Karen is a 67-year-old female. Karen has two children who live in interstate, her NOK is her next-door neighbour, Fiona. Karen smoked for 40 years and has been diagnosed with COPD 8 years ago. She has had 2 falls in the last week. Karen has recently been experiencing a persistent cough throughout the day, is producing large amounts of sputum and is feeling more SOB on exertion. In the last 4hrs, Karen has noticed she is unable to walk and is now talking in broken sentences. Karen phoned 000 and was taken to emergency, the paramedics hand over Karen to you in the resus bay. Your A-E assessment on Karen:
Airway: Patent, Unable to talk
Breathing; Respiratory Rate: 40, Auscultate: wheeze, Trachea: Midline, Effort: Tripod position, pursed lip breathing, use of accessory muscles. SPO2: 86% with 6L O2 via HM
Circulation: Cyanosed, clammy, central cap refill 5 sec, pulse 140bpm, blood pressure 220/105.
Disability: GCS: 14, Alert, PERL, BSL: 4.9,
Exposure: T: 37.9, Skin Intact
Considering the observations that you have just taken on John and Karen using the A-E approach, who will be your priority patient? Explore the top two priorities for that patient in depth and discuss why these were selected. Your answer can include nursing interventions, diagnostic tests, and medical orders/interventions, consider the purpose/benefit of these interventions. Exclude pharmacology here.