When a person suffers from a stroke, there is limited time frame to provide lifesaving interventions to that individual. The recommended door-to-needle time for a patient in need of tissue Plasminogen activator (tPA) administration, for treatment of an ischemic stroke, is one hour. Within this time period, the affected individual must be brought into the Emergency Department (ED) from the ambulance and registered. They are then required to have a full set of vitals taken, as well as a CNS assessment done by the Registered Nurse and ED Physician. Blood work is then taken and while the patient is sent to CT scan, the blood is processed.
Module title: Principles of assessment and management of the acutely ill adult Module Leader: Briege King word limit: 500 student 's name: Hema Elizabeth Philip This particular case study shows the assessment and management of an acutely ill adult who presented to the emergency department. This will explain pathophysiological cause of the illness, the assessment and the treatment given to the patient consent received from the patient and my manager as I am discussing the patients information. I am using mrs.Smith as patients name as I do not want to reveal the patients original name due to the confidentiality(an bord altranais 2012). Mrs.Smith 80 years old female brought by ambulance with complaints of increased shortness of
a. Increased b. Decreased 9. Differences in the following factors may affect stroke recovery. (Select all that apply) a. Gender b. Race c. Socioeconomic status d. Support 10. Medical complications of acute ischemic stroke are common and influence outcome after ischemic stroke. Which disease is the most frequent serious medial complication in stroke?
Ten patients were used to test reliability in this assessment process, and the calculated interrater reliability at 94% with a confidence interval (CI) of 95%. The sensitivity of the CAM-ICUs at 76% presented a CI of 95% with a specificity of 98% and a CI of 95% (Mitasova et al., 2012). The validity of this study shows a high incidence for detecting delirium in post stroke patients when using the CAM-ICU as an assessment tool. This effective and reliable tool should be used at the local level in determining delirium in the critically ill population of post stroke patients. Implementation can be easily integrated into daily assessments providing early detection and treatment effectively and decreasing complications related to unrecognized
For this paper I researched strokes, more specifically, transient ischemic attacks or TIA’s. The difference between a transient ischemic attack and a stroke is that the blockage with a TIA is transient, or in other words temporary. A transient ischemic attack is what occurs when the blood flow to part of the brain is either blocked or reduced. This usually happens because of a blood clot. After some time the blood begins to flow normally again and the symptoms dissipate. According to WebMD, “people call a TIA a mini-stroke, because the symptoms are those of a stroke but don 't last long”. This is a very important health concern because most often a TIA is somewhat of a warning and means that you are very likely to have a stroke in the future.
Ongoing assessment and monitoring for injured patient is essential in the rehabilitation settings. Taylor will undertake a general neurological assessment including history of presented problem, previous medical history, results of specific examinations (X-rays, blood reports, CT scan). Other collection of information such as social state (family help, occupation, accommodation), pain, other ongoing treatment, everyday routine, mobility, vision and hearing, continence, swallowing, lethargy, expectations of treatment and functions of position and balance, range of movement, reflexes and sensory A neurological assessment has two functions: the current neurological level and the observation for changes in neurological level. It is divided in to five components such as brain function, cranial nerves, motor response, sensory level and reflexes. Taylor’s level of consciousness and cognition level must be considered and specific observation regarding changes in mental status, emotional status and intellectual functioning should be recorded and documented and compare over the
The Patient Assessment is one of if not the most important skill and tool in the in the career of an Emergency Medical Technician. EMS stands for Emergency Medical Services this is like the genus or the foundation and Paramedic, Advance Emergency Medical Technician (AEMT), and Emergency Medical Technician (EMT) are like the spices. Each of these spices has different ranges of the skills they are allowed to perform but each one has to go through one common step and that is the Patient Assessment. There are five steps to the Patient Assessment those steps are Scene size-up, Primary assessment, History taking, Secondary assessment, and Reassessment.
I recently attended a seminar hosted by CIAO with guest speaker Melanie Potock, MA, CCC-SLP, a feeding specialist, certified speech language pathologist, international speaker and author on the topic of picky eating and feeding difficulties. Although this broadened my knowledge on feeding difficulties I have an interest in swallowing that I cannot grasp as an assistant to an SLP. It is no secret this field is highly competitive, nonetheless being accepted into a program that tailors to your interest is a beautiful vision made
The results are based on the effects of the age, volume, consistency and gender on the duration of the swallowing assessment. The clinical importance of the results showed the difference in timing and how the diameter of the pharynx between male and female can affect the result of swallowing. 1. What did the researchers conclude?
IV bolus of unfractionated Heparin or Subcutaneous injection of low molecular weight heparin (LMWH) may be used to prevent the formation of new blood clots. Nursing consideration: Require regular monitoring of activated partial thromboplasitn time (aPTT) and needed frequent heparin dose changes (Brunner and Suddarth’s, et al, 2010: 765). Fibrinolytic therapy: This therapy is given to dissolve the thrombus in the artery and restore the blood flow. There are two fibrinolytic drugs which are streptokinase and Recombinant tissue plasminogen activators (r-TPA) which includes Alteplase, reteplase and tenecteplase (Brunner and Suddarth’s, et al, 2010: 772).
Her medical diagnosis of ARDS from overdosing and pneumonia are the cause of her deteriorating condition. Then, it moves on to the first two primary nursing diagnoses of impaired gas exchange and risk for infection, followed by the lower ranked ones of impaired tissue integrity, anxiety, and finally decrease cardiac output. The case study then explored her expected outcomes, the interventions used for her primary two nursing diagnoses with literature reviews, and finally an evaluation of the plan of care. The learning from this patient is that it is not our place as nurses and medical personnel to judge, but to treat with fairness and compassion. It is easy to look down on this patient for her chronic illnesses that affect her long-term health, but she needs help, and now may never be back to her pre-hospitalized state.
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.
Appendix NCLEX Questions The following two alternate format NCLEX questions were created related to the case study information and focus on the nursing responsibilities prior to blood administration and the signs/symptoms of acute hemolytic transfusion reactions. NCLEX Question #1 The RN on day shift is looking after Anita, a 93-year-old female patient in with an upper GI bleed. Anita’s latest lab results show an Hgb of 62
He is eating, but he still has signs and symptoms consistent with depression. Based on the medical report on 5/2/16, the patient presented for follow-up for his sleep-disordered breathing. Impression includes severe obstructive sleep apnea with daytime hypersomnia and significant improvement with the use of
After dispensing, monitoring, and providing a following evaluation of the medication risk, this gives the physician an accurate representation of how the patient is doing in response to the medication that was prescribed. The alarming facts in Lewis’s case are there were reduced bodily functions such as urination, no bowel sounds, no blood pressure, high respiratory pulse, and initial dehydration that continued throughout. All of these signs should have notified a nurse or medical provider that something was seriously wrong with this child. The patient’s safety in Lewis’s case would have benefited from acknowledging anyone of these significant vitals signs that were not normal signs of a healthy young boy. Patient safety comes from consistent patient observation using vital signs patient monitor equipment, individual patient condition assessments, mandatory daily check-ups and check-ins from a physician, especially with inpatients after any procedure to monitor reactions from prescribed medication, or to monitor any developing progressive conditions before they become an unnecessary