...answer. You should then write all appropriate nursing diagnoses in PES format. l. Is patient able to maintain personal hygiene? Bathing and Oral Care: Client is able to handle her own bathing and oral care with assistance and help from the aide. Client's vision is very minimal. As per her chart she has glaucoma and she stated that it is very difficult for her to see. Client is aware of the necessity of Handwashing before meals as well as after eliminating wastes but still requires assistance in order to see. In regards to respiratory secretions, patient is able to handle on her own. 2. What is patient's temp? Was unable to read temperature because we were only provided with tympanic thermometers and client had hearing aides in both ears. I was advised to skip the procedure. WBC's? Lab results indicated a level of 5.9, which is within normal range. 3. Are skin and mucous membranes intact? None of the following were observed. Client's skin seemed to be soft and well moisturized. Did observe lentigo spots on the client's arm but other than that no other skin or mucous membrane issues were observed. Lesions Surgical Incision Decubitus Ulcer Redness or swelling IV's or other invasive linesTubes Catheters 4. Has culture and sensitivity been done on blood or secretions? What is result? Was unable to find any culture and sensitivity results in the client's chart. 5. Is patient subjected to an abnormal amount of stress...
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...refers to excessive motor activity when it is not appropriate; in adults may manifest as extreme restlessness or wearing others out with their activity Impulsivity refers to hasty actions that occur in the moment without forethought and that have high potential for harm to the individual Desire for immediate rewards or inability to delay gratification Attention-Deficit/Hyperactivity Disorder Establish that the patient has either inattention or hyperactivity/impulsivity or both that has persisted at least 6 months to a degree that is maladaptive and inconsistent with their developmental level Several symptoms that caused impairment presented before the age of 12 Clear evidence of clinically significant impairment in social, academic or occupational functioning Impairment observable in two or more settings (e.g., school, home, work) ADHD: Historical Timeline Hyperkinetic Reaction of Childhood Minimal Brain Attention Deficit Damage Hyperactivity Disorder 1902 1930 ADHD-like syndrome first described 1960 1968 Minimal Brain...
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...Autism Spectrum Disorder Introduction Imagine seeing and hearing a parents complain to doctors that they have been noticing their infant is not responding to their love and affection like other babies their age. This infant does not babble, make eye contact, smile, or show any interest or emotion to a happy game of patty cake, instead he is staring off fixated on something in the distance. The parent explains to the doctor that their child grunts, seems to just want to play by himself, and will not try to interact with others or show any type of emotion. Now imagine these same parents being told that there is nothing wrong with their child and the child is just lagging behind other infants their age. Unfortunately, these parents find out a...
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...What is Down syndrome? Down syndrome is genetic disorder that causes lifelong mental retardation, developmental delays and other problems. Down syndrome varies in severity, so development problems range from moderate to serious. Down syndrome is the most common genetic cause of severe learning disabilities in children, occurring in one in every 700 to 800 infants. Increased understanding of Down syndrome and early interventions make a big difference in the lives of both children and adults with Down syndrome. Down syndrome is also known as Trisomy 21 syndrome. Trisomy 21 is due to an extra copy of chromosomes number 21. Instead of having the normal two copies chromosomes number 21, the person with Down syndrome has three copies of chromosomes 21. Meaning normally a fertilized egg has 23 pairs of chromosomes. In most people with Down syndrome, there is an extra copy of chromosome 21. (Rogers, 2007, pg.6) The formal story began in 1866, when a physician named John Langdon Down published an essay in England in which he described a set of children with common features who were distinct from other children with mental retardation. Down was superintendent of an asylum for children with mental retardation in Surrey, England when he made the first distinction between children who were cretins (later to be found to have hypothyroidism) and what he referred to as "Mongoloids." Down based this unfortunate name on his notion that these children looked like people from Mongolia,...
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...RELIGION/SPIRITUAL CONSIDERATIONS: Unknown OCCUPATION/HOBBIES/RECREATIONAL ACTIVITIES: Retired LIVING SITUATION/WITH WHOM: (home, assisted living, LTC, etc) Lives with daughter. SOCIAL HISTORY: (tobacco, ETOH, illicit drugs, family dynamics) Quit smoking many years ago, no history of ETOH or drug use. NURSING CARE PLAN ADMITTING MEDICAL DIAGNOSIS: Client's principal admitting diagnosis was leukocytosis. Definition: (from Taber’s) “An increase in the number of leukocytes (usually above 10,000/mm3) in the blood. It occurs most commonly in disease processes involving infection, inflammation, trauma, or stress, but it also can result from the use of some medications” (Venes, 2009, p. 1327). Etiology/pathophysiology: ( NOT from Taber’s or Wikipedia) Etiology: Causes of leukocytosis are infection, inflammation, tissue damage, immune reaction, bone marrow problems, medications, and stress (Drug Information Online, 2011). Pathophysiology: “Leukocytosis can be a reaction to various infectious, inflammatory, and, in certain instances, physiologic processes (eg, stress, exercise). This reaction is mediated by several molecules, which are released or regulated in response to stimulatory events that include growth or survival factors (eg, granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, c-kit ligand), adhesion molecules (eg, CD11b/CD18), and various cytokines (eg, interleukin-1, interleukin-3, interleukin-6, interleukin-8, tumor...
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...rather focused on old patients who have locomotive problems. These old patients can no longer engage in massive physical activities. The reduced activities may be due to various physical impairments. In a situation where the patient is suffering from hypertension and angina, the best medical practice shift to oxygenation. The paper gives a close analysis to a patient by the name Danilo Ocampo. The patient is a retired pathologist. The patient is 74 years old with a declining health in the past few years. The patient is suffering from hypertension, angina, myocardial infarction, and class II heart failure. These multiple ailments have incapacitated his movements. Due to his cardiovascular disorders the patient takes medication such as metoprolol, lisinopril, and Aldactone which is also supplemented with furosemide off and on. Ocampo has a well background in medicine which offers him a good understanding of pharmaceutical properties of the medication. He has on and off admissions to the hospitals due to a multiple combination of the medication that he takes. The adverse side effect of the drugs he is using has caused multiple admissions to the hospital. At times he is forced to get out of the hospital before he gets better so as to take care of the ailing wife. Mobility concept Mobility impairment is a limitation in independent and purposeful physical movement of the body or of one or more extremities. The alteration in a person’s mobility can either be permanent or temporary. The...
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...Autism and children Contents Autism Defined Qualitative Impairments in Social Interaction Qualitative Impairments in Communication Restricted Repetitive and Stereotyped Behaviors, Interests, and Activities The Diagnosis of Autism Causes of Autism Treatment for Autism What research is being done? References Autism Defined Autism is the most common condition in a group of developmental disorders known as the autism spectrum disorders (ASDs). Autism is characterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests. Other ASDs include Asperger syndrome, Rett syndrome, childhood disintegrative disorder (CDD), and pervasive developmental disorder (PDD). According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), published by the American Psychiatric Association (2000, pp. 70-71), children with autism demonstrate the three core symptoms: qualitative impairments in social interaction, qualitative impairments in communication, and restricted, repetitive, and stereotyped patterns of behavior, interest, and activities. The symptoms vary according to the severity of the disorder. Qualitative Impairments in Social Interaction Social interaction is characterized as having problems with interacting with other people. Among the symptoms with infants is they do not exhibit any eye contact, and this is something...
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...Labeling deafness as a disability fails to acknowledge the social process through which a Deaf child could become ostracized and excluded from society. It is commonly argued that if a child becomes isolated, it was the fault of the disability itself, not the society as large. Historically, the dominant hearing culture has demoted Deaf people to social categories such as handicapped, disabled, and outsider (Kelleher, 2017). An ever-increasing number of Deaf people do not consider themselves to be handicapped or disabled, but demand to be recognized and respected as a distinct cultural group with its own beliefs, needs, opinions, customs and language (Padden, 2006). The Deaf Community disputes deafness as a disability and they are currently...
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...Nursing 122 Fundamentals of Neuro-Sensory nursing --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- Review major structures and functions of both central and peripheral nervous system. (Carolyn Jarvis, Physical Examination and Health Assessment, 3rd ed., pages 688-692 Structure and function of the CNS and PNS --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- Potter and Perry, Fundamentals of nursing (8th), Chapter 16 p. 210-211 Types of Data --There are two primary sources of data: subjective and objective. Subjective data are your patients’ verbal descriptions of their health problems. Only patients provide subjective data. For example, Mr. Jacobs's report of incision pain and his expression of concern about whether the pain means that he will not be able to go home as soon as he hoped are subjective findings. Subjective data usually include feelings, perceptions, and self-report of symptoms. Only patients provide subjective data relevant to their health condition. The data sometimes reflect physiological changes, which you further explore through objective data collection. --Objective data are observations or measurements...
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...was on September 13, 2011 for a pneumothorax. She was also admitted sometime in August for a COPD exacerbation. Significant client health history (include family history) C.W. is a 65 year old female who lives with her ex-husband. She has a history of leukocytosis, anemia, hyponatremia, COPD, valley fever, chronic pain syndrome, back pain, osteoporosis, small-bowel obstruction, peripheral neuropathy, constipation, and pneumothorax. C.W. also admits to being a current smoker. She smokes approximately 1½ packs per day. C.W. has a family history of hypertension, diabetes, and peripheral neuropathy. C.W. stated that she recently lost her sister who suffered from a massive heart attack. Pathophysiology of primary diagnosis (definition, etiology, signs and symptoms. Underline behavior exhibited by this client. Cite reference.) Chronic obstructive pulmonary disease (COPD) is a disease state characterized by...
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...However, the longer you have diabetes, the greater your risk for complications is. These complications may occur gradually and include: heart disease, nerve damage, kidney damage, eye damage, foot damage, skin conditions, hearing impairment, and Alzheimer’s disease (Mayo Clinic). The list of complications is clearly extensive and can be very serious, therefore, it is important to manage your diabetes as best as you can and to see a doctor regularly. Gestational diabetes can also cause complications to both the mother and child. Complications for the baby include: excess growth, low blood sugar, type 2 diabetes later in life, and death. Complications for the mother include: preeclampsia, subsequent gestational diabetes, and an increased likelihood of having type 2 diabetes later in life (Mayo Clinic). Once again, monitoring blood sugar levels will help reduce the chance of these complications. Monitoring is especially important in terms of prognosis, given that better...
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...Mock Treatment: Autism Aleksandr Drebskiy Queens College at City University of New York I. Diagnostic Criteria A. Persistent deficits in social communication and social interaction across multiple contexts as manifested by the following, currently or by history: 1. Deficits in social-emotional reciprocity ranging from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing interests, emotions or affect; to failure to initiate or respond to social interactions. 2. Deficits in nonverbal communicative behaviors used for social interaction ranging from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understating and use of gestures; to a total lack of facial expressions and nonverbal communication. 3. Deficits in developing, maintaining, and understating relationships ranging from difficulties adjusting behavior to suit various social context; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers. Specify current severity: Level 1, Level 2, Level 3 B. Restrictive, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following, currently or by history: 1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys, echolalia, idiosyncratic phrases). 2. Insistence on sameness, inflexible adherence to...
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...Schizophrenia which affects approximately 1 percent of the population usually begins before age 25 and persists throughout life. The illness is a life long debilitating condition for about 40% of patients and is enormously costly in both social and economic terms. Despite the presence of delusions, hallucinations and cognitive impairment which characterize the illness, overall life expectancy is not altered (although there is a significantly increased risk-of suicide in the early years). Schizophrenia is usually viewed as a functional psychosis, a label which implies that the symptoms arise from the disorderly activity of neurons without accompanying anatomical and pathological alterations of brain structure. This view is due to the failure of pathologists to find convincing pathological changes associated with the disease in the first seven decades of the century. Over the last ten years things have changed considerably. Recent CT and MRI scan, and also postmortem studies show that various brain areas of schizophrenic patients are altered. HISTORY The two key people in the history of Schizophrenia were Emil Kraepelin and Eugene Blealer. Kraepelin organized the seriously mentally ill patients by three diagnostic groups: dementia praecox, manic depressive psychosis, and paranoia. Kraeplin’s description of dementia praecox emphasizes a chronic deteriorating course, in addition to including such clinical phenomena as hallucinations and delusions. Kraepelin reported that...
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...Chapter 1 Introduction to Pathophysiology Lee-Ellen C. Copstead Key Questions • What is pathophysiology? • How are etiology and pathogenesis used to predict clinical manifestations and response to therapy? • How are normal and abnormal physiologic parameters defined? • What general factors affect the expression of disease in a particular person? • What kinds of information about disease can be gained through understanding concepts of epidemiology? http://evolve.elsevier.com/Copstead/ • Review Questions and Answers • Glossary (with audio pronunciations for selected terms) • Animations • Case Studies • Key Points Review Pathophysiology derives from the intersection of two older, related disciplines: pathology (from pathos, suffering) and physiology (from physis, nature). Pathology is the study and diagnosis of disease through examination of organs, tissues, cells, and bodily fluids. Physiology is the study of the mechanical, physical, and biochemical functions of living organisms. Together, as pathophysiology, the term refers to the study of abnormalities in physiologic functioning of living beings. Pathophysiology seeks to reveal physiologic responses of an organism to disruptions in its internal or external environment. Because humans exhibit considerable diversity, healthy structure and function are not precisely the same in any two individuals. However, discovering the common and expected responses to abnormalities in physiologic functioning is useful, and it...
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...Hepatic Encephalopathy Raven Dunn, SRN Augusta Technical College Adult Nursing II RNSG 2210 Ms. Kandace Chariff, BSN, MSN July 23, 2012 Table of Contents Abstract Page 3 Case Study Etiology and Pathophysiology Page 4 Clinical Manifestations Page 5 Diagnostic Findings Page 7 Treatment and Nursing Interventions Page 7 Patient Presentation Page 8 Conclusion Page 9 References Page 10 Appendix I Page 11 Appendix II Page 11 Appendix III Page 12 Appendix IV Page 13 Appendix V Page 13 Appendix VI Page 16 Abstract This paper will focus on the clinical manifestations of hepatic encephalopathy and its effects on Mrs. X. She is a 64 year old female who has been an alcoholic for more than 40 years. The constant abuse of alcohol has left her with cirrhosis of the liver. One problem of cirrhosis is the inability of the liver to filter ammonia. When the levels of ammonia build up in the body, it affects various organs and systems. In Mrs. X’s case, it affected her brain. She manifested impaired cognitive abilities as well as physical limitations. This case study will expand on these processes as well as her prognosis and nursing implications. Hepatic Encephalopathy Mrs. X is a 64 year old white female and was a functional alcoholic and smoker for more...
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