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Select one of the nursing care interventions listed (A to C below) for the patients in the clinical scenarios. For the nursing intervention you select develop a discussion of the specific differences and similarities required in provision of nursing care for Mr. John as compared to Alice. Particularly focus on discussing how nursing care will need to be modified for the intervention selected based on the age and developmental considerations for each of the patients. Use a mix of contemporary text and research articles to support your discussion points. It is suggested that you use only a brief introduction and conclusion and employ the majority of the word length in addressing the focus of the assessment task.
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Length: 1000 words
Check the Criteria Referenced Assessment (CRA) grid to review assessment.
Clinical Scenarios
Interventions planned for both Mr John and Alice include the following:
A. maintain adequate level of oxygenation
B. maintain safety when mobilising out of bed
C. maintain hydration and positive fluid balance
Mr John is a frail looking 85 year old man admitted to hospital today with a 7 day history of a respiratory illness recently diagnosed as Influenza A with a secondary bacterial infection. He has experienced a severe productive cough fever and malaise. He looks pale and says he feels really awful faint and has a headache. His respirations are laboured and chest expansion is equal. In handover night staff said he was disorientated at times during the night and removed his oxygen mask so they changed him over to nasal prongs. Mr John currently has oxygen 2 litres per minute delivered by nasal prongs. His most recent vital signs are BP 140/85 mmhg lying down pulse 96 beats/minute and regular respirations 28 breathes/ minute temperature 37.8C and Sa02 95%. When the nurse inquires if he has pain Mr John says he has a dull ache in his upper back that has got a bit better since another nurse got him a hot pack. He has an intravenous bung in his right forearm through which antibiotics are administered Mr John usually lives independently with his wife of 60 years in their Brisbane home. He uses a walking stick when mobilising to aid his balance.
Alice is a 4-year-old girl accompanied by her mother and admitted today with a 72-hour history of a respiratory illness recently diagnosis as Influenza A with a secondary bacterial infection. She has experienced high fever frequent coughing and running nose at home. Mum Helen says I bought her in as she seemed so unwell and miserable Alice is unusually quiet and wants to stay in bed or be sitting on my lap which is very abnormal for her. Alice has an intravenous bung in her right forearm through which antibiotics are administered. Alice also has oxygen 1 litre per minute delivered by nasal prongs. Night staff said she removed the nasal prongs several times in her sleep and has been crying and angry when staff have cleaned mucus from her nostrils and replaced them. She told Helen it hurts when I cough. Her most recent vital signs are pulse 124 beats/minute and regular respirations 30 breathes/ minute temperature 37.8C Sa02 95%. Peripheral capillary refill on the skin of her knee is a little slow at 2 seconds. Both Alice and Helen are accommodated in a single room with Helen staying as a boarding parent. Alice is the youngest of 2 siblings in this family. Helen is able to stay in hospital with Alice as her other child is being cared for by her grandmother.
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