Novel Coronavirus Disease (COVID-19) Part III: Critical Care Unfolding Reasoning

John Taylor, 68 years old Primary Concept Immunity/Gas Exchange/Perfusion Interrelated Concepts (In order of emphasis)  Clinical judgment  Communication  Acid-base balance  Patient education NCLEX Client Need Categories Safe and Effective Care Environment  Management of Care  Safety and Infection Control Health Promotion and Maintenance Psychosocial Integrity Physiological Integrity  Basic Care and Comfort  Pharmacological and Parenteral Therapies  Reduction of Risk Potential  Physiological Adaptation Covered in Case Study        NCSBN Clinical Judgment Model Step 1: Recognize Cues Step 2: Analyze Cues Step 3: Prioritize Hypotheses Step 4: Generate Solutions Step 5: Take Action Step 6: Evaluate Outcomes Covered in Case Study © 2020 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN Part III. Transfer to ICU John is emergently transferred to ICU due to acute respiratory failure. You receive the following SBAR report in preparation to assume care: Situation: Name/age: John Taylor is a 68-year-old African-American male. BRIEF summary of primary problem: He presented to the emergency department because he felt crummy; complaining of a headache, runny nose, feeling more weak, “achy all over” and hot to the touch and sweaty the past two days. When he woke up this morning, he no longer felt hot but began to develop a persistent “nagging cough” that continued to worsen throughout the day. He has difficulty “catching his breath” when he gets up to go the bathroom. Transferred to MedSurg four hours ago and was clinically stable until he got up to use the bathroom and went into acute respiratory distress with increasing O2 needs and decreasing O2 sat. B