Nursing Management and Pharmacological Application for Mrs Grace

Running head: NURSING KNOWLEDGE
NURSING KNOWLEDGE
Name of the Student
Name of the University
Author Note

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NURSING KNOWLEDGE
Introduction
In case of Mrs Grace an 80 year old lady it has been found that she fall unwitnessed
and at present she does not remember any occasion leading to the fall. Her present vital signs
are BP 147/77 which is regular, heart rate is 112 which is high and irregular, respiration rate
is 24 which is also high, oxygen saturation is 99 percent which is normal and temperature is
37.2. However, her GCS score is 13/15 which highlights that she is not properly conscious
and also cannot remember the cause of the fall. At the ambulance she has been administered
Fentanyl 100 Mcg by nasal prongs. Her regular medication includes Rivaroxaban 15 mg,
Thyroxine 50 mcg, Amiodarone 100mg, Metoprolol 25 mg and after the admission to the
emergency department she has been administered Bupivacaine + fentanyl femoral block,
Panadol 1 g, Neurofen 400 mg, Morphine 5 mg. She has been reported to experience high
level of pain in ED and also the right hip X-ray showed that she has fracture on the neck of
the femur. It has been also reported that she has an allergy to Penicillin. She has a history of
hypothyroidism, hypertension, arterial fibrillation, ischemic heart disease along with multiple
falls as well. On this context it can be stated that the risk of the patient is now fracture, pain
and the trauma she is experiencing. Thus based on this case scenario in the following section
the nursing management and the pharmacokinetics along with the treatment flaws and the
changes would be discussed.
Nursing Management
Based on the above discussion the factor of the vital signs showed some abnormalities
for the patient as the blood pressure is in slightly higher range based on the age of the patient
however, the heart rate and the respiratory rate are severely high which can be marked as red
flag symptom for the patient. Thus it can be stated that the condition of the cardiovascular
and the respiratory function is showing some abnormal condition. On the other hand the past

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NURSING KNOWLEDGE
medical history of the patient highlighted that she had IHD, RF, hypothyroidism and also
HTN issues. Hence, the need of the pathological tests could be seen which refers to the
investigation of the cholesterol level, blockage in the vessel system and also the assessment
of the respiratory system would be required as well. The pain management of the patient
would be the primary focus of the nurse in case of the treatment of the patient (Smith et al.,
2018). The pain management here would be focused on the medication management of the
patient (Curl et al., 2016). On the other hand the nurse should also focus on the past medical
history of the patient. The prescribed medicines in the ED would be assessed on the basis of
the previous medicines as all the medicines would be affecting on the cardiac muscles of the
patient. On the other hand the age of the patient should also be considered in terms of the
medication process. On the other hand the consoling skills that is the communication skills of
the nurse (Giuliano & Hendricks, 2017). Thus it can be stated that the holistic approach of the
registered nurse should be used in this process of the treatment of the patient (Malec &
Shega, 2015). On the other hand the process of the communication and the observation of the
vital signs would be prioritised as well. Mrs Grace admitted in the ED with a high heart rate
and respiratory rate thus the abnormality in the cardiac function of the patient should also be
consulted with the supervising doctor or the physician in order to provide a patient centred
care.
Pharmacological Application
Based on the medication of the patient it can be sated the registered nurse should be
able to administer the medicines properly by means of administering pathway, dose, timing
and also the absorption process of the medicine should also be assessed by the nurse. Hence,
it can be stated that the nurse should have the knowledge about the proper medication and the
pharmacokinetics or pharmacodynamics of the medicines along with the side effects of each
medicine prescribed to the patient as well.