Can someone help me to answer this Case study? Thank you!CASE STUDYINSTRUCTIONSList the abnormal lab valuesList 3 priority assessments, nursing interventions and rationaleAnswer the critical thinking questions.Provide referencesCritical thinking:List the changes that have happened to your patient from the initial report and your assessment.Would you reposition the patient? If yes, why? If no, why? What position?What meds would you give and why?Would you hold any meds and why?Does the patient need O2? If yes, how many litres would you start with? What device would you use? Ex. Nasal prongs, oxymaskWould you contact the MRP? If yes, why? If no, why?What is your nursing diagnosis?What is your nursing plan for treatments?What are the barriers of discharge?What services are available for the patient upon discharge?CASE STUDYReason for admission: Mr. Smith, 73 yr. old male presented in the ED with, “feeling unwell and achy all over”. It is noted that the patient is pale and diaphoreticVS T: 37.9. P: 136. R: 22. BP: 94/60. SPO2: 93% RAIt is 0700hrs, you just received report from the night shift nurse.Report Received:Pt sent from ED. Mr. Smith was admitted with Abd pain NYD. NKDA, Pt is from home and lives alone. Hx. CHF, COPD, NIDDM, HTN, Enlarged Prostate, A-Fib. Pt states, “I take all my meds every day” T: 37.9 P: 128 R: 22 BP: 100/60 O2 sat: 94% RA, A&Ox3, no specific complaints of pain, NPO, AAT, Ringers 125ml/hr,18g IV in LT AC, TBA 200ml. Tylenol 500mg PO given @ 0300. Airway is patent and clear, Air entry is decreased bilaterally, Circulation normal, cap refill less than 2 seconds. PPP, BS x4, skin warm, diaphoretic at times. No wounds or dressings noted. Pt denies any UTI symptoms, and bloodwork reflects elevated WBC 19.0. Urine sample was obtained and sent along with urine and blood cultures. Results are pending.Your assessment:0730hr- you note that Mr. Smith is sitting in high fowlers position and appears uncomfortable, he is drowsy++ and not orientated to place and time. Pupils are equal and react to light and accommodate. Breath sounds are clear bilaterally at the apex with bilateral wheezing t/o, pt. is tachypneic, Pt states feeling SOB, pulses are bounding and irregular. Bowel sounds are present in all 4 quadrants, Abd is soft but tender upon palpation in RLQ and LLQ, pain radiates to back. Skin is cool and pale. You note that Mr. Smith is diaphoretic and mucus membranes are dry. He has a 18g IV SL in his left AC, and states he is experiencing 8/10 pain.VS: T: 40.0. P: 143. R: 24. BP: 82/60. SPO2: 88% RADrs ordersChest Xray – req sent, tbaRL 1L Bolus than 125cc/hrQ4h vitalsNPOAATGMR dailyHypoglycemic protocolMEDS:Salbutamol 2 puffs inh BIDPrednisone 5mg PO BIDFlovent 2 puffs inh BIDFurosemide 20mg PO ODMetoprolol 25mg PO ODAmlodipine 5mg PO BIDTamsulosin 0.4mg PO ODPiperacillin/Tazobactam 3.375g IV q6hMetformin 500mg PO q12hDalteparin 5000u SQ qhsMorphine 2mg – 5mg IV q4h prnTylenol 1g PO q4h prn for temp greater than 39Dimenhydrinate PO/IV 25mg – 50 mg q6h prn
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