Using the information in the scenario and a structured ABCDE approach, discuss the assessment and management of Bob Henriques’ deteriorating condition. Include a discussion of Bob’s mental capacity.

Question Paper

Scenario

Bob Henriques is a 69 year old man who has been admitted to your ward with acute shortness of breath. He is a smoker and uses inhalers for COPD. Bob also has a history of schizophrenia. He weighs 80kg.

Bob is currently drowsy, confused and unable to talk in complete sentences. You can hear a wheeze when you stand close to the bed and you notice that he is coughing up copious amounts of sputum.

Observations:

RR           31/min
SpO2      86% on room air
HR          111/min
BP          131/78mmHg
CRT        2 seconds
Level of consciousness V – verbal
Temp.    37.9°C
CBG 5.   1mmol/L

Urine output Passed 110mls within the last hour (using a bottle)

Bob has been diagnosed with an acute exacerbation of his COPD.

The nursing team are trying to administer nebulisers, but Bob is refusing to wear the mask and believes the nurses are trying to harm him.

Question:

Using the information in the scenario and a structured ABCDE approach, discuss the assessment and management of Bob Henriques’ deteriorating condition. Include a discussion of Bob’s mental capacity.

Word count: 2000 (maximum)

You should utilise the Assessment Brief and Writing-up Guidelines for this assignment. Ensure that the presentation of your essay adheres to the guidance outlined in the Programme Handbook.

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