This assessment will cover the following questions:
- Discuss about nursing management that can help to provide treatment and health care to patient with emergency.
- Explain and elaborate nursing intervention and medication that should provide medication for their after-health care according to prescription.
- Provide information about pneumonia and their different symptom which includes muscle pain, chest pain, productive cough, rising in fever and many more.
INTRODUCTION
Emergency department refers to accident emergency department in which there is an emergency room or word which sees casualty and provide facility of medical treatment and able to provide acute care to patient without prior appointment. Emergency department refers to responsible healthcare premises which is able to carry out treatment to patient and available all time in Healthcare. In this, there are always some registered nurse that can help to initiate treatment during emergency in healthcare process. Registered nurse has their own role in emergency department where they fulfill each and every requirement to providing initial care to patient. This paper aims to provide primary survey for comprehensive patient assessment and helps to interpret abnormal assessment finding. There is interpretation of abnormal findings according to medical history and temporary symptoms of patient after interpretation. It provides help to find out any abnormality with present during emergency. There is need to provide better care to patient. There is discussion about pathophysiology of abnormal condition. There is also some discussion about nursing management that can help to provide treatment and health care to patient with emergency. In this report, there is also discussion about nursing intervention and and medication that should provide medication for their after health care according to prescription (Tiley, (2018)).
MAIN BODY
Primary survey
Primary survey refers to initial assessment which is helpful to find out any emergency with patient. This is the one which can help to detect any immediate threat of life which needs to provide effective care and treatment to patient in relation to improvement in health. There are some of the framework that can be used in primary survey are discussed further.
General impression of patient- According to case study, this is the one in which there is need to ensure about shortening of breath and its cause due to shortness of breath. There can be speaking problem along with this, there can also be coughing all time. There is chance of chest infection that can be arise due to long term smoking which is the history of Doris. In relation to this, there is also chance of lungs infection which can cause due to smoking (Wang, (2018)). Doris have been stopped smoking in last 2 years but was smoking from teenage. So, there is high chance for problem of asthma or chest cancer that can cause due to daily conjunction of cigarette.
Assessing patient's mental status- This is the one in which there is need to find out responsiveness and unresponsiveness of patient by different alert, painful, verbal and unresponsive.
Alert- In this, there is need to some response during talking and waiting.
Verbal- When present find out as unresponsive, then there is need to produce loud verbal stimuli which can help them to look at you, moan or speak.
Painful- When patient don't respond to verbal stimuli, then there is need to create painful stimuli which includes gentle pain on shoulder.
Unresponsive- In this, there is no any response of verbal towards stimuli or painful from patient (Laurence, (2017)).
Assess the patient's Airway- In this, it is necessary to check out patient's airway either open or not. Doris is able to breath but not in continuous manner and this can create problem. There is need to provide gentle air and for this, there is a need of medical support and quick treatment.
Assess the patient's breathing- In this, there is need to have some adequate breathing and to find out patient is either breathing or not. To find out presence of breath, there is need to put ear on patient's mouth and nose and then need to watch patient's chest movement. Through this, it can be possible to listen expelling of air. There is also need to provide quality of breath sound to ensure about regular respiration.
Assess the patient circulation- In this, Doris should have adequate pulse which should be insured by registered nurse in emergency department. There is also need to get circulation assessment that can include temperature, color, motion, pale skin which can help to find out abnormal case like pale cool or most skin that can lead to shock indication (Mendel, (2020)).
Making decision for priority for urgency in patient transport- There is need to control the present situation. This can be there with Doris in relation to provide some relief from pain. There is also need to transfer the patient to better location which is in urban area. That should have high quality healthcare premises access of treatment of high quality and for this, Doris need better healthcare promises. Doris have chest pain, that is adequate and due to this, there is a need for emergency service with better facility. For this, there is need to transfer Doris from rural area to urban area where Healthcare promises have better facility. For transferring Doris during emergency time she needs some temporary treatment which can help to cover the distance without any serious problem. For this, nursing staff need to provide some effective treatment that can help better health and effectiveness for some hour to get better healthcare premises.
Underlying pathophysiology
Pulmonary Fibrosis refers to the condition where lungs tissue get thick, stiff and scared and this condition set to Fibrosis in medical terminology. Blood vessel and alveoli in lungs have the responsibility to provide oxygen in different organ of body. In relation to damage of lung tissue it can create difficulty during transferring of oxygen in bloodstream. Moreover, body organs don't get oxygen which leads to reduced functioning of body and properly. These are said to be fibrous in various cases (Gupta, (2018)). Pulmonary Fibrosis have no any known causes and due to this, it is known by Idiopathic Pulmonary Fibrosis (IPF). In this situation, there is breathing problem, breath shortness, joint pain, productive cough, muscles pain or low grade fever that can persistent and are seen in Doris. There is different debate of Idiopathic Pulmonary Fibrosis pathophysiology among health professionals. There is inflammatory instrument has involved which recurring destruction of immunology Pathology and inflammation and sound healing response propagation is there (Alimi, (2017). There can also be observed about the complexity which is understand by health condition in pulmonary Fibrosis. There is pathology mechanism which involves and not still cleared. In relation to this, this condition is not recognized by Health Care professional where involvement of cell is there and are called as alveolar epithelial cells. This is the cell when it gets damage, body repair itself and produce another cell that is known by fibro-blast. Production of this fibro-blasts get no control on it and creates a scaring and hardening of delicate tissue within lungs. This creates difficulty during expansion of lung tissue along with breathing with time. This is caring out was there and create difficulty in work properly and produce different symptom that is of Idiopathic Pulmonary Fibrosis (Gousseff, (2020)). There is a reason for which cell get damage and there is no information regarding this. Role of alveoli is to deliver gas exchange in lungs where oxygen moves toward capillaries to pick up carbon dioxide from blood scaring of lung tissue within Idiopathic Pulmonary Fibrosis where process is not properly carried out which creates various symptom including shortness of breath and dry cough.
Pneumonia pathophysiology
In any infectious organism that could reach risk of life have highly virulent. There is already pivoted defense mechanism of body physically. Therefore, it can be able to overwhelm microfibers (Namasivayam-MacDonald & Riquelme, (2020)). Resultant, preserve production can be observed which can feel the neighbouring alveolar blast and creates infection and need to get stick with each other. This can also lead to damage of lung tissue and creation of fibrous with pulmonary edema and result and lung expansion can be observed. In this, inflammatory responses it can get to pleurae effusion development and get 40% complicated in pneumonia case. This result to reduction of gaseous exchange along with carbon dioxide and lead to oxygen they provide. In relation to respiratory breath effort is also increase normal physiology disturbance. In this, it can be observed and can create increase in respiratory rate and heart rate and rise CO2 level along with falling of oxygen level (Feng
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