Pacing (pacemaker) wires x 2 are in situ and pacing box is at the bedside. The treatment plan I have outlined is for Mr. Wannabe’s post-operative nursing management while in the ward setting in reference to Gulanick & Myers’ (2013) nursing care plan (pp. 312-324). Assess the
Patient was given perineal care prior to the straight catheterization, which is performed every four hours. Beforehand, the cna had a bladder scan on the patient and there was 321 milliliters of urine left in the bladder. During the process of inserting the straight catheter, the patient was asked to take a deep breath while they inserted the catheter through the urethra. At the same time, the nursing students had to teach the patient about bladder management and possible the high risk for urinary tract infections due to multiple insertions of the straight catheter.
If something goes astray during a hospital birth, the mother does not need to go anywhere. All the medical equipment the mother would need it at the hospitals disposal. Hospital also have a wide range of medicine to make the birth more comfortable. Numerous types of pain relievers and procedures such as epidurals can relieve pain from the mother during labor and birth. The minimal amount of time for the mother to access equipment if something does go wrong, is essential to reduce the amount of
Assisting in healing open stage II sacral or perineal wound in the incontinent patient to prevent further skin breakdown. For patients who will require a period of prolonged immobilization, due to broken bones, procedures and other medical complications. When inserting foley catheters the CDC (2009) strongly recommends performing hand hygiene. Hand hygiene must occur immediately before and after insertion and with any manipulation of the catheter device or site. Facilities should ensure that only properly trained staff who have been trained on the correct technique of aseptic catheter insertion and maintenance is given this responsibility.
Accompanied with these devices is the risk of infection, causing localized infection up to systemic infections. Improved nursing care and patient education for CVC’s can potentially have a monumental impact on the percentage of patients that encounter contamination and subsequent infection related to these implanted access ports. Several risk factors have been identified that may aide with this resolution. Early placements of CVCs before patients encounter deterioration of functional systems and immunocompromised circulation systems. Extended use of catheters contributes to the risk of infection and damage at the insertion site of the device.
The protocol has a standard system depending on the patients age to give an amount of fluids over an hour. This protocol uses normal saline instead of lactated ringers due to the department doesn’t carry lactated ringers. The protocol states to give two large bore IV's and infuse a total 124cc per hour of normal saline to pt that is less then the age of five. A patient from the age of six through thirteen give the pt 250cc per hour and a patient above the age 13 give the pt 500cc of fluid per hour. Why do I prefer this standard over other formulas is cause how easy it is to use and remember it takes the stress out of doing math during a stressful call.
Thus, the CDC set standards that health care institutions must follow to prevent Catheter Acquired Urinary Tract Infection. For example, the CDC set guidelines for when is catheter necessary and what are the risk factors for CAUTI. Furthermore, the Center for Disease Control and Prevention recommends that health care organization implement quality improvement (QI) programs to enhance the appropriate use of indwelling catheters and to reduce the risk of Catheter-Associated Urinary Tract
This will help in delays of getting patients discharged. If the discharge nurse cannot make it in time, then the bedside nurse can also do the discharge. This planned change would happen immediately, but will likely take many months for it to actually work. I will give this plan a two-month time change. The doctors have to be encouraged to continue to do this.
Providing care for hospitalized patients can be both stressful and demanding. Nurses often find themselves overwhelmed with the number of tasks they are expected to complete. Due to the large amount of patient care tasks, many nurses forget to implement orders or educate patients on important prophylactic treatments. All hospitalized patients are at an increased risk of developing a venous thromboembolism, no matter the reason for their hospitalization (The American Heart Association, 2017). Venous thromboembolisms pose great risks and are a substantial source of morbidity and mortality to hospitalized patients.
An example includes respecting the decision when a patient refused to take lactulose because it made him have frequent bowel movements. In EPIC, we would chart patient refused the medicine resulting in providing patient-centered care. For quality improvement, the unit has data on how many infections have occurred with central lines and utilize benchmarks and evidence-based practice guidelines to prevent infections. For instance, I had to perform proper hand washing and scrub the hub for at least 30 seconds with alcohol pads to prevent infections in patients who have intravenous lines.
A patient presented to the labor and delivery unit in labor. The patient was a gravida four and para three at 35-weeks gestation with a history of precipitous labors and a previous cesarean section. Upon vaginal examination, the patient was dilated to a six and the physician ordered for the patient to be admitted. The standard protocol of admitting a labor patient, which included lab work, patient history, the signing of consents, and establishing an intravenous (IV) access. During the admission process, the patient’s labor progresses and requests an epidural for labor pain control.
In the examples of catheterization witnessed in the hospital, those three patients were placed at risk for the development of infection. The nursing intervention of catheterization if done improperly can impair the patient. Jan Powers states urinary tract infections account for 30% of hospital infections, and of the 30%, 70-80% are related to urinary catheters (Impact of an aseptic procedure). The four nursing literature pieces used consult three main factors in preventing complications related to urinary catheterization. The first factor is the duration of how long the catheter will remain in the patient.
This is to ensure it is going according to the IV regime and the catheter is draining approximately 30mls of urine per
After caring for Max, I found myself reflecting on the situation at hand and how I could utilize it to expand my nursing skills. From this reflection process, I had many crucial nursing skills reinforced, including the importance of monitoring IV lines at least once every hour to ensure there are no issues (Jantzen, 2014, p. 978), in addition to keeping IV lines organized to prevent tangling and/or confusion. This reflection process also presented me with the idea that if my patients are alert and oriented times three, according to the Glasgow Coma Scale (Jensen, Stephen, Skillen, & Day, 2012, p.717), I could ask them to notify me or any other nurse if they believe there is an issue with any of their IV(s) so that the situation, whatever it
Note characteristics, odor and weigh peri pads to quantify blood loss. Administer oxygen and intravenous (IV) fluids as ordered. McKinney (2018) recommends administering oxygen by face mask at 8-10 L/min and administration of a bolus dose of IV fluids as ordered to increase blood flow to the fetus. Start a secondary IV line in case the patient needs a blood transfusion. Monitor urine output and insert an indwelling catheter as ordered to assure accurate measurement of urine output which is an indicator of renal function.
