Additional nursing initiated assessments the registered nurse should perform and monitor
Question 1.
Given a provisional medical diagnosis of pneumonia, provide pathophysiological rationales for each of the five listed initial assessment findings.
(10 marks)
Question 2.
Select five specific additional nursing initiated assessments the registered nurse should perform and monitor. For each assessment, provide the physiological rationale for performing/monitoring each assessment.
(5 marks
Question 3.
Provide an overall interpretation of Mr McKay’s arterial blood gas results. For each parameter that you note to be deviated, provide a physiological explanation for the change.
(5 marks)
Question 4
Mr McKay requires intravenous fluids to restore his circulating blood volume.
(10 marks)
Question 5.
Your patient undergoes a portable chest X-ray. Using a systematic approach, interpret his chest X-ray. Your answer can be presented using dot points.
(5 marks
Question 6.
In order to optimise ventilation and oxygenation, you decide it is necessary to change Mr McKay’s position from his current position of semi-Fowlers.
Discuss the rationale and physiological consequences of positioning the patient on both his left and right side with reference to his CXR results and the effects on ventilation and perfusion matching/mismatching.
(5 mark)
Question 7: Extended response
“Respiratory dysfunction is a known clinical antecedent of adverse events such as cardiac arrest, need for medical emergency team activation and unplanned intensive care unit admission and mortality. The way in which nurses assess, interpret, use and document clinical indicators of respiratory dysfunction is influential in identifying patients at risk of clinical deterioration and adverse events, as well as preventing adverse events related to respiratory dysfunction. To prevent adverse events, nurses must recognise and interpret signs of respiratory dysfunction and initiate interventions to correct respiratory dysfunction” (Considine, 2004, p. 624).
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