Dyssynchrony Case Summary

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Mr. A is admitted to the critical care unit post bowel resection, splenectomy, acute respiratory distress syndrome (ARDS) and patient-ventilator dyssynchrony (PVD). He is an eighteen-year-old African American man who is placed on an IV infusion of Norcuron and Ativan. The major outcomes expected for Mr. A would be for him to be able to wean of the ventilator, be hemodynamically stable, heal adequately, tolerate his diet, have adequate bowel elimination, and be able to adjust to his life with optimal functioning. The problems that are to be manage include, being on the ventilator, being sedated, having an elevated temperature, having a low hemoglobin, post surgical bowel resection, splenectomy, hypoxia and diet intolerance. The problems that Mr. A is at risk for would include ventilator- associated Pneumonia, coagulation issues, speech compromise and muscle impairments. Although Mr. A. is young, he could still be at risk for pressure ulcers because of lack of movement, decrease nutrition and immunity compromise related to the splenectomy.
The nurse will have to monitor vital signs, laboratory values, intake and output, wound healing and the patient as a
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A is only eighteen years old and this injury will affect him. He will have to change his eating habits depending on the extent of his injury. Foods that he may have enjoyed in the past may have to be eliminated. Adequate fluid and fiber may have to be considered as a must in his diet. He may have to deal with a colostomy, which may be challenging for his body image. Activity has to be centered on his needs rather than his wants. Mr. A may not understand all the events and medical terms because of his age therefore it needs to be explained in simple terms that he can understand. Mr. A may not be the one making decisions for himself. His mother or grandmother has a big influence over health care decisions, which may conflict with his own. Mr. A may not be compliant because of his level of psychological
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