Nursing Care Study Essay

The generate of this care for safeguard study is to demonstrate that, as a student nurse, the source is capable of maturation and delivering the skills compulsory for assessing and addressing each someone(a) endurings plow needs. Included in these set of skills, is the ability to develop critical thinking, decisive decision making and the ability to reflect on events so as to become a better health care provider. The tolerant in which the source willing discuss was based upon an eighty three year old man, nom de guerre Mr. Scott who was admitted into accident and emergency via a referral from his creation(a) practitioner presenting with exacerbation continuing preventive pneumonic sickness (COPD) with a history of congestive cardiac failure (CCF). On gate to accident and emergency Mr. Scotts team took arterial stock gases, arranged a pneumonic travel tests and a chest of drawers X-ray.Prior to the exacerbation of Mr. Scotts specification he regularly atten ded a cardiac clinic due to cosmos a presbyopic term sick person of congestive cardiac failure and withal attended pulmonary function clinic for tests (pulmonary function tests). Through these clinics Mr. Scott was educated on his medications and current characterize. On admission of Mr. Scott, the author decided to use the frameworks Roper Logan and Tierney (2000) Orems Self treat Framework (1995) and Gibbs (1988) which incorporates each cats-paw of assessment cognise as, plan, implementation, military rating, educate and reflection. development the above frameworks, an improvement of Mr. Scotts current exacerbation of chronic preventative pulmonary disease (COPD) was seen to find been re dissolved and a new evaluation of Mr. Scotts care was highly-developed.The chosen tool of reflection used is known as the Gibbs wheel of reflection. The source applied this tool in order to evaluate the diligent care. The rationale behind this was to attempt to fully understand refl ection so as to apply this to everyday practice, thus improving as a student nurse. The Gibbs cycle involves a description of the incident, feelings and thoughts experienced plus the evaluation and analysis of the incident, conclusions and movement plan (Gibbs, 1988). According to Barnett (2005) using a tool of reflection, to give an account of experiences in the clinical setting can incite the nurse to analyse and explore their feelings regarding patient role role care.Main body eighty three year old Mr. Scott was admitted to accident and emergency with a referral from his general practitioner, presenting with a recurrent upper respiratory tract infection and a history of exacerbation of chronic obstructive pulmonary disease (COPD) and congestive cardiac disease. Due to his history of chronic obstructive pulmonary disease (COPD), Mr. Scott was sent for a chest x ray to assess the disability of his lungs due to his educate. (Alexander et al. 2009) Post admission into accident an d emergency, Mr. Scott was sent to St. Pat, Thomas, Johns hold where the source was working at the time as a student nurse.The writer found, when assessing Mr. Scott, that he lived alone, locally, was a widower of ten geezerhood and had two daughters who similarly lived near by. Although Mr. Scott had many cin one caserns, he also had a good mixer network such as the support of family and a home back up package of six hours a week, which included meals on wheels. The local earth health nurse also called to see Mr Scott on a brotherly capacity. Presently the main health concerns which faced both Mr. Scott and his family were the deterioration of his dyspnoea, link to his chronic obstructive pulmonary disease pressure ulcers, due to developing pressure ulcers while in hospital in previous years and anxiety from both Mr. Scott and his family due to the unknown. Reassurance was given and they were explained what care he was to receive. sleep together 1 Breathing.The key featur e of chronic obstructive pulmonary disease (Barnett, 2009) is that of experiencing breathlessness. Being breathless for most patients can be both a stressful and frightening experience, which can raise anxiety levels. In yesteryear studies, men predominantly more than women were found to be affected by chronic obstructive pulmonary disease (COPD) but in a recent study carried out by Meilan et al. (2007) research has found that cases of chronic obstructive pulmonary disease (COPD) are increasing in women world wide. The care Mr. Scott received was split in two, short term and long term care both of which were everlastingly re-evaluated to maximise efficiency and woodland of care.As part of the short term care plan the writer ensured that the bedside was set up with suctioning equipment help prepared for potential complications. To avoid complications, for precedent tachypnoea (rapid lively) which is found to be an early indication of respiratory distress (Jevon and Evens 2001) t he rosy rule of thumb, depth and rate of breathing was monitored and recorded accurately (Jevon, 2010). but reducing the risk of complications occurring, Mr. Scott was back up to sit up in a semi fowler position while enduring deep breathing exercises enabling him to breathe with greater ease and comfort. The rationale behind this was supported by a study carried out by Duggan et al. (2005).The long term name and address was to ensure that an oxygen saturation level between 88%-94% is well-kept (Alexander et al 2009). To monitor oxygen saturations levels, a pulse oximeter was place on Mr. Scotts finger. The rationale for this is to detect oxygen absorption of haemoglobin (Plaice &Graham, 2000). A study carried out by Groeben (2003) shows that administering high concentrations of oxygen to patients with chronic obstructive pulmonary disease (COPD) will reduce the respiratory drive, resulting in respiratory depression. This finding gives rationale to why a moo flow of oxygen t herapy is given to patients with chronic obstructive pulmonary disease (COPD). Humidification was added to Mr. Scotts oxygen therapy to fiery and moisten the gas (Jevon and Ewens 2001) promoting secretions while enhancing patient comfort (Woodrow 2005).The rationale for this is that oxygen is known to dehydrate exposed membranes in the upper respiratory tract. veer 2 Pressure ulcers.According to Lawrence et al (2010), every individuals throw together changes with time, this is a normal process of ageing. With this change comes a reduce in its elasticity and turgor, therefore with age one has to ensure that racy care of skin is given in an attempt to avoid skin breakdown. Due to Mr. Scott being an elderly man of eighty three, the writer was refer about skin integrity. A tool known as the wet low score was used in order to assess the likeliness of Mr. Scott developing any pressure ulcers during his stay in the hospital (Whiteing 2009). As Mr. Scott had developed pressure ulcers in a former(prenominal) experience, he would live with an change magnitude chance of a re-occurrence. In an attempt to prevent this stead the writer requested that Mr.Scott be nursed on an air mattress. (Stafford and Brower 2009). incommode 3 safety and deleriumAnxiety is an emotional state influenced by past experience, which exists at a given point in time with a level of intensity colligate to an upcoming perceived threat (Passer and smith 2007) The provision of information is extremely important to the patient as studies from, Biswajit et al. (2009) has shown that an intercommunicate patient with a good collar of their condition reduces anxiety. Harvey (2002), recommend share control in patient-practitioner interactions in that patients effectively participate in autocratic important events. After liaising with Mr Scotts medical team regarding his anxiety, a low sexually transmitted disease of Alprazolam brand name Xanax 5mg, was charted and given in an attempt to r elieve his anxiety. Alprazolam reduces anxiety within patients (De Witte, et al 2002). aesculapian care administeredOn admission to the ward Mr. Scotts medical team ordered pulmonary function tests. These tests determine what type and extent of restriction the patient is experiencing (Alexander et al 2009) furthermore indicating any increase/decrease in their condition (Daly 2009). Arterial blood gasses were checked in order to determine the measurement of O2 to be administered reducing the risk of hypoxia. The rationale for taking arterial blood gases was to determine the bloods Ph and the O2 levels circulating within the blood. (Alexander et al 2009). A languor sample was also attained from Mr Scott and sent to the lab for culture and predisposition testing to trace which bacteria is present in the sputum so as to treat the infection (Gray et al 2008). Through reflection the writer recalled that oedema may be present in the lower extremities collateral to Mr. Scotts history of congestive cardiac failure and chronic obstructive pulmonary disease (COPD) and recorded the findings.The rationale for this was that, Mr. Scott suffered with congestive cardiac failure which increase the risk of developing oedema while in juxtaposition, putting increased pressure on functioning internal organs (Morley et al. 2009). During the writers assessment of Mr. Scott it appeared that he was suffering from a sudden onset of dyspnoea, (laboured breathing). Using critical thinking, the writer administered oxygen therapy at maximum of twenty four percent and at one time informed Mr. Scotts team on his condition. The rationale behind administering low dose O2 is due to the fact that the hypoxic drive can be decreased by administering a large dose of O2 leading to respiratory failure and the impairment condition of the patient, (Simmons et al. 2004). Using the Gibbs reflection cycle, the writer believes students should be under constant supervision in order to attain the knowled ge of administering O2 to patients diagnosed with chronic obstructive pulmonary disease.The medical team looking after Mr. Scott prescribed an antibiotic drug called Tazocin (4.5grams three times a day) to be given intravenously. The rationale for administering this antibiotic was to attempt to fight any infection that the patient may possess developed. Also prescribed for Mr. Scott was a sex hormone and bronchodilator. The rationale for charting a steroid and bronchodilator was that, they are found to decrease inflammation in the air authority and also to open up the airway (Greenstein et al 2009). Due to Mr. Scotts condition he was a long term user of spontaneous Corticosteroids. Studies (Walters et al. 2008) have shown that, corticosteroids reduce the need for additional medical therapy while, also shorting hospital stay.On previous reflection (Gibbs 1988) as a student nurse, the writers knowledge developed due to reflection from previous patient care. The writer knew that du e to Mr. Scott being on steroids, his blood sugar levels needed to be checked once a day as to ensure it stayed within the normal range. The rationale behind monitoring Mr. Scotts blood sugar once a day was due to the side effects that are directly related to the administration of corticosteroids. Such side effects are as utter ulcers, weight gain and increased skin thinning (mayoclinic.com). The writer encouraged Mr. Scott to rinse his mouth out with water post administration of oral steroids to reduce the development of oral ulcers or a candida infection of the mouth, (Greenstein et al 2009).The Roper, Logan, Tierney (RLT) 2000 nursing framework aided the writer in focusing upon the care study. This model encompasses key factors such as social status, environmental factors as well as the physical/ psychological factors which influence people in their daily lives (Roper et al 1991 2003, Newton 1991). This model is designed to be universal to any patient and not for the patient to adapt towards the model of nursing therefore it allows the nurse to care for each patient on an individual level (Roper et al 2000).Nursing can therefore be specify through this model in terms of helping people to prevent, alleviate, solve or cope with problems (actual or potential) when relating to the activities of daily living, (Roper et al. 1990).ConclusionAlthough the Roper Logan and Tierneys model of nursing covers a holistic view, a model known as the Orems Self Care Framework according to Fawcett (1995) concentrates on the individuals self maintenance and regulation through a type of action known as self-care. This model could be seen as beneficial to Mr.Scott as a patient whom has been diagnosed with chronic obstructive pulmonary disease as a main part in maintaining good health is a good understanding/ communication, knowledge and education of how to care for ones self (Eva et al. 2009).The aim of this piece of work was to assemble while using tools of assessment an indi vidual care plan. This was to be drawn up together with the patient and the writer so the system of care would be of an individual status. The writer also aimed to demonstrate that with critical thinking and decisive decision making the patient involved received intervention when needed.As the writer worked on the ward mentioned a strong therapeutic relationship had been built between patient and student nurse, this allowed the patient to feel at ease when asking questions regarding his condition enabling the writer to educate the patient at a higher(prenominal) understanding. Upon Mr. Scotts discharge he expressed a better understanding of his knowledge about his condition, he also felt that if or when he experienced another exacerbation he would not feel as anxious and be better able to cope with it. Hearing this as a student nurse the writer felt that it had enhanced lord development for further nursing practice.Reference ListAlexander, M.,Fawcett, J., Runciman, P.2009. Disorder s of the Respiratory clay IN Edmond, C., Mc Clean, I., Mc Clean, J., Wilson, L.(eds.) Nursing Practice Hospital and Home. tertiary ed. Edinburgh Livingstone.Alexander, M.,Fawcett, J., Runciman, P.2009.Nursing Practice Hospital and Home. 3rd ed. Edinburgh Livingstone.Barnett, M. 2005.Caring for a patient with COPD a pensive account. Nursing Standard.online.19, (36),pp41-46. addressable from http//web.ebscohost.com.remote.library.dcu.ie/ehost/pdfviewer/pdfviewer. 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