Nursing case study

    See Jessica scenario below and answers the questions below. Throughout this case analysis, your responses need to be supported by current (less than 7 years), peer-reviewed, scholarly sources. The emphasis of this subject is the connection between theory and practice so you need to ensure that theory and evidence underpin all areas of your response. Question 1. Identify the systematic health assessment framework you would use to assess this patient. Apply this framework to your chosen case to identify the information that is present in the case and the assessments that you would need to perform to complete your assessment.     Question 2. Identify the evidence for the safe administration of all of the medications, intravenous fluids and blood products (as applicable) that have been ordered for this patient to support appropriate nursing care of the patient.     Question 3. Identify the legal, ethical and professional issues with this case and discuss the nurse’s role in addressing these issues.       Part 1 Jessica is a 27 year old female presenting with an acute onset of shortness of breath. She presented to your ED two hours ago with tachypnoea, audible wheezing and she was very distressed. Jessica is a university student studying nursing. She has been using her Ventolin Inhaler several times a day for the past three days, according to her next door neighbour. She has been very stressed about an assignment she has due tomorrow and she has not been sleeping or eating well as a result. Jessica was intubated with asthma twice in the past. Her neighbour mentioned Jessica was reluctant to come to hospital. Despite being prescribed a preventative inhaler, Jessica confesses she hardly even knows where it is. She is speaking to you in 4-5 words at a time and looks fatigued and distressed despite having three doses of nebulised salbutamol since arriving. She is still wearing her clothes that she came in with. She is beginning to feel ‘jittery’ and nauseous. You need to assume care of Jessica as a multi-vehicle motor vehicle accident has just occurred down town and the other ED nursing staff are required to stabilise the people involved as they are arriving in ED. EXTRA NOTES: JESSICA IS ADMINISTERED SALBUTAMOL NEBULISER WITHOUT GOOD EFFECT, SHE IS THEN STARTED ON NON-INVASIVE VENTILATION PRIOR TO BEING TRANSFERED TO THE INTENSIVE CARE SECTION FOR INTUBATION. JESSICA IS INTUBATED AND HAD A CVC INSERTED USING PROPOFOL AND MORPHINE (THESE DRUGS TAKE A WHILE TO LEAVE THE BODY AND REQUIRE MONITORING). JESSICAS NEIGHBOUR COMES TO VISIT HER IN HOSPITAL AND THE NURSE PROVIDES ALL JESSICAS DETAILS TO HIM, AS SHE THOUGHT HE WAS A FAMILY MEMBER. Part 2 Jessica is a 27 year old female who presented with an acute onset of shortness of breath. She was diagnosed with severe asthma. Her symptoms worsened in ED to the point that she was intubated and admitted to the Intensive Care Unit. Jessica is largely unaware of the events of the last 4 days. She has been heavily sedated for two days and then moderately sedated until last night. She had a central venous catheter (CVC) inserted in her left subclavian (SC) vein which has remained functional since insertion. She had an arterial line in the right radial artery but this became non-functional this morning so it was removed. The most recent Arterial Blood Gas (ABG) indicates Jessica has improved substantially since her intubation and her chest x-ray is much improved. She is likely to be extubated this morning once reviewed by the Intensive Care Specialist (Doctor). Jessica’s sedation has been weaned overnight so she is now completely awake and aware of what is happening to her.