oral viva acute

Respiratory distress

Patho: Inflammation/fluid accumulating in the alveoli, impairing gas exchange, leading to hypoxemia

PP: Breathing ( inflammation within the alveoli, impairing gas exchange and reducing oxygen delivery to tissues)

NI: Administer oxygen as per protocol ( 2-4L NP)

CI: Met Call

Evaluation SPO2 improves, decrease RR, pt reports easier breathing

Opioid overdose

Patho: Suppress the resp centre in brainstem causing resp depression and hypoventilation

PP: Breathing (Fentanyl suppresses the respiratory centre within the brainstem, causing respiratory depression and reducing oxygenation.)

NI: adminster oxygen and cease PCA

CI: Met call and prep for naloxone

Evaluation: RR increase to normal rate 12-20

Sepsis

Patho: Infflmmatory response leading to vasodilation and capillary leak. Leads to hypotension, poor tissue perfusion and organ dysfunction

PP: Circulation ( sepsis causes systemic vasodilation and capillary leak, leading to poor tissue perfusion and organ dysfunction.)

NI: Initiate sepsis pathway which includes oxygen therapy

CI: Met call and fluid resuscitation

Evaluation: Vital improvement ( BP,HR) confusion resolves, urine output improves, improved perfusion

Acute Coronary Syndrome ( Chest pain)

Patho: coronary artery occlusion reduces blood flow to myocardium leading to myocardial ischameia and reduced cardiac output

PP: Circulation ( coronary artery occlusion reduces blood flow to the myocardium, causing myocardial ischaemia and impaired cardiac output)

NI: semi fowler position and prep for ECG

CI: urgent medical review and chest pain pathway

Evaluation: chest pain improves, bp and hr stabilises

Stroke

Patho: reduced cerebral blood flow which deprives brain tissue of oxygen and glucose causing neurological deficits

PP: Disability (Reduced cerebral blood flow is causing neurological dysfunction)

NI: Elevate head at 30 degree in semi folwer and neuro obs

CI: Urgent medical review and activate stroke pathway

Evaluation: Neurologucal status improves or remains stable no worsening numbness and weakness.

Brain Bleed/ head trauma

Patho: Increase in intercranial pressure, reducing cerbral perfusion

PP: Disability (Intracranial bleeding increases intracranial pressure, reducing cerebral perfusion)

NI: elevate head to 30 degree in semi fowler, prep pt for CT

CI: Met Call and urgent CT

Evaluation: GCS stablises/improves, no further neurological changes.

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