D- The patient arrived on time for her session as she was seen outside. The patient reports, she has to see her cardiologist for 35 days at noon to monitor her blood flow sometime next month. She is also scheduled on 05/23/2016, at night to conduct her sleep apena and also, scheduled on a Tuesday for a ultrasounds, referring to her pulse to her legs to ensure there is no blockage in her legs.
Furthermore, the patient then reports about quitting smoking and has made progress to this goal, at which this writer commends the patient. This writer reviewed the patient records as the patient as the patient tested positive for on 05/14/2016 for opiates, benzo, and oxycodone. Denies using any opiates as the patient reports, she has tested positive for this in the past. Denies relasping to using illicit drugs and says it's her medication, especially her steroid cream for her skin infection as the patient develop hives for the past several months. The patient felt being accused of using illicit drugs by the clinic and this writer informed the patient, no one is accusing her of anything, it's just clarification about her UDS Result as she has tested positive for benzo and oxycodone, not opiates since she's been assigned to this writer as to why this writer questioned the patient of the positive result and whether or not, something has changed in her livelihood. The patient was able to calm down and accepted this writer comment.
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Then the patient requested to decrease her dose by 5mgs as she wishes to stabilize at a lower dose.
This writer completed the dose change request form; however, warned the patient, the medical team, referring to Nursing, APRN, and.or Doctor will reach out to her PCP to ensure a decrease is acceptable due to the patient medical condition. The patient feels that the decrease should not be an issue and is okay for the clinic to contact her medical
provider. Nevertheless, the patient informs this writer about a pending blood work for everything, referring to her health. And also, about a foot problem as there is a pending medical procedure to address her hammer toes and and a large bunions. This writer strongly advised the patient to keep this writer informed about any medical procedure that will be scheduled in the near future, at which the patient agreed. A-Based on this writer's assessment, the patient appeared to be alert, engaging near the end of the session, and oriented. There was no evidence of SI/HI. P-The next appointment is scheduled on 05/27/2016 at 6am.
Dr. Murray, the chief resident who arrived around 8:00pm, charted Lewis’ heart rate as normal and noteds a probable ileus; however, nursing documentation at the same time recorded a heart rate of 126 beats per minute (Monk, 2002). Subsequent heart rates at midnight and 4:00am arewere charted as 142 and 140 beats per minute respectively without documented intervention (Monk, 2002 ). On Monday morning Lewis noted that his pain suddenly stopped after being very constant and staff charted that they were unable to get a blood pressure recording in either arm or leg from 8:30-10:15am despite trying multiple machines (Monk, 2002; Solidline Media, 2010).
Registered Nurse Pausits, a defendant out of the many involved with Parson’s case, has failed to provide Randy Parson with the correct prescription drug during his stay at Standish. The Plaintiff wanted to prove that she unsuccessfully administered medication to Randy Parsons and that a reasonable jury can conclude the fact Pausits was aware of the risks to Parsons. The court has reversed the grant of summary judgment to Nurse Pausits, because this case would rise to the level of deliberate indifference. Plaintiff Parsons revealed that Pausits perceived facts to infer substantial risk to Randy Parsons and drew the inference. She had to state she was aware, which she did, of a substantial risk. Evidence has shown that Nurse Pausits could have gotten Dilantian for Randy Parson if she viewed the situation as an emergency. Pausit’s case has discovered confirmation that she administered 100mg of Dilantin to Randy Parsons August 27, at 6:00 p.m. However, in Randy’s toxicology report, no Dilantin was shown in his body for 3 days before his death, which was August 28. Wellbutrin was shown in Randy’s body instead of Dilantin, which is a form of an anti-depressant that helps people suffering from seizures and can prevent causing a seizure. Displayed that Pausits signed Randy’s Medication Administration Record (MAR), when the prison log showed that Registered Nurse Alexander performed the medication August 27, raises a red flag as to who performed the medication and what prescription was given. The Plaintiff provided enough evidence towards Pausits in that she has unsuccessfully administered the medication to Randy and that Pausits was aware of a substantial risk to Randy Parsons. Because of this, a jury can place more significance on the t...
Shaniya Robinson arrives at the County Human Services Authority for her monthly appointment with her social worker. Ms. Robinson is a 25 year old African American female who is receiving treatment for schizophrenia from the adult behavioral health services program. During a session the client reports that she is under a great deal of stress because she is having difficulty adjusting to being a new mother. Her five month old baby girl Shanice is teething and cries frequently. Ms. Robinson is also struggling financially because she is currently unemployed; her mental illness makes it difficult to sustain employment long term. And she does not receive support from the child’s father on a consistent basis. The combination of these interactional difficulties is weighing heavily on the client who reports an increase in positive and negative symptoms (i.e. auditory hallucinations and social withdrawal). Because the client does not have insurance she disclosed to her social worker that she self-medicates using marijuana in an effort to manage symptoms. More noteworthy, the client explains that she uses the same method to soothe the baby by blowing marijuana smoke in the infant's face. It is certain that Ms. Robinson divulged such information for several reasons, she wants help and she believes that any information she shares within the context of her sessions are confidential.
On 02/10/16, Mr. Newsome submitted to a random drug screen. The test was returned positive for Ethyl Glucuronide (ETG). On 02/17/16, Mr. Newsome reported for case management with Crest Aftercare and Probation. Mr. Newsome admitted to drinking 3 beers on 02/08/16. Mr. Newsome was placed on contract with Crest Aftercare. On 06/29/16, Mr. Newsome submitted to a random drug screen. The test was returned positive for Amphetamines. Mr. Newsome did not have any known medication prescribed to him by his primary care physician at the time of the drug screen.
...ts, electrocardiogram, sonogram and cardiac rehabilitation. As a clinical observer, I found an opportunity to create a solid foundation on patient diagnosis and treatment, and not to mention, long hours with charting and recording patients’ information.
Today’s clinical experience truly affected me in multiple ways. I went into this day with an open mind, and was pleased with the patients and the way I was able to conduct myself. This clinical affected me because throughout the day I felt that I experienced many emotions. A few times during my day I did have to fight back tears. I felt I had this emotion because some of the individuals expressed how they wanted to get better in order to get home to their families.
Case most recent UDS she tested positive for Marijuana, Benzo and Oxycodones. Ms. Case reports recently having surgery and having to go to multiple hospital for pain medications. She expressed multiple times she is not med seeking, however has show many med seeking behaviors. This is evidence by documentation of her frequent hospital visits and prescribe pain medications, continuous asking this clinician to make sure she gets pain medication to go home with when she has been informed this clinician dos not prescribe medications, and conflicting stories about being prescribe medications. Ms. Case also reports she smokes marijuana daily and buys 3.5 grams every 2
Patient has a history of abusing other substances and was very med seeking for benzos and opiates in the ED ("I don't want yall to give me nothing if it ain't IV Ativan and Morphine"). He reports drinking a 1 gallon of wine daily. He denies other drug use and this was confirmed by his most recent drug screen which was negative for substances with a BAC of .42. Upon arrival patient was put on detox protocol with Ativan scheduled every 6 hours. Upon assessment this morning patient denies any withdrawal symptoms. After TACT confronted him about malingering and patient admitting this, TACT then began to discuss discharge options. When TACT asked Mr. Farley about withdrawal symptoms he only expressed
...ort her actions, then Jack must do so as he is too responsible for making this situation known to the appropriate people. However, one must acknowledge how difficult this may be for Jack due to the long-standing relationship he has with Linda. It should also be apparent now that Linda’s actions are unjustifiable. She is not only acting unprofessionally and unethically by not delivering the medication but she is committing an illegal offence by falsifying records and stealing from the ward. To conclude, it is important to remember that the Department of Health and Children (2008) acknowledge that healthcare has originated in a world which is not flawless and that as humans, errors are possible. However, members of the healthcare system must try and prevent these errors from occurring where possible to ensure a high standard of care which is owed to the service users.
B.V. is a 42 year old male patient admitted for severe angina chest pain. He previously had coronary artery bypass surgery a month ago. His incision site from the surgery was dry, intact with no inflammation present. He currently was not on any pain medications upon admission. He tested positive for hepatitis C and was homeless. He had a history of drug and alcohol abuse and left hip replacement. He is currently taking medications for hypertension and diabetes through Medicare. When getting report on the patient, the nurse stated that the patient kept asking for pain medications every hour but didn’t look like he was in pain. He was in a comfortable position in bed while laughing and watching television. The previous nurse thought the patient just wanted pain medication since he is previous drug addict. This situation reminded me of what I learned in Medsurge about trusting your patient if they
I introduced myself to the patient stating that I was a student nurse and gained verbal consent to carry on with the assessment, as a student nurse you must respect patients wishes at all times, if t...
P-The patient will continue to comply with the program policy and her next scheduled appointment is scheduled on 03/28/2016 at
D. standing near her room, breathing sharply. While asked what has just happened, she answered, ‘I feel dizzy and can faint!’ Mrs. D. then explained that she rose up from her chair in the television room and felt lightheaded. I decided to bring her to the room hoping she would feel less dizziness if she could sit. After consultation with my mentor and third year unit nursing student, I decided to perform measurement of her vital signs. Since only electronic sphygmomanometer was available for me that time, I had to use it for my procedure. Gladly, I discovered that I have already used such equipment in my previous nursing practice. Using the standard sized calf, I found that her blood pressure was 135/85, respirations were 16, and her pulse was 96 beats per minute (bpm). However, I decided to recheck the pulse manually, founding that it was irregular (78 bpm). The patient stated that she felt better after rest. Immediately after the incident I made a decision to explore carefully the medical chart of Mrs. D., along with her nursing care plan. That helped me to discover multiple medical diagnoses influencing her
I attended the University of Hartford from August of 2015 through July of 2016. I stopped attending the school for the reason that I was struggling emotionally and needed to attend treatment. I attended Silver Hill in July of 2016 through August of 2016. I then transitioned to an IOP (Intensive Outpatient Program) in New York City from August 2016 to January 2017. I subsequently, unfortunately, developed another breakdown which resulted in me going to Yale-New Haven for psychiatric treatment. They thought it was in my best interest to go to a residential treatment program in North Carolina called Cooperriis from January 2017 to July 2017. In all of the treatment I attended I learned that if I work hard enough I can move past any downfall. Moreover,
Clinical reasoning is the ability to 'sort through a cluster of features presented by a patient and accurately assign a diagnostic label, with the development of an appropriate treatment strategy as the end goal'. It is central to our clinical practice, yet it remains an enigma and continues to present a challenge to teachers and learners. There are at least two reasons that make clinical reasoning problematic for clinicians. Firstly, experienced clinicians often use rapid unconscious cognitive reasoning processes and find it difficult to slow down and explain how they are thinking.