HSNS373 - ISBAR And Bruce Reynolds Case Study - Nursing Assignment Help

Assignment Task

Bruce Reynolds is a 84 year old man who lives in the community nursing home, he has been a resident in the nursing home for the past 12 months. He was admitted due to his decreased mobility and heart failure. While you are showering Bruce this morning you notice swelling to his knees and you ask him how long they have like this for in which he replies a few days. You also notice he is short of breath and is only able to speak in short sentences. You assess Bruce and note an increased work of breathing, intercostal recession and crackles at the lung bases. Bruce is warm to touch, diaphoretic and pink with a capillary refill of less than 2 seconds. You finish showering Bruce and he passes urine while in the shower. You then settle him into his chair and read his notes from the past week to see if there is anything documented about his oedema. There is no documentation on this and there has been no recent observations taken, however he had a BGL yesterday of 6.4 mmol/L.

You notice there to be an increase in his shortness of breath, you advise Bruce that you will call his doctor, Dr Polson. Bruce has an Advanced Care Directive which states he is not for active resuscitation or invasive airway management and ventilation, however he is for active treatment and non-invasive ventilation.

Questions:

1. Discuss your assessments on this patient, identify signs of deterioration and clearly state if the patient requires a clinical review or rapid response as per Between the Flags (BTF). Justify your decision with data from the case and relevant support.

2. Document a succinct and accurate ISBAR handover in verbal script format (eg. Hello, my name is...)

3. Considering the assessment findings, prioritise and discuss the immediate nursing management of the patient

4. Succinctly discuss the ongoing management of this case and integrate the relevant members of the interdisciplinary team

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