Delivery in day(s): 4
Health Variations Nursing Proof Reading Services
Question 1.Prioritise the nursing responsibilities and associated rationales related to the administration of morphine to Eleanor
Ans: Due to the suffering through ulcerative colitis, the sensational abdominal pain and the cramping pain has offered numerous problems to Eleanor. Thus, she was unable to eat and drink as she required. Thus, she has lost nine kilograms in last two weeks. Based on the situation, the health care practitioner attending Eleanor has suggested the nurses to offer morphine to reduce the pain before the surgery has offered to her. The administration of the morphine as the drug based solution, the concept is termed as “analgesic solution” to Eleanor. The exact priority to offer the morphine to Eleanor by the nurses attending her at hospital is refereed as the “nurse controlled analgesia”.
It is required to offer the morphine as drug as it binds with the opioid receptors in the brain and in the spinal cord for the perfect alteration of the transmission of impulses along with the pathway of the pain that Eleanor is suffered through. On the other hand, administration of this drug as prescribed by the attending doctor is required to be offer to the patent in accurate measurement, or else the side effects will get raised and it may also pose the additional problem to Eleanor. The nursing responsibilities are as below:
1. Checking the status of the severe pain of the patient before application of the drug and reporting to the doctor regarding the modification of dose of Morphine
2. Abide by the rules and regulations to offer the same treatment irrespective of the cultural barrier’s as the ethical aspect maintenance.
3. During the application of the drug , taking care of the proper dose application and progress about the heath recovery also are required to be monitored by the nurses and proper reporting to the supervisor is required to be followed by the nurses.
It is required to prefer the tasks by the nurses to maintain the ethical, and the legal considerations for their practice related issues.
Question 2 Describe the structural and functional changes that occur in the pathogenesis of ulcerative colitis that led to Eleanor’s episodes of diarrhoea with blood and pus.
Ans: During the execution of the ulcerative colitis, the changes in the pathogenesis takes place as below:
1. The primary lesion commences as the inflammation at the base of the mucosal layer which is situated at the base of crypts of Lieberkuhn in the anal at the retrosigmodial area.
2. It starts with the tiny pint point haemorrhages to the crypt abscesses moving towards the necrosis and ulceration
3. Lesions often expands laterally resulting to the large denuded areas
4. It affects at the primary level at the mucosal layer and then gradually spread to the submucosa.
5. After that the proximal extension of inflammation takes place in a continuous manner.
6. It results to the devastation to the muscosa in terms of cramping pain as the patient has suffered through.
7. The chronic inflammation causes to the narrowing and shortening of the colon for which the artificial replacement is required which matches with the criteria as the case study patient has offered for ileostomy.
8. The narrowing of the colon thus results into the development of pseudopolups, and also the alterations of the intestines take place due to the loss of absorption through the mucosal surfaces, and due to the rapid colonic transit time.
The diagram representation of the healthy colon and the ulcerative colon has been mentioned below:
The progress of the ulcerative colitis is as below:
A. Cell damage in Rectum
B. Causing procitis
C. Affecting the colon
D. Damage of the cell of colon
E. Excreting of blood from the affected colon and rectum to form blood and puns in stools
Question 3 Explain the characteristics of the intravenous fluid that was ordered for Eleanor, and the rationale, related to Eleanor’s specific fluid balance status, for the administration of this intravenous fluid to Eleanor.
Ans: The Hartmans solution has been ordered for Eleanor as the intravenous fluid. The composition of this solution is with sodium lactate, Potassium Chloride, Sodium Chloride, and calcium chloride. These composition are formulated in water to apply as injection. The composition of this solution is as below:
This solution maintains the electrolyte balance as well as offer the required energy and water for the perfect hydration. It also normalise the PH balance of the acid base balance of the physiological balance in an effective manner. The intervention of the application of this solution has been ordered in every 6 hours which is required to maintain the fluid balance in the body of the case study patient.