Nurses Using Critical Thinking to Implement Patient Care Essay

Nurses Using Critical Thinking to Implement forbearing Care - Essay ExampleAs the patient is sapiently ill, assessment and interventions should proceed simultaneously. Assessment is through by history taking, physical examination and investigations. History taking should include the duration for which the symptoms pee-pee been present, the endure of illness, associate symptoms such as cough, any obvious or clear triggering event, history of smoking and do drugs malignment in the recent past times, history of signifi trickt weight loss and any significant past medical or surgical history. As the patient is having difficulty in speaking due to suddenness of breath, history should be taken from the accompanying family member .The clinical record of the previous day should be reviewed which may contain the history given by the patient. Obtaining the history is important to arrive at the etiology. So far as physical examination is concerned, patients vital parameters are recorded an d ceaselessly observeed. As patient is hyperpyrexic, hourly temperature recording should be done. Signs of respiratory distress namely tachypnea, use of subsidiary muscles of respiration, wheezing and findings on chest auscultation are documented (Prigmore 50). General physical examination includes examination for jumble rash and color, needle marks, lymphadenopathy, icterus and sudor. Cardiovascular assessment evaluates blood pressure, heart rate, rhythm, pulse volume stipulation and cardiac murmur, if any. The rationale behind all these assessments is to localize the site of infection, determine the cause of fever and to monitor the respiratory function and progress of the disease. Hydration status of patient should be assessed as fever can maven to significant evaporative losses and dehydration. Consciousness level and status of the pupils is assessed. Any tests and investigations that have been done public treasury now are reviewed. Patients socioeconomic, professional a nd family background should be briefly appraised. Nursing diagnosis Fever is generally indicative of an infective pathology. Also, the patient has coexisting respiratory distress with diaphoresis. Thus, differentials of the nursing diagnosis in this patient are an acute respiratory infection like community acquired pneumonia of bacterial, viral or fungal etiology (Prigmore 50). Sudden deterioration with fever, tachycardia and tachypnea suggest acute lung injury. A young patient having a severe illness should prompt a diagnosis of immunosuppresion such as AIDS. Thus, the patient may have HIV related pneumonia and septicemia (Kalikiri, Kandala, and Sachan). Patients occupation where he may have been acutely exposed to large amount of dust or noxious fumes could have caused pulmonary inflammation. spin workers may be predisposed to fungal infections. Fever with sudden onset respiratory distress and diaphoresis can also be a feature of acute infective endocarditis leading to heart b ereavement as a result of intra venous drug abuse (Cabell, Abrutyn, and Karchmer 185-187). Some drug over dosages can also cause hyperpyrexia with shortness of breath. Non cardiogenic pulmonary edema and pulmonary hemorrhage are known complications of heroine abuse (Gotway et al 120-122 Dettmeyer et al 87). Patients lifestyle warrants an evaluation for substance abuse. An unhealthy lifestyle in a young patient can also cause accelerated atherosclerosis and myocardial infarction which is however, unlikely in the absence