Hamish McDonald

Question 1

What action will you take if PEWS SCORE 8? (1 mark)

Answer 1

Level 3 review immediately. Consider 2222 if unable to review immediately.

Question 2

From the history and assessment, outline four physiological concerns you have for Hamish and relate them to the pathophysiology of asthma.
(4 marks)

Answer 2

> Hamish is having difficulty breathing.

> Hamish’s HR and BP are elevated.

> Hamish has peri-oral cyanosis.

> Hamish is using his accessory muscles to breathe.

Question 3

Hamish is having difficulty breathing.
(2 marks)

Answer 3

> Alveoli have tightened, likely due to an allergen,

> thereby not allowing effective gaseous exchange, lowering oxygen saturation.

Question 4

Hamish’s HR and BP are elevated.
(2 marks)

Answer 4

Heart rate and BP will also increase to move the reduced blood oxygen around the body faster.

Question 5

Hamish has peri-oral cyanosis.
(2 marks)

Answer 5

Lower oxygen saturations cause perioral cyanosis as body protects major organs only.

Question 6

Hamish is using his accessory muscles to breathe.
(1 mark)

Answer 6

The body will try to improve gaseous exchange by using the accessory muscles around the lungs to force more oxygen into the body.

Question 7

Name one concern relating to Hamish’s mental wellbeing.
(1)

Answer 7

He is anxious and stressed.

Question 8

Explain the process you would follow in preparation for prioritising care and writing a plan of care.
(6 marks)

Answer 8

> Review Hamish’s history.

> Review assessment and clinical observations and decide which are out with acceptable limits.

> Decide the ADLs with which Hamish needs support.

> Consider the priority of importance of Hamish’s needs.

> Write the care plan, ensuring each element is SMART.

> Ensure evaluation date is set.