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hi,matt.i'm in nsw,australia. in our school,we only use nanda when we are asked to do a care plan. we will look at the nursing issues,goals,interventions and rationales.for this case study,we are asked to write a primary survey using the abcdefg algorithm then answer the questions.

I really appreciate for everyone's help.I have done my own work.However,I can't just write my answers on the internet.Cuz,other students may have seen this and copy my answers.So,this has been a difficult issue for me.But,I will try my best to share my own thoughts on this. Here we go.Airway obstruction and respiratory distress are the most life threatening issue now.Decrease oxygen levels and increase levels of carbon dioxide,therefore,it indicates type II respiratory failure and respiratory acidosis with partial compensation.Expiratory wheeze indicates bronchospasm. I will immediately sit the pt in High Fowler’s position.Stop feeding and take out food and suction sputum from her mouth.Because SaO2 88% on NP at 2L/min,therefore, increase flow rate to 4L/min. I will give PRN bronchodilators and corticosteroids as charted as well as antibiotics.

You are a new graduate nurse on your second rotation in a 30-bed medical ward. It is 0800hrs during a morning shift, and you have been allocated the care of a 70-year-old female, who has been on your ward for the last week, recovering from an acute infective exacerbation of chronic obstructive pulmonary disease (copd). Past medical history: ischaemic heart disease (ihd) and severe copd (with type ii respiratory failure). When assisting the patient with breakfast you notice she has become increasingly breathless, only speaking in single words, and not interested in eating. A set of observations are taken: SAO2 88% on np at 2l/min bp 160/90, hr 144 resp rate 45 b/min, and Temperature 37.2. auscultation of the lung fields reveals wide spread expiratory wheeze bilaterally. lab results: abg uec's fbc ph 7.33 na 144mmol/l hb 155 g/l pa02 55 mmhg k 4.5 mmol/l wcc 11 x 109/l pac02 70 mmhg cl 109 mmol/l plt 400 x 109/l hc03 36 mmol/l urea 8 mmol/l creat 90 µmol/l Questions 1. Using the information given in the (above) case study start by prioritizing and justifying your immediate care of this patient? 2. You also need to interpret both clinical and lab results, and 3. what physiological processes may be responsible for the abnormal clinical or lab results?

Can anyone tell me how to decide an appropriate oxygen flow rate or percentage for the patient? For example,if a patient's Sa02 is 90% RR10 b/min GCS is 8. Do I commence oxygen at 6-8 L/min via a Hudson mask? Another example,If a patient's Sa02 is 88% HR 144 RR 45 b/min. Should I commence oxygen at 15 L/min via a Non-rebreather mask? How do I choose the flow rate and device of oxygen therapy for different patients? thx a lot.

What about risk for falls related to visual and hearing difficulties evidenced by history of falls?

mrs florence lee (94 yrs old) is a resident of the jasmine waters retirement village. she has recently moved from the self care facility to the nursing home facility due to developing dementia and increased care needs. florence has led an active life, surfing in her youth and enjoying lawn bowls until her mid 80's . now she prefers to watch sport on tv as it gets too hot for her outside. her daughter reported she has had "meals on wheels" for 3 years, but often forgets to eat the meals. she seems unaware when she spills her hot black tea on her handsor lets her cigarette burn down. she is also forgetting to wash her hands after toileting. her skin has become very dry, pale and thin, tearing easily even when she simply scratches an itch. what are the two problems/consequences of lack of skin awareness in nursing care that could develop with elderly in nursing home? i'm thinking of skin tear/breakdown,pressure sores,skin cancer in her case.or maybe risk of other skin conditions eg eczema & impetigo. am i on the right track?

I know the transmission of microorganisms can cause some problem.But most of the elderly patients don't wash hands after toileting and the nurses sometimes don't wash their hands before or after contacting the patients in the aged care center or nursing home.Is handwashing not that important?

my understanding is the blood tests need be done to check for infection, electrolyte balance, dehydration, loss of electrolytes and other complications. lft is used to test for liver disease and fbc is used for test infection and other diseases. bsl is used to test the blood glucose levels because patients have a raised blood sugar level when they have a myocardial infarction. am i on the right track?

What are the causes and psychodynamics factors and influences affecting mental health behind the development of Sam's Substance abuse disorder？

Thx all of ur advices.What about ineffective coping related to alcohol abuse?

I know he has alcohol abuse disorder,but is this considered a mental health problem as well?

sam is experiencing multiple mental health issues. what are the 3 major problems or potential risks in the case study ??? i'm thinking depression,sucide and mania.but i'm not sure i'm on the right track.can anyone have a look? case study sam is a 42 years old male who was brought into the mental health unit by the police under section 22, after he physically threatened to hit his boss at work for firing him. for the last several months, sam has been showing up late for work, unable to complete his allocated duties, has been involved in verbal altercations with his workmates and was observed to sneak in alcohol and drink it at lunchtime. his boss warned him to seek help for his problems otherwise he will lose his job; however, sam always denied having a drinking problem and eventually was fired from work. on admission, sam was irritable, argumentative, with slurred speech, poor judgment and his breath smelled of alcohol. sam admits to consuming 3-4 drinks of alcohol every night when he comes back from his work. he states, "it relaxes me and makes me feel good". he has been drinking heavily for the last 2 weeks, almost half a bottle of whisky every night after his wife and children left him. in the past, his wife threatened to take the children and leave him if he did not stop drinking, but she did not leave because she felt obliged to keep the family together. however, two weeks ago, she could not cope anymore and decided to leave. she was scared for the safety of herself and children due to sam's increased incidence of anger outbursts and physical threats. whilst taking sam's family history, he stated "i'm like dad, we both love alcohol and there is nothing wrong in that". upon further assessment, sam reveals to you that his father used to shout and yell at him and he witnessed his father bashing his mother when he was drunk. sam reported that he had a poor relationship with his father as a child, he always felt insecure, threatened and scared. he grew up with constant worry, feelings of worthlessness, fear and guilt. sam revealed to you that he drinks alcohol to help him forget about his painful past and to cope with the stress he was having at work. he also tells you that "i have been drinking heavily lately because i miss my wife and kids and i feel lonely and bored with my life". whilst conducting a risk assessment, sam expressed feelings of guilt, hopelessness and despair. he tells you "i am a failure and no good for anyone...i lost my wife, my kids and my job...i wish i was dead".

i desperately need journal articles & books on the alcohol abuse disorder，such as prevalence/incidences, possible causes, hospitalisation rates& burden of disease of alcohol abuse disorder also causes and psychodynamics factors/influences affecting mental health behind the development of this disorder. this is for the assignment， can anyone help me？thx