Question

This assessment task aims to develop your ability to apply the first three phases of the clinical reasoning process, at an introductory level, to the patient scenario below. You are a student nurse working with a school nurse (registered nurse) in a secondary school. You and your mentor are supervising a bubble soccer match this afternoon (26th March) which commenced at 1400 hrs. The match goes for 40 minutes with a 5-minute break in between the two halves. It is a hot and sunny day, the air temperature is 32 oC and the humidity is 45%. After the match, your mentor asks you to perform a range of health assessments to make sure the students are fit to go home. Jessie Lin is 16 years old and in Year 11. It is now 1450 hours. You assess Jessie's vital signs and record the following results: Temperature (tympanic) 38.5 oC Pulse rate 140 beats/min Respiratory rate (RR) 29 breaths/min Blood pressure (BP) 130/70 mmHg Jessie has flushed skin (see picture above) and her t-shirt is soaked. Her past medical history has not yet been documented in the school record as she is a new student and only enrolled in the school last week after moving from another state. She informs you that her mother is waiting for her in the car park, but she feels very hot and that her heart feels like it is beating very fast. She asks you for a bottle of cold water and a chair. Jessie's previous observation records (on a clinical chart) are: Date BP Pulse RR Temp 23rd March 2020 110/60 70 14 36.8 24th March 2020 112/60 74 12 36.6

Question:

Propose what further cues you want to collect and explain why these are relevant and important to the situation (approx. 450 words) To do this successfully, you will need to form a logical opinion about what the further cues should be, when you would undertake the assessments to collect these cues (e.g. after some immediate actions for Jessie) and why these cues should be assessed. Relate your justification to Jessie's situation AND to the principles of anatomy and normal physiology (focusing on homeostasis).

Answer 1

Given:temperature of jessie-38.5 degree celsius,pulse rate 140 bpm,respiration rate-29 rpm,flushed skin and sweating

Environment :hot and humid

Condition indicate hyperthermia

The condition occur when body's heat regulation system becomes overactive by outside factors like hot temperature etc and results in internal temperature rise.

Normal core body temperature is 35.5 to 37.5 degree celsius.Now,temprature of jessie is above 38 degree celsius.Heat exgaustion us one of more serious stages if hyperthermia.Any activity that involves exercise in warm,humid environment increases chances of hyperthermia condition.

Client was sweating because body attempts to cool itself by sweating and it takes water,crucial salts and electrolytes causing dehydration.Mild dehydration results in headache and muscle cramping.

Without treatment it can lead the client's ability to stop cooling and lead to organ failure or death.

Stages of hyperthermia causes:

Excessive sweating

Exhaustion -It can lead to heat stroke.Increasing deep breathing.

Flushed orcred skin

Muscle cramping

Headache

Nausea

To protect the student,student should immediately taken to cool,shaded place with good airflow.

Should given sipping cool water with elecrttolytes like ORS (oral rehydration solution)

Loosening of excessive clothes

Lying down the studemt and make her relax

Placing a cool wet cloth on forehead.

Not resuming any activity until symptoms are gone

Ice compressing underarms and groin.

Using a fan to cool the skin

If heat stroke is suspected then emergency call should be made

Hyperthermia occurs when the body lose its ability to maintain normal body temperature.

Body has different coping mechanism (hoemostasis)to get rid if excess body heat,largely breathing,sweating and increasing blood flow to the sirface of the skin.If outside environment is too hot and humid,body evaporate sweat,making it difficult to maintain body temperature.Warm weather will raise the temperature.People who are under 16 or above 65 are more prone to hyperthermia.Also activity like soccer,football,rugby increases the risk of hyperthermia.

As overheating present,more moisture and electrolytes are lost from the body ,lowering blood pressure and limitibg sweating.