Topic: Nursing essay case scenario questions assignment

Question 1

Harry Ware is a 45-year-old gentleman who has recently visited his General Practitioner (GP) complaining of a ‘chest infection’. He was admitted immediately to your ward where he was diagnosed as suffering from acute bronchopneumonia. On admission, he had a productive cough and complained of general pain in his chest when breathing deeply, felt lethargic and tired.

Ward baseline Observations
Oxygen saturations 85% on 2 litres (24%)
Temp 390C
Blood Pressure 110/60mm Hg
Pulse 125 beats per minute
Respiratory rate 32 breaths per minute
Medications as per drug chart;
Oxygen 2 litres continual via nasal or mask
Amoxicillin 500mg IV tds (three times a day)
Paracetamol 1g qds (four times a day)

Six hours after admission, Harry’s condition deteriorated, and he became pyrexia and was sweating. His breathing was noisy and rapid, with a faint expiratory wheeze. His tachycardia was increasing, and his pulse felt weaker than it did earlier (and his respiration rate was increasing). Harry was also more lethargic than he was on admission.

Discuss Harry’s acute management and nursing care in the first 24 hours following the deterioration with reference to the relevant pathophysiology.

Question 2;

Maria Carr is a 67-year-old retired teacher. She has been admitted to the accident and emergency (A&E) department with left sided arm and facial weakness, which started an hour ago. While in A&E an emergency CT scan was performed and confirms the diagnosis of an ischaemic stroke. As Maria had been in A&E less than 4.5 hours, the medical team administered Alteplase 900 micrograms/kg as prescribed. GCS and BP to be monitored at 30-minute intervals to check for deterioration. If BP increases above 180 mmHg systolic or 105 mmHg diastolic, Maria is to be reviewed by the medical team. She has been transferred to the acute stroke unit. You have been assigned to her care.
On admission Maria is very drowsy but responding to verbal stimuli, she is snoring loudly, and her left sided weakness remains.
Medications as per drug chart
Dipyridamole 200 mg BD (twice a day)
Aspirin 75 mg OD (once a day)
Ward baseline Observations
Pulse: 90 beats per minute
Respiration rate: 9 breaths per minute
Blood Pressure: 170/95mmHg
Temperature: 36.50C
Oxygen saturation: 94% on Room Air
Verbal on ACVPU scale
Her pupils are size 3mm equal and reacting to light (PEARL)
Glasgow Coma Scale: 11

Considering relevant pathophysiology, discuss Maria’s acute management and nursing care in the first 24 hours after admission.

Type of assignment: Academic paper writing
Type of assignment: Essay
Subject: Nursing
Pages/words: 10/2700
Number of sources: 5
Academic level: Bachelor
Paper format: Harvard
Line spacing: Double
Language style: UK English

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