Subsequently, parts of the affected organ begin to malfunction and shut down due to poor oxygenation, hence the failure of the kidney to filter wastes from the blood. Thus, any medical interventions in such a case should aim to restore the volume of blood in the body and ensure that the kidney is not harmed in any way (Nolan & Pullinger, 2014, p. 3; ). This section outlines three clinical interventions that ought to be implemented to averse further clinical deterioration of hyperpofusion in the patient, Ms. Miller. i) Nursing intervention 1: Assess for risk Since nurses are usually the primary caregivers for the patients, they are thus mandated with the task of close monitoring and observation of the patient so as to assess any forthcoming risks (Roberts et al., 2015, p. 675; Elliott & Coventry, 2012, p. 621). Risk assessment is the premier intervention that precedes any other medical intervention, and involves checking the patient to know the main cause of the hyperpofusion. As Nolan and Pullinger (2014, p. 3) state, hyperpofusion mainly results from massive blood loss through traumatic injuries, internal bleeding from surgical complications, or postpartum hemorrhage. Early risk assessment and patient evaluation enables the nurses to know the extent of the hyperpofusion and the damages caused so far. Also, the nurse may evaluate the vital signs and level of consciousness parameters to gauge the level of the organ shock or malfunctioning in the patient. Evaluating hemodynamics measurements may also significantly help in telling the gravity of the organ shock as well as how the patient is reacting to the already-administered treatment (NRSNG, 2018, p. 1).
CLINICAL REASONING 6 Hemodynamics measurements involve gauging the Mean Arterial Pressure (MAP); Central Venous Pressure (CVP); Cardiac Output (CO); and Systemic Vascular Resistance (SVR) (NRSNG, 2018, p. 1). Decreasing levels of the MAP (less than 60 mmHg), CVP (less than 4 mmHg), CO, and SVR indicate deteriorating shocks and vice versa (NRSNG, 2018, p. 1). When identified early, the patient may be saved from further clinical deterioration as the remedy responses and treatments are administered on time, before the ailments worsen. ii) Collaborative intervention: Administration of blood products and nutrition If the risk assessment reveals that the patient has lost a lot of blood, then administration of blood transfusion and nutrition is necessary to restore the lost blood volume (Karrowni et al., 2016, p. 1). As Afshar and Netzer (2013, p.31) assert, blood transfusions require collaboration from the patient and his immediate family members as well as support and approval from the Comprehensive Medical Emergency Team (CMCT). To begin with, the clinical workforce must obtain consent from the patient and his immediate family prior to the onset of the transfusion. After consent is obtained, the nurse shall draw the patient blood and send the sample to the laboratory to determine the blood type and its crossmatch (Friedman et al., 2012, p. 560). Blood transfusions are critical medical processes and are superseded by standard transfusion protocol.
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- Fall '12
- Chronic kidney disease