Case study Essay
Length: – 1800 words
Sally with Talipes who has had TendoAchilles lengthening
Sally is a 4 month old baby girl with unilateral talipes equinovarus (TEV) and congenital hip dysplasia. Serial plasters in hospital began since day three of her birth and today she is admitted to the day surgery unit for left Tendo Achilles lengthening and plaster cast application. Following surgery Sally has returned to the ward with an intravenous cannula in her right hand and a plaster of paris cast encasing her left lower leg and foot. The focus of this essay is Sally’s two priority nursing problems, which are post surgery pain related to Tendo Achilles lengthening and the plaster cast application, and secondly peripheral tissue
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Opioid side effects to consider include respiratory depression, nausea and vomiting, and should be minimised by monitoring for symptoms such as RR, HR and appetite, to avoid compromising pain management and adverse effects such as constipation should be prevented or promptly treated (AAP & APS, 2001; ANZCA, 2010; Forster & Fraser, 2007; MIMS, 2012). For infants on continuous intravenous infusion of morphine, you should also consider availability of an opioid antagonist and equipment for artificial ventilation in case of overdose (Gahart, Nazareno, 2011; MIMS, 2012). The efficacy of Sally’s analgesia is evaluated by the nurse though criteria of examination techniques with normal findings at least 4hourly and/or before repeat medication (Wilson & Giddens, 2009). The nurse observes Sally’s posture and behaviour, facial expressions, sounds made, skin colour , skin temperature, measure blood pressure, pulse, respiratory rate and pupillary size (Wilson & Giddens, 2009). Analgesia frequency and strength is adjusted in accordance to normal findings (AAP & APS, 2001). The use of non-pharmacologicalmethods can help reduce opioid intake and potentially harmful physiological and psychologicalresponses to pain (DiGiulio, Jackson, Keogh, 2007; He, et al., 2010). Non-pharmacological methods for relieving children’s pain have been sustained by various evidence and testimony (DiGiulio, et al., 2007; He, et al., 2010; Polkki,
Incremental cash flows is the difference between the cash flows a company will have if it implements the new project versus the cash flows the company will have if they choose not to embark
The second choice for the alternative design for Dynacorp would be Functional / Product matrix of strategic design. Dynacorp manufactures a range of products in the field of global information systems and communications. Since it has the major functional structures defined such as engineering, manufacturing and marketing, it can be linked to the various products Dynacorp manufactures. This allows comparatively easier transformation from the existing structure.
1. Describe bone physiology and the bone remodeling cycle. Be sure to emphasize the two types of bone tissue and the roles of osteoblasts and osteoclasts.
As a member of management Clive Jenkins is responsible for boosting employee morale to ensure that company goals are met
2. What types of symptoms did Jennifer, Cassandra, and James have in common? Which organ or tissue seems to
The main purpose or mission of the Greenhill Community Center was to provide human service programs for learning, growth, and enrichment throughout life within an intergenerational setting. The mission seems to fill the need in the demographical setting of the location. The center is located in one of the poorest cities on the East Coast. In the textbook it states a mission as being “the reason an organization exists, and it must be the starting point for its planning.” (Worth, p.172) The mission of the center is very sound, but in the process of hiring a new director, I think the mission focus was lost. I saw a couple of incidences of “mission creep“ in the reading. (Worth, p.173) One being the focus the trustees put on not
Poor work life balance for gen. y – When gen. y can’t work due to their social life outside of work. The gen. y wanted more flexible working hours instead of wanting to only have to work full-time. Francoli gave them the solution to pick between two option which where 1) was to work longer hours four days a week and have the Friday off or 2) employees get to choose when they want to work put to only 8 hours a day.
Scenario: John is a 4 year-old boy who was admitted for chemotherapy following diagnosis of acute lymphoblastic leukemia (ALL). He had a white blood cell count of 250,000. Clinical presentation included loss of appetite, easily bruised, gum bleeding, and fatigue. Physical examination revealed marked splenomegaly, pale skin color, temperature of 102°F, and upper abdomen tenderness along with nonspecific arthralgia.
Scott Starson, a brilliant physicist has been in and out of mental institutions due to his bipolar disorder. He was lastly admitted again after he made death threats to his roommates and was found not criminally responsible for that offense. His physicians suggested different sorts of treatment for his illness. Scott Starson refused to give consent to the treatment for reason that he had a scientific research to finish and he didn’t want the medications to slow him down. His physicians not finding him competent enough to critically make that kind of decision, brought the case
Functional magnetic resonance imaging (fMRI) technology would be best reveal the location and extent of damage to Tim’s brain produced by his
Overview: Universal Luxury Group is an international group of companies principally engaged in the production and sale of luxury goods including Food and Beverages, Fashion and Leather Goods, Perfumes and Cosmetics, Watches and Jewelry, and other business. Among them, this case is handling Perfumes and Cosmetics business group that accounts for EUR 2,231M, 19% of sales revenue.
Mr. Hugh Tudor (55 yrs) is a well-known person in Milville, where he has been living for 30 years. He is involved in lot of social activities and has a reasonable pension and savings. He is becoming restless in his retirement and shows interest in investing in The Leeds Livery, local British pub in Milville, which could provide him with more challenges. While discussing this matter with his friend, he found out that the pub has great potential to perform well as it once exceeded the profit percentage of the industry. Mr. Tudor is in the process of exploring this opportunity but still has several questions rising in his mind.
The subjective human response to acute pain is a response that is most often self-reported and is dependently measured on a pain scale by health care providers. The phenomenon of pain is that it sometimes is difficult to manage without the perplexities of the typical opioid analgesic side effects. More than often, these accompanying side effects Hoffman et al. (2011) state the inclusion of sedation, constipation, nausea, and cognitive disorientation. In addition, repeated use of opioid analgesics gradually decline in effectiveness without dosage adjustments and can lead to a state of tolerance with ultimately a reliance of opioid dependency (Hoffman, et al. 2011). Non-opioid analgesics may compliment opioid analgesics, however, the
The World Health Organization suggests using a three step analgesic ladder that involves nonopioids, weak opioids, and strong opioids. These may be used along or in conjunction with an adjuvant medication to achieve a desired effect. Medicines are given around the clock to stay ahead of pain and to prevent breakthrough pain. A pain assessment must always be done, and the lowest dose is always tried first. Allowing clients to self-administer medications can help with self-esteem and boost morale. Non-pharmacologic methods of pain control may be useful along or in conjunction with medication therapy. Some popular methods include massage, guided imagery, distraction, self hypnosis and acupuncture. Educate the client and family about the resources available as far as CD’s, podcasts, exercises or
1.What do McRae and Costa mean by introversion and extraversion? Is Subira introverted or extraverted? Find examples in the case to support your answer.