When I left my patient’s room I recalled some of the observations that I have made. When we gave our patient a shower I noticed that her feet were significantly darker than the rest of her body. Her feet were dark blue or cyanotic. I also noticed a round looking ball on the patient’s left brachial. I thought back to class lectures and was able to relate the patient’s cyanotic feet to hypoxia. The patient’s cyanotic feet explained her need for the oxygen tube. Walking into my second patient’s room I was a little bit less nervous. I walked into the room with more confidence than how I walked into my first patient’s room. My second patient was also very friendly. But she did not need as much assistance as my first. She just asked to fill up her basin with water. Later that morning, I had the opportunity to take my second patient’s blood pressure. It was difficult to tell the reading of the systolic and diastolic number due to being very nervous and the voice from the television remote but I ended up with a number that was pretty close to the accurate reading. Despite that, I was happy that my first time taking a patient’s blood pressure went
5. Assess Circulation. Does the patient have a pulse? Are they bleeding all over? What does their skin look like? Is it warm and pink or is it blue and clammy? Treat any problems that arise.
“Orthostatic hypotension is a condition in which there is insufficient recovery of the blood pressure drop which occurs after getting up, which causes a temporary reduction of cerebral perfusion. This increases the risk of falls resulting in injuries (JAHR, 2018).” When lying blood pools in the legs and the abdomen when changing positions from lying, to sitting, to standing. A person may exhibit clinical symptoms of OH when systolic pressure drops below at least 20 mmHg and diastolic drops at least 10 mmHg during position transition.
*This device measured blood pressure with an external cuff on the patient’s arm or leg
This clinical experience has really helped me to sharpen my communication skills and realize just how important it is to understand mental health. We are told multiple times in class that mental health issues can be seen on any floor and that is the truth. I’ve seen patients in my older adult clinical on the pulmonary floor suffer from issues that range from anxiety to bipolar disorder and depression. Being able to understand how to approach people that suffer from these types of illnesses, allows us, the nurses, to give the patient the best care that we can. It helps to build a trusting relationship and get to know them on a personal level. Patients with mental health illnesses are many times defined because of their diagnosis and that is
Blood pressure fluctuates throughout the day and normally decreases during nighttime. Patients can be classified as either dippers or non-dippers dependent on how much their blood pressure decreases over the course of the night. Dippers are considered patients whose blood pressure reduces by at least 10% during the night in comparison to their daytime readings, a dipping pattern is desired. The goal blood pressure for nighttime is <0.005). Nondipping blood pressure is a common manifestation associated with cardiovascular risk factors such as diabetes, chronic kidney function and coronary artery disease which may have an impact on all-cause mortality results, since these comorbidities are more prevalent in nondipping patients.
The walls of veins are far thinner and the lumen passage much larger. The walls are not muscular and blood is pushed through the vessels by the action of skeletal muscles. Veins carry deoxygenated blood (dark red) to the heart, except for the pulmonary veins which carry oxygenated blood. Blood pressure is very low in the veins, so there are valves in the endothelial layer which prevent the back flow of blood (Tucker, 2015).
The estimation of preload is based on the assumption that pressure and volume are equated. Therefore, pressures are used to estimate end diastolic volume. Likewise, RA pressure is used to assess end diastolic volume of the RV, and PAWP is used to evaluate left ventricular preload. Afterload is the resistance to ventricular ejection and is influenced by PVR. PVR assesses the right ventricular afterload, and SVR indexed to BSA estimates left ventricular afterload (Morton & Fontaine, 2013). Contractility is not directly determined; however, stroke volume index for right and left ventricles is used to estimate
The cardiovascular system is broken down into two circulatory pathways: systemic circulation and pulmonary circulation. Systemic circulation carries oxygenated blood away from the heart to the body or organs, and then returns deoxygenated blood to the heart. Whereas the pulmonary circulation transports deoxygenated blood from the body or organs to the right side of the heart to the lungs and return oxygenated blood to the left side of the heart (Marieb, Nicpon, and Hoehn, 2013). The cardiac cycle consists of an ejection and a filling stage: systole and diastole, respectively. During the diastolic phase the heart ventricles are relaxed as the heart fills with blood, and blood pressure is the lowest; during the systolic phase the heat ventricles contract and pump blood out of the arteries, and blood pressure is increasing.
Through this course I have learned that history taking and performing a physical assessment and being able to differentiate normal from abnormal findings is one of the most important roles of a health care provider. If an accurate physical assessment is not performed, whether for baseline data or when the patient’s condition changes, then the patient is not receiving the level of competent care he deserves.
I arrived at Hospice around 0750. I gave the name of our contact, and she showed me where I needed to go. There was a little confusion with who I was going to go with, so I waited outside the office until they were able to figure it out. I ended up getting placed with a lady named Judy and she was very helpful throughout the day. We sat in her office until nine and she just asked me questions about myself, like where I was from and what kind of nursing I was interested in going into.
The heart is a tough operating mechanism which moves blood around the body through a very advanced system called arteries and capillaries; the blood is then carried back to the heart by means of veins. Blood pressure is the thrust of this blood in the body pushing up against the inside walls of the arteries
‘’Blood pressure is a measure of the force that your heart uses to pump blood around your body. Blood pressure is measured in millimetres of mercury (mmHg) and is given in two figures: systolic pressure and diastolic pressure’’. (www.nhs.uk/blood pressure).
The requested service is not medically necessary because: After review of the clinical information provided by Dr. Corinne Benchimol, the Medical Director has determined that Ambulatory Blood Pressure Monitoring Device (monitors blood pressure as you move around) is not medically necessary. The information we have does not support the need for an Ambulatory Blood Pressure Monitoring Device (monitors blood pressure as you move around). You can use a standard device to take your blood pressures during the day into the evening. The information we have does not explain why a standard approach to frequent blood pressure checks could not be followed to monitor and adjust treatment based on those results. The request has been denied as not medically
Blood pressure is the force of blood pushing against the walls of the arteries, carrying blood from the heart to other parts of the body. Blood pressure rises naturally, and down throughout a normal day. If it stays high for a long period of time, it can cause damage to the heart and lead to problems in the health of the body. High blood pressure increases the risk of stroke and heart disease, the leading cause of death in Saudi Arabia.