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NR 341 Complex Adult Health Interdisciplinary Care

Background Information

Mrs. J.E., a 62-year-old African American female, was admitted to the emergency room on 03/10/2018 as a complete code. She presented with shortness of breath and an opiate overdose, likely due to her chronic smoking of a pack of cigarettes daily, consumption of four to five glasses of wine daily, and combined use of heroin and painkiller medication. Her medical history included asthma, hypertension, urinary incontinence, urinary tract infection (UTI), and type II diabetes mellitus. She had previously undergone a right knee replacement surgery and a benign cyst removal from her right breast. The current diagnosis for Mrs. J.E. is bilateral pulmonary infiltrate with suspicion of opiate overdose.

During the day of care, Mrs. J.E.’s vital signs revealed a blood pressure of 98/58mm Hg, an oral temperature of 98.9°F, a respiratory rate of 8 breaths per minute, a weight of 146 pounds, a radial pulse of 40 beats per minute, and an oximetry reading of 88% on room air. Additional assessments indicated the presence of alcohol and smoke odors, intoxicated behavior, inflamed nasal mucosa, gingival ulceration, warm skin, and lacerations and bruises on her abdomen, legs, and arms. Despite her condition, Mrs. J.E. remained alert and oriented. However, she exhibited respiratory distress symptoms such as shallow and labored breathing, dyspnea, wheezing, and respiratory depression.

NR 341 Complex Adult Health Interdisciplinary Care

The nursing diagnosis for Mrs. J.E. includes ineffective airway clearance due to drug effects, inadequate health maintenance, and a risk for suicide related to substance abuse. The desired nursing outcomes are to improve airway patency, promote health-seeking behavior, and ensure patient safety. Nursing interventions involve monitoring blood gas values and pulse saturation levels and providing emotional support to achieve these outcomes. The patient’s respiratory, neurologic, and cardiovascular health are continuously assessed.

Regarding routine nursing management, the nursing team focused on maintaining a patent airway by positioning the patient in a high Fowler position and utilizing mechanical ventilation. Naloxone, the antidote for opiate overdose, was administered, and continuous ECG monitoring was initiated. The interdisciplinary team, including respiratory therapists, nurses, emergency medical doctors, ECG technicians, lab personnel, and assistive personnel, collaborated in providing care to Mrs. J.E. Respiratory therapists administered respiratory care treatments and managed life support mechanical systems.

NR 341 Complex Adult Health Interdisciplinary Care

Nurses provided hands-on care, administered medications, and communicated with doctors. Emergency medical doctors assessed the patient’s condition, ordered tests, and provided treatment. ECG technicians monitored cardiac activities, and lab personnel performed tests and procedures. Assistive personnel supported patient care under the supervision of nurses. Therapeutic modalities, such as psychosocial and continuous patient assessments, were employed to provide non-surgical, medication-free care.

Nurses engaged in effective communication actively listened to patients, and provided a comforting presence. These modalities aimed to promote trust, independence, and overall well-being. Reflecting on my role as a nursing student during this experience, I recall the intense atmosphere of the emergency room when Mrs. J.E. arrived. Assisting with vital sign measurements and ECG electrode placement, I observed the coordinated efforts of the medical team in providing immediate care. The nurse I was paired with demonstrated composure and efficiency, ensuring all tasks were carried out appropriately. It was a valuable learning experience that reaffirmed my passion for nursing.

Conclusion

In conclusion, the complex adult health interdisciplinary care provided to Mrs. J.E. involved addressing her immediate medical needs, promoting health-seeking behavior, and ensuring patient safety. The nursing team played a crucial

References

Carpenito, L. J. (2017). Nursing diagnosis: Application to clinical practice. Philadelphia, PA:

Wolters Kluwer. For All Your Nursing Needs. (n.d.). Retrieved March 30, 2018, from 

https://nurseslabs.com/

Lewis, S. L., Dirksen, S., Heitkemper, M., & Bucher, L. (2014).

(9th Ed.). Elsevier Mosby. Lilley, L. L., Collins, S. R., & Snyder, J. S. (2017). Pharmacology and the nursing process. St. ALouis, MO: Elsevier.

Vallerand, A. H., (2015). Davis’s Drug Guide for Nurses (14th Ed.). Philadelphia, PA: F.A Davis Company.

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