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Checking vital signs nursning
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1. What are routine daily clinical observations that are found on a care plan that would you perform on a patient? SPo2, Resps, HR, BP, Temp, pain scale, alert scale, 2. Name the observation that you would perform on a patient that has a head injury. Identify what is accessed in this type of observation. - Glasgow coma scale:- checking the eyes for a reaction - Neurological obs:- which includes pain stimuli, GCS scale, limb movement, pulse and BP and verbal response - Neurovascular obs: warmth, colour, movement sensation, pulses, venous return and pain score (Chrisp & Taylor, 2011) 3. Name the observation that you would perform on a patient that has had a fractured arm pined and plated and is now in a full cast. Identify what is accessed in this type of observation. …show more content…
- Neurovascular obs and capillary refill in the fingers to check the circulation of blood in the arm that’s been cast. (Chrisp & Taylor, 2011) 4. What causes errors in blood pressure measurement in relation to the cuff? The cuff can be too big or to small, the pts body position could affect the reading ‘person lying on their arm and gravity’, peoples condition right/left sided weakness d/t stroke, the BP is always higher in the leg. (Chrisp & Taylor, 2011) 5. Complete the basic life support flowchart Danger: Check for danger, electrical cords, water, slipping material, risks and hazards Response: Call out, raise alarm, pull cord out of wall, press met button ect.
Ask the pt their name, can they tell me, can they squeeze my hand, open their eyes Airways: Put into recovery position, Check airways, put finger in airways to scoop out sputum and anything else Breathing: Put fingers under nose and mouth to feel breaths or see rise and fall of chest Compressions: Start 100X 1 min chest compression lots of 30 and 2 breaths then check pulse or reaction Difribulate: Set up automatic defibrillator pads and then let machine calibrate, attach paddles and tell everyone to clear away (sasvrc.qld) 6. Would the protocol for cardiac arrest differ from an acute care setting to an aged care facility? Explain your answer. In a nursing home it would be the same as in hospital, the only deference would be if the person has a NFR and it is discussed at handover, even still the patient would still be made comfortable and oxygenated in both care settings (Chrisp & Taylor, 2011) 7. What signs/symptoms would you expect to see if a patient was suffering from hypoxia? Cyanosis, SOB, resp rate low, SPO2 low, BP and pulse and BP
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I intend to explore the effects of a parietal brain injury from the perspective of a neuropsychologist; ranging from types of tests that are employed when trying to determine the extent of the damage, to gaining an understanding of how this damage will affect the rest of the brain and/or the body. I will also explore the effects of a brain injury from the perspective of the family members, and their experiences with the changes that occur during the rehabilitation process. According to The Neuropsychology Center, “neuropsychological assessment is a systematic clinical diagnostic procedure used to determine the extent of any possible behavioral deficits following diagnosed or suspected brain injury”(www.neuropsych.com). As mentioned previously, a brain injury can be the result of many types of injuries or disorders, thus a broad range of assessment procedures have been developed to encompass these possibilities.
Three of them are: does the patient have a history of falls, is the patient at risk of falling, and to identify the cause of a fall (Recommendations 2011). The first recommendation the healthcare team should consider is, does the patient have a history of falls? During the initial assessment the healthcare team should ask the patient and family members present about fall history. Carefully examining the patient's chart for any indicators of past falls is also recommended. These can be clear indicators of the presence of fall risks. Once a patient has fallen once, the likelihood of a second fall is greatly increased. The second recommendation the healthcare team should consider is, is the patient at risk of falling? Both extrinsic and intrinsic factors should be considered. Examination of the patient's chart for a list of current medications being taken, fall history, any underlying conditions, neurological status, and psychological status should be done. Previous studies have shown that psychotropic, diuretic, digoxin, and Class 1a antiarrhythmic medications are associated with significantly increased risks of falls (Kehinde, Pope, & Amella, 2011). An examination of environmental status should also be done. For example, looking at lightning, cords on the floor, slippery floors, whether the call light is accessible, and whether the room
Basic life support (BLS) is a skill that many people in the community are lacking. Nearly 400,000 out-of-hospital cardiac arrests occur annually in the United States (American Heart Association, 2012), and of this 89% of the people die because they did not receive immediate CPR by a bystander (American Heart Association, 2012).
Recognition, response and treatment of deteriorating patients are essential elements of improving patient outcomes and reducing unanticipated inpatient hospital deaths (Fuhrmann et al 2009; Mitchell et al 2010) appropriate management of the deteriorating patient is often insufficient when not managed in a timely fashion (Fuhrmann et al 2009; Naeem et al 2005; Goldhill 2001). Detection of these clinical changes, coupled with early accurate intervention may avoid adverse outcomes, including cardiac arrest and deaths (Subbe et al. 2003).
Observe, record, and report to physician patient's condition, treatment provided, and reactions to drugs and treatment
-“Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND
The purpose of this essay is to reflect and critically study an incident from a clinical setting whilst using a model of reflection. This will allow me to analyse and make sense of the incident and draw conclusions relating to personal learning outcomes. The significance of critical analysis and critical incidents will briefly be discussed followed by the process of reflection using the chosen model. The incident will then be described and analysed and the people involved introduced. (The names of the people involved have been changed to protect their privacy) and then I will examine issues raised in light of the recent literature relating to the incident. My essay will include a discussion of communication, interpersonal skills used in the incident, and finally evidence based practice. I will conclude with explaining what I have learned from the experience and how it will change my future actions.
Firstly we lay them on the back to get the resting heart rate and we
The breath is brought into the nose and exhaled through the mouth with slightly pursed lips which should help you to feel a deeper contraction of the abdominals. = == == ==
Traditionally nurse’s role in evaluating a patient has to record the observations made but not to interpret them. The main observation includes pulse, temperature, rate of respiratory, blood pressure and consciousness level (Alice, 1985). The ability of nurse to record such observations accurately will determine the priority of the patient care. Assessment based on priority setting is one of the major skills that nurses that are newly fit may lack. Th...
Most of the noninvasive imaging methods estimate brain activity by changes in blood flow, oxygen consumption, glucose utilization, etc. Discuss the potential problems with using this type of indirect measure.
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
This week’s clinical experience has been unlike any other. I went onto the unit knowing that I needed to be more independent and found myself to be both scared and intimidated. However, having the patients I did made my first mother baby clinical an exciting experience. I was able to create connections between what I saw on the unit and the theory we learned in lectures. In addition, I was able to see tricks other nurses on the unit have when providing care, and where others went wrong. Being aware of this enabled me to see the areas of mother baby nursing I understood and areas I need to further research to become a better nurse.
It is important to ensure that the patient is getting a bath daily, oral care, as well as brief changes so they are not setting in their excretions.