The case study is about a 70-year-old Mr John Douglas and he has admitted with a complaint of nausea and vomiting from the past 4 days. His vitals reveal increased temperature, increased heart rate and low blood pressure. The major issue identified after observation is pain 7/10 and he has not opened his bowel from past 4 days with abdominal distension. The medical history of the patient reveals that diverticulitis with right carpal tunnel repair.
The different assessment that can help to identify further complication concerning the patient medical, as well as lifestyle history, includes
The patient current assessment reveals that he has not opened bowels for 4 days and he has also examined with the abdominal distension. The medical history of the patient also reveals that he has also suffered from the diverticulitis that on complication can lead to bowel obstruction. The colonoscopy is important to identify the obstruction in the intestine that is necessary to treat the patient accordingly. The study presented by Kastenberg et al. (2018, p.2833) describe that colonoscopy help to evaluate the polyps, cancer or other diseases that can increase complication for the patient. It is the endoscopic examination that helps to evaluate the bowel by the CCD camera that directly pas through the anus.
The priority that needs immediate attention as per the patient condition is the abdominal pain that is of about 7/10. The abdominal pain can be addressed by relaxation techniques. One of the article presented by Norton et al. (2017, p.115) describe that relaxation technique is useful to improve the abdominal pain of the patient that directly reduce the health-related complication. The relaxation intervention includes psychological intervention followed by dietary intervention to reduce the pain and improve comfort. The psychological intervention includes cognitive therapy, distraction method, biofeedback process and behavioural therapy. The dietary intervention includes managing the daily intake of the calories and managing its energy expenditure.
According to Kooienga & Wilkinson (2016, p.3), Registered nurses are expected to collaborate with the patient during the care to improve the understanding of the patient concerning the treatment that will improve patient participation. The nurse can assist the patient to understand the different aspect of relaxation technique to improve the results and better patient health.
Nausea and vomiting are the major complaints of the patient during the admission to the emergency department. He was facing an issue with nausea and vomiting from the past four days that has increased his complication. Droperidol is one of the medications that are utilized for treating nausea and vomiting that is increasing complication for the patient. The article presented by Lai & Huang (2018, p.1) describe that droperidol is the short-acting butyrophenone that has an antiemetic and antipsychotic effect. It is completely absorbed after the intramuscular administration that led to extensive metabolism of the drug. It directly works by blocking the dopamine receptors that are responsible for the chemoreceptor trigger and it leads to nausea or vomiting. The study presented by Salmond & Echevarria (2017, p.12) describes that changed healthcare and increase the role of Registered nurse to improve the care process. The registered nurses are expected to assist the patient in the care by indulging in the intervention, medication and follow-ups. The nurse can help the patient with maintaining the routine of medication concerning the doctor prescription and reduce the chances of side effect that can occur as per the medication.
The decrease in blood pressure should also be immediately addressed to improve patient health status. Hypotensive resuscitation is one of the methods that can be used to address the hypotension state and reduce the chances of complication. The study presented by Finfer et al. (2018, p.541) discusses that intravenous fluid therapy is important to improve the electrolyte balance in the individual that is necessary for blood pressure maintenance. The state occurs when there is misbalance in the homeostasis of the electrolyte that leads to decrease absorption which causes a drop in the blood pressure. The patient with hypotension state should immediately be provided with fluid therapy to decrease the chances of complication. According to Birks et al. (2016, p.522), the registered nurse is considered to be the backbone of the patient care system and they have to follow the professional practice to improve quality of care. The nurse can help to explain the importance of the treatment followed by keeping an eye to decrease the chances of any complication.
The closures of the bowel from last four days also require attention as it can increase the complication for the patient. The article presented by Loftus et al. (2015, p. 13) describe that the nasogastric tube is used to treat the bowel obstruction that is increasing complication for the patient. The fine tube is inserted to the stomach that is used to drain out the stomach content and decompress the stomach that is important to improve the bowel movement. The nasogastric tube will help to decrease the complication that has occurred due to the decrease or blocked bowel movement and it assists the patient to improve the bowel routine. The study conducted by Powers et al. (2019, p.131) describe that patient care is incomplete with the registered nurse as they are considered to be an integral part of the care. The registered nurses are considered to maintain a rapport with the client that is important for the care. The nurse should continuously follow with the client and should help the client to understand the procedure with its importance.
The fever is also observed in the patient after the assessment thus there is a need to lower down his body temperature to improve the health status of the patient. Acetaminophen is one of the drugs that can help to decrease body temperature and decrease complication. One of the studies presented by Young et al. (2015, p.2215) discussed how acetaminophen is preferred by the health care professionals to reduce the temperature that is necessary for the patient. It works by blocking the cycloxygenase in the brain that directly decreases the release of prostaglandin in CNS this lead to the antipyretic effect. The decrease in body temperature is necessary to improve the health status of the patient that is important to decrease the recovery time. The study presented by Norful et al. (2017, p.15) discusses the role of registered nurses in primary care and their impact over the patient health status. Primary care requires a registered nurse to play an integral role that aims to provide quality care that assists the patient. The nurse can help the patient to routinely monitor the fever and evaluate the side effect of the medicine that needs urgent attention.
The increased heart rate can increase the risk of heart-related disorders that can be dangerous for the patient. The increased heart rate should be immediately addressed to decrease the chance of complication that can deteriorate the health status of the patient. One of the studies presented by Al-Majed et al., (2017, p.287) discuss that propranolol is one of the medicines that is utilized to decrease the racing heart rate that is not suitable for the patient. They selectively block Beta 1 receptors in the heart that decrease the force of the contraction. According to Campagna et al. (2019, p.297), the registered nurse is important to provide quality care to the patient. The nurse can help the patient to understand the importance of medication and routine so that heart rate can be managed.
The social justice frameworks provide services are such a way that aims to reduce inequality and provide a supportive environment to the population. The three actions that are covered in the social justice framework include enabling, mediating and advocating. The social justice framework is important to improve equity in the services that help the individual to get person-centred services (Fleck-Henderson & Belkin Martinez, 2014). The discharge planning demands better communication so that proper exchange of information can be done to improve patient understanding regarding the care. The discharge planning should include the participation of the nurse, patient and doctor that proper information can be transferred to the patient concerning the care. The discharge plan should include all the information regarding the treatment process, medication and current health status (New et al., 2016, p.57).
The patient discharge plan should include information regarding the current treatment process and their outcomes. The current health status like vitals, bowel status, pain and blood pressure should be included in the discharge plan. The lifestyle and dietary modification that is recommended to the patient like calories intake and mild exercise should be included in the plan. The patient discharge plan will also include certain things and dietary material that needs to be avoided to maintain health status. The different referrals will also be included in the discharge plan so that patient can refer in case of any emergency so that proper assistance can be provided to the patient.
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