Emergency Nursing Assessment Framework Assignment

Emergency Nursing Assessment Framework - Assignment Example at bottom the care for process, use of the stated example has been demonstrated to be effective as a contextualised framework relevant to emergency conditions. This framework consists of 5 steps of history taking, potential red flags, clinical examination, investigations, and nursing interventions (Curtis, Murphy, Hoy, & Lewis, 2009).The inspection of his chest revealed intercostal muscle recession, and auscultation revealed diminished air entry at both bases of the lungs with crackles clunky in the right base. The respiratory rate was higher than the baseline at 28 per min with muddy and laboured breathing. His SpO2 was 89% on Hudson mask at 6 L of group O with elevation of PaCO2 to 54. tout ensemble these information indicate that he was in acute respiratory failure (Delerme & Ray, 2008).The clinical see indicates that this transition in respiratory function has occurred over a short period of time. This patient w as at baseline hypoxaemic indicated by his need for supplemental oxygen to maintain his oxygen saturations above 95%. Given his be on and potential blood loss due to fractured neck of right femur this is expected, although the history does not nominate any degenerative respiratory disease at the baseline (Calverley, 2003). This is an important part of history since quite frequently such patients develop acute respiratory failure superimposed on a chronic pulmonary condition such as chronic obstructive pulmonary disease, which is common in time-honored men of his age (OMalley, Marcantonio, Murkofsky, Caudry, & Buchanan, 2007).While initially 3 L of oxygen per min via nasal prongs ensured a 99% of SpO2 of 99%, postoperatively in 2 days time, his condition deteriorated. The assessment while trying to expire a diagnosis must include an attempt to determine causes for such changes. Although high temperature of 38.5 degrees Celsius may conduce to higher rate of breathing, the labou red breathing and findings at auscultation strongly suggests respiratory failure, which is further confirmed by rise of PaCO2 to above 50 (El Solh & Ramadan, 2006). While a fall of PaO2 to below 50 is expected, given his oxygen supplementation, this may not occur always unless there is severe respiratory failure. As expected the pH is 7.30 which is less than 7.35 indicating respiratory acidosis along with oxygen destaturation indicated by SaO2 of 89%, which is below normal (Antonelli, Pennisi, & Conti, 2003). The X-ray picture confirms right sided basal consolidation and collapse, which may indicate an infective episode, which perhaps is the cause of this failure, since the other former of overuse of PCA can be ruled out through the patients statement.Q2. The doctor initially prescribed two antibiotics. The later appearance of fever and concomitant respiratory failure due to consolidation and right sided pleural effusion leading to collapse indicated that this infection has been a cquired in the hospital.