The management of the intensive care unit is very crucial for critical patients. This type of healthcare unit can offer the best and most effective system to give them the environment in which they can recover from the life-threatening moment of their life. This type of management, it can achieve a superior position by accomplishing the multidisciplinary method with an effective medical professional. This unit is designed based on the requirement of the patient separately for the benefit of the effective quality of treatment. This study thoroughly investigates the clinical history of a patient who experienced a critical condition and the data from the health records can guide in understanding the reason for his condition.
The section of the discussion of this study will focus on the critical evaluation of the medical history based on the data of Frank Jones. This patient is a 65-year-old man with a medical history of COPD or chronic obstructive pulmonary disease. He had experienced a myocardial infarction about four years ago (Chiang, et al. 2021). He also has other comorbidities including hypertension and type 2 diabetes. So this will evaluate the medical data of this patient and give an association with the suitable pathophysiology.
Critical Evaluation Of The Data Of Medical History
Clinical Data evaluation of the respiratory system
Frank Jones experienced respiratory issues when he was in the emergency department. The professionals find that the situation of his COPD has deteriorated so they recommend taking the nebulizers of ipratropium bromide and salbutamol. But the condition of his health became worse so the process of the intubation was going to be necessary (Hartfiel, et al. 2021). The settings of the ventilator management include the mode of PC-BiPAP; which specifies that Frank was on the controlled pressure. The other data of the fraction of the oxygen received is 0.5 which designates the concentration of the getting oxygen as 50%. The clinical data also indicates the rate of respiration of Frank is 14 breaths/Minute. Here it also gives data on the tidal volume of the patient which is referred to as the volume of the air and can be transported with each breath in the body. The tidal volume of Frank has shown a value of 300 to 390ml. The level of oxygen saturation observed in the patient was 90% which means it is the percentage of saturation of hemoglobin in the patient's blood.
Figure 1: Management of ICU for respiratory disorders
Clinical data evaluation of Arterial blood gas
The result of arterial blood gas represents the data by giving the balance of the alkaline acid in the patient's body. Here in the scenario of Frank, it has been observed that the low pH value of 7.29 which designates the kind of acidosis. The lower value of bicarbonate which is +6.5mmol/L in the body has also been observed. 8.5KPa of PaCO2 recommends that the situation of the respiratory acidosis (Mitra, et al. 2020). 8.1KPa of PaO2 has been observed which is low in the body and suggests that the content of oxygen is sustained. Cooximeter is an equipment that is used to measure the status of the oxygenated hemoglobin in the blood. Here the raised level of lactate whose value is 3.2mmol/L helps to understand the situation of the patient, in this case, it indicates the situation of shock or hypo perfusion. If the patient is in a condition of stress the glucose level can be elevated which is relevant in this case also, here 9.8mmol/L is the value of the elevated glucose in the blood.
Blood pressure of Frank has resulted in 98/45mmHg which was significantly low but the rate of the NIBP or noninvasive blood pressure was higher resulting in 102/49mmHg.the pressure of the central venous of the patient was in the normal condition at 6mmHg. 66 % of ScvO2 or the saturation of oxygen in the superior vena cava recommends the actual delivery passage of oxygen (Arrar, and Mohammed, 2020). The temperature of the patient's body has been observed at 38.1°C in his peripheral area. 3seconds of CRT or time of capillary refill shows that there is an infection in the body. Here the rhythm beats of the heart are observed as the 90 beats per minute in the strip of the record of Frank.
Clinical Data Evaluation of the renal system
The output of urine was observed as 20mls for the last 2 hours which designates the situation of the patient was in a dysfunctional renal system of Frank. The previous data records were seen as the level of lactate was raised which also indicates that the patient was in shock (Tabah, et al. 2020).
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Figure 2: The state of kidney during the ventilation procedure
The flow rate of blood will be reduced if the patient is in the condition of shock. Here has also observed that his renal function also deteriorated so the urine production in the kidneys was reduced.
Clinical data evaluation of neurological function
The data on the neurological designates that Frank was being relaxed by the administration of drugs including fentanyl and propofol. The examination of the pupillary has been observed as +3 with the inactive state of the patient. Voice and any kind of stimuli of the patient were lacking which indicates that the patient induced into the condition of Coma (Rabec, et al. 2020). The scores of the sedation scale or RASS observed at the value of -5 which refers to the sedation level of the patient in a serious situation.
Clinical evaluation of the blood results
The emergency department has shared the blood results of Frank which covered the different parameters of blood (Frivold, et al. 2022). 0.6mmol/L of magnesium is suggested as the low level in the blood of the patient. 2.15mmol/L of calcium has been observed which is in the normal range. 40mg/L of c reactive protein or CRP helps to indicate that there was an inflammatory response in the body. The levels of urea and creatinine are also represented and were in the elevated level which indicates the dysfunction of the kidneys. 27g/L of albumin level specifies the state of hypoalbuminemia (Mady, et al. 2020). The clinical data of WBC has increased in this situation and the count of platelets was decreased. The parameters of coagulation in the blood of Frank are normal but the level of fibrinogen was monitored as the lower value at 4.2g/L.
Management of the Intensive Care Unit
The case scenario of Frank Jones represented that he was on the ventilation system associated with the mode of PC-BIPAP. In contrast, it has been noticed that the saturation level of oxygen is low. The fentanyl and propofol drugs were used for sedation to make the process of relaxation of the nervous system. This sedation process is vital for management in the ventilation so it requires thorough intensive care to get a quick recovery. The output of the urine has been noticed as the lower value with the prominent value of the lactate (Lopez, et al. 2020). The conditions of the patient required continuous care in this ICU for hemodynamic assistance. The dysfunction of the renal system requires offering the balance of fluid in his body. From the clinical history of Frank, it has been noticed that COPD is there, it is the state of the patient where the entrance of the air is bilateral. The high level of lactate represents the state of the hypotension of the patient with the lower level of urine production in the body. In the process of intubation in the ICU the lower pressure in the blood was also responsible for the myocardial infarction of the patient. The data of the blood tests of the patients provide the values of the WBC and CRP which indicate that there was any kind of inflammation in his body for this reason this data were responsible. The condition of acidosis in the respiration process was liable for the shock of the patient. So the management of the intensive care unit is crucial to managing this very effectively and the process of recovery of Frank from this worsening situation (Syed, et al. 2021). The state of his medical emergency requires a multidisciplinary approach to combat it including the management of the ventilation process, identifying the shock of the patient, and the responsible causes of deteriorating of his condition. So ICU needs the constant monitoring of this kind of patient who requires thorough assessment. This unit should support the communication between the patients with his family which can play a significant role in improving the condition of the patient.
The case scenario of Frank Jones shares his experience through the clinical assessment in this study. His experience in the ICU is very crucial to know the situation of the patients from his and family’s side which can better the system of treatment (Ebrahimi, et al. 2020). Here the patient experienced a severe medical condition including the various factors of his illness. He is suffering from acute exacerbation of COPD or a chronic disease of the respiratory system that can result from acidosis in the respiration process. The failure of the respiratory system can happen because of the bronchospasm. The lower level of oxygenation was also noticed with the hypoxia of the tissues; these occurred in his body due to the shock, anxiety, and acute damage to renal function. For this reason, Frank needs to be admitted to ventilation support to relax the muscles of the respiratory system. His body also required the proper equilibrium of the fluid management given by the care unit. This fluid management helps to sustain the perfusion with the preload to recover the edema of pulmonary. Hemodynamics, the function of the renal system with his mental condition needs to progress while his breathing state stabilizes after giving effective ventilation assistance and the saturation of oxygenation (Bergman, et al. 2021). So his life-threatening ailment requires the proper guidance of ventilation to develop the state of his breathing condition with the proper urine production. He might be conscious after regaining his sense which is sedated by the drugs to reduce the pressure in the nervous system.
Analysis Of Validity And Potential Sources Of The Assessment
This section of the study effectively manages the rationality with the prospective sources of the measurement of the clinical assessment. Here any kind of inaccuracy which is happened during the offering of treatment will also be enlisted. The planning care will also be represented which can be used in the management of critically ill patients.
Validation of the different parameters
The settings of ventilation in the ICU, and the results of the arterial blood gas along with the rate of respiration can offer crucial information regarding the respiratory condition of Frank. Here the prospective sources of impreciseness may consist of the tidal volume with the asynchrony of the ventilation system. For the cardiovascular factors the blood pressure, rate of the Scvo2, and CVP are the main signs to decide the status of the cardiovascular of him. The process of sedation can affect the level of blood pressure in the human body as well (Peine, et al. 2021). His blood pressure can also be exaggerated by the use of a vasopressor or the use of an effective system of management in the health unit. For the renal system, the output of the urine is the significant marker. The inappropriateness of the measurements can be determined by different factors including the catheter of the renal system. Frank’s neurological condition can be affected by different indicators consisting of the sedation process, and sensitivity of the nervous system. Here the accuracy can be maintained by the sedation process and the assessment of the reactions of the stimuli. The biochemical indicators consist of the different factors of lactate magnesium and calcium. These factors can play a significant role in the process of metabolic decomposition and inflammation in the body. Here the validity can be checked by the proper laboratory assessments of these biological tests and the collection of the specimen from the patient in accurate time. In hematology, there are some indicators that are responsible such as the count of the white blood cells and platelets. The coagulation factors are also responsible for the possible contamination of the coagulopathy (Rafa, et al. 2021). The accuracy of this assessment can be determined by the process of handling the sample properly and the perfect intervention.
The measurement of the synchronization of the ventilation process can be determined by the accuracy of the tidal volume associated with the measurement of the air passage system in the ventilation support of Frank. The settings of the ventilation can be impacted by the excretions or the mucus. The readings of blood pressure are influenced by the employing of the sedation process in the ICU. The differences in the line of arterial can lead to inaccuracy in the measurement. The dysfunction of the catheter system can make differences in the management of fluid in the body and this can incorporated into the proper urine production. The uses of diuretics may also influence the elucidation of the urine excretion from the body [Refer to appendix 1].
Future Information On The Planning Of Care Management
In this particular section of this research works different types of information that are associated with the care planning of this particular patient are described. The essential and effective healthcare management plans are mentioned below,
Precise Ventilators
In the proper implementation process of various precise ventilators, a healthcare professional can properly identify the interactions which are related to the patient. With the help of this specific approach, one can get more detailed information about this particular patient’s data (Ñamendys-Silva, 2021). This system will also become beneficial for the proper management of various factors such as “asynchrony” and resistance of the airways.
Biological Media Cultures
The future planning of healthcare management pans that are related to this patient’s neurological disorder should utilize the process of media culturing. For the identification and understanding of proper pathogens and disorders, healthcare can use the culturing process of biological samples such as blood, respiratory samples, etc. It would be very beneficial during the process of targeted therapies for this specific man with a neurological disorder.
SOFA results
The further healthcare management plan can include the results of the SOFA test which are used to identify various organs’ activities. With the help of this SOFA score calculation, one can easily get the information which would be very vital during the precise treatment process (Huang, et al. 2022). On the other hand, this specific test result can provide effectiveness in the current treatment process.
Proper EEG
Identification of continuous improvement of the patient’s nerve conditions healthcare professionals should take the help of the EEG process (Endacott, et al. 2022). If positive outcomes are found for the patient’s condition this process might not be effective but if the situation of the patient becomes problematic it would be very effective for the identification of issues with the patient’s nervous system.
Analysis of Medical History
The proper analysis of the patient’s medical history needs to be identified for the further treatment process of this patient. If there was any previous record of any nerve disease healthcare professionals can identify those problems properly which will be very effective for future treatment planning.
Patient-centered Care Planning
Healthcare professionals can plan the treatment process according to the patient’s characteristics and with the proper recommendations of their families (Cardinal, et al. 2020). It was identified with the help of patient-centered care medical professionals can plan the treatment of this particular patient properly.
The Reflective Analysis Of My Own Knowledge Development Regarding The Clinical Assessment Of Ill Patients
This particular part of this research analysis contains a detailed reflective analysis of my skills and knowledge of mine which are developed throughout this entire research work. The clinical assessment process which is done about this particular patient’s disorder has been very beneficial for the development of my knowledge and skills regarding the clinical treatment process.
Throughout the clinical assessment, I have identified and understood a wide variety of details which was associated with the patient’s disease conditions. I have learned about different types of diagnostic and treatment procedures which are essential for the management of a patient’s disease. Whenever I have obtained the details of new patients I have gathered knowledge about various new aspects of clinical care. I have also gained knowledge about different types of aspects which are associated with clinical signs and symptoms and the development which are associated with it.
The proper analysis of various ICU procedures I have learned different aspects of the techniques and procedures which are used in the ICU ward of a healthcare place. During this clinical assessment of ill and diseased patients, I have learned various factors such as how the treatment is done in the ICU environment and what approaches should be essential for the proper development of health care in the ICU environment properly. These continuous evolutions have become very significant for the development of my personal skillset for the clinical care procedures.
Conclusion
In conclusion it can be concluded that the study of the effectiveness of the intensive care unit in managing the condition of the patient in a suitable way is very essential for the professionals and the patients also. Here is the clinical assessment of the patient was evaluated with proper clinical data in different parameters which helps to understand the state of the patient and the requirement of the effective assessment of patient. The data are clinically evaluated in this study to associate with the pathophysiology. This has effectively discussed the management of ICU to deal the patient properly and the experience of him in this position of the body. This study has also focused on the validity sources of the data and how can it be accurate in the assessment. It has encompassed that how the planning of the care can be improved to get benefits.
References
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