Homework Help | DQ response

Nursing homework help

Gateway Essay Writing Help

No enough time to write your essay? Don’t worry. Our experts will help you in writing your essay. Place an order and let our team help you get the best grade in this essay.

Plagiarism Free Essays

Plagiarism is the greatest enemy of academic assignments. You must make sure that your essays are well-referenced and uses enough citations. You must also work diligently to make sure your essay is original and with zero plagiarism. Our experts deliver quality papers that are plagiarism free.

Order Completion Rating

Online Tutors

Orders Completed [High Quality]

 

This assignment was solved yesterday, for the first time by our experts.

 

DQ response

 

Kristy Maracle
Posted Date
Apr 28, 2022, 5:05 AM
Unread
You are making rounds in the intensive care and the nurse reports the patient has spiked a fever, oxygen saturations are below 85%, tachycardia, and variant hypotension. The patient is intubated and has been treated for COVID pneumonia for 10 days. What are some specific aspects of assessment and diagnostic workup on which you would want to focus? Provide three differential diagnoses at this point and what treatment parameters you need to start while ruling out complications. What are the risk factors necessary to take into considerations as you develop treatment parameters for this patient? Think about sepsis from multiple sources of a prolonged ICU stay. 
Covid is a multisystem disease that is believed to be fueled by cytokine overproduction, leading to multiorgan dysfunction. This virus has been isolated from the lungs, blood, urine, feces, liver and gallbladder and autopsy findings include vascular involvement, congestion, consolidation, hemorrhage, and diffuse alveolar lung damage that is consistent with ARDS. Additionally, SARS-CoV-2 has a strong association with hypercoagulopathy related to endothelial injury and statis, leading to increased risk of thromboembolism. Severe COVID cases are often managed in the ICU setting with mechanical ventilatory support and invasive devices, which further complicate the course of this disease (Tufan, Kayaashan, & Mer, 2021). As such, even with vigilant management, the likelihood of disease progression and unintended secondary infection is high. The patient in the scenario is experiencing symptoms for which ARDS, pulmonary embolism (PE), secondary blood/pulmonary infection/sepsis are potential differential diagnoses. The focus of the assessment and diagnostic workup for this patient would include ABG’s to rule out impending respiratory failure, CXR, CTA with d-dimer to rule out PE, evaluation of urine output to exclude ventilator induced kidney injury, and  other evaluations including assessment of invasive devices to look for possible sources of infection to include blood cultures, urinalysis with culture,  sputum culture and skin inspection to rule out an undetected infected pressure injury. The initiation of empiric broad-spectrum antibiotics and aggressive fluid resuscitation is warranted since the patient meets the SIRS criteria (Tufan, Kayaashan, & Mer, 2021)
Risk factors that need to be taken into consideration before implementing a treatment plan include advanced age, history of diabetes, hypertension, chronic respiratory failure, heart disease, and impaired immunity, which are all associated with greater risk of mortality. Additionally, prolonged mechanical ventilation is associated with diaphragm weakness, muscle wasting and weakness, deconditioning, recurrent symptoms, and derangement of the hypothalamic-anterior-pituitary-peripheral-hormone axis, which may be exacerbated by some changes in ventilator settings. Furthermore, mechanical ventilation for greater than 8 days is associated with a greater risk of development of pressure ulcers and the need for a tracheostomy (Ambrosino & Vitacca, 2018). 
Covid is often managed with higher levels of PEEP, especially in the setting of ARDS, which has been shown to increase CVP and airway pressure, leading to higher blood pressure and tachycardia. This is most prevalent in those over the age of sixty-five and in those with hypertension or heart disease (Zhou et al, 2019). Research also indicates that keeping Covid patients on the drier side is associated with better outcomes for which the fluid resuscitation for possible sepsis may become questionable (Tufan, Kayaashan, & Mer, 2021). 
References
Ambrosino, N., & Vitacca, M. (2018). The patient needing prolonged mechanical ventilation: A narrative review. Multidisciplinary 
Respiratory Medicine, 13:6. https://doi.org/10.1186/s40248-018-0118-7
Tuftan, Z.K., Kayaashan, B., & Mer, M. (2021). Covid-19 and sepsis. Turkish Journal of Medical Sciences, 51(7), 3301-3311. 
https://doi:10.3906/sug-2108-239
Zhou L., Cai, G, Xu, Z., Weng, Q., Ye, Q., & Chen, C. (2019). High positive end expiratory pressure level affect hemodynamics in 
elderly patients with hypertension admitted to the intensive care unit: A prospective cohort study. BMC Pulmonary Medicine, 19:224. 
https://doi.org/10.1186/s12890-019-0965-9

 

By placing an order with us, you are guaranteed to obtain an original solution to this assignment. Our rates start at $9.

Click here to order a solution.

Gateway Essay Writing Help

No enough time to write your essay? Don’t worry. Our experts will help you in writing your essay. Place an order and let our team help you get the best grade in this essay.

Plagiarism Free Essays

Plagiarism is the greatest enemy of academic assignments. You must make sure that your essays are well-referenced and uses enough citations. You must also work diligently to make sure your essay is original and with zero plagiarism. Our experts deliver quality papers that are plagiarism free.

Frequently Asked Questions – King Service FAQs

Is this service Legit?

This is an extension of Gateway Assignment essay writing services. Gateway is a group of writers brought together by the desire to help students achieve more in essay writing. Our Writers are experts in tutoring, research, and writing activities. We have worked with over 5,000 students pursuing college, undergraduate, Masters, and Ph.D. degrees. Our Services are Trusted and Verified.

Will My Paper have plagiarism?

No. Absolutely Not. All our Papers are Original and are written by our experts from scratch. To be sure, you can request a plagiarism report when placing an order.

How Fast can you deliver my paper?

Any duration you select when choosing a deadline for the paper. The number of hours could be 3 hours to 24 hours to 2 days, a month, or any other duration.

For short assignments ranging between 1 page and 3 pages(100 – 1000 words), we can have them delivered in 1 hour.

Can I get a professional writer to write my essay?

Absolutely Yes. If you are looking for the most reliable and executive essay writing service, you are in the right place.

Our Service is a program dedicated to improving student’s achievement in essay writing assignments. In our company, professional tutors and expert writers work together to create original solutions to help students complete their assignments.

Our essay writing service is the most reliable writing help online. Our writers are former students and researchers in leading institutions across the world.

Our founder, Frank, is a legend writer and educator who has contributed significantly to improving the performance of thousands of students.

The goal of Gateway Assignment is to lead in changing the learning process by allowing students to access unlimited resources in writing their essays.

How Much will it Cost?

Our Rates start at $10 per page (275 words). Plus:

  • Free First Page
  • Free Reference Page
  • Free Unlimited Revisions
Can I get a Discount for my first paper?

Ofcos. Use the discount code “GATEWAY20” at checkout to get a 20% discount off on all essays you order.

Do I get a refund if I am not satisfied with the paper?

Yes. Anytime you establish that Our Services did not help you meet your desired outcome, you are entitled to a Full Refund. Read our refund policy to learn more.

'One More Question'?

Chat with a live agent on the floating chat. Frank is online now.

Get a Plagiarism-free paper Today

Order an essay, term paper, research paper, or any other assignment and get an expert to work on it. Use GATEWAY20 to get a 20% discount on all papers.

Alternatively, Check Out the FIVE STEPS in writing an essay