The Deteriorating Patient - Assignment

THE DETERIORATING
PATIENT

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Which issues and concern are identified in the case study.........................................................3
What assessment and intervation requires for the client.............................................................3
Plan of care for the Client...........................................................................................................4
How to evaluate and monitor growth of the patient....................................................................5
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
Deteriorating patient is the individual who's health position is declining, deteriorating phase
occurs in the life of a individual when they attend the older age. These reports highlights the
issue which are faced by nurse in primary assessment. Fuhrer these report highlights the
assessment requires for MR. Ornik. After that report shows the plan of care for the client. In the
end it explains how the growth of the patient can be evaluate.
MAIN BODY
Which issues and concern are identified in the case study
Patient was reluctant: Mr. Orkins was not feeling comfortable with the female nurse attending
him in his personal Hygiene, he was hesitating in discussing the problem he was facing in the
treatment, which was proving difficult for nurse to assist him (Della Ratta, 2016).
Not able to speak properly: Mr. Orkins was getting difficulty in communicating his thoughts to
the nurse as due to his age the pronunciation of word was poor, rhythm of the sentence suddenly
changes and he start murmuring, which is proving difficulty for nurse to understand what he is
trying to say.
Hyper salivation: Mr. Orkins was suffering from Hyper salivation as saliva was dropping from
the mouth of Mr. Orkins, it was proving very difficult for nurse to communicate with the patient.
Laying toward right side: Mr. Orkin body and mouth was laying down more toward the right
side of his body which is proving difficulty for the nurse to assess his whole body properly
(McGaughey and et.al., 2017).
Urge Incontinence: Mr. Orkins was suffering from the Urge Incontinence as there was a odour
of urine was found in the room which proves difficulty for the nurse as it proves that in these age
Mr. Orkins was not having the control over his body.
What assessment and intervation requires for the client
Stress Level: Nurse should take care that Mr. Orkins is taking a good amount of rest as not
taking a rest can increase the Stress level of the Mr. Orkins which can result in increase of the
Blood Pressure level as Blood Pressure level of Mr. Orkins is 150 - 98 which is little bit high.
Timely Medicines: Nurse should take care about the timely medicines are taken by Mr. Orkins
as timely medicines will help the nurse asses the improvement in the health of the patience,
which will also help the doctor to change the medicines if requires after some point of time
(Kaner and et.al., 2015).
3

Monitoring and Test: Nurse requires to do time to time monitoring of the patient health and
also requires to do a timely health test of the patient as old age patient like Mr. Ornik body takes
a time to respond to the remedies, which requires a timely monitoring of the health by nurse to
asses the improvement of the health.
Plan of care for the Client
Assessment Nursing
Diagnosis
Planning Nursing
intervention
Rationale Evaluation
Patient was
being
collapsed and
also the blood
pressure rate
and
respiratory
rate was
found high.
Also the
saliva was
flowing from
his mouth. He
was also
uncomfortable
with female
nurse.
It was
diagnosed by
the nurse that
respiratory
rate and heart
rate was very
high. Also the
patient was
suffering
from
hypertension
Proper
Medicines:
Proper and
timely
medicines
should be
provided to
the Mr.
Orkins as
blood sugar
level of Mr.
Orkins is 10.4
mmol/ml
which is very
high as
normal blood
sugar level is
5.6 mmol/ml,
Diamicron 80
is the
medicine
which can
help the Mr.
Orkins to
Improving
confidence
Level:
Confidence
level of the
patient plays
a very vital
role in
improving the
health of the
patient as if
patient will
loose the
hope than it
will be very
difficult for
the patient to
recover from
the illness, so
hospital will
try to improve
the
confidence
level of the
Holistic care:
Providing a
holistic care
to the patient
can help in
improving the
health of the
patient as in
holistic care
nurse
consider the
patience
body, mind,
culture, spirit
and
environment
when
attending a
patient in the
hospital
which helps
the patient to
feel
comfortable
Monitoring
through
evidence
based care:
Evidence
base care is
the most
common care
way which is
used by
almost all the
nurse in the
world as it
helps in
improving the
health of the
patient, as
evidence
based
approach
helps the
nurse to guide
the decision
with
4

lower down
the blood
sugar level.
Blood
pressure of
Mr. Orkin is
also little bit
high as
normal blood
pressure
range is upper
120 – lower
80 to upper
140 - lower
90 and Mr.
Orkins blood
pressure was
upper 150 -
lower 98,
Amlodipine 5
is the
medicine
which will
help the Mr.
Orkins to
lower down
the blood
pressure level
(Care, 2019).
patient. and express
their thoughts
on illness
freely
(Holistic
nursing,
2013).
evaluation
and
qualitative
approach
(Flynn and
et.al., 2017).
5

How to evaluate and monitor growth of the patient
Timely Test: Regular medical test of Mr. Ornik will help the doctor to known the progress in the
health of the Mr. Ornik as doctor can compare the report of two test to evaluate the growth of the
business and to change the prescription according to the result of the evaluation (Thornton,
2016).
Change in Health: Regular assessment of health of the patient by the nurse helps the nurse to
see the improvement in the health of the patient, improvement can be seen by evaluating the
changes in the activities of body part of the patient.
Confidence level of Patient: Confidence level of employee is also uses as a basis to evaluate the
growth of the patient health in the hospital as explain above confidence level of employee is the
big reason behind the improvement of the patient health (Ellis, 2019).
CONCLUSION
These report summarised that Mr. Ornik was suffering with a few disease at a point when he was
admitted in the hospital and also feeling reluctant to the female nurse, few changes in medicines
and diet are require to improve the health of Mr. Ornik.
6

REFERENCES
Books and Journals
Della Ratta, C., 2016. Challenging graduate nurses' transition: Care of the deteriorating patient.
Journal of clinical nursing. 25(19-20). pp.3036-3048.
McGaughey, J. and et.al., 2017. Early warning systems and rapid response to the deteriorating
patient in hospital: A systematic realist review. Journal of advanced nursing. 73(12).
pp.2877-2891.
Ragusa, R. and et.al., 2018. Evaluation of health status in patients with hepatitis c treated with
and without interferon. Health and quality of life outcomes.16(1). p.17.
Kaner, G. and et.al., 2015. Evaluation of nutritional status of patients with depression. BioMed
research international, 2015.
Care, D., 2019. Standards of Medical Care in Diabetes 2019. Diabetes Care. 42. p.S81.
Flynn, J.T. And et.al., 2017. Clinical practice guideline for screening and management of high
blood pressure in children and adolescents. Pediatrics. 140(3). p.e20171904.
Thornton, L., 2016. What is holistic nursing. Retrieved on 19th January.
Ellis, P., 2019. Evidence-based practice in nursing. Learning Matters.
Online
Holistic nursing, 2013: https://www.americannursetoday.com/holistic-nursing-focusing-on-the-
whole-person
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