Acute Nursing Care
Recognising and Responding to Medical Emergencies
Helen Dutton, Ian Peate, Helen Dutton, Ian Peate
- 580 pages
- English
- ePUB (mobile friendly)
- Available on iOS & Android
Acute Nursing Care
Recognising and Responding to Medical Emergencies
Helen Dutton, Ian Peate, Helen Dutton, Ian Peate
About This Book
Delays in recognising deterioration, or inappropriate management of people in acute care settings can result in late treatment, avoidable admissions to intensive care units and, in some instances, unnecessary deaths. As the role of the nurse in healthcare settings continues to change and evolve, today's nursing and other healthcare students need to be equipped with the fundamental skills to recognise and manage deterioration in the patient in a competent and confident manner, appreciating the complexities of caring for those who are acutely unwell as you learn to become practitioners of the future.
Using a body systems approach, and fully updated in light of new NEWS2 and NMC future nurse standards, as well as acknowledging the challenges faced by people with delirium in acute care settings, the second edition of this book provides a comprehensive overview of the essential issues in this important subject. Topics covered include recognition and identification of physiological and mental deterioration in adults; identification of disordered physiology that may lead to a medical emergency linked to deterioration of normal function; relevant anatomy and physiology; pathophysiological changes and actions that need to be taken; immediate recognition and response; investigations, diagnosis and management issues; and teaching and preventative strategies.
Including case studies and test yourself questions, this book is an essential tool for student nurses who are required to undertake acute care experiences and are assessed in theory and practice.
Frequently asked questions
Information
1 Assessment and recognition of emergencies in acute care
- Give an overview of developments to date aimed at supporting the adult who has the potential to become acutely unwell.
- Understand that there are usually clinical signs of deterioration many hours before most life-threatening events.
- Use the National Early Warning Score (NEWS) 2 as a tool to calculate risk, escalate care and become familiar with interdisciplinary communication tools, such as SBAR.
- Perform, analyse and interpret a rapid clinical assessment of a patient who is at risk of deterioration/medical emergency.
- Understand how a āchain of preventionā can be used to structure processes to detect patient deterioration.
- Have a context on which to base future chapters in recognising and responding to medical emergencies.
Introduction
Recognition of the problem
Early identification
Example of acute illness | Physiological derangements and clinical consequences | Signs of compensation that may be evident |
Airway swelling | Airway obstruction Failure to ventilate causing hypoxaemia and hypercarbia | Raised HR and blood pressure Intercostal retraction |
Acute asthma | Bronchoconstriction reducing airflow through bronchioles and alveoli. Work of breathing increased. Sp02 falls, hypercarbia may follow | Raised respiratory rate, HR, BP Use of accessory muscles |
Pneumothorax | Presence of air in the pleural space, leading to lung collapse Pain Hypoxaemia | Sensation of breathlessness, Use of accessory muscles increasing RR, HR and BP |
Myocardial infarction | Death of myocardium due to blockage of a branch of a coronary artery Pain | Raised RR, HR, BP, peripheral vasoconstriction. |
Acute left ventricular failure | Failure of the left ventricle to pump blood effectively into the aorta and round the body. Pulmonary venous pressures rise, causing the development of pulmonary oedema, hypoxaemia, frothy sputum | Profound respiratory difficulty and distress Raised RR & HR Use of accessory muscles, peripheral vasoconstriction. |
Hypovolaemic shock | Reduction of amount of blood/fluid in the circulation Hypoxaemia | Raised respiratory rate, lowered HR, lowered BP, peripheral vasoconstriction |
Sepsis | A dysregulated response to infection causing organ damage Inflammatory mediators cause vasodilation and increased capillary permeability | āNew confusionā Raised HR, RR Warm and dilated peripheries Lowered BP |