Background Information:
Patient R.S. is a 78-year-old male with a background in accounting; his career prior to retirement 13 years ago as an accountant. R.S. was diagnosed with COPD, community acquired pneumonia, impaired gas exchange, TURP and shortness of breath. R.S. appeared to be worn out and exhausted, he was wearing the hospital gown, had a Foley catheter in, two PICC lines bilaterally in the antecubital area, air compression legs wraps bilaterally, and heart monitor and was also wearing oxygen. He was very friendly and cooperative with having to have his vitals taken, medication given, and bed bath done. R.S. spoke in a low, happy voice. Most of the time he was smiling while we were talking throughout the day, even though he was concerned with his wife having surgery and being in the hospital.
Observations:
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was wearing a hospital gown, he looked exhausted, his gray hair needed to be brushed, and his skin was pale. He has oxygen therapy via nasal cannula, and needed to be adjusted on his face. His gown was pulled down some by the heart monitor he was wearing, and his blanket was falling off. The air compression leg wraps were compressing when I walked in the room. R.S. was unable to bathe himself, brush his teeth, or feed himself. His voice was soft and kind and he smiles a lot. R.S. had occupational therapy, physical therapy, and respiratory therapy throughout the day while I was there. All the therapies in a row seemed to exhaust him more, since they were back to
On 10/29/2015 SO EMT Perez was dispatched to PV-119 regaurding foot pain. SO EMT Perez knocked and was verbally greeted in by the resident a Mrs. Suzanne Truss. Mrs. Suzanne Truss was very stressed and seemingly overwhelmed and she stated that she had foot pain but before SO EMT Perez had a chance to evaluate Mrs. Suzanne Truss got up on her own strength from her bedside and proceeded to walk to her bathroom with assistance of her walker. Mrs.Suzanne Truss wanted SO EMT Perez present in the bathroom because she stated it made her less nervous. After Mrs. Suzanne Truss finished in the bathroom and walked to her bed SO EMT Perez began an assesment which revealed the following; Blood Pressure 110/72, pulse rate of 75bpm, and foot pain of the
While auscultating sounds of lung fields no wheezing was found, and VS were within normal range for patient as determined through comparison of chartings on 10/23/2015 thru the morning and lunch VS of 10/26/ 2015 before impaired gas exchange was detected. 10/26/2015 2. Administer O2 @ 2L N/C
Before I even step foot in the door I could hear sobbing and the distress in a woman 's voice. I carried in the necessary equipment, the cops were actively doing CPR as the advanced life support provider (ALS) was looking for IV access. As EMS personnel we took over for the cops, we placed a LUCAS device on him, it 's a device that does compressions for you. Then, we continued ventilating the patient and placed him on a backboard in preparation to transport and move the patient.
She didn’t look as bright as the first afternoon I saw her and still reported hypotension and lightheadedness on standing. She now also had upper abdominal discomfort. As Mildred had a pulmonary embolism history, alarm bells went off in my head. I asked Mildred if her care team was addressing the problem and if I could do anything. Mildred didn 't ask me to talk to the medical staff and not being her health care proxy or wanting to overstep my boundaries, I didn’t.
Uses a walker. • Mr. Raj Singh, a 68-year-old admitted with chest pain and scheduled to have a cardiac catheterization done today at noon. He is very anxious and rings the call bell every 15 minutes to ask whether he is going to die and if the cardiac catheterization is really necessary. • Mr. George Rivera, a 38-year-old Mexican male, admitted with high blood sugars and newly diagnosed with diabetes.
Annette’s reason for admittance at the hospital is an overall weakness, flu-like symptoms, and difficulty with breathing (Prizio, n.d.). She is diagnosed with diabetic acidosis, left upper lobe pneumonia, and a bacterial infection (Prizio, n.d.). Unfortunately, her condition becomes worse. Annette’s right lung collapses, her heart rate is irregular, and she has an episode of unresponsiveness that leads to mechanical ventilation (Prizio, n.d.). Annette has challenges weaning off the mechanical ventilation, which resulted in the placement of a tracheostomy and percutaneous endoscopic gastrostomy tube (Prizio, n.d.).
Nursing Bedside Reporting, Patient Safety, And Satisfaction Scores The American Nurses Association estimates that up to 80% of serious medical errors involve miscommunication between caregivers when patients are transferred or handed off during shift report (ANA 2012). In the nursing profession change of shifts require the successful transfer of information from nurse to nurse to prevent medical errors and adverse events (Sullivan, 2010). Research shows that when patients are included and engaged in their health care there is greater potential to lead to measurable improvements in safety and quality of care.
This week at coastal hospice I felt more comfortable with the staff and was able to address some of the concerns without hesitation. The only thing I still do not like is how I have not been able to keep one consistent preceptor during my rotation. This would not be an issue if I was being trained to work there. I think it is a great idea to learn from multiple nurses and get an insight of the way everyone does something differently.
The patient is a 52-year-old gentleman who is admitted inpatient because of redness of the left leg with pain and itching. The patient in fact was scheduled for an outpatient cardiac. He had a positive stress test. He was actually brought for catheterization and coronary angiogram the day of admission, however when seen in the cath lab the procedure had to be canceled because of a roaring cellulitis of his left leg. It started 1 week prior to admission.
Visiting Nurse and Hospice Care (VNHC) is a admired non-profit in the Santa Barbara area. It has been serving all patient populations for over one hundred and eight years. In 2015 VNHC had net patient service revenue in excess of $28 million while servicing over 12,000 patients between the different service lines. 90 percent of the population served is over 60 years of age and 50 percent of the population served live in high poverty areas. VNHC is especially proud of meeting the needs of the local underserved population and has performed over $2 million in charity care each of the past five years.
Personal observations during the interview We interviewed two candidates which is candidate A and candidate B to fill the position as a nurse. During the interview we observed the candidates in different perspectives. Both candidates provided us different answers based on their knowledge, skills, attitudes and abilities. So we compared between the two interviewees and observed on which of them is suitable to fill the vacancy.
I was fortunate to be able to observe academic education of nursing students at DeSales University. This education was held in a classroom setting on Mondays and Wednesdays. My observation time was 16 hours in which I observed Alyssa Robertson prepare for class, prepare exams, give lectures, provide hands on education, assist students in learning, and provide support to students. I also observed many student interactions and learning techniques. The learners were NU 220 Pharmacology and NU 230 Therapeutic Nursing Interventions students.
I would place a warming blanket for Mr. C, to ensure he achieve nomorthermia. This close monitoring and intervention of treatment such as for pain represent a comfort intervention that addresses a particular care and it is a relief form of comfort. In my current setting, we do not have a respiratory therapist (RT)
To improve respiratory status patient was put on Bilevel positive airway pressure machine, given Lasix and Antibiotics intravenously. He was transfused with few units of blood and platelets, and later was put on permanent hemodialysis 3 times/week,
The lab experience was great since with have the opportunity to work with physical Therapist students and learn from that experience how to communicate and interact with others health care workers. The patient was alert and in a spontaneous (SP) mode with a FIO2of 30%, CPAP of 5cmH2O, and pressure support of 10. Oxygen saturation of 93% while in SP mode and Sedation vacation began 30 minutes ago tell us that the patient was good for early mobility. My role as a RT was to manage the ETT tube, ventilator, and patients O2 saturation. As a group we decided that when the patient was not tolerating the treatment.