A minor patient was admitted to the hospital for fracture left elbow and left hand. Mother gave the consent for a surgery
A minor patient was admitted to the hospital for fracture left elbow and left hand. Mother gave the consent for a surgery. The was put on a heart monitor and pulse oximeter and she was put on morphine, through a pump. Because the client's pain improved and, the physicians order the nurse to turn down the pump. However, the nurse accidentally turned the pump up to high.
What action should the nurse take in this situation? How should the facility respond to this medication error?
Hello this is a question regarding medication error. I would appreciate a proper response from a clinical nurse who worked in the hospital and knows wat to do if this happens.
Suggest three dietary changes that may help George lose weight without compromising the nutrient density of his diet.
Suggest three dietary changes that may help George lose weight without compromising the nutrient density of his diet. Be sure to explain how your recommendations may not only help George lose weight, but also the health benefits these changes convey. Support your answer with data, facts, key terminology, specific examples and other information drawn from the textbook and at least one other supplemental source."
To assist George in losing weight while maintaining the nutrient density of his diet, consider the following three dietary changes:To assist George in losing weight while maintaining the nutrient density of his diet, consider the following three dietary changes:
1. Increase Fiber Intake
Recommendation:
Teach him to take high fiber diet since it is good for his health by taking vegetable, fruits whole grains and beans. Processed and non processed foods that contain soluble and insoluble fiber should be eaten e. g Oatmeal, beans, lentils and vegetables such as broccoli and carrots.
Benefits:
Satiety: Fiber makes one to have a feeling of fullness hence leads to reduced intake of calories. This has got some merits since it takes a shorter time to digest and has got the capacity of absorbing water, thereby making the stomach to remain full for a longer period (Slavin, 2013).
Digestive Health: Even for constipation which is a major digestive problem, fiber rich foods are essential in enhancing bowel movements (Anderson et al. , 2009).
Glycemic Control: Portion of the soluble fiber can assist in avoiding fluctuations in blood sugar levels which will go a long way in preventing obesity and ware Type II diabetes (Keller et al. , 2015).
Data and Facts:
Researchers of a paper that appeared in Obesity showed that fibre consumptions was directly proportional to a decrease in BMI and fat mass control in a specified period (McKeown et al. , 2014).
The intake of dietary fibre has been estimated to be between 25 and 30 grams for adults while the actual intake is around 15 grams a day (U. S Dietary Guidelines 2020).
2. Reduce Refined Carbohydrates
Recommendation:
Recommend to George that he should reduce intake of foods that are made from white flour which include breads, pastries, sweets, and soften drinks. He ought to consume whole grains and include brown rice, quinoa, and whole-grain breads for instance in his diet.
Benefits:
Weight Loss: Cutting out refined carbs is also linked with cutting down on calorific intake and thus better weight control. Processed foods also includes and evolved carbohydrates that contain high Glycemic indexes which aspiring blood sugar and causes increased hunger (Ludwig et al. , 2010).
Nutrient Density: More nutrients are found in whole grain products than in refined carb because they possess vitamins, minerals and fiber (Slavin, 2013).
Metabolic Health: Cut down on refined carbohydrates can also enhance metabolic risk factors, decrease possibility of insulin resistance and metabolic syndrome (Patterson et al. , 2018).
Data and Facts:
Micha et al. , (2017) in a study published in the American Journal of Clinical Nutrition noted that reduced intake of refined carbohydrates had a of resulting in improved weight reduction and better lipid profile as compared to diets with high amounts of refined carbohydrates.
According to the contemporary advice issued by the American Heart Association, the consumption of refined sugars and processed grains should be restricted for consumers with heart problems (AHA, 2020).
3. Incorporate Lean Proteins
Recommendation:
Sources of lean proteins include; Lean meat which should be limited to once a week especially in the form of Chicken breast, turkey, Tofu, Fish and legumes. High fat meats and processed proteins such as bacon or sausage should be made minimum on the list of foods to be consumed.
Benefits:
Muscle Maintenance: Essential for the muscle preservation and stated to raise base metabolic rate for beneficial effect in weight loss regime (Westerterp-Plantenga et al. , 2009).
Satiety: Protein makes one to feel full and this will assist in controlling on the total amount of food to be consumed. It has a higher thermic effect than carbohydrates or fats with this implying that more energy is expended in the digestion and metabolism of proteins (Westerterp-Plantenga et al. , 2009).
Metabolic Health: Consuming proteins can help in avoiding the loss of muscles during weight loss, which are useful in later maintaining weights and metabolism (Schoenfeld & Aragon, 2018).
Data and Facts:
Studied done show that by enhancing protein intake a person can potentially improve their weight loss and body composition (Paddon-Jones et al. , 2008).
The Institute of Medicine followed the formula that 10-35% of calories per daily protein intake is heath to human body and also for managing weights (IOM, 2005).
References:
Anderson JW, Baird P, Davis RH Jr, Ferreri S, Knudtson M, Schaefer EJ and Kolberg LW. Some of the health benefits related to the consumption of dietary fiber are; Nutrition Reviews, 67(4), 188-205.
American Heart Association (AHA). (2020). General Guidelines and Restrictions in the Management of Cardiovascular Disease.
Institute of Medicine (IOM). (2005). Dietary reference intake (DRI) for energy, carbohydrate, fibre, fats, fatty acids, cholesterol, protein and amino acids.
How to use self-organization effectively: Existing knowledge applied to the Keller-Refresh project with study focus on the methodical organization of self-organization by Ute Keller und Dr. Jochen E B Reusch. Dietary Fibre and Glycaemic Control. J Nutr 2005 Aug;135(8):1712-8.
Ludwig and Willett; 2010; Is there something wrong with the ‘Western diet’? Can pre-diabetes be prevented through consumption of certain types of food: a review on recommended diets for prevention of type 2 diabetes. JAMA, 304(6), 727-728.
McKeown, N. M. , et al. , (2014) A review of the relationship between fiber and cardiovascular disease. Obesity, 22(2), 383-388.
Micha, R. , Peñalvo, J. L. , Cudhea F. & Imamura F. ( 2017). Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes: Meta-analysis of Systematic reviews. JAMA, 317(9), 912-924.
Patterson, R. E , Newman, V. , Flatt, S. , Vitolins, M. , & Coble, M. E. (2018). Food-based whole grain intake is inversely associated with risk of cardiovascular disease. AM. J. CLIN. NUTR. ., 107(1), 56-67.
Paddon-Jones, D. & Leidy, H. J. (2008). Dietary protein and muscle mass: The role of sufficient protein in the diet. Journal of the American College of Nutrition, 27. 5 (2008): 600-608.
Schoenfeld, B. J. & Aragon, A. A. , Prologue, and Acknowledgments, both in Schoenfeld (2018). How many grams of protein can the body utilise in one sitting to make muscle? Journal of the International Society of Sports Nutrition 15(1) .
Slavin, J. L. (2013). A brief look at fiber and body weight regulation. Nutrition, 29(4), 437-444.
Effect of increased oxygen availability on patterns of bacteriochlorophyll and photosystems of bacteriochlorophyll containing bacteria: Specificities of photoreactions in gas environment. The use of protein in the success of weight loss and management. A apparent source of information is the American Journal of Clinical Nutrition ISSN number 0021-8568 Volume 90 Number 3 September 2009 pages 594-601.
Oxygenation
Mai Nguyen has been complaining of fatigue and a persistent cough for approximately 2 weeks. Nam scheduled an appointment for her at the clinic where you are a nurse. Mrs. Nguyen appears disheveled. Her clothes are mismatched and rumpled, and her hair is tousled. Normally she is dressed neatly and wearing makeup. She has a hard time signing in at the desk and tells the receptionist she has a 1pm appointment, but it is now 9am. Mrs. Nguyen's vital signs are: BP 142/90; HR 94; Resp 24; temp 99.6�F. She is very confused and her weight has dropped 7 pounds since her visit last month. Her mucous membranes are dry, and she is dyspneic with any activity. She is diagnosed with pneumonia. Because of her rapid decline, Mrs. Nguyen is admitted to the hospital to receive intravenous antibiotics. At the hospital, her pulse oximetry reading is 90% and she is unable to cough up secretion. After 4 days in the hospital she is discharged home. She asks the nurse, ""What can I do to make sure I never get that sick again? ""How would you answer this question?
Fluid, Electrolytes, & Acid-Base Balance
Nam has been prescribed Lisinopril, hydrochlorothiazide and metformin. Today at the clinic he had blood drawn for analysis. The following are the results.
Sodium 136
Potassium 3.0
Chloride 96
Bicarbonate 24
BUN 18
Creatinine 0.8
Lippincott advisor Lab values
Sodium: 135-145
Potassium: 3.5-5.0
Calcium:8.5-10.5
Chloride: 96-108
BUN: 7-18
Creatinine: 0.6-1.3
Bicarbonate:23-29
Compare the lab work with the norms listed in the lab & diagnostic reference on Lippincott Advisor. Determine which labs are out of the normal ranges and give an interpretation of the abnormal results.
What additional assessment data would be useful to gather at this time?"
Oxygenation
Response to Mrs. Nguyen's Question:Answer to the Question of Mrs. Nguyen
To help prevent future episodes of severe illness like pneumonia, consider advising Mrs. Nguyen on the following:The following is information that may be useful in order to prevent future episodes of severe illnesses such as pneumonia:
Vaccinations:
Pneumococcal Vaccine: Against pneumococcal pneumonia which might be important for the elderly and clients with chronic illness.
Influenza Vaccine: Reduces the rate of flu which is one of the main causes of pneumonia, more so among the at-risk population.
Healthy Lifestyle:
Balanced Diet: Feed well so that your body could be strong enough and free from different sicknesses. Amongst the best things that has to be taken when in a need of boosting Immune system includes; fruits, green Veggies, whole grain foods , proteins.
Regular Exercise: Exercise in as much as she maybe capable of depending on the condition that she is suffering from. Much as exercise is famous for all the health complications that are associated with it, it has been ascertained that it is favorable, especially to the lungs.
Smoking Cessation:
Avoid Smoking: If Mrs. Nguyen is a smoker. the following are true; there is a reduction in respiratory tract infections and improvement of the symptoms associated with chronic lung diseases and she will improve if she stops smoking.
Hygiene Practices:
Hand Hygiene: The findings of the present study have clearly indicate that washing of hand does have a significant part to play in preventing; various types of infection.
Avoiding Illness Exposure: Stay away from people who are sick and use your hands constantly to wash them most especially during winters when flu prevails.
Regular Health Check-ups:
Routine Medical Visits: Visits to the HER physician in order to discuss ones health status and the handling of the diseases that are an issue to the client.
Home Environment:
Maintain a Clean Home: Measures against dust and the other agents brings about the health of the respiratory systems.
The regulation of body weight: electricity and electrolytes; acid base balance
Lab Work Interpretation:
Potassium:
Lab Value: 3. 0 mEq/L
Normal Range: 3. 5-5. 0 mEq/L
Interpretation: Here the record shows that potassium level is low this is referred to as – hypokalemia. Diuretic such as hydrochlorothiazide has a tendency to cause hypokalemia due to increase potassium excretion. Hypokalemia; symptoms/manifestations include; muscle weakness, fatigue/ weakness, muscle cramps and arrhythmias.
Sodium:
Lab Value: 136 mEq/L
Normal Range: 135-145 mEq/L
Interpretation: Sodium is normal The patient’s sodium levels are normal hence he or she is within the normal internal environment or milieu.
Chloride:
Lab Value: 96 mEq/L
Normal Range: 96-108 mEq/L
Interpretation: The chloride is a little low at 98 and this is not an abnormally low chloride value, however it is considered low in the normal frame work.
Bicarbonate:
Lab Value: 24 mEq/L
Normal Range: 23-29 mEq/L
Interpretation: That of the Bicarbonate is normal.
BUN:
Lab Value: 18 mg/dL
Normal Range: 7-18 mg/dL
Interpretation: As it has been pointed out earlier to almost normal it has now reached the upper limit with the value of 24mg/dl. Elevated levels of BUN may be due to the particular hydration state of a man and work of the kidneys.
Creatinine:
Lab Value: 0. 8 mg/dL
Normal Range: 0. 6-1. 3 mg/dL
Interpretation: Creatinine is also normal and this implies that the Kidneys are eliminating Creative as it should.
Additional Assessment Data:
Electrolyte Levels:
Monitor Potassium: As a result it becomes appropriate to ask for signs and perhaps alter the patients drugs or diet.
Hydration Status:
Check for Dehydration Signs: For them, screen for other manifestations of either dehydration or fluid on blood since they affect BUN level.
Cardiovascular and Neuromuscular Symptoms:
Monitor for Symptoms: One should conduct a search for any sign that can be attributed to low potassium such as; fatigue, muscle twitching or a rapid heartbeat.
Medication Review:
Assess Current Medications: Assess the usage of such drugs particularly the hydrochlorothiazide on the balance of the electrolytes.
Dietary Intake:
Evaluate Potassium Intake: The need arises as well to discuss in detail the diet and assess how much potassium a person consumes.
With specific reference to the above aspects, you will have a clearer way of approaching the medical conditions of Mrs. Nguyen’s and Nam and the things that could be done in the future and the things that could be monitored.
Topic: Multiple Sclerosis
Answer the following question: 1. Define the conditions 2.Describes the sign and symptoms, how physical, emotional, social, spiritual, cognitive aspects of the person may be affected. 3. Prognosis- worst case scenario and best- case scenario( with effective treatments if any). 4. Describes how this illness impacts the family and family relationships."
Multiple Sclerosis (MS) Overview
1. Definition:
Multiple Sclerosis (MS) is a recurrent autoimmune disease because the proper functioning of the body’s immune defense against the CNS is disrupted in such that it attacks the myelin sheath —the protective covering of the nerve fibers. This damage affects the relay of signals in the nervous system between the central nervous system and the entire body hence all the physical and learning complications.
2. Signs and Symptoms:
Physical Symptoms:
Fatigue: Frequent fatigue that is not relieved by sleep, Snoring and pauses in breathing during the night.
Muscle Weakness: Most often develops in limbs creating issues with motility.
Numbness and Tingling: Again presented in the extremity or face.
Coordination and Balance Issues: Abnormal gait, balance disorders and incoordination.
Vision Problems: Fuzzy or hazy vision; seeing two of everything ; or loss of vision in one part of the field of vision.
Spasticity: Muscle rigidity is another high-frequency complication of the use of neuroleptic agents which may present itself as muscle stiffness or spasms.
Emotional Symptoms:
Depression: Low morale with frustration resulting from the course of the condition that is considered to be chronic.
Anxiety: Symptom management stress and other stresses arising from contingencies about the nature and development of the disease.
Social Aspects:
Isolation: Reduced mobility and fatigue which makes the person socially inactive.
Social Support Challenges: Problems in interpersonal relationships, or inability to engage in the social activities.
Spiritual Aspects:
Existential Concerns: Philosophical questions of existence and how to come to terms with the loss of previous functioning.
Spiritual Well-being: Some people can be comforted by your beliefs or by the fact that they too can be commonly prayerful while the disease may hamper their spiritual beliefs.
Cognitive Aspects:
Memory and Concentration Issues: Cognitive deficits including those that contribute to short-term memory, attention and impaired problem solving.
Executive Function Challenges: Problems of planning, the organization of work, and decision-making.
3. Prognosis:
Worst-Case Scenario:
Severe Disability: Slow progressive degeneration of patients’ mobility that might culminate in the need for a wheelchair or the inability to move at all.
Significant Cognitive Decline: It may also entail moderate to serious loss of cognitive abilities relative to activities of daily living.
Increased Risk of Complications: Such as infection, pressure ulcers, and secondary conditions such as osteoporosis.
Best-Case Scenario:
Relapsing-Remitting MS (RRMS): A large number of the patients have episodes of relapses which are partially or fully reversible thus enabling them to lead almost normal lives.
Effective Treatments: Disease-modifying therapies (DMTs) help to minimize the flare-ups and lessen the attacks and in some cases, they help to halt progression of the disease. New therapies and other medicine and ways of managing the condition might increase the prognosis in the long run.
4. Impact on Family and Family Relationships:Impact on Family and Family Relationships:
Emotional Impact:
Stress and Anxiety: They found that the families of patients with cancer came under stress as a result of giving care and as a result of the erratic manner in which the diseases might progress.
Emotional Burden: When one is faced with MS diseases, they can feel emotionally drained and become physically exhausted as well.
Financial Impact:
Economic Strain: They include the cost of the medical treatment, which may put a financial pressure on either the patient or the carer, if they reduce working hours in order to carter for the patient and also home modifications or extra care.
Caregiving Role:
Increased Responsibilities: They said that family members may have to assume functions of carers such as helping in feeding, bathing, giving out medicines and taking them for treatment.
Respite Needs: It also gives caregivers needed services to enable them to balance their own health needs.
Social Impact:
Changes in Family Dynamics: It is a fact that new role changes and the assumed responsibilities can cause changes in the families and human relations.
Social Isolation: Basically, families face social issues because of the restraint of the patient and lack of time among the caregivers.
Communication and Support:
Need for Open Communication: In addition, explaining problems within the family means that every member can look for a solution to the issue together with voicing support for the other members.
Seeking Support: For families, they may need support groups, counseling, and other community services to deal with the psychological and financial aspects of having MS.
An insight of each of these facets in the Multiple Sclerosis would facilitate the understanding of the holistic nursing care needs of the patients and their families.
What could be 1 nursing diagnosis, 1 outcome/smart goal
What could be 1 nursing diagnosis, 1 outcome/smart goal, 5 interventions, 5 rationales, 5 evaluations for a patient who is a 66-year-old who is diagnosed with Edema/Anasarca? The patient is at risk of ineffective airway clearance RIT neurological dysfunction evidenced by the patient's CVA dysphagia present. History of present illness: The patient was brought to the hospital for generalized edema. Past medical and surgical history: Hypothyroidism, rheumatoid arthritis."
For a 66-year-old patient with edema/anasarca and a risk of ineffective airway clearance due to neurological dysfunction, here’s a detailed nursing care plan:For a 66-years old patient with edema/anasarca as well as the risk of ineffective airway clearance: neurological dysfunction here is the detailed nursing care plan.
Nursing Diagnosis:
function as referring to the capability to clean the respiratory tract in the case of edema/anasarca and neurological deficit in view of CVA and dysphagia relevant to IAC.
SMART Goal:
At the end of shift the patient’s respiratory rate will be within the normal range of 12-20 breaths per minute; findings will be normal there will be no crackles or wheezing and breath sounds will be clear and enhanced.
Interventions:
Monitor Respiratory Status:
Rationale: Examination signs of the patient in relation to respiratory rate, oxygen saturation and noises heard over the lungs are made in an attempt to identify the later signs of poor airway clearance.
Evaluation: Include an evaluation of the patient’s respiratory rate and O2 saturation level assessment as to if it is normal range or not and his/her lung sounds that may be more or less audible compared to previous assessment.
Elevate Head of Bed:
Rationale: Lifting the upper end also helps to reduce oedema in the chest area and aids to fully extend the lungs so that proper coughing is achieved.
Evaluation: Therefore, notice whether the patient complains of shortness of breath and compare the results to the extent of respiratory movements.
Administer Diuretics as Prescribed:
Rationale: Diuretics are useful in increasing the urine output and decreasing the edema as well as over all airway clearance.
Evaluation: Examine the patient’s weights, intake output and presence or absence of peripheral oedema if diuretics are to be used.
Implement Swallowing Precautions:
Rationale: Because dysphagia the texture of food and liquids need to be changed in a way that the patient will not aspirations, and the airway must also be protected.
Evaluation: Determine the patient’s ability to handle and swallow food and liquids without chocking or aspiration reviews the texture and change to foods and liquids if difficult.
Encourage and Assist with Deep Breathing and Coughing Exercises:Promote and Supporting Techniques of Deep Breathing and Coughing for Client:
Rationale: Techniques such as, breathing exercises and coughing exercises help in the process aeration of secretions, exercise of lung capacity and removal of any blockage.
Evaluation: Ask the patient about how independent, cooperative and performant the patient is with the exercises as well as get the fact about the respiratory sounds and secretion clearance.
Rationales:
Monitoring Respiratory Status: It has the advantage of helping to determine presence of the acute respiratory distress at a time when it can be managed.
Elevating Head of Bed: It offloads a load that is put on the lungs when one is making efforts to breathe better air.
Administering Diuretics: Prevents pressure on the respiratory system by preventing oedema and fights the development of some of the fluids which lead to oedema.
Implementing Swallowing Precautions: Prevents aspiration, and other similar respiratory problems.
Encouraging Breathing Exercises: It assists in experctoration and also improves on the capabilities of the lungs.
Evaluations:
Respiratory Rate and Oxygen Saturation: Ensure that these are within acceptable level of parameters which will imply proper clearance of the airways.
Lung Sounds: Look particularly for the absence of lung sounds and to hear for increased and clear lung sounds instead of abnormal ones.
Fluid Status: Oversee a little amount of oedema and satisfactory amount of diuresis.
Swallowing Safety: Assess and document safety of swallowing and alter the interventions if and as required.
Effectiveness of Breathing Exercises: Monitoring of variation in degree of disability evidenced by patient’s capability to perform exercise and other respiratory tests.
This presents the current care plan on the patient and its particular emphasis on the problem of impaired airway clearance consequent upon edema and neurological compromise and identifies ways in which the patient might be helped.
Explain how case notes can ensure agreed actions are implemented.
Case Notes are important because they help in ascertaining that all agreed cares in the treatment of the patient are carried as planned. Here's how they contribute to this process:Here's how they contribute to this process:
Documenting Agreed Actions: Case notes operate as an expanded record of the management of patient care conferences or other forms of consultation. They record the mutual decisions, the plan of actions to be taken, and the treatment process that has been worked out so that there are well-defined, documented accounts of what is expected to be done.
Providing a Reference for All Team Members: Electronic case notes can be viewed by all members in the healthcare team who have come across the patient in his/her practice. This makes it possible for everyone to be tuned to the next step to be taken, who should do what, and when. By so doing it minimizes on chances of misunderstanding as well as in the provision of care.
Tracking Progress: Updates in case notes must also be done in order to remain updated on the progress of the patient and the effect of implementing decided upon actions. It gives a method to know whether or not the actions are being conducted in the ways envisioned and how efficient they are. Such continuous recordaid in the detection of any divergence from the plan or schedule and makes it easier to correct them.
Ensuring Accountability: Meaning that case notes can record who is supposed to do what. This is advantageous since it assists in asking accountability from the team members as well as in delineating responsibilities. This is especially so where there are problems or where there has been a delay; case notes will show who did what and when.
Facilitating Communication: Thorough documentation in case notes also helps in easy flow of information among the care givers at a given facility especially when there is change of shift or care givers. They give the health care practitioner and the patient a written and detailed record of the various aspects of the patient including his health status, the history and the actions that are planned for the patient thus enhancing on the care plan.
Supporting Legal and Ethical Standards: Adequate and true case notes are useful in the sense that if there are issues that may arise in the future as to whether the client received adequate care, then the notes will speak for the client. They keep records of every activity in compliance with the legal and ethic practices to ensure that the process of caring for the patients has been well recorded.
Enabling Review and Reflection: Case notes should be done in order to have time to review the patient’s care plan or the action that was done. They can be employed to ponder over contending of what made sense and what has not to help in fine tune of another care plan and action to take.
To sum up, case notes are very useful to ensure that agreed useful actions in the management of patient are instituted. They are used as signposts at ensuring that coaching actions which are done are properly documented, passed over to the next one and followed up in a way which enhances the quality and continuity of care offered.
1) Describe the neurologic deficits that may result from CVA
1) Describe the neurologic deficits that may result from CVA
2) Explain the tests and procedures used to diagnose CVA and nursing responsibilities for patients undergoing those tests and procedures."
One, neurologic deficits due to CVA
A stroke or also known as Cerebrovascular Accident (CVA) can have many different neurologic deficits due to the location of the affected part of the brain. Here are common deficits associated with CVA:Here are common deficits associated with CVA:
Motor Impairments:
Hemiparesis or Hemiplegia: Temporary or prolonged paralysis of one side of the body; temporary or complete loss of control of the muscles on one side of the body.
Difficulty with Coordination and Balance: In doing this, problems like those related to impaired hand skills for instance the ability to hold an object or even walking.
Sensory Deficits:
Loss of Sensation: Tingling or a feeling that a part of the body is ‘sleeping’.
Visual Disturbances: New, neglected acute eye disease or chronic disease in which the condition has worsened, for example, partial or complete loss of vision in one eye, or in half the visual field (hemianopia).
Speech and Language Problems:
Aphasia: Aphasia, this is when one has problems with words, either saying the wrong thing, or not being able to understand what is being said to him or her.
Dysarthria: Slurring of speech because the muscles responsible for speaking are weak.
Cognitive and Emotional Changes:
Confusion and Memory Problems: Memory loss, confusion, and reduction in the mental ability to learn new ideas or process them well.
Emotional Instability: Alterations in affective reactions, which may include elevated levels of anxiety, depression or, conversely, are related to labile affect.
Swallowing Difficulties:
Dysphagia: They include problems with swallowing and are inclined to aspiration that in turn heightens the risk of pneumonia.
Neglect Syndrome:
Unawareness of One Side of the Body: Occasionally patients may pay no attention to one side of the body or have no perception of the opposite side of the body (unilateral neglect).
2) Diagnostic Techniques, Examinations used for CVA and Role of a Nurse in Their Administration
Tests and Procedures:
CT Scan (Computed Tomography):
Purpose: For example to decide whether there is bleeding (hemorrhagic stroke) or to detect other pathologies as a tumor or edema.
Nursing Responsibilities: Make sure the patient is also steady during the process, there is check-up for any signs of allergy if contrast is used during the process, and the patient should be counseled to reduce anxiety.
MRI (Magnetic Resonance Imaging):
Purpose: To visualise small structures and areas of ischemia or other pathology that cannot be picked up on a CT scan.
Nursing Responsibilities: Check whether the patient had a metal implant, then make sure the patient is well positioned and then explain to them in detail the procedure.
Carotid Ultrasound:
Purpose: To determine whether there was a significant obstruction in the carotid arteries responsible for stroke.
Nursing Responsibilities: Rarely can any preparation be required and you can just tell the patient that you are going to do a procedure then help him or her get into the right posture.
Cerebral Angiography:
Purpose: To map blood vessels in the head and to reveal presence of pathologies such as aneurisms or AV-fistulas.
Nursing Responsibilities: Explain the procedure to the patient, assess for contrast sensitivity and watch for any complications during the procedure and afterwards look for hemorrhage and infection at the site of catheter entry.
Lumbar Puncture (Spinal Tap):
Purpose: To perform a lumbar puncture, that is, the doctor takes a sample of the cerebrospinal fluid in order to check for signs of bleeding or infection.
Nursing Responsibilities: Help with the placement of the patient, observe the pt for post ME procedure headaches/back pain and administer post ME procedure care by keeping the patient flat on their back to possibly avoid headaches.
Blood Tests:
Purpose: To ascertain other ill conditions that may be causing the formation of clots such as infection, clotting disorders among others.
Nursing Responsibilities: Draw blood samples, label properly and observe for any mismatches as well as adverse reactions respectively.
General Nursing Responsibilities Across Procedures:General Nursing Responsibilities Across Procedures:
Preparation and Education: Discuss the expected procedure with the patient and all his or her concerns about the procedure.
Monitoring: Supervise circulatory, respiratory, and other indices as well as patient’s state prior to the treatment, during treatment, and after the treatment.
Comfort and Safety: Check the patient needs, talk to them about their feelings, and help with their positioning.
Documentation: Capture the procedure done and the reaction of the patients as well as any side effects or issues noticed.
Knowledge of these tests and the roles that nurses perform in relation to the tests contributes to patient care when caring for a patient that has been evaluated and managed after a stroke.
Briefly discuss some of the percussion notes in the thorax, include its description and cause/s.
11. Resonant
12. Flat
13. Dull
14. Hyperresonant
15. Tympanic
MATCHING TYPE.
Image transcription text
ANSWER DESCRIPTION TYPE OF BREATH SOUND 16. Musical, prolonged
A. Crackles {or rales) 17. Discontinuous B. Wheezes and rhonchi 18. Soft,
high pitched, very brief C. Fine crackles 19. Continuous D. Cour... Show more
Image transcription text
(Dalubhasaan ng Narsing) 30. Vesicular sounds E. May be caused by
inflammation of the respiratory mucosa or tension in the air passages from a
tumor or enlarged peribronchial lymph nodes Wheezes 31. Bron... Show more"
Having focused on individual freedoms andeach person’s choice of an occupation and workplace, Tom’s workconveyed an unexpected theme, percussion notes in the thorax.
Resonant
Description: A natural, bright and slightly bass tone.
Cause: Usually sounded through healthy parenchyma where air is known to exist. It points to the fact that the lung parenchyma is clear of disease and there is no less or more than the proper amount of air therein.
Flat
Description: Its tone can best be described as high pitched, short and absolutely dull.
Cause: Usually heard over parts of the chest wall that contains more solid tissue or fluids such as over the pleural effusion or a huge tumor. Thus, it silently pleuralizes that, in the present disease, there can be less air in the underlying tissue, which may hint at consolidation or a solid mass.
Dull
Description: A dulled sound, somewhat ‘ttemplar-like’.
Cause: It is audible over regions of higher population, say a lung consolidation, eg pneumonia or fluid filled regions such as pleural effusion. It represents dilution in air content and increase in solid and or liquid phases of the substance in question.
Hyperresonant
Description: A deeper and more resonant sound than that of a bass drum.
Cause: Is generally associated with the rise in the air content in the thoracic cavity caused by diseases and conditions such as pneumothorax or emphysema. That is considered as a sign of too much air in the lungs or the space between the lungs and their covering.
Tympanic
Description: It gives off a high pitch, hollow, empty sound, a bit close to a drum.
Cause: Normally detected over zones that contain too much air, for example a massive pneumothorax or in the stomach as it is not normally encountered in thorax. It may also lie marked over regions of large, pathological gas bubbles.
Matching Type: Breath Sounds
Musical, prolonged
Answer: B. Crackles and rales
Description: Wheezes are musical, vocal sounds that are continuous, high pitched that are most commonly heard during expiration due to constriction of the air passages. Rhonchi are longer and more humming in character and may be auscultated throughout the respiratory cycle; these may signify obstructions or secretions.
Discontinuous
Answer: A. Crackles or rales
Description: Wheezes are souond that is continuous and high pitched that is heard during spontaneous or forced expiration and is related to disease of airways, such as in asthma or bronchitis while crackles are inspiratory sounds that are brief and discontinuous that are usually heard in fluid or consolidation of the small airways or alveolar such as in heart failure or pneumonia.
Soft, high-pitched, very brief
Answer: C. Fine crackles
Description: Wheeze is a continuous musical sound that is produced during the expiratory phase and is fine if it is high pitched and is heard during the inspection of the lungs, it is characteristic of fluid in the alveoli seen in pulmonary fibrosis.
Continuous
Answer: B WHEEZES AND RHONCHI
Description: We have musical or prolonged sounds which are usually wheezes and low pitch sounds denoting secretions or obstruction which are known as rhonchi.
Vesicular sounds
Answer: E. Resonance may be due to inflammation of the respiratory mucosa, or to tension in the air passages due to tumor or to the presence of large peribronchial nodes.
Description: Vesicular sounds are still vesicular which are deep, soft and low pitched best heard in the peripheral zones of lungs. It is related to normal lung air movement and it is best heard during inspiration.
Discuss barriers caused by an organizational culture that can be encountered by nursing leaders that can make them feel powerless.
Organizational cultural factors that might hamper the nursing leaders include the following:
Resistance to Change
Description: Consequently, organizational culture that is bureaucratic and slow to change pose challenges to nursing leaders who require to bring changes or enhance on some aspects. This resistance might ensue from past practices, standard procedures, or bureaucratic procedure, or simply from not knowing better.
Impact on Nursing Leaders: Managers and nurses may feel helpless when implementing EBP or the new protocol in practice, and none or little support is given. This may result to frustration of the leader and feeling of hopelessness in the process of implementing the changes since the ideas of the leader might not be welcomed in the organization.
Hierarchical Structure
Description: In organizations where there is higher level of structural formalization, there is tendency for decision making to also be highly centralized. This can hinder the independence as well as the decision making abilities of nursing leaders may be compelled to consult superior officers even for minor alterations.
Impact on Nursing Leaders: This hierarchical barrier of communication can keep the nursing leaders from addressing some emergent concerns or making decisions that have impacts on the patients. This requirement of multiple authorities means that change can be slowed down by the necessary approvals and weakens the punctual responses of the leader.
Another effect of having subpar Leadership and Management is that there is minimal support for Professional Development.
Description: Congruencies in organizational culture that fail to embrace or foster continued professional development of the leaders can be damaging to the advancement and productivity of the nursing leaders. The lack of training or mentoring or any continuing education that the formal education system offers can limit the knowledge and practice the leaders have of current theories and practices.
Impact on Nursing Leaders: Lack of support for professional development in nursing might create a situation where nursing leaders lack necessary skills and manage to face employ situations or even to effectively lead. Failure in the development of these areas can lower the confidence and the perception of inadequacy to combat the challenges.
Inadequate Communication Channels
Description: Some organizations have failed communication structures and this becomes a hindrance to nursing leaders since it hinders the processing of information. When the communication is centralized and not done with full disclosure, the nursing leaders may not get some important updates, or feedback or resources which are available to other members.
Impact on Nursing Leaders: Lack of communication breaks down the link between the nursing leaders and the organization causing the leaders to lack a proper understanding of the goals and decisions made by the firm. This can result in passive experiences of the lack of ability to support their staff or their patients, because they do not have adequate information.
englisms and reward systemsunsupported
Description: When the nursing leaders are not appreciated and promoted within the organizational culture of an institution, their morale and power can be reduced. When proper achievements and efforts are not appreciated it causes a worthlessness and uselessness sensation on the side of the leader.
Impact on Nursing Leaders: This leads to lowered morale and general implications of being underrated or out of recognition, especially to the nursing leaders. This can undermine their self-confidence and decrease their motivation on how to steer the organization, while at the same time increasing feelings of powerless.
Measures to Mitigate These Barriers
Fostering a Culture of Change: Underline the best and successful changes and have the human resource fully participate in the change strategies.
Promoting Shared Governance: Promote the ideas of the shared governance system that provides more autonomy and decision-making responsibility for the nurse leaders.
Investing in Professional Development: Provide for continuing education and training for the nursing leaders so as to be able to improve on their competency levels.
Improving Communication: Whenever it may be appropriate, resolve communication structures to finality and guarantee that nursing leaders obtain the requisite information and be in a perfect position to offer feedback on the extremely.
Recognizing and Rewarding Contributions: It is important to promote such things as award and recognition in order to motivate the leaders and other members of the nursing team.
By minimizing these barriers, it is possible to support the nursing leaders and make them more productive in the organizations and enhance the outcomes of the patients that they handle and also the performance of the organizations as a whole.
Concepts of grief and dying are different between cultures/religions.
Identify one culture and answer the following questions.
1. What region of the world is this culture/religion predominantly practiced?
2. What are the origins of this culture/religion?
3. What are three things you find most interesting about the culture/religion's death and dying practice?
4. Compare and Contrast your own beliefs on death and dying to that of the culture/religion you chose to learn about.
5. How does what you learned about another culture/religion influence your nursing practice going forward?"
It’s time to take a look into one more culture – the Hindu – to find out what they think of the death and dying process. Here's a detailed look into the questions:
1. Which part of the globe is this culture/religion most common?
Hinduism is mainly followed in India and Nepal but is also followed in some extent in other countries due to migration of people from India, such as in United States of America, Canada, United Kingdom, etc.
2. Where did this culture/religion come from?
Hinduism has been the tradition of India as far as 1500 BCE. The root of modern Hinduism was established as a Vedic faith by the Indo-Aryans, and the Hinduism developed in phases in the course of different historical and cultural era such as the Upanishadic phase as well as the emergence of various schools of Hinduism.
3. I like to ask three things that interest a person regarding the culture/religion chosen and their death and dying practice.
Reincarnation and Karma: Like many Eastern religions, Hindus also hold the doctrine of rebirth; the soul is reborn in a ‘new’ body. The quality of the new life depends on karma that is done in the previous life. This tends to influence their understanding of death not as finality but as a change of phase.
Rituals and Ceremonies: Concerning the Hinduism death rites plays major roles. Burial of the dead is not common and the cadaver is usually burnt on a pile of wood so that the soul can be liberated. The last rites are conducted by eldest son or any other family member and it is a way of leading a soul to the other world in a safe manner.
Mourning Period: This mourning period ranges from 10 to 13 days and one can include the following activities; certain foods are shunned, the bereaved cannot attend any eventing, and a few rituals are performed to help the departed soul.
4. Do you agree with the culture/religion that you have studied regarding the ideas on death and dying and/or how does your perspective coincide with them?
Personal Beliefs (Hypothetical Example): If you were brought up on more or less secular Western style of thinking you might tend to see death as cessation of life than as transitory process and thus might prefer memorialism over rebirth symbolism. You may also not think of bereavement as something you have to do mechanically or in accordance with traditional rites.
Comparison:
Similarities: Contrarily, both views acknowledge the roles of mourn and grief as well as the requirement to pay respect to the deceased.
Differences: Concerning Hinduism, reincarnation and karma beliefs are inconsideration of the fact that secular perspectives do not have considerations of afterlife or reincarnation. Thus, it seems that the Hindu approach to death and dying is conceptually more developed and concrete than the secular one, which may be tending more toward the idiosyncratic.
5. In what ways do you think the knowledge about another culture/ religion to be helpful to you while practicing nursing in the future?
Understanding Hindu death and dying practices will influence your nursing practice in several ways:Understanding Hindu death and dying practices will influence your nursing practice in several ways:
Cultural Sensitivity: You will be better prepared to respond to cultural needs of Hindu patients and families and their customs.
Patient and Family Support: Failing to respect what is sacred and meaningful such as reincarnation and certain rituals may lead to a lack of adequate support through comforting words and perhaps actions such as obliging to the rituals or allowing family involvement in the healthcare of the patient.
Education and Communication: Understanding these cultural practices can be instrumental in explaining to the patients and or their families the identified care plans and any issues that a given culture or religion may present.
Applying an understanding of culture into carrying out nursing practices is very paramount since it will allow the provision of appropriate and culturally sensitive care to patients and their families.
