Critical analysis of a nursing intervention for a highly dependent patient.

Title: A critical analysis of a nursing intervention for a highly dependent patient.

[Dear writer, Important requirements: I very much NEED TO GET THE ESSAY IN PARTS after you complete each part of this work, to review with my tutor and give you the feedback from the tutor BEFORE THE COMPLETION DATE and need to amend and update accordingly.] Do not include a Bibliography. BUT PLEASE Use only a minimum of 18 references you used in the ESSEY AS THE REFERRENCE LIST. Please make sure good communication between you and me, through out the work. I mean an interactive or supportive work model. I am a nurse and doing my Masters in Intensive Care Course (nursing).

Please do not hesitate to ask me for any assistance related to the essay, (clarification with the guidelines, direction etc) I will be more than happy to provide anything within my capacity. I will try my level best to reply ASAP, and I really hope you will also do the same for me. Thanks a lot and good luck.

Assignment guidelines
Title: A critical analysis of a nursing intervention for a highly dependent patient
Format: A written assignment of 3,000 words

Assignment Guidelines to follow:
” The essay should be structured in essay style, but sub-headings may be used. It should include an introduction, main body and conclusion. The essay should be logical with lines of argument developed.

” From the scenario used during the course, select one identified patient problem (please see below for the scenario).
The selected Scenario for this assignment is : Care of the breathless patient in an Intersive Care Unit & the Patient Problem : HYPOXIA.
” (Focus on one) appropriate nursing intervention when caring for a patient with that problem is:
(Nursing INTERVENTION CHOSEN) CPAP (continuous positive airway pressure).


” Give a rationale for the intervention chosen; justify reasons for choice and support with evidence-based literature.

” With reference to the interdisciplinary team, critically examine the nurses role in managing the intervention.

” Consider the decision-making processes involved.

” Discuss what impact the intervention would have on a patient s condition.

” Critically analyse how the effectiveness of the intervention would be evaluated.

” The work should be supported throughout with relevant references, which justify why and how the intervention is used.

” The essay should show an understanding of the appropriate physiological, psychosocial aspects of the problem and how the intervention can improve outcome.

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In Depth Critical analysis of Nursing Intervention.

The information below in ITALIC FONT is an example of the structure an format of the essay. The essay should follow the GUIDELINES.

Patient Problem: Hypoxia > CPAP

Introduction plus Road Map (200words). Why did you pick this topic?.

 Talk about patient problem
 Rational behind intervention, using literature ( only relevant to patient problem).
 Nurse role in managing intervention, using literature.
-Eg. Psychological support, safety , complications
-how well do nurses do it?
-consent when pt. confused?
-training? Where should pt. be situated?
 Nurse VS MDT (multi disciplinary team)
Eg. CPAP  work with physiotherapist  who makes what decisions, who sets up the equipment?
 Consider decision making process involved.
Eg. Is it appropriate intervention for that pt.?
CPAP and conscious level. Nurse advocate for pt.
 Impact of intervention on pts. Condition
Eg. CPAP lover RR, improved ABG s , increased O2.
 Understanding of psysiological, psychological and psychoscial effect.
Eg. SOB psychological impct and nurses role eg. Support.

Conclusion (200 words: Draw into a conclusion the points you discussed in the essay.


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Scenario . Breathless Patient.

IMPORTANT NOTE:

This ASSIGNMENT IS NOT A CASE STUDY based on this scenario. The below scenario is the one we used in the class. Please do not copy this. Use this as an EXAPLE OF PATIENT PROBLEM. Indicate in the introduction that you are using a pseudo name for maintain confidentiality.

Focus only on ONE PATENT PRPBLEM (HYPOXIA) and ONE NURSING INTERVENTION (CPAP).
Please follow the assignment guidelines.

Mr Adams, a 65-year-old gentleman, is admitted to the Accident and Emergency department with severe breathlessness. He has had a productive cough for two weeks and feels very hot to touch. He is expectorating thick green sputum. His partner accompanies him.


Using the framework of Airway, Breathing, Circulation, Disability, Exposure/Environmental (ABCDE), explore the assessments you will need to undertake with Mr Adams. (please see below).


The casualty officer has now seen Mr Adams. A chest x-ray has been performed, bloods sent for full blood count, urea and electrolytes and sputum for microbiology, culture and sensitivity. His arterial blood gases indicate hypoxemia but no hypercarbia. A provisional diagnosis of community-acquired pneumonia has been made

Using ABCDE as a framework, discuss the relevant treatment and interventions for Mr Adams.

Twenty-four hours later, Mr Adams is showing no signs of improvement. He is exhausted and tachypnoeic with a respiratory rate of 44 breaths per minute. His oxygen saturation (SpO2) is 88% on FiO2 0.6 and arterial blood gases indicate poor oxygenation with a PaO2 of 7.8 Kpa (58.5 mmHg). Carbon dioxide levels (PCO2) remain normal.


What further interventions could be instigated? [PLEASE REMEMBER FOCUS ON ONE PATIENT PROBLEM and ONE nursing INTERVENTION (CPAP) for the assignment].

Assessment tools to use.
ABCDE frame work.
A- AIR WAY
B- BREATHING.
C- CIRCULATION
D- DISABILITY (CNS DYSFUNTION)
E- EXPOSURE (FULL EXAMINATION OF THE PATIENT).
Harward Referrencing. PLEASE Use only a minimum of 18 references you used in the ESSEY AS THE REFERRENCE LIST.Do not just include a Bibliography.

INDICATIVE READING LIST.


Barnett M (2004) Supported discharge for patients with COPD. Nursing Standard. 18(45): 33-37

British Thoracic Society (1997) BTS guidelines for the management of chronic obstructive pulmonary disease. Thorax 52: supplement 5.

British Thoracic Society (2002) Non-invasive ventilation in acute respiratory failure. Thorax 57(2): 192-211

Cowan, T. (1997) Pulse oximeters Professional Nurse 12 (10): 744-750

Coombs, M. (2001) Making sense of arterial blood gases Nursing Times 97(27): 36-38

Cross. S. (1997) Revised guidelines on asthma management Professional Nurse 12(6): 408-410.

Day, T. (2000) Tracheal suctioning: when, why and how? Nursing Times 96(20 NT Plus) 13-15

Day, T.L., Farnell, S. and Wilson-Barnett, j. (2002) Suctioning: a review of current research recommendations. Intensive and Critical Care Nursing 18: 79-89

Day, T.L., Farnell, S., Haynes, S., Wainwright, S. and Wilson-Barnett, J. (2002) Tracheal suctioning: an exploration of nurses knowledge and competence in acute and high dependency ward areas. Journal of Advanced Nursing. 39(1): 35-45.

Doherty, M.J. and Greenstone, M.A. (2000) Non-invasive ventilation in acute exacerbations of chronic obstructive pulmonary disease (COPD):
Who is eligible? Care of the Critically Ill 16 (4): 126-130

Durren, M. (1992) Getting the most from pulse oximetry. Journal of Emergency Nursing. 18: 340?342.

Epstein, P. (2000) Clinical Examination. 2nd Edition. Barcelona. Mosby International Ltd.

Flenley, D.C. (1990) Respiratorv Medicine. 2nd Ed.
London: Bailliere Tindall.

Juniper, M. and Davies. C.(1998) New guidelines for the management of life threatening asthma. Care of the Cntically Ill 14(2): 61-64.

Mcquay, H., Moore, A. a