Bachelor Nursing Patient Scenario

Question: Discuss about theBachelor Nursingfor Patient Scenario. Answer: I did mistake in using blood pressure cuff for blood pressure measurement in Mr. Fox. I used wider blood pressure cuff than required. Proper positioning of the blood pressure cuff is very important in collecting blood pressure data. Now I realized that, blood pressure cuff should be approximately 40 % of circumference of the limb size. I know this fact, however performing actual procedure, I didnt gave much attention to it. I think, there may be less blood pressure recording as compared to the actual blood pressure. Next time, I would definitely give proper attention to use accurate blood pressure cuff to measure exact blood pressure in Mr. Fox (McKinnon, 2016). Mr. Steven Fox is 73 years old and admitted to medical centre due to fall. He looks pale and feels tired and dizzy. He lost his interest in eating and drinking. He has hypertension since last 30 years which is under control by use of medications. He also has hernia which repaired 2 years ago and asthma. He has seafood and hives allergy. He is having habit of 1 to 2 beers every week. Before 20 years, he used to smoke 1 pack per day. He married since 50 years and he has 2 sons and 5 grandchildren who stays in the nearby suburb. He is a retired banker and stays in the 4 bed room house in North Sydney. Most of the time his health condition is stable at home and he used to perform physical activity in the form of swimming. Yesterday, he was confused whether he took antihypertensive medication or not. Hence, he took it again. After 6 hours of consumption of medication, he urged to use bathroom and fall in the bathroom at 0400 hours. His vital signs were measured at 0600 and 07300 hours in the emergency department (Cooper Frain, 2016). Collect Information: His vital signs are as follows: Blood pressure 110/50 mm/Hg, pulse 110 beats/minute, temperature 36.5?C and respiratory rate 17 breaths/minute. Other than this new information should be gathered for Mr. Fox. This information includes : appetite nil, oral intake reduced, cognitive state confused, color pale, physical status tired and dizzy and level of thirst increased thirst. His medical history indicates that he is associated with hypertension and patients with hypertension usually have increased thirst. He is also suffering through asthma and patients with asthma and hypertension usually feels tired (Berman et al., 2014). Process Information: Blood pressure measured in Mr. Fox is 110/50 mm/Hg. Normal blood pressure should be 120/80 mm/Hg. It indicates that his systolic blood pressure is in the normal range and diastolic blood pressure is in hypotensive stage. This might have occurred due to excess consumption of the antihypertensive medication. He might have consumed this medication two times because he was not sure whether he had consumed his medications yesterday. His pulse rates are 110 beats/minute. It is evident that, his pulse rate is increased. Normal pulse rate should be between 60 to 100 betas/minute. In patients with hypotension, heart starts to pump blood at faster rate. Thus might be reason for increase in the pulse rate in Mr. Fox. His respiratory rate is 17 breaths/ minute and it is in the normal range. Normal respiratory rate should be between 10 20 breaths per minute. His recorded body temperature is 36.5?C and it is in the normal range. Normal body temperature should be between 36.1?C to 37.2?C. Patients with hypotension are usually exhibit dizziness and tiredness (Levett-Jones, 2013; Cook, 2014). From the collected information and based on the medical history of Mr. Fox, it is evident that nursing intervention should be provided to Mr. Fox for hypotension developed due to excessive consumption of medication, increased pulse rate, eating and drinking, pale skin and dizziness. Hypotension may cause hypovolemia and as result anaemia in Mr. Fox. This anemia may result in the shock and loss of counsiousness in Mr. Fox. It is evident that, his diastolic blood pressure is very low. Due to this Mr. Fox may enter in the coma state also. Due to hypotension, he may not concentrate properly and fainting can occur. This can lead to further fall in him. There are increased chances major injury to the body and bleeding due to fall in him. However, in case of hypotension patients, it would be difficult to stop bleeding. This can further exaggerate hypotensive state in him. Mr. Fox dislikes eating and drinking. It can lead to electrolyte imbalance which may increase chances of fall and also h ypotension in him. Thachycardia which is increased pulse rate can increase chances of blood clot in Mr. Fox which may lead to stroke. Frequent fainting and uncosciuosness may be there in Mr. Fox due to tachycardia, which can increase chances of fall in him. Due to thachycardia, heart may not pump blood in proper way. Hence, there may be chances of heart failure in case of Mr. Fox (Alfaro-LeFevre, 2012; Smith Roberts, 2011). Reflection: At the time of collection of vital sign data, I maintained reflective communication with him and his family members. I was explaining them all the procedures to be used for him. By this Mr. Fox would not feel anxiety about the procedures to be performed on him. He felt comfortable with all the procedures and extended cooperatation in recording vital signs. It would be helpful in maintaining normal vital signs in him. This patient centered approach is my strength in nursing practice. I developed this skill since my college days. I used to talk to patients very politely and cardinally. I used to understand their problems and tried to give solution for their problems. This helped to build strong bond with patients. Same approach, I applied for Mr. Fox also. In Mr. Fox also, this approach helped to get accurate vital sign data of Mr. Fox (Bulman Schutz, 2013). References: Alfaro-LeFevre, R 2012, Applying Nursing Process: The Foundation for Clinical Reasoning, 8th edn. Lippincott Williams Wilkins, London. Berman, A, Snyder, S, J, Kozier, B, Erb, G, L., et al., 2014, Kozier Erb's Fundamentals of Nursing Australian Edition, 3rd edn. Pearson Higher Education AU, Melborne. Bulman, C Schutz, S 2013, Reflective Practice in Nursing, 5th edn, John Wiley Sons, N.J. Cook, R 2014, Vital Signs, Pan Macmillan, N.J. Cooper, N Frain, J 2016, ABC of Clinical Reasoning, John Wiley Sons, N.J. Levett-Jones, T 2013, Clinical Reasoning: Learning to Think Like a Nurse, Pearson Australia, Melborne. McKinnon, J 2016, Reflection for Nursing Life: Principles, Process and Practice, Routledge, New York. Smith, J Roberts, R 2011, Vital Signs for Nurses: An Introduction to Clinical Observations, John Wiley Sons, N.J.