Reflective essay using critical analysis. An analysis of a critical incident related to the care of a patient of a higher dependancy who is critically ill.

Presentation; this must be a level six essay.
This essay must demonstrate comprehensive knowledge and understanding of current theories, principles and concepts.

Demonstrates exceptional and A WELL-SUSTAINED CRITICAL ANALSIS of implications for practice.
Utilises an exceptionally strong and sustained critical evaluation and synthesis of issues.
This essay will also include an imaginative and innovative approach to problem solving within the practice arena using a breadth of evidence reasoning and reflection.

Raymond Jones is a 42yrs old man who has just been admitted to your ward with acute pancreatitis. he hs a history of heavy drinking and has recently separated from his wife.

He has a serum amylase result of 700U/I and is complaining of severe abdominal pain. Mr Jones vital signs are _ Resp. 34 per min, a bounding pulse of 120 and BP 90/60. His capillary refill is normal and his peripheries feel warm and clammy. He has been catheterised and you note that his urine output is falling. He has only passed 10mls of urine in the last two hrs. His blood glucose level is 18mmol/I and his temp. is 38.6

Mr Jones has been prescribed a bolus infusion of 250mlsof 0.9% saline which is in progress.

Explain why acute pancraetitis results in the signs and symptoms exhibited by this patient. With refrence to literature , identify and provide a rationale for the immediate priorities of care(fluid resuscitation and pain management using abcde approach.

http://bmj.com/cgi/content/full/316/7148/1853#BIBL
http://bmj.com/cgi/content/full/316/7148/1853#otherarticles
http://bmj.com/cgi/content/full/316/7148/1853#responses
Guideline; Nice Guideline Acutely ill Patient in Hospital
• Guideline: NPSA Guideline Recognising & Responding Appropriately to Early Signs of Deterioration in Hospitalised Patients
•
Key Document: DoH Comprehensive Critical Care
•
Key Document: Quality Critical Care
Cochrane library (online)
Adams,S.&Osborne,S. (2005) Critical care nursing;science and practice.2nd Ed. Oxford University Press
Basset,C.&Makin,L. (2000) Caring for the seriously ill patient. Arnold: london.
Jevon,P.& Evans,B. (2002) Monitoring the critical ill patient ( essentual clinical skills for nurses). Blackwall
Marieb,E.(2006)Human anatomy & physiology. 7thEd. Lippincott,Williams& Wilkins: Philadelphia.
Moore,T.&Woodrow,P. (2009)High dependency nursing care. Routledge: London.
Woodrow,P.(2006) Intersive care nursing: a framwork for practice.; Routledge London.
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