SNEAD STATE NURSING DEPARTMENT Client-Care Critical Thinking Activity 1. Client information: Initials: ES Age: 72 Reason for admission (patient’s complaint and medical diagnosis): Worsening of shortness of breath Date of admission: 02/21/2015 Diet: Regular Diet Activity: Ambulate Ad Lib On a separate sheet of paper, answer the following: 2. Client history: Important information from history: COPD, asthma, congestive heart failure From the history, the MOST IMPORTANT data impacting this hospitalization is: COPD 3. Diagnostic testing/ lab tests / procedures ordered related to diagnosis: Name of test: CBC Why was this test ordered? to determine blood loss, infection Name of test : CHEM 14 Why was this test
A patient is in the oliguric phase of acute kidney failure. During this phase the nurse expects | | | Your Answer: | urine output of more than 800 mL/24 hr. | | Rationale: Incorrect: Please review Module 7, Lesson 4, Topic 2 | | elevated serum potassium level. | | Rationale:Correct | | | Question 2 - INCORRECT | The type of renal replacement therapy that uses a filter and dialysate is called | | | Your Answer: | Peritoneal Dialysis | | Rationale: Incorrect: Review Module 7, Lesson 5, Topic 2 | | Hemodialysis | | Rationale:Correct | | | Question 3 - INCORRECT | The degree of removal of waste products from peritoneal dialysis is dependent upon | | | Your Answer: | Gastrointenstinal motility | | Rationale: Incorrect: Review Module 7, Lesson 5, Topic 3 | | Length of dwell time | | Rationale:Correct | | | Question 4 - Correct | _________________________ plays a role in regulating renal blood flow by responding to a drop in systemic blood pressure by releasing epinephrine. | | | Your Answer: | Sympathetic nervous system stimulation | | Rationale: Correct | | | Question 5 - INCORRECT | Tubular secretion of excess substances from the blood into the tubules is: | | | Your Answer: | Is accomplished only by diffusion | | Rationale: Incorrect.
If a blood clot in a narrowed artery blocks the flow of blood to the part of the heart muscle, a heart attack occurs. The section of heart muscle that does not receive the blood begins to die. This condition is called myocardial infarction, or M.I. As a result of M.I., heart action can be seriously impaired. A heart attack may be a sudden episode.
Print. This article talks about the variability in the sedation-analgesia and neuromuscular blockade protocols in therapeutic hypothermia in comatose survivors of cardiac arrest. The patient may have renal or hepatic involvement and the medications that can be used are susceptible to complications with the use of these drugs. Metabolism and elimination of these drugs are delayed for an unpredictable amount of time. Hypothermia produces delay in metabolism
Her blood results will show elevated urea and creatinin while urine output will reduce to under 20mls/per hour. (WebMD. 2005-2013) 2.What other symptoms and signs might occur? Other symptoms to look out for are confusion, fluid retention, fatigue, drowsiness, and an ammonia smell to the breath are a few other signs and symptoms that may occur with acute renal failure although some signs may be confused with post-operative complaints (The Mayo Clinic Staff, 2013). 3.What is causing Ms. Jones’s kidney disease?
The following procedures will be performed: Cold-activated PET/CT scan; body composition DXA scan; blood tests, questionnaires and abdominal fat biopsy. During hormone therapy, the participant will return to the clinical once after 3 months, and again after 6 months, to draw blood for laboratory tests. After 12 months of hormone therapy, the participant will return to teh clinic to repeat the following procedures: Cold-activated PET/CT scan; body composition DXA scan; blood tests; questionnaires and abdominal fat biopsy. Eligibility Genders Eligible for Study: Male Accepts Healthy Volunteers: No Sampling Method: Non-Probability Sample Study Population Men initiating androgen deprivation therapy with a GnRH agoinist or antagonist Criteria Inclusion Criteria: Adenocarcinoma of the
Medication Safety Analysis Medication safety indicates that an individual should be responsible for one’s own action, making sure prescription accuracy, inhibiting adverse effect, putting a stop to tragic error, and encouraging monitor medication incident (Pharmacy theory course package, 2014, p.87). In March 2004, an 83 year old woman names Carol Smith died suddenly due to pharmacy technicians in the center pharmacy mix up potassium chloride instead of sodium chloride for a batch of dialysis solution (Cummings et al., 2005. pg. 73). This medical incident belongs to the wrong drug category, two look-alike drug bottles mixed up which cause by several reasons and it lead tragic death (Pharmacy theory activity booklet, 2014, p.57). In the cardiovascular intensive care unit at Foothills Medical Centre, Carol was going through renal replacement therapy with dialysate solution (Pharmacy theory activity booklet, 2014, p.57).
CRITICAL REFLECTION ON FACTORS INFLUENCING A CLINCAL DECISION. The purpose of this assignment is to critically reflect on factors influencing a clinical decision based on one of the experiences I have witnessed during my clinical placement. The clinical decision will be focusing on the care of a client and involves a nursing input. The episode of care I will be examining what happened in a recovery theatre following orthopaedic surgery for the removal of screws to the left ankle. The clinical decision which I witnessed involves bringing pain under control by administration of 1mg of midazolam intravenously to a 12year old patient who said she was in crucial pain after administration of 10mg Morphine.
The doctor and surgeon had already been in the room and had ordered pain medication for the patient; Morphine and Valium with Phenergan. My preceptor and I pulled the medication from the Pixus and checked the order over again. I took a set of vitals as a baseline for pre-narcotic protocol and asked the patient about her allergies. Everything looked great with the patient so we pushed the medications slowly and ensured the side rails were up and the patient was comfortable. My preceptor left the room for a minute to speak with the doctor, and it was then that things turned ugly on us!
Follow up with Echocardiogram to evaluate ejection fraction. Metoprolol dose decreased as per physician’s order, heart rate now in 70’s. Lasix dose maintained, BP 156/78, Patient stated that he did not really have a clear understanding of what his medications are supposed to do. Teaching plan for medications initiated. Referred to CHF clinic for outpatient follow up.