CIWA-A Case Study

CAM-ICU is an effective assessment tool in the early recognition of delirium. ICU patients are at an increased risk of developing delirium, a significantly underdiagnosed neurologic condition (Gusmao-Flores, Salluh, Chalhub, & Quarantini, 2012). CAM-ICU is effectively incorporated into daily assessments by clinical staff. This process allows for clinicians to appropriately identify and treat delirium before there are adverse

Targeted Temperature Management (TTM) previously known as therapeutic hypothermia, is an intervention that has been shown to improve the outcome of comatose patient after cardiac arrest and traumatic brain injury (TBI) by maintaining body temperature ranged from 32℃ to 36℃ for at least 24 hours and 48 hours respectively. 1,2,3,4,5

We discussed alternative approaches to the treatment of anxiety with different medications. The two medications my preceptor often suggests to patients that are non addictive are Vistaril and Seroquel. Because these two medications are non-addictive as well as offer a calming effect on patients with anxiety, my preceptor said that they are often used for his patients. My preceptor encouraged me to offer Seroquel or Vistaril first in the future when I am when dealing with patients and their anxiety. I still strive to accomplish the goal of knowing which medications would be best for aparticular patient, and how to decide on one of these drugs over the other one based on the patient’s needs. I think I will get into the habit of presenting both medications to my patient, and letting them decide what sounds like a good fit for

The patient is a 53 year old male who presented to the ED via EMS intoxicated and reporting suicidal thoughts. The patient denies homicidal ideations and symptoms of psychosis. The patient endorses depressive symptoms including: tearfulness, isolation, and insomnia.

I’m have the privilege to work with and serve the veteran population in the settings of outpatient, inpatient, surgery, home- based primary care and also community living. The psychosocial challenges to occupational engagement of the veterans are unique in this population. One of the many psychosocial challenges affecting veterans on each ward is the fear of failure and disappointment. Those veterans who acquire a debilitating dysfunction are very vulnerable to feelings of disappointment and failure if they do not “get better” in the time frame they expected to. In response to that emotion, many veterans take initiative to improve their function. Veterans who served in various eras have the mentality to be a hard worker and believe in the moto, “no pain, no

Kuerbis, A., & Sacco, P. (2013). Substance abuse: Research and treatment: A review of existing treatments for substance abuse among the elderly and recommendations for future directions Libertas Academica. doi:10.4137/SART.S7865

There are drugs that people take to alter their mood; some in a good way others may be bad. Some people are prescribed mood enhancing medication. One of these are called Xanax or (alprazolam). This drug is in the class benzodiazepine. It is used to treat anxiety disorders and panic disorders. Many side effects can occur upon taking this drug. It may be legal but that does not mean it is deemed safe or for everyone. Although it sounds great there are many problems with it. Some of the extreme side effects may include; memory problems, uncontrolled muscle movements, seizures, hallucinations, suicidal thoughts and many more. This drug is

While doing the initial home assessment I started with the living room. In the living room I found prescribed medication containers on the floor and living room table. There was clothing all over the floor and couch. The couch seemed as if someone sleeps there, newspaper ads were just laying around the ground. I came across a rodent behind the shelf. There was an open window cleaner near the electrical port. Then I moved to the kitchen where I found a sink full of dishes with a knife not properly stored. Laundry detergent were just left out and not stored with some bottles being opened on the ground. There was a roach infestation all over the sink and stove. When the refrigerator was inspected there was some basic food like: peanut butter, ham, eggs and milk. It was also filled with

The RN would first review the goals and outcomes of the patient care plan. The next step would be to collect Reassessment Data, " Assess the client response to the interventions."(pg. 128 Treas, Wilkinson) in which include vitals, auscultation of breath sounds, observation of activity, and asking the patient how they are feeling and family for observation. The RN would record the evaluation summary in the nursing note or care plan about the conclusion whether the outcome was achieved and the reassessment data supports the judgment. In order to revise a care plan, an RN must " review all the steps of the nursing process."(pg. 130 Treas, Wilkinson).

Opioids are a category of pain medications that reduce the stimulus of pain signals sent from the brain. Within this category are medications such as hydrocodone, oxycodone, morphine, codeine, and other similar drugs. These medications are used to treat mild to severe pain depending on dosages and type of opioid given. With the reduced perception of pain also comes a plethora of unpleasant symptoms such as drowsiness, mental confusion, nausea, constipation, and, depending upon the amount of drug taken, can depress respiration. However, many experience a euphoric experience after administration that drives them to abuse opioids. This abuse leads to addiction or overdose which

This is a 42-year-old female with a 2/7/2015 date of injury. A specific mechanism of injury has not been described.

Ms. Smith is a 42-year-old African American female born November 10, 1972. She currently lives in with her mother. She states she has one adult son from a prior marriage. Ms. Smith states she has a 2-year nursing degree from and was employed as a nurse until 2012.

In GP Practice, the measuring system CRB65 is recommended (3); as confusion, respiratory rate and blood pressure are easily measured. NICE guidelines recommend home-based care for any patients with a score of 0, and considered referral to hospital for all others. When deciding on home treatment, the patient’s social circumstances and wished must be taken into account in all instances

Upon examination, one would realise that this was a case that could have easily been preventable. While these types of drugs are known to depress respiratory effort, situations like this unfortunately occur with great rate, especially in critical care units where opiate narcotics and benzodiazepine sedatives are daily drugs in clinical practice. These types of drugs require special diligence and awareness by the nurse to guarantee safe

Past research has focused on on the use of the SBIRT__________; however, did not review the association between the BAC level and the effective treatment interventions for patients to change their drinking behaviors, reducing re-hospitalization. Based on the review of literature, it can be hypothesized that the higher toxicology levels in patients receiving care in the STICU department at MCV will be associated with higher alcohol related intervention needs as suggested by the SBIRT. Additionally, we hypothesized that these results will vary by age, older patients screening higher on the SBIRT, than younger patients for more intensive interventions. In addition, a comparison review will look into the level of impairment in the patients who