QSEN Patient Case Study
Application of Informatics
On February 11, 2014, a 64 year old female began having tingling and numbness in her right side and face, she notified family and they called 911 to dispatch an ambulance to her home. The ambulance transported her to Ellis Medicine’s emergency room on Nott Street in Schenectady. In the emergency room her main complaints and symptoms were right-side weakness, headache, nausea, and decreased level of consciousness. The symptoms were consistent with signs and symptoms of a stroke. A CAT scan and MRI show a left-sided cerebral hemorrhage. The Neuroscience team diagnosed her with Amyloid Angiopathy, a genetic disorder that causes protein to deposit on the walls of blood vessels in the brain. Deposits cause the blood vessel walls to break and crack. Blood leaks into the brain causing damage and hemorrhagic stroke (Angiopathy, 2013).
The cerebral hemorrhage occurred in the left side of the brain which caused a significant bleed and brain damage. She has expressive aphasia and right-side hemiparesis a result of the hemorrhage. The expressive aphasia created a communication barrier. I learned about who the patient was through pictures, family and use of pen, paper and the white board. I learned she worked nights full-time for Walmart, as a freight hauler, lives alone in a one story home in Schenectady, NY. Divorced with 4 grown children who are unable to assist with care. The support systems in place are coworkers and a sister from Old Forge, NY.
Key disciplines of the health care team are the neurologist, physician assistant, speech-language therapist, physical therapist, occupational therapist, social worker, and nurse.
On morning assessment, day one the Foley catheter bag w...
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... Instead Senior Care. Retrieved March 12, 2014, from http://www.homeinstead.com/334/aboutus/Pages/AboutUs.aspx
Lippincott, W. (2013). Management of Patients with Cerebrovascular Disorders. Brunner and suddarth's textbook of medical -surgical nursing 12th ed. + nursing diagnosis, (p. 1895). S.l.: Wolters Kluwer Health.
Poslawsky, I., Schuurmans, M., Lindeman, E., & Hafsteinsdóttir, T. (2010). A systematic review of nursing rehabilitation of stroke patients with aphasia. Journal Of Clinical Nursing, 19(1-2), 17-32. doi:10.1111/j.1365-2702.2009.03023
Power to End Stroke. (2013.). American Stroke Association. Retrieved March 12, 2014, from http://powertoendstroke.org/
The Joint Commission. (2014.). National Patient Safety Goals. Retrieved March 11, 2014, from http://www.jointcommission.org/standards_information/npsgs.aspx
...lood pressure medication in order to keep his blood pressure in the normal state of 120/80. Other than taking medications, there is another alternative such as surgery, such as “ventriculosmy, craniotomy, and carotid endarterectomy” (Kluwer, 2012). The patient also has the option of going to a rehabilitation center where the patient may be able to receive speech therapy, occupational therapy, and physical therapy. In addition, the rehabilitation center may also include “functional electrical stimulation” (Kluwer, 2012).
2/ Based on the chosen what I made above, I think the top three professions involved wil be Doctor of medicine, nurse practitioner and Physician Assistant. The Physician Assistant can provide health care services under the direction and supervision of a doctor of medicine. Nurse practitioner can work together with doctors as a joint health care team. And the MD is also important because they can make diagnosis, treatment and correction, give an advise, or prescript for any human disease, injury, ailment,deformity, infirmity, physical or mental,pain, real or imaginary or other condition.
It goes without saying that everyone’s health is important and should be taken care carefully. Everyone has heard of strokes before but many people do not really know its meaning, types, and the number of individuals of that dies due to this issue. According to Centers for Disease Control and Prevention (2015), strokes kills an average of 130,000 people a year and it is one of the most common deaths that happen in the United States. An average of 800,000 of people die from cardiovascular disease and strokes and it is also a reason of long-term disability (Centers of Disease Control and Prevention, 2015). Strokes, which can also be called cerebrovascular accident or CVA happen when the blood supply to the brain is interrupted or the blood vessel going towards the brain burst. Then part of the brain dies or become seriously injured because the brain cells do not receive oxygen and they eventually die. People’s lifestyle may also impact seriously on their health and increase the possibility of having a stroke. Some of the risk that can severely increase the cause of stroke would be high blood pressure, heart disease, diabetes, cigarette smoking, as well as strokes that
health care team who, with doctors, provide quality care to patients. In order to do that,
...ook at the effect that these variables had on measures of language impairment in people with stroke-induced aphasia. This study also supported the idea that an increased intensity of therapy was associated with improvements of language impairment.
Strokes are not only the leading cause of mentally disabling adults, but they are also the third most common reason for deaths worldwide (Jarvis, 2012). In general, a stroke, also called a “cerebrovascular accident,” occurs when blood flow of the vascular system is blocked from reaching parts of the brain (Jarvis, 2012). There are two types of stroke, an ischemic stroke or a hemorrhagic stroke, and they differ in the way they affect the vascular system. An ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes, and it is due to a thrombus or embolus blocking blood vessels supplying the brain (Durukan & Tatlisumak, 2007). A hemorrhagic stroke is less common, but is caused by the rupturing of a blood vessel in the brain and causes bleeding (Jarvis, 2012).
BM is a 63-year-old women born in St. Joseph Missouri. She sustained a right cerebrovascular accident 3 years ago responsible for her left hemiplegia. Since her stroke BM has not been able to independently live on her own, work or care for herself. Due to her health condition she is completely wheelchair bound and is dependent on the caregivers at the assisted living facility where she resides. BM feels that she has lost her independence since her stroke and it has greatly impacted her ability to
173, para 2). Working together as a team, nurses and other health care providers tend to communicate and collaborate effectively thus complementing and compensating each other’s strengths and weakness to endeavor even in the most adverse times.
The goal for nurses as a profession is not only to be “patient advocates” but also assist the patient to learn and gain the necessary skills to achieve the best level of functioning for the patient based on their current illness. In order to help a patient achieve their optimal level of functioning the nurse must work with the patient and the interdisciplinary team to create a collaborative plan that is logical for the patient. Through examining a musculoskeletal disorder case study #35 from Preusser (2008), one can create a critical pathway for the patient, S.P. a 75 year old female, with severe rheumatoid arthritis (RA) and admitted to the orthopedic ward for a hip fracture status post fall (p. 183). Since the patient’s needs is unique and complex the nurse must tailor a plan with the patient which will include “…assessments, consultations, treatments, lifestyle changes, disease education…” in order for the patient have the most appropriate evidence-based care and make informed decisions when it is necessary (Oliver, 2006, p. 28). The aim for the nurse caring for the S.P. is to help prepare the patient for an upcoming procedure and focus care to the patient by gathering necessary information about her while. Collaboration with the patient, family members, rehabilitation, medical and surgical team about the treatment plans can help us provide proper patient’s care by utilizing actions and interventions within the scope and standards of the nursing practice.
Intro- Collaboration with the interdisciplinary team plays a big part in the care of a patient.
Webb, L. & Holland, K. (2011). Nursing: Communication Skills in Practice. Nursing Education in Practice. Retrieved from http://gateway.library.qut.edu.au/login?url=http://search.proquest.com.ezp01.library.qut.edu.au/docview/1446976140?accountid=13380.
Stroke can be thrombotic (local formation of a clot), embolic a clot traveling from a remote place in the body), or hemorrhagic (bleeding into the brain). Ischemic stroke is characterized by the sudden loss of blood circulation to an area of the brain, reacting in a corresponding loss of neurologic function. Acute ischemic stroke is more common than hemorrhagic stroke, and is caused by thrombotic or embolic occlusion of a cerebral artery.” Hemorrhagic stroke is less common than ischemic stroke and epidemiologic studies indicate that only 8-18% of strokes are hemorrhagic. However, hemorrhagic stroke is more associated with high mortality rates than mortality in ischemic stroke is.” (Broderick, 2007)
Mrs. D. was admitted to the unit in 2011. She is 84 years old widow who was diagnosed with dementia, diabetes mellitus type II, hypertension, high cholesterol
Thinking about going into the nursing field? If so I hope you are the type of person who
Crumbie, A. (2007) Caring for the patient with a cardiovascular disorder In: Wash, M. & Crumbie, A. Watson’s Clinical Nursing and Related Sciences. 7th Ed. Bailliere Tindall Elsevier. London pg 244 – 324.