Hypothetical case study

Case study of a 68year old patient who has just been transferred to the ward on account of previous episodes of loose stools from the side room but now clear, all stool samples negative. Patient has a background history of type 2 Diabetes, Barrett’s Oesophagus, Heart failure amongst others.

At the start of the shift, patient was noticed to be curled in bed, weak, with oxygen in situation at 4L/hr with a nasogastric tube in situation. Alert and orientated. Has a urinary catheter in situ.

Observations done with the following parameters

Temperature: 37.8°C

Heart rate: 98bpm

Respiration:22cpm

B.P : 66/48mmHg

Oxygen Saturation: 97%.

NEWS2 score of 8 out of 10. Critically discuss the initial assessment, planning,monitoring and treatment

Patient further deteriorated with systolic blood pressure on riding to about 90mmHg and persistently stayed in the 80smmHg.

Temperature: 38.2°C

Heart rate: 118bpm

Respiration:22cpm

B.P : 80/42mmHg

Oxygen Saturation: 94%.

Critically analyse the management of this patient and intervention. Including bloods and treatments.

Using NICE,UK guidelines .

Patient later moved to the intensive care unit for further management. Critique with timing of referral and management protocol.

Reflect on the practice and what could have been changed to prevent or change the outcome for patient.

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