Complex Care Nursing Essay Example | Topics and Well Written Essays - 2500 words - 1

Complex Care Nursing - Essay Example ) Hb Haemoglobin 130g/L. 140-174 g/L WCC White cell count 12.89x 109/L 4-10 X 109/L Table 1 Investigation results of Mr. Smith Chest X-ray showed right middle lobe pneumonia. Being a non-smoker, Mr.Smith had not travelled overseas and had no exotic pets. Clinical assessment Mr Smith had scored 15 on the Glasgow Coma Score (Trauma-org). This indicated that Mr. Smith was having the best score and that he was in a good clinical condition where his neuropsychological status was concerned. This meant that he had his eyes open and they were responding. He was oriented, answering questions and obeying commands. Mildly febrile, he had accompanying tachycardia and his pulse had changed from the normal 72 beats per minute to 98 per minute. This could be partly due to the raised temperature and partly due to the progression to acute pulmonary oedema. The middle lobe had an anatomy which predisposes it to frequent involvement. The narrowness of the lobar bronchus and the acute angle at which it took off made it prone to difficulties of drainage. Pneumonia formed one cause of non-obstructive middle lobe syndrome (Bordow et al, 2005). The isolated position of the middle lobe also produced an impairment of collateral ventilation from the neighbouring lobes. Clearance of secretions was simultaneously defective. Inflammations constituted 47% of middle lobe syndrome in researches (Bordow et al, 2005). The history of symptoms of cough, fever with chills and the expectoration that Mr.Smith presented with correlated to the middle lobe pneumonia. Frontal and lateral chest X-rays provided the best pictures of the middle lobe. The Blood Glucose level was a little raised from the normal. He could be a borderline diabetic who needed to be watched and advised for a sugar-free diet. The stress due to the illness also could raise the glucose level. Investigation at intervals could help in the diagnosis. The electrolyte levels were slightly less than normal. Due to the fever and illness of the past five days, he could have reduced his food intake. Potassium reduction could also have been due to dehydration through excessive sweating following the fever. Serum creatinine was just above normal level. The glomerular filtration rate was however near normal. Repetition of the investigations would help in deciding whether the patient was going in for other complications. Haemoglobin level was slightly less suggesting again that dietary intake could have been less. Caution must be taken to prevent anaemia. The high CRP level at 287 mg/L was indicative of the previous history of MI in Mr.Smith. It could also be an accompaniment of the middle lobe pneumonia, an infectious process. BP was slightly raised. Respiratory rate was 20/min. with shallow breathing. The saturated oxygen level was 98% using a 6-litre Hudson mask and it was the percentage of hemoglobin saturated with oxygen at the time of the measurement. The 98% was a favorable level but the best was the 100% saturation. An indwelling catheter had been inserted. An IV access was also found. Subsequent assessment In the assessment after one hour, the condition of the patient had