Discuss who would be involved in pt’s person centred care (Multi-disciplinary Team, Inter professional working)?

Assessment

Please, Do not use :’I’, use the author or the writer of this paper, etc. In this paper ( please mention) the tasks will be observed by the student nurse or will be done by the student nurse under supervision. The case study will present (acute illness) the first 24-48 hours of the patient in the hospital. Many thanks

5000 word written assignment to critically appraise the evidence-based principles
underpinning short term, acute and critical adult nursing care

Assessment: Care Study of 5000 Words

You should choose one of the patients whose care you have been following in this unit.

• The case study will be a written paper of 5,000 words in which you will be expected to demonstrate your understanding and critically analyse the role of the nurse in the assessment , planning , provision and evaluation of person centred care of the patient with acute, short term and critical care needs. This will be done within the context of the multidisciplinary / multi -agency team.

• You will choose one patient with an acute, short term condition from your secondary care placement and critically evaluate the pathophysiological changes which occur within the chosen condition.

• This case study will include the safe use and action of medications administered for the chosen presenting acute condition.

The case study: 74 years male with Acute Kidney Injury
– -presentation of an acute illness
– -Will be considered the first patient’s 24 hours
– Role of the nurse in A -E assessment
– Pathology
– Multiagency involvement
– investigations
– Given drugs and why

• Mr Z, a 74 year old man with hypertension, chronic kidney disease (CKD) and type two diabetes complicated by peripheral neuropathy. He had a BMI of 28. Mr Z lived with his wife and was under regular review. His blood pressure was stable and satisfactory at 134/80. An HbA1c was 64 mmol/mol, serum creatinine 144 umol/L with no microalbuminuria. His medications included Ramipril 5mg OD, Furosemide, Mixtard-30, Simvastatin, Paracetamol; Ibuprofen 400mg TDS PRN
and Gabapentin.

A GP home visit was requested by his wife as Mr Z had been vomiting for 24 hours and was experiencing hypos, disorientated, agitated and unwell but afebrile. His blood pressure was 75/45. Urgent admission was arranged.
Admission: On admission he was found to be in hypovolaemic shock with oliguria. His admission serum creatinine was 480 umol/L with accompanying serum potassium of 7.1 mmol/L. He was resuscitated with IV fluids. Ramipril, Furosemide, ibubrufen and Gabapentin therapy were temporarily suspended.
Final Diagnosis: Acute Kidney Injury following hypovolaemia.

What would your immediate assessment priorities be for M?
How would these priorities help you plan care? Discuss the rationale, implications and nursing interventions of the care?
What is the NEWS 2 Score?

1
With rationale what are the pathophysiological mechanisms for the vital signs recorded so far?
Demonstrate how you would escalate your concerns? Who would you escalate to?
How would you help to reassure patient and patient’s partner?

2
With rationale explain how pt’s acute condition would be monitored and evaluated?
Discuss who would be involved in pt’s person centred care (Multi-disciplinary Team, Inter professional working)?
With Rational discuss how you would prepare pt. for further investigations including preparation for possible surgery?

3.
With rationale discuss the indications for the use of medications that could be administered to the pt. during this time?
With rationale discuss the safe administration of medications including the route, dose, contraindications & assessment?
4. Pt. requires fluid management. Discuss the rationale, implications and nursing interventions when administering IV Fluids includicixng the use of Colloid or Crystalloids?

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