Hello. Could I please request some assistance regrading the.

Hello. Could I please request some assistance regrading the… Hello. Could I please request some assistance regrading thedown below. “Outcomes/ Evaluation of the interventions” (How will you know if the interventions work? What do you need to measure (data/observations) to know if you need to stop or escalate treatment?).Theis the third pasted picture. I have already highlighted the abnormal cues in green extrapolated from the case study of Meg Wright, processed the information from the abnormal cues, and then have identified three critical problems and worked out 6 nursing interventions, two for each critical problem, plus rationales to explain the pathophysiology. I have pasted five sections which include; collect cues, process information, the case study of Meg Wright,7. “Outcomes/ Evaluation of the interventions”, and then the three critical problems, 6 interventions and rationale for each intervention.Use the below urls to help you link up the outcomes with my chosen interventions. If you feel that there could be better chosen interventions and rationales I wouldn’t mind if you came in altered anything to help me learn. I have uploaded some files onto my dropbox which are great learning resources taken from my university course.https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0005/291803/Adult-Sepsis-Pathway.PDFhttps://www.dropbox.com/sh/2s8vikwkte3uzwk/AACFttRSMINgnx6Rv4DAsAnna?dl=0 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 text7. OUTCOMES/EVALUATION OF THEINTERVENTIONS You can score 3 marks ifthe all the six interventions for … 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 the 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) 1. Critical Nursing ProblemIneffective tissue perfusion related to metabolic acidosis secondary to lactic acidosis as evidenced by hyperventilation, tachycardia, hypotension and altered LOC (confused to place). Two time-critical Interventions:1. Administer 500mls of normal saline 0.9% over an hour as per fluid chart via Mr’s Wright’s IVC access in her Left posterior forearm. Rationale: Adequate fluid intake maintains proper pressure, which optimizes cardiac output for tissue. It will also aid in the restoration of a bicarbonate deficiency.Outcome: 2.  Perform a neurological examination by checking Mr’s Wright’s level of consciousness (LOC) using Alert, Voice, Pain, Unresponsive (AVPU) at least every 30 minutes.Rationale: To determine if there have been any changes in level of consciousness or if there is a risk of an increase in ICP. If the ICP rises, certain activities should be avoided to avoid reducing cerebral blood flow, which could lead to organ damage or death if it falls further.Outcome:2. Critical Nursing ProblemIneffective breathing pattern related to altered tissue perfusion (metabolic acidosis) as evidenced by increase respiratory rate and compensation of PvCO2. Two time-critical Interventions:3. Administer respiratory medications PO and 2L of oxygen via NP as ordered by the doctor.Rationale: Beta-adrenergic medications to relax the smooth muscle of the airway and cause bronchodilation, which allows passages to be opened. ß-adrenergic blockade therapy has beneficial effects in patients with sepsis, such as the reduction of inflammatory cytokine production, suppression of hypermetabolic status, maintenance of glucose homeostasis, and improvement of coagulation disorders.Outcome:4. Encourage deep breathing/diaphragmatic breathing/inspiratory muscle training on a regular basis.Rationale: To encourage deep breathing, which improves oxygenation and prevents atelectasis.Outcome:   3. Critical Nursing ProblemHyperthermia related to sepsis as evidenced by distended abdomen (peritonitis) and decrease bowel sound. Two time-critical Interventions:5. Request blood cultures from Consult Infectious Diseases Physician or Clinical Microbiologist, then administer STAT loading dose of Vancomycin 2g within 60 minutes of sepsis recognition and 1g of IV paracetamol for fever prn as per medical chart.Rationale: Antibiotics are used to treat bacterial infections that cause hyperthermia, and antipyretics are used to stimulate the hypothalamus and help put the body temperature back to normal.Outcome: 6. Provide a tepid bath/ sponge bath, apply ice packs and infuse IV cooled saline as ordered to Mrs Wright until temperature has lowered.Rationale: To allow the core temperature to be cooled through evaporation.Outcome: Health Science Science Nursing NURS 3101

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