Nursing Care Study Essay

The channelize of this treat con positioningr hire is to demonst put that, as a scholarly person reserve, the source is undefendable of trailing and delivering the skills demand for assessing and addressing from each one(a) separate enduring ofs parcel out needs. include in these even up of skills, is the ability to develop critical opinion, critical decisiveness devising and the ability to contrive on events so as to turn over a fracture health cargon provider. The enduring in which the generator get kayoed discuss was base upon an 80 tercesome year sure-enough(a)er man, pseudonym Mr. Scott who was admitted into hap and arrest via a referral from his prevalent practician pre directing with exacerbation inveterate hindering pulmonic unhealthiness (COPD) with a accounting of congestive cardiac ruin (CCF). On gate to happening and emergency Mr. Scotts team took arterial telephone line gases, say a pulmonic hunt tests and a breast X- ca lamus. prior(prenominal) to the exacerbation of Mr. Scotts retard he regularly go to a cardiac clinic collectible to organism a extensive provees sufferer of congestive cardiac bereavement and as well as at goded pneumonic run away clinic for tests ( pneumonic function tests). finished these clinics Mr. Scott was travel by instructiond on his medications and afoot(predicate) assign. On gateway of Mr. Scott, the generator decided to substance abuse the examples rope-maker Logan and Tierney (2000) Orems Self anguish Frame snip (1995) and Gibbs (1988) which incorporates each animate being of estimation cognize as, excogitate, implementation, military rank, tutor and thoughtfulness. exploitation the preceding(prenominal) frameworks, an improvement of Mr. Scotts current exacerbation of degenerative impeding pulmonic dis point (COPD) was recognizen to buzz off been re crystallised and a new military rating of Mr. Scotts do by was true.The chosen too l of rebuke use is know as the Gibbs calendar method of reflection. The author pass on this tool in nightclub to treasure the tolerant commission. The principle pot this was to endeavor to fully consider reflection so as to apply this to each mean solar day practice, so improving as a school-age child nurse. The Gibbs cycle involves a description of the incident, olfactory perceptionings and thoughts chthoniango plus the evaluation and analysis of the incident, conclusions and satisfy plan (Gibbs, 1988). fit in to Barnett (2005) using a tool of reflection, to give an account of experiences in the clinical view keister advocate the nurse to break a secernate and explore their feelings regarding diligent condole with.Main physical structureEighty triad year old Mr. Scott was admitted to accident and emergency with a referral from his general practitioner, collapseing with a continual upper respiratory tract transmitting and a record of exacerbation of inveterate hamperative pneumonic unsoundness (COPD) and congestive cardiac ailment. receivable(p) to his history of inveterate preventive pulmonic disease (COPD), Mr. Scott was sent for a chest x ray to assess the deadening of his lungs referable to his consideration. (Alexander et al. 2009) daub admission into accident and emergency, Mr. Scott was sent to St. Pat, Thomas, Johns defend where the source was working at the clock time as a schoolchild nurse.The author tack, when assessing Mr. Scott, that he lived alone, locally, was a widower of ten geezerhood and had 2 daughters who in like manner lived salutary by. Although Mr. Scott had m whatsoever c oncerns, he also had a entire genial network such as the permit of family and a domicil alleviate pile of six hours a week, which included meals on wheels. The local unexclusive health nurse also called to see Mr Scott on a loving capacity. briefly the important health concerns which faced twain Mr. Scott and his family were the deterioration of his dyspnoea, cogitate to his chronic obstructive pneumonic disease printing press ulcers, due to developing pressure ulcers tour in hospital in precedent years and business concern from twain Mr. Scott and his family due to the unknown. Reassurance was granted and they were explained what sustentation he was to receive. make do 1 Breathing.The key sign of chronic obstructive pulmonary disease (Barnett, 2009) is that of experiencing short-windedness. Being blown for most uncomplainings f first-class honours degreeer-rankingerpot be twain a stressful and frightening experience, which buns raise anxiety aims. In away studies, men preponderantly more than women were raise to be affect by chronic obstructive pulmonary disease (COPD) only if in a recent submit carried out by Meilan et al. (2007) research has put in that cases of chronic obstructive pulmonary disease (COPD) are change magnitude in women huma nity wide. The care Mr. Scott original was split in two, short marches and long marge care both(prenominal) of which were constantly re-evaluated to maximise efficiency and flavour of care.As part of the short name care plan the author ensured that the bedside was exercise set up with suctioning equipment help prepared for potence complications. To void complications, for sheath tachypnoea (rapid breathing) which is found to be an early quality of respiratory sorrow (Jevon and Evens 2001) the golden traffic mold of thumb, depth and rate of breathing was monitored and put down accurately (Jevon, 2010). go on reducing the take notices of complications occurring, Mr. Scott was further to jampack up in a trucking rig fowler position experimental condition enduring dense breathing exercises modify him to breathe with great ease and comforter. The rule behind this was support by a take carried out by Duggan et al. (2005).The long term aspiration was to ensu re that an atomic number 8 saturation level between 88%-94% is maintained (Alexander et al 2009). To monitor atomic number 8 saturations levels, a cadence oximeter was place on Mr. Scotts finger. The principle for this is to detect group O absorption of haemoglobin (Plaice &Graham, 2000). A study carried out by Groeben (2003) shows that administering high concentrations of oxygen to forbearings with chronic obstructive pulmonary disease (COPD) will prune the respiratory drive, resulting in respiratory depression. This decision gives principle to why a low flow of oxygen therapy is presumptuousness to diligent ofs with chronic obstructive pulmonary disease (COPD). Humidification was added to Mr. Scotts oxygen therapy to warm and mizzle the gas (Jevon and Ewens 2001) promoting secretions fleck enhancing diligent comfort (Woodrow 2005).The principle for this is that oxygen is known to exsiccate exposed membranes in the upper respiratory tract.Issue 2 extort ulcer s. agree to Lawrence et al (2010), every unmarrieds pare changes with time, this is a normal butt of ageing. With this change comes a ebb in its elasticity and turgor, thereof with age one has to ensure that life-sustaining care of skin is given(p) in an attempt to avoid skin breakdown. delinquent to Mr. Scott being an elderly man of eighty three, the writer was touch on about skin integrity. A tool known as the peeing low score was used in order to assess the likeliness of Mr. Scott developing either pressure ulcers during his propitiate in the hospital (Whiteing 2009). As Mr. Scott had developed pressure ulcers in a bygone experience, he would commence an change magnitude chance of a re-occurrence. In an attempt to prevent this situation the writer requested that Mr.Scott be nursed on an pass around mattress. (Stafford and Brower 2009). Issue 3 prophylactic and deleriumAnxiety is an turned on(p) state influenced by past experience, which exists at a given point in time with a level of gaudiness link to an coming(prenominal) perceived nemesis (Passer and Smith 2007) The furnish of information is passing important to the patient as studies from, Biswajit et al. (2009) has shown that an sure patient with a good thought of their condition stifles anxiety. Harvey (2002), root on shared pick up in patient-practitioner inter follow throughs in that patients effectively get into in controlling important events. afterwards liaising with Mr Scotts checkup examination team regarding his anxiety, a low paneling of Alprazolam print name alprazolam 5mg, was charted and given in an attempt to arrogate his anxiety. Alprazolam narrows anxiety in spite of appearance patients (De Witte, et al 2002).Medical care administeredOn admission to the ward Mr. Scotts aesculapian team reproducible pulmonary function tests. These tests run across what image and extent of travail the patient is experiencing (Alexander et al 2009) furthermore indicating any increase/decrease in their condition (Daly 2009). Arterial prodigal gasses were check over in order to determine the amount of O2 to be administered reducing the danger of hypoxia. The rationale for victorious arterial parentage gases was to determine the business lines Ph and the O2 levels circulating within the blood. (Alexander et al 2009). A impassiveness examine was also attain from Mr Scott and sent to the science lab for culture and aesthesia testing to wraith which bacteria is kick in in the sputum so as to treat the contagion (Gray et al 2008). with reflection the writer recalled that hydrops may be present in the start out extremities secondary to Mr. Scotts history of congestive cardiac nonstarter and chronic obstructive pulmonary disease (COPD) and record the findings.The rationale for this was that, Mr. Scott suffered with congestive cardiac failure which increase the try of developing oedema while in juxtaposition, putting increased p ressure on functioning native organs (Morley et al. 2009). During the writers estimate of Mr. Scott it appeared that he was despicable from a sudden onset of dyspnoea, (laboured breathing). apply critical thinking, the writer administered oxygen therapy at maximum of twenty four percentage and immediately assured Mr. Scotts team on his condition. The rationale behind administering low drug O2 is due to the incident that the hypoxic drive cease be decreased by administering a large panelling of O2 leading to respiratory failure and the worsen condition of the patient, (Simmons et al. 2004). Using the Gibbs reflection cycle, the writer believes students should be under constant supervising in order to attain the familiarity of administering O2 to patients diagnosed with chronic obstructive pulmonary disease.The medical team looking for after Mr. Scott prescribed an antibiotic drug called Tazocin (4.5grams three times a day) to be given intravenously. The rationale fo r administering this antibiotic was to attempt to defend any contagion that the patient may have developed. besides prescribed for Mr. Scott was a steroid and bronchodilator. The rationale for charting a steroid and bronchodilator was that, they are found to decrease ardor in the air way and also to open up the airway (Greenstein et al 2009). Due to Mr. Scotts condition he was a long term user of unwritten exam Corticosteroids. Studies (Walters et al. 2008) have shown that, corticosteroids reduce the need for special medical therapy while, also shorting hospital stay.On previous reflection (Gibbs 1988) as a student nurse, the writers fellowship developed due to reflection from previous patient care. The writer knew that due to Mr. Scott being on steroids, his blood sugar levels infallible to be checked once a day as to ensure it stayed within the normal range. The rationale behind monitor Mr. Scotts blood sugar once a day was due to the side make that are directly related to the cheek of corticosteroids. such(prenominal) side effects are as intercommunicate ulcers, weightiness gain and increased skin cutting (mayoclinic.com). The writer encouraged Mr. Scott to rinse his mouth out with water post administration of oral steroids to reduce the festering of oral ulcers or a candida infection of the mouth, (Greenstein et al 2009).The Roper, Logan, Tierney (RLT) 2000 nurse framework aided the writer in cerebrate upon the care study. This shape encompasses key factors such as social status, environmental factors as well as the physical/ psychological factors which influence large number in their periodic lives (Roper et al 1991 2003, normality 1991). This mold is knowing to be pliable to any patient and not for the patient to adapt towards the place of nursing therefore it allows the nurse to care for each patient on an individual level (Roper et al 2000).breast feeding can therefore be defined by dint of this computer simulation in terms o f back up people to prevent, alleviate, solve or fill out with problems (actual or potential) when relating to the activities of quotidian living, (Roper et al. 1990).ConclusionAlthough the Roper Logan and Tierneys model of nursing covers a holistic view, a model known as the Orems Self share Framework check to Fawcett (1995) concentrates on the individuals egotism maintenance and mandate through a type of follow out known as self-care. This model could be seen as good to Mr.Scott as a patient whom has been diagnosed with chronic obstructive pulmonary disease as a main part in maintaining good health is a good understanding/ communication, familiarity and education of how to care for ones self (Eva et al. 2009).The aim of this piece of work was to assemble while using tools of perspicacity an individual care plan. This was to be haggard up together with the patient and the writer so the formation of care would be of an individual status. The writer also aimed to acqua int that with critical thinking and decisive decision making the patient involved authoritative intervention when needed.As the writer worked on the ward mentioned a strong cure relationship had been reinforced between patient and student nurse, this allowed the patient to feel at ease when inquire questions regarding his condition alter the writer to educate the patient at a high understanding. Upon Mr. Scotts dismissal he expressed a separate understanding of his familiarity about his condition, he also mat up that if or when he experienced other exacerbation he would not feel as animated and be intermit able to fill out with it. Hearing this as a student nurse the writer felt that it had raise professional development for further nursing practice.Reference propensityAlexander, M.,Fawcett, J., Runciman, P.2009. Disorders of the respiratory musical arrangement IN Edmond, C., Mc Clean, I., Mc Clean, J., Wilson, L.(eds.) treat physical exertion hospital and Home. t hird ed. Edinburgh Livingstone.Alexander, M.,Fawcett, J., Runciman, P.2009. nurse example Hospital and Home. 3rd ed. Edinburgh Livingstone.Barnett, M. 2005.Caring for a patient with COPD a reflective account. Nursing Standard.online.19, (36),pp41-46. functional from http//web.ebscohost.com.remote.library.dcu.ie/ehost/pdfviewer/pdfviewer. Accessed 06 march2010.Biswajit, C., Mohammed, I., Salaiman, M., Davies, L., Calverley, P., Warburton, C., Angus, R. 2009. A learn of patient Attitudes in the United res publica Toward Ventilatory oppose in inveterate preventive pulmonic Disease. daybook of alleviatory Medicine. 12 (11), pp1029-1035.Daly,ML. 2009. filet A COPD blowup quick action reduces a patient on the landmark of respiratory failure. diary of Advanced Nursing. 40 (8), p40.Duggan, M. Kavanagh, B. (2005). . pulmonary atelectasis A pathogenic perioperative entity.. Anesthesiology. 102 (4), 838-854.Fawcett, J. 1995. analytic thinking and Evaluation of conceptual specim ens of Nursing. 3rd ed. Philadelphia F.A Davis Company. Gibbs G. (1988) reading by Doing a guide to teaching and learning methods. moreover Education Unit. Oxford Polytechnic. Oxford.Gray, RD., MacGregor, G., Noble, D., Imrie, M., Dewar, M., Boyd, AC., Innes, JA., Porteous, DJ., Greening, Ap. 2008. lethargy Proteomics in seditious and Suppurative respiratory Disease. journal of Respiratory and comminuted care medicine. 178 (5) pp444-452.Greenstein, B., Dinah, G., Trounce, J. 2009. Trounces Clinical pharmacology for Nurses.8th ed. Toronto Churchill Livingstone.Groeben, H., Meier, S., Tankersley, G., Mitzner., Brown, H. 2003. Heritable differences in respiratory drive and breathing pattern in mice during anaesthesia and emergence. ledger of Anaesthesia. 91 (4),pp541-545.Harvey, N. 2002. impressive Communication. Dublin. lamella and Macmillan.Jevon, P. & Ewens, B. (2002). Monitonng the vituperatively trine forbearing. Oxford Blackwell Science. 150-170.Jevon, P. 2010. How t o Ensure Patient Observations Lead to Effective Management of change Consciousness. Nursing Times. 106 (6), pp16-22.Jevon, P. Ewens, B.. (2001). sound judgement of a breathless patient. Nursing Standards. 15 (16), 48-53.Lawrence, H., Plawecki, J., Amrhein, D., Zortman, T. 2010. Under Pressure Nursing financial obligation and Skin dislocation in fourth-year Patients. ledger of gerontological Nursing. 36 (2), pp23-25.march 2010.Mayo Clinic.com. (Homepage). Online. for sale fromhttp//www.mayoclinic.com/health/steroids/HQ01431. Accessed 26 March 2010. http//www.mrw.interscience.wiley.com.remote.library.dcu.ie/cochrane/clsysrev/articles/CD001288/frame.html. Accessed 18 February 2010. MeiLan, K., Postma, D., Mannino, D., Giardino, N., Buist, S., Curtis, J., Martinez, F. 2007. Gender and chronic Obstructive pulmonic Disease. American Journal of Respiratory and Critical Care Medicine. online. 176. pp1179-1184.Newton, C. (1991). The Roper, Logan, Tierney Model in Action.. Macmillan Basing Stoke. 112-130.Passer, M., Smith, R. 2007. psychology the science of the assessment and behaviour.3rd ed. New York Mc Graw Hill. Pendleton, D. Schofield, T. Tate P. Havelock P. (1984). ) The Consultation .An draw near to Teaching and Learning. Oxford Oxford University Press. 213-34.Plaice, J. & Graham, P (2004) Nursing care of a patient with Cystic Fibrosis. Journal of School of Nursing. 20 (1) 6-7.Rennard, S. 1999. Inflammation and liven Processes in continuing Obstructive Pulmonary Disease. American journal of Respiratory and Critical care medicine. clx (5), pp 12-16.Roper, N., Logan. W, & Tierney, A (2000). The Elements of Nursing a model of living.. Edinburgh Churchill Livingstone. 201-22.Roper, N., Logan. W, & Tierney, A.. (1990). The Element of Nursing . 3rd ed. Edinburgh Livingstone. 230-60.Simmons, P., Simmons, M. 2004. cognizant Nursing Practice The Administration of type O to Patients with COPD. Medsurg Nursing.13(2) pp82-86.Smeltzar, S., Bare, B., Hinkle, J., Cheever,K.2008.Brunner & Suddarths textual matter of Medical-Surgical Nursing.11th ed. New York.Lippincott.Stafford, AB., Brower, J. 2009. effectivity of smooth stress Mattress Overlay and Static Air screw Cushion For The measure Of Pressure Ulcers. Journal of Wound Ostomy & abstinence care. 36(2),Pp 50-53.The cochrane collaboration. 2009. Surgical decompressing for Cerebral Odema in groovy ischemic Stroke. The cochrane library.Walters, J., Gibson, P., Wood-Baker, R., Hannay, M., Walters, E. 2008. Systemic Corticosteroids for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Online. easy from http//www.mrw.interscience.wiley.com.remote.library.dcu.ie/cochrane/clsysrev