RTT1 Task 1 Western Governors University RTT1 Task 1 This is an examination of the nurse sensitive indicators in the case study concerning Mr. J, who is an elderly Jewish male patient with a fractured right hip and a history of dementia in a hospital setting. Nurse sensitive indicators presented in Mr. J’s case were: patient falls, restraint prevalence, complications of pressure ulcers, and patient satisfaction will be addressed in this task. Better care is provided by nurses when they are aware of nurse-sensitive indicators. A. Nursing Sensitive Indicators Nurse sensitive indicators included in this case are Mr. J’s use of restraints, complications of pressure ulcers, and patient satisfaction.
Nurses are relied upon to advocate for our patients dignity, privacy, confidentiality, improper and incompetent care. The case of Marianne is a good example of how the ANA code of nursing ethics could help a patient that can't make convey their needs the healthcare team. The stroke has left Marianne unresponsive and without an advanced directive the healthcare team has no way of knowing what her desires would be for the plan of care. Her husband and children are in disagreement with which direction to go in regards to her care. The ANA code of ethics has provisions in place to assist in a decision for this case.
Treatment plan “Approximately 28%–58% of individuals with heart failure (HF) suffer from cognitive impairment, commonly identified as difficulty with concentration and/or memory” (Bauer, Johnson, & Pozehl, 2011 p. 577). Mr. P needs a treatment plan that he will be able to adhere, considering his cognitive decline. His wife should be included in his treatment plan and will have to become a leader from now on. When Mr. P admitted to the emergency department, nurses provide basic care in order to sustain life. Nurses should be recording vital signs, order appropriate laboratory work ups, put Mr. P on oxygen via cannula, put him on I&O, administer prescribed medications, and strict daily weights.
How the ANA Code of Nursing Ethics would influence a final decision in each case study. With the patient with the hemorrhagic stroke, it is our responsibility to discuss with the patient’s family possible options in which they would feel comfortable taking. According to the Code of Nursing Ethics, “the nurse’s primary commitment is to the patient, whether an individual, family, group, or community” (ANA Code of Nursing Ethics). With the patient having no advanced directives, the decision is much harder to take. Ethics committees can be useful in this situation, because they can help explain the patient’s situation and provide possible answers to those hard questions.
Unit 13 1.1 The term Dementia is described by a number of symptoms such as memory lose, changes in mood, and unable to communicate normally. A mental decline in the ability to function in every day life. 1.2 Key functions of the brain affected by dementia are frontal lobe, temporal lobe, parietal lobe, occipital lobe, cerebrum and hippocampus. 1.3 Dementia can be mistaken for depression, delirium and age-related memory impairment because they are very similar in appearance. 2.1 The medical model sees the patient with dementia as a problem.
The ethical issue of the wrong food tray will be addressed by using the appropriate referrals and resources. Nursing-Sensitive Indicators A CNA is called into the patients’ room to assist the patient to the bathroom, when the patient’s daughter notices and points out a red, depressed area over the patient’s lower spine and the CNA tells the daughter that the red area should go away on its own. The nursing sensitive indicator of pressure ulcer should be used in this case. The CNA needs to be educated in identifying what the preventative steps for avoiding pressure ulcers are by using the Braden Scale which should of been implemented upon this patient being admitted (Fosco, 2012). When the scale is used it can trigger the appropriate interventions before a pressure ulcer forms or gets worse, for example the CNA can pass on to other care team members if this pressure ulcer was prior to admission or formed during the patients hospital stay (Fosco, 2012).
I feel that withholding information on a lucid patient fully in control of her mental faculties is tantamount to lying. I believe the patient has the right to know the conditions surrounding her health care treatment plan. Step 4 I verbalize the problem by saying, “Should I inform the patient of her terminal health care condition or should I follow the wishes of the patients’ daughter and withhold information on the seriousness of her condition?” Step 5 There are many courses of action possible, but I believe the best outcomes would like along these three possible scenarios. The first option would be to disclose all medically pertinent information to the patient so that she is fully informed. The second option would be to as for assistance from a social worker or a preacher or priest from the members church to talk with the daughter and mother.
The physician did perform an exploratory laparotomy on her for a small bowel obstruction after the patient came in complaining of severe abdominal pain. Second, the patient has to prove that the physician was derelict. This means the patient has to prove that the physician failed to comply with standards of a physician. The physician left a sponge in her abdominal area which they later say is not the cause of her death but it caused severe abdominal pain and her and her husband kept reporting the pain to the nurses and morphine was kept given. If the patient didn’t die from heart failure first then she would had complications persisting from the sponge left in her body.
In the scenario, Mr. J. is a 72 year old retired rabbi who has mild dementia and was admitted to the hospital for a fractured right hip. The scenario provides numerous issues that put the patient’s health at risk. They include the use of restraints, a hospital acquired pressure ulcer, and also the lack of cultural sensitivity, which lead to a unsatisfied patient and his family. As nurses, we are taught throughout our time in nursing school that we have a responsibility to protect our patients. It is important for nurses to understand nursing-sensitive indicators, and how they can be used to prevent injuries to patients.
For example, when a child is having to get a blood test done and is afraid and refusing to do, the nurse will look for a positive behaviour and then gives the patient immediate reinforcement by saying, “you are such a big boy” or “you did an excellent job”. Another time the behaviourist theory is used in health care is a classical conditioning it is done when the patient is recovering from alcoholism, they are given a drug mixed with alcohol which produces undesirable physiological effects such as nausea and vomiting. This helps the patient associate the alcohol with the horrible effects, making the needs and wants to avoid drinking alcohol, because the body has started to know the reactions while drinking the alcohol which is not necessarily true but because of the pain that the drug has caused changes their