Betty Johnstone - Standard Mini Mental State Exam - Nursing Assginment Help

Assignment Task

Assessment
1.Dementia care
2.Ageing assessment- incapable of looking after themselves- preparing for discharge home
3.Standard mini mental state exam
4.Proton pump inhibitor

1.Increase rate of IV THEAPY TO 6/24 RATE
2.ADMINISTER NG/PO THYROXINE
3.ADMINISTER IV ANTIEMETIC
4.COMMENCE PPI INFUSION

Why has Bettys BGL only been monitored once since her admission. Do u think bgl should had been monitored more frequently
- If the initial measurement is within normal limits, then there is usually no indication to take this again

Why do u think doctor ordered betty ondansetron instead of metoclopramide
-as metoclopramide is an antiemetic antagonist that works centrally by blocking dopamine receptor and increase motility of the upper GIT.
Given that betty has an upper GI bleed, increasing the motility of a GIT in a patient who had a procedure to stop the bleeding, may not be the best decision
What other tests will betty be undergoing routinely to ensure the bleeding has ceased

-Doctor will routinely be ordering a full blood examination for betty to check her RBC, WBC and her haemoglobin level. Betty should be routinely have her stool checked for occult blood to ensure that the bleeding has stopped.

Can fasting cause hypotention
Yes, given by doctor  for the purpose of reducing the risk of aspiration while the patient is undergoing their procedure. A low circulating fluid volume may result in the patient being dehydrated and hypotensive.
Assessment of Bettys fluid status including her fluid balance chart will exclude if this is the cause of her hypotension

What is the most likely reason for the stabilising of Bettys vital signs at 2000 hrs
- Vital signs taken at 2000 hrs indicate that betty has achieved homeostasis. Her vital signs are within normal range

Wt is the most likely reason for Bettys increased spo2 despite not having supplement oxygen insitu

-betty has now has 2 units of packed RBC administered and the bleeding has ceased. This will result in her having a greater circulating blood volume. With more RBC available, there is now increased hb and more capacity for the oxygen to be carried to the tissues. This will increase of blood volume and red blood cells will directly increase Bettys oxygen saturation
 

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