By 1350 she was complaining of back pain of 9/10 and she was given Morphine 2mg IVP and denied any pain 10 minutes later. Come 1530 the patient’s vitals were stable on room air, she ambulated to the bathroom independently and at 1535 a loud thud was heard in the bathroom. The patient was found lying on the floor with a laceration above her left eyebrow, not responsive to verbal commands and breathing at a rate of 4 per minute. We will discuss the immediate concerns and treatment for the patient and then we will go back and see what could have been done differently with the patient to prevent the situation that occurred. The nurse immediately assessed the ABC’s and activated the MET team.
NURSING DIAGNOSIS:Impaired physical mobility1 | RELATED TO: Loss of integrity of bone structures (S/P right knee surgery)Pain (reported 7/10. Acceptable =3)2 | AEB:Limited ability to perform gross motor skills (Pt unable to ambulate without assistance)Difficulty turning (Pt unable to turn side to side unassisted)3 | PLANNING (Expected Outcome):By end of shift, pt will be able to ambulate 100’ with P.T. twice (BID)By end of shift, pt will be able to turn in bed unassisted.4 | INTERVENTIONS5NI # 1Medicate with Vicodin 1-2 pills q4h throughout shift whenever pt reports pain level greater than 3. | Rationale:6Vicodin is an opioid analgesic that is effective in post-surgical patients by binding to opioid receptors to block pain transmission
At an exam when Kira was 9 months, her pediatrician advised to keep her away from sick people, and checking out new foods for her, allowing a few days in between each new food to test for allergies. At birth I decided to breast feed Kira, yet supplementing with formula to make things easy when I was either not around or needed a break from nursing her. I feel that tapering off breast-milk from Kira’s diet may have made her more susceptible to illnesses. When Kira was 3 months, she often cried after meals and frequently suffered from diarrhea. At that time I decided to try switching Kira’s formula to test for allergies.
The patient later develops jaundice while in our care. The patient was later diagnosed with renal disease and placed on dialysis. The patient reacted to acute pain and combativeness during cannulation (needlesticks) for hemodialysis. The patient is now stabilized, and family members were notified. GSUMC's nephrologist informed the family that the patient will require dialysis 3x a week during her lifespan.
Patient was status post right knee replacement two weeks ago. Intravenous fluid was administered in the emergency room for hypotension, and orthopedic surgeon consulted. On arrival to the unit, the patient’s blood pressure was 90/ 50, temperature 101.9-degree Fahrenheit. On assessment, patient‘s right leg was red, swollen and warm to touch, pain level was 8/10 pain scale on numeric pain scale. Two hours after admitting her to the unit, her B/P started dropping, temperature elevated.
The author assumes that this surgery will correct future complications that Ashley might possibly encounter. However, she did not point out the fact that proceeding with surgery on a child who is already disabled might trigger worse case scenarios since this procedure has never been tested. Gibbs describes how anyone who takes estrogen is at risk for a blood clot and quotes Ashley’s doctor, “’There were very few reports of thrombosis amount the teenage patients, he says, ‘So I suspect the risk is fairly low...’”(742). It is stated that he “suspects”, meaning he’s only “guessing” that the chances of something dangerous happening is unlikely to occur. Gibbs gives an example of the doctor comparing a child to a teenager concluding that if a teenager’s risk of thrombosis is low then a child risk will be even lower.
Trochanteric Bursitis: A Case Report Word Count: 3,713 Abstract: This case study describes a 20 year old female who had reported bilateral lateral hip pain for the last 7 years. A diagnosis of trochanteric bursitis was established by a GP and referred to physiotherapy. The patient underwent a full course of physiotherapy for strengthening and stretching exercises, lower limb and lumbar rehabilitation. Because minimal improvement was seen in the patient’s pain level following physiotherapy, a consultation was requested of a fellow staff member in the same physiotherapy department who also happened to be involved with injection therapy. Confirmation of re-calcitrant trochanteric bursitis led to a recommendation for a corticosteroid injection.
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.
Nutritional matinence; 4.) Oral contraceptives and smoking- risk of blood clots/stroke 5.) Infrequent physical examinations Nursing Diagnosis #1: Pain (acute) related to postprocedure swelling and nerve damage as evidenced by patient report of pain (Gulanick, Myers pg 124). Nursing Intervention 1 | Desired Outcome 1 | Desired Outcome 2 | Evaluation Method | Rationale | Nurse will monitor patients pain on a scale of 0-10 every shift (Nanda, 2012). | Patient will report satisfactory pain control at a level less than 3-4 on a 0-10 rating scale X 30 days.
2) Physical Therapy is an important part of your rehabilitation. You will have PT while in the hospital. Outpatient PT will be arranged when you return for your 2-week post-op appointment if it hasn’t already been set-up. Pain: 1) A prescription pain medication will be given to you before you leave the hospital. 2) Take 2 aspirin each day for 1 month (unless you are allergic to aspirin or have been directed by Another doctor not to take aspirin).