Background Patient name: Ngarla Kngwarreye Age: 62 Next of Kin: Son Gwoya and Daughter's Inala and Jenna Consultant: Dr Parry. Diagnosis: End Stage Chronic Obstructive Pulmonary Disease Patient notes Ngarla Kngwarreye is a 62 year old Anmatyerre woman from Urpuntia in Central Australia. 2 years ago Ngarla developed a Hospital Acquired Pneumonia during a hospital stay for exacerbation of her COPD. Since this time her lung function has continued to deteriorate until 6months ago she was admitted to hospital with respiratory failure and her conditioned was critical, at discharge her COPD was categorised as End-Stage. Three days ago Ngarala was again admitted with exacerbation of her COPD requiring extensive oxygen support, multiple antibiotics and high dose steroids to stabilise her. You are the nurse responsible for her care. Since admission, Ngarla's condition has failed to improve, her breathing has progressively worsened and she is now in the deteriorating palliative care phase of her illness. A family meeting has been held online (facilitated by the local community health nurse) with Ngarla, her family medical and nursing staff in the hospital and the community support available at home. During this discussion decisions concerning her ongoing care were made. Ngarla has decided that she wanted to return to country with a package of care designed to enable her to die at home and to support her family. An initial clinical assessment was conducted by the consulting palliative care nurse who visited Ngarla on the medical ward. This information is to be used in the referral to the community palliative care nursing team Vital signs His last vital signs were taken at 0800 today: BP: 114/58 mmHg HR: 90 bpm RR: 20 bpm Temp: 35.8 SpO2: 84% RA 88% 2l02 NP Regular Medication Budesonide/formoterol (Symbicort) 2 MDI BD Tiotropium (Spiriva)1 cap MDI OD Prednisolone 5mg Mane Doxcycline Hyclate 50mg BD Coloxy and Senna 2 tablets Nocte Morphing SR (MS Contin) 5mg BD PRN Medication Salbutamol 2 MDI Shortness of breath 4/24 Movicol sachet 1-2 Mane PRN constipation Morphine Elixir 1mg every 2/24 maximum dose 10mg Question? Identifies and utilises high level evidence to develop, inform and support care plan actions.
Background
- Patient name: Ngarla Kngwarreye
- Age: 62
- Next of Kin: Son Gwoya and Daughter's Inala and Jenna
- Consultant: Dr Parry.
- Diagnosis: End Stage Chronic Obstructive Pulmonary Disease
Patient notes
Ngarla Kngwarreye is a 62 year old Anmatyerre woman from Urpuntia in Central Australia. 2 years ago Ngarla developed a Hospital Acquired Pneumonia during a hospital stay for exacerbation of her COPD. Since this time her lung function has continued to deteriorate until 6months ago she was admitted to hospital with respiratory failure and her conditioned was critical, at discharge her COPD was categorised as End-Stage. Three days ago Ngarala was again admitted with exacerbation of her COPD requiring extensive oxygen support, multiple antibiotics and high dose steroids to stabilise her. You are the nurse responsible for her care.
Since admission, Ngarla's condition has failed to improve, her breathing has progressively worsened and she is now in the deteriorating palliative care phase of her illness. A family meeting has been held online (facilitated by the local community health nurse) with Ngarla, her family medical and nursing staff in the hospital and the community support available at home. During this discussion decisions concerning her ongoing care were made. Ngarla has decided that she wanted to return to country with a package of care designed to enable her to die at home and to support her family.
An initial clinical assessment was conducted by the consulting palliative care nurse who visited Ngarla on the medical ward. This information is to be used in the referral to the community palliative care nursing team
Vital signs
His last vital signs were taken at 0800 today:
- BP: 114/58 mmHg
- HR: 90 bpm
- RR: 20 bpm
- Temp: 35.8
- SpO2: 84% RA 88% 2l02 NP
Regular Medication
- Budesonide/formoterol (Symbicort) 2 MDI BD
- Tiotropium (Spiriva)1 cap MDI OD
- Prednisolone 5mg Mane
- Doxcycline Hyclate 50mg BD
- Coloxy and Senna 2 tablets Nocte
- Morphing SR (MS Contin) 5mg BD
PRN Medication
- Salbutamol 2 MDI Shortness of breath 4/24
- Movicol sachet 1-2 Mane PRN constipation
- Morphine Elixir 1mg every 2/24 maximum dose 10mg
Question? Identifies and utilises high level evidence to develop, inform and support care plan actions.
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