Get Answer: Andrian Patient With Question Guide
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Original Question
Andrian, a patient with a history of recurrent pneumothorax (lung collapse), presented to the ED through the ambulance with severe left-sided chest pain described as a sharp, stabbing, and aching accompanied by a significant SOB. His breathing is shallow, and he is unable to take deep breaths due to the pain. He has experienced three previous episodes of pneumothorax, with 1 occurring on the same side (left) and 1 on the other side the most recent one was 1 year ago. His symptoms in this presentation closely mirror his previous episodes suggesting a recurrence of pneumothorax. Hi diagonosis is Pneunothorax air inside of the lung, when it expand it can compress lung and cause collapsed lung which can be life threatening for him. The chest xray had been done and it revealed that pneumothorax starts off small but it can actually expand bigger over time it can get worse and worse. The doctor was explaining if his oxygen goes down he could become unconscious, and potentially die from it. Upon diagnosis of pneumothorax Adrian receives immediate pain management including sedation, local anesthia and ketamin. A chest x ray reveals small pneumothorax promoting the insertion of a chest drain to evacuate the trapped air. Despite this initial intervention, a follow up x ray shows the sixe of the pneumothorax has increased necessitating a chest drain to air out tge pleural space and allow the lung to reexpand. Adrian oxygen level, Pain management OBS, Continue ECG are monitored throughout this treatment. The initial management with the chest drain was successful, and the final chest x-ray confirmed that the lungs were reexpanded and the pneumothorax had resolved. However, Adrain is admitted to the respiratory team for further management. The team will evacute the underlying cause of his recurrent pnenothorax and decide on long term strategies to prevent future episodes. As part of the management plan, the doctor has recommended a pleurodesis procedure to address the recurrent pneumothorax. The procedure involves the use of a substance ( often a glue or chemical irritant), as per Adrian in the video, to adhere the lung to the inside of the chest wall, which reduces the risk of further pneumothoraces. This will likely require another surgical intervention for Adrian. The key concerns moving forward include pain management, the risk of infection at the chest drain site, and determining the appropriate duration for the chest tube placement to ensure full recovery and prevent further complications. This is the summary of the case video which I wrote it down. 1. Table of Contents 2. Introduction 3. A summary of the chosen clinical case, defining any key terms- Rubric- The chosen patient story is thoroughly summarised with logical flow, defining key terms or new concepts. It is clear that the student has a sophisticated understanding of the case complexity and is person-centred in their approach. 4. A detailed 1 A4 size page concept map, flow chart or mind map to clearly demonstrate your understanding of the key concerns for the patient from a pathophysiological perspective. Highlight key pathophysiological processes relevant to the case presentation and include case study cues/details that relate to this. Note – regardless of the style of map it should have ease of readability ie deliberate use of white space, careful use of text (heavy use of text can impact readability) and, use of arrows and lines to represent relationships between ideas. Rubric- Pathophysiological processes included demonstrate a highly developed understanding of the clinical condition and high acuity status of the patient; connections and inclusions of the patient case specifics further illustrate. 5. Applying clinical reasoning, identify and describe two (2) of the highest priorities of care (providing a rationale for these choices) during the acute initial assessment and care phase in the emergency patient presentation Rubric- Priority 1. Applying clinical reasoning, identify and describe one of the highest priorities of care (providing a rationale for this choice) during the initial assessment and care phase in the emergency department for the chosen patient case. Priority identified and described is appropriate during the acute illness phase, a sophisticated rationale is provided to justify choice. 6. Discuss two (2) high acuity technologies* supporting the assessment and care of the patient, include rationales for these interventions in your case. Rubric- Excellent description of the technology and its purpose/usefulness specific to this case; the discussion is sufficiently detailed to demonstrate sound understanding of the technology and its value in enabling the interprofessional team to assess and care for a high acuity patient, case details are integrated into the analysis and discussion. 7. Examine up to three (3) pharmacological interventions to support the care and comfort of the patient in your chosen case – these may be observed in the video or recommended based on your research related to the case study clinical condition(s) and the specific therapies the patient is receiving. Rubric- Examine up to three (3) pharmacological interventions to support the care and comfort of the patient in this case. Excellent recommendations for pharmacological interventions to support the care and comfort needs that are relevant to the patient case. 8. Analyse the pre-requisites from the Person-Centred Practice Framework** (McCormack & McCance, 2010) and critically discuss the pre-requisites nurses require to be an effective health advocate for patients and families in high acuity environments. Link your discussion explicitly to the case study chosen. In your discussion, outline at least 2 (two) distinct and specific personal strategies that will strengthen your capability to advocate for safe high acuity care as a student nurse. 9. Conclusion Adrian’s case, he is given “painkillers” which can be assumed to be fentanyl, local anaesthetic and ketamine. Please give me a concise detailed answer in a long explaining everything specially highest priorities of care, high acuity technologies* supporting the assessment and care of the patient, pharmacological interventions to support the care and comfort of the patient in very much detailed.
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