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Name
Chamberlain University
NR-341 Complex Adult Health
Prof. Name
Date
Mrs. Watson . is a 62-year-old African American female admitted to the emergency room on March 10, 2018, as a complete code. She presented with shortness of breath and an opiate overdose, likely caused by her chronic lifestyle, which includes smoking a pack of cigarettes daily, consuming four to five glasses of wine per day, and using heroin alongside painkillers. Her medical history consists of asthma, hypertension, urinary incontinence, urinary tract infection (UTI), and type II diabetes mellitus. Additionally, she has undergone a right knee replacement and benign cyst removal from her right breast. Currently, Mrs. Watson. is diagnosed with bilateral pulmonary infiltrates, with a suspected opiate overdose contributing to her condition.
On the day of care, her vital signs were notable: blood pressure was 98/58 mm Hg, oral temperature 98.9°F, respiratory rate 8 breaths per minute, weight 146 pounds, radial pulse 40 beats per minute, and oxygen saturation was 88% on room air. Further assessments revealed the presence of alcohol and smoke odors, intoxicated behavior, inflamed nasal mucosa, gingival ulceration, warm skin, and bruises and lacerations on her abdomen, legs, and arms. Despite her severe condition, she remained alert and oriented. However, she showed symptoms of respiratory distress, such as shallow and labored breathing, dyspnea, wheezing, and respiratory depression.
The nursing diagnosis for Mrs. Watson involves ineffective airway clearance due to the effects of drugs, inadequate health maintenance, and a risk of suicide linked to substance abuse. The primary goals of nursing care include improving airway patency, promoting health-seeking behaviors, and ensuring the patient’s safety. To achieve these outcomes, the nursing interventions included monitoring blood gas levels and pulse oximetry readings and offering emotional support. Her respiratory, neurological, and cardiovascular functions were consistently assessed throughout her care.
Routine nursing management focused on keeping her airway patent by positioning her in a high Fowler position and administering mechanical ventilation when needed. Naloxone, an antidote for opioid overdose, was given, and continuous ECG monitoring was initiated. A collaborative interdisciplinary team provided comprehensive care, including respiratory therapists, nurses, emergency physicians, ECG technicians, laboratory personnel, and support staff. The respiratory therapists administered treatments and managed mechanical ventilation systems, while the nurses provided direct care, administered medications, and communicated with the physicians.
The emergency physicians evaluated Mrs. Watson’s condition, ordered appropriate tests, and initiated treatment. ECG technicians monitored her heart activity, while lab personnel carried out necessary procedures. Assistive personnel supported patient care under nurse supervision. Non-surgical and medication-free therapeutic modalities were employed, focusing on psychosocial support and continuous patient assessments.
Effective communication played a crucial role in care, with nurses providing active listening and a comforting presence to the patient. These therapeutic efforts aimed to build trust, foster independence, and improve overall well-being. Reflecting on my role as a nursing student in this situation, I remember the intense atmosphere in the emergency room when Mrs. Watson arrived. I assisted in measuring vital signs and placing ECG electrodes, observing how the healthcare team worked together to offer immediate and efficient care. The nurse I was paired with displayed calm and efficient behavior, ensuring that all tasks were completed correctly. This experience was valuable and reinforced my passion for the nursing profession.
In conclusion, the interdisciplinary care provided to Mrs. Watson addressed her immediate health concerns, promoted health-seeking behavior, and ensured her safety. The nursing team played a crucial role in managing her condition and delivering high-quality care in a coordinated and timely manner.
Carpenito, L. J. (2017). Nursing diagnosis: Application to clinical practice. Philadelphia, PA: Wolters Kluwer.
For All Your Nursing Needs. (n.d.). Retrieved March 30, 2018, from https://nurseslabs.com/
Lewis, S. L., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9th ed.). Elsevier Mosby.
Lilley, L. L., Collins, S. R., & Snyder, J. S. (2017). Pharmacology and the nursing process. St. Louis, MO: Elsevier.
Vallerand, A. H. (2015). Davis’s drug guide for nurses (14th ed.). Philadelphia, PA: F.A. Davis Company.
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