The patient was discharged after 24 hours, to be followed up for the next 2 months at the first, second, and fourth weeks, then at the end of the second month. Statistical analysis Data were analyzed using Statistical Package for Social Science (SPSS version 16). Values are shown as mean ± SD, range, percentage, and number. Statistical analysis was performed with the use of the Mann-Whitney test and Wilcoxon Signed Ranks test for the VAS and morphine consumption changed from the baseline. Statistical significance was assigned as P value less than 0.05.
Patricia Douglass is a 28-year-old, gravida I, para 0 at 34 weeks gestation. She is carrying a set of twins. At her most recent office visit with Dr. Sanders, Patricia had an elevated blood pressure of 158/86. She was brought to the hospital by ambulance. Upon arrival Patricia is immediately assessed and states that she has failed to comply with her prescribed blood pressure medication, Labetalol 200mg BID.
Figure 1 shows the electrocardiogram (ECG) after the angiography. A carotid endarterectomy was performed 5 months before due to an atheroembolic stroke. During the postoperative period, she presented atrial fibrillation with rapid ventricular response and amiodarone was added to her habitual treatment. Her current treatment is ASA 325 mg/day, atenolol 50 mg bid, enalapril 20 mg bid and amiodarone 200 mg bid. One month before the event she attended the outpatient clinic and an echocardiogram was performed, which showed: normal left ventricular dimensions, wall thickness mildly increased, normal left atrium and aorta, mild left ventricular dysfunction with an estimated ejection fraction of 50%, hypokinetic basal inferior and mid inferior segments and mitral inflow filling pattern of delayed relaxation (according to her age).
Kalebi AY, Hale MJ, Wong ML, Hoffman T, Murray J. Surgically cured hypoglycemia secondary to pleural solitary fibrous tumour: case report and update review on the Doege-Potter syndrome. Journal of cardiothoracic surgery. 2009 Aug 18;4(1):45. 2. Daughaday WH, Kapadia M. Significance of abnormal serum binding of insulin-like growth factor II in the development of hypoglycemia in patients with non-islet-cell tumors.
The condition of Mr. G.P. Nair was initially diagnosed in the hospital as tuberculosis and treatment was started. It is clearly witnessed that in the course of said treatment, the patient showed other symptoms and later diagnosed to be a case of jaundice and in view thus he was treated in the hospital for jaundice by one Dr. P.P. Joseph from September 15, 1989. The patient was transferred to the Medical College Hospital only on September 18,1989 and while undergoing treatment there, he departed on September 28, 1989.
Dallas Berrier Case Study: Falls Guilford Technical Community College March 11, 2018 1. Provide a brief explanation of what orthostatic hypotension is and identify the vital signs and their values that define orthostatic (postural) hypotension. In the Journal of Gerentological Nursing, Momeyer (2014) describes orthostatic hypotension as being the sudden drop in blood pressure as a result from changing positions from lying or sitting to standing. Mr. O 'Brien 's vial signs are consistent with the definition of orthostatic hypotension. His blood pressure continues to fall upon position changing and his heart rate is increasing in order to try to compensate for the fall in blood pressure.
Chest x-ray showed no acute pulmonary findings. She was diagnosed with a viral syndrome. A follow-up visit was recommended. A visit note from Mary Grace Lasquety, MD (Internal Medicine), dated 05/22/2017, indicated that the claimant presented with headaches since the
Before Bill was given medication, food, or fluids he was assessed for ineffective swallow by the nurse. If the screening shows swallow impairment the patient must be referred to SALT within 24hours (NICE,2008). The screen used in this hospital was the “Stroke dysphagia screen” (Lepine,2009 cited in Barnard,2011). This involves giving an alert patient (absent of facial droop and with a gag reflux) a sip of water, if they can swallow without coughing/choking they are allowed more and observed for coughing/choking (Barnard, 2011). If facial droop present, as in this case, the test is not done and the protocol requires immediate referral to SALT.A nursing diagnosis of “ineffective swallowing” was
10.7 RECENT RESEARCH A research was carried out in Changi General Hospital, Division of Geriatric medicine, Singapore. The study was carried out to find out the types and frequencies of complication after a stroke attack, especially in a rehabilitation setting, the hospital wanted to find out the type of complication that will result in referring patient back to the initial physician. The study was conducted over a period of six months from January 2001 to June 2001 to patients transferred to the rehabilitation team. The complications that occurred were noted and their rate of occurrence. At the end of the study a total of 140 case notes were reviewed.
The physician has written discharge order for Rudd. Rudd`s son, Matthew is also at the bedside, waiting for the nurse to bring the discharge paperwork. Rudd`s blood work and X-ray, CT scan results do not show any signs of organ damage. The assigned RN checked vital signs before discharge. The vitals are as follows: Temperature: 97.20F, Heart rate: 70 beats per minute, BP: 130/76 mmHg, respiration: 18breaths per minute, and Pulse oximetry: 98% on room air.
Recently on the post-surgical unit at Children’s Medical Center of Dallas (CMCD), the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) scores have declined. It was noted that scores for nurse attentiveness to patient requests and responsiveness to call lights dropped, with an overall decrease in patient satisfaction scores. After careful review of the literature, CMCD plans to implement hourly rounding on the post-surgical unit. Current practice on the post-surgical unit at CMCD is for nurses to check on their patients every two hours. Ethical Dilemma Nurses make a moral commitment to care for all patients and take responsibility for the healthcare environment they work in.
Per protocol, the paramedic notifies the bedside nurse and the attending physician of the CLABSI score so that appropriate antibiotics can be ordered. A 4 month old male is admitted for tracheitis and is on continuous cardio- respiratory monitoring. There are no parents staying with the patient. The patient has an O2 de-saturation of 85% which triggers the monitor alarm. Per protocol, the paramedic audio- videos into the patient’s room and visualizes that the patient’s trach has dislodged and patient has increased work of breathing.
Evaluating antibiotic use and recurrent (Clostridium difficile infection) Risk among hospitalized patients with a history of clostridium difficile infection: Opportunities in Stewardship. In Open Forum Infectious Diseases (Vol. 3, No. suppl 1, p. 1038). Oxford University
Introduction: Diabetes Insipidus (DI) is a common complication following pituitary surgery. It has been traditionally reported in the range of 5 to 15% after transsphenoidal resection of pituitary adenomas. Here we report our experience with Diabetes Insipidus following Endoscopic resection of pituitary adenomas. Methods: We retrospectively reviewed the Stanford University Pituitary Adenoma database. Between the years 2007 and 2012 we identified 183 patients who underwent endoscopic resection of pituitary adenomas by the senior author (G.R.H).