This paper presents complex care nursing about the patient named Mr. Smith. The signs and symptoms which Mr. Smith is experiencing are much related to his acute pulmonary oedema. The paper will also evaluate five core nursing interventions in Mr. Smith’s case…
It is evidently clear from the discussion that because of the lung’s diminished capacity to oxygenate the blood, hemoglobin is circulated without being adequately oxygenated; in effect, this causes shortness of breath and cyanosis in the patient. With more oedema, oxygen supply to the brain decreases and this causes disorientation and altered cognition in the patient. Dyspnoea manifests with decreased oxygen supply and lung stiffness. The air moving into the alveolar field causes the crepitations and crackles heard upon lung auscultation. With the fluid moving through the larger air paths, the crepitations and crackles become louder. Mr. Smith’s dyspnoea, as was discussed, is caused by the accumulation of fluid in the lungs. “Excessive secretions and inability to clear such secretions can compromise airways and increase airway resistance”. In physically separating the alveoli from the pulmonary capillary vessels, the swelling or oedema would interrupt the carbon dioxide and oxygen exchange. In effect, there is lesser space in the lungs for slow and deep breaths; as a result, the patient’s dyspnoea manifests with rapid and shallow respiration. This difficulty in breathing causes the patient to exert more effort in breathing and in lung filling – hence the increased use of accessory muscles in breathing. His decreased oxygen saturation is primarily caused by the decreased oxygen being carried and circulated to the different cells of the body. Due to decreased volume of oxygen taken in by the lungs and due to the decreased capacity of the alveoli to exchange carbon dioxide for oxygen, the oxygen saturation of the cells is compromised and is detected by the pulse oximeter as lower O2 saturation. The patient’s anxiety is triggered by his above symptoms. His difficulty in breathing and other symptoms like his pink-tinged sputum all trigger his anxiety. As his pulmonary oedema becomes worse, his anxiety is also bound to increase. As his anxiety increases, the more that he will seem confused, and later, stuporous. Five core nursing interventions 1. Monitor vital signs every 10 to 15 minutes This is a crucial intervention on the part of Mr. Smith because vital signs are the best parameters of a patient’s condition. It is an essential part of client’s care and it often forms the basis for identifying issues and planning interventions. In Mr. Smith’s case, it is possible to evaluate the worsening or the improvement of his condition through vital signs monitoring. Since Mr. Smith is a critical care patient, his vital signs are not stable and are expected to abruptly change. It is therefore important to monitor his vital signs at closer intervals. Such monitoring would assist in detecting abrupt changes in the patient’s vital signs. In such case, adjustments in the patient’s medication and interventions may be made accordingly and as each incident unfolds. Mr. Smith’s condition is critical and is bound to change based on each intervention implemented on his behalf. ...
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