Homeostasis and Pain Management in Multi-System Failure
Homeostasis and Pain Management in Patient with Multisystem Failure
Homeostasis and Pain Management in Patient with Multisystem Failure
A. Assessment of Patient
The assessment of Mrs. Baker should include vital signs including pulse oximetry. Given her difficulty in breathing, lung sounds should be auscultated. Because she is on two different medications that could affect blood pressure, lisinopril and hydrochlorothiazide (HCTZ), hypotension could be one cause of her collapsing. In addition to vital signs, decreased peripheral pulses and capillary refill can also be indicators of hypotension. Also, because HCTZ is a diuretic, dehydration should be considered. Since she was in her backyard when she collapsed, it could be that she was doing yard work. Thus, it is important to know what she was doing before she collapsed. The outside temperature and whether Mrs. Baker became overheated or drank enough fluids could be useful factors in assessing her fluid-electrolyte balance. Serum electrolyte levels and vital signs should be taken, and color and skin turgor should be assessed. Dehydration could also contribute to hypotension. Mrs. Baker should be placed on a cardiac monitor and an EKG obtained to rule out any dysrhythmias. Given Mrs. Baker’s respiratory symptoms and her history of hypertension and diabetes (which are the two biggest risk factors for congestive heart failure), a chest x-ray should be done. Arterial blood gases could assist in further assessing her oxygenation, as well as acid-base balance. Also, since Mrs. Baker is a diabetic, a blood glucose level should be done, since hypoglycemia could be a cause of her mental status changes.
When Mrs. Baker is alert, pain can be assessed through a verbal “numbers” scale, or a “faces” scale if she is mildly confused. When she becomes unresponsive, non-verbal indicators of discomfort should be observed, such as muscle tension, grimace, and grunting. B. Technological Tools
A stethoscope is an
Homeostasis and Pain Management in Patient with Multisystem Failure
A. Assessment of Patient
The assessment of Mrs. Baker should include vital signs including pulse oximetry. Given her difficulty in breathing, lung sounds should be auscultated. Because she is on two different medications that could affect blood pressure, lisinopril and hydrochlorothiazide (HCTZ), hypotension could be one cause of her collapsing. In addition to vital signs, decreased peripheral pulses and capillary refill can also be indicators of hypotension. Also, because HCTZ is a diuretic, dehydration should be considered. Since she was in her backyard when she collapsed, it could be that she was doing yard work. Thus, it is important to know what she was doing before she collapsed. The outside temperature and whether Mrs. Baker became overheated or drank enough fluids could be useful factors in assessing her fluid-electrolyte balance. Serum electrolyte levels and vital signs should be taken, and color and skin turgor should be assessed. Dehydration could also contribute to hypotension. Mrs. Baker should be placed on a cardiac monitor and an EKG obtained to rule out any dysrhythmias. Given Mrs. Baker’s respiratory symptoms and her history of hypertension and diabetes (which are the two biggest risk factors for congestive heart failure), a chest x-ray should be done. Arterial blood gases could assist in further assessing her oxygenation, as well as acid-base balance. Also, since Mrs. Baker is a diabetic, a blood glucose level should be done, since hypoglycemia could be a cause of her mental status changes.
When Mrs. Baker is alert, pain can be assessed through a verbal “numbers” scale, or a “faces” scale if she is mildly confused. When she becomes unresponsive, non-verbal indicators of discomfort should be observed, such as muscle tension, grimace, and grunting. B. Technological Tools
A stethoscope is an
References: Schunk, K. What is a stethoscope and how does a stethoscope work? Retrieved from http://acousticheart.com/what_is_a_stethoscope_and_how_does_a_stethoscope_work.html