301 Part A
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University of Wollongong *
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301
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Health Science
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Feb 20, 2024
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SNUG301 Managing Deterioration 2024
Assessment 1: Part A
Airway and Breathing
1.
In your own words, describe the underlying condition, Review the SAGO chart, and identify and connect the early and late warning signs
.
The Underlying condition that Mr Matisse is experiencing, is an exacerbation of COPD. An exacerbation of COPD is essentially the worsening or a “flare up” of the COPD symptoms. Mr
Matisse has a history of Smoking which is primarily relevant due to smoking being a major risk factor to the exacerbation of COPD. Mr Matisse has previously required hospitalisations due to smoking, leading us to believe that this is the primary cause for this COPD exacerbation.
Indicators of increased respiratory distress are early warning signs of exacerbation of COPD. An early sign that Mr Matisse displayed was increased dyspnoea which is a common symptom of airflow restriction. Another warning sign displayed was the increasing sputum production which indicates a restriction within the airways, creating shortness of breath. Late warning signs indicate a serious deterioration in respiratory function. Mr Matisse displayed an increase in his Respiratory Rate, which is the body trying to make up for the decline. This also caused his Sp02 to drop as insufficient oxygen supply was being circulated,
which can result in a spike of Blood Pressure and Heart Rate. Recognising and addressing the early warning signs, prevents the progression of the exacerbation and eliminates the need of identifying the late warning signs. 2.
Apply a systematic Person-Centred Approach to Assessing Sudden Deterioration. Develop an Immediate Plan of Care for Sudden Deterioration
It is essential to apply a Person-centred approach to the sudden deterioration of Mr Matisse. This is extending beyond the clinical aspects, and viewing the personal aspects of Mr Matisse. This requires incorporating his background, personal preferences, and wellbeing. Providing a holistic view allows for a comprehensive assessment beyond just the clinical aspects. The most essential component of the immediate care is to ensure that Mr Matisse is supported, and reassured throughout all components of care. A continuous evaluation of his wellbeing should be completed alongside clinical care. The clinical aspect of the immediate plan of care would be to call a rapid response due to the respiratory distress displayed. Sitting Mr Matisse up into a high fowlers position and adjust oxygen therapy, to allow for better airflow. Administering a short acting bronchodilator relaxes the muscles in the lungs and widens the bronchi to make breathing easier. During this process, we would continue to monitor Mr Matisse’s RR/HR and Sp02 to ensure he is breathing easier. 117fdfd7c72373e03278834f56439ed3b0d9831c.docx
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Continuing communication with the healthcare team is important to ensure care is provided
promptly and correctly, this communication must continue on even once Mr Matisse is stabilised to ensure that a person-centred approach is applied and long-term solutions can be established.
3.
Outline Recommendations with rationales for ongoing nursing care interventions and
planning. Continuing to monitor and adjust appropriate interventions is essential for the ongoing care of Mr Matisse. The exacerbation of COPD requires continuous assessment and care due to its dynamic nature. This monitoring includes full counts of RR, HR, breath sounds and effectiveness of implemented interventions. Monitoring Sp02 and making any necessary adjustments is also very important. The recommendations given to Mr Matisse would be a referral to a respiratory specialist to optimise respiratory function and offer techniques to maximise future exacerbations, ultimately improving his outcome. We would provide Mr Matisse wit patient education prior to discharge on the management of COPD and lifestyle modifications to suit this. Including recognising the early signs of exacerbation, medication adherence, and the significance of adopting a smoke free lifestyle for long term management. 117fdfd7c72373e03278834f56439ed3b0d9831c.docx
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