Part 1 Demonstrate the understanding of discharge plan
As per the given case, Tom lewis is a person whose age is 72 year old gentlemen. He has several health issues like abdominal discomfort, indigestion, fatigue and constipation. The major issue identified in the care of Tom is regarding to the age of patient, current medication and clinical observation (Anderson & Kaye, (2014). As he has several kinds of healthcare issue through which it is quite complex to identify each issue and provide care and medication accordingly. Furthermore, his age is too old through which new nurses and new fresher health experts can not able to provide treatment to them. In order to provide effective service to them there is requirement of high qualified and experienced health professional so as right services and care can deliver to them. Tom is independent with his activities of daily living. In order to deliver him a proper care and treatment there is requirement of systemic planning for 24 hours under which three kinds of therapy should provide that is indwelling catheter on hourly urine measure, vacuum wound drain in situ and 2L oxygen via the nasal prongs. In this planning of treatment and care of Tom, several kinds of medication will also include such as regular IVIparacetamol, aspirin 100mg daily, lipitor 20mg daily, PRN ondansetron and metaclopramide, patient controlled analgesia morphine 1mg bolus with five minutes lockout and intravenus infusion. With help of well systematic planning and time schedule of medication, effective service and care can deliver to them through which his health issue can improve (Marschall & Yokoe, (2014).
PART 2 Analyse the case to identify potential clinical issues:
There are many comorbility related to cardiac heart disease. It is related to heart failure. Generally, it occurs when heart can't pump enough blood and oxygen to support body. This can also result in heart attack (Morton & Gallo, 2017). As Tom has already got heart attack it is important to give timely treatment to him.
Smoking is very harmful for lungs. It can cause cancer. In case of Tom there is no relation of smoking with heart disease. It is because Tom smokes from 40 years so he will can have a heart attack. Smoking can lead to hypertension. It is because increase in stress will force person to smoke. This overall affects mental and physical health.
Heart disease can occur due to heart failure or heart attacks. It can lead to death. Therefore, it is very important to provide effective care within 24 hours otherwise it will lead to serious conditions. The reason for heart disease can be increase in cholesterol, hypertension, etc. there is high relation of comorbility of heart disease with other disease ()Anderson & Kaye, 2014).
There are certain complications that can arise in 24 hours time. It is given below :-
Smoking - As Tom is having a smoking history of 40 years. So it may be difficult to provide effective care to him. Also, he is 72 years old so it might be risk in providing care to him. Besides this, he is having history of rip replacement, MI, hypertension, high cholesterol, etc. Smoking can cause various disease.
Cardiac heart disease- Tom is already having a cardiac heart problem. So in 24 hours time his heart rate can increase leading to failure of heart (Shamian & Thomson, 2016). Also, he can have a heart attack. So it may be difficult to control this critical situation. Leading to these diseases can make Tom heart fail resulting in death. In heart disease 24 hours are very essential for saving life of a person.
The nurse can take various measures in order to prevent clinical deterioration. It is describes below :-
The nurse can provide effective and timely care to patients who are suffering from heart disease. They can ensure that medicines and food are provided timely to patients. Besides this, nurse can develop a plan that can be followed daily so that there is no problem or mistake in providing care (Roberts & Mant, 2015). Moreover, by making proper arrangements nurse can create a better and positive environment. They can also regularly do check up of patient like checking BP, heart rate, etc. to ensure proper functioning of body parts. They can frequently communicate with doctors so that proper care can be provided to them. In case of critical patients nurse can be available to them for 24 hours. This will be very beneficial in providing timely care to patients. Furthermore, nurse can be help in providing social care to person (Yokoe & Lo, 2014) By interacting with patient the needs can be identified. This will help in giving care in proper way.
In case of Tom it is been analysed that he was taken to postoperative acute care unit where his treatment was done. So it is very important to provide effective care to Tom in this stage. It is because he is already suffering from various disease. Besides this, Tom is having a midline incision with an occlusive dressing (Marschall & Yokoe, 2014). So it is essential to consult colorectal surgeon before removing dressing. The main intervention in this case are Tom past medical history and age. He is having high cholesterol and hypertension that is controlled by oral medication. These both can become a major problem. So if he omits this it can lead to serious situation. Tom should be given cholesterol free food to eat. Efforts must be made by Tom to quite smoking. This will help in making tom health better. Also, it will help in reducing cholesterol and hypertension. In my view heart disease patient should be treated by professional doctors. They must quickly take actions to provide basic care. This will be crucial in deciding further step. By interacting with patient the needs can be identified. This will help in giving care in proper way. Checking BP, heart rate can be useful in identifying condition of patient.