Acute Care: Care Implementation and Evaluation.
This assignment will be based around the care that is implemented and evaluated, within a National Health Service (NHS) Foundation Trust (FT). The focus of the assignment will be to discuss two health problems that a selected patient has and has been admitted to the FT with. The selected patient had been admitted into FT with breathing difficulties and also suffering from dehydration. The assignment will focus upon the goals that are set for the patient whilst in FT and the reasons why the goals are set. The patho-physiology of the two problems will also be discussed and also the care that had been implemented to achieve the goals. Throughout the assignment, the patient will be known as Terry with the permission from the patients parents, according to the Nursing and Midwifery Council (NMC, 2008) confidentiality guidelines. The assignment will also aim to discuss the role of the Health Care Professional (HCP) in planning appropriate care for the patient, in particular, using the assessment technique of goal setting by using Specific, Measurable, Achievable, Realistic and Time Set (S.M.A.R.T) target planning technique (Roper et al, 1996). The reasons for planning care can involve the HCP assisting in preventing potential health problems, for example, breathing difficulties for the patient becoming worse and to also assist in solving problems where possible. Care planning can also assist in alleviating possible health problems that cannot be solved by HCP’ s and so will need the assistance of Multi Disciplinary Team (MDT) , for example, consultant, physiotherapists to further improve an develop the care plan. Terry is a 42 year old single man, who lives with his parents, and has suffered from a number of illnesses throughout his life, for example, optical glyoma, Deep Vein Thrombosis (DVT), epilepsy, and also learning difficulties. Terry has difficulty with breathing, and this appears to have been caused by respiratory rhythmicity centre in the medulla and the pons (areas of the brain which can control breathing) and these appeared to not be working in the correct way (MacKenzie, 1996; Waugh et al 2006). Terry’s reduced neurological status was due to trauma that had been suffered in the motor pathways, and the peripheral nerves, in the brain (Iggulden, 2006). Terry was admitted to the Intensive Care Unit (ICU), within the NHS FT, suffering from numerous problems that were mainly neurological. Terry's admission to ICU was due to the increased breathing difficulties that he was experiencing. Due to the breathing difficulties, the nursing team, and Terry's consultant, agreed that it would be best for Terry to have a percutaneous tracheostomy inserted. Due to Terry suffering from a probable cerebellar lesion, severe learning difficulties and poor communication skills; it did appear that Terry could not understand what the nursing team were informing him of, the medication that he needed and the care that was being delivered (NMC, 2008). Due to the fact that Terry appeared not to be able to understand or communicate with the nursing team, and that his parents and family members were with him, the nursing team, and myself, ensured that the parents, and family members, were informed of what was happening regarding the care that had given to Terry. The fact that Terry could not understand the instructions given to him, due to learning difficulties, consent to insert a percutaneous tracheostomy had to be given from Terry’s parents, to the Consultant (NMC, 2008).The tracheostomy that had been inserted into Terry helped the nursing team in the ICU and on the ward, to oxygenate Terry to the optimum level of 98%. The tracheostomy, also ensured that Terry was able to maintain a breathing rate of between 35 and 50 breathes per minute (Bailey, 2008). Although Terry was able to maintain a respiration rate, the normal respiration rate for an adult is normally between 14 and 18...
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