HNB3140 Assessment 2: Prioritization, Clinical Scenarios, and Actions

This report presents a comprehensive analysis of patient care within a healthcare setting, addressing key aspects such as immediate actions, prioritization, and ethical considerations. Section 1 focuses on a clinical scenario involving a patient experiencing seizures, detailing immediate actions, assessments, hypotheses, and rationales. Section 2 tackles patient prioritization based on concurrent demands, evaluating the urgency of care for four patients with varying needs, including those with asthma, pre-operative requirements, IV therapy issues, and stroke-related mobility challenges. Section 3 delves into a professional scenario involving an ascitic tap procedure, exploring ethical dilemmas and responsibilities when staff shortages arise, emphasizing the importance of patient safety, ethical conduct, and adherence to nursing standards. The report provides detailed explanations, rationales, and references to support the clinical and ethical decision-making processes, demonstrating a strong understanding of nursing principles and practices.

Professional studies and inter-
professional practices

SECTION 1 Assessment and Actions
Immediate actions for patients
Assessment: In the present case situation a male patient who has been admitted for investigation
of seizures is found on floor. The patient was on floor before nurse entered room. The immediate
action in this scenario will be to detect consequences of fall. In this nurse will be engaged in
analyzing any urgent problem. In this they will be involved in controlling bleeding and airways.
If in any case situation fracture is been detected, then patient must not be moved and sharp
objects must be removed. If there is no sign of injury or obvious fracture, then patient must be
provided with assistance back to bed. If the person is lying down, turn them on their side, with
their mouth pointing to the ground. The water, food, pills must not be given if patient is not fully
aware. It will assist nurse in controlling saliva falling out of patient’s mouth, so that they can
breathe more easily.
Hypothesis: The hypothesis for these actions is that there are chances that a person may be on
floor because of seizures. It is necessary to stop falling saliva from patients mouth as nurses has
responsibility to make sure that patients breathing is fine. During a tonic colonic seizure, a
person may fall on floor because of it (Nunnery, (2019). This usually happens when the muscles
of chest triggers. So breathing must be appropriate. When the seizure will end the muscles will
be able to relax easily and by this the breathing will be able to resumed easily. It is also
necessary to provide adequate assistance to patient lying on floor. This is because if any kind of
seizure would have appeared, it can be frightening for patient. Nurses should also ensure that
they patient is safe once they have woken up. If there is a loss of consciousness, nurse should
check about how long it has lasted.
Actions and rationale: It is really necessary for nurses to make this type of immediate actions as
it will assist in enhancing wellbeing of patient. It has also been analyzed that if these necessary
steps are not being taken by nurses then wellbeing and quality of life of patients can be lowered
down (Maurício et.al., (2017).. The reason for not placing sharp objects close to patient is that
they can get injured and also other type of harm can be faced by them. It is also necessary to
provide them with adequate oxygen facilities, if breathlessness is being felt by patient. It is also
important to make sure that they promote airway clearance. This can be done by maintaining
lying position and also to loosen clothes of patients from their neck side. Once the patient
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become conscious nurses is being engaged in improvising self-esteem of an individual as by
lying on floor because of any reason, this can frighten them so self-esteem must be improved.
SECTION 2 Prioritization
The order which will be followed for these requests made to nurses, will be as followed. It
includes following:
Patient 4: Mr Stavropoulos has been admitted for acute asthma. He is due for ventolin and
prednisolone at 0800. His BGL at 0700 was 4.6 mmol/l. It was being analysed that blood sugar
level is normal. So this decision is being taken by nurse to take Mr. at first. This is because the
signs and symptoms for their acute asthma can be managed. Main reason for taking him as first
is that acute asthma can be life threatening. It is a condition of severe asthma and can affect the
patients well-being conditions severely. Patient can lose their lives if not taken at priority. It has
also been analysed that immediate attention will be provided to patient 4 so that their well-being
and health outcome can be enhanced. It has also been analysed that for more adequate attention
nurse should also be engaged in informing their health care professional. This will assist them in
improvising quality of life of patient. Adequate and immediate attention needs to be given to
patient so that their well-being and health outcome can be enhanced and improved. This will
assist nurse in enriching quality of patient 4 life.
Patient 2: Mrs Walters will the first priority as she needs to get ready as soon as possible. One of
the reason for patient becoming first priority is that ANUM is been searching for pre-operative
checklist of Mrs. Walters. All the preparations related to operations is due and it will take place
within the period of half an hour. So this is first and foremost priority of nurse. In this nurse will
be engaged in making patient undergo various tests such as blood, x-rays which is necessary for
surgery. All the report is to be given to ANUM on timely basis which is really necessary to be
done. There are other various procedures which needs to be take place before surgery so Mrs.
Walter will become first priority (Hudacek, DiMattio & Turkel, (2017). Also, main role of nurse
in making patient go to surgery is to check that all necessary documents are been signed by
patients and other parties. All the chart needs to be filled before going to operations theatre.
There are various preparations that needs to be done like cutting down of patients nails and also
the preparation related to taking care of their hygiene condition is also needs to be done.
Patient 1: Mrs. Peterson requires assistance for removing the en-suite. She had suffered from
stroke and is also been marked at high risk of fall. So in the order of priority she will be in the
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third. Hemiplegia is basically a condition which is been caused because of brain damage. In this
the person can face a situation of paralysis. In order save her from the risk of fall, it is really
necessary to provide patient with assistance as soon as possible. This is because patient is weak
and also there can be a loss of strength. They might fall and get themselves injured. It has also
been analysed that patient must be kept safe and there should be no sharp objectives placed in
front of patient as they can get injured because of it. It has also been analysed that nurses are
provided with responsibility to make adequate decision so that health outcome of patient can be
enhanced. This will assist in improvising well-being.
Patient 3: In this case study patient 3 is nil by mouth and has IV therapy running at 167mls per
hour. The infusion pump alarm is sounding and the IV flask appears to be close to empty. In this
a nurse responsibility is to stop IV pump from beeping. It also means that bag is empty and
infusion is completed (Disler et.al., (2019).. Patient is also complaining of pain which can be
because of intravenous therapy given to them. Adequate medication must be given to patient so
that their well-being can be improved. Patient 3 will be last priority as they are being suffering
from pain. IV therapy is a complicated procedure and several medical complications can appear.
If the bag remains empty for longer duration of time, then the risk of infection can be increased
and because of this the patient can face unstable situation. Also, it is necessary that the treatment
must be provided at utmost priority so that health outcome of patient can be enhanced. This will
also assist in improvising well-being which is really necessary to be done.
SECTION 3 Professional scenario
In the present case situation, it has been analysed that Mr. Stanley is having an ascitic tap on
the ward today. An ascetic tap is a procedure in medicine where a needle is being used to drain
fluid from the internal body cavity. It is being taken from the abdomen belly. In this procedure
appropriate care needs to be taken of patient and also their vital signs and symbols must be
analysed so that wellbeing can be enhanced and improved. If any immediate attention is
required, then it must be given by nurse (Schmidt & McArthur, (2018). It is really necessary to
provide better medical facilities to patient. I have noticed that resident medical officer is going in
room of Mr. Stanley and there are no nurses available as they are having lunch break. I was also
being engaged in attending patient who are been suffering from hypoglycaemia. It is a situation
where blood sugar level goes down. It mainly affects people who are suffering from diabetes.
There is various reason because of which this type of disease occurs. But now the situation is
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RMO is visiting ward of Mr. Stanley. It has been analysed that in such situation I will be
engaged in analysing vital signs and symbols of patient. In this situation I will attend patients
ward and make RMO explain whole situation. I will do this in early time so that proper attention
can be laid to patient suffering from hypoglycaemia too. In this situation, it is necessary that
patient history is been recorded and the medical history of patient is also being noted. RMO is
visiting as the ward rounds are essential so that quality of care can be provided to patient. In such
scenarios nurses have responsibility, to be in charge and also they can re-shift their personal
schedule and lay proper emphasis on patient. It has also been analysed that the nurse must not be
short as if this happens then proper care cannot be given to patient (Black, (2019). It can affect
their well-being and also by this quality of life can be hampered and their well-being is
negatively affected. Nursing standard 2 has provided details that proper planning must be done
by nurses and also they should also have engaged others in plan.
Nurses must be ethically responsible for any act which has been done by them. Like in
situation of this patient. All nurses are busy in having lunch which is ethically wrong. There first
liability is patient and also better emphasis must be laid on patient. Standard 4 has provided
details that nurses needs to be engaged in evaluating their own outcome and then make changes
in way of working. Monitors, evaluates and documents treatments/interventions in accordance
with person- determined goals and health care system outcomes. So, in this situation ethically my
responsibility to make hospital management aware about shortage if staff. This will assist in
making sure that no such type of issue arises in future (Jenkins, Kinsella & DeLuca, (2019). This
will assist in enhancing wellbeing of patient and also it will help in making sure that no such
miss-management is been done in future. So it has been analysed that patient is first and
foremost priority of nurse. It has also been analysed that in such situation health care
professional also must be informed about miss-management which existed. Nurses needs to
make sure that ethical code of conduct is been followed by them. There first priority is patient.
They can have their lunch afterwards. All these aspects are being mentioned in ethical code of
conduct. Nurses and midwives needs to follow all these ethical standards so that their work can
be improved. It will also assist them in enhancing their quality of care which is really necessary
to be done. It has also been analysed that culturally safe and respectful practice must be done and
followed by nurses. In this situation hospital management must be informed about shortage in
staff. This will assist in making sure that no such situation happens in future. nurses have
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responsibility, to be in charge and also they can re-shift their personal schedule and lay proper
emphasis on patient. It has also been analysed that nurses should be held liable if any type of
issue is being faced by patient.
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REFERENCES
Books and Journals
Black, B. (2019). Professional nursing E-Book: Concepts & challenges. Elsevier Health
Sciences.
Disler, R. T., White, H., Franklin, N., Armari, E., & Jackson, D. (2019). Reframing evidence-
based practice curricula to facilitate engagement in nursing students. Nurse education in
practice, 41, 102650.
Hudacek, S. S., DiMattio, M. J. K., & Turkel, M. C. (2017). From academic-practice partnership
to professional nursing practice model. The Journal of Continuing Education in
Nursing, 48(3), 104-112.
Jenkins, K., Kinsella, E. A., & DeLuca, S. (2019). Perspectives on phronesis in professional
nursing practice. Nursing Philosophy, 20(1), e12231.
Maurício, L. F. S., Okuno, M. F. P., Campanharo, C. R. V., Lopes, M. C. B. T., Belasco, A. G.
S., & Batista, R. E. A. (2017). Professional nursing practice in critical units: assessment
of work environment characteristics. Revista latino-americana de enfermagem, 25.
Nunnery, R. K. (2019). Advancing your career: Concepts of professional nursing. FA Davis.
Raghubir, A. E. (2018). Emotional intelligence in professional nursing practice: A concept
review using Rodgers's evolutionary analysis approach. International journal of nursing
sciences, 5(2), 126-130.
Schmidt, B. J., & McArthur, E. C. (2018, January). Professional nursing values: A concept
analysis. In Nursing forum (Vol. 53, No. 1, pp. 69-75).
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