A Complex Patient Scenario Encountered During The Student 's Senior Semester Clinical Practicum

HISTORY OF PRESENT ILLNESS: This 46-year-old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis, presents to the emergency room after having had three days of abdominal pain. It initially started three days ago and was a generalized vague abdominal complaint. Earlier this morning, the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o. earlier around

ABDOMEN: The lung basis appeared unremarkable. The liver, spleen, gallbladder, adrenals, kidneys and pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seen constant with acute appendicitis. Osseous structures of the abdomen appeared unremarkable. No free air was seen.

I began ICU nursing immediately upon graduating nursing school in a medical/surgical ICU. I cared for patients with a wide variety of illnesses and thus, acquired ICU nursing skills that would allow me to manage most types of ICU patients. We cared for patients with acute pancreatitis, diabetic ketoacidosis, gastrointestinal bleeds, liver failure, septic shocks, pulmonary hypertension, congestive heart failure, acute myocardial infarction, renal failure, and respiratory failure. The hospital for three years was in an underprivileged area, and the hospital itself lacked several resources I would later find at Emory. I provided compassionate nursing care by planning and implementing nurse plans of care with a focus on education, patient safety, and quality outcomes in cooperation with the ICU team.

Although the qualitative study states no procedures were utilized in safeguarding the study participants, the study was conducted through interviews done with twenty health care providers, which included physicians, nurses, quality improvement coordinators, infection control practitioners, respiratory therapists, and pharmacists in two surgical intensive care units (SICU). The study was subject to an external review through the Institutional

Medical Surgical Nursing clinical has allowed the author with the opportunity to take care of several patients suffering from a variety of diseases processes. This paper will discuss the pathophysiology of a chosen patient’s medical diagnosis and comorbidities, as well as the nursing diagnosis and interventions individualized for the patient. The chosen patient will be referred to as J.C. throughout this paper to ensure patient privacy.

Despite technological and medical advances today, chronic disease and resultant co-morbidities are prevalent in the Australian Healthcare System. As a result, patients, especially in the acute care setting, have more complex care needs. The management and care of patients with these complex care needs present a challenge for the contemporary nursing professional. Positive patient outcomes will be dependent on a number of factors, such as the assessment of the patient’s condition, the identification of potential risks for the patient, the planning of appropriate care and the management of the subsequent interventions that may be required.

Introduction. As the article continues with the introduction, the introduction states the problem, which is, that, currently there are no guidelines for the management of AWS in the ICU patients. For nurses to properly perform the CIWA assessment, patients must be conscience and able to answer questions regarding the severity of the illness, making it hard for nurses to either over or under sedate the patient causing further complications, building a persuasive argument for the new study. Towards the end of the introductory paragraph, the article states the hypothesis, by implementing this new protocol would result in shorter duration of AWS treatments and its associated complication. As the article

The general public understanding of hospitalization is that it is a simplistic process. However, not all patients who arrive at the emergency department are admitted. The patient's journey from admission to discharge is a multi-faceted pathway that involves professionals from various disciplines. This paper will analyze the hospitalization of a seventy-eight-year-old male patient, henceforth referred to as Rick, exploring the circumstances that led to his admission to hospital, the roles of nurses and interprofessional (IP) teams in maximizing the client's health, nursing considerations and discharge planning.

The articles demonstrate that more protocols should be in place to begin mobilization of the Intensive Care Unit patient. The current practices are based upon physician orders, early mobilization is often overlooked for a variety

The origin of critical care nursing stems from a time in healthcare when there was a drive to bring together the needs of ill patients and rapidly growing medical knowledge. During the 1950s and 60s, nurses began to adapt their practice to better care for the needs of a person who is physiologically unstable or at risk of dying. According to Fairman and Lynaugh (2000), this was the beginning of what would eventually become a field

Abdomen: Has normal bowel sounds, soft. Right upper quadrant costal tenderness with deep palpation. No hepatosplenomegaly. No rebound or guarding. No CVA tenderness.

A nursing diagnosis is obtained during the initial assessment and acts as an outline for the nurse to follow in terms of how to provide appropriate prioritized care. Prioritization of care is placed in order of patient’s immediate survival and demand for safety. For these reason, nursing diagnoses are organized in importance by looking at “airway, breathing, and circulation” (Herdman, 2016). Interventions are also dependent on a nursing diagnosis. The selection as to which intervention will be implemented is based upon the patient’s current health status. If the patient’s airway, breathing, or circulation is compromised, the nursing diagnosis related to that condition will be treated

The author was suitably qualified to undertake the study based on his qualification and experience in critical care. However, this is his first published work which makes him a novice researcher. Robson (2011) stated that it can be challenging and complicated to conduct a reliable

Vital signs were as follows: blood pressure 118/80 mm Hg; pulse 84 beats/minute; respirations 16/minute; oxygen saturation 99% on room air, temperature 97.1 F, body mass index 27.45 kg/m2; pain 3/10. The patient was in no acute distress. Lungs were clear to auscultation bilaterally with no use of accessory muscles. Cardiac exam revealed normal rate and rhythm, no murmur, gallops, rub or jugular venous distention. His abdomen was non-distended, non-tender, without masses,

The patient was a 62 year old man who was admitted with history of intermittent pain abdomen of 3 years duration. There was no history of fever, loss of appetite, loss of weight, diarrhoea or anti-tuberculosis treatment. Patient had no history of trauma or radiation therapy. Abdominal X-ray showed a heterogeneous spherical