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.
The CIWA evaluation tool is sometimes replaced with the Richmond Agitation-Sedation Scale (RASS) and Confusion Assessment Method (CAM) assessment tools when patients reside in the ICU.24 These are well validated tools that evaluate the level of a patient’s agitation versus sedation and presence or absence of
During my clinical preceptorship at New York Presbyterian Hospital, many patients that came into the hospital with urinary retention a catheter was inserted to determine the amount of urine in their bladder or post-void residual (PVR). Many patients later developed pain and a urinary tract infection or Community Acquired Infection secondary to frequent cauterization. Therefore, the gap identified was related to a knowledge deficit of the current practice that inserting a
Yes. According to CACI 1001, defendant had a duty to use reasonable care to keep the property in a reasonably in a safe condition. A landowner must use reasonable care to discover any unsafe conditions and to repair, replace, or give adequate warning of anything that could be reasonable expected to harm others. The defendant hosts a party every year and should have made a reasonable effort to make sure his land was safe to enter. Defendant conduct appears to be considered as a substantial factor in causing plaintiff’s injuries.
Patients that are admitted to the hospital frequently require intravenous (IV) fluids. Many hospital policies require IV sites to be changed every 72-96 hours to reduce the risk of complications caused by the IV catheter. There is increasing evidence supporting that routine IV site replacement is ineffective (Rickard, McCann, Munnings, & McGrail, 2010, p. 2). Working in the labor and delivery department, we rarely have patients that require an IV site for more than 24-48 hours.
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.
TACT consulted with Dr. Gentry and it was recommended to refer for inpatient hospitalization for safety and stabilization. TACT assisted the ED doctor in completing IVC paperwork. TACT will search for appropriate
Discuss the population at increased risk for CAUTI and identify evidence-based practice in maintaining a Foley. 4. Identify the appropriate anatomical location for catheter insertion and demonstrate suitable inches for catheter insertion for male versus female. 5. Demonstrate the correct technique in cleaning a catheter using water and soap. 6.
Working in a renal/urology medical-surgical unit, it is a challenge for both the nursing staff and nursing administration to have readmissions due to fluid and electrolyte imbalance from patients with ESRD and CHF. In my own experience, patients who have been in and out of the hospital for the past six months to a year are at a higher risk of acquiring nosocomial infections resulting in a weaker immune system to an already compromised one, as well as longer hospital stay. Readmissions from these patients pose as a physical, emotional and financial strain to both patients and/or their families. Additionally, readmissions within 30 days for patients with CHF poses as an additional cost for hospitals as there is reduced Medicare payments for Inpatient
Part 1 Explain why it is important for nurses to use credible and relevant evidence to underpin their clinical practice. (Justify and support answers with credible and relevant evidence whilst adhering to UWS referencing guidance). The role of nurse changes as new research emerges and finds new and improved ways of helping patients to be restored to health. As Aveyard and Sharp (2016) suggested, evidence based practice requires that the approach is clear but also up to date and it based on the best type of evidence available at the point in time. The Nursing and Midwifery Council Code (2015) is to always provide the best possible service related to the best available evidence that is also in line with the patient’s preferences.
In order to combat this, a nurse must find ways to increase human dignity while also decreasing the likelihood that an infection will be acquired by the patient. The use of an indwelling catheter is a known threat to human dignity and can cause urinary tract infections. The use of intermittent catheterization, allowing the patient to be involved in the decision to insert or remove a catheter, and educating the patient on catheterization can increase human dignity while decreasing cases of catheter associated urinary tract
The writer currently works in an emergency room that has a cardiac catherization lab. Therefore, the emergency room sees patients that are suffering from a myocardial infarction that go up to the cardiac cath lab. This author finds it interesting to see what common nursing interventions are performed after a cardiac catherization because this author does not get to see what happens after the procedure. This author found it interesting that getting a patient up and changing position in bed can make a difference in comfort without increasing risk of bleeding. In nursing school, student nurses are taught not to move the patient after a cardiac catherization and to keep the sandbags on to prevent bleeding, it is interesting to see how often and quick nursing interventions can change based on evidence based
Assessment is a fundamental component of any nurse’s role. However, from what I observed today it seems particularly vital to the PACU nurse. While they do provide interventions, the majority of PACU nurses’ time is spent assessing their patients and documenting their findings. Patients in the PACU have undergone the significant stressor of surgery under general anesthesia and they have the potential for very serious complications. It is up to the PACU nurse to observe if the patient is declining and act quickly and appropriately.
(REF must not be thrown away) .I place an Inco - pad on the chest of the patient for the anaesthetist to put the removed tube, for cleanliness and to prevent infection (REF). Prior to the extubation of the patient, the Anaesthetist checked the patient’s response to verbal command and recalled after
The circulating nurse also initiated the time-out. During the time-out, the circulating nurse said the patient’s name, the surgery that the patient was getting, and the limb in which the surgery was being performed on. The other health care professionals agreed that it was the right patient, right site, and right procedure. Throughout the surgery the circulating nurse continued to ensure the safety of the patient by watching the surgical staff and making sure that the sterile field was not contaminated. This nurse’s role also included gathering materials for the surgeon, throwing away trash, and keeping the environment comfortable for the staff.
