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Complex Fluid and Electrolyte Balance - Essay Example

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Medical treatment and related monitoring for patients under intensive treatment phase is vital due to dilemma faced by numerous physicians in emergency departments. In this case, it is significant to recognize the role taken by physicians in emergency departments during the…
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Complex Fluid and Electrolyte Balance
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Complex Fluid and Electrolyte Balance Table of Content Overview of the Medical Treatment and Associated Monitoring Emergency Department 3 Reasons for Monitoring Mr. B for Simple Chest Infection 4 Purpose of the CPAP, CVC, art line and IDC 4 Two Psychosocial Effects of Highly Technical Medical Treatment on Individual 5 Emotional and psychological trauma 5 Post-traumatic stress disorder (PTSD) 5 Nursing Care to Address these Effects 6 Effects of the Medical Monitoring (CPAP, CVC, Art Line, IDC) On Mr. B and His Wife 6 Discharge Plan, Including Ongoing Follow-Up with Allied Health Discipline 6 Services Required By Mr. B on Discharge 7 References 8 Complex Fluid and Electrolyte Balance Overview of the Medical Treatment and Associated Monitoring Emergency Department Medical treatment and related monitoring for patients under intensive treatment phase is vital due to dilemma faced by numerous physicians in emergency departments. In this case, it is significant to recognize the role taken by physicians in emergency departments during the early stage of treatment (Andrews & Nolan, 2006). Moreover, a substantial part of treatment reinforcement and redefinition is offered in emergency department. However, physicians take additional responsibilities of offering health care services for patients, who are admitted. Nevertheless, complex and prolonged illnesses lead to overcrowded facilities and overextension of staff. The paper explores a case involving an individual experiencing complex fluid and electrolyte balance. There is need to understand various monitoring devices used in the emergency department for patients under intensive treatment (Lewis, Dirkse, Heitkemper & Bucher, 2010). In fact, understanding of these devices facilitates improvement of care efficiency and increases physician’s confidence while dealing with patients. Complexities have been added by technological advancements to procedures of monitoring patients under intensive care unit leading to increased efficiency and simplicity (Brown & Edwards, 2011). In fact, this facilitates increased capability for physicians dealing with muddled situations, whereby they gain complete control. Nevertheless, treatment and related monitoring patients under intensive treatment phase can be explored through an overview of emergency medicine practice that involves respiratory, neurologic and hemodynamic monitoring (Meyers & Weingart, 2007). Physicians in the emergency department focus on monitoring respiratory condition for critically ill patients as one of the vital procedures in emergency department. Moreover, physicians have an obligation to assess patient’s hemodynamic condition as a way of ensuring sufficient organs perfusion and oxygenation of tissues (Roberts, 2008). Nonetheless, monitoring of neurological function is highly complex though attainable. In addition, electroencephalography (EEG) is one of the sophisticated devices employed during neurological monitoring, though it surpasses the scope of numerous practices undertaken by numerous physicians (Jarvis, 2012; Brotto & Rafferty, 2012). Reasons for Monitoring Mr B for Simple Chest Infection One of the reasons for monitoring Mr. B for simple chest infection is due to the information provided by his wife, whereby she indicated that Mr. B had been suffering from a cold for the last ten days, increased congestion, and wet cough. On the other hand, it is evident that physicians in the emergency department had an obligation to conduct a respiratory assessment on the patient (Kuitert, 2011). Therefore, through physical examination, it was noted that his chest produced a rattling and crackling sounds. In fact, this was an indication of restricted entry of air below the fourth vertebrae, while his respiratory rate was twenty-eight breaths per minute. Purpose of the CPAP, CVC, art line and IDC The purpose of CPAP is to ensure that a patient is supplied with ample oxygen, while eliminating sufficient amount of carbon dioxide concurrently in his or her cells. In addition, instigation of CPAP decreases breathing task for the patient. Care of CVC is undertaken to reduce chance of blood samples contamination in the process of drawing blood cultures, thereby ensuring that the results from blood sampling are accurate. Art line refers to a fine plastic tube, which is inserted into an artery for measuring blood’s level of oxygen and pressure, while IDC temperature sensor is used to measure and maintain patient’s core temperature (Scheinkestel, 2013). At the stage of treatment, the patient’s mean arterial pressure would expected to be above or equal to 60 mm Hg and blood pressure would be above or equal to 70 mm Hg (Lehman, Saeed, Talmor, Mark & Malhotra, 2013). Two Psychosocial Effects of Highly Technical Medical Treatment on Individual Emotional and psychological trauma Highly technical medical treatment on a patient can cause emotional and psychological trauma given that the patient undergoes a stressful episode that changes their sense of security. Moreover, this leads to a feeling of helplessness and vulnerability as the patient undergo traumatic experienced that threatens his or her life and safety (Lemone & Burke, 2011). Therefore, highly technical medical treatment may be overwhelming and traumatic to individual, even in situation when there is no harm (Robinson, Smith & Segal, 2013). In this case, the patent’s emotional experience serves as a determinant of whether the event was traumatic. Post-traumatic stress disorder (PTSD) Highly technical medical treatment causes traumatic experiences that involve a normal feeling of sadness, anxiety, and disconnection (Tollefson, 2012). However, if this experience does not fade, it becomes PTSD, whereby a patient is stuck with memories and contact sense of insecurity (Smith & Segal, 2013). In fact, patients feel like they will never get over the traumatic experience, though they may seek treatment or support in order to develop new skills for coping with this problem and overcome PTSD (Gerrig & Zimbardo, 2009). In this case, PTSD develops after a traumatic experience that threatens patients’ life, thereby leaving them helpless in situation where it is uncontrollable or unpredictable. Nursing Care to Address these Effects Nurses can take responsibility of a therapist to address effects of traumatic experience caused by highly technical medical treatment. In fact, nurses establish quality relationship with patients in order to facilitate the process of addressing these effects (Levett-Jones, 2013). Moreover, they have to ensure that patients feel comfortable by earning their trust, making them feel respected and safe (Elder, Evans & Nizette, 2013). Therefore, the nurses create a sense trust in these relationships in order to facilitate process of healing from psychological and emotional trauma. In this way, they are able to resolve the patients’ intolerable and memories. Effects of the Medical Monitoring (CPAP, CVC, Art Line, IDC) On Mr B and His Wife Both Mr B and his wife witnessed CPAP procedures, whereby a rubber band positioned behind Mr B’s head masked his face to ensure that it is sealing around the chin. This indicated that the patient’s life was in great danger because he was not able to breathe; thus, it led anxiety and helplessness. CVC and Art Line procedures involved use of a needle to draw blood from the patient and insert a plastic tube into his arteries respectively; thus, this may have caused his wife to feel guilty and blame herself for the pain endured by her husband. Discharge Plan, Including Ongoing Follow-Up with Allied Health Discipline Discharge plan and ongoing follow-up with allied health discipline derived from specialist clinic guidelines involve a series of appropriate practices, which underpin the discharge process and policies. Patients are involved in their care, whereby the specialists offer acute and time limited communication regarding the health care services to the patient (Ignatavicius & Workman, 2010). Policies and protocols involved in the discharge are crucial in addressing the needs of different patients and their family (State of Victoria, 2010). Discharge plan should facilitate the process of offering patients long-term care as a follow up action by specialist clinic (Levett-Jones & Bourgeois, 2011). In fact, this promotes consistency of the practice between the specialists; thus reinforcing use of specialist clinical resources. Services Required By Mr B on Discharge The process begins with sending a discharge summary to the Mr. B’s wife before the discharge in order to inform her that her patient is going to be discharged. In fact, this involves dissemination of information that entails substantial elements of medication and care management before the sending discharge summary. They should also ensure that Mr. B has access to his discharge summary, document actions and guidelines before discharge. Mr. B requires care for short and long-term issues associated with management of home post discharge and follow-up appointment that involve a medical specialist and outpatient clinic. In addition, follow-up action should involve checking whether support service is experiencing problem while managing care plan. References Andrews, J. & Nolan, J. (2006). Critical care in the emergency department: monitoring the critically ill patient. Emerg Med J. 23(7): 561–564. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579555/ Brotto, V. & Rafferty, K. (2012). Clinical Dosage Calculations for Australia and New Zealand. Wadsworth: Cengage Learning. Brown, D., & Edwards, H. (2011). Lewiss Medical Surgical Nursing: Assessment and Management of Clinical Problems (3rd ed.). Sydney: Elsevier. Elder, R., Evans, K., & Nizette, D. (2013). Psychiatric and Mental Health Nursing (3rd ed.) Sydney: Elsevier. Gerrig, R. & Zimbardo, P. (2009). Psychology and Life. Frenchs Forest: Pearson Education Ignatavicius, D. & Workman, L. (2010). Medical-Surgical Nursing: Patient-Centered Collaborative Care (6th ed.). Philadelphia: Elsevier/Saunders. Jarvis, C. (2012). Physical Examination and Health Assessment: Australian and New Zealand (6th ed.). Chatswood NSW: Elsevier. Kuitert, L. (2011). Winter colds, flu, and chest infections - differentiating between the wintry ailments. totalhealth. Retrived from: http://www.totalhealth.co.uk/clinical-experts/dr-lieske-kuitert/winter-colds-flu-and-chest-infections-differentiating-between-wintry-ailments Lemone, P. & Burke, K. (2011). Medical-Surgical nursing: critical thinking in client care (1st ed.). Frenchs Forest: Pearson Australia. Meyers, C & Weingart, S. (2007). Critical Care Monitoring In the Emergency Department. EBMedicine.net. Retrived from: www.ebmedicine.net/topics.php?paction=dLoadTopic&topic_id=20     Levett-Jones, T. (Ed.). (2013) Clinical reasoning: Learning to think like a nurse. Frenchs Forrest, NSW: Pearson Australia. Lehman W., Saeed M., Talmor D., Mark R., & Malhotra A. (2013). Methods of blood pressure measurement in the ICU. Crit Care Med 41(1):34-40 Retrieved from:http://www.ncbi.nlm.nih.gov/pubmed/23269127 Levett-Jones, T., & Bourgeois, S. (2011). The Clinical Placement: An essential guide for nursing students (2nd ed.). Sydney: Churchill Livingstone. Lewis, M., Dirkse, R., Heitkemper, M., & Bucher, L. (2010). Medical-Surgical Nursing : Assessment and Management of Clinical Problems (7th ed.). St. Louis: Mosby. Robinson, L., Smith, A. & Segal, J. (2013). Healing Emotional and Psychological Trauma Symptoms, Treatment, and Recovery. Helpguide.org. Retrived from: http://www.helpguide.org/mental/emotional_psychological_trauma.htm Roberts, D. (Ed.). (2008). Medical–Surgical Nursing Review Questions (2nd ed.). Pitman, NJ: Academy of Medical Surgical Nurses. Scheinkestel, C. (2013). Intensive Care Unit Information: Information about Procedures and Treatments. The Alfred Hospital. Retrieved from: http://www.alfredicu.org.au/assets/Miscellaneous-Downloads/ICUprocedurehandouts.pdf State of Victoria. (2010). Victorian public hospital specialist clinics Discharge guidelines. Department of Health. Retrieved from: http://docs.health.vic.gov.au/docs/doc/83338F906DE88BE7CA25791700059E50/$FILE/discharge_guidelines.pdf Smith, A. & Segal, J. (2013). Post-traumatic Stress Disorder (PTSD) Symptoms, Treatment and Self-Help. Helpguide.org. Retrived from: http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm Tollefson, J. (2012). Clinical Psychomotor Skills: Assessment tools for nursing students (5th ed.). Katoomba: Social Sciences Press. Read More
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