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Evolution Of Nursing
Evolution Of Nursing
Chapter 1- The Evolution of Nursing
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As I review Capnography, I refreshed a couple of key concepts. First, a Capnograph measures the CO2 during each phase of the respiratory cycle (Sullivan, 2015). Second, the carbon dioxide is the drive to breath; if there are high levels of CO2, respiratory rate should increase (Sullivan, 2015). Similar to reading of an electrocardiogram, the capnography waveform measures the arm movement in the lungs (Sullivan, 2015). A couple of thoughts came to mind from your initial post. The healthcare industry and practice is evolving and continually changing (Miller, Hayes, & Carey, 2015). The “sacred cow” approach or the reply “we’ve always done it this way” in Nursing is discouraging and challenging (Miller, Hayes, & Carey, 2015). After pondering
HENDERSON, Y (1998) A practical approach to breathing control in primary care. Nursing Standard (JULY) 22 (44) p41
According to the Registered Nurse (RN) Scope of Practice Position Statement, “the RN is responsible for providing safe, compassionate, and comprehensive nursing care to patients and their families with complex healthcare needs” (Texas Board of Nursing, 2011). Nurses often care for five to six patients at one time; therefore, in order to provide the best quality care, patients are often connected to monitoring devices such as, physiological monitors, venti...
Goodfellow, L. T. (2011). 2015 and Beyond: Usable and Unbiased Data. Respiratory Care, 56(12), 1977-1978. doi: 10.4187/respcare.01619
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
Hess Dean R., M. N. (2012). Respiratory Care: Principles and Practice 12th Edition. Sudbury, MA: Jones and Bartlett Learning.
Over the last 10 years evidence-based practice (EBP) has grown substantially and is changing the nursing care delivered to patients along with the nursing work environment. Nurses are more involved in the decision making process, and are making clinical decisions with better patient outcomes (Good, Fink, Krugman, Oman, & Traditi, 2011). With technology growing at such a fast pace, new and more effective medicines, medical devices, and procedures are developed daily. Digestible sensors that monitor your bodily systems and 3D printing of embryonic stem cells, blood vessels, and sheets of cardiac tissue that actually beat like a real heart, are significantly impacting the future of healthcare (Honigman,
An audit of patient records completed in 2005, revealed a low incidence of respiratory rate recording. An initial audit completed revealed that only 7% of 341 patients had a respiratory rate recording (Butler-Williams 2005). Due to this worrying outcome, the priority was to implement appropriate training to raise respiratory rate significance. Due to the audit being completed hospital wide and with no prior warning, it is an accurate indicator of an overall attitude of practice towards the recording of respiratory rate. Various studies have been conducted in order to gain an understanding as to why this precious sign is so often ignored. Jacqueline Hogan explored the paucity of patient monitoring on acute wards, completing qualitative research using focus groups in 2004. Four major themes were identified, firstly the issue of the nursing workload. Many participants acknowledged the expansion of the nurse’s role and with this added responsibility, the need for delegation of activities such as patient observations. Observations are often delegated to junior staff members such as healthcare assistants and student nurses. Although many nurses admitted to delegating this vital activity, 73% of nurses did not consider healthcare assistants possessed the required knowledge to interpret observational results. With this lack of knowledge comes the absence of appreciation for the completion of such vital signs, and
In this discussion post we are to describe the structures and functions of the respiratory system. We were asked to include major organs and how they work within the body and to notate symptoms of failure within the respiratory system.
Caring for people is my passion. My senior year of high school is when I witnessed my grandmother live on a ventilator for about a week. It awakened a new level of passion in me to care for people with cardiopulmonary problems. The Respiratory Therapy Care profession has intrigued me with how they improve the quality of life in their patients. I will enjoy working closely with patients in addition to working high tech equipment. By entering into this program and graduating out of this program I know that this will satisfy my personal goals for the next five years in many ways. The continues challenges of trying to figure out what’s wrong the heart that day or what’s wrong with the lung the next day will always keep me on my toes. It will always
The Respiratory System 1. Define respiration. Respiration is the process of converting glucose to energy, which goes to every cell in the body. 2. Describe the organs of external respiration.
Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...
There are 2 types of breathing, costal and diaphragmatic breathing (Berman, 2015). Costal refers to the intercostal and accessory muscles while diaphragmatic refers to breathing using your diaphragm (Berman, 2015).It is important to understand the two different types of breathing because it is vital in the assessment of the patient. For example, if a patient is suing their accessory muscles to aid in breathing then we can safely assume that they are having breathing problems and use a focused assessment of their respiration. Assessing respiration is fairly straightforward. The patient’s respiration rate can be affected by anxiety so a useful to avoid this is to check pulse first and after you have finished that, while still holding their pulse point, check their respiration rate. Inconspicuous assessment avoids the patient changing their breathing because they know they are being assessed which patients can sometimes do subconsciously. Through textbooks and practical classes I have learned what to be aware of while assessing a patient’s respiratory rate. For example; their normal breathing pattern, if and how their health problems are affecting their breathing, any medications that could affect their respiratory rate and also the rate, depth, rhythm and quality of their breathing (Berman, 2015). The only problem I found while assessing respiration rate was I thought it seemed a bit invasive looking at the
The Mechanism and Regulation of Breathing Breathing is an involuntary movement that is controlled by the medulla, which is part of the hind brain. Air is sucked into the lungs. through an active process called inspiration. The external intercostals muscle contract and the internal intercostals muscle relax this causes. the ribs to be drawn upwards and outwards.