Task #1 Key assessments that should be done to a patient upon arrival to the emergency department help assess and identify the patient's condition or status. First I would assess Mrs. Baker by using the stethoscope to listen to heart, lungs, and abdomen, at the same time checking her body and skin to see is there are any abnormalities. Next, I would check Mrs. Baker's neurological status to see if she recalls what happened and where she is at that time. I would also ask her about her health history and check to see which medications she takes at home and if there's any new medications that she's started on. Then I would ask her if she's having pain. However if Mrs. Baker is unresponsive, I would assess her facial, body expression, and behavior to determine if she's having pain. IV access would be started, in case Mrs. Baker needs more fluids or iv medications. Next, I would ask the nursing assistant to take the patient's vital signs to see if there's any major issues with her vitals, especially her blood pressure. I would also ask lab to get stat labs for the patient with an order from the attending physician. Labs would include, stat CBC, CMP, and ABG's. The CBC would help to determine if she's having any bleeding, anemic, or having an infection. The CMP would help to determine if there's an electrolyte imbalance. The ABG's would help to determine if she's having a respiratory or a metabolic reaction, and if she's acidic or alkalitic. ABG results will also help in assessing to see if Mrs. Baker is having a compensatory reaction due to her abnormal blood sugar/ history of diabetes. After the labs are taken I would put Mrs. Baker on 2 liters of oxygen via nasal cannula and a continuous pulse oximeter to continuously assess her oxygen saturation. Next, I would get an order for a stat EKG to check her heart rhythm and rate. This would help determine if she needs to be on telemetry monitoring. I would also obtain a chest x-ray to check to see if Mrs. Baker is having any lung issues, such as pneumonia or pleural effusion. While waiting for the EKG technician, I would use the accucheck machine to check Mrs. Baker's blood sugar. If the blood sugar is too low, then Mrs. Baker would be given dextrose to help bring her sugar back up. There are many technological tools that would be used to help assess and treat patients. As mentioned earlier, there's the stethoscope, blood pressure cuff, EKG machine, continuous pulse oximeter, accucheck machine, x-ray machine and more. I would utilize these specific tools to help determine the patient's condition and find treatment and immediate interventions that would help save the patient's life. There are many benefits to the tools used to determine the patient's condition. As mentioned earlier, checking the patient's vital signs helps to determine if the patient has very high or low blood pressure. Using the accucheck machine to check the blood sugar can determine if the patient has a high or a low blood sugar. Finally, the EKG machine can also save a patient's life by determining if the patient has a fatal heart rhythm or rate that can cause the patient to die. As far as prioritizing Mrs. Baker's care, I would use the ABC method. First I would make sure that she's breathing okay and put her on oxygen to help her with her oxygenation and relieve her anxiety. Next, I would worry about her heart rate and blood pressure. After that I would be concerned with her blood sugar and any other health problems. In an alert geriatric patient, I would assess pain by first asking the elderly patient if he or she is having pain. If so, then I would use a 0-10 scale to determine the severity of the patient's pain. The rate of pain would then help determine the type and dose of pain medicine to be given to the patient to help control the pain. In a patient who's not alert, I would use my own assessment by observing the patient. What I mean by observing the patient is assessing and noting the patient's facial and body expression. I would also ask my self “Is the patient grimacing?”, “Is the patient showing any restlessness or any guarding of any body part?”. I would also check to see if the patient “moans or screams” if any of the extremities are moved. Those questions will help to determine if the non-alert patient is having pain. I would manage pain in a patient who's experiencing multisystem failure who's not alert or responsive enough by using IV pain medicines. For example, if I had a choice between giving a patient who's not alert or responsive either Acetaminophen 500mg by mouth, or Morphine 0.05 mg/kg, or Morphine 0.1 mg/kg IM, I would give the Morphine IV. The reasons for using the IV pain medicine are the patient is not alert enough to swallow any pills, and giving a medication using the IM route would cause a patient with altered status more distress and discomfort. I would know that my choice of pain management is successful by assessing the non-alert patient for any restlessness or facial grimacing or body guarding. The patient would also be noted to be resting or sleeping if the pain medication and management tool is successful. I learned that the assessment of the geriatric patient is slightly different than a young adult patient in a few ways. One is the geriatric patient shows pain by showing physical signs instead of verbally reporting that they’re in pain. For instance, geriatric patient's may show restlessness or grimacing and moaning. Some may show guarding of a certain body part. On the other hand a young patient would verbalize that they are in pain. Collaborative team members that would be called on in the scenario such as Mrs. Baker's scenario are the ER nurse, ER physician, nursing assistant, respiratory therapist, the phlebotomist, EKG and X-ray technicians. Each of the team members has a very important job in helping to identifying and recognizing the care and treatment that is needed for a patient who's experiencing changes in levels of consciousness and increasing respiratory distress.