Recognising and Responding to Acutely Ill Patient - Desklib

Recognising and responding to
acutely ill patient

TABLE OF CONTENTS
INTRODUCTION ..........................................................................................................................2
MAIN BODY...................................................................................................................................3
Assessment.......................................................................................................................................3
Airway..........................................................................................................................................3
Breathing......................................................................................................................................4
Circulation....................................................................................................................................4
Disability......................................................................................................................................4
Exposure......................................................................................................................................5
Pathophysiology...............................................................................................................................5
Nursing and medical management ..................................................................................................7
Holistic care.....................................................................................................................................9
CONCLUSION .............................................................................................................................11
REFERENCES..............................................................................................................................13

INTRODUCTION
The documentation will provide an idea about the professional nursing competencies
which are required by NMC (nursing & midwifery council, 2018). The case study is related to
the Michael Green as the patient whom was 62-years old male. In order to identify its current
psychosocial impact of sepsis on the recovery of Michael (Burdick, Lin and Shune, 2021) and
will be reflecting the importance of patient centred care. Michael Green was suffering a pressure
in his chest and pain radiating to his lower jaw. After 25 minutes the pain had significantly
increased. Before the investigation, Michael had already faced an episode of hypertension and
anxiety due to his continuous smoking of cigarettes on a daily basis. Initial nursing assessment
and the A-E suitable approach provide the best assessment in the context of deteriorating patient.
This approach focuses on examining the fatal condition of Michael Green, preserving his safety
and minimising the level of mortality. The role of the National Health Service (NHS) in this
assessment and measuring the current health condition of Michael Green play a significant part
in investigating the low blood pressure of the patient. In addition, it will discuss the psychosocial
impact and how it will help in the recovery of Michael green and identify the importance of
holistic approach in patient recovery. In this report, it will discuss the ABCD approach to
identify the need for patient. It will focus on the initial assessment and implementing suitable
approaches and regularly examine the effects of treatment.
MAIN BODY
Assessment
In context of performing Michael’s nursing assessment, A-E (Airway, Breathing, Circulation,
Disability, Exposure) approach has been performed as it has been used for critically ill patients.
Along with this, NEWS2 (National Early Warning Score 2) that has been designed by the Royal
College of Physicians (Bedoya and et.al., 2017).
The A-E assessment is aligned with the systematic procedure in context of assessing the
clinically deteriorating patient. This approach has been designed with the motive of managing
the condition of patient and assures effective clinical outcomes. NEWS2 has been determined as
the standardised tool that has been used for determining the scoring of abnormal physiological
attributes in patients. A score has been given to each patient and the normal and abnormal range
in context of A-E assessment is evaluated. Furthermore, NEWS2 score is one of the superior

tools that helps in detecting the current and future condition of the patient. In some cases
healthcare professionals need to consider the use of NEWS2 score if it does not reflect the
accurate concern about patients (Echevarria, Steer and Bourke, 2019). At the time of assuring
care to the patient it is important to using SBAR (Situation, Background, Assessment,
Recommendation) as the communication tool for enabling efficient handover of the patient
(Müller and et.al., 2018).
Airway
Michael’s airway is free from the obstructions as he is able to speak in full sentences. Focusing
over the patient airway is fundamental priority when the caring has been assured to critically ill
deteriorating patients. Airway management assures open pathway for gas exchange among the
patient’s lungs and atmosphere. Obstruction in the airway can result in lack of oxygen in the
patient and even there is a threat of heart attack in patient (Linz and et.al., 2018). Often, service
users find difficulties while speaking and communicating. In the case of Michael was talking in
full sentences, has maintained control over his airway and communicated concerns with adequate
brain perfusion.
Breathing
Breathing examination of Michael reveals that, the respiratory rate (RR) is 26 breath per minute
which indicates that he was tachypnoeic. However, normal breath rate should be between 12 to
20. This is triggering the NEWS2 score of three. The clinical reason for causing high RR
includes fever, heart diseases, dehydration and anxiety. Furthermore, Michael has been
experiencing shortness of breath which are clearly linked to the unstable chest angina he has
been admitted with. However, these symptoms can often be signs of other issues such as, asthma
and anxiety in patients. SpO2 92% on room air indicates that, his pulse was low as the standard
SpO2 needs to be around 96. Thus, indicating that the patient is hypoxic and scoring a NEWS2
of 2.
Circulation
Michael’s heart rate was monitored at 115 beat per min indicating sinus tachycardia and higher
than normal heart rate (51-90 bpm) which can also result in dizziness. The NEWS2 score of the
patient is 0. Michael’s blood pressure has also been monitored at 133\88 mmHg also scoring 0
according to NEWS2. The temperature has been found at 36.2° C that is indicating NEWS 2