Mr. R is a 76yr old male who lives with his family, has complained of daily episodes of chest pain with palpitation for the last 2 months, has been non-compliant with medications for 2 months and has had a decreased oral intake. Mr. R also complained of increased shortness of breath and unable to mobilizes due to being “out of breath” and felt fatigued when walking a short distance, he also complain of burning whilst urination, becomes distressed and therefore suffers a panic attack which are relieved with reassurance. Mr. R has excessive sweating at times, at rest, and has also noted over the last 2 months he has overall swelling to his body and a persistent cough with increased palpitations at night and regular falls with “blackouts”
RTT1 Organizational Systems Task 2 Jenene McDowell Western Governors University RTT1 Organizational Systems Task 2 The purpose of this paper is to analyze the unfortunate sentinel event of Mr. B, a sixty-seven-year-old patient presenting with severe left leg pain at the emergency room. A root cause analysis is necessary to investigate the causative factors that led to the sentinel event. The errors or hazards in care in the Mr. B scenario will be identified. Change theory will be utilized to develop an appropriate improvement plan to decrease the likelihood of a reoccurrence of the outcome of the Mr. B scenario. A Failure Modes and Effects Analysis (FMEA) will be used to project the likelihood that the suggested improvement plan would not fail.
Meet the Client: Bert Graham Sixty-three-year-old Bert Graham visits the health care clinic complaining of increasing fatigue and difficulty breathing. Physical assessment findings include a rapid, irregular heart rate of 138 beats per minute, BP of 140/86, and a respiratory rate of 28. His breath sounds are clear with fine crackles in the bases bilaterally. He has positive jugular vein distention (JDV) bilaterally and 1+ pitting edema of his ankles bilaterally. His initial medical diagnosis is heart failure (HF).
4. A 68-year-old male presents to the office complaining of pronounced weakness on the right side of his body and slurred speech for the past 24 hours. Based on the examination, the physician orders an MRI to investigate a possible transient ischemic attack (TIA). The range of codes that would be used for this patient would be Codes 390-459 because the treating physician ordered and MRI to rule out a transient ischemic attack. These codes are for Diseases of the Circulatory System 5.
Jackie Bright Hesi Pt Review: metabolic acidosis. A 20-year-old man hospitalized with Crohn's disease You are a nurse in a large medical center, on a medical-surgical unit. Jackie Bright, 20 years old, has been a patient for the past two days. Jackie has Crohn's disease and for the past week has experienced nausea, anorexia, abdominal pain, and severe, bloody diarrhea. He was severely dehydrated, anemic, and malnourished on admission.
REFLECTION For the purpose of this assignment I will provide a brief definition of what reflection means according to Johns (2009). I will then demonstrate my understanding of two different models of reflection by describing, Gibbs (1988) reflective cycle and John’s (1994) model of structured refection. I will then offer a critical analysis of the processes of reflection and how they can contribute to personal and professional development. Finally I will apply Gibbs (1988) model of reflective practice when discussing a comment I made to a patient whom I shall refer to as David a seventy two year old gentleman during a multi-disciplinary team meeting known as ward round. The placement setting where David resides is a forensic low secure hospital houses men who are detained under the Mental Health Act (1983) http://www.dh.gov.uk/.
Biopsychosocial Impact In this reflective account I will demonstrate the knowledge and understanding I gained from working with a service user in the community mental health setting where I had been based. The service user in question had a diagnosed of depression which was due to a stressful period in his life which had resulted in changes he was experiencing difficulties For this purpose I have chosen Gibbs (1988) reflective cycle (www.ahot) In compliance with the Nursing and Midwifery Council (2008) ( www.NMC) and the General Social Care Council code of conduct relating to client confidentiality (www.GSCC) I have changed the service users name and for the purpose of this reflective account I will refer to him as Albert. I was allocated the case of a gentleman of 72 who had previously been diagnosed with depression by his GP who had prescribed him anti depressants. Depression can be described as a range of symptoms and behaviours (Freeman, Gilliam, Shearin, Plamping 1997 page 15) which can indicate a mild to severe form of the illness which is usually expressed as sadness or worry and can affect an individuals daily activities (Freeman, Gilliam, Shearin, Plamping 1997 page 14). The symptoms include low or depressed mood, for the same two week period (Freeman, Gilliam, Shearin, Plamping 1997 page 14) which is accompanied by at least five other symptoms ranging from loss of interest or pleasure in normal activities, inability to concentrate, disturbed sleep, poor appetite, self hate and suicidal tendencies (Freeman, Gilliam, Shearin, Plamping 1997 page 14).
RTT1 Task 1 Carmen Miranda-Maze Western Governors University RTT1 TASK 1 In this scenario several hospital employees provide care for a 72 year-old male retired rabbi patient. The patient was admitted with a broken hip, he is restrained and during his stay he was given the wrong meal tray. Nursing-sensitive indicators such as pressure ulcers and patient satisfaction will be addressed. These indicators can be addressed and measured by the hospital through collecting data pertaining to pressure ulcer prevention and Press Ganey scores for patient satisfaction. The ethical issue of the wrong food tray will be addressed by using the appropriate referrals and resources.
Chronic Illness Psychosocial Implications Using the Behavioral Nursing Assessment Tool as a guide, this paper begins with a personal interview with a patient who had a right Below the Knee Amputation (BKA) related to Peripheral Vascular Disease (PVD). Mr. Gerke is a 72-year-old retired investment banker who was admitted at Manor Care Hospital on October 4, 2008 for post-op BKA rehabilitation. This assessment tool assists in developing psychosocial assessment criteria for individuals and families adapting to physical illness. Assessment Health Perception-Health Management Mr. Gerke has a history of hypertension, Diabetes and Peripheral Vascular Disease (PVD). He previously had undergone a right 5th toe amputation at Hemet Valley Hospital.
Past Medical History This was an observed consultation which took place in surgery with a GP. A 44yr old male who had previously been treated for a muscular problem was found to have a blood pressure of 165 systolic. BP remained elevated at subsequent visits despite monitoring at home. NMC (2008) recognise that patients have a right to have their confidentiality respected and for this purpose the patient shall be referred to as John Brown. John is a current smoker of 20-30 cigarettes per day and has an excessive alcohol intake; his weight is also at the upper end of a healthy range.