Introduction:

Nursing care of a patient in multisystem failure involves complex observation and decision making. This often means quick assessments of the patient’s level of homeostasis, oxygenation, and pain. In this task, you will review the case scenario involving an aged patient in multisystem failure experiencing issues with fluid and electrolyte imbalance, acid/base imbalance, oxygenation imbalance, and blood glucose imbalance. These are all issues that have a significant impact on patients suffering from multisystem failure. The geriatric patient who experiences multisystem failure will present different and complex signs and symptoms.

Scenario:

Mrs. Elli Baker is a 73-year-old female who is transferred to the emergency room after collapsing in her backyard. Just prior to this, while talking to her friend on the phone, she seemed confused and beside herself. Upon arrival to the ER, she complains of some dyspnea with an increase in her respiratory rate and pulse. Her previous history includes diabetes and hypertension. She has recently started a new blood pressure medication: lisinopril. Her other medications include metformin and hydrochlorothiazide. The nurse is able to ask Mrs. Baker a few questions, but she then becomes unresponsive and has a more difficult time breathing.

Task:

Reflect on your analysis of the geriatric patient in multisystem failure by doing the following:

A.  Explain key immediate assessments you should make that would help assess the patient’s homeostasis, oxygenation, and level of pain.

Note: Be sure to include physical observations and observations made through technology and in the laboratory.

B.  Describe the technological tools you would utilize to assess and treat the patient.

1.  Explain why you would utilize these specific tools.

2.  Explain the benefits of the tools in determining the patient’s status.

C.  Discuss how you prioritized data collection in the scenario.

D.  Compare how you would assess pain in a geriatric patient who is alert and conversant to a geriatric patient who is not alert.

E.  Discuss how you would manage pain in a geriatric patient experiencing multisystem failure and showing signs of pain (e.g., moaning, restlessness, grimacing) who is not alert enough to respond to questions.

Note: Assume you have standing doctor’s orders to administer acetaminophen 500 mg by mouth or morphine 0.05 mg/kg IV or morphine 0.1mg/kg IM.

1.  Discuss how you would know whether your choice of pain management was successful.

2.  Discuss what you learned regarding assessment of the geriatric patient.

F.  Identify the collaborative team members pertinent to the care of the geriatric patient in the scenario, including the emergency room nurse’s response to changes in the level of consciousness and increasing respiratory distress.

G.  If you use sources, include all in-text citations and references in APA format.