Week 1

S: The patient is a 61 year old male admitted to the ward following a coronary artery bypass graft surgery. The patient has an extensive smoking history of 20 cigarettes a day for 50 years. The patient is from the country and lives with a work colleague. The patient was previously independent with all mobility and domestic duties. He is a self employed brick layer.

T: Perform an assessment and treatment for the patient

A: I checked the patient’s chest, and then re-educated the patient on deep breathing exercises and a supported cough. I then monitored the patient’s oxygen saturation levels with and without the use of oxygen. I took the patient for a short walk without the use of oxygen but took a portable oxygen trolley just in case it was needed.

R: The patient managed the walk however his oxygen saturation levels decreased to 86% off the oxygen. I then asked the patient to rest and take deep breaths in an attempt to increase the oxygen levels. The oxygen level only improved to 91% so I then placed the patient on oxygen and returned the patient to the room where I continued to do deep breathing exercises with the patient.

E: I think I managed the situation appropriately. I was able to determine when it was appropriate to place the patient back on oxygen and cease the session. It was challenging as the patient was not showing any signs of respiratory distress but I took the necessary precautions to make sure my session was safe.

S: I asked my supervisor when it would be appropriate to place the patient back on the oxygen even if they were asymptomatic. I also liaised with the med team regarding the levels of oxygen they were happy with for the patient to be off the oxygen.