In this essay, reflection on the nursing care of an adult patient will be done to meet the goals for the improvement of analytical thinking skills such as being able to identify problems that might arise, being aware to new or different ideas, and anticipating the consequences of one’s actions.
60 year old Mr.X was brought to the out patient department with cough and easy fatiguibility on and off since 6 months, breathlessness since 2 months and worsening of breathlessness since 2 days. He was accompanied by his wife and son. Mr. X, a retired teacher, was a chronic smoker. He was a known patient of hypertension and appeared obese. He used to exercise regularly until 6 months prior to coming to hospital, when he developed exercise induced cough and breathlessness which he thought was due to asthma. Initially, his symptoms responded to inhalers, but later the symptoms continued to persist. He was on amlodipine for hypertension. The problem which has been identified to discuss in this essay is breathlessness.
A detailed history was taken in Mr. X to evaluate causes of breathlessness. The history included history of chest pain, edema, giddiness, exertional breathlessness, breathlessness in lying down position, vomiting and epigastric pain. Cough was present through out the day and was productive. Mr. X had only exertional breathlessness. The breathlessness was graded according to the Medical research Council Dyspnea Scale (table-1).
On examination, the patient appeared mildly pale. He had no fever. Pulse rate was 100 per minute, respiratory rate 30 per minute, blood pressure 140/90mmHg and saturations were 89 percent in room air and 94 percent with 3 liters of oxygen through rebreatheble mask. Examination of other systems were unremarkable. Electrocardiogram was normal. The initial investigations which were sent were complete blood picture and arterial blood gas analysis. Complete blood picture was normal ...