Patient Health Deterioration Detection: Case Study Analysis

This report presents a case study focusing on the detection and management of patient health deterioration. The case involves a patient, Mr. Benner, admitted to the emergency department with respiratory issues and pain. The report details the assessment process, including vital signs monitoring (blood pressure, pulse rate, oxygen saturation, respiratory rate, and temperature), and the patient's mental state. It highlights the progression of the patient's condition, from initial assessment to subsequent deterioration, including changes in vital signs and mental status. The discussion section identifies the deterioration based on communication, actions, and vital signs, while also considering the effects of medication. The report then explores evidence-based nursing interventions, such as oxygen supplementation, electrolyte provision, and communication strategies, referencing the "Between the Flags" intervention model. The conclusion emphasizes the importance of evidence-based practice, patient-centered care, and the need for a balanced approach to address patient health deterioration effectively. References to relevant research and guidelines are also included.

Running head: PATIENT HEALTH DETERIORATION DETECTION
PATIENT HEALTH DETERIORATION DETECTION
Name of the Student
Name of the University
Author Note

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PATIENT HEALTH DETERIORATION DETECTION
Introduction
Patient health deterioration is a factor that should be detected with high priority by the
nurse and the process of the detection can be done with the help of the vital sign detection along
with the mental state of the patient as well. The pain level detection along with the body
temperature can also be stated that the factor of the deterioration or changes of the condition of
the patient’s health. Hence, it can be stated that on this context of the detection process Mr.
Benner has been found with some complications as the Blood pressure, respiration rate, Oxygen
saturation rate was not normal in the first assessment along with some pain in the lower rib. It
has also been seen that with time the condition of the patient deteriorated as the vital signs were
in more complex stage and the confusion of patient rise on higher level. Hence, in the following
section the deterioration detection process would be discussed along with evidence based nursing
intervention process of this case.
Discussion
Identification of Deterioration
The detection of the deterioration of a patient can be done with the help of the
communication with the patient, actions of the patient and vital sign detection of the patient. The
evaluation of the effects of the medication on the patient’s health also should be considered
(Mok, Wang & Liaw, 2015). In this case Mr. Benner has been admitted in the emergency
department with two days increasing dyspnoea, lethargy and non-productive cough. He has
stated that he was feeling pain in the lower rib and also the X-ray report highlighted that he has
crackles in the lower lob of the lungs as he has history of pneumonia. The vital signs after the
admission of the patient in the emergency department showed the readings such as BP 123/98,
pulse rate 82, Oxygen saturation 93 percent, respiratory rate 22 and the pain was 5/10 along with

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temperature of 38.8o. On the other hand the patient is conscious and identifying everything
properly which refers to the GCS score 15/15. The ECG report showed normal result and also it
has been stated that he is fit and had a history of asthma. After this assessment the assessments
done within 15 minutes intervals where he has been transported to the assessment bed and the
nurse provided him with nasal prongs and 4 lt Oxygen and an oral paracetamola and the doctor
prescribed several blood and other tests. This situation can be identified as the first deterioration
of the patient as the breathing issue started and thus the supplementary oxygen provided to him.
Hence the nurse used cannula and taken the blood sample for the blood tests. After this
assessment the right lob of lung consolidation has been commenced along with antibiotic
providence to the patient. After this the next assessment has been done and the vital signs found
that BP 121/96, pulse 91, respiratory rate 25, oxygen saturation 95 percent with the nasal prongs
provided temperature 38o and pain level 4/10. After this the patient has been transferred to the
medical ward and the grad nurse was responsible there for the patient. The grad nurse found that
the patient cannot recognize his name and also could not breathe properly. Hence, this condition
can be referred as the mental deterioration of the patient. Here the vital signs of the patient seen
to be deteriorating as the BP 100/55, pulse 98, respiratory rate 28, oxygen saturation 88 percent
and GCS score was 14/15 as he could not be able to identify several things. The patient stated
that he was not feeling any pain however, when coughing he holds his chest. On this situational
description it can be stated that the vital sign deterioration occurred in the patient’s body and also
the GCS scale level falls that is the mental condition deterioration occurred as well. On this
assessment the medical officer prescribed 10 lt oxygen supplies to the patient along with using
Hudson mask. The patient also provided with Hartmann’s IV solution for raising the blood
pressure. Hence, the condition states that the patient’s respiration capacity and the BP were

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deteriorating. Thus on the basis of this assessment between regular intervals it can be seen that
the patient deteriorated in terms of the vital signs and the mental state of the patient has also been
deteriorated (Carson-Stevens et al., 2016). The nurse should be able to determine the condition
of the patient and plan the probable intervention that can help the patient. However, as the case
proceeded it has been seen that the deterioration of the patient occurred along with the
supplementation of oxygen and also providing the medication to the patient. Hence, it can be
stated that the effect of the medication has been nullified in case of the patient. The lower blood
pressure and the higher respiratory rate along with the pulse rate could be affecting the blood
flow and as the oxygen saturation of the patient is low thus it can be stated that the condition
leading to the myocardial infarction. These are the assessment that showed that the patient’s
condition is deteriorating with time (Www1.health.nsw.gov.au, 2019).
Evidence-Based Nursing Intervention
Based on the assessment of the patient the nurse should be able to develop an
intervention plan which can be able to at least stabilize the condition of the patient. Thus
referring to the condition of Mr. Benner it can be recognized that the his body is experiencing
Traumatic Brain injury (TBI) as the blood pressure of the patient as it is lowering with time and
that would lead the lower blood transport to the brain of the patient. It can also be stated that the
adverse effect of the medicine provided to the patient can be able to affect the brain tissue which
would be the cause of the TBI as well (Rch.org.au, 2019). Hence, on this context the nurse
should be able to identify the proper solution that can be able to deliver the proper intervention in
this condition (Csipke et al., 2016). The factor of the electrolyte providence through the saline
solution that is the Hartmann’s IV and also providing proper oxygen supply to the patient would
be helpful in the buildup of the proper blood pressure that can be able to stabilize the condition

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of the body. This can be stated as the possible intervention of the deteriorations. The first
deterioration intervention would be providing nasal prongs and 4 lt oxygen providence. The
second intervention would be including the sensory integration for the activity control of the
patient and also providing oxygen. Third intervention would be providing electrolyte to the
patient for vital sign development and the fourth intervention would be providing high
concentration electrolyte, oxygen and verbal and active communication with the patient in order
to help him to be conscious. Based on this case it can also be referred that the factor of the
Between the Flags intervention on Slippery Slope Diagram can be implemented by the nurse
(Cec.health.nsw.gov.au, 2019). The factor of the intervention thus needed to be considering the
aspects of the prevention process that includes the supplementation providence to the patient in
order to stabilize the condition, clinical review that is the assessment with time, rapid response
that is the aspect which would be stated as the stabilization of the vital signs with immediate
response to the intervention. However, the confusion level of the patient can be referred as head
injury effect from past or in the infant age which affected the brain tissues as well
(Www1.health.nsw.gov.au, 2019). On this context it can be stated that the possible intervention
for the patient would be providing support to the respiratory system of the patient, providing
electrolytes in order to stabilize the vital signs of the patient and transferring the patient to the
acute care unit or the ICU in order to prevention of the possible myocardial infarction or multi
organ failure (Kihlgren et al., 2016). Thus it can be stated that the factor of the intervention
should be depending on the proper observation of the patient in time and helping the patient as
well with the proper medication or other supplementation. The past medical history should be
assessed along with the present condition in order to provide the improved care and the evidence
based intervention also required. The evidence based nursing intervention would be helpful in

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finding the proper solution and the possible causes of the condition of the patient as well
(Massey, Chaboyer & Anderson, 2017). Thus on this context it can be stated the nurse should be
able to address all the possible causes of the condition of the patient and also providing help to
that patient with proper outcome evaluation. Hence, finally the nurse would focus on the
condition of the patient should provide the patient centered care to the patient as well. Thus it can
be stated that the factor of the intervention should be focused on evidence based practice and also
patient centered approach (Anzanpour et al., 2017).
Conclusion
Based on the above discussion it can be concluded that the factor of the identification of
the patient health would be dependent on several factors of the assessment of the vital signs and
other health conditions of the patient. If the condition of the patient’s health preceding towards
the negative direction it can be stated that the deterioration is occurring and the intervention
provided to the patient is not recognized by the body of the patient. Hence, on this context Mr.
Benner’s case it can be found that the process of the intervention and the health deterioration of
the patient should be able to find the proper balance that can be able to help the patient in
sustaining the against the negative situation. Thus it can be stated that the intervention of the
patient should be done with the evidence based practice and the patient centered approach.

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References
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