Please use recent referencing and guidlines from UK.
Part 1 -Instructions 1. Critically evaluate the data below, link it
with appropriate pathophysiology, discuss the current ICU management, and
specifically consider the patient’s experience. (60%)
Part 2.- Critically discuss the validity and potential sources of
error in the measurement or assessment of any of the items of data below and
discuss further information that would be useful to plan care. (30%)
Part 3 I have started but needs
re-writing Utilising a
reflective model, reflect on how you could develop your knowledge and skills
for clinical assessment of critically ill patients. (10%.
Reflection – What, So What, Now
What. Rolfe et al.’s (2001) I was
allocated to look after a patient who needed a new Arterial line and Central
Venous Catheter (CVC). As I was busy, I drew the sample and placed it in the
Blood Gas Machine; while speaking to another staff member about items I needed
during the night, I selected Venous without focusing. The sample was analysed
as an arterial sample but was a venous sample that had been processed. The
reading of Svo2 was very high, indicating that the artery is rich in oxygenated
blood. This meant that there was a possibility of the CVC line being in an
artery instead of a vein. This was a cause for concern as the results were
transferred to the flowsheet, so when the medical doctor saw that Svo2 was
<60% for a venous site, that meant the sample was inaccurate, or the
catheter was placed in the wrong site as the expected level should be 60-80%. I
then retook both samples separately, analysed the results, and transduced the
CVC line with tracing and reading; CXR was requested by the medical doctor for
NG placement and CVC position check to be more confident. Because of this learning curve, I am now much
more focused when performing tasks by minimising the amounts spoken and
distractions so that samples and labelling of items are done correctly, thereby
reducing stress levels that are already high and reducing delays in treatment
time for patients.
