Critical Analysis of Prioritizing Problems in Nursing: Case Study

This assignment presents a critical analysis of a nursing case study focusing on a patient suffering from acute pulmonary oedema. The analysis prioritizes the patient's immediate needs, starting with the restoration of gas exchange, which is critical due to the patient's decreased breath rates and the presence of fluids in the lungs. The study emphasizes the importance of interventions aimed at reducing fluid in the alveoli and promoting chest expansion to prevent intrapulmonary shunting. Should these initial interventions prove insufficient, the analysis highlights the importance of addressing the hypoxemic condition to prevent tissue damage and potential life-threatening events like cardiac arrest. The essay refers to the patient's symptoms, x-ray reports and emphasizes the importance of immediate intervention to prevent anaerobic metabolism and its severe consequences, such as acidosis and cell death. References are also provided to support the analysis.

Running head: CRITICAL ANALYSIS OF PRIORITIZING PROBLEMS IN NURSING
CRITICAL ANALYSIS OF PRIORITIZING PROBLEMS IN NURSING
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1CRITICAL ANALYSIS OF PRIORITIZING PROBLEMS IN NURSING
This essay demonstrates the critical analysis of the treatment provided to a patient,
suffering from flash acute pulmonary oedema. In this disorder, fluids are accumulated in the
lungs and leads to impaired gas exchange, hypoxaemia and kidney failure as well (Force, 2012).
While treating a patient with such disorder, the priority should be restoring the gas
exchange as imbalance in the gas exchange can lead to a severe condition of hypoxaemia leading
to tissue failures (Purvey & Allen, 2017). The provided case study mentions that the patient has
decreased breath rates. The x-ray report also points out accumulated fluids in both the lungs. The
patient is unable to talk and has increased pulse rates. The other symptoms such as dyspnea
cracked breathing sounds and central cyanosis as well. Therefore, the first priority should be
treating the impaired gas exchange in the patient. Without restoring the adequate gas exchange,
the blood being returned to the circulation, will carry limited oxygen back to the tissues, leading
to tissue failure (Purvey & Allen, 2017). At first interventions need to be used to reduce the
amount of fluid from the alveoli. Then a basic care plan to promote chest expansion and to
reduce intrapulmonary shunting of blood.
However, if these interventions does not work on the patient, the second priority should
be reduce the hypoxemic condition. This condition is more problematic as due to lack of oxygen
in the blood cells become hypoxic leading to hypoxaemia. Hypoxaemic condition leads to
anaerobic metabolism and leads to mass damage of tissues, which can result as life threatening
diseases such as cardiac arrest (Prabhakar & Semenza, 2012). Lactate, which is secreted during
anaerobic metabolism, induces osmotic loads and acidosis. Cell death occurs, as the ATP
produced in the cell cannot complete the demand of cells. Therefore, this should be the second
priority while treating such patient. Interventions need to be followed to restore the adequate
circulation of oxygenated blood to prevent necrosis.

2CRITICAL ANALYSIS OF PRIORITIZING PROBLEMS IN NURSING
References
Force, A. D. T. (2012). Acute respiratory distress syndrome. Jama, 307(23), 2526-2533.
Prabhakar, N. R., & Semenza, G. L. (2012). Adaptive and maladaptive cardiorespiratory
responses to continuous and intermittent hypoxia mediated by hypoxia-inducible factors
1 and 2. Physiological reviews, 92(3), 967-1003.
Purvey, M., & Allen, G. (2017). Managing acute pulmonary oedema. Australian
prescriber, 40(2), 59.