg=PP1&dq=Frownfelter,+D.+(2014).
+Facilitating+ventilation+patterns+and+breathing+strategies.
+Cardiovascular+and+Pulmonary+Physical+Therapy-E-Book:
+Evidence+to+Practice,
+352.&ots=QqAaJkyFwr&sig=Drl_FOUT3UgLRm5WMtOb6RAF228#v=onepage&
q=Frownfelter%2C%20D.%20(2014).%20Facilitating%20ventilation%20patterns
%20and%20breathing%20strategies.%20Cardiovascular%20and%20Pulmonary
%20Physical%20Therapy-E-Book%3A%20Evidence%20to%20Practice%2C
%20352.&f=false
Jary, H. R., Kachidiku, J., Banda, H., Kapanga, M., Doyle, J. V., Banda, E., ... & Mortimer,
K. (2014). Feasibility of conducting a randomised controlled trial of a cookstove
intervention in rural Malawi. The international journal of tuberculosis and lung
disease, 18(2), 240-247. DOI: https://doi.org/10.5588/ijtld.13.0485
Liu, Y., Pleasants, R. A., Croft, J. B., Wheaton, A. G., Heidari, K., Malarcher, A. M., ... &
Strange, C. (2015). Smoking duration, respiratory symptoms, and COPD in adults
aged≥ 45 years with a smoking history. International journal of chronic obstructive
pulmonary disease, 10, 1409. DOI: https://dx.doi.org/10.2147%2FCOPD.S82259

4NURSING AND ACUTE CARE
McIver, L., Kim, R., Woodward, A., Hales, S., Spickett, J., Katscherian, D., ... & Naicker, J.
(2015). Health impacts of climate change in Pacific island countries: a regional
assessment of vulnerabilities and adaptation priorities. Environmental health
perspectives, 124(11), 1707-1714. DOI: https://doi.org/10.1289/ehp.1509756
Patel, A., & Bahna, S. L. (2015). Immediate hypersensitivity reactions to
corticosteroids. Annals of Allergy, Asthma & Immunology, 115(3), 178-182. DOI:
https://doi.org/10.1016/j.anai.2015.06.022
Rogers, B. B., Shankar, P., Jerris, R. C., Kotzbauer, D., Anderson, E. J., Watson, J. R., ... &
Bost, J. E. (2014). Impact of a rapid respiratory panel test on patient
outcomes. Archives of Pathology and Laboratory Medicine, 139(5), 636-641. DOI:
https://doi.org/10.5858/arpa.2014-0257-OA
Yang, F. (2015). Oxygen-driving and atomized mucosolvan inhalation combined with
holistic nursing in the treatment of children severe bronchial pneumonia. Pakistan
journal of pharmaceutical sciences, 28. Retrieved from:
https://web.a.ebscohost.com/abstract?
direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=1011601X&AN=109
346617&h=
%2fxn1GwpUcrNPw0%2fgx4Ov8%2bt7o80WK94WJpcddhP3%2b8SX6X14t8BqI
M6hw5UwDlRigNLvFC1T8ixJNRs%2bQ8a1og%3d
%3d&crl=c&resultNs=AdminWebAuth&resultLocal=ErrCrlNotAuth&crlhashurl=log
in.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype
%3dcrawler%26jrnl%3d1011601X%26AN%3d109346617