Could I please have some assistance for identifying three cr
Could I please have some assistance for identifying three critical… Could I please have some assistance for identifying three critical problems (time-critical nursing diagnoses) based on Meg Wright’s case study. I have highlighted the abnormal cues in green and have pasted my answer for Meg Right’s current situation and the conditions’ pathophysiology that is affecting her. Theis the last pasted picture down below.Image transcription text2. Collect Cues DETECT ASSESSMENT A-E Cues collectedat 22:40 pm Normal ranges A-Airways Patent PatentB-Breathing RR 24 Sp02 96% RA pvCO2 39 mm… Show more… Show moreImage transcription textIn ED – Triage At 10:30 PM – Meg Wright, 83-year-old female, wassent in from a nursing home to the ED with a 15-hour history ofacute confusion that started in the morning. Staff fr… Show more… Show moreImage transcription text4. IDENTIFY CRITICAL PROBLEMS Youcan score up to 6 marks if you prioritisethree (3) relevant and time… Show more… Show moreAirway: Patent Breathing: RR 24 (the patient is hyperventilating as a compensatory mechanism due to the presence of metabolic acidosis) PvCO2 (this is also a compensatory mechanism of the respiratory system because of the presence of metabolic acidosis) Circulation:HR 125, tachycardia (this is a compensatory mechanism of the heart because the patient is having decreased perfusion in the body or hypovolemic shock as evidence by weak pulse, BP 85/55, delayed capillary refill (Normal: 1-2s), cool clammy skin, and shivering to touch) Ph = 7.27, HCO3 = 20 mmo/L – this is a metabolic acidosis partially compensated(partially compensated since the PVCO2 of the patient is towards alkalosis side, meaning the respiratory is trying to compensate from the metabolic acidosis, it will be only “fully compensated” if the patient went back to normal) Lactate= 3 (this means lactic acidosis probably due to dehydration of the body and again patient experience metabolic acidosis)Disability:Fluctuating LOC & Confused to place (probably due to acidosis or hypovolemic shock – there is poor oxygenation in the brain)Pain score at 0/10 Distended Abdomen Decreased bowel sound (this is a sign of peritonitis due to septic shock)Exposure:Temp: 39. 5 (indication of fever) Decreased turgor (due to dehydration of the body)Explanation:Based on the case scenario, Meg Wright is probably experiencing Urosepsis. Untreated urinary tract infections may spread to the kidney, causing more pain and illness. It can also cause sepsis. The term urosepsis describes sepsis caused by a UTI. Urosepsis is sepsis caused by infections of the urinary tract, including cystitis, or lower urinary tract and bladder infections, and pyelonephritis, or upper urinary tract and kidney infections. Sepsis is a systemic inflammatory response to infection that can lead to multi-organ dysfunction, failure, and even death. Pathophysiology: A UTI begins with the colonization of the urethral meatus or vaginal introitus by either uropathogens or fecal flora that ascends via the urethra to the bladder. It may also ascend further up to the kidneys via the ureters and cause pyelonephritis. Pyelonephritis also can be caused by bacterial seeding of the kidneys via the lymphatics. While the bacterial pathogen causes the initiation of the disease process, the host response drives and defines sepsis and its severity. The immune response of the host is triggered when the proteins of the microbial pathogen interact with those of the host’s cell membrane. The severe pro-inflammatory response can lead to cell necrosis, an increase in neutrophil production that produces bactericidal substances, and increased permeability of endothelial cells that lead to edema formation. After this initial phase, there is an anti-inflammatory response that leads to immunosuppression in the body where neutrophils become dysfunctional and cause further damage to nearby cells. Other systems in the body affected by this inflammatory response include coagulation, autonomic, and endocrine systems.Sepsis reflects a circulatory dysfunction caused by immunologic overactivity. When a localized inflammatory response becomes systemic, capillaries grow more permeable, hypotension sets in, and fluid and immune mediators are released. These events compromise blood flow to organs and tissues.Due to this inflammatory response causes increase permeability of the vascular system fluid from blood vessels leaks out causes hypovolemic shock and abdominal distention (peritonitis).Severe sepsis and septic shock are characterized by inadequate tissue perfusion with metabolic acidosis as a result.Health Science Science Nursing NURS 3101
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