...NORTH CAROLINA CENTRAL UNIVERSITY DEPARTMENT OF NURSING 4003 Modified Nursing Care Plan You must submit the clinical tool with the care plan Student Name : Crystal Stephenson Date: October 27, 2012 ------------------------------------------------- Patient Summary: J.M. is a 25 year old Caucasian female G1 T1 A0L1 who began Stage 1 of labor 10/21/12 at 2300. She presented at Wake Med 10/22/12 at 1655 with SROM and contractions. She received treatment for GBS after testing positive. She delivered a baby girl weighing 6lbs 6oz 10/22/12 at 2057 with the assistance of a vacuum. Baby’s AGARs were 8/9. Client received an epidural during labor. Her estimated blood loss was 400 ml. She received a 3rd degree laceration to her perineal area during labor and has not been able to void since even when she has had the urge to. An indwelling foley was placed 10/23/12 at 1230 to relieve urinary retention and bladder distension. 600 ml of urine was collected 10/23/12 at 1800. She was prescribed Dermoplast 20% to use while providing peri care to relieve the discomfort and swelling of her perineal area. Client is currently breast feeding. She received education about different feeding positions and has demonstrated a good latch with the baby in the football hold. Client is allergic to Macrobid and experiences hives and itching when exposed...
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...Nursing Health Alterations Syllabus1 Nursing Health Alterations Course Information Organization Course Number Credits Contact Hours Instructor E-mail Address Course/Faculty Website Office Campus Address City/State/Zip Office Hours Office Phone Office Fax Beginning Date Number of Weeks Meeting Times/Location WTCS - Wisconsin Technical College System 543-305, 543-105 3 54 Cynde Larsen clarsen@swtc.edu 608-778-4842 cell (texts=Yes; voice messages =No) 1639 Health Sciences Southwest Tech 1800 Bronson Boulevard Fennimore, WI 53809 Mondays 1-3, Wednesday 8-9, 11-12 and others by appointment. 1-608-822-2642 Ext. 2642 (Voice messages=OK) 608-822-2772 01/13/14 16 Mondays 9:30-10:50 Health Sciences Building Room 3608 Description This course elaborates upon the basic concepts of health and illness as presented in Nursing Fundamentals. It applies theories of nursing in the care of patients through the lifespan, utilizing problem solving and critical thinking. This course will provide an opportunity to study conditions affecting different body systems and apply evidence-based nursing interventions. It will also introduce concepts of leadership and management Prerequisites Nursing Fundamentals Nursing Skills Nursing Pharmacology Nursing: Introduction to Clinical Practice General Anatomy and Physiology, Anatomy and Physiology 1, or Body Structure and Function (PN Only) Textbooks Lemone, P. & Burke, K., Bauldoff, G. (5th Ed.). Medical-Surgical Nursing Textbook. London, M....
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...Darren & Jenny’s Nursing Study Guide Darren & Jenny Nursing Study Guide Nursing Formulas and Conversions Drugs and Dosage Formulas and Conversions Volume 60 minims = 1 dram = 5cc = 1tsp 4 drams = 0.5 ounces = 1tbsp 8 drams = 1 ounce 16 ounces = 1pt. 32 ounces = 1qt. Weight 60 grains = 1dram 8 drams = 1 ounce 12 ounces = 1 lb. (apothecaries') Household 1tsp = 1tsp = 3tsp = 1tbsp = Household 1tsp=5cc 3tsp=1tbsp 1tbsp=0.5oz or 15cc 2tbsp=1oz or 30cc 1pt.=16oz or 480cc 1qt=32oz or 960cc 1/60 grain=1mg 15 grains=1g 2.2 lbs.=1kg Apothecary 1 dram 60 gtts (drops) 0.5 ounce 0.5 ounce Metric 5cc=1tsp 15cc=1tbsp 30cc=2tbsp(1oz) 1cc=16minims Apothecary 1fl.dram=4cc 4drams=0.5oz 8drams=2tbsp(1oz) 16minims=1cc 500cc=0.5L or 1pt. 1000cc=1L or 1qt. Temp. Conversion C= F-32/1.8 F= 1.8*C-32 2 Darren & Jenny Nursing Study Guide NOTES CARDIOVASCULAR Arterial Ulcer – Pale, deep base, surrounded by tissue that is cool with trophic changes such as dry, soluble skin and loss of hair. Cause by ischemia from inadequate arterial blood supply of oxygen and nutrients . Venous stasis Ulcer – Dark, red base, surrounded by skin that is brown in color with edema. Caused by the accumulation of waste products of metabolism that are not cleared due to venous congestion. Stage I Ulcer – Reddened area with intact skin surface. Management of DVT – Bed rest, limb elevation , relief of discomfort with warm, moist, heat and analgesics (Tylenol, not narcotics) prn. Ambulation is contraindicated...
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...Darren & Jenny’s Nursing Study Guide Darren & Jenny Nursing Study Guide Nursing Formulas and Conversions Drugs and Dosage Formulas and Conversions Volume 60 minims = 1 dram = 5cc = 1tsp 4 drams = 0.5 ounces = 1tbsp 8 drams = 1 ounce 16 ounces = 1pt. 32 ounces = 1qt. Weight 60 grains = 1dram 8 drams = 1 ounce 12 ounces = 1 lb. (apothecaries') Household 1tsp = 1tsp = 3tsp = 1tbsp = Household 1tsp=5cc 3tsp=1tbsp 1tbsp=0.5oz or 15cc 2tbsp=1oz or 30cc 1pt.=16oz or 480cc 1qt=32oz or 960cc 1/60 grain=1mg 15 grains=1g 2.2 lbs.=1kg Apothecary 1 dram 60 gtts (drops) 0.5 ounce 0.5 ounce Metric 5cc=1tsp 15cc=1tbsp 30cc=2tbsp(1oz) 1cc=16minims Apothecary 1fl.dram=4cc 4drams=0.5oz 8drams=2tbsp(1oz) 16minims=1cc 500cc=0.5L or 1pt. 1000cc=1L or 1qt. Temp. Conversion C= F-32/1.8 F= 1.8*C-32 2 Darren & Jenny Nursing Study Guide NOTES CARDIOVASCULAR Arterial Ulcer – Pale, deep base, surrounded by tissue that is cool with trophic changes such as dry, soluble skin and loss of hair. Cause by ischemia from inadequate arterial blood supply of oxygen and nutrients . Venous stasis Ulcer – Dark, red base, surrounded by skin that is brown in color with edema. Caused by the accumulation of waste products of metabolism that are not cleared due to venous congestion. Stage I Ulcer – Reddened area with intact skin surface. Management of DVT – Bed rest, limb elevation , relief of discomfort with warm, moist, heat and analgesics (Tylenol, not narcotics) prn. Ambulation is contraindicated...
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...have learned so far, but who ultimately helped me realize that I can and will became a great nurse in the near future. My clinical experience has been taking place at Presbyterian Hospital, thus far I have really enjoyed my time there. My clinical instructor has been extremely positive, helpful and encouraging. While I have been there I have encountered a couple of patients that have left an impression, but there was one particular patient that tested all the knowledge I have learned so far and required me to use all my personal skills to use in order to build a trusting relationship with her. I was assigned to a patient that I would work with for the majority of the day, and I would also have to complete my care plan on this particular patient. The Nursing care plan requires a combination of subject and objective data, it is a long questionnaire that requires the participating patient to disclose Page 2 a lot of personal information. Having this in mind, I knew that in order to receive the most truthful information I would have to build a...
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...Journal Today I felt like I am not ready for the clinical. I was worried about tomorrow exam and my focus was more on exam then clinical. We had a pre-conference as usual which gives us information on what we are going to focus on while taking care of a client. We discussed about oxygenation and about medication. I was assigned with a client who has pneumonia, seizure disorder, and second degree MVA. Soon I entered the client room I washed my hand, introduce myself, checked client id and started assessing the client which I was lacking before example checked whether the tubing are intact or not. After that I took vital signs which were easier than before. I learnt something new while giving a bath to a client. I learnt to put on the condom catheter to a client with the help of the professor. I was scared while changing the condom catheter since it was my first time but at last I did it. I gained little self-confident after doing it. Changing the bed sheet was challenging one since I have to turn and lift my client. At last we had a post conference where we took some data from the client record and we discussed about what we did so far. We talked about our client and related nursing diagnoses. This conference gives much knowledge and it is really helpful. Two questions: Q1. How would you determine if the client has adequate fluid intake? Q2. What kind of feelings are there when giving a bath to a...
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...Assessment tools are useful for nursing care as they can act as a guideline while trying to assess patients. Finding the right assessment tool to match the nursing care going to be given is important. All assessment tools may not match the type of care going to be given. It is important to evaluate the assessment tool not only to match the care, but also to make sure the tool is thorough and useful. The three assessment tools discussed in this essay are an admission assessment by Pamela Craig, a nursing needs assessment tool by the Department of Health Social Services and Public Safety, and a physical assessment tool by F.A. Davis. The admission assessment by Pamela Craig was designed through evaluation of the previous admission assessment tool in which Pamela Craig redesigned it to fix the flaws of the old one. The tool begins with baseline vitals upon admission, with the inclusion of how the patient was brought to the facility and from where. The tool includes allergies, with a section specific to latex allergies. It includes who the information is obtained from, in case the information is not able to be obtained from the patient. There is a place for family history information, as well as history of past diagnoses for the patient. There is a section for nutrition that includes questions about weight loss, nausea and vomiting, enteral feeding, and changes in appetite. The physical assessment part of the assessment tool covers each system. There are boxes to check within each...
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... Post incision and drainage Cues | Diagnosis | Inference | Plan of care | Nursing Interventions | Rationale | Evaluation | Subjective:“ sakit sugat ko dito ma” as verbalized by the patientObjective: * Localized erythema and edema * (+) pruritus on the site of the incision. * (+) Facial grimace * (+)Irritability * (+) Guarding behavior * (+) Crying * (+) VS normal T= 36.8 ‘ c PR= 77 RR= 25 * Pain assessment>Location: Right post auricular area>Interval: frequent | Acute pain related to tissue trauma secondary to incision and drainage as manifested by * Localized erythema and edema * Pruritus on the site of the incision * Facial grimace * Irritability * Crying * Guarding behavior * Frequent interval of pain | Nociceptive stimuli(wound/inflammation)↓Nerve fibers (nociceptor) ↓ ↓A-delta fiber C-fiber (fast) (slow) ↓ ↓ Spinal cord & Dorsal horn pain modulating circuit (primary touch fiber) Neospino- Paleospino- thalamic thalamic tract (sharp, tract (dull,bright pain) aching pain) Substantia Gelatinosa (synapse) Thalamus (center of awareness of pain) Cerebral Cortex (center of interpretation) Responses | After 6 hours of nursing interventions, the pain will be...
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...While the Registered Nurse, be it ADN or BSN, provides similar care as regards skill level, medicine administration, and composition of care plans, the LVN is more limited in scope. The LVN is not permitted to hang or push IV medications, perform admission assessments, write nursing care plans, or flush PICC/Central lines. Differences between ADN and BSN are often more subtle as regards both learning and application. Bachelor level nurses typically demonstrate a higher level of competency when dealing with patients of greater comorbidity and acuity as well as a more sophisticated approach to decision making. Medical terminology indicates comorbidity as multiple system diagnosis of disease, such as a patient with both acute renal failure and congestive heart failure. Such an individual presents a unique challenge in that blood pressure control is at risk via both systems. While both ADN and BSN may approach the nephrologist regarding use of a diuretic, the BSN will have a superior understanding regarding risks/side-affects as pertains to each system, ideal length of use, and related laboratory results to communicate to each physician specialist. This difference in ability stems, in part, from additional hours exposing them to extensive pathophysiology, pharmacology, and research involving all aspects of the profession. Acuity reflects patient stability and while list of diagnosis, patient history, and physical may contribute a more intimate knowledge of client needs, the...
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...S.S.N.M.M COLLEGE OF NURSING SEMINAR ON UNIT PLAN SUBMITTED TO; SUBMITTED BY; PROF:MRS.SAMPATH ANEESH S P VICEPRINCIPAL 1st yr Msc Nursing SUBMITTED ON: 11.11.2011 INTRODUCTION With in the last two decades , more and more educators have come to accept the unit as the basis of organization of learning. They recognize the facts that learning in units more effectively meets the needs of the students than traditionally daily lesson-assigning and lesson learning procedure. The concept of unit learning is still in the stage of development. Consequently , it has come to mean different things to different teachers . the situation has caused the evolution of various names which are used to differentiate between the several interpretations ,such as contract plan , Dalton plan ,project method , unit assignment ,Winnetka plan and others . The basis of unit idea can be traced to JOHANN FRIEDRICH HERBART (1776-1841) . herbart stressed 4 essentials in learning process 1. Clear apprehension by the student of each individual fact . 2. Association or comparison of the facts. 3. Systematization...
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...Heritage Assessment Paul Bockoven Grand Canyon University NRS429-V October 14, 2012 Heritage Assessment Cultural assessments can be useful tools for a registered nurse to develop adequate plans of care, especially when it comes to education. They have limits however, as not every individual within a certain cultural ‘category’ can be expected to conform the way their heritage may dictate. Assigning a score to any person to predict how they may act, or learn, is contrary to the direction nursing care plans in general have taken. With that in mind, there is some value to using tools like the heritage assessment as a baseline, or starting point. The problem arises because of this particular tool being used to generalize instead of individualize. Developing a sense of a person’s cultural heritage and assigning an ambiguous score has no real meaning when the focus of a care plan is not supposed to take into account anything that is not directly related to the individual for whom it is being tailored. Standards clearly state that the assessment, planning and delivery of a person's care must be centered on the individual, and developed with them or their significant others (Rollin, 2011, p. 541). A person filling out the heritage assessment may, in fact, not adhere to or agree with it’s findings, may not understand it’s significance and as such, this tool could actually lead a caregiver in the wrong direction. The idea that any person who, according to this tool, identifies...
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...Complete and submit the Nursing Expertise Self-Report Scale located on pp. 175 & 176 in Clinical Delegation Skills. Answer each question based on your personal experience as a nursing professional. • Write a 350-word reflection on your results from the Nursing Expertise Self-Report Scale and explain how you plan to use this information to improve your communication skills in health care settings. The Nursing Expertise Self-Report Scale and Reflection was an interesting assessment on my nursing skills. The questions that were asked in the scale were difficult to answer based on the grading scale. Overall it was a good reflection of how I approached my patients and utilized my skills. After completing the nursing scale, I realize that there are some things that I need to do different. For example, question number six mentioned, “Emotional attachment to get in the way of good care.” (Hansten, 2009, pp. 175-176) I feel that is a question that is difficult to answer because a nurse needs to have an emotional attachment to connect. The reason we became nurses is because we care for others and we want to care for their health. We came into this field with an emotional attachment. I will continue to treat my patients how I would like to be treated and show them the respect they deserve being under my care. Every nurse is different in how they treat and care for our patients. We all have procedures and guidelines to follow by as a health care professional, but...
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...Nursing Care Plan Mohave Community College Nur 122. Nursing 2 November 8, 2011 MOHAVE COMMUNITY COLLEGE NURSING DEPARTMENT NURSING CARE PLAN NUR 122 ASSESSMENT A. ADMISSION DATA Date of admission 10/07/11 Client initials CW Medical diagnosis COPD/Leukocytosis Age 65 Sex Female Marital Status Divorced Ethnicity Caucasian Religion Catholic Vital signs upon admission: B/P 107/61 P 98 R 20 T 97.6 Ht 5’4 Wt 99.9lbs Allergies C.W. is allergic to ASA, it causes her to have an upset stomach. B. HEALTH-ILLNESS TRANSITION History of present illness C.W. is a 65 year old female with a history of COPD. She has been admitted to the hospital on several different occasions for a COPD exacerbation. C.W. was admitted through the ER on October 7, 2011 for an increased cough, shortness of breath, which got progressively worse with chest tightness. C.W.’s most recent hospitalization 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....
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...Dorothy Johnson - Nursing Theorist Biography and Career of Dorothy E. Johnson Dorothy E. Johnson was born on August 21, 1919 in Savannah, Georgia. She earned her Bachelor of Science in Nursing in 1942 from Vanderbilt University in Nashville, Tennessee. In 1948, she received her Master's degree from Harvard University. During her career, Johnson was an assistant professor of pediatric nursing, an associate professor of nursing, and a professor of nursing at the University of California in Los Angeles. She retired in 1978. Dorothy Johnson Works written by Dorothy Johnson include: Theory Development: What, Why, How? Barriers and Hazards in Counseling Dorothy Johnson's Contribution to Nursing: Behavior System Model Johnson is known for her Behavior System Model of Nursing, which was first proposed in 1968. The model advocates the fostering of efficient and effective behavioral functioning in the patient to prevent illness. The patient is defined as a behavioral system composed of seven behavioral subsystems. Each subsystem is comprised of four structural characteristics. An imbalance in each system results in disequilibrium. The nurse's role is to help the patient maintain his or her equilibrium. Johnson's theory of nursing defines nursing as "an external regulatory force which acts to preserve the organization and integration of the patients behaviors at an optimum level under those conditions in which the behavior constitutes a threat to the physical...
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...upper arms. P.R. is able to move his shoulders to slightly lift his arms, but has no movements in his legs or the trunk. P.R. requires total assistance for all activities of daily living, and is incontinent of both bowel and bladder function. He speaks primarily Spanish and cannot communicate in English. He is verbally abusive and becomes combative with care givers. He does not have family support in America and is having difficulty adapting to American foods. P.R. has stage III ulcers on each of his buttocks, with various bruises on his lower forearms from trying to attack the faculty personnel. Both feet are starting to turn downward, indicating plantar flexion contractures. The purpose of this paper is to demonstrate the issues that are involved in nursing care, based on Maslow’s hierarchy of needs. This includes physiological, psychological, safety, and social concerns. An example of a complete nursing care plan will be provided for each category of needs identified in P.R’s case study. Patient Care Issues General Spinal cord injuries to an individual present with multiple areas of concerns to nursing care providers. Physiological issues are first addressed when the patient arrives in the emergency room to stabilize the patient according to the airway, breathing, and circulation. Then, spinal cord injury will lead to loss of motor function, urinary/bowel incontinence, sexual dysfunction, trouble breathing, and difficulty sitting upright (O’Sullivan and Schmitz...
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