GCS5 Glasgow coma scale 5/15 Scores for eyes opening, motor response, verbal response Scores less than 8 are classified as severe What concerns do we have for this patient to consider in treatment? ROM Wound healing Level of awareness Posturing Contracture UMN signs Positioning considering wounds and fractures, aspiration Positioning schedule Paresis Coordination Tone Cognition Communication DVT What impacts may the location of the hemorrhage have on his recovery and outcome? What does decorticate posturing indicate? What does a RLA II look like? Generalized response: total assistance Inconsistently and non-purposefully respond to stimuli Responses are the same no matter the stimulus and delayed Physical or physiological
Mr. Fix-it is a 59 year old man with a history of alcohol abuse and diabetic hypertension. Mr. Fix-it has been currently experiencing symptoms such as: rambling speech, poor short-term memory, weakness on the left side of his body, neglects both visual and auditory stimuli to his left side, difficulty with rapid visual scanning, difficulty with complex visual, perceptual and constructional tasks, unable to recall nonverbal materials, and mild articulatory problems. The diagnosis for Mr. Fix-it’s problem is most likely a right-hemisphere stroke. A right-hemisphere stroke is occurs when a blood clot blocks a vessel in the brain, or when there is a torn vessel bleeding into the brain. “A right-hemisphere stroke is common in adults who have diabetes and who are over the age of 55”, similar to Mr. Fix-it (Kluwer, 2012). In addition, Mr. Fix-it has a history of alcohol abuse in which it could have also increased his chances of experiencing a right-hemisphere stroke.
- If all of the options were explored, and patient is given antibiotics and is treated without any pain or suffering than the treatment identifies with the ethnical principles of autonomy, non-maleficence, and veracity. In turn, Mrs. Dawson will be happy with the outcome of the procedure.
The case study, `Will GM 's Strategic Plan Lead to Success,` is about how the company General Motors Co. Plans to overcome financial deficits, ensure growth within the company, and remain competitive in the automotive industry. To help with overcoming financial deficits, GM was apart of the bailout, which assisted GM in relieving themselves of almost $40 billion dollars of debt. This restructuring gave GM an advantage over other automakers. Most other automotive businesses, that did not participate in the bailout, still have billions of dollars of debt they must repay in addition to competing with its adversaries.(Kinicki & Williams, 2013). GM made many cutbacks to ensure growth within the company. The reduced the amount models that are in production. They have recognized that some changes need to be implemented with global production in order to remain ahead.
Being a nursing student, I understand that Mr. John suffer hemiplegia resulting in weakness and also have limited ability to move, he cannot eat by mouth which restricts to have enough nutrition for the body, these are the some of the reason that make Mr John prone to have pressure injury as limited mobility and sickness causes the blood vessels to collapse easily so when for hours or days continuously pressure remains on the skin it leads to pressure sore and these pressure sore increases the risk of infection (Reddy, Cottrill, & Cansino, 2011). Usually, sustained pressure causes injuries over a bony prominent area especially in those who are malnourished and immobilized or limited mobilized. Routine assessment of skin is recommended to observe any sign of infection, 2 hourly position helps to relieve the pressure on the area (Barret, Kevin, James,
3. Childs NL, Mercer WN. Brief report: late improvement in consciousness after post-traumatic vegetative state. N Engl J Med 1996;334:24-25. (report of a 16 year old patient with PVS who recovered significantly after 17 months).
A serious brain injury could lead to bleeding in or around your brain, causing symptoms that may develop right away or later.
The rapid objective methods in the diagnosing, evaluating, and follow up of the battlefield mild traumatic brain injury needs treatment standards. There are standards for the moderate to...
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
Patients in the Intensive Care Unit are at a high risk to develop delirium. It is one of the most common conditions encountered by the staff in an Intensive Care Unit. Delirium can be hyperactive or hypo active according to the patients’ behavior. Disorientation, agitation, hallucinations, or delusions are characteristics that may be observed in the patient with hyperactive delirium. Apathy, quietly confused, withdrawal, lethargy, and even total lack of responsiveness are all symptoms of hypoactive delirium. Some or all of these symptoms may occur at any time.
Brott, T., et al., Measurements of acute cerebral infarction: a clinical examination scale. Stroke, 1989. 20(7): p. 864-70.
Students are becoming increasingly self-aware and finding their identities earlier than before (Poteat et al.). Daviess County High School needs a Gay-Straight Alliance (GSA) as a club because it will bring awareness to the school’s diversity and create a safe zone. Having a GSA will make the school safer with education enlightening the minds of the students of the problems and solutions that are presented in the club. A GSA is an organization that will make the school a safer and inclusive place for students of all backgrounds. The organization relates to a number of students heterosexual or LGBTQ, the club builds leadership skills, and it increases inclusivity among groups.
Grievant is a FTR with bona-fide bid job at APBS. APBS bid job requires successful bidder to be a to be qualified keyers through training prior to working and keying mail at The CBA, JCIM, ELM, BQNet, etc, require that clerks must successfully complete training prior to working and keying mail at the APBS.
So that, the diagnostic and therapeutic course of management should have been commenced sooner. Contacting other therapeutic members and explaining the situations to different people including nurse manager, consultant, senior registrar and anaesthetists have delayed the management. However, I believe that my action benefitted the patient and his family by avoiding further delay in the management. And also, ensuring the presence of a staff member with Michael’s wife should have assisted her to go through the unforeseen situation. I understand the neurological deterioration of GCS >8 and respiratory distress are indications of intubation of neuroscience patients. However, intubation is also indicated for therapeutic and diagnostic procedures in aggressive and uncooperative patients (Souter & Manno 2013). This scenario highlights the importance of the person-centred approach to clinical judgement and decision
The main discussion discussed was strategic. It involved the internal operations of a firm, where the business will break through costs, major in cost differentiation and product leadership. The decision made focused on how the firm planned to outdo the rivals in the industry, by doing the same activities in a different way. It centered on performing activities in a way that will ensure that the business profitability rises. The key decisions were made at the formulation stage by the middle level managers. This is the stage which formulates and implements most decisions in the organizational management pyramid.
Of the four key factors associated with TC, multidimensional communication is my favorite. Many circumstances affect the way people communicat...