You are an Emergency nurse working in Accident and Emergency when Sally Smith a 38-year-old
schoolteacher is brought in with breathing difficulties pain in her chest and confusion.
The paramedics report she had influenza-like symptoms for the past five days and seems to be getting
worse.
References (in Text and End text) no less than 10 references 2006 and above only. More marks allocated
for recent Journal articles. I WOULD LIKE 14 REFERENCES with JOURNAL ARTICLES). NO WEBSITE PLEASE NO
Wikipedia
The Breathless patient
You are an Emergency nurse working in Accident and Emergency when Sally Smith a 38-year-old
schoolteacher is brought in with breathing difficulties pain in her chest and confusion.
The paramedics report she had influenza-like symptoms for the past five days and seems to be getting
worse. On assessment the paramedics find Sally tachypnoea confused and oxygen saturations of 90%
they commence high flow oxygen via a non-rebreather mask and insert an intravenous cannula into her
left hand.
After hand over you complete another set of observations and find Sally has:
Pulse 122bpm
BP 90/48mmHg
Temperature 38.6
RR 38
Despite her high flow oxygen Sallys oxygen saturations are only 90%. Mrs Smith is weak and unable to
support herself she cannot concentrate and your main concern is her Oxygen saturations are still
decreased since receiving high flow oxygen.
Question 1.Discuss in Detail how you would perform a full respiratory assessment and what you would
document in the patients notes. Include in our answer diagnostic tests that would be performed. and
how you would achieve accurate oxygen saturation readings with the saturation monitor.
Sallys condition further deteriorates quickly and she is diagnosed with Type 1 respiratory failure
secondary to a community-acquired pneumonia. She needs further respiratory support to improve her
oxygenation and close monitoring of her Arterial Blood Gases conscious state and respiratory effort.
Sally is moved from Emergency to the High Dependency unit within the hospital.
Question 2. Sally has been diagnosed with Type 1 respiratory failure; she is at risk of progressing to
Type 2 respiratory failure with tissue hypoxia. Discuss in detail Type 1 respiratory Failure and
interventions that Sally may require to prevent Type 2 respiratory failure.
Include in your answer Non Invasive ventilation (NIV) contraindications for using NIV monitoring her
conscious level and general nursing care that Sally may need.
Question 3. Sally requires antibiotics as part of her treatment. Research Roxithromycin Benzylpenicillin
Doxycycline and Ceftriaxone. Include Actions Route and Indications for use contraindications for use
and adverse drug reactions.
Question 4. Sallys Family are very concerned with her well being she is usually very fit and is only 38
years old. The family have asked for a meeting with the multi-disciplinary team members to discuss her
care. Who would you get involved to discuss Sallys care and what is their role within the team?
INTRUCTIONS:
This is a case study relating to Sallay Smith 38 years old having breathing difficulties chest pain and
confusion. There are four questions relation to this case study assessment. Below
Answer these separately with their individual questions as sub heading.
EXAMPLE QUESTION 1 QUESTION AS SUBHEADING FOLLOW BY ANSWER IN PARAGRAPH . THAT SHOULD
INCLUDE ALL ANSWERS RELATING TO QUESTION 1. WHEN ANSWERING QUESTION 1 USE APA 6TH
REFERENCING WITH INTEXT AND END TEXT WITH JOURNAL ARTICLES FROM 2006 TO 2014.
EXAMPLE QUESTION 2 (QUESTION AS SUBHEADING FOLLOW BY ANSWER IN PARAGRAPH . THAT SHOULD
INCLUDE ALL ANSWERS RELATING TO QUESTION 2. WHEN ANSWERING QUESTION 2 USE APA 6TH
REFERENCING WITH INTEXT AND END TEXT WITH JOURNAL ARTICLES FROM 2006 TO 2014.
QUESTION 3 AS SUBHEADING FOLLOW BY ANSWER IN PARAGRAPH . THAT SHOULD INCLUDE ALL ANSWERS
RELATING TO QUESTION 3. WHEN ANSWERING QUESTION 3 USE APA 6TH REFERENCING WITH INTEXT AND
END TEXT WITH JOURNAL ARTICLES FROM 2006 TO 2014.
QUESTION 4 AS SUBHEADING FOLLOW BY ANSWER IN PARAGRAPH . THAT SHOULD INCLUDE ALL ANSWERS
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