Answer To: NUR250 Assessment 1 SS 2019 Assignment template Please note: As indicated in Assessment 1...
Rimsha answered on Dec 10 2021
NUR250 Assessment 1 SS 2019 Assignment template
Task 1
Patient’s Condition
The patient is 57 years old Caucasian women from a Darwin. She has been admitted to the hospital due to exacerbation of COPD. She has dyspnoea, fever and productive cough. When vital signs are tested, although, airway of the patient is own, open and clear, but her respiratory rate is 26 which is abnormal. On the contrary, oxygen saturation rate of the patient is 89%. Despite the heart rate of the patient is 89 base per minute which is normal, but blood pressure of the patient is 160/95 mmHg, which is relatively very high. Patient complains about the chest pain on inspiration. Since patient reported fever, her temperature is 38.6 degree Celsius.
Pathophysiology of the Disease
Exacerbation of the COPD is a sudden worsening of the symptoms of COPD. Expiratory flow limitation (EFL) is a pathophysiological mark of the COPD. Patients suffering from this disease are said to be flow limited when the expiratory flow is generated during tidal respiration. It represents maximal flow that can generate at the volume (Capistrano, Van Reyk, Chen & Oliver, 2017). In flow-limited patients, the time for the emptying of the lungs during spontaneous breathing is not enough to allow end expiratory lung volume (EELV). It declines its natural relaxation volume, which resulted in lung over inflation. The inflow-limited patients, EELV become dynamic instead of static. It becomes a variable that fluctuates depending upon the extent of EFL and prevail ventilatory demand. Dynamic hyperinflation is an acute and variable increase in EELV from the base value (Jones, Noble, Elliot & James, 2016).
Dynamic hyperinflation occurs during in flow-limited patients because inspired tidal volume increases and expiratory time decreases. It resulted into severe mechanical constraints on ventilation. It resulted into respiratory discomfort. There is reduction in inspiratory capacity, which led to the increase in EELV. During COPD exacerbations, airways resistance is abruptly increased and it worsens the EFL (Sohal, 2016). The time constant for lung emptying is prolonged and EELV drastically increased. In exacerbation, patients adopt rapid shallow breathing pattern, which limits the time availability for emptying of the lungs and promotes the greater dynamic hyperinflation in a vicious cycle. Acute increase in ventilation is associated with DH inflow limited patients. DH can be life threatening during severe exacerbation (Negewo, Gibson & McDonald, 2015).
Linking current condition of the patient with past medical history
The patient has a history of smoking. He smokes 20 cigarettes per day. He has a history of type 2 diabetes, hypertension, hyperlipidaemia and obesity. He drinks one bottle of wine per day. It is important to note that smoking is a leading cause of the chronic obstructive pulmonary disease. Smoking acts as a trigger for COPD flare-ups (Liang et al., 2018). Since the patient is suffering from diabetes, obese and hypertension, which are chronic diseases and lower the quality of the life, patient is weak and thus, easily they have worsen COPD symptoms. Apart from this, smoking damages the air sacs, airways and inner lining of the lungs. This injured the lungs. Injured lungs have trouble in movement of air inside and outside of the lungs. This makes it difficult for the person to breath easily. COPD symptoms are worsened due to smoking. Patient’s history has impact on his current condition (Mahmood et al., 2016).
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Last name__ _student number_NUR250 SS 2019 Assessment 1
Task 2
Nursing Care Plan: Mrs Rose Wilson
Nursing problem: Acute Pain
Related to: dyspnoea, cough and chest pain
Goal of care
Nursing interventions
Rationale
Evaluation
To reduce the chest pain while expiration
To control the symptoms of cough
To ease the breathing
· Regularly observe the intensity of the chest pain
· Administer of the pain medication to control chest pain
· Check the phlegm
· Administer the antibiotic to relieve cough
· Breathing control exercise to ease the breathing
· Monitoring of the respiratory rate and oxygen saturation
· Administer of the oxygen therapy when oxygen level lowers
· Administer of the pain medication help in relaxing the chest pain having 2 score (Cullen et al., 2015)
· Cough occurs due to bacterial infection. Administer of the anti-bacterial medicine helps in reduction of the growth of the bacteria. It also kills the bacteria (McCallum, Plumb, Morris & Chang, 2017).
· Training of the breathing control exercises help the individual in controlling in breathing rate and relaxes the muscles to ease the breathing. Since laboured breathing cause panic in the individual, this panic worsens the breathing further (Lahham et al., 2018).
· Pain medication reduces the chest pain and, in few hours, patient does not feel any pain
· Administering of the antibiotic medication reduces the cough and controls the phlegm. In 2-3 days, cough is completely get treated
· Use of the breathing exercise technique, patient can control the breathing and have ease in breathing
Nursing problem: Risk of ineffective tissue perfusion
Related to: obesity, hypertension, hyperlipidaemia, and diabetes
Goal of care
Nursing interventions
Rationale
Evaluation
To control the obesity and come within the expected BMI index range
To control the blood pressure so that hypertension can be prevented
To control the blood sugar level so that diabetes can remain in control
· Patient is given weight management plan which includes customised diet chart based on the lifestyle and eating habit of the patient
· Patients are tough some exercises which are effective in weight management
· Lifestyle of the patient will be changed which include limit on the smoking and wine drinking and regular exercise
· Control of the salt, sugar and fat rich- food in diet
· Administers of medication for hypertension, hyperlipidaemia and diabetes
· Development of the weight management plan is based on the health condition of the patient and include instruction for necessary change so that an...