“A moderate sedation/analgesia (“conscious sedation”) policy requires that the patient remains on continuous B/P, ECG, and pulse oximeter throughout the procedure and until the patient meets specific discharge criteria (i.e., fully awake, VSS, no N/V, and able to void).” The trained nurse had the equipment to insure that this policy was followed, however failed to perform her duties as required by this policy. The second event is that the LPN reset the alarm and made no effort to provide an intervention for the alarm. The LPN did not inform the RN of the O2 Saturation level. The LPN Was not trained properly. The third event was that there was not enough staff called in for the level of acuity that these patients had. The administration should have been made aware of the emergency coming in and called in more staff to accommodate the staffing need.…
Nightingale Community Hospital needs to repeat the steps taken to evaluate the tracer patient on a wider range of patients. They need to re-evaluate the care of at least 100 patients receiving general anesthesia and inpatient surgery within the last 60 days. This is an important step to take to make sure these mistakes were not made as an isolated incident and more as an over all hospital wide issue. Assuming these mistakes are typical to Nightingale Community Hospital, it should proceed with the following steps.…
I had the opportunity to shadow a Certified Registered Nurse Anesthetist (CRNA) who was involved in a cataract surgery for a patient with history of asthma. Bronchodilators were given prior to the procedure, however, patient was desaturating on 3L nasal cannula during the procedure with slight agitation. The CRNA increased the oxygen level and tilted the head of the patient but all actions where in vain until nasal trumpet with lidocaine cream was placed via patient’s nose to keep the airway open. At that time, I realize I want to be a CRNA in order to impact the lives of my patients.…
References: Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011). Medical-Surgical Nursing: Assessment and Management of Clinical Problems (Eighth Edition). St. Louis, MO: Elsevier Mosby.…
The first priority is to perform a focused assessment to include the patient’s respiratory function, pain, mental status, and any medication the patient has taken. The patient’s airway and ability to breathe and maintain a patent airway becomes the first priority. By asking the patient the four questions of orientation the nurse can assess the patient’s mental status. The patient’s pain can also be assessed quickly by using a numerical value or the Wong-Baker Scale prior to the patient becoming unresponsive, as well as asking the patient for a brief history of her medical condition and any co-morbidities. For the patient’s airway and breathing, the patient should be placed on 15 liters of oxygen with a non-rebreather mask to allow for increased oxygenation and a pulse…
Perioperative routine practices vary from state to state and even facility to facility. It is important for the surgical nurse to be well versed in perioperative procedures and constantly question the effectiveness and positive/negative outcomes related to each one. Several preoperative procedures take place on the surgical unit of my hospital, and after research and discussions with surgeons, I discovered a preoperative procedure that could be tweaked in order to improve post-op results.…
Anything abnormal needs to be reported to the doctor. These findings need to be documented as well. Document allergies according to facility policy. Accurate measuring and recording of height and weight are important for proper dosage of anesthetic agents. Ensure that the results of all laboratory, radiographic, and diagnostic tests on the chart. Document any abnormal results, and report them to the surgeon and the anesthesia provider. If the pt. is an autologous blood donor or has had directed blood donations made, those special slips must be included in the chart. Record a current set of vital signs within 1 to 2 hours of the scheduled surgery time, and document any significant physical or psychosocial observations. Report special needs concerns, and instructions (advance directives) to the surgical team, as required by The Joint Commission’s NPSGs. For example, advise the surgical team if the pt. is a member of Jehovah’s witnesses and does not accept blood products or if the patient is hard of hearing and does not have his or her hearing aid. This information assists the surgical team in providing continuity of care while the pt. is in the surgical area.…
She will be instructed not to eat or drink to minimize the risk of complications such as pulmonary aspiration and vomiting during the operation (Liddle, 2014). Before Audrey goes to the operating room, nurses must check the contents of the medical record to be sure that appropriate laboratory result are available as well as her fluid balance charts, medications and x-ray results. Also, nurses must ensure that informed consent has been obtained, as it is a medical-legal and clinical aspect of health care practice and the current progress notes must be charted as well as her allergy for Bactrim. Current vital signs must be taken and recorded as well. If pre operative vital signs are abnormal, notify the doctor straight away as it may increase Audrey’s surgical danger. Basic personal hygiene such as bathing will be performed or applying antiseptic agent on the skin at the incision site. It lessens the number of bacteria on the skin and reduces the risk of developing surgical site infection. Also, mark her left hip for the incision site. Audrey will also be checked and documented for any prosthetic device such as dentures and hearing aids to prevent damaging of the item during the surgery. Moreover, pre operative medications will be administered as per doctor’s order to reduce Audrey’s anxiety, lessen the chances of having nausea and vomiting and respiratory tract secretions (Taylor, 2009). Lastly, promote a restful and comfortable environment and offer her a…
* Performing physical exams to identify any issues that may affect the anesthesia care plan…
My insatiable appetite for knowledge coupled with compassion and commitment to nursing shape my desire to pursue a DNP in nurse anesthesia. Clinical rotations in OR as a close observer during an open Heart Surgery at the IMMC, while a student at the DePaul University also afforded me opportunity to see administration anesthetic drugs by a CRNA. In concretizing my interest to purse a DNP in Nurse Anesthesia, nothing can be more absolute than witnessing the births of our three children and the joy that they have brought in to my life. I saw firsthand as the nurse anesthetist administered the epidural…
DeLamar, L.(2007) ‘ Anaesthesia’ in Rothrock J (ed) Alexander’s care of the patient in surgery. 13th edn. Missouri: Mosby. Pp.120 – 122.…
Eric Weed, a Certified Registered Nurse Anesthetist (CRNA) participates on the health care team providing all aspects of anesthesia for…
The Nurse Anesthetist told me everything that was going to happen from the beginning of…
My purpose is to become a nurse anesthetist that can provide a patient with their anesthesia needs before, during and after surgery. Becoming a Nurse Anesthetist is important because ultimately, I feel this is not just for me, but for everything that I go through in the pursuit of this amazing career is to provide for my future family and to teach my kids what it takes to reach your own personal greatness. In doing this strive for greatness and achieving my goal, I will be able to be a part of a life-saving team and provide for my future family. My personal goals are to purchase my first car within the year of 2017 and to return to the sport of boxing and to start fighting at the amateur level. My academic goal is to earn a master’s degree…
This essay will discuss the plan of care I developed for Mr X while he was under my care in a post anaesthetic unit. It will discuss my nursing assessments, and what diagnoses I developed from this. It will then discuss the rationale behind my nursing interventions using relevant literature. My plan of care will be analysed throughout while identifying how my nursing care meets best practice guidelines.…