Patricia Douglass is a 28-year-old, gravida I, para 0 at 34 weeks gestation. She is carrying a set of twins. At her most recent office visit with Dr. Sanders, Patricia had an elevated blood pressure of 158/86. She was brought to the hospital by ambulance. Upon arrival Patricia is immediately assessed and states that she has failed to comply with her prescribed blood pressure medication, Labetalol 200mg BID.
When a patient has an issue or problem nurses must work together as a team to find the answers and help their patient. There may be that one patient that might be acting a bit off; perhaps they are normally cognitively intact and continent of bowel and bladder but now they are incontinent and confused. Nurses must act as a team to figure out what is going on with their patient; do they have a urinary track infection? Should we get a urine culture and sensitivity? Should we start an antibiotic or maybe try increasing oral intake first?
As the act of abortion conflicts with the social workers’ values, they may feel torn. And instead, they may wish to encourage the client to choose another alternative. Hence, in such cases, the practitioners faced the struggle between balancing their own value systems and their professional obligation as a social worker. The third ethical dilemma is when the social work practitioner overheard the conversation between the patient and her family members that the hospital staff has been verbally abusing the patient. However, the social work practitioner does not have any evidence to prove the abuse.
Clinicians need to be aware that conventional cardiovascular risk calculators have not been validated in women with PCOS. All women with PCOS should be assessed for CVD risk by assessing individual CVD risk factors (obesity, lack of physical activity, cigarette smoking, family history of type II diabetes, dyslipidaemia, hypertension, impaired glucose tolerance, type II diabetes) at the time of initial diagnosis. In clinical practice, hypertension should be treated; however, lipid-lowering treatment is not recommended routinely and should only be prescribed by a specialist. Psychological issues should be considered in all women with PCOS. Depression and/or anxiety should be routinely screened for and, if present, assessed.
Then he was kept for observation for 3 days. The patient developed fever again (39oC) and parenteral paracetamol was able to decrease his temperature temporary for only 2 hours and kept rising again to 39oC. Parenteral antibiotics were started again for a week. However, the fever didn’t decline at all. Abdominal CT scan was performed but revealed nothing except cholelithiasis.
The claimant has a past medical history significant for diabetes mellitus, hypercholesterolemia, and benign essential hypertension. An emergency room visit on 03/02/2017 indicated that the claimant presented with a history of diabetes and hypertension with complaints of intermittent severe headaches that started 2-3 months prior the visit. He had complaints of dizziness and disorientation. He stated that he had a CT scan the previous year which did show an aneurysm that was not important. MRI 9 months ago showed no abnormalities.
Case study: 67 year old female of colored ethnicity from wellington, transferred from Paarl hospital intubated, ventilated will host of problems including Chronic Obstructive Pulmonary Disease grade ii , Community Acquired Pneumonia (CAP) , Gastro Intestinal Tract bleed which occurred just before transferring from Paarl, also history of smoking, one packet year, and ethanol (ETOH) abuser. Conclusion: Diagnostic criteria, is clinical presentation and chest x-ray. The simplest of all clinical scoring system is CURB-65 using 5 prognostic variables to determine the severity of Pneumonia, instead of 20. Much easier and practical can be applied at patient bedside. Inverse ratio ventilation to aid and improve filling of non-compliant
Besides, the nurse has breached the ethical principle of non-maleficence. There was nothing done after being notified of continued bleeding and the resident bled to death from gastrointestinal hemorrhage. Lastly, the nurse has just breached the ethical principle of fidelity. She has failed in keeping up with commitments of nursing by not being competent in taking care of the resident. She did not perform her responsibility of keeping copies of her notes or reports during calls from
Before Bill was given medication, food, or fluids he was assessed for ineffective swallow by the nurse. If the screening shows swallow impairment the patient must be referred to SALT within 24hours (NICE,2008). The screen used in this hospital was the “Stroke dysphagia screen” (Lepine,2009 cited in Barnard,2011). This involves giving an alert patient (absent of facial droop and with a gag reflux) a sip of water, if they can swallow without coughing/choking they are allowed more and observed for coughing/choking (Barnard, 2011). If facial droop present, as in this case, the test is not done and the protocol requires immediate referral to SALT.A nursing diagnosis of “ineffective swallowing” was
In this case, patients have made up their mind and have weighed the merits and demerits of the treatment in a rational way. Various elements has contributed to the lack of confidence of the patients to the drugs and failed to motivate them to consume the essential drugs. For instance, due to illiteracy in some patients, it creates a condition where patients are dubious about their medications and may lead to many adverse effects such as drug dependency, development of other diseases as well as decreased in long term efficacy. Psychological state of the patient in which they claimed that particular dugs can remind that they are ill also may bring about the state of non-adherence. Patient counselling and proper communication between patient and physicians are required to encourage patient to adhere to the
The patient was placed on HOLD to see the Senior Counselor for an update on her efforts of contacting Blue Hill Hospital. Please note, the patient appeared to be irritable and upset about being place daily and missing her transportation. The writer had to remind the patient that she had 1 week prior to take care of the matter and did not comply. The writer and the patient called Intercommunity together and spoke with Julia from the Detox department. During the phone screening- the patient was found ineligible as it was determined that the patient is not a chronic user due to her only using Valium three times and stopped for the past three weeks.
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.
Chief Complaint Left-sided facial tingling. History Patient is a 56-year-old right-handed white female who presented to her PCP in May complaining of several weeks of tingling sensation on the left side of her face, mainly in the V1 and V2 distributions along with some facial twitching. She thought she may have had a tick bite prior to that and her Lyme titers were checked. They were negative, but her ESR was 47, CRP was 7.2. She did have an MRI, which revealed only one small subcortical T2 and flair white matter lesion in the left frontal region.
The family request a permanent feeding tube, and the children request that the doctors don’t tell the poor husband his wife 's conditions. They believe the news will just kill him. Scenario two, an 84 year old women with mild dementia and compensated congestive heart failure is admitted to a nursing home. The husband gives the physician a signed AD that states that under no circumstances does the 84 year old women want resuscitation. Scenario three, 87-year-old man with advanced metastatic lung carcinoma admitted to an acute hospital is fed a gastrostomy