Cardiac surgery models were based on previous methods published” (Khuri et al., 1998) as well. Instituting a program based on pre-surgical risk factors they were able to determine those at risk for surgically related complications. Studies involving interventions with expected outcomes (O/E) and are considered particularly suitable for determining effectiveness of the subject studied. Computer based records were examined for workload data (volume) and for risk-adjusted data; the variables and outlier information that would eventually be used or set aside to ensure that consistent, error-free data was used for the most accurate results possible. “Logistic regression analysis was used to develop predictive models for surgical death and complications” (Khuri et al., 1998, p. 494).
In the clinical, adrenal teratoma is most occured in young women, the right area and 90% are benign. The patients have no symptoms in the early time. Most of them can be found in the hospital routine physical examination. With the increase of the tumor, the oppression of the surrounding organs or secondary infection can cause the symptom, such as low back pain, paroxysmal abdominal pain . In our case , the patient was diagnosed as hamartoma by radiologist at first.
The Bleeding Time (BT) was introduced as a tool for predicting the risk of bleeding in relation to surgery. Test the vascular integrity, qualitative and quantitative defects of platelets. Principle: The Ivy method is the traditional method for carrying out this test. In the Ivy method, a blood pressure cuff is placed on the upper arm and inflated to 40 mmHg. A disposable lancet is used to make two separate cuts into the forearm usually 5-10cm apart in quick succession.
According to Schull’s drug handbook (2006), Phytonadione acts on the liver to promote the production of active prothrombin, proconvertin, plasma thromboplastin component, and Stuart factor. In other words, it promotes blood clotting. The safe dose for neonate is 0.5 to 1 mg injected intramuscularly within one hour of birth. Adverse reactions include: hyperbilirubinemia, pain, swelling, tenderness at injection site, and anaphylactoid reactions. Because neonates in the first few hours of life usually don’t have adequate vitamin K in their blood stream, physician often prescribes Phytonadione to prevent hemorrhaging of the newborn.
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.
This treatment is administrated to a patient by putting a patient into an unconscious state then passing a current of 0.6 amps through the brain. It works instantly, restoring certain neurotransmitters such as nor epinephrine and serotonin. A further biological treatment is psychosurgery; this is broke sown into two surgical procedures: prefrontal lobotomy and sterotactic psychosurgery. A prefrontal lobotomy is often seen as a last resort because the method is very severe and it has a 6% fatality record. A prefrontal lobotomy is administrated by using a probe that enters the brain through the nose or the eye and it then picks and nerves to deconstruct them.
It affects patients’ physical well-being, emotional well-being, social well-being, spiritual well-being and survival. The treatment should be the most disease-specific and palliative therapies, taking into account cost, availability, side effects, and patient wishes (Kuebler, Heidrich and Esper, 2007). Although medications will help to varying degrees, relief of dyspnea requires a comprehensive approach to its management. Treatment of the underlying condition or disease while concurrently addressing the symptom would be the main goal to alleviate the dyspnea, unless the patient requests comfort measures only. For the palliative care patient, the goal is excellent symptom control with the least possible sedation, allowing continued patient/family interaction (LeGrand and Walsh, 2010).
This essay focuses on a clinical case scenario of Karen, initially admitted to hospital with complications of Rheumatoid Arthritis (RA). After Karen’s discharge under a specified medication regime, Karen then presented a second time to hospital with a fractured left neck of femur due to a fall. The pathophysiology and relative risk factors behind her comorbidity of RA are identified and the management strategies for RA are discussed. The diagnostic tests of RA are investigated and the relevance of their finding analysed. The information obtained in these diagnostic tests would indicate whether Karen is experiencing severe pain due to post surgery or RA.
Mack Ervin, Jr. Prof. Marcia McCormick Biopsychology Tues 7-10pm 11/30/11 Patient Assessment A 39 year old female patient presented in the doctor’s office with the following symptoms: Headaches, insomnia, rapid thoughts, dizziness, and a lack of motivation. The patient initially said her symptoms began approximately 2 months ago and have been fairly persistent. While she is in some discomfort, she does not appear to be in immediate danger: All of the patients’ vital signs were within normal range. In an attempt to make a preliminary diagnosis I began to ask questions about her condition. I wanted to address each of her symptoms and try to find causation.
Throughout this paper all patterns will be covered and assessed according to subjective and objective data. Assessment is ‘the collection of data about an individual’s health state’ (Jarvis 2004, p.7). Subjective data are ‘the client’s perception about their health problems, only the client can provide this information’ (Crisp & Taylor 2009, p.260). Objective data are ‘observations or measurements made by the data collector’ (Crisp & Taylor 2009, p.260). The activity-exercise pattern which is domain 4 will be covered in more depth, because Mrs Louisa has been diagnosed with spinal stenosis which affects this pattern significantly.