NR 341 Complex Adult Health Interdisciplinary Care

NR 341 Complex Adult Health Interdisciplinary Care

Student Name

Chamberlain University

NR-341 Complex Adult Health

Prof. Name

Date

Background Information

Mrs. Watson, a 62-year-old African American woman, was admitted to the emergency department on March 10, 2018, as a complete code case. She presented with severe shortness of breath and an opioid overdose, most likely related to her long-standing lifestyle habits. Her daily behaviors included smoking one pack of cigarettes, consuming four to five glasses of wine, and using heroin in combination with prescription painkillers.

Her past medical history includes asthma, hypertension, urinary incontinence, recurrent urinary tract infections (UTIs), and type II diabetes mellitus. She also underwent a right knee replacement and the removal of a benign breast cyst. At the time of admission, her primary diagnosis was bilateral pulmonary infiltrates, with opioid overdose being a significant contributing factor.

On the day of care, the following vital signs were documented:

Vital Signs	Findings
Blood Pressure	98/58 mm Hg
Oral Temperature	98.9°F
Respiratory Rate	8 breaths/min
Weight	146 lbs
Radial Pulse	40 beats/min
Oxygen Saturation (Room Air)	88%

Additional physical assessments revealed alcohol and smoke odor, signs of intoxicated behavior, inflamed nasal mucosa, gingival ulceration, warm skin, and multiple bruises and lacerations on the abdomen, arms, and legs. Despite her severe presentation, Mrs. Watson remained alert and oriented but showed symptoms of respiratory distress, including shallow and labored breathing, wheezing, dyspnea, and respiratory depression.

NR 341 Complex Adult Health Interdisciplinary Care

Nursing Diagnosis and Goals

The nursing diagnoses for Mrs. Watson included:

• Ineffective airway clearance caused by drug effects.

• Inadequate health maintenance due to substance use disorder.

• Risk for suicide linked to polysubstance abuse.

The primary care goals were:

1. Maintain and improve airway patency.

2. Encourage and support health-seeking behaviors.

3. Ensure patient safety by reducing risks of further self-harm.

Nursing Interventions

The following interventions were implemented to achieve these goals:

• Frequent monitoring of arterial blood gases (ABGs) and pulse oximetry.

• Providing consistent emotional support to reduce anxiety.

• Positioning in a high Fowler’s position to improve oxygenation.

• Administering mechanical ventilation when indicated.

• Administering Naloxone (opioid antagonist) to counteract overdose effects.

• Continuous ECG monitoring to evaluate cardiac rhythm.

• Ongoing assessment of respiratory, cardiovascular, and neurological status.

Interdisciplinary Team Involvement

The case required a collaborative interdisciplinary approach, where multiple healthcare providers contributed to the patient’s recovery:

Team Member	Role in Care
Respiratory Therapists	Administered oxygen therapy, assisted with intubation, and managed ventilators.
Nurses	Provided direct patient care, administered medications, monitored progress, and communicated with physicians.
Emergency Physicians	Conducted diagnostic evaluations, ordered necessary investigations, and initiated treatment.
ECG Technicians	Monitored and recorded cardiac activity.
Laboratory Personnel	Performed blood work and toxicology screening to guide treatment decisions.
Assistive Personnel	Provided support under nurse supervision, helping with positioning, hygiene, and safety.

Alongside medical interventions, psychosocial support was prioritized. Therapeutic communication strategies such as active listening, reassurance, and building rapport were used to enhance trust and promote patient cooperation.

Student Nurse Reflection

As a student nurse, I experienced the intensity of emergency care during Mrs. Watson’s admission. I actively participated in measuring vital signs and assisting with ECG electrode placement, observing how the interdisciplinary team worked seamlessly under pressure.

The registered nurse I was paired with demonstrated calmness, efficiency, and precision, ensuring that all tasks were performed safely. This experience highlighted the importance of teamwork, quick decision-making, and compassion in nursing practice. It reinforced my motivation to continue developing my clinical skills and deepened my passion for providing holistic patient care.

Conclusion

In summary, Mrs. Watson’s case required urgent and comprehensive management due to her complex presentation involving opioid overdose, respiratory depression, and multiple comorbidities. The interdisciplinary team played a vital role in stabilizing her condition, supporting health-seeking behavior, and ensuring safety. Nurses were central to her care, ensuring airway maintenance, timely interventions, and emotional support. This case demonstrates the significance of integrated healthcare delivery, where teamwork and effective communication directly impact patient outcomes.

References

Carpenito, L. J. (2017). Nursing diagnosis: Application to clinical practice. Wolters Kluwer.

Lewis, S. L., Dirksen, S., Heitkemper, M., & Bucher, L. (2014). Medical-surgical nursing: Assessment and management of clinical problems (9th ed.). Elsevier Mosby.

Lilley, L. L., Collins, S. R., & Snyder, J. S. (2017). Pharmacology and the nursing process. Elsevier.

NR 341 Complex Adult Health Interdisciplinary Care

Vallerand, A. H. (2015). Davis’s drug guide for nurses (14th ed.). F.A. Davis Company.

For All Your Nursing Needs. (n.d.). Nurseslabs. Retrieved March 30, 2018, from https://nurseslabs.com/