Maintain skin integrity by turning patient every two hours, no cresses in the sheets, monitoring incontinence by changing brief when wet and making sure perineal area is clean and dry. Apply a barrier ointment during changes. Always using personal protective equipment when entering into the room to prevent infection. Provide proper hand washing before, in between, and after care to prevent the spread of infection. Make sure the bed is always lowered, side rails up and call light within reach to promote
An internal “pouch” is made from part of your ileum. A partial incision will be made in the ileum, and the ileum will be folded back on itself to form a pouch inside your body. This pouch will be connected to your stoma through a valve and a catheter used to drain waste. • Your stoma and any other incisions will be covered with bandages (dressing). If you had a loop ileostomy or an end ileostomy, an ostomy pouch will be attached to your
Post operative, the Cardiac Surgeon had ordered targeted systolic blood pressure of less than 130mmHg. The surgeon had prescribed blood pressure medication, such as Sodium Nitroproside infusion and for pain, Dormicum plus Morphine infusion. As a critical care nurse I need to monitor and observe patient very closely. I need to administer the medication that was prescribed accordingly. When Mr. C begins to arouse as a result of the anesthesia is wearing off, he started to grimace and his blood pressure shut up above the target level.
Upon arrival Patricia is immediately assessed and states that she has failed to comply with her prescribed blood pressure medication, Labetalol 200mg BID. The paramedic reports a moderate amount of dark red vaginal bleeding, blood pressure 84/46, heart rate of 130, and respiratory rate of 26. The patient complains of severe abdominal pain rating it a 9/10. When the abdomen is palpated by the nurse there is localized uterine tenderness in the upper right quadrant and it is boardlike. Upon observation a large blood clot is seen on the patient’s pad.
The nurse should be aware of the patient’s medical history and know their patient well. Patient safety is very important. “Nursing management of older adults with any form of dementia always considers the safety and physical & psychosocial needs of the older adult and family” (Potter & Perry, 2012). Quality Improvement Interventions An intervention for quality improvement is to make sure the patient understands what is happening. The patient should be given time to express their thoughts.
Nurses also work closely with ultrasound technicians and patients. Nurses act as the messengers between patients and doctors. They also act as messengers for physicians when they can not be present. The nurses are the ones caring for patients, and taking all that information to the doctor, then if the doctor orders an ultrasound, the nurse then takes that information to the patient. After consulting the patient, the nurse would put in the order and ensure that the ultrasound was scheduled (and took place if within a hospital).
The big concern of allergic reaction is airway constriction, shortness of breath. PT’s swelling has decreased after one hour so Epinephrine as well as transferring to the hospital for further evaluation and treatment at this point is not needed. However, PT is instructed to follow up with primary healthcare provider or cardiologist for the cause of allergy reaction as well as the evaluation of antihypertensive treatment within the five days. Also, PT is instructed to bring all medications for this appointment. Enalapril is an ACEI that can be used as first-line treatment for hypertension in diabetics and in those with HF.
I communicated with the patient’s, my preceptor, other nurses, the PCT’s, PT, and the kitchen staff. When I was in the patient’s room I was sure to explain what I was doing, and answer any questions the patients had about their plan of care. I worked with my preceptor throughout the shift, asking questions, clarifying orders, clarifying medications, procedures and more. I communicated with other nurses by thoroughly receiving and handing off report. I communicated with the PCT’s that I would perform the vital signs for my patients and worked with the PCT when my patient needed labs to be sent down.
404). A competent nurse can “begin to see his or her actions in terms of long-range goals or plans” (Benner, 1982, p. 404). I believe in my nursing career I have reached this stage. When a patient comes in with a specific complaint, I can anticipate what will happen and what the doctor will order even before the doctor comes in to see the patient. For example I know a person that has a complaint of chest pain will need an electrocardiogram, troponin, cardiac monitor and depending on the patient medications, aspirin.
CBC was administered to determine the WBC and platelet count and to confirm/rule out leukemia and anemia. Lymph node biopsy was completed to observe whether or not Reed-Sternberg cells are present, confirming/denying the presence of lymphoma. X-ray: Medium-sized mass present in the mediastinum. PET-CT scan: Shows enlarged lymph nodes in the chest and spleen. CBC: Normal WBC and platelet levels, ruling out leukemia and anemia.
The National Institute of Health and care Excellence, (2008) (NICE) issued national guidelines of what checks should be done in anaesthetic room. The Sign in on the WHO surgical checklist was conducted. The WHO surgical checklist requires practitioners to confirm details such as patient’s identity, surgical site, allergies, consent and airway issues. This was done before induction of anaesthesia. McHale and Tingle (2007), stated that it is a legal and ethical principle for practitioners giving care to patients to have a valid consent before starting treatment.
Thank you very much for referring Glenys along for further investigation of the abnormalities detected on the CT scan of her chest which was done for investigation of night sweats. As you have mentioned, she has seronegative rheumatoid arthritis for which she is normally on prednisolone, methotrexate and Arava, but the methotrexate and Arava have been stopped recently due to an elevated liver function test. The CT scan of her chest, abdomen and pelvis did not reveal any cause for her night sweats but did reveal the presence of mild, mid and upper lung paraseptal emphysema with some non-specific scarring in the basal segment of the right lower lobe basal lingula and anterior basal left lower lobe. There were multiple scattered small irregular cysts elsewhere throughout the lung. Alongside this, there were also two small pulmonary nodules in the right middle lobe and right lower lobe which were 3mm.
Although a lengthy advice has been given whist in hospital by the surgeons and nurses, the patient may not be ready to comprehend a load of information at once. We discharge our patients with educational materials they can read and digest at home and contact support groups they can join. According to the New Zealand Guidelines Group (2002), all patients following a coronary bypass graft are recommended to have a comprehensive cardiac rehabilitation. It have been shown to prevent further cardiovascular events by empowering patients to choose a healthy lifestyle, to improve quality of life for the patient and their family and to assist in the patient’s return to full and active life by enabling the development of their own
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.