Nursing Management Essay: Emergency Department Case Study Analysis

This essay provides a detailed analysis of nursing management within an emergency department setting, using the case of an 80-year-old patient, Mrs. Jane Smith, as a focal point. It explores the critical aspects of patient assessment, including the interpretation of vital signs and the need for further investigation through targeted questioning of both the patient and her family. The essay delves into potential pathophysiological issues, emphasizing the importance of nursing diagnosis in guiding effective interventions. It also covers patient-centered care, medication pharmacokinetics (specifically Bupivacaine, Panadol, Neurofen, and Morphine), and the crucial role of patient education regarding medication interactions and long-term effects. The discussion highlights the importance of timely medication administration and the need to inform patients about their treatment options and potential side effects. The essay concludes by underscoring the significance of comprehensive nursing management in improving patient outcomes within the emergency department. This document is contributed by a student to be published on Desklib, a platform which provides all the necessary AI based study tools for students.

Essay

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
Nursing management refers to the performance of decision making in healthcare
premises which can provide effective treatment and care to the patient for improved health. It
includes different processes like planning, organizing, staffing, directing and controlling in the
Healthcare premises. In this essay, there is discussion about and old lady Mrs. Jane Smith who is
80 years old and having not good health due to which she has been admitted in emergency
department. There are different complications and there are different findings which are not
normal for the old lady. There is a discussion about need of further investigation along with type
of question. Nursing staff need to collect for providing effective treatment and pathophysiology
issues related with the patient and identification of nursing diagnosis needed immediately for the
intervention. There is also discussion about the nursing management for providing effective care.
There is also discussion about the pharmacokinetics of the medicines. There is also a discussion
about the information which need to be shared with the patient for better interaction and long-
term effect of the medication (Mitchell, (2019)).
MAIN BODY
There are different data deviation from the finding. There are some of the vital signs like
blood pressure is highly deviated and need to be control for the relaxation of Mrs. Smith. There
is also elevation in heart rate which is more than normal and due to irregular, it create health
related issues and leads to the risk of life. Respiratory rate is also higher where it needs to be in
the normal range from 12 to 28 per minute. Mrs. Smith is having 24 beats per minute which
create emergency. Body temperature is also deviated which should need to be 35 degree to 36
degree Celsius which has been elevated to 37.2 which need to be lower for the normal. There is
also need to collect more information which is related with the health of Mrs. Smith. Therefore,
further investigation can help nursing professionals to collect more information related with Mrs.
Smith. It can help to gather the information which can provide help in further diagnosis and
treatment for improvement in the health. Nursing staff need to ask a different type of question
from Mrs. Smith and with her son too. They can provide the brief information and help nursing
staff for gathering of enough information that can get to provide effective treatment and care
(Vandali, (2017)). Their is need to ask some normal questions which can provide the information
of reason for worsening of health of Mrs. Smith. Mrs. Smith can provide the information and the

cause with the worsening of health. This can provide enough help for the nursing staff to
gathering of data and collectively helped to provide effective treatment and care to Mrs. Smith.
Gathering information can provide improved health and can help you decide the medication and
related treatment accordingly.
There is need for further investigation which can provide additional information to the
nursing staff by asking some of the questions. These can help to provide gathering of patient
information related with case scenario for providing better health treatment and care to the
patient for improved health. There are some of the additional questions to ask are discussed
further.
What happened? This is the question which can help nursing professional to interrogate
patient about the specified scenario which creates the situation of emergency. This question can
provide the information about the exact scenario which was happened and created the
emergency.
What was the time and duration when this incident taken place and what was your inner
feelings? The question can provide the information to the nursing staff about the time of the
incident and the behaviour during this incident. Nursing staff should consider the situation which
should be there at that time. This can help staff to decide the diagnosis and treatment which is
based on explained scenario.
Have you ever feel such type of health issue previously? This is the question which can
provide their medical history of the patient related with same type of health condition. This can
help to decide for delivering of treatment and for the care and management for improved health
of Mrs Smith (Lee & Ogata, (2018)).
There are also various questions which need to be asked like what was the response to the
incident? Have you report this incident to physician or doctor? Do you know the reason for the
incidence? Is there anything else which you would like to tell which is not been asked?
There are different physical problem which can be cause and have focusing on the
pathophysiological issue according to the provided information. It can be evaluated that there
could be a chance of chronic kidney disease due to having an increased risk of arterial
fibrillation. There is also risk of heart attack or a stock which is due to high blood pressure
within patient. This can be created due to hardening and thickening of arteries wall which can
create atherosclerosis and can lead to create stock, Heart Attack and other complications within

patient. Due to unwitnessed fall, it has been observed through diagnosis that there is a neck of
femur which can lead to create a direct impact on the backbone and have needed for the
replacement treatment of hip bone. Due to having old age, there is different complications while
providing different type of treatment. There could be chance of different other disease through
which Mrs. Smith may be suffered as per associating the pathophysiological issues. This can be
chance of suffering from high blood pressure along with due to fall there is neck of femur and
different other disease like hypothyroidism, high blood pressure, chances of diabetes problem
which should need to be provided treatment and diagnosed for evaluating the type of disease
through which Mrs. Smith is suffering from (Scopetti & Fineschi, (2021)).
Nursing diagnosis refers to a clinical judgement which is concerned with patient response
to health condition. Nursing diagnosis can provide the basis for selecting the nursing intervention
to achieve positive outcome for delivering of effective healthcare treatment to the patient.
Nursing diagnosis can help in identifying the nursing priorities and to direct nursing
interventions which is generally based on identifying priorities. It also provide the basis of
evaluation which help to determine the nursing care which is provided to the patient is beneficial
or not. There are two type of nursing diagnosis which includes problem-focused nursing
diagnosis and Health Promotion nursing diagnosis. This provide immediate intervention which
can help the nursing staff provide effective care and management for the improved health of Mrs.
Smith. This can provide enough nursing management to improved health of the patient. Problem-
focused diagnosis determined during nursing assessment where it can be observed of the patients
entire health and to provide nursing and medical care which is based on different components
like reflected factors, characteristics and nursing diagnosis. There are some of the example of the
nursing diagnosis with including chronic functional, constipation, impaired gas exchange and
decreased cardiac output. Health Promotion diagnosis can provide improvement and overall
well-being of patient. This includes readiness for enhanced hope, standard lifestyle and for
delivering effective health care services (Sadruddin, (2017)).
There is need for providing patient-centred care to the patient. Due to having different
complication with patient and Mrs. Smith age is also a reason for providing patient-centred care.
Mrs. Smith is not able to provide herself high level of care. So, nursing staff can help for
providing effective care and management. Creative awareness can also help to promote
healthcare services by providing effective care to Mrs. Smith. There is need to provide person-

centred care which can help to better and effective care. This can be helpful for delivering of
medication on proper time and to look after which can be highly beneficial for nursing
management plan (Rowley-Conwy, (2017)).
Pharmacokinetics of Bupivacaine can metabolized primarily within liver with the help of
glucuronic acid and conjugation. Panadol consists of Paracetamol which is generally observed
and able to distributed in body rapidly and evenly which is having the 0.9L/kg volume of
distribution which is predominantly metabolized in liver. This can provide below the body
temperature and relief from pain. Neurofan is having the property of getting observe rapidly
when taken through oral administration. This is nonsteroidal anti-inflammatory drug which
provides relief from pain by blocking prostaglandins chemicals. Morphine pharmacokinetic
property of can creative result in plasma concentration within 60 to 90 minutes and create the
impact of analgesia. These drugs can provide relief from pain and to manage the acute pain of
Mrs. Smith (Ishida, (2020)).
There is a need for nursing management related with prescribed medication in the
emergency department. There is need to provide care to the patient by nursing staff should be
always available to check on the patient for proper medication on proper time for providing
effective care and improvement in health. There is some of the side effect of Bupivacaine which
creates allergic reactions like sneezing, vomiting, dizziness, difficulty in breathing, itching, red
rash, swelling in face, throat etc. Due to having higher age Mrs. Smith is not able to disintegrate
every medicine should have a higher pharmacokinetics impact (Liss, (2017)). There is an adverse
reaction of panadol is constipation, vomiting, nausea, pain on injection site which can create
difficulty due to is complication and not having higher ability to metabolized every medicine.
There are different side effects of Neurofen which includes stomach pain, ringing in ears, feeling
tired and sleepy, nausea and vomiting, difficulty in breathing and due to which causing slow and
fast heart rate, chances of blood related issues which can be having chance due to high age of
Mrs Smith. There are also some side effect of morphine which includes a small puppies,
difficulty in urination, causing of pain during urination, nervousness, headache, dry mouth and
drowsiness which can be due to higher age of Mrs Smith (Häuser & Krčevski Škvarč, (2021)).
There is need to provide the information to the patient which is related with their health.
As a healthcare professional, there is need to provide every detail of the patient which can have
impact on Mrs Smith health. There is need to provide every treatment which is needed to be done

and provide them the other options for substitute of those treatment. Patient have the right to
choose their treatment and to get involved in the treatment process. There is also need to
maintain the confidentiality of the patient health. There is need to provide information about type
of medicines, their doses, type of administration, their frequency and various diagnosis tests
which are performed or needed to be performed. These information should be provided to the
patient. There is need to educate patient about the interaction and long-term effect of regular
medication. This can be done by creating awareness about the long-term medication programme.
There are different medicines which have different effect. This can help to aware Mrs. Smith
about the value and benefit of taking medication on right time. There is also need to make aware
to patients family about the medication. This can help you create awareness about medication to
the patient health which can provide effective improvement in health (Mankowitz, (2018)).
CONCLUSION
From above discussion, it can be concluded that there is need to provide medication on
right time and awareness of medication related with their benefit should be informed to the
patient. There is also need for different diagnosis process which can help to identify the health
related issues and the reason of the worsening of health. There are different diagnosis process
which need to be performed for identification of worsening of health. Asking different question
and gather of information can help to decide the diagnosis process and medication accordingly.

REFERENCES
Books and Journals
Häuser & Krčevski Škvarč, (2021). European* clinical practice recommendations on opioids for
chronic noncancer pain–Part 1: Role of opioids in the management of chronic noncancer
pain. European Journal of Pain, 25(5), 949-968.
Ishida, (2020). Evaluation of pneumonia severity scoring systems in nursing and healthcare-
associated pneumonia for predicting prognosis: a prospective, cohort study. Journal of
Infection and Chemotherapy, 26(4), 372-378.
Lee & Ogata, (2018). Literature research using text mining analysis: priority of Japanese
oncology nursing in the article title. Japan journal of medical informatics, 38(4), 235-
244.
Liss, (2017). An update of the American Urological Association white paper on the prevention
and treatment of the more common complications related to prostate biopsy. The Journal
of urology, 198(2), 329-334.
Mankowitz, (2018). Ketamine for rapid sedation of agitated patients in the prehospital and
emergency department settings: a systematic review and proportional meta-analysis. The
Journal of emergency medicine, 55(5), 670-681.
Mitchell, (2019). Carrying out a holistic assessment of a patient with constipation. British
Journal of Nursing, 28(4), 230-232.
Rowley-Conwy, (2017). Critical care nurses' knowledge and practice of delirium
assessment. British Journal of Nursing, 26(7), 412-417.
Sadruddin, (2017). Patient education and mind diversion in supportive care. British Journal of
Nursing, 26(10), S14-S19.
Scopetti & Fineschi, (2021). Expanding frontiers of risk management: Care safety in nursing
home during COVID-19 pandemic. International Journal for Quality in Health
Care, 33(1), mzaa085.
Vandali, (2017). Case Study on Tetanus. International Journal of Nursing Education and
Research, 5(4), 389-391.
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