...Teaching Plan When a patient has surgery it is important for them to keep their lungs healthy and to take slow deep breaths. After surgery it can hurt too much or they may feel too weak to take the deep breaths, which can cause lung illnesses. A device that can be used is an incentive spirometer. Its important for someone to learn who to use the incentive spirometer as they will not benefit from using it if not used correctly. A nursing diagnosis for a patient after surgery is ineffective breathing pattern related to surgery as evidenced by patient being short of breath. A short-term goal for this is the patient will use the incentive spirometer for 5 sets 10 times a day. To teach the patient how to use the incentive spirometer I would take the time and sit with them and explain how to use it and also demonstrate how to use it. Then I would have the patient show it back to me and I would give them feedback. Also when I go in the room again I would ask them to show me how it’s done to make sure they are doing it correctly. The step-by-step outline that will be used to teach the patient includes: 1. I would have the patient to sit in semi-fowler position if they can as this will increase lung expansion. 2. Since they are post op I would place a pillow or folded blanket over chest or abdominal incision for splinting. 3. Show the patient how to steady device with one hand and hold mouthpiece with the other. 4. Instruct the patient to exhale normally and then place lips securely...
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...1. Describe one risk to patient safety that you identified and the interventions taken to ensure patient safety. One risk to safety I identified in my patient was a risk of falls. I had a patient that was very unstable on his feet and was also hooked up to an IV infusion pump. Not only was him being unstable on his feet an issue but also him pulling out the IV that was in his arm. I made sure that a bed and chair alarm was placed in this patient’s room. I also educated him on why it is important to use to call light to ask for assistance when getting out of bed. Core Competency: Caring 2. Describe one situation where you utilized advocacy resources appropriately (e.g., social worker, chain of command, interpreter) During this clinical rotation, I was able to advocate for my patient through the chain of command. I had a patient...
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...The Baccalaureate degree nurse has a 4year education that encompasses skills and management education. The Grand Canyon University Nursing Philosophy states that,” Baccalaureate nursing practice incorporates the roles of assessing, critical thinking, providing care, teaching communication and leading. “After the 4years the nurse can also sit for the NCLEX exam and gain the RN title. The debate between an associate degree levels versus the baccalaureate degree level nurse is an ongoing debate. Associate degree nurses are very strong on the nursing skills level while the latter is educated on research, leadership, policies and ethics hence this type of education level opens up jobs on the management level. In today’s age healthcare has become a business competition with vast changes and thus many hospitals seek magnet status thus the demand for baccalaureate degree nurses is a value that is recognized. Patients also equate great outcomes and care through magnet status hospitals that have these Bsn prepared nurses. Quality patient care is co related to a well-educated nurse. Research has argued that baccalaureate level nurses make fewer medication errors, lower mortality with great patient outcomes. This is due to the critical thinking acquired in school with various subjects besides the bedside skill. According to the AACN which shows a study published in the...
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...Diagnosis: Breathing Pattern, Ineffective | Patient Goals/Objectives (What do you hope will be the result of your efforts? Make sure goal is patient oriented, measurable, and has a time frame). | Planned Interventions: (What is indicated for the management of this particular problem? Name three priority interventions making at least one patient teaching). | Rationale: (Why/How does the intervention work?) Cite page number and source for each intervention. | Evaluation of Patient Goals:(Was patient’s goal met/ not met/ ongoing? Why/why not? List evaluation criteria. If intervention is ongoing, list what patient has accomplished. | Short Term: Within three days: 1. Patient will state relief of SOA. 2. RR will return to within normal limits of 12 to 18 rpm. 3. Oxygen saturation will return to normal expected range of greater than or equal to 90% on room air | 1. Place patient on O2 @ 2lpm/nc. 2. Place patient on oxygen saturation 3. CXR 4. Teach patient to use the incentive spirometer to increase available lung capacity. | 1. This will increase the available oxygen in the patient’s blood. 2. This will monitor the amount of oxygen within the red blood cells within the patient’s blood. 3. This will assist in determining the effects of the fluid present in the patient’s lungs. 4. This will increase the patient’s available lung capacity and enable patient to be involved in his own care. | 1. Goal met: Patient state’s, “I can breathe so much...
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...Dale Gordon has been a patient in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him. Joan assesses Mr. Gordon using the Braden Scale and determines that his score is 12. What does this score indicate about Mr. Gordon’s pressure ulcer risk? Joan is assessing Mr. Gordon’s skin and notices that he has a 3 cm blister and a shallow crater on his buttock. Mr. Gordon winces when Joan palpates the area. How should Joan stage this area? A. Stage I pressure ulcer B. Stage II pressure ulcer C. Stage III pressure ulcer D. Stage IV pressure ulcer Rationale: Mr. Gordon has drainage coming from his surgical incision, and his dressing needs to be changed. What assessments of the incision should Joan perform while changing? Answer: Rationale: Claudia asks Joan what she can do when she takes him home to help prevent...
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...MANAGING PATIENTS WITH OXYGENATION AND PERFUSION PROBLEMS Erica Schultz Breckinridge School of Nursing NU 230 Mrs. John September 23, 2015 MANAGING PATIENTS WITH OXYGENATION AND PERFUSION PROBLEMS As we may know, oxygen is one of the most vital elements that we need to live and function. Cells and tissues depend on oxygen to perform their roles, but some cells such as brain cells and heart muscle cells, are very dependent on oxygen (Ignatavicius & Workman, 2013). Without this crucial element, our body begins to suffer and our cells begin to die. We will learn the process of breathing and how taking a simple breath fuels these cells, to what to look for and how to confirm when a person is not getting enough oxygen, emergency treatments for these situations, and nursing considerations that can be implemented for these patients. The source of the oxygen for all body cells and tissue is the air that we breathe into our lungs (Ignatavicius & Workman, 2013). Breathing is an involuntary action that most people do not have to think about to perform. With each breath that we take, our body performs specific steps so that our body stays healthy and alive. It all begins with inspired oxygen from the environment entering the body through your mouth or nose and it moves down your respiratory tubes which includes the trachea, bronchi, and bronchioles, and then into the air sacs of the lungs. Once the oxygen is in the air sacs, it then moves across the alveolar capillary membrane...
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...this into the nurse’s practice. Concepts (in order of emphasis) I. Gas Exchange II. Infection III. Acid-Base Balance IV. Thermoregulation V. Clinical Judgment VI. Pain VII. Patient Education VIII. Communication IX. Collaboration I. Data Collection History of Present Problem: Pneumonia-COPD JoAnn Walker is an 84-year-old female who has had a productive cough of green phlegm 4 days ago that continues to persist. She was started 3 days ago on prednisone 60 mg po daily and azithromycin (Zithromax) 250 mg po x5 days by her clinic physician. Though she has had intermittent chills, she first noticed a fever last night of 102.0. She has had more difficulty breathing during the night and has been using her albuterol inhaler every 1-2 hours with no improvement. Therefore she called 9-1-1 and arrives at the emergency department (ED) by emergency medical services (EMS) where you are the nurse who will be responsible for her care. Personal/Social History: JoAnn was widowed 6 months ago after 64 years of marriage and resides in assisted living. She is a retired elementary school teacher. She called her pastor and he has now arrived and came back with the patient. The nurse walked in the room when the pastor asked Joan if she would like to pray. The patient said, “Yes, this may the beginning of the end for me.” What data from the histories is important...
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...Associate Degree Nursing Program NURS 122 Concept Care Map Evaluation Rubric: Maternal-Newborn |Value/categories |0 |1 |2 | |Assessment with Pathophysiology | < 90% data filled |> 90% data filled in |Complete with | | |incorrectly |correctly |Pathophysiology | |Lab work/rationale or reason for| | | | |labs | | | | | |0 |1 |2 | | |95% lab work and reasons | | |documented |documented |documented | |Step 3 - Care Map |0 |1 |2 | |Problem category Physiological |2 appropriate problems with|3 appropriate problems with|4 or more appropriate | |and psychological related to |Reason for admit and key |Reason for admit and key |problems with Reason for | |stages of postpartum |assessments |assessments |admit and assessments | | ...
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...1 M, L Health Care Provider: A P Sex: M Weight: 255 lbs 12 oz Code Status: 02 Isolation: 00 Food Allergies: 00 Diet: 01 Hospital Floor: Age: 62 Y Height: 6' Alerts: 00 Drug Allergies: 00 Env. Allergies: 00 BMI: 34.7 Medical-Surgical Student: Marlen Flores Assignment: Assessment 1 Submitted: 02/16/2016 15:49 Clinical Assignment Grading Assignment Objectives No assignment objectives entered. Clinical Set-up Details First Day of Clinical: 02/10/2016 Primary Diagnosis: Chronic obstructive pulmonary disease (COPD) Provider Name: P, A Secondary Diagnosis: Student Details: Patient Details: First Initial: M Identifier 1: L Last Name: Flores Identifier 2: M Credentials: SNPC Gender: M Age: 62 Years Pre-Clinical Manager Patient Info Identifier: M, L Gender: M Age: 62 Y Nurse Initials: M Flores, SNPC Diagnosis (1) Primary Diagnosis: Chronic obstructive pulmonary disease (COPD) Patho-Physiology: A progressive disease that is associated with difficulty breathing due to severe injuries to the pulmonary alveoli. The cause of this disease is the continuous exposure to cigarette smoke either actively or passively, and contaminated environments which reduces the shortness of breath and chest tightness. COPD may appear as two distinct disorders: emphysema and chronic bronchitis. Emphysema is the broadening of the alveoli and the destruction of their walls...
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...succeeding decade. Diseases of the gallbladder and biliary tract are common and painful conditions that may be life threatening and mostly require surgery. They are generally associated with deposition of calculi and inflammation. B. CLIENT CENTERED Patient R.D. is a 24 year old female, was admitted at Candelaria District Hospital on 17th of August, 2011 with a reported history of recurring right upper quadrant pain for the past 4 months and complaining of severe RUQ abdominal pain that radiates to her back. She nauseated and has had a few episodes of vomiting at home. The pain is less intensed if she walks around bent forward. An ultrasound revealed stones in the gallbladder. She was admitted for the gallbladder stone removal. C. STUDENT CENTERED We, group 2, students of Columban College would like to thank Candelaria District Hospital, and also our Clinical Instructor, Ma’am Charmaine Abdon, for her patience in teaching us and making sure we learn the most from our clinical exposure. The purpose of this case study is to be familiar with a patient that undergo Cholecystectomy; How it starts, what are the causes and what are the signs and symptoms; especially how to prevent, treat and manage the patient by giving medication for treatment and...
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...CaucasianWeight: 109 kg 240 poundsHeight: 183cm 72 inchesReligion: ProtestantMajor Support: Jon (son) Phone: 869-555-3452Allergies: no known allergiesImmunizations: Influenza last fall; tetanus – 4 years agoAttending Physician/Team: Dr. Frank BakerPast Medical History: Diabetes Type 2 diagnosed ______ (insert month that is six months prior)History of Present illness:Developed an ulcer on his big toe that was treated at home for 2 weeks. Son brought patient to ER 6 days ago and patient was treated for sepsis with IV antibiotics.Social History: Widower; Son (Jon) lives nearbyPrimary Medical Diagnosis: SepsisSurgeries/Procedures & Dates: L4-5 laminectomy – 25 years ago; transurethral resection of the prostate – 6 years agoNursing Diagnoses: Impaired Walking; Impaired Skin Integrity; Ineffective Health Maintenance; Ineffective Self Health Management | Psychomotor Skills Required Prior to Simulation Basic head to toe assessmentAssisting a patient with ambulationWound assessment and wet to damp dressing changeCognitive Activities Required prior to Simulation [i.e. independent reading (R), video review (V), computer simulations (CS), lecture (L)]SBAR or other standardized communication tool (R)Readings on functional decline in the hospitalized older adult (R)Tools in the Try This ® and How to Try This Series, available at www.ConsultGeriRN.org.Specific tools recommended for this scenario are theKatz...
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...Nursing Management 1 PULMONARY TUBERCULOSIS CATEGORY I, PLEURAL EFFUSION RIGHT ON TREATMENT, STATUS POST CHEST TUBE THORACOTOMY INSERTION Nursing Management of a Pulmonary Ward Patient Having Pulmonary Tuberculosis Category I, Pleural Effusion Right on Treatment, Status Post Chest Thoracotomy Tube Insertion Bumolo, Olimpia T. Torres, Pauline Bianca G. Our Lady of Fatima University, Quezon City Nursing Management 2 Nursing Management of a Pulmonary Ward Patient Having Pulmonary Tuberculosis Category I, Pleural Effusion Right on Treatment, Status Post Chest Thoracotomy Tube Insertion Private P, A.B., a 25 year old male, single. He finished second year college (Bachelor of Science in Education). He lives in Barangay Monbon Irosin, Sorsogon City. Five months Prior to Admission, patient began to experience dry cough, general body malaise, back pain, low grade fever in the afternoon, hoarseness of voice and restlessness. At first, patient took solmux and amoxicillin three times a day for three days. The signs and symptoms still persisted. He sought consult to the Commission Army Station Hospital, Lucena City and underwent another chest x-ray and had nebulization to liquefy secretions. He then was advised to go home. His immediate superior (official) advised him to go to the Armed Forces of the Philippines Medical Center due to unavailability of a pulmonologist in the area. He then was transported...
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...Case Study Pulmonary Tuberculosis Nursing Management 1 PULMONARY TUBERCULOSIS CATEGORY I, PLEURAL EFFUSION RIGHT ON TREATMENT, STATUS POST CHEST TUBE THORACOTOMY INSERTION Nursing Management of a Pulmonary Ward Patient Having Pulmonary Tuberculosis Category I, Pleural Effusion Right on Treatment, Status Post Chest Thoracotomy Tube Insertion S, J, S. Our Lady of Fatima University, Quezon City Nursing Management 2 Nursing Management of a Pulmonary Ward Patient Having Pulmonary Tuberculosis Category I, Pleural Effusion Right on Treatment, Status Post Chest Thoracotomy Tube Insertion Private P, A.B., a 25 year old male, single. He finished second year college (Bachelor of Science in Education). He lives in Barangay Monbon Irosin, Sorsogon City. Five months Prior to Admission, patient began to experience dry cough, general body malaise, back pain, low grade fever in the afternoon, hoarseness of voice and restlessness. At first, patient took solmux and amoxicillin three times a day for three days. The signs and symptoms still persisted. He sought consult to the Commission Army Station Hospital, Lucena City and underwent another chest x-ray and had nebulization to liquefy secretions. He then was advised to go home. His immediate superior (official) advised him to go to the Armed Forces of the Philippines Medical Center due to unavailability of a pulmonologist in the area. He then was transported via ambulance and was seen in Emergency Room and chest x-ray was...
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...of Care | Met | Unmet | Example | Recommendation | 1. Patients have access to the health care organizations’ services based on their identified health care needs and the organizations’ mission and resources. | * | | Patients are being cared of according to their complaint: * The patient is complaining of flank pain, the health care provider in the institution performs assessment and laboratory examinations. | | 2. The patient has a process for admitting patients to the organization. | * | | The institution has the TRIAGE system. * The institution utilizes this system in determining priorities and intervening to needs. | | 3. Patients with emergency or immediate needs are given priority for assessment and treatment. | * | | | | 4. At admission, the health care organization provides the following information to patients’ and appropriate family member and decision makers; information on the proposed care, the expected results of the care, and any expected cost to the patient for the care. | * | | Consent for admission is being explained to and signed by the significant other and the patient. | | 5. The organization seeks to reduce physical, language, cultural and other barriers to access and delivery of service. | * | | * As much as possible, patients having different dialect are being entertained by using the same dialect. * During blood transfusion, patients’ cultures are being respected after proper and complete explanation...
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...SEMESTER: 2 INTAKE: JANUARY 2012 NBNS3504 COURSE: BACHELOR OF NURSING SCIENCE WITH HONOURS COURSE TITLE: RENAL NURSING CONTENTS NO | TITLE | PAGES | 1 | INTRODUCTION * URINARY SYSTEM * WHAT DO NORMAL KIDNEYS DO? | 3 | 2 | RENAL REPLACEMENT THERAPY * HEAMODIALYSIS * PERITONEAL DIALYSIS | 4 - 7 | 3 | RENAL TRANSPLANTATION * TRANSPLANT PROCEDURE * TISSUE TYPING * CONTRAINDICATION OF TRANSPLANTATION * TYPES OF TRANSPLANT * DONOR WORK UP * RECIPIENT WORK UP | 8 - 14 | 4 | PRE OPERATIVE MANAGEMENT | 14 - 15 | 5 | INTRA OPERATIVE MANAGEMENT | 16 | 6 | POST OPERATIVE MANAGEMENT | 16 - 17 | 7 | COMPLICATIONS OF KIDNEY TRANSPLANT | 17 - 18 | 8 | NURSING PROCESS | 18 - 21 | 9 | HEALTH EDUCATION FOR PATIENT | 22 | 10 | CONCLUSION | 23 | 11 | REFERENCES | 24 | INTRODUCTION URINARY SYSTEM The urinary system consists of the kidneys, ureters, urinary blabber and urethra. The kidneys produce the urine and account for the other functions attributed to the urinary system. The ureters convey the urine away from the kidneys to the urinary bladder, which is a temporary reservoir for the urine. The urethra is a tubular structure that carries the urine from the urinary bladder to outside of the body. WHAT DO NORMAL KIDNEYS DO? * Remove extra water. * Remove waste products. * Balance chemicals in the body. * Help control blood pressure. * Help make red blood cell. * Help build strong bones. When the kidneys no longer...
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