Mr Jensen Case Study

Assessment 2 Short Essay Question -01 Discuss Mr. Ronald bates systemic assessment and priorities of management Mr. Ronald bates presented to the emergency department with shortness of breath (Respiratory rate- 24 breaths/min) and general discomfort (pain score- 4/10) and it was started in the morning and worsens when doing activities. The above presenting complaints lead to a possible cardiac event, so that this presentation would be triaged as category 2. Therefore, medical officer would be notified regrading patient presentation and put Mr. bates to semi fowler’s position in the Emergency bed if this position is comfortable for him. Further primary systemic assessment of the patient starts with an order with an assessment of

He is in no acute distress. Blood pressure 120/78. Pulse 70 and regular. Weight 177 pounds. Height 5 '6".

Root Cause Analysis A root cause analysis is mandated by The Joint Commission (TJC) to be completed for every sentinel even. By doing this it allows healthcare providers to review contributing factors, establish a baseline and how to prevent future events from occurring. Root causes are identified factors within a process that can be restructured to decrease the risk of harm being repeated. (The Joint Commission, 2013)

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.

Justin is the registered nurse that has been given the handover for Kelly Malone’s postoperative care in the surgical unit. Kelly Malone is a 49 female patient who has had a septoplasty and a right ethmoidectomy. Justin is working with Kelly to identify Kelly’s needs in order for Kelly to be discharged from the hospital. Kelly’s postoperative observations were a temperature of 36.2 degrees celsius; heart rate of 68 beats per minute; respiratory rate of 18 breaths per minute, blood pressure of 111 systolic over 73 diastolic millimetres of mercury; oxygen saturation at 93 percent of room air and a self-rated pain score of two out of ten. Kelly has a history of ‘not being able to breathe well through her nose’ and a history of disturbed sleep.

As a result, these patients can’t bring the carbon dioxide out, they become retain the carbon dioxide which makes it so hard for them to breathe

His symptoms are linked to his CBC results that are below the reference range of RBC, hematocrit and hemoglobin. Harold has an elevated mean of RBC volume while having a low RBC and hematocrit count, this indicates that he is producing an abnormally large RBC that does not efficiently carry oxygen. 3. Doctors have determined that Harold is anemic. Describe this condition.

Mildred Pasek, my friend and colleague died on August 8th 2017 following an anterior approached back surgery on July 28th at the New England Baptist Hospital. Before you read on, my goal is not to criticize the orthopedic or vascular surgeon’s professionalism, immense skill or personal care of Mildred as these cases affects all providers on a deep emotional and professional level. My concern is for the post-operative care of patients, like Mildred, who have comorbidities, are not necessarily in the ideal condition going into surgery, or at a critical time can advocate for themselves. As well as the debilitating arthritis, she had hypertension required three antihypertensive medications to control. Those meds were held pre surgery, and never resumed.

Include one intervention to address each of the nursing diagnoses that are still applicable. In 24 hours the patient goal was not met regarding Impaired Gas Exchange. The patient oxygen saturation was at 94 percent

The low amount of blood delivered to the kidneys causes inadequate renal perfusion. When this happens, renin is released to secrete aldosterone, a vasoconstrictor that promotes sodium and fluid retention. Aldosterone increases the preload to increase the systolic volume (Moreau, 2006). However, this is counterproductive in the long run because an increase in the preload will wear out the heart by working double time as well as increasing lung congestion. The heart failure causes multiple organ failure in chronic conditions such as altered digestion, decreased brain perfusion

Rashid Ahmed Guided Reflection Questions Opening Questions How did the simulated experience of Rashid Ahmed’s case make you feel? Overall, the simulation case of Mr. Ahmed was a positive experience that makes me feel in control and challenged by the situation. I perform multiple nursing skills and acknowledge acquired during lectures. For example, in reference to fluid, electrolyte, and acid-base balance information, I was able to identify the needs of a dehydrated patient.

4.1. Vasovagal Causes. 4.2. Orthostatic hypotension. 4.3.

The desired outcome will be having the patient with clear lung sounds, edema free and denies dyspnea on exertion. To achieve these outcomes we need to monitor body weight daily, ? changes in bodyweight reflect changes in body fluid volume? (Methney, 2010). Mean time we need to monitor extension and location of edema?

CRITICAL INCIDENT ANALYSIS The aim of this report is to reflect about a critical incident that happened during my practice as an anaesthetic nurse trainee using the Gibbs reflective model (1988), which is one of the models that suits better in healthcare settings. This critical incident fits perfectly with the description made by Benner (1984) in a way that promotes nursing care with a substantial difference on the patient outcome. A critical reflection framework is a learning method that promotes a critical thinking from the past with consequent actions in the future, highlighting behaviors, assumptions and views.

The Skin Structure and Function: The skin is the largest organ. It covers the whole body and is water-resistant. The skin consists of two layers; the Epidermis and Dermis (under which lies the subcutaneous or fatty layer).