These are: Environment (like maintenance of temperature control, as well as, appropriate surroundings maintenance), De-escalation (For e.g. Whenever I try to get help from them they always try best to assist me. After we assess the authenticity of the uploaded content, you will get 100% money back in your wallet within 7 days. The report contains a detailed analysis of serious patient safety incidents reported to the Agency’s NRLS over a one-year period. Further, in addition to the FAST HUGS, following parameters were considered in the patient. Kidney disease is quite common nowadays and the association of pain is very much concerning among the people who are suffering from chronic kidney disease. The patient had mild hypothermia of 38.4 degree which is an indicator of infection .His respiratory rate of 26 breaths per minute sits him in tachypnoeic state as the normal range lies between 12-18 bpm. Recognising the deteriorating patient. To View this & another 50000+ free samples. Activity Based Accounting Assignment Help, Competition and Consumer Law Assignment help, Financial Statement Analysis Assignment Help, Dissertation Research Assistance Services, Mcdonalds Pestle Analysis Marketing Case Study, CDR Sample on Telecommunications Engineers, CDR Sample on Telecommunications Network Engineer, https://myassignmenthelp.com/free-samples/case-study-on-clinical-deterioration, NUR104 Biophysical And Psychosocial Processes, SAP102 Welfare Systems And Services In Australia. >> Mr Harry’s body alignment has been done for the optimal respiratory excursion to promote lung expansion, as well as, to improve the air exchange. Introduction Our best price guarantee ensures that the features we offer cannot be matched by any of the competitors. Get different kinds of essays typed … Dexmedetomidine versus propofol/midazolam for long-term sedation during mechanical ventilation. Moreover, the general practitioner noted respiratory failure in the  patient. The patient’s daily care plan was always updated on the daily basis. Examination has been conducted as per Hospital protocol and noted accordingly. Measuring health outcomes of a multidisciplinary care approach in individuals with chronic environmental conditions using an abbreviated symptoms questionnaire. Prioritise people Introduces self to the patient … 2017). Give the first player card to the player designated as the Patient 4. These groups may include: – adults, children and young people taking multiple medicines. They assume they are being monitored and that any deterioration in their condition will be detected and acted on quickly. Some of our popular services include math assignment help, economic assignment help, accounting assignment help, statistics assignment help, law assignment help and more at a reasonable price. When the RGN phones the SHO, place the two players (RGN & SHO) back to back to simulate communication via the phone 6. The provision of precise supportive care is very important and essential part in the management of the critically ill patient. . Highly Upon Intensive Care Unit (ICU) admission, the patient was awake, orientated and afebrile. The clear and relevant information regarding the problem and the intervention was being discussed with the patient and his family for better understanding of the treatment (Featherstone & Krist, 2016). He/She asked for my information and helped me to record a video demo to let me understand how the program (It\'s a R programming) run.. 20180425 Deteriorating Patient WebEx Current Treatment Option & Problem Resolution -. The patient was an ex- smoker and is married with three children. These papers are intended to be used for research and reference On auscultation, crackles were heard in the right lung, and oxygen saturation was 94% on Continuous Positive Air Pressure. _î#If^œ;//Ú`õ؈{©hø‚?Ø'AŽtq%þßÑ"Jñ‘}ÙÕ[üðˆP/3A9ñá¦F2ŋ»`±@,I†cgŸO{ûøâóé/˜ïlÈ8ïlà%,ȼŒöžÁV³O½ÿùúU‹÷Å¢s±æœÅ,‰/ÏÐÿ ÏO¬q6¢\"úÜwiA˽z„¯—G±à¼xQ[][kûõùBp‚°XæÂøÕP‘Ç9L/…©à¶xœÈ®–G© P´øä‚ëÍÃò(Y°¾`ð¼–ÌZÜ1üt-†±s! Bob is also struggling to maintain his identity by engaging in his hobbies, traditional roles, and occu... Answer: Respiratory Symptoms, Pneumonia, What Is the Organism?. Framework for senior citizens: Endotracheal tubes and intubation. . ; Gauge the patient’s peripheral skin temperature by … Psychosocial support (for patient, family, as well as, the staff) (Vincent & Hatton, 2009). From the chosen case study identify and discuss two (2) Critically ill patients need “FAST HUGS BID” (an updated mnemonic). purposes only. The need of effective communication within the multidisciplinary team is very important for providing benefits to the patient’s care. As per doctor’s direction, Stool and urine sample has been taken and sent for testing. Due to the diversity in our expert team, we are capable of providing academic assistance in more than 100 subjects. good work in general. My pro is really like those ideas. A senior citizen at this time has bee... Just share requirement and get customized Solution. Please put (2009). All rights reserved. Marik, P. (2004). The patient had sinus rhythm with pulse of 128 beats per minute which showed the evidence of tachycardia. Case Study On Clinical Deterioration. The physical assessment of those body systems involved; c. His infection can be the underlying cause of fever associated with pneumonia. After the successfull payment you will be redirected to the detail page where you can see download full answer button over blur text.You can also download from there. February 3, 2021 >> Jedda Merindah 33 yeasr old male of indigenous heritage who has been admitted to the Hematology/Oncology unit. To start the scenario: 1. Holistic Nursing Practice, 25(2), 57. Abdominal examination showed no abnormalities in his abdomen. How to assess deteriorating patients. DETERIORATING PATIENT SIMULATION: ELDERLY UROSEPSIS LEARNER PREPARATION PACKAGE BRIEF SUMMARY OF CASE 82 year old male/female encountered in the ER department upon transfer from a long-term care (LTC) facility, with foley catheter in situ, and wrist restraints tied to bed/stretcher rails. When a patient lose 85-90% of kidney function, dialysis is required at that stage (Kimmel et al. Set up room with the patient in a chair 3. MyAssignmenthelp.com stores a huge Pneumonia can prevent the lungs from transferring enough of oxygen supply into the bloodstream (Swischuk, 2007). BP drops as condition deteriorates. To send you invoices, and other billing info, To provide you with information of offers and other benefits. I experienced circumstances where the quality of health care services and patients’ safety was substantially compromised by the healthcare professionals in the clinical setting. Past Experiences of Patients’ Safety Issues My Assignment Help, 2017, https://myassignmenthelp.com/free-samples/case-study-on-clinical-deterioration. During the patient’s health care following interventions was followed: CNS:  Propofol was used as a sedative to make the patient comfortable, reduce oxygen demand, as well as, to ensure patient safety (Ruokonen et al., 2009). From the next time, Blood pressure (BP): is an indication of the effectiveness of the cardiac output. . In case of intubation Head up position should be 30 degrees. First2Act – Examples of materials for face to face patient ... What are the six essential actions in the initial management of the deteriorating patient: a) 1. collecting additional information, 2. positioning the patient appropriately, 3. Sampalli, T. (2008). Various reports based on the patient’s profile  showed signs of respiratory failure and infection as given below :-. To start the scenario: 1. They are very friendly and work very well. WebEx. Bob is also much concerned about his relationship. Medication administration record, as well as, chart was regularly reviewed. When the RGN phones the registrar, place the two players (RGN & registrar) back to back to Any abnormality observed in the patient’s vital signs whether it is blood pressure or respiratory rate was immediately informed to the higher authrorities and necessary steps were taken to bring them back to the normal range. CVS: Noradrenaline was given to the patient to treat his low blood pressure. Monitoring your patient's temperature is also important. month. I am so glad for that. unique. For his infection, the patient was given a combination therapy of antibiotics i.e., Ceftriaxone and Azithromycin. The patient was then further transferred to the ICU at 9 am this morning from the Emergency Department. Assign roles to each player 2. Thank you for your help and I love it! The regular report of the patient was obtained and maintained from the registered nurse. He has increased use of accessory muscles and low level of consciousness (Glasgow Coma Scale 10/15). His physical examination findings showed that he was febrile (temperature of 38.8), had rigors, dry cough, myalgia, and exertional dyspnoea. Blood cultures: Sent for further evaluation. Learn more about this type of research by reading the article. Person centred care planning. treatments that are no longer required). x 87Zìħd±.ð„‹‹ï_›rýì+¯àñ>¯Ü¡‹ó÷gðÅŒ]/2­fðs+Pmð$T„¼ƒ™ïá+œ®D÷{…Þ0œþV=eÍŸ‰¦qꅒ¤g ¿Ø6ˆÍ=ÒÅÚà#{8þC®÷“™5JB\’¨£0?âÑâ‹~Ro—4%ûŸåQN“×ðòÜM|ïÖLAۋÔü2X'ZVëRüNûò(`ø‹ª¹µ6œ8Äë'”ßšaÖ` ¦HpŽŸhÒCQ"9Bª«„jD†Z±¦Êþ=2­7;*ÉB':¨´€tÄr8ûq…$Ž¬ãl˜ýN²(£+Ø¿6W}Ml1i&¥–€%Äq¿X|ZJþû*˜u…ñèI>B"ÃR^ ¿Âï° ¡a&˜ŽûFâI†ù"â6¶mvúH?æ-žà'BxÄ)7J*ôd¾—Jê¦tµÓ‹Ù'?š3‡UHpøHdª®«e[àµ+„4¸Á…²{w—$C3$'Á~ƒdč‘âRX wâPܔwJ>Ñh?7¤,£ÎºEh?ó"ç@£æåFڕ can access that from your personalized library. 2 Nursing Times Deteriorating Patient Supplement When patients come into hospital they put their trust in the professionals caring for them. However, he is non- alcoholic. Highly Journal Of Multidisciplinary Healthcare, 97. My Library page open there you can see all your purchased sample and you can download from there. Upon Intensive Care Unit (ICU) admission, the patient was awake, orientated and afebrile. ... Upholds the patient’s dignity and privacy. He had a past medical history of polycythemia, asthma, neuropathic pain, and pancreatic cancer. Holistic care: It is an integrated approach to one’s health care and focus on treating the "whole" person, and not only the symptoms, as well as, the disease. The patient was an ex- smoker and is married with three children. Reducing the work of breathing during noninvasive-ventilation sessions may also allow respiratory muscles to regain efficiency. The purpose is to teach junior trainees how to recognize and learn to … Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. Pulse oximetry has been used continuously for the regular monitoring of oxygen saturation  and pulse rate. Moreover, Pregabalin was given to the patient for his neuropathic pain. Relevant information was clearly communicated amongst all the members of the teams. In a scenario lead survey nursing staff were unable to identify a deteriorating patient, and felt they were not supported when they did. How to assess deteriorating patients. Nutritional, as well as, psychological counseling was also provided as needed associated with the holistic care provided to the patient. You get free haystack. The main issues were 1) septic shock- right lobe consolidation and hypotension. Multidisciplinary approach, as well as, holistic health care is very important in the present times. My Assignment Help. only 1 Task description: For this essay you are required to select ONE (1) case scenario related to the clinical deterioration of a patient: Option 1: Hypovolemic shock Option 2: Septic Shock. This chapter describes essential steps and nursing actions in the recognition and management of a deteriorating patient in a hospital setting. Case study on clinical deterioration of 72-year-old male Mr Harry. The hospital anticipatory care plan. My Assignment Help. recommend. He is critical about his sexual life and doesn’t want to take medication as he feels it will make him impotent and affect his relationship with his wife. Endotracheal intubation was done to protect his airways as the patient was unable to maintain an open airway (Brown, 2012). In dementia cases, a person struggles to maintain his or her identity. Case study on clinical deterioration of 72-year-old male Mr Harry. The patient was also put on endotracheal intubation. 266/189 Queen St, Melbourne VIC 3000, Australia. Pediatric Emergency Care, 23(9), 676-677. Received my assignment before my deadline request, paper was well written. His vital signs included pulse rate of 76bpm, blood pressure 131/62 mmHg, and respiratory rate 24 bpm with dyspnoea. Pediatric Anesthesia, no-no. Protection should be given to these seniors and certain steps have been taken by the United Nations in 2011 through human rights conventions. access its content with a few clicks on your mouse. A Multidisciplinary Approach to Improving Communication Across the Care Continuum. Canadian Medical Association Journal, 183(3), E195-E214. longer need to spend hours to locate the sample you need. Respiratory: Endotracheal tube was intubated. Our protocol of intermittent noninvasive ventilation resulted in significan higher rates of improvement in the abnormalities of gas exchange as compared to the standard treatment. The use of non-invasive ventilation during acute respiratory failure due to pneumonia. Valid for Assessment name: Case Study: The Deteriorating Patient. Suction will be provided twice to clear the secretion in case the patient is unable to clear his airway effectively. Using reliable plagiarism detection software, Turnitin.com.We only provide customized 100 percent original papers. Give the Second player card to the player designated as the EN 5. Particular reference to NSQHS Standards 6 (Clinical Handover) and 9 (Deteriorating Patient) was made, to underpin the development of these sessions. Indeed, elevated workload, reduced nurse-to-patient ratio, and interprofessional conflicts between the healthcare teams resulted in situations that not only deteriorated the healthcare environment but als... Answer: Later in the afternoon, his vital signs were showing him hypoxic, which makes him febrile and agitated. pharmacist counselling, telephone follow-up, and GP or nurse follow-up. Increased oxygen tension in the alveoli may result in more oxygen diffusion into the capillaries. Hence, the protocol of FAST HUGS was being followed in the intensive care unit, which includes the following: H- Head of Bed elevation/Head up position. In the best interest of the patient, the patient was intubated and the endo tracheal tube was inserted into the patient. Moreover, all the necessary, as well as, timely information related to his vital signs was provided to the senior practitioners for better and effective management of the patient. . Swischuk, L. (2007). Oxygen therapy was indicated and has been given to the patient as per prescription. Critical Thinking Scenario – Nursing Essay Critical thinking is an essential part of a nurse’s professional growth because it determines the quality of decisions made in the course of practice. Following Sir Bruce Keogh’s review of 14 NHS Trusts, Buckinghamshire NHS Trust was found to have higher mortality rates than the England average. ... • Run through scenario with participants and ask them to repeat it back. Case 1 Mrs. Puffer is a 35-year-old single mother, just getting off the night shift. Biology Of Blood And Marrow Transplantation, 22(3), S439-S440. I will definately try for another assignments also and thankew to all for such things like helping the students over here. Vincent, W. & Hatton, K. (2009). Aim: To examine, in a simulated environment, the ability of final-year nursing students to assess, identify and respond to patients either deteriorating or at risk of deterioration. Special nursing care intervention is required in case of patients having chronic illnesses and in the nursing care of the patients that are admitted in the Intesive care unit. The term senior citizenship applied to them who are surpassing their lives with regenerative abilities and illness. you Balance any chemical equation in minutes just by entering the formula. Mechanisms of improvement may include the beneficial effects of PEEP on the redistribution of extravascular fluid, on alveolar recruitment, and in treating atelectasis at an early stage and the ability of pressure support to reduce the work of breathing (Ferrer et al., 2012). S – Spontaneous Breathing Trial or other ventilator separating strategy. Featherstone, C. & Krist, N. (2016). His hypoxic condition was sign of further deterioration, which may cause respiratory failure. apply current Australian Resuscitation Council Guidelines to the patient whose condition is deteriorating in a given simulation scenario. A collection of interactive medical and surgical clinical case scenarios to put your diagnostic and management skills to the test. The patient must not be left without the nurse in attendance at any time during the admittance. "Case Study On Clinical Deterioration." If you are unable to calculate word count online, ask our customer executives. Accessing the collection of documents is absolutely easy. Current infectious disease reports, 13(5), 399-405. Brown, T. (2012). You no Moreover, High Flow Nasal Prongs was also used to give patient the break from the treatment. Blood Test: Blood tests were obtained, which showed the increase in blood platelet count, WCC=17.4. Workplace violence is a significant stressor for nurses working in Emergency Department settings worldwide(Gates, Gillespie &Succop 2011). Hand, L. (2011). Assign roles to each player 2. He had visited the general practitioner yesterday who ordered CXR. Set up room with patient in a chair 3. Deteriorating Patient: Virtual Case-Scenario Approach In the virtual cases, students can repeat the cases as many times as they want to achieve mastery with the case. deteriorating patient scenario examples By Reflection on Nursing Practice /Rect [183 714.500000 225 724.250000 ] endobj Disclaimer: The reference papers provided by MyAssignmentHelp.com serve as model papers for students How to answer: Tell a story about a hostile patient and your step-by-step actions. ӆZ‰x¸*—rE‡¤. The team should work in collaboration with each other and should discuss and provide all the relevant information related to the patient for better care and management. Propofol is used to lower the blood pressure as it is the related side-effect of Propofol (Marik, 2004). Set up room with patient in a bed 3. Our writers can provide you professional writing assistance on any subject at any level. Critical Care Medicine, 37(7), 2326-2327. Biophysical and psychosocial processes (2017). A nursing case study is a detailed study of an individual patient, which allows you to gain more information about the symptoms and the medical history of a patient and provide the proper diagnoses of the patient’s illness based on the symptoms he or she experienced and other affecting factors. My Assignment Help. Measure the patient’s blood pressure as soon as possible; low blood pressure (relative to the normal blood pressure of the patient) is often a late sign in the deteriorating patient and can be an adverse clinical sign (Mallet 2013). Mr Harry’s body alignment has been done for the optimal respiratory excursion to promote lung expansion, as well as, to improve the air exchange. The patient was seen in the local clinic accompanied by his wife. The Future of Nursing and Holistic Care. The use of standardized patients [SP] in a deteriorating patient scenario [DPS] is a low-fidelity simulation technique, used to enhance conflict resolution skills in the emergency room [ER] [1]. Planning & Implementing solutions Two clinical champions were recruited from each area, to give the project carriage on the ground deteriorating patient. We used the multidisciplinary team approach to implement the medical care protocol to its maximum, including adjustment of various medications, as well as, outpatient pulmonary rehabilitation treatment necessary for the patient. The patient was presentedwith type 1 respiratory failure with septic shock secondary to whole lung right sided pneumonia and was admitted to the Intensive Care Unit. It... Answer: Every time you find something useful, you can save that using the bookmark tool. It is important and necessary to acknowledge that both the person, as well as, the family-centred care should be focused on the whole individual as a unique personality and not just on the basis of the patient’s illness or ailments. Give the second player card to the player designated as the student nurse 5. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. There are many possibilities including creating a simple standalone practical workshop, online resources (such as a scenario bank), or even an ongoing Continuing Professional Development programme. Hence, the patient will be assessed for lung sounds periodically and will listen closely for the presence of any crackles or wheezing sounds. She is a female and has arthritis… Use of Opioid in dialysis patients you can Intensive care medicine, 35(2), 282-290. It is too easy to create or access your own library, just enter your email and make your search In the case under analysis a deteriorating patient was brought into the hospital, and from my view, he needed special care so as to save his life. Or you can also download from My Library section once you login.Click on the My Library icon. In viewing the patient through this lens, all the health-care providers are able to know, as well as, understand the life story of the patient, his experience related to the health, the role of family played in the patient’s life, as well as, the role they have to play in supporting the patient to achieve his/her health ("The Future of Nursing and Holistic Care", 2011). The condition of Mr Harry had been rapidly deteriorated after being transferred to the Intensive Care Unit from the Emergency Department. Copyright © 2021 MyAssignmenthelp.com. In this case, there is a patient who is elderly, just retired, and is aged 60 years old. groups of people when they have been discharged from hospital, such as. Managing a deteriorating patient is not that complex, but in a stressful situation nurses and nursing students can forget the key essentials. Feel free to contact our assignment writing services any time via phone, email or live chat. The NPSA launched the fifth Patient Safety Observatory report Safer care for the acutely ill patient: learning from serious incidents in July 2007, in which ‘deterioration’ was identified as a key theme. This personalized library allows you to get faster access to the necessary documents. The following are examples of clinical situations and the ABGs that may result, as well as causes and solutions for ABG abnormalities. Hence, Mr Harry was encouraged to become responsible for the daily care of his health through maintaining his diet, exercise, attitudes, as well as, his lifestyle contributing towards his wellness. Unfortunately, this is not (polypharmacy) Case scenarios: medicines optimisation (July 2015) This case study is based on clinical deterioration of 72-year-old male Mr Harry. That's our welcome gift for first time visitors. Give the second player card to the player designated as the RGN 5. The patient was from African background weighing 65kg and height of 165cm. The patient had co-morbidities including asthma and Hypertension. The patient’s respiratory rate was 37bpm, heart rate was 140, and blood pressure was 90/30 mmHg. Answer: Ruokonen, E., Parviainen, I., Jakob, S. M., Nunes, S., Kaukonen, M., Shepherd, S. T., . The deteriorating patient – a community perspective. Calculate your semester grades and cumulative GPa with our GPA Calculator. 2017 [cited 22 February 2021]. The patient was from African background weighing 65kg and height of 165cm. 1 Assignment Help Company Since 2007. He lived with his wife and is currently unemployed. Fentanyl was also administered to the patient as an analgesic to alleviate the patient’s pain (Minami et al., 2009). To export a reference to this article please select a referencing stye below: My Assignment Help. Early and adequate antibiotic therapy in the treatment of severe sepsis and septic shock. A series of SBE sessions was designed to offer Graduate Nurses the opportunity to consolidate theory into practice in a safe, supported (simulated) environment. It is estimated that a quarter of all health employees are likely to experience violent incidents, either verbal or physical, in their direct patient care during their career (World Health Organization 2016). I get the best solution and the expert is very professional. Moreover, the intubation process was being discussed, as well as, explained to his family. Communication and escalation for deteriorating patients. Review your knowledge and understanding related to: The physiology and pathophysiology of the different types of shock for your selected scenario; b. Calculate the number of words and number of pages of all your academic documents. Get all your documents checked for plagiarism or duplicacy with us. It may also help in maintaining the tidal volume, which is compatible with the adequate alveolar ventilation. Close monitoring of the symptoms should be done regularly to avoid occurring of any fatality. Get different kinds of essays typed in minutes with clicks. Ferrer, M., Cosentini, R., & Nava, S. (2012). Globally and within Australia, there is an increasing level of workplace ... Answer: Systematic assessment is central to recognising a deteriorating patient and to taking timely and appropriate action to minimise the incidence of further deterioration. Once you bookmark a sample, Moreover, the patient is allergic to tramadol. The patient’s past social history revealed that he was an ex-smoker. choose and bookmark any document you wish. 'Case Study On Clinical Deterioration' (My Assignment Help, 2017) accessed 22 February 2021. Our writers make sure that all orders are submitted, prior to the deadline. MyAssignmenthelp.com boasts a pool of 3000+ experts from different backgrounds, who are solely dedicated to providing premier quality assignment help. This case study is based on clinical deterioration of 72-year-old male Mr Harry. Review your chosen case scenario with the lecture and tutorial material associated with the deteriorating patient. /Border [0 0 0] Ruokonen, E., Parviainen, I., Jakob, S. M., Nunes, S., Kaukonen, M., Shepherd, S. T., . Buckinghamshire NHS Trust … Further, ventilation delivered through a face mask can improve the pathophysiological manifestations of hypoxemic respiratory failure (Keenan et al., 2011). Arterial Blood Gases: Showed pH of 7.2 and Pco2 of 55, which is suggestive of respiratory acidosis. The patient has been feeling unwell for the past 3 days and was unable to perform any daily activities as he was feeling extremely lethargic. good format, good reference. Chest X-ray: His chest x-ray showed focal consolidation in the right lower lobe, suggestive of pneumonia. Personalizing your own library relieves you from that stress. 0 NS Student Decision Support Events. We have sent login details on your registered email. * $5 to be used on order value more than $50. Mock Scenario for Nursing Associate OSCE We have developed this scenario to provide an outline of the performance we expect and the criteria that the test of competence will assess. The nursing plan’s main objective was to monitor the presence of shortness of breath if any, respiratory rate, blood pressure, as well as, heart rate in the patient based on the evidence discussed above. Case study 1 and are not to be submitted as it is. COLLECTION OF QUESTIONS AND SAMPLES, which you can refer to any time you want. Later in the afternoon, his vital signs were showing him hypoxic, which makes him febrile and agitated. Morbidity includes an increased risk for ventilator-associated pneumonia (VAP), ventilator-induced lung injury, increased needs of sedation that contribute to prolonged ventilation, and complications of the upper airway related with prolonged translaryngeal intubation (Ferrer, Cosentini, & Nava, 2012). The approach that nurses take to assess all patients that are deteriorating or critically ill is conventional because it follows the same procedure despite the type of illness (Bernstein and Lynn, 2013). Case Study On Clinical Deterioration [Internet]. As part of a series of implementations and investigations to address this, a quality improvement project looking at clinical responses to the deteriorating patients was designed. In this report, we describe a DPS simulation session in which SPs act as "difficult patients" in the setting of a busy ER. Available from: https://myassignmenthelp.com/free-samples/case-study-on-clinical-deterioration. Other clues that your patient may be deteriorating include changes in pulse quality (irregular, bounding, weak, or absent), slow or delayed capillary refill, abnormal swelling or edema, dizziness, syncope, nausea, chest pain, and diaphoresis. Higher heart rate and respiratory rate was clear indication of initial hypoxia.