Mods Case Study
Homeostasis and Pain Management in Patient with Multisystem Failure
Western Governor’s University
Multisystem organ failure, also known as multiple organ dysfunction syndrome, is defined by The Principles of Internal Medicine as the “dysfunction of more than one organ, requiring intervention to maintain homeostasis” (Braunwald et al., 2001). To adequately assess multisystem organ failure in regards to Mrs. Baker, the emergency room nurse caring for Mrs. Baker must be concerned with maintaining homeostasis, assess her level of oxygenation and pain level as well. The emergency room nurse must first go back to nursing basics and remember her ABCs; airway, breathing and circulation. The airway must first be secured as the case study indicates that Mrs. Baker became unresponsive after having a difficult time breathing. The initial assessment shall include vital signs, oxygenation, level of consciousness, blood sugar, and pain. The taking of vital signs will provide an abundance of information with blood pressure, temperature, pulse and respirations being monitored frequently for changes as these are clues to what is happening in Mrs. Baker’s body. If the blood pressure were to decrease, this could indicate dehydration. If the temperature increases, this could be indicative of an infectious process. An increase in the pulse could indicate dehydration or blood loss and an increase in respirations could indicate stricture in the airway or not enough oxygen being circulated. Though vital signs must be taken often to give the provider direction in his or her assessment, they are not the only thing to be immediately assessed. To continue assessing homeostasis a pulse oximeter should be used to assess oxygenation as lower levels can cause difficulty breathing and lead to unresponsiveness similar to what Mrs. Baker is experiencing. Assessing skin color is also another way to evaluate oxygenation; a blood gas would also be helpful in determining adequate oxygenation. While all
Western Governor’s University
Multisystem organ failure, also known as multiple organ dysfunction syndrome, is defined by The Principles of Internal Medicine as the “dysfunction of more than one organ, requiring intervention to maintain homeostasis” (Braunwald et al., 2001). To adequately assess multisystem organ failure in regards to Mrs. Baker, the emergency room nurse caring for Mrs. Baker must be concerned with maintaining homeostasis, assess her level of oxygenation and pain level as well. The emergency room nurse must first go back to nursing basics and remember her ABCs; airway, breathing and circulation. The airway must first be secured as the case study indicates that Mrs. Baker became unresponsive after having a difficult time breathing. The initial assessment shall include vital signs, oxygenation, level of consciousness, blood sugar, and pain. The taking of vital signs will provide an abundance of information with blood pressure, temperature, pulse and respirations being monitored frequently for changes as these are clues to what is happening in Mrs. Baker’s body. If the blood pressure were to decrease, this could indicate dehydration. If the temperature increases, this could be indicative of an infectious process. An increase in the pulse could indicate dehydration or blood loss and an increase in respirations could indicate stricture in the airway or not enough oxygen being circulated. Though vital signs must be taken often to give the provider direction in his or her assessment, they are not the only thing to be immediately assessed. To continue assessing homeostasis a pulse oximeter should be used to assess oxygenation as lower levels can cause difficulty breathing and lead to unresponsiveness similar to what Mrs. Baker is experiencing. Assessing skin color is also another way to evaluate oxygenation; a blood gas would also be helpful in determining adequate oxygenation. While all
References: Braunwald, E., Fauci, A., Kasper, D., Hauser, S., Longo, D., & Jameson, J. (2001) Harrison’s principles of internal medicine (15th ed.) Evaluation of the organic dysfunction in elderly patients in the intensive care unit. (2003). Critical Care Fillion, L., Fortier, M., Gelinas, C., Puntillo, K., Viens, C. (2004). Pain assessment and management in critically ill intubated patients: A retrospective study Mauk, K. (2010). Gerontological nursing: Competencies for care. Jones & Bartlett Learning: Woods Hole, Ma. National Institute of Health. (January 17, 2007). NIH Pain Consortium. Retrieved July 31, 2012, from http://painconsortium.nih.gov/pain_scales/index.html. Nursing 2012 drug handbook (32nd ed). (2012). New York, NY: Wolters Kluwer/Lippincott Williams & Wilkins Rauen, C, and C. Stamatos. (1997). Caring for geriatric patient with MODS. The American Journal of Nursing, 97 (5), p