Clinical Intervention in Hypovolemic Shock Management

Introduction:

Management of acutely unwell patients is associated with determining health issues of patient by using proper healthcare techniques, setting clinical intervention to managing these issues and promoting heath and wellbeing of patients by implementing relevant healthcare strategies. Here, the essay is going to highlight the pathophysiology, anatomy and physiology of the patient in the given case study. In this essay, it would be discussed that how the effective and proper care process can be used by healthcare professionals in terms of manging the critical and complex needs of the patient. In addition to this, the essay will also discuss the team management, proper communication and effective decision making in terms of making self-reflection in the healthcare context. The essay will depict the safety and secure policies that are needed to be maintained by healthcare professionals while managing critical and complexed needs of patients. In addition to this, the essay is going to discuss the importance of ethical, safe and professional practices in managing patient’s health, illustrating how healthcare dissertation help can guide these discussions. Here the essay will use relevant theories while discussing the delivery of professional and quality are service in healthcare context. Finally, the essay will make a suitable conclusion, that infers the main aspects of entire discussion.

Explaining pathophysiology, anatomy, physiology and pharmacology of patients in the case study:

Here in the given case study, Daniel is going through the resection of the bladder tumours, that can lead to hypovolemic shock. As mentioned by Valentine et al. (2019), in hypovolaemia is the health condition in which the patients suffer from internal bleeding. The pathophysiology and physiology of Daniel have suggested that the Daniel is highly prevalent to hypovolaemic shock, that occurs due to decreased volume of circulating blood into the veins as well as in the body cells. During the resection of the bladder tumour, it is very natural that the circulating volume for eth blood in the cells in which the tumour was located will reduced, which enhances the pressure by et blood on the veins and nerve through which it passes. In thus context, Daniel has high chances of facing low blood circulation through the cells which leads to abnormal pulse, blood supply, blood pressure and poor oxygen supply to organs. In addition to this, through analysing the pulse rate (124 beats per minute), respiratory rate (26 breath per minute) and BP (95/60 mm Hg), it can be stated that the pathophysiological condition of Daniel point out the high risk towards reduced blood supply into different cell of the body which can cause hypovolaemic shock. In this condition there will be no oxygen supply in organs of Daniels’s body, that can lead him to coma or death. While discussing the pathophysiological and physical condition of Daniel, it needs to be mentioned that, there is high chances of severe haemorrhage within the nerves and veins if Daniel, which leads to deteriorating circulation and venous return that are associated with occurrence of hypovolaemic shock. In this context, it can be stated that, in case of Daniel, the heart pumps blood in proper amount, but the organs are unable to receive the blood in proper rate due to reduces volume of veins and nerves. Therefore, minimum amount of blood return to heart which developed a condition which is known as proload. In case of Daniel, he has high chances of suffering from poor oxygen supply into different organs. Afterload can be defined as the amount of blood that comes out of heart after its contraction. On the other hand, the stroke volume can be referred as the amount of blood that come out from left ventricle of heart in each contraction. Therefore, it can be stated that, the lower the stroke volume the lower would be return of blood to heart. It can lead to the reducing of cardiac output that cause the lower rate of tissue oxygenation. In this stage the patients can face increased heart rate, pulse rate and blood pressure. Therefore, the high pulse rate of Daniel which is 124 beats per minute (normal is 60-100 beats per minute) and the respiratory rate which is 26 per minute (normal is 12-24 per minute), is higher than the normal ranges which represent that he is suffering from hypovolaemia. While analysing eth physiology and anatomy of Daniel, it is seen that, there is one receptor, BETA 1 that is associated with increase cardia contractility that is the reason behind high pulse rate and respiratory rate. Due to the increased cardiac contraction, the overall blood supply as well as oxygen supply inti the cells of different organs reduces which leads to important functioning of organs. In this context, it can be stated that Daniel needs proper care and support from the healthcare professionals and heath staffs. In addition to this, Daniel needs proper medications and relevant clinical intervention which normalise the respiration rate, BP and the pulse rate that are imponent for maintaining smooth internal body functions. While treating the hypovolaemia condition of Daniel the health professional can use two medicines that are highly important for its treatment such as hetastarch and hydroxyethyl starch. These medicines will improve the blood supply to cells by enhancing the contraction and relaxation of cardiac muscles that are associated with regulating the proper blood supply into cells.

Pathophysiology of hypovolaemic shock:

Hypovolaemic shock is referred to the physical condition in which sufficient amount of blood cannot reach each organ which interrupt with the normal body system (Abidin and Kamaruddin, 2018). In case of Daniel, he is highly prevalent to the hypovolaemic shock, as the inner walls of blood vessels case of Daniel, is thickened which leads to reduces blood circulation through blood vessels. While body organs can not receive the sufficient amount of blood that leads to scarcity of the oxygen in each body cells. Oxygen is associated with energy generation in the body cells, which is the main sources of maintaining people balance among the functions of different body parts, therefore, it can be stated that, in case of Daniel, he is highly prevalent towards reduced oxygen supply to the lungs, heart and other organs which not only impact on the physical system of body but also on the psychology and emotional wellbeing of Daniel. The clinical case study of Daniel, shows that her has lower oxygen saturation percentage (92%), that point out his prevalence toward hypovolaemic shock dur to reduced blood supply and oxygen supply to body system.

Renin Angiotensin System:

In case of normalising lower blood pressure in case of Daniel, health professionals need to recommend renin hormone injection or medicines containing renin, that is associated w improving the overall blood pressure in patients. Renin secreted from kidney in response to the low BP in patients. In case of Daniel, renin will first interact and react with Angiotensinogen, which will produce angiotensin 1. Then angiotensin 1 is transformed into Angiotensin 2 in lung with the involvement of an enzyme, Angiotensin Converting Enzyme (ACE). Angiotensin 2 then instigate the secretion of ADH (antidiuretic hormone), which enhances the water absorption into eth renal tubules and thus increase the Blood pressure again.

Performing A to E tool patient assessment tool, in assessing health and wellbeing of Daniel:

The A to E method is one of the most preferred health assessment methods that is used by health professional as well as nurse in terms of assessing physical health condition of patients (Aveyard, 2014). In the gen case study, nurses are going to use this A to E tool, in assessing current health condition of Daniel, that assists nurses to take proper strategies as well as clinical settings to improve his health condition by meeting all his health neds.

Airway:

The important organs that are associated with airways are mouth, pharynx, larynx, bronchi, bronchioles and trachea (Butler, 2016). In case of Daniel, though conducting the airway assessment, nurses will be able to determine whether the anatomical functions of all these organs are normal in Daniel. In addition to this, the assessment process will also determine that whether the process of airways circulation into body is normal or any types of instruction is face by Daniel.

Breathing:

In breathing assessment process, nurse generally use LLF technique (Listen, Look and Feel technique) (Challis et al. 2018). In this technique, nurses will focus on determining any sign of respiratory distress in Daniel which assist them to analyse respiratory cycle and respiratory rate in case of Daniel. The respiratory cycles would be measured within 15 seconds duration and respiratory rate will be measured within a full minute. The normal acceptable oxygen saturation rate is >96% in case of patient suffering from COPD. On other in normal person without any respiratory illness, the normal oxygen saturation rate is 95-100%. In breath assessment process, nurses will determine the respiratory rate and respiratory cycles which will assist the nurses to detemir the current respiratory condition of the patients. In this context to needs to stated that in case if Daniel, the respiratory saturation rate is 90%, which is lower than the normal ranges, therefore, from the assessment it can be stated that, Daniel, health professional need to prescribe suitable inhaler and medicines to Daniel, in terms of normalising his respiratory condition.

Circulations:

In this assessment process, health professionals as well as nurses determines the overall condition of blood circulation from heart to the entire body system (Butler, 2016). Here in eth case study of Daniel, due to the thickening of inner wall of vein and nerves, there is restrictions on overall blood supply to different organs, which enhance health risk of Daniel. Due to poor circulation in different body parts, in case of Daniel, the overall body function can deteriorate with times which can lead to major health risk even death in Daniel. In this context, nurse and health professional need to prescribe proper medication that can reduce the thickening of the inner wall of vein and nerves in terms of normalising the overall blood supply into different organs of Daniel.

Disability:

Disability assessment is associated with determining eth actual reason behind unconsciousness in patient (Abidin and Kamaruddin, 2018). Although, in case of Daniel, no case of unconsciousness is determined by nurses, the deteriorating health condition with reduced circulation and lower oxygen saturation in the body can enhance chances of unconsciousness in case of Daniel. In conducting disability assessment, nurse can analyse the ACVPU status of Daniel, which will assist them to determine overall health condition of the patient, the ACVPU stands for alert, confusion (new), response to voice, painful stimuli, and unconscious. Here vin case of assessing disability in case of Daniel, the nurses can identify the pupillary size, responsiveness of Daniel towards different voice, feeling and experiences of Daniel.

Exposure:

In this assessment process nurses will use ASSKING tool that stands for assessment, skin assessment and skin care, surface, skin, keep, incontinent, nutrition. In case of exposure assessment for Daniel by using the ASSING tool, nurses will determine whether Daniel has any allergic reaction on skins, or any skin disease. In addition to this, nurses will also determine whether there is side-effects of any medicines on Daniel’s skin, that can assists et health professionals as well as nurse to determine whether the medicines that are prescribed to Daniel, is suited with his health condition.

Safety in drug calculation:

Drug calculation is associated with using correct dosage of each medicine for treatment of patients. In the health are, the healthcare professionals as well as healthcare staffs need to maintain as well as follow proper guidelines of using dosage of each medicines. In the given case study of Daniel, health staffs a sure that the dosage of hetastarch and hydroxyethyl starch will be given to him in correct manner. In this context, health staffs need to take proper training and development courses in workplace in terms of developing their knowledge regarding using correct dosage of each medicine. While treating Daniel, health professional will assure that they have trained the healthcare staffs such as nurse, ward boy and midwives who are assigned to take care of Daniel regarding using the proper dosage as well as quantity of each medication, Through using proper dosage of each medicines, the health professionals would be efficient in terms of maintaining good health and promote the wellbeing of patients by managing their complex and critical needs. Here in the case study, Daniel, needs timely and correct dosage of each medicines which not only will assist him to get recover from eth overall health condition, but also improve his mental and psychological heath which will enhance his self-confidence and problem skills. Here in case of maintaining safety and security while calculation dosage of medicines in case of Daniel, healthcare staffs needs to follow the following guidelines:

Healthcare staffs would follow the instruction as well as guidelines set eth health professional and healthcare authority regarding maintaining proper dosage of each medicine. In Daniel’s case, the healthcare staffs would be highly-skilled as well as proper training in using the correct dosage of medicines (Abidin and Kamaruddin , 2018).

The healthcare staffs would have proper knowledge in maintaining safety while dealing with patient with critical and complex needs. In this context, the healthcare staffs who take car of Daniel, needs to use all the safety policies in terms of promoting the health and wellbeing of this patients. Here in the case study, the healthcare staffs need to maintain proper hygiene while giving medicines to Daniel. In addition to this, nurse will heck the pulse rate, respiratory rate and BP of Daniel, before giving particular dosage of the two medicines.

Healthcare staffs needs to have proper knowledge on side-effects as well as adverse impact of wrong dosage of medicines. In case of Daniel, nurse will be highly professional in selecting proper dosage of this health condition. In this context it can be stated that, in all times not all types dose can be recommended for a particular health condition, rather the healthcare professional as well as heath staffs need to have proper understanding of correct dosage for eth particular health condition. In case of Daniel, healthcare professional needs to use correct dose that can normal his BP, Pulse rate and the respiratory rates by improving the overall blood supply to the cells in different organs.

In context of drug calculation, the health professionals will assist healthcare staffs to understand proper meaning of each dosage of particular drug, which will assist the healthcare staffs to use safe and correct diose for particular medicines in terms of meeting eth critical and complex needs of patients.

From above-mentioned discussion, it can be stated that, in case of Daniel, the healthcare staffs need to focus on gathering proper knowledge on drug calculation that will assist them to use medicines in safe and correct manner so that the correct dose of each medicines would be received by Daniel. The usage of correct dose of each medicine will assist Daniel to recover his overall physical as well as mental health by improving the overall psychology, behaviour, decision-making skill and self-confidence.

Critically analyse the delivery of safe, professional and ethical practice by using theories:

In term of providing high quality as well as highly professional service to patients, health care staffs and health professions would determine eh critical and complex need of patient suffering from chronic disorder. While dealing with Daniel, healthcare staffs need to provide high quality care ad modern treatment process. Providing highly relevant and quality care as well as treatment process to Daniel, can be possible if healthcare staffs are highly skilled who have proper understanding of how to maintain ethical and moral policies, professional standard and safety in treatment and care process. By using Health Promotion Model of Ponder, it can be stated that the health is not a state of being free from any illness or disease, rather health promotion can be referred as process of enhancing the patient’s physical and mental wellbeing. Based on the theory, the healthcare staffs such as nurses, doctors and other healthcare staffs who are taking care of Daniel, can use highly effective clinical strategies that will assist them to enhance the level mental, physick and emotional, wellbeing in Daniel. While providing eth high quality treatment to patients, it is important for healthcare staffs as well as healthcare professions to implement practical as well as professional knowledge in terms of not only determining healthcare condition of patients but also maintaining safety and ethical values while treating them. In case of Daniel, as he suffers from abnormal health condition such as haematuria and abnormal BP< respiratory rate and pulse rate, he need proper ae plan which is highly safe as well as relevant to his health condition. While providing the care process, healthcare staffs and health professional need to maintain their professional values and ethical as well as moral values that will assist the healthcare staffs to meet quality and standard of care. In this context Abidin and Kamaruddin (2018) argued that healthcare professionals and heartache staffs need to meet the codes of practices and care standard set by the healthcare authority. In the case study, if the health professionals as well as healthcare staffs need to improve the overall mental and physical health condition of patients, they need to develop their professional standard, ethical values and moral understanding which will assist them to maintain highly relevant as well as safe treatment process. Through maintaining the safe treatment process, healthcare staffs will assure that patients there is no adverse effect or side effects of this treatment press and clinical intervention as highly relevant techniques and tools are used in the treatment process. In case of Daniel, the healthcare staffs as well as health professional need to maintain strong communication with the high healthcare authority in terms of referencing proper health care regulation and principles which will maintain proper ethical framework in healthcare field.

Critical analysis of observation, identification, monitoring and holistic care of patient with complex health needs:

Holistic care process is one of the most preferred care system in modern healthcare context, in which healthcare professionals consider not only the physical and mental health needs of patinas in terms of dealing with their complex needs rather the health professionals consider the social, cultural and emotional context that can have strong impact on eth overall physical and psychological condition of the patients (Donetta et al. 2015). In this case study, Daniel suffers from huge physical abnormalities such as high pulse (124 beats per minute), high respiratory rate (26 breaths per minute) and abnormal capillary refill rime (4 seconds). In addition to this, Daniel also has haematuria that makes him suffering high level pain and drowsiness.by analysing eth pathophysiological and anatomical condition of Daniel, it can be stated that Daniel needs the holistic care process in high quality healthcare setting which will assist health staffs as well as healthcare professional to o tony evaluate the physical condition of the patients but also determinant the psychological distress in Daniel that he experiences throughout illness. As mentioned by Ferlie (2017), during the holistic care process, heath profession needs to use better observational monitoring process and proper clinical intervention process which will assist them to determine the how different factors such as physical, psychological, social and cultural factors impact on overall health and wellbeing of the patients. While using holistic care process the health professional skill, maintain healthy as well as friendly relation with Daniel, which will improve the overall observational of his health by health staffs, through forming strong relation with Daniel, nurse and doctors will be able to allow him sharing his issues, preferences, experiences and feelings with them. As mentioned by Abidin and Kamaruddin (2018), in holistically care, the health professional as well as healthcare staffs need to take person-centred approach which assist them to involve patients in their recovery process. For maintaining better monitoring and and observation system in holistic care process, health care manger in the room of Daniel, needs to check the footage of cctv camera each day, in terms of assisting the healthcare staffs working in this meet all the needs of Daniel and obey all the guidelines as well as clinical instruction while giving him the treatment process such as medication, health check-up and timely food delivery. On the contrary Ferlie (2017) argued that, sometimes it is not possible for health professional to follow the clinical instruction or meditational guidelines in terms of maintaining healthy relation with patients during holistic care process, as it can cause high level of ethical dilemmas in them. For example, as Daniel is old man and differs from several critical health condition, nurse and doctors need to analyse his preferences and interest regarding his own treatment before meeting these demands or preferences because sometimes his demand can interfere with the integrity a successful ethical care process. As addition to this, the healthcare staffs as well as the health professional need to maintain strong communication and interaction with Daniel, makes clear information delivery system between them. During monitoring ad observing the entire healthcare process, the healthcare mangers need to use the online tracking system by using spy camera, which will assist them to check whether nurse d healthcare staffs work in roper manner to needs of Daniel. In this context Glasby (2017) argued that, in mots of eth times online tracking system in the healthcare interfere with the trustworthy relationship between th healthcare staffs and care mangers, which then create high level on miscommunication among them that interfere with quality care process. Therefore, in case of Daniel, as he proper holistic and person centred care process in terms of managing his complex health need , the healthcare professional and higher healthcare officials needs to conduct the self-assessment test and professional ability test of health staffs on regular basis, that will assist the care mangers, supervisor and higher healthcare official to evaluate the abilities and performances of each staff. This assessment process is associated with proper monitoring and screening of professional skills of each health staffs that assists health care authority to assist that all staffs as well as professional in healthcare setting work by complying with the standard of care and codes of practise in terms of providing high quality care service to Daniel.

Critical reflection:

By reflecting on my performance as trainee nurse in the local healthcare centre, I can evaluate the professional and personal skills that I had gathered in the workplace. Being a nurse, always prioritise some factors that are important for proving quality care to a patient. The factors are communication, proper interaction, strong analysis of own skills, self-assessment and healthy relation with all healthcare officials as well as staffs. During my work process, I use to maintain healthy and clear communication with the patients as well as with all the healthcare staffs and health professionals which assist me to share as well as get important information regarding the care process. In addition to this, I always believe in teamwork, that assisted me to work synergistical with team members in different team. Through working in different team, I use to brings about innovate and creative decision as well as strategies in the team which assist the care managers to set such clinical process that will mange the critical needs of patients. I had quick decision-making skills that I had gathered during the module, that I use in my workplace in terms of taking any decision regarding patient health, clinical intervention and medication. I always focus on taking right and relevant decision in dealing with current situation in the workplace, that can be beneficial for patients, healthcare staffs and health care profession in maintaining highly transparent as well as efficient care setting in health centre.

Conclusion:

This study concludes that; management of a critical patients is not only associated with determining the needs of the patient but also managing as well as meeting these needs by using proper holistic and person-centred care. The above-mentioned study also concludes that, healthcare authorities need to ensure the transparent and highly effective care settings in which patient’s interest and needs are treated on priority basis with using modern as well as innovating treatment process.

Reference list:

Abidin, S.Z. and Kamaruddin, N., 2018. Service Design: Issues and Opportunities. In Proceedings of the Art and Design International Conference (andic 2016) (pp. 9-16). Springer, Singapore.

Aveyard, H., 2014. Doing a literature review in health and social care: A practical guide. London: mcgraw-Hill Education (UK).

Butler, M., 2016. Introduction of the Productive Ward: Releasing Time to Care to Programme. Introducing the programme to the Care of the Older Person Unit.

Challis, D., Chesterman, J., Luckett, R. And Stewart, K., 2018. Care management in social and primary health care: the Gateshead Community Care Scheme. Routledge.

Chiswell, C., Cooper, R. And Packham, C., 2015. Healthcare public health. Practising Public Health: A Guide to Examinations and Workplace Application, pp.45.

Coward, M., Crombie, A., Joy, M., Ream, E., Tremblay, M. And Wilson, P., 2016. Primary Care Strategic Workforce Planning Programme.

Donetta, S., Pierri, P., Tsianakas, V. And Robert, G., 2015. Experience-based co-design and healthcare improvement: realizing participatory design in the public sector. The Design Journal, 18(2), pp.227-248. Simonet, D., 2015. The new public management theory in the British health care system: a critical review. Administration & Society, 47(7), pp.802-826.

Drummond, M.F., Sculpher, M.J., Claxton, K., Stoddart, G.L. and Torrance, G.W., 2015. Methods for the economic evaluation of health care programmes. London: Oxford university press.

Ferlie, E., 2017. Exploring 30 years of UK public services management reform–the case of health care. International Journal of Public Sector Management, 30(6-7), pp.615-625.

Glasby, J., 2017. Understanding health and social care. London: Policy Press.

Heath-Kelly, C. And Strausz, E., 2018. The banality of counterterrorism “after, after 9/11”? Perspectives on the Prevent duty from the UK health care sector. Critical Studies on Terrorism, pp.1-21.

Kenyangi, B.D., Keith, R.S. and Adegboye, A.R.A., 2019. Exploring Infant and Young Child Feeding Practices in the Royal Borough of Greenwich, London, to Improve Health and Nutrition Outcomes in Children Under 2 Years of Age. World Nutrition, 10(3), pp.26-50.

Kurten, M., 2017. Fall Prevention in the Greenwich Hospital Emergency Department.

Mason, A., Goddard, M., Weatherly, H. And Chalkley, M., 2015. Integrating funds for health and social care: an evidence review. Journal of health services research & policy, 20(3), pp.177-188.

Mccarthy, A. And Morris, L., 2017. P-107 Improving the experience of people with advanced dementia at the end of life in greenwich and bexley boroughs. BMJ Supportive & Palliative Care, 7, p.A48.

Moro Visconti, R., 2016. Healthcare public-private partnerships in Italy: Assessing risk-sharing and governance issues with PESTLE and SWOT analysis.

Oham, C. And Macdonald, D., 2016. Leading and Managing a Social Enterprise in Health and Social Care. London: Community Training Partners.

Schyns, P.F.M., 2016. The technological future of the wealth management industry for portfolio management investment services (Bachelor's thesis, University of Twente).

Valentine, A., Maddy, N., Adeboye, A., Algahtani, F. And Jegede, A., 2019. Exploring Adult Mental Health in Minority Ethnic Groups in the Royal Borough of Greenwich: Implications of Partnership Working. Open Journal of Social Sciences, 7(9), pp.238-248.

Valentine, A., Maddy, N., Adeboye, A., Algahtani, F. And Jegede, A., 2019. Exploring Adult Mental Health in Minority Ethnic Groups in the Royal Borough of Greenwich: Implications of Partnership Working. Open Journal of Social Sciences, 7(9), pp.238-248.

Williams, M., 2017. Greenwich focuses on young lives. Early Years Educator, 19(6), pp.66-66.