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Patient RW is a 72-year old male that came into the hospital by ambulance from an assisted living facility in the Des Moines area. Patient RW has lived fulltime in an assisted living facility since 2013. His daughters come and visit him daily and are also by his side in the evening while he is staying in the hospital. His support system is small, but is very involved in his cares within the living facility and the hospital. He was admitted to 7 South for chest pain and is on continuous telemonitoring and on four liters of oxygen. According to his daughters, he is an average Christian, with no religious or culture aspects that would affect the health care that needs to be given. Though, no religion or culture is affecting care, his past …show more content…
He is also on medications for his hypertension and to manage the pain he is experiencing. These medications are given at his assisted living and within the hospital, so teaching has been done, but the nurse was able to briefly explain the medications to his daughters as each one is administered so that the patient was aware of what is being given each time. He is taking 40 mg by mouth at bedtime of Atorvastatin as a primary prevention for cardiovascular disease and lowering the risk of a heart attack (MI) or stroke. It is a lipid-lowering agent, HMG-CoA reductase inhibitor. This medication requires a nursing assessment to be done involving monitoring the patient’s serum cholesterol and triglyceride levels before starting this medication and to monitor the liver function throughout the drug therapy. If the patient develops muscle tenderness, the nurse will need to assess CK levels in the patient (Deglin, Vallerand and Sanoski, 2014, p. 642). 75 mg by mouth at bedtime of Clopidogrel, which is an antiplatelet agent, is being used to reduce atherosclerotic events. When giving this medication, the nurse needs to assess for symptoms of stroke, PVD, or MI periodically during treatment. Also, the nurse needs to monitor for signs of forming blood clots and monitor bleeding (Deglin, 2014, p. 327-328). Metoprolol 25 mg daily is a …show more content…
It is not the reason he is admitted to the hospital at this time, but it is crucial in the way he receives care because he is no longer able to speak or hear. Though he is alert, and can respond appropriately, he does suffer with forgetfulness from time to time, and that comes with both age and his injury. “A traumatic brain injury (TBI) is damage to the brain from an external mechanical force and not caused by neurodegenerative or congenital conditions” (Ignatavicius, Workman, Blair, Rebar and Winkelman, 2015, p. 946). In RW’s case, his TBI was caused by a car accident. TBIs can be temporary or permanent and lead to numerous impairments, whether it is cognitively, physically, and/or psychosocially. He is currently hospitalized for chest pain, and with a stress test and angiogram, doctors found there to be a mild case of cardiomegaly and atherosclerosis within 3 vessels of the heart. Cardiomegaly is an enlargement of the heart, but atherosclerosis is what the doctors really want to treat and prevent. “Atherosclerosis is a type of arteriosclerosis, which is a thickening or hardening, of the atrial wall, often associated with age. With atherosclerosis, plaque is formed within the arterial wall and is the leading risk factor for cardiovascular disease” (Ignatavicius, 2015, p. 706). The exact pathophysiology is unknown, but is said to occur from blood vessel damage, causing inflammation. Populations at
The role of nurse practitioner in the Canadian healthcare system is relatively new compared to the traditional roles of doctors and registered nurses, and as with any new role, there are people who oppose the changes and others who appreciate them. Some members of the public and the healthcare system believe that the addition of the nurse practitioner (NP) role is an unnecessary change and liability to the system because it blurs the line between a doctor and a nurse; this is because nurse practitioners are registered nurses with additional training (usually a masters degree) that allows them to expand their scope of practice into some areas which can be treated by doctors. Other people feel that nurse practitioners can help provide additional primary care services, while bridging communication between nurses and doctors. There are always legitimate challenges to be overcome when changing a system as complicated as healthcare,
The patient that I have chosen for this discussion is an elderly woman. Her diagnosis was a fracture of the left femur which happened as a resident in a long-term care facility. Comorbidities include Alzheimer 's disease and diabetes type II. She was described by other staff as being mean, uncooperative, difficult, and lazy; little did they know that I was a nurse at the long-term care facility and have cared for this women many times prior to this hospitalization. The staff seemed to all chime in eager to express the faults in
Often the injury is caused by being hit with a blunt object, serious illness of a degenerative brain disease. The degree of severity depends on the extent of the damage. In some cases, it can be temporary. However, in such a case as Greg’s, it can be progressive. It normally affects the memory storage area of the brain, which are located in the frontal lobes. Apparently, the frontal lobes have a series of functions. They are involved in motor skills, language, memory, impulse control, sexual behavior and judgement. In this regard, damage to this area will cause problems with all of the above areas though to varying degrees. According to Levin (1987), TBI (traumatic brain injury) often causes harm to the frontal lobe. Memory impairment in TBI occurs in three main categories explicit, implicit and source-context memory. Explicit memory deals with recognition and recall. Patients with this form tend to perform poorly in visual and cure-recalled tests that their healthy counterparts. This form seemed the most prevalent in
Today he chooses to have a healthy life and control his diabetes. He takes one medication orally for his diabetes, Metformin. JR has a good, healthy diet as well as exercise habits like taking walks with his dog. JR takes seven medication on the daily with three being for his heart, one for his high blood pressure, one for his cholesterol, one for his diabetes and another one to prevent blood clots. After making sure there was no drug to drug interaction between any of this medications, I informed my patient that his medication can not cure diabetes and high blood pressure but control
A registered nurse (RN) is someone that went through a university or college and studied nursing; and then passed the national licensing exam to obtain a license to practice nursing. The degree earned by an RN at the need of the program is deemed a professional nursing degree. The RN top nursing staff and they usually works independently. On the hand, an LPN only earns a practical nursing degree after completion of the program. LPNs are mostly recognized only in USA and Canada; they are also named as License Vocational Nurse (LVN) in the state of California and Texas. LPN work under the supervisor of an RN or a physician.
“Elaine” is a 34-year-old white female patient with an extensive medical history. She has a history of seizures, uncontrolled diabetes since the age of fourteen, neuropathy, fibromyalgia, COPD, Sleep Apnea, and is currently suffering from two venous ulcers on her feet. She came to the ER one week ago with nausea and vomiting and was found to be in Diabetic Ketoacidosis and her wounds had become infected. She spent three days in the ICU and for one day was ventilated. She was then sent out to the Medical/ Surgical for further management 3 days ago.
Throughout the Practical Nursing program, there has been many opportunities to closely observe working nurses in different hospitals and facilities. It also has been a great chance to grasp the general idea about professionalism in the workplace and how it can have a great impact in a successful work environment. Combining what was observed and what was learnt from the class, there were three particular aspects of professionalism that seemed to be key characteristics of professional nurses: knowledge from continuous education, autonomy, and positivity. Out of all other characteristics for professionalisms in nursing, those three were the most remarkable features found from the some of the great nurses observed from the clinical sites.
There are many who believe that the next shortage will be worse and the demand for nurses will increase. There will be more jobs available especially with the baby boomer nurses retiring. Wood believes that when nurses retire, the next shortage could be even worse than the previous shortage. According to Wood this would lead to an “intellectual drain of institutional and professional nursing knowledge” (Wood, 2011, para 15). Staiger agrees as well that a shortage of nurses is expected again when nurses retire and since the economy will be more stable full-time nurses will go back to being part-time (Huston, 2017). Huston expects for the supply of nurses to grow minimally in the next couple of years and for a large number of nurses
It was a quiet and pleasant Saturday afternoon when I was doing my rotation at the surgical medical unit at Holy Cross Hospital. It’s time to get blood sugar levels from MM, a COPD patient. His BiPAP was scheduled to be removed before his discharge tomorrow. When I was checking the ID badge and gave brief explanation what I needed to do. The patient was relaxed, oriented and her monitor showed his SPO2 was 91, respiratory rate was 20. His grandchildren knocked the door and came in for a visit. I expected a good family time, however, the patient started constant breath-holding coughing and his SPO2 dropped to 76 quickly. With a pounding chest, the patient lost the consciousness. His grandchildren were scared and screaming,
Mrs. Denise Callaway (RN, BSN) is my charge nurse at the hospital in rural Georgia. She is a patient advocate. In her interview, she stated that she is a patient advocate first and foremost. She believes that all nurses, RN?s and LPN?s, have a responsibility to advocate for their patients. She admits that she try to put herself in the patient?s and/or family?s place. She was taught to? do unto others? and she has followed that philosophy throughout her nursing practice. Mrs. Callaway always encourages her staff to see the best in the patients. She never sets in an office. She is always out on the unit helping staff, it does not matter if it is housekeeping, and she is always there to lend a hand when needed. She always includes her patients
Including family members in the care of the patient helps them cope better with the patient’s illness and helps them plan ongoing care when the patient goes home. Gaining both the trust of the patient and family can help the health care team get any details that may have been missed on admission, such as medications the patient takes, or special diet, or spiritual needs. Also, the family may provide pertinent information that the patient may not have divulged to the nurse. Encouraging the patient and family to voice their concerns will help implement a safe plan of action.
A week before Christmas in 2013, my stepfather suddenly lost consciousness. His body stiffened and he began to violently convulse – he was having a seizure. Later in the hospital, the doctors informed us that my stepdad had suffered a hemorrhagic stroke. The anguish that I felt that night was eased by a nurse who talked to my family about my stepfather’s condition and assured us that the hospital would do everything that they can to assist him with recovery. The next few weeks were filled with uncertainty as my stepdad laid comatose, no knowledge of when or even if he would wake up. During that time, my interactions with the nurses always made me feel safe and comforted Unfortunately, he passed away in January 2014. Though this was a traumatic and life altering experience, what I remember most are the nurses that provided care to my stepfather. They went above and beyond their outlined job duties to care for my loved one and to make my family feel secure even in such a difficult time.
Faith Community Hospital, an organization who's mission statement is to promote health and well-being of the people in the communities. They serve through the extent of services provided in collaboration with the partners who share the same vision and values. Though the mission statement is the model that everyone should be following, everyone does not think the same about every issue. We all may face similar situation at one point in time but the end result may be different for each individual because we all have different values and beliefs. There are many differences between ethics, laws, beliefs, and oaths that all affect the decisions from patients to staff members. Some patients refuse to take medical services and there are staff members who refuse to provide certain services due to those value lines. Some of the staff members are caring so much for the patients that they sometimes take radical positions to respond to their well-beings. In these situations medical intervention can conflict with religious beliefs or personal moral convictions. Hospital pharmacists are even taking positions which they believe to be important such as filling uninsured prescriptions by accepting payments in installments. Staff members in ICU initiated Do Not Resuscitate procedures with out written orders. Doctors are putting patients first from various interpretations. In "right to die" situations the doctors seem to be getting too involved in compassion and passions with their patients. We need to stay focused on what our jobs are and what we are promoting which is to provide healthcare and its services to members of the communities. Counselors are also treating some of their clients with no authorization of the values and beliefs they have. On the other hand, there are some staff members within the hospital who refuse to serve patients unless they have confirmed insurance coverage. If a patient is to pass away because of unauthorized decisions, this can cause a stir with the media as well as with current or future patients in the community.
Aside from what the other nurses and I believed was best for this patient, it will always be up to the patient and family to decide the most appropriate decision for the patient situation. Therefore, no matter what the patient and family decides they want to do for this patient, whether it be to continue invasive life sustaining measures or have the patient begin palliative care, we have a duty to provide respect and compassion for our patients. I think this experience helped me to realize that no matter where I decide to work, there will always be ethical situations or dilemmas that I am faced with and the best thing I can do when faced with these issues is to support my patient and advocate for their wishes. This event will help shape my practice because it made me realize that we have to continue to have empathy for our patients because we never truly know the amount of pain or discomfort they are in. This patient had a long list of serious disorders and I am thankful I was able to be by her side throughout some of the weakest points of her life. She continued to thank me for providing oral cares and moisturizing her lips, or repositioning the pillow where it felt right and minimized the pressure on her sore. I also realized that we may be the patients only form of support throughout a certain point in their life and so it’s best to stay as supportive as possible. I
Within the past week, I was able to meet a patient that had been through a very difficult life. He was admitted into the hospital almost one month ago because he had a stroke. He was a carnival worker and was only planning to be in Lexington for a temporary amount of time until the carnival left. When he was admitted into Saint Joseph Hospital, there were no indications that he had family and/or friends that should be contacted. At first, he was unable to talk, and his mobility was extremely limited.