4: the high blood pressure and heart rate would contribute to a potential heart attack. The combination of lasix N…
She will need IV fluids to replace the fluid she lost due to the burns covering her body. She could go into shock…
- That's what we want to do. We'll keep her here so we can assess her... and start administering treatment. Please do everything you can... - to help her. - We'll do everything we can.…
Admitted to the medical-surgical unit with a chief complaint of “breathing problems”. She speaks broken English & requests that her daughter be allowed to stay with her. She is on nasal cannula oxygen & sitting up in bed. At this time, she seems slightly short of breath, but is not in acute distress. You note that she is pale & has a petite frame. Her ankles are swollen. Her daughter tells you that she has been complaining of feeling more tired in the evenings & “unable to catch her breath”. While at home, she has been sitting up either in an easy chair or in bed with three pillows. Her daughter states that Mrs. Lee has not had to urinate as much in the last 2 days, but she gets up twice each night to use the bathroom.…
Mr. Jones with past medical history of MI, and be came to clinic today complaining of DOE that began 6 months ago. Currently he developed edema on his low extremities, and he gained 13 lbs recently. His LVEF is less than 20%. His SOB is worsening in last 4 days, which he has a difficulty to breathe after 30 feet of walking. According to the ACC/AHA guidelines, his hemodynamic subset is class II, which he has a warm and wet due to his sign and symptoms of edema, ascites, and hypertension. Also, he is currently NYHA FC IV, as he can’t breathe regularly at when he lays down1. Currently he is not respond to thiazide (HCTZ). Thus an initial dose of diuretic (furosemide 40 mg qd) to attempt to get Mr. Jones to alleviate his edema and dyspnea symptoms, which is class I of recommendation. He also needs to monitor is K+ between 4.0 to 5.0 meq/L and BUN less than 20. Realizing that his LVEF is less than 20%, and he currently is hypovolemic, which is not increased the dosage of Metoprolol. Once he is euvolemic, Metoprolol dosage will be considered to increase to improve his LVEF. In additional he needs to monitor his diet. Also, he needs to stop naproxen for his pain. Naproxen is an NSAID class, which is contributed to worsen to his heart failure and MI condition. The APAP or Tramadol is recommended to treat his pain as needed. Also, the high dose of ASA is not showing better beneficial for his HF and MI condition. However, it has an inference with Lisinopril, which reduce Lisinopril’s efficacy, and ASP is needed to recude to 81 mg qd. The DASH diet is recommended for his current status, and he needs to watch and keep his sodium diet less than 3 grams per day. He also needs to keep weighting himself. He needs controlled his hypertension carefully. Hypertension plays an important role to increase the risk of his heart failure. Cough is likely a side effect that developed from Lisinopril. He is intolerance to ACEi, and he is…
The nurse can also intervene by administering oxygen, encouraging coughing and deep breathing. Stop the use of medications that…
In planning, the prioritized person would be Josie, who is the patient. The important goals for Josie at the time she was in the medical surgical floor would be to get her healed as soon as possible, which includes close monitoring of the patient and appropriate care. As a nurse, I would attend to patient’s needs, pay close attention to her changes, and listen to the parents for feedback (of the patient’s state), but also judge the patient’s state myself.…
Critical care nursing is a field of nursing that focuses on the provision of care to critically patients, unstable patients, or pediatric patients. Critical care nursing is usually implemented at the Emergency Room (ER) and at the Intensive Care Unit (ICU). Because of the unstable nature of the client’s illnesses, on nurses who specialize in critical care nursing are allowed to handle them. Nursing assistants, Licensed Practical Nurse, or Licensed Vocational Nurses are utilized on rare occasions.…
Sole, Mary Lou, PhD, RN, (2009). Introduction to Critical Care Nursing (5th edition). St. Louis,…
Medical Statistics reveal that the number of deaths has increased over the years because of lack of critical care by nurses depending on the condition of a patient. Patients admitted to the Intensive care unit sometimes lack the proper care and treatment to allow for quality treatment in the care units. The clinical practice issue, in this case, entails the provision of critical nursing services within non-traditional care sites as an advancement of patient monitoring practice, especially in the Intensive care unit. Critical nursing practices need implementation at various levels to allow for quality treatment procedures and advancement of the methods of carrying out operations. The critical practice issue…
The nursing assessment of the acutely ill adult is of significant importance and needs to be carried out using a systematic approach and a range of skills acquired by the nurse. It is vital that a nurse performing assessments on acutely ill patients is adequately equipped to recognise a deteriorating patient and act accordingly (NICE, 2007). During the nurse’s assessment, it is critical to consider all aspects of the patient’s condition and general health and maintain dignity of the patient throughout. The first assessment carried out by the nursing staff is an approach known as the ABCDE approach. This is an ongoing assessment of the patient that analyses the patient’s airway, breathing, circulation, disability and exposure (Pratt, 2006).…
This assignment will present a nursing care study of a patient on a cardiac ward. The patient will be referred to as Ann to maintain confidentiality (NMC, 2008). Ann’s consent was gained prior to starting this care study. The care study will be developed using the Nursing process and the Roper, Logan and Tierney model. These will both be outlined. The assignment will focus on the assessment process and one problem identified during the assessment and the nursing care which followed this.…
The initial step is to assess the patient and the plan of care. It is then important to identify tasks that someone else can perform within their scope of practice. These steps must be directly related to the condition or conditions the patient is suffering from and provide the support they need to understand and cope with their ailment or condition. The final steps are to implement the plan of care and assign and supervise task performance. This implementation must be strictly followed to ensure that the proper steps associated with the care plan are carefully followed thereby increasing the quality of care and the morale of the patient as they undergo treatment.( Journal of Nursing Regulation; Apr2016, Vol. 7 Issue 1, p5-14,…
The purpose of my supervision meeting is to talk over any issues I might have or my manager might have regaurding my placement.It is also to talk about things I would like to improve on or things I would like to learn more about. In my supervision meeting my manager Elaine was present,myself Joanna and my SVQ assessor Maxine.In my surevision meeting my manager Elaine asked me to fill out a supervision meeting form.On the form it asked me some questions like- What I enjoyed about my role at Headways to which I stated that I enjoyed being able to interact with the members and the great staff.I also said I liked helping with the daily activitys that go on at headways. What I find challenging in my role- I said I find it hard to understand some members with speech problems due to their brain trauma. I feel imbarressed that they might not think I am listening properly to what they are saying? Any issues that I would like to raise regaurding my role at headways- I don’t feel at this present time that I have any issues at my placement that I would like to raise. How I view my role and things I would like to change or improve on? I feel I would like to help more with care planning and risk assesments at headway. Areas of improvement- I feel headways is helping me improve and develop my communications skills as every member including the staff are very helpful and approachable. Once I had spoken to Elaine about theses questions she gave me feed back on what she thought. We…
The competitive advantage of nations: is Porter’s Diamond Framework a new theory that explains the international competitiveness of countries?…