This essay focuses on the importance of recognising of the deteriorating patient and knowledge gained from the rehabilitation lectures.The lecture sereies briefly discusses the anatomy and physiology, medical management as well as the nursing management of a rehablitation patient.It also provides, nurses the importance of recongnising a clinical deteriotation with the help of early warning and reponse systems.
Recognition of the deteriorating patient is very important in clinical setteings. Interpretation of patient vital signs help to recognise clinical signs of deterioration.The clinician needs to record the vital signs that are deliberate when using early warning and response systems.For the better interpretation, clinicians need a data which is consistant, complete and avilablie.ADDS (Adult deterioration detection sysytem) is the new system which introduces by queensland health, to improve the early recogniton and response to clinical deterioration in adults.ADDS assists clinicians to follow a patient’s physiological status by providing a graphical illustration of vital signs over time and across the specific parameters.ADDS is colour shaded graphic data,which helps qucikly and easily identify the changes with the scoring system.All patients must have baseline observation recorded in ADDS on admission.Montioring the vital signs assists in advance warning of deterioration.This early intervention help to achieve faster and better outcomes in a declinig condition.
SBAR is a communication tool which use to help deliver messages more effectively. S stands for what is the immediate situation needed this communication; B stands for which clinical background led to this situation, A stands for explain the current issue, R stands for the recommendation which required to adress the particular problem. It helps in patient safety and assists in improving patient care.
In review of cardiovascular sysytem, 75% patients who admitted in the rehabiliatation ward in 2008 related cardivascular diseases.The normal blood pressure varies in each pesron according to age and sex.Blood pressure and ECG monitoring is very important in stroke, aged and diabetes.Hypertension is a high risk factor of stroke, myocardial infarction and heart failure in old age people.Both drug and non drug therapy are very important in treating hypertension.CHADS score is commonly using tool to find cardiovascular risk status.Proper management of venous thrombo embolisam is essential in stroke patients.Unfractioned heparin is the key prophalaxis of venous thrombosis in stroke patient while non ambulent.For the better management of VTE,needs to avoid the risk factors such as trauma to the lower leg,intravenous cannulation in lower limb and pressure areas.Bedcradles and heel wedges are helps to reduce the risk VTE.
Most of the patients in rehabiliatation facing breating difficulteis .It may relate diseases such as asthma, bronchitis, COAD, spinal cord injury, deconditon and infiltrarting diseases.Routine observations helps to identify early signs of respiratory distress.Respiratory function tests helps to identify proper diseases. Pharmacological and physical agents are using the management of dysponoea.
Dehydration and electrolyte imbalance are most common problems in stroke and other rehabilitation related patients.Body fluid composition is related the age and sex of a person.Dehydration leads to hypotension, delerium, urinary tract infections and constipation.Isotonic fluids are recommended to treat dehydration through subcutaneous infusions.Fluid restriction also optional in patients who using diuretics.Urinary retension and incontinence are common problems in rehabilitation patients.Urinary retension always treated with urinary cathetes according to high bladder residual. Prazocin and oxubtinin is drug of choice to manage bladder problems.Bowel incontinecnce and constipation is major concerns in