Roper-Logan-Tierney Model | Nursing Assignment

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student
Name of the university
Author’s note

NURSING ASSIGNMENT1
Patient scenario
Ron is a 16 years old boy Essex. He had been admitted to the hospital with asthmatic
attack. Ron’s asthmatic attacks becomes acute especially at the time of falls. At the time of the
history taking, it was found that Ron’s mother suffered from allergic rhinitis. In the year 2014,
Ron had been diagnosed with the Asthma. He had admitted that he had been introduced to
smoking and often smokes when he hang out with his friends. Within the last years, he had been
admitted to the hospital two times due to the exacerbation of asthma. On final admission he has
been prescribed with Ventolin, Seretide. He had been admitted via the emergency department for
regular salbutamol nebulizers. He had reported that he could not sleep overnight and had been
complaining the about chest tightness.
The following vital signs have been obtained-
PaO2 : 70 mmHg
PaCO2: 53mm Hg
HCO3 : 20 mmHg
SpO2 : 87 %
pH: 7.2

NURSING ASSIGNMENT2
Systematic assessment
The Roper –Logan – Tierney model for nursing care can be referred to as a framework
which has been done on the basis of the activities of daily living (ADL). The main aim of using
this framework is to conduct an assessment throughout the care of the patient. This model has
been used to the prepare checklist and is often used for assessing how the life of a patient can be
altered and modified due to the burden of illness, admission or injury to a hospital rather than as
a way of planning the for enhancing the independence and the quality of life of the patient
(Holland and Jenkins 2019).
Asthma is a chronic illness that is featured by irreversible and obstruction of the airways
where the airway of a person always gets the inflamed, swells and becomes narrow to form extra
mucus making it difficult to breathe with exacerbations often indicating the worsening for the
disease. The nurse would first assess for the activities of daily living –“breathing”. Diagnosis of
asthma should be able to regulate that the episodic symptoms of the obstruction of airflow are
present, the airflow obstruction is partially reversible and that all the alternative diagnoses are
eliminated (O’Connor and Carey 2017). A physical examination needs to be initiated focusing on
the chest, skin and the upper respiratory tract. It is necessary to check whether the patient is able
to breathe properly. On physical examination, Ron was found alert, but looked anxious and was
breathless or exertion and rest. He was observed and the vital signs were noted for establishing
baseline observations. The respiration rate along with the character was assessed for achieving an
indicator of the respiratory function, and these are regarded as the sensitive predictors of
deterioration of the health conditions. Ron was assessed for wheezing and the abnormal breath
sounds. The respiratory depth was 29 breaths per minute, she was wheezing along with shallow
breathing and the patient was using the accessory muscles for the breathing. The pulse oximetry

NURSING ASSIGNMENT3
and the arterial blood gases were measured for assessing the severity of the exacerbations.
Assessment of Ron’s sputum was necessary for assessing Ron’s ability to expectorate or cough
out the excess mucus. The consistency, color and the smell of the sputum produced at the time of
coughing were charted and the sample was sent to the laboratory to analyze any occurrence of
infection. One of the important activities of daily living that has been listed in the Roper Logan-
Tierney model of nursing are preservation of a safe milieu for the patient. Nurses should
immediately the try to understand the trigger of the asthmatic attack and get it removed
(O’Connor and Carey 2017). The case study reveals, that Ron suffers from such asthma attacks
at the time of falls and also indulges in smoking whenever he hang out with his friends.
Blood pressure was observed to be 140/90 mmHg in a sitting position. The second
activity that was accessed is the “temperature’. The temperature was about 37.5 degree Celsius.
Effective communication is one of the crucial element for assisting the patient to with the
optimal level of functioning in the daily life (Holland and Jenkins 2019). Hence, it is necessary
to assess whether Ron is alert and is capable of communicating with the nurse. Ron might be
unable to communicate due to pain and excessive respiratory distress. A pain assessment was
carried out to identify the intensity of pain. Again the nurse in the clinical area should observe
and note down the problems, like the hydration status of the patient. The water intake helps the
body cells to replenish the nutrients required by the cells to maintain the normal functioning of
the body. The nurse should note whether eating or drinking in the patient is compromised
anyway (Holland and Jenkins 2019). It has been recorded in many of the studies that mild
dehydration is common in acute childhood asthma.