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In the given case study, I would apply a focused assessment to Brian. To know that why I chose focused assessment over the others, I will provide a brief description of all four types of inspections. Starting from the comprehensive health assessment, it is the type of evaluation that provides the nurse with an insight of what the patient holds physically, his physical health status through observation and measuring the vital signs of the body; here, Brian doesn’t have a physical disease like an infection. Next comes ongoing partial assessment that is a regular checkup of the patient along with his already going on examination, this might help a bit but not much because regular inspections don’t include a detailed checkup. Next comes an emergency assessment. In this, the patient is treated with some predefined ways to tackle an unstable patient while Brian is stable in this condition but requires medical assistance (Cooper & Cant, 2014). Lastly comes focused assessment why I chose it because the focused evaluation is a detailed nursing assessment of a patient’s specific body systems that are affected by the problems he is currently facing since Brian came up with new symptoms that he didn’t have before, so a detailed focused assessment is required to reach the roots of his disease.
Brian’s blood pressure came out to be 160/90 mmHg, while the average blood pressure of a human body is between 90/60 mmHg and 120/80 mmHg. The comparison leads us to a high blood pressure that Brian is diagnosed with. The average respiration rate for a human body is 12 to 16 breaths per minute, whereas Brian has 18 breaths per minute that lead to a high respiration rate. The brain’s pulse rate came out as 102 beats per minute while the standard pulse rate rests between 60 to 100 per minute, and an increased pulse rate is found. A typical body temperature resides between 37.2 degrees Celsius to 36.1 degrees Celsius, and findings in Brian’s assessment tell his temperature is normal. He has familiar general body aches that may result in an outcome of tiredness. His glucose levels are also high compared to that of a non-diabetic patient. Glucose levels higher than seven mmol/L are considered diabetic, and Brian’s history already says he was a diabetic patient. Brian is 170 cm in height, an average heightened person in general. Keeping in view all these findings and comparisons, the focused assessment is prescribed because it will focus on the detailed checkup of the patient’s body that might include one or more than one systems of the human body depending upon the symptoms that might affect several systems and this varies from person to person. The focused assignment provided four steps to go through and performed a detailed assessment that is an inspection that allows the doctor to review the patient’s condition along with his medical history, auscultation followed by percussion and lastly, we have palpation Habich & Letizia, 2015). These steps will enable us to get a better insight into the patient’s body and how the symptoms are affecting what systems and in what way, leading to the leading causes.
Brian takes multiple medications currently, of which I am going to research on the one named captopril 25mg that he takes twice a day. Captopril is an artificial and synthetic equivalent of the snake venom peptide. It was first made in 1975 and was used in the market expendable just six years. It is considered as a founder of the whole family of ACE inhibitor drugs and medications that are used to deal with conditions related to hypertension since Brian is a patient of hypertension that involves conditions like high blood pressure and the blood pressure in that of arteries in the circulatory system keeps escalating. Moreover, it is used to treat kidney problems and diseases like nephropathy that is mainly encountered by diabetic patients with type 1 diabetes (Veenema, 2018). At the same time, the brain is a type 2 diabetic patient that states why Brian is using these tablets.
Moreover these pills are used for patients that have a disease called retinopathy. Captopril is a whole set of medications, a class of ACE (angiotensin-converting enzyme) inhibitors. That is used to deal with situations like hypertension. Now I will state down how captopril can affect vital signs of Brian in the findings we had.
In general, captopril causes a substantial decrease in blood pressure without causing an increase in the heart rate. That Brian’s condition is quite favorable since his findings show he has increased blood pressure with an increased heart rate, so medication is helpful to reduce that. As captopril includes the ACE inhibitors that tend to positively affect the respiratory system cause an average pace to occur that is 12 to 16 breaths per minute while Brian experiences a fast respiration rate, this medication will help to put it back to normal. In general, captopril does not affect the heart rate of a person and does not change it. In contrast, in some specific cases, captopril came out to increase and decrease the heart rate, keeping in view every human body varies from each other and tends to behave differently to the same set of conditions (Messerli & Bangalore, 2018). Side effects of captopril can include faintness, lightheadedness with a loss of taste. The person may suffer from a dry cough if the symptoms worsen but no effects on body temperature. Captopril supervisions tended to decrease the glucose levels by 0.6-2.2 mm the total variance was substantial at 1200 to 1400. So keeping everything in view, captopril is suitable in Brian’s conditions.
There might be many factors of lifestyle Brian adopts that are impacting his health. Out of those two much essential factors can be seen and highlighted that are number one, excessive consumption of takeaway food and long hours of work and keeping in mind his age and health, these factors affect him more than they would have effected a much younger adult since this age causes a delicacy in the human body including all the systems, mainly respiratory, immune, cardiovascular, digestion and many more, the human body cannot fight against the firm and harsh conditions faced as effectively as he could be at the age of ’20s to ’40s. The immune system becomes delicate as age increases, and with the pre-acquired diseases, Brian’s health will be effected faster when encountered with these factors. Takeaway foods may hold the extent of germs and bacteria transfer since the main focus of such centers is to make more sales than focusing on hygiene; thus, a spread of germs and bacteria can come into existence (Parham, 2014). And a person like Brian can easily be prey to such conditions, next comes the longer hours of work that eventually cause lots of tiredness and lack of comfortability, and these can result in supporting his diseases to spread faster in away.
What I will suggest after looking through everything will be that Brian needs to cut down on takeaway foods from outside and bring food from his home to his workplace with the increased use of more fruits, natural juices, raw vegetables and lots of water to nourish and keep his immune system as strong and healthy as possible, to help fight off his diseases much efficiently. Also, Brian sits for long hours of work. He can perform a set of relaxing and breathing exercises while sitting in his workplace and doing nothing. He can perform these exercises which will help to wear off the tiredness, eventually leading to a better and healthier body.
A check on his medications that he takes timely will also contribute to his health and maintenance of his systems, mainly immunity.
There are many respiratory diseases, but I am going to state down about asthma here. Asthma is a condition in which a person’s airways swell and contract with a production of extra mucus. This very thing reasons breathing difficulty and activates coughing that may become harsh with the spread of disease and the time it takes to develop stronger. Also, a shrilling and whistling sound erupts when the person breathes in and out, and this may even cause shortness of breath.
The speedy relief and quick way to tackle this problem is the use of quick-relief inhalers that soothe down the shortness of breath and help restore the breathing process by opening the swollen airways.
For more critical and harsh conditions, asthma control medications are set in use along with allergy medications if the person persists any. These medications are to be taken daily in the person’s routine and are the major cornerstones for supporting an asthma treatment.
Up till now, science couldn’t find a way to prevent this disease, yet it can be controlled, and a step by step plan could be devised for the person to live with this condition. The patient and the doctor together can sit down and write a detailed plan for the medications to be used with how the asthma attacks could be handled when encountered, which can lead to fewer complications.
Cooper, S. J., & Cant, R. P. (2014). Measuring non-technical skills of medical emergency teams: an update on the validity and reliability of the Team Emergency Assessment Measure (TEAM). Resuscitation, 85(1), 31-33.
Habich, M., & Letizia, M. (2015). Pediatric Pain Assessment In the Emergency Department: A Nursing Evidence-Based Practice Protocol. Pediatric nursing, 41(4).
Messerli, F. H., Bangalore, S., Bavishi, C., & Rimoldi, S. F. (2018). Angiotensin-converting enzyme inhibitors in hypertension: to use or not to use?. Journal of the American College of Cardiology, 71(13), 1474-1482.
Parham, P. (2014). The immune system. Garland Science.
Veenema, T. G. (Ed.). (2018). Disaster nursing and emergency preparedness. Springer Publishing Company.
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