Multidimensional Care For Sarah - Directions And Information

Topic Multidimensional Care For Sarah 6directionssarah Is A 69 Year

Sarah is a 69-year-old female who presented to the emergency department with shortness of breath. Her past medical history includes anxiety and PTSD. Her pulse oximetry on room air is 82%, and she reports numbness in her fingers. The provider orders oxygen at 2 L via nasal cannula. Her chest X-ray reveals no abnormalities. Arterial blood gas results show a pH of 7.40, PaCO2 of 28 mm Hg, PaO2 of 78 mm Hg, and HCO3 of 26 mEq/L. She is admitted to a general medical floor, and as the nurse assigned to her, several critical issues and care strategies need to be considered.

Paper For Above instruction

In caring for Sarah, a comprehensive, multidimensional nursing approach is essential to address her immediate respiratory needs, underlying psychological conditions, and potential complications. The initial findings of hypoxemia, with an oxygen saturation of 82% despite supplemental oxygen, along with her symptoms of numbness in her fingers, suggest potential issues such as inadequate oxygenation, possible hyperventilation, or neurological concerns. The arterial blood gas (ABG) results provide important data indicating that her pH is normal, but her low PaCO2 (28 mm Hg) suggests respiratory alkalosis due to hyperventilation, which may be a response to her anxiety or distress.

Potential Problems Based on Findings

Several problems can arise from Sarah’s condition. First, persistent hypoxemia poses a risk of tissue hypoxia, affecting vital organs such as the brain, heart, and kidneys. While her ABG indicates that her oxygenation is somewhat adequate at 78 mm Hg, her saturation remains low, and increasing oxygen delivery may be necessary. Second, her numbness in the fingers can indicate hypoxia or neurological impairment, requiring careful monitoring and further assessment. Third, her hyperventilation, evidenced by low PaCO2, may lead to respiratory alkalosis, which can cause vasoconstriction and decreased cerebral blood flow, worsening her neurological status. Fourth, her history of anxiety and PTSD increases the risk of exacerbating her distress, potentially worsening her respiratory and cardiovascular status if not managed appropriately. Additionally, her age predisposes her to comorbidities such as cardiovascular disease and respiratory compromise, complicating her recovery.

Multidimensional Care for Sarah

Caring for Sarah requires a holistic, patient-centered approach encompassing physical, emotional, and psychosocial domains. Physically, her immediate priority is optimizing oxygenation. Increasing oxygen delivery to maintain SaO2 above 92% is crucial, potentially by adjusting oxygen flow or using interval oxygen therapy. Monitoring her ABGs regularly helps assess her ventilation status and guides therapy adjustments. Given her low PaCO2, interventions to reduce hyperventilation include positioning strategies, relaxation techniques, and potentially pharmacological interventions like anxiolytics if appropriate, under medical supervision.

Addressing her psychological needs is equally important. Her history of anxiety and PTSD necessitates interventions aimed at reducing psychological distress, such as providing reassurance, maintaining a calm environment, and involving mental health professionals if needed. Nursing care involves establishing trust, using therapeutic communication, and assessing her mental status continuously. The involvement of a multidisciplinary team—including mental health professionals—supports her emotional well-being and promotes a more favorable recovery trajectory.

Nutrition and mobility are additional considerations. As she stabilizes, maintaining adequate hydration and nutrition supports her immune function and overall health. Mobilization as tolerated prevents complications of immobility, such as pressure ulcers and thromboembolism. Physical therapy consultations may be necessary to assist her in regaining mobility and strength.

Furthermore, comprehensive safety measures include skin assessments, fall precautions, and vigilant monitoring for signs of respiratory deterioration, such as increasing work of breathing or altered mental status. Education about her condition, medication adherence, and identification of early warning signs empower her to participate actively in her care.

Roles of Other Departments in Sarah’s Treatment Plan

The multidisciplinary approach involves collaboration among various hospital departments to optimize her care. The respiratory therapy department plays a key role in managing oxygen therapy, assessing her ventilatory status, and providing inhalation therapies if necessary. Respiratory therapists also assist with nebulization or ventilator support if her condition worsens. The mental health team, including psychologists or psychiatrists, provides support for her PTSD and anxiety, addressing her psychological needs that directly impact her physical health. They can implement behavioral therapies, prescribe anxiolytics if appropriate, and develop coping strategies to reduce her distress.

The physiotherapy team is vital in promoting mobility and preventing complications associated with immobility. They develop individualized exercise programs to enhance her respiratory function and physical strength. Pharmacists ensure safe medication management, especially considering her age, comorbidities, and psychological medications, to avoid adverse drug interactions. Social workers assist with discharge planning, evaluating her support system, and addressing barriers to care, such as transportation or home safety. Nursing staff coordinates these efforts, ensuring seamless communication among departments and providing ongoing patient education and support.

This multidimensional approach not only addresses her immediate clinical needs but also promotes her holistic well-being, fostering recovery and preventing future complications. Continuous assessment and adaptation of the care plan, based on her evolving condition, are essential components of effective nursing practice.

Conclusion

Sarah’s case exemplifies the importance of multidimensional nursing care, integrating physiological management with emotional and psychological support. Addressing her hypoxemia, hyperventilation, and neurological symptoms through coordinated efforts across multiple departments can improve her health outcomes. A comprehensive, patient-centered approach ensures she receives optimal care and is supported holistically throughout her recovery process.

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