According to Meleis (2007) knowing includes knowledge based on observation, research findings (evidenced based), clinical manifestations and scientific approach. As a stroke nurse empirical knowing it’s very important in taking care of stroke patients. I determine patient’s neurological status by performing neuro checks frequently every 1-2 hrs as the patient’s condition might deteriorate the first 24hrs and perform swallow test to determine if the patient can swallow medications. Patient’s plan of care is based on assessment findings(vital signs, Glasgow coma score).If a patient is confused and very weak fall precaution is observed by activating the bed alarms, request for a PT/OT consult, if the patient does not pass the swallow test, a speech therapist is consulted. Sometimes patient’s neurological deficits get resolved after a few hours or days and that calls for change of treatment plan.
Which additional clinical manifestation(s) should the nurse expect to find if Nancy's symptoms have been caused by a brain attack (stroke)? (Select all that apply.) A) A carotid bruit. Feedback: CORRECT The carotid artery (artery to the brain) is narrowed in clients with a brain attack (stroke). A bruit is an abnormal sound heard on auscultation resulting from interference with normal blood flow.
Circulation with hemorrhage, a nurse must assess the level of consciousness, such as the Glasgow coma score and AVPU which are “alert, voice, pain and unresponsive” to control hemorrhage, check the radial and carotid pulses, check for another external bleeding. 4. Disability asses’ neurological status, and Glasgow coma score. 5. Exposure or environment control the nurse should maintain a safe environment to the patient if the patient shows some symptoms or signs of weakness, pain, dizziness or confused and shaking.
Report changes to the provider. Hyperkalemia can result in EKG changes that include tall peaked T waves, prolonged PR interval, and widened QRS interval” (Ackley & Ladwig, 2011, pg. 343) The nurse monitoring an acute renal failure patient should implement safety precautions such as falls prevention protocol
Data source: Using PubMed and Cochran three articles were found, using the keywords therapeutic hypothermia, cardiac arrest, hypothermia post cardiac arrest and, neurologic function post cardiac arrest. A Guideline was also retrieved from the Agency of Healthcare Research and Quality. (AHRQ) Results: Arrich and colleagues (2012) performed research to determine the effectiveness of therapeutic hypothermia in patients after cardiac arrest and, concluded that the patients who received therapeutic hypothermia had better neurologic outcomes than those than didn’t. Bernard and colleagues (2009) completed research the, demographic characteristics of the patients were similar in the hypothermia and normothermia groups. Hypothermia was associated with a lower cardiac index, higher systemic vascular resistance, and hyperglycemia.
ORIGINAL RESEARCH ARTICLE Drugs Aging 2009; 26 (8): 687-701 1170-229X/09/0008-0687/$49.95/0 ª 2009 Adis Data Information BV. All rights reserved. Prescribing Optimization Method for Improving Prescribing in Elderly Patients Receiving Polypharmacy Results of Application to Case Histories by General Practitioners A. Clara Drenth-van Maanen,1 Rob J. van Marum,1 Wilma Knol,1 Carolien M.J. van der Linden2 and Paul A.F. Jansen1 1 Department of Geriatric Medicine, University Medical Centre, Utrecht, the Netherlands 2 Department of Geriatric Medicine, Catharina Hospital, Eindhoven, the Netherlands Abstract Background: Optimizing polypharmacy is often difficult, and critical appraisal of medication use often leads to one or more changes. We developed the Prescribing Optimization Method (POM) to assist physicians, especially general practitioners (GPs), in their attempts to optimize polypharmacy in elderly patients.
Abstract The impact of stress on a person’s life is well documented. The effect of stress on cortisol and catecholamine levels leading to atherosclerosis and resulting in coronary artery disease may leave the person with a poorer quality of life. Medical interventions for heart disease include medication to lower cholesterol and vasodilator to assist blood flow to the heart. Treatments for stress are antidepressants and therapeutic techniques. In this case study, the personality of a heart disease candidate is discussed and the nature of the illness and its effects on the person.
Annotated Bibliography Chen, L., Houghton, M., Seefeld, L., Malarick, C., & Mao, J. (2010). A survey of selected physician views on acupuncture in pain management. Pain Medicine, 11, 530-534. This article was a naturalistic inquiry conducted between 2007 and 2088 on acupuncture use as an alternative treatment for managing pain.
This assignment will analysis the pathophysiology of pain and the related care of severe pain in patients who may be attended by the emergency ambulance services by the use of ketamine as an analgesic agent. This assignment will also explore the pharmacokinetics and pharmacodynamics and the routes of administration and rates of absorption of ketamine. The legal issues associated with drug administration and the protocols utilised by paramedics to deliver drugs in the out of hospital setting will be discussed and how prescription drugs can have adverse effects on patients during exacerbation of illness or injury will also be analysed. One of the most vital points to consider in relation to the control of pain and the administration of analgesia in the pre hospital setting is that, in many cases, it is inadequate (Lord and Parsell: 2003 and Hennes, Kim and Pirrallo 2005). It could be said that any delay in handing a patient over to the Accident and Emergency Department, due to a particular busy period or during a major incident, thus delaying in hospital analgesia administration, amplifies the beneficial impact of adequate pre hospital administration of pain relief.
For example the nurse notices the patient has an increased respiratory rate, she is unaware of patient’s recent activity but she sees the head of the bed flat and immediately elevates the head of the bed. The nurse has identified a problem and developed a short term plan for immediate resolution but further planning will be needed. She will gather further information from her client such as present illnesses, history, and any underlying risk such as smoking. This leads us into our next phase of diagnosis. During the diagnosis phase the nurse will analyze the assessment data, draw conclusions and determine actual and potential health problems.