Present case defines issue of pain facing by John during breathing. For this regular medication and effective handling of systolic blood pressure is required. There are different type of aspects that are required to be focussed upon.
- Determine factors for patient safety for every phase.
- Identify primary treatments.
- Underline issues facing by John Smith.
- Analyse the concept of Central Venous access insertion.
INTRODUCTION
This report is based on the patient whose name is John Smith who is 81 years old retired farmer which married to Jean. One day, John Smith is found semi-conscious and his wife Jean has taken him into the hospital. While having primary observation he has been found that his RR 28, SpO2 90% RA, GCS15, HR94 Sinus rhythm, T36.4 tympanic, and have hypertension of 122/64 and also have discomfort which totally shows in the left buttock. For that he has given an appropriate treatment for lowering down the drugs in an effective manner (Daver and et. al., 2015).
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Part 1
The brief examination when conducted on John, it has been identified that respiratory rates was around 28 which is normal considering age of patient. The normal respiratory rate of a person for 80 year and older ranges between 10-30. the next step is considered to check the saturation of red blood cells through SpO2 which stood near 90%. which also emerged to normal taking into account age of an individual. The next step which was taken up by the practitioners is to identify the level of consciousness which is being possessed by patient. The results which were identified with the GCS tests is that this patient has been suffering from mild brain injury. The neurological symptoms which were being portrayed by the patients can results in damages in the neurological systems which were further established through CT scan and MRI. Upon further tests and examination, it was identified that the patient has been experiencing severe pain on the left side of the body. There was abrasion on left side of the chest, his back and going until his left hip joint. The pain in the left part of the body was being rated 8/10 which means it is severe and unbearable for the patient. It was discovered that this patient has been taking medication for hypotension as he was experiencing a lower blood pressure (Buyukasik and et. al., 2013).
The primary treatment which was given to patient is FiO2 6L, the reason being the person is encountering with difficulty with breathing. This approach attempts to insert two cannulas in nasal of a person so that flow of oxygen could be enhanced and leading to make an individual ambulate. There is a use of 20G IVC in R cubital fossa so that central catheter is being placed between the arteries so that pulse could be controlled. The pain which has been encountered by an individual is being countered with morphine with nominal dosage. However, it is said that morphine dosages ideal for person suffering from heart diseases and severe pain. Considering the history of the individual, there are strong chances that this individual is being experiencing with TIA, but considering pain in the thigh it can be said that chances of recurrence of GORD are strong. The symptoms which are being portrayed by a person are a combination of both the disease therefore it is essential to make sure that necessary tests are to be conducted in the ideal manner so that treatment can be initiated.
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Phase 2
John is facing severe pain while having breathing and it is observed that Pt states pain in L hip as 6/10 while having rest and 10/10 on the movement. By assessing it has been found that the respiratory rate of the tells the number of breaths per minute, or can be seen that the number of movements indicative of inspiration and expiration per unit time. In practical, respiratory rate is normally identified by counting various times chest up and down per minute. Aim of evaluating respiratory rate is to identify whether the respirations are within the range, abnormally fast and abnormally slow. In this cited case, John is having his respiratory rate 26 which is beyond the normal thing. As this would lead to have the respiratory problems.
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