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Randomized Clinical Trial Of Effectiveness

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Randomized Clinical Trial Of Effectiveness

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An assessment provides an opportunity for nurses to set up a firm and desired therapeutic effect. Assessment involves multiple steps with the objectives being to diagnose which later become the basis for nursing treatment. The three most important steps in assessment that would be conducted to Jim in the day of admission include, comprehensive assessment, quick priority assessment and lastly focused assessment (Rajinikanth, 2012).
Comprehensive assessment comprised of a detailed assessment on the client. The relevance of admission assessment is to establish a complete data base, find a base line information and problem identification. Treatment plan to follow. Obtaining all this information helps in narrowing the problem of the client. In accurate observation of the client may lead to his death, example Jim has a blood pressure of 158/86 mmHg indicating that he was hypertensive and needed immediate care or else it might resulted to a heart attack.
Quick priority assessment is done at the start of each shift or whenever the condition of the patient changes at any time. The relevance of this assessment is to identify the life threatening problems example in rapid assessment of the airway. The information gotten is used in the development of a care plan. In accurate assessment for Jim may result to serious complication for example Jim has dyspnea if this problem is not identified early it may lead to suffocation due to lack of adequate oxygen.
Focused assessment is a detailed nursing assessment which deals body systems. The relevance of this assessment is to determine the status of a specific problem identified in the earlier assessment, expose the problem and treat it, the major aim of this assessment is to diagnose and treat the patient so as to stabilize the condition. Lack of proper focused assessment may lead to not finding the root cause of the client’s problem hence no diagnosis and treatment would be established (Bennett, 2013).
Nursing Care Plan:   Jim
Note:  Dot points recommended in care plan.   Click and type in each cell, click enter in a cell to make it longer. Do not remove text from the template.
A reminder that all rationales must be referenced 
Medication management
Oseltamavir 75mg orally bd is used in the treatment of symptoms caused by influenza virus. It relieves and makes less severe symptoms such as fatigue, fever, aches and stuffy nose. This interferes with the release of progeny influenza virus from infected host cell, thus halting spread of infection within the respiratory tract (Hirsch, 2013). The nurse should ensure that the client takes the drug daily for five days. The drug should be taken orally and should be taken with food to enhance tolerability. Most of the side effects of this drug don’t really need medical attention. Common side effects of Oseltamivir include nausea and vomiting.
Paracetamol 4/25 orally pm is used in the treatment of mild to moderate pain example headaches, pain in the muscles, lowering of high temperatures such as fever and lastly relieving  fever and  malaise caused by colds and flu (Olson, 2011). The nurse should ensure that the patient takes the recommended dosage of the tablets per day, over dosage of the drug may cause toxicity hence liver damage. Before administration the nurse should management that the client is not allergic to the chemical components of the drug and he also no liver problem. The drug usually has no side effects, in case of any allergic reactions examples rashes or swelling the treatment therapy should be stopped.
Fluvax IM stat dose is used in the prevention of influenza (Levinson, 2012). It contains inactivated form of the influenza virus which cannot cause infection hence making the body to develop antibodies which act as a defence from getting flu. The nurse should ensure the vaccine is vaccinated once a year and documented in a card indicating the next vaccine. The drug is injected in a muscle mostly the upper arm that is the deltoid muscle. The nurse should take care of not injecting a vein. The side effects of the drug include allergic reactions which occur rarely and resolve without treatment.
Patient teaching
Lifestyle modification for hypertension prevention and management include, lose weight if overweight, limit alcohol intake, increase aerobic physical activity 30-45 minutes a day, sodium should be taken in low quantities, recommended intake of potassium in the diet, recommended intake calcium in the diet and magnesium for a healthy body and lastly decrease fatty foods and cessation of smoking for a general cardiovascular health.
The importance of this topic should be understood by Jims so as to familiarise the disease is caused and how lifestyle modification and medication can regulate hypertension. The client’s needs to know hypertension can be controlled rather than be cured. The client should know why tobacco should be avoided not because is connected to hypertension but because  it can cause a heart disease for anyone with high blood pressure.
The only assurance method that will be used so as Jim will understand why it is important, is by taking him all around the hospital showing him patients who have the problems that he might have if he doesn’t consider the advice given. In order to prevent the future outcomes Jim should stop smoking.
Clinical judgement and handover
Jim has on a medication for influenza and he was recovering but judging from the presenting vital signs, high temperatures of 39.6c, a rapid heartbeat of 125beats/min and a high respiration rate of 24 breaths per minute and a low oxygen saturation on room air, Jim has developed withdrawal syndromes this is evidenced by the history taken which indicated that he smokes cigarettes five to ten time a day. On the two days that he has been in the hospital he has not been smoking cigarettes hence the withdrawal symptoms. The following drugs can be used to decrease the amount of nicotine in the body, they include over the counter nicotine replacement medications such as the skin patches and the nicotine gum and second is the nicotine prescription replacement methods such as the inhalers and nasal spray.
 MR Jim a 58 year old indigenous male was presented to the emergency department with dyspnea, myalgia, fatigue, malaise, rhinorrhoea and headache. On examination he was found out to have clear nasal discharge. His medical history indicated that he had asymptomatic hypertension, allergic to chicken and an active smoker. On physical assessment the skin was hot and diaphoretic. He had musculoskeletal joint disorder, bilateral wheezes and undernourished. Vital signs check-up showed he had high temperatures, heart rate and blood pressure. The patient was diagnosed with influenza and was administered Oseltamivir as a starting dose. Other medication administered were paracetamol and fluvavax. Day three post his admission Jim had tested positive for influenza A and the influenza symptoms had decreased over the past 24-48 hours. Jim was scheduled for discharge only after this morning he started complaining of feeling cold. He had high temperatures of 39.6c, a heart rate of 125 beats per minute, respiratory rate of 24, blood pressure of 124/79 mmHg and indication of withdrawal symptoms. Close monitoring is required to assess his progress. He has been reviewed by the doctors and advised to continue with management and rest.
Bennett, C. (2013). Portfolios in the nursing profession – use in assessment and professionalportfolios in the nursing Profession – use in assessment and professional. Nursing Standard, 23(6), 30-30.
Boushey, H., Fick, R., Lazarus, B., & Martin, A. (2012). anti-ige: a unique approach to asthma management. Gardiner- Caidwell syner med NJ, 2, 24.
Garner, J. (2011). hospital infection control practises advisory committee: guidelines for isolation precaution in hospitals. infection control and hospital epideomiology, 17, 53-80.
Hirsch, M. (2013). medical management of influenza infection. Annu rev med, 59, 397.
Knebel, A., Bentz, E., & Barness, P. (2013). Dyspnea management in alpha-1 antitrypsin deficiency: Effect of oxygen administration. nursing research, 49(6), 333-338.
Levinson, W. (2012). CSL biotherapies Australia is taking extra steps to ensure the safe use of Fluvax [influenza virus vaccine] in young children. Reactions Weekly, 32, 2.
McAlister, F., Levine, M., Zarnke, K., & Campbell, N. (2012). Canadian recommendations for the management of hypertension. Canadian Journal of Cardiology, 17(5), 543-559.
Moser, M. (2014). . World Health Organization-International Society of Hypertension guidelines for the management of hypertension—Do these differ from the U.S. recommendations? Which guidelines should the practicing physician follow? journal of clinical hypertension, 1, 48-54.
Olson, K. (2011). poison and drug overdose. Mc graw hill, 5, 32.
Pohl, J. (2011). Smoking cessation and low-income women: Theory, research, and interventions. Nurse Practice Forum, 11(2), 101-108.
Rajinikanth, A. (2012). nursing assessment. Application of Nursing Process and Nursing Diagnosis, 12(1), 18-43.
Rosenstein, N., & Perkins, B. (2010). Update on Haemophilus influenzae serotype b and meningococcal vaccines. Pediatric Clinics of North America, 47(2), 337-348.
Shay, L., & Freifield, A. (2013). The current state of infectious disease: A clinical perspective on antimicrobial resistance. Lippincott’s Primary Care Practice, 3(1), 1-17.
Shlaes, M., Gerding, D., John, J., & Bronstein, D. (2014). Society for healthcare epidemiology of America and the Infectious diseases society of america joint committee on the prevention of antimicrobial resistance. Guidelines for the prevention of antimicrobial resistance in hospitals. Infection Control and Hospital Epidemiology, 18, 275-291.
Truesdell, S. (2014). Helping patients with COPD manage episodes of acute shortness of breath. med surge nursing, 94(4), 178-182.
Zaragoza, M., Salles, M., Gomez, J., & Trilla, A. (2012). Handwashing with soap or alcoholic solutions? A randomized clinical trial of its effectiveness. American Journal of Infection Control, 27, 258-261.

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