NUR241: Contexts of Practice- Health Alteration Case Study- Nursing Case Study Assignment Help

Internal Code: 1HCDC

Nursing Case Study Assignment Help:

Task: Mr. Edward Hunter, an 89-year old widower, was admitted to your medical ward with hypoxaemia (oxygen saturations 82% in the ambulance) and a recent history of viral influenza. He has been receiving intensive home support from the ‘acute care in the home’ nursing team for over 6 months, which includes home oxygen therapy as his chronic obstructive airways disease worsens limiting his ability to care for himself at home. Within 24 hours of admission Mr. Hunter’s condition continues to deteriorate. He is receiving 10 liters of oxygen via a Hudson mask. Severe dyspnoea renders him immobile and barely able to eat. He has little appetite and is cachexic. Overnight night he becomes quite restless, breathless, tachypnoeic and develops a productive cough. The respiratory team reviews Mr. Hunter because he was experiencing increased pleuritic pain on inspiration and was expectorating rust colored sputum. Subsequently, he was diagnosed with pneumococcal pneumonia and was prescribed cough suppressant, a sedative andantibiotics. Consider the patient situation Question 1. Mr. Hunter is 89 years old. What are the specific considerations a Registered Nurse should understand in relation to the clinical manifestations of pneumonia in the older person? Collect information: pathophysiology Question 2. Outline the pathophysiology of altered ventilation and diffusion in relation to Mr. Hunter’s pneumonia. Yesterday evening, in handover to the night duty nurse, it was explained that Mr. Hunter was becoming confused and drowsy during the day but was easily roused and orientated once woken and maintaining oxygen saturations 92 -94%. Mr. Hunter is clearly distressed and extremely dyspnoeic. The consultant reviews Mr. Hunters medication and prescribes Oxygen (high flow) to achieve oxygen saturation > 92% Benzyl penicillin 1.2g IV 6 hourly for a total of 7 days Process information Interpreting information can be difficult if you process it subjectively based on your own past experiences, beliefs and opinions. By critically appraising the information about the various types of pneumonia, it is possible to make a reasoned judgment about Mr. Hunter’s future management. Question 3. What are the differences between hospital acquired pneumonia (HAP, community acquired pneumonia (CAP)and aspiration pneumonia? Part 2. The consultant also requests that Mr. Hunter has 4 hourly observations of his vital signs and to report a heart rate above 100 and oxygen saturations below 90% and a temperature above 38.5c. Take action The registered nurse recognises that Mr. Hunter requires care beyond that requested by the consultant. Question 4. Explain the nursing care required the patient with pneumonia. Provide a rationale for all elements of the care provided that reflects the particular needs of Mr. Hunter.