AHE3100 Advanced Physiology: Physiology of Normal Blood Pressure
Explain the physiology of one of the 5 vital signs.Discuss the importance of professionalism when caring for this patient.
Here you should explain the normal physiology of one of (blood pressure Remember to stay within the normal parameters) the vital signs and normal parameter.
Answer:
The Physiology of normal blood pressure
Blood pressure in the major circulation is characterized by the greatest difference - from the maximum value in the left ventricle and in the aorta to the minimum in the right atrium, where at rest it normally does not usually exceed 2-3 mm Hg. Art ., often taking negative values ??in the inspiratory phase. In the left ventricle of the heart, K. d. By the end of diastole is 4-5 mm Hg. Art ., and in the period of systole increases to a value commensurate with the value of systolic K. d. in the aorta. The limits of the normal values ??of systolic K. in the left ventricle of the heart are 70–110 in children and 100–150 mmHg in adults (Klabunde, 2012).
It is noted that in the range of normal values ??in men, blood pressure is higher than in women; higher values ??of blood pressure are recorded in obese subjects, in urban residents, persons of mental labor, lower - in rural residents, in those who are constantly engaged in physical labor and sports. In the same person, blood pressure can clearly change under the influence of emotions, with a change in body position, in accordance with daily rhythms (in most healthy people, blood pressure rises in the afternoon and evening hours and decreases after 2 hours a night) (Klabunde, 2012). All these fluctuations occur mainly due to changes in systolic blood pressure with a relatively stable diastolic.
In children under 8 years of age, blood pressure is lower than in adults. In newborns, systolic blood pressure is close to 70 mmHg. Art., in the coming weeks of life, it rises, and by the
end of the first year of the child's life reaches 80-90 with a diastolic blood pressure of about 40 mm Hg. st . In the subsequent years of life, blood pressure gradually increased, and at 12–14 years old, boys and 14–16 years old boys showed an accelerated increase in indicators of blood pressure to values ??comparable to the blood pressure in adults. In children at the age of 7 years, blood pressure has values ??in the range of 80-110 / 40-70, in children of 8-13 years old - 90-120 / 50-80 mm Hg. Art., and in girls 12 years old, it is higher than in boys of the same age, and in the period between 14 and 17 years of age, blood pressure reaches 90-130 / 60-80 mm Hg. st., and in boys, on average, it is higher than in girls. As in adults, there were differences in blood pressure in children living in the city and in the countryside, as well as fluctuations during different loads. Blood pressure is noticeable (up to 20 mm Hg. Art.) Increases when the child is excited, when sucking (in infants), in conditions of cooling the body; when overheating, for example in hot weather, blood pressure decreases. In healthy children, at the end of the action of the cause of the increase in blood pressure (for example, an act of sucking), it quickly (within about 3-5 minutes) decreases to its initial level (La, 2011).
Professionalism
Based on the texts and articles associated with this course such as the NMC and the NHS Constitution, I have learned many things about professionalism in nursing profession. I have learned that nurses should respect patients. A nurse should always be prepared to provide competent assistance to patients regardless of their age or gender, nature of the disease, social or financial situation, and other differences. When providing care, a nurse should take into account the patient’s personal needs, respect his right to participate in the planning and execution of treatment. In communicating with patients, one should never forget the following rules: always listen carefully to the patient, asking a question, always be sure to wait for an answer, express your thoughts clearly, simply, and intelligibly (In Scott, 2017). Manifestations of arrogance, neglect, or degrading treatment of the patient are not allowed. The nurse does not have the right to impose his moral, religious, political beliefs on the patient. When prioritizing the provision of medical care to several patients, a nurse should be guided only by medical criteria, excluding any discrimination. In cases that require, for medical reasons, control over the patient's behavior, the nurse should limit his intervention in the personal life of the patient to purely professional necessity.
I have also learned that nurse should not do harm. The nurse does not have the right to violate the ancient ethical commandment of medicine "First of all, do no harm!". The nurse does not have the right to be indifferent to the actions of third parties seeking to bring such harm to the patient. The actions of the nurse for nursing, any other medical interventions involving pain and other temporary negative phenomena are permissible only in his interests. "The medicine should not be worse than the disease!". When making medical interventions that are fraught with risk, the nurse is obliged to provide for safety measures, for stopping complications that threaten the patient’s life and health.
I also learned that a very important principle in modern health care is the principle of informed voluntary consent. This principle means that the medical worker should inform the patient as fully as possible and give him optimal advice (Standing, 2011). Only after that the patient should choose their own actions. In this case, in our country, the law gives the patient the right to receive all the information. Providing incomplete information is a hoax. The moral and professional duty of a nurse is to explain to the patient the consequences of refusing a medical procedure to the best of his qualifications (McSherry, McSherry & Watson, 2012). The patient’s refusal should not affect his position and adversely affect the attitude of the nurse and other medical personnel towards him. A nurse is entitled to assist without the patient’s consent (or without the consent of a legal representative of an incompetent patient - a child under 15 or an incapable mentally ill) only in strict accordance with the legislation. When providing care to incompetent patients, a nurse should, as far as the condition of such patients allows, involve them in the decision-making process. If the patient is unable to express her will, the nurse is entitled to carry out the emergency medical intervention shown to him, within her competence, on the basis of her own decision.
Additionally, I learned that a nurse should keep confidential from third parties the information entrusted to her or made known to her by virtue of performing her professional duties about the patient’s health status, diagnosis, treatment, prognosis of her disease, and the patient’s personal life even in the event of the patient’s death (Gallagher & Hodge, 2012). The nurse is obliged to strictly perform their functions to protect confidential information about patients, in whatever form it may be stored. A nurse has the right to disclose confidential information about a patient to a third party only with the consent of the patient. The right to transfer information to a nurse to other specialists and medical professionals who provide medical care to the patient, presupposes his consent. The nurse is entitled to transmit confidential information without the patient’s consent only in cases provided for by law. In this case, the patient should be informed of the inevitability of disclosure of confidentiality of information. In all other cases, the nurse bears personal moral, and sometimes legal, responsibility for the disclosure of professional secrets (Armstrong, 2007).
A nurse should maintain the authority and reputation of her profession. Neatness and personal hygiene are essential qualities of a nurse’s personality. A nurse has a personal moral responsibility to maintain, introduce and improve nursing standards. She should not claim to the degree of competence that does not possess. The right and duty of a nurse is to defend their moral, economic and professional independence. A nurse should refuse gifts and complimentary offers from the patient if the basis is his desire to achieve a privileged position compared to other patients (Crouch, Charters, In Dawood & Bennett, 2016). A nurse has the right to accept gratitude from a patient if she expresses herself in a form that does not destroy the human dignity of both, does not contradict the principles of justice and decency and does not violate legal norms. Intimate relationships with the patient are condemned by medical ethics. The behavior of a nurse should not be an example of a negative attitude towards health.
A nurse should pay tribute of deserved respect to their teachers. In relations with colleagues, a nurse should be honest, fair and fair, recognize and respect their knowledge and experience, their contribution to the treatment process (Mandelstam, 2011). The nurse is obliged to the best of her knowledge and experience to help her colleagues in the profession, counting on the same help from their side, and also to assist other participants in the treatment process, including volunteers (Keown, 2012). The nurse is obliged to respect the long tradition of his profession - to provide medical assistance to a colleague for free. Attempts to gain credibility by discrediting colleagues are unethical. The moral and professional duty of a nurse is to help the patient carry out the treatment program prescribed by the doctor. The nurse is obliged to accurately and efficiently perform the medical manipulations prescribed by the doctor. The high professionalism of the nurse is the most important moral factor of companionship, collegial relations between the nurse and the doctor (Toon & Royal College of General Practitioners 2014). The familiarity, unofficial nature of the relationship between a doctor and a nurse in the performance of their professional duties are condemned by medical ethics. If a nurse doubts the advisability of the doctor’s medical recommendations, she should tactfully discuss this situation first with the doctor himself (Macdonald, Magill-Cuerden & Mayes, 2011).
A nurse, faced with illegal, unethical or incompetent medical practice, should defend the interests of the patient and society. A nurse is required to know the legal regulations governing nursing, the health care system in general and the application of traditional medicine (healing) methods, in particular. A nurse has the right to seek support from state health authorities, the Nurses Association, by taking measures to protect the interests of the patient from questionable medical practice (Peate & Peate, 2012).
In modern conditions, the principle of distributive justice, which means the obligation to provide and equal access to medical care, is especially important. Unfortunately, distributive injustice especially often arises when distributing expensive drugs, using complex surgical interventions, etc (Tingle & Cribb, 2014). At the same time, enormous moral damage is inflicted on those patients who, for a number of reasons, are deprived of this or that type of medical care. The nurse is obliged to provide the patient with quality medical care that meets the principles of humanity and professional standards. She bears moral responsibility for her work in front of the patient, colleagues and society. The professional and ethical duty of a nurse is to provide, to the extent of her competence, emergency medical care to any person.
The nurse should put compassion and respect for the patient's life above all else. The nurse is obliged to respect the patient’s right to alleviate suffering to the extent that the current level of medical knowledge allows. A nurse is not entitled to participate in torture, executions and other forms of cruel and inhuman treatment of people (Ballatt & Campling, 2011). The nurse does not have the right to contribute to the suicide of the patient. The nurse is responsible, within her competence, for ensuring the rights of the patient, proclaimed by the World Medical Association, the World Health Organization and enshrined in the legislation
Concerning professional requirements, nurse should utilize many things such as a creative approach to their duties, the ability to quickly navigate information, choose from it the most necessary, constantly improve their knowledge and skills, improve their cultural level (In Peate & In Wild, 2018). A nurse should be competent about the patient’s moral and legal rights. She receives the highest standards in the field of nursing practice, considering real situations, guided by the requirements of the legislation of Ukraine, the principles of professional ethics. A nurse is personally responsible for the performance of her professional duties.
References
Armstrong, A. E. (2007). Nursing Ethics: A Virtue-Based Approach. London: Palgrave Macmillan UK.
Ballatt, J., & Campling, P. (2011). Intelligent kindness: Reforming the culture of healthcare. London: RCPsych Publications.
Crouch, R., Charters, A., In Dawood, M., & Bennett, P. (2016). Oxford handbook of emergency nursing. Oxford: Oxford University Press.
Gallagher, A., & Hodge, S. (2012). Ethics, law and professional issues: A practice-based approach for health professionals. Basingstoke : Palgrave Macmillan
In Peate, I., & In Wild, K. (2018). Nursing practice: Knowledge and care. Hoboken, NJ : John Wiley & Sons, Ltd
In Scott, P. A. (2017). Key concepts and issues in nursing ethics. Cham, Switzerland : Springer
Keown, J. (2012). The law and ethics of medicine: Essays on the inviolability of human life. Oxford, UK: Oxford University Press.
Klabunde, R. E. (2012). Cardiovascular physiology concepts. Lippincott Willams and Wilkins.
La, B. L. (2011). Blood pressure basics. New York, NY: Rosen Central.
Macdonald, S., Magill-Cuerden, J., & Mayes, M. (2011). Mayes' midwifery. Edinburgh: Baillière Tindall.
Mandelstam, M. (2011). How we treat the sick: Neglect and abuse in our health services. London: Jessica Kingsley Publishers.
McSherry, W., McSherry, R., & Watson, R. (2012). Care in nursing: Principles, values, and skills. Oxford: Oxford University Press.
Peate, I., & Peate, I. (2012). The student's guide to becoming a nurse. Chichester, U.K: Wiley-Blackwell.
Standing, M. (2011). Clinical judgement and decision making for nursing students. Exeter: Learning Matters.
Tingle, J., & Cribb, A. (2014). Nursing law and ethics. Chichester, West Sussex, UK : John Wiley & Sons Ltd
Toon, P. D., & Royal College of General Practitioners. (2014). A flourishing practice?. London : Royal College of General Practitioners.
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