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Multisystem Failure in a Geriatric Patient
Multisystem Failure in a Geriatric
Reflect on your analysis of the geriatric patient in multisystem failure by doing the following:
Explain key immediate assessments you should make that would help assess the patient's homeostasis, oxygenation, and level of pain.
There are various diagnoses undertaken in assessing the patient's homeostasis, oxygenation, and level of pain. The immediate objective that nurses prioritize on is checking the patient's vital symptoms. Vital symptoms form the baseline of the assessment by providing significant information that illustrates whether the most essential organs function as required.
The assessment may involve checking the health status of the patient in the laboratory (Kane, 2004). In the laboratory, there is an assessment of the patient's capillary tube, urine test and blood pressure. When there is simultaneous malfunctioning of the body organs, nurses refer to this condition as multiple organ dysfunction (MODs).
Multiple organ dysfunction is a condition that alters the normal functioning of the organs. When it occurs, the patient is unable to maintain homeostasis, and the only way out to deal with the condition is through intervention and optimization of oxygen supply. In using vital signs is the initial criterion applied in analyzing the Hemodynamic condition of an ailing patient (Kane, 2004).
Vital signs form the baseline recommended by the nursing practitioners while making such triage decisions. These signs determines whether the condition of the patient require a quick response team, activation of the trauma group or preparation of emergency room / specialists in order to attend to the ailing patient. In addition, scoring system is truly significant in determining the degree of the patient's illness (Mick & Ackerman, 2004). This system also relies on the information collected from the vital signs.
In assessing Mrs. Baker's homeostatic condition, nurses will also rely on the physical observations as well as observations obtained through technology and in the laboratory test. The first sign is to assess the patient's pulse rate. This determines whether the patient is developing a homeostatic condition.
This necessitates the nurses to undertake a prompt action and avert development of any condition that might be life threatening to the patient. In case of an increase in the pulse rate, there is a clear indication through high loss of blood or even through severe dehydration. Such a patient could suffer low blood pressure in relation to the prescribed medication of using lisinopril together with the prescribed hydrochlorothiazide.
Other factors that could alter the normal functioning of the pulse rate includes, fever, rigorous exercise, and other extra medications beside those prescribed by the nurses. In addition, if there is any acute change discovered in patient's mental status, this could have an impact in the patient's pulse rate (Mick & Ackerman, 2004).
Other signs that nurses prioritize on in assessing the patient is the airway, the rate of breathing and air circulation. For this reason, nurses might decide to assess Mrs. Baker's homeostatic condition by first analyzing her intake behaviour and the urine output. This facilitates in evaluating the functioning of the kidneys. Besides the laboratory tests, nurses rely majorly on the vital signs that the patient portrays. They use the vital signs in evaluating any changes in body temperature, the rate of heartbeat and the blood pressure.
If the signs indicate a low level of blood pressure this may indicate severe dehydration. In addition, an increase in the heart rate could indicate that blood supply from the heart is extremely poor. Therefore, the immediate thing to do to Mrs. Baker on her arrival into the Emergency room is to commence an IV, which assists in restoring lost fluids because of dehydration.
Putting into consideration that Mrs. Baker suffers from diabetes, nurses should consider assessing her blood sugar in order to determine her health status, that is, whether her state is hypoglycaemic or hyperglycaemic. In addition, nurses should assess whether there are any crackles or wheezing sounds from the lungs.
He/she does this by listening to the lungs. Oxygen is extremely necessary in ascertain continuous functioning of the body organs. In order to determine whether there is sufficient, oxygen in the various parts of the body, nurses conducts oxygen saturation. When there is low oxyhaemoglobin, this means that most body cells are deficient of oxygenated blood. Since Mrs. Baker is complaining difficulties in breathing, nurses use a pulse Oximeter in checking the oxygen saturation
Describe the technological tools you would utilize to assess and treat the Patient?
Pulse Oximeter is a technological tool used in the course of oxygen therapy, and it is very significant to homecare patients. This tool is helpful in assessing oxygen saturation. EKG tool is an electrocardiogram (EKG or ECG) device that assesses the problems that alters the electric performance of the patient's heart. In broader terms, EKG is helpful in analyzing the cardiac function in order to assess the cardiac injury. Nurses also evaluate the level of temperature in determining the presence of fever, which could indicate the possibility of an infection.
1. Explain why you would utilize these specific tools.
It is important for nurses to utilize specific tools in assessing the signs exhibited by the patient's condition. Firstly, using specific tools means that the process is first, and this may save life and stop worsening of a certain condition. In essence, Speed is of the essence while attending to Emergency room patients. Any delays might cause death, which would be possible to avoid when utilizing the right tools. For instance, Pulse Oximetry evaluates oxygen saturation in patients in seconds, and therefore, treatment is very first.
Accuracy and simplicity in utilizing tools plays a larger role in determining the problems patients suffer from. For instance, when a condition calls for immediate attendance, specific tools are necessary. Some emergent situations require attending to them in seconds, and when nurses use wrong tools death becomes the outcome.
Specific tools are Non-Invasive and consistent. When assessing the pulse rate, the nurses requires obtaining blood from the fingertips, and therefore, when nurses use Pulse Oximetry in the appropriate way, they are confident of the results obtained. In addition, there is minimal or no damages on the arteries.
2. Explain the benefits of the tools in determining the patient's status.
Use of specific tools benefits both the nurse and the patient. To the nurse, he/she is aware of the diagnoses to use and the medications necessary. On the other hand, the patient is aware of his/her condition and has a right to decide whether to go through the medication process or initiate a home- based care. Together with that, the patient acquires some knowledge from the nurses on how to maintain his/her health and steps to take in case of emergence.
C. Discuss how you prioritized data collection in the scenario.
Any information collected from the patient plays a major role in assessing the health status of the patient. However, it is the role of the health provider to prioritize the data collected. In Mrs. Baker scenario, the first thing to consider is the previous medical history, in which, she discloses that she has diabetes and high blood pressure. This forms the baseline of the diagnosis while relating to the immediate signs that necessitate Mrs. Baker's situation to the ER.
D. Compare how you would assess pain in a geriatric patient who is alert and conversant to a geriatric patient who is not alert.
Assessing pain in a geriatric patient differs from assessing pain a geriatric patient who is not alert, or rather from the normal medical assessment. In the geriatric patient who is alert, nurses may use double sessions in order to obtain all the necessary data. This is because the process of obtaining medical history and physical examinations may cause fatigue to the elderly patients that are alert.
In essence, use of medical history is significant because the elderly might forget some necessary information, especially if they are suffering from chronic illness. On the other hand, in a geriatric patient who is not alert, nurses should use the technological tools to assist them assess the situation, and thereafter, evaluate the problem after the patient gains conscious (Rosenthal & Kavic, 2004).
E. Discuss how you would manage pain in a geriatric patient experiencing multisystem failure and showing signs of pain (e.g., moaning, restlessness, grimacing) who is not alert enough to respond to questions.
1. Discuss how you would know whether your choice of pain management was successful.
A nurse can utilize numerous techniques in determining the degree of success of prescribed drugs to Mrs. Elli Baker. Considering Mrs. Elli Baker's age, the nurse should administer acetaminophen morphine 0.1mg/kg IM. This is because of the low level of consciousness and respiratory pain. The efficiency of acetaminophen morphine 0.1mg/kg IM is accessible by conducting a titration of the prescribed amount, therefore effective for patients suffering from this condition (Esteban, 2004). This situation requires adding doses in small volumes with a given time.
Another alternative that nurses can utilize is using the patient focused outcome measures.…[continue]
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6. Identify the collaborative team members pertinent to the care of the geriatric patient in the scenario, including the emergency room nurse's response to changes in the level of consciousness and increasing respiratory distress. The collaborative team here would consist of a primary care physician / geriatrician, pain management specialist, laboratory specialists, and x-ray team. Additional consultants may be neurologist, neurosurgeon, gastroenterologist, psychologist, and drug and alcohol detoxification specialist. In the case
Sometimes, studies show that elderly patients are perceived not to be in pain because they do not complain about pain, or that the perceive it differently than younger people. In both receptive and non-receptive patients, one can observe facial tics and/or grimaces, blood pressure (elevated blood pressure sometimes indicates more pain), body temperature, and even mobility. For the functional patient, assessment can be done by observation of body movement, gait,
Nursing Case Study The first concern is that Mrs. Baker is taking a new drug that has side effects such as she is experiencing. Although the other high blood pressure medication has similar side effects (Drugs.com, 2012), she has been taking it for a long period of time and should not be experiencing as much difficulty. It seems germane to ask her how long she has been taking the hydrochlorothiazide though.