Case Study Infective Endocarditis

Once the patient is stabilized the nurse can begin to assess the cultural aspects of care for this patient. Noting that the patient is African American the percentage of that ethnicity having adequate health care and education is very low. The last admission may have very well left her without a leg and any means to help care for it. Setting her up for another admission due to infection. She does have a primary healthcare provider but as far as knowing the extent of her home care or education level the patient could have been set up for failure. During the admission, it is the nurses job to educate the patient when appropriate. Clearly, she needs teaching on the importance of knowing her medication, signs and symptoms of infection, and taking proper care of a surgical site. Although since we do not know exactly what her health insurance will and will not pay for it is important for the patient and family to be properly educate before

Emotional Support and encouraging involvement of family and friends- Listening to patient with undivided attention .Providing clear, timely and meaningful information regarding the illness. Providing enough information regarding the patient’s illness. Respecting and acknowledging the family and friends’ support in patient care and providing supportive environment.

The patient’s vital signs have stabilized, with HR in the 70s, BP is in the 120s/60s, regular RR and 37.6o Celsius temperature. Graft site wound bed is pink with tissue granulation noted. The learner is expected to prepare the patient for discharge. This SCE prepares the learner for the following items of the NCLEX-RN test format:

the mitral valve 16 months ago and a Streptococcus mutans infection of the aortic valve 1 month ago.

3) Is her history of rheumatic fever relevant to her current symptoms? Explain. Rheumatic fever caused by Group A Streptococcus bacteria may cause damage to heart tissues including valves. Overtime, congestive heart failure may have developed. However, the pulmonary semilunar valve seems to be the issue in this case study, whereas rheumatic fever normally affects left heart tissue.

The patient will require surgery to repair the hole in the intestines, and subsequently will have a drainage tube, NG tube, and feeding tube. All drains will need to monitored for placement/movement, and drainage. Input and output will be closely monitored and recorded. The patient will remain on NPO, or nothing by mouth, to rest the bowels along with frequent assessments to monitor for infection and bleeding. The nurse will need to monitor for bowel sounds, vital sign changes, temperature changes, pain, abdomen girth, and wound/incision inspections. The following labs will require monitoring: CBC, H&H, albumin, BUN & creatinine, glucose, and ABG’s and lactic acid if sepsis is suspected. Careful and frequent monitoring of labs will alert the nurse if the patient develops sepsis, or hypovolemia due to excessive bleeding (Belinhof, et al., 2012). In addition to vital signs and labs, the nurse will also include patient assessment into consideration before drawing conclusions by means of critical thinking. After the full assessment has been made, the nurse will report any findings to the health care provider that require further investigation or

acutely ill patients. The nurse should allow the family to observe care and explain the

Clinical coordinators would oversee the process to monitor for safety, quality, recruitment, and retention of patients in the program. The patients would receive detailed instructions and protocols on how to make calls daily, report vital signs, weight, and answer questions about their health and symptoms of heart failure. (Chaudrey et al., 2010). Results would then be transferred via a secure network connection. The providers could then evaluate the data to identify and manage early signs of decompensation, and to make recommendations on patient care. Providers could also provide patient education to help patients understand their discharge instructions and medications. (Inglis et al., 2011).

This paper explores a complex patient scenario encountered during the student 's senior semester clinical practicum. Nursing care was provided to a cardiac intensive care unit (ICU) patient over a period of 24 hours in two different shifts approximately one week apart, under the supervision of an experienced critical care registered nurse. The pathophysiology of the post-open heart surgery patient 's multiple disease processes was explored, as well as the interrelationships between the different conditions. The patient 's medical and surgical history was examined in relation to the presenting signs and symptoms, laboratory results, and diagnostic results. Psychosocial, spiritual, and cultural factors guided nursing interventions such as developing priority nursing diagnoses, safety and privacy, nursing assessments, patient teaching, and interdisciplinary referral suggestions. Nursing interventions and outcomes were evaluated for effectiveness. Health prevention and promotion were additionally explored related to this patient 's disease processes to help improve health outcomes.

Oral piercings have become more and more popular among the past couple of decades, especially with younger groups of people.1 They get these piercings because they think it will make them more popular in their social groups or because they think it looks good to get their tongue or lip pierced.2 Years ago, people got piercings because of their certain religious practices or different ethnic groups, but today oral piercings are becoming increasingly popular with the general population regardless of their cultural beliefs.3 The most common places to get piercings in the mouth are the tongue and the lips.4 Over the years, though, the tongue has become very popular.3 With piercings becoming more prevalent, research is finding that there and many complications and risk factors involved. One of the risk factors from getting an oral piercing is infective endocarditis. This is especially significant for someone who has heart disease because he is more prone to getting infections.5 Furthermore, Oral piercings are not to be considered a simple procedure that can be done by anyone, they should actually be considered a surgery that is to be done by professionals because of the complications that can arise from them.6 Some of the early complications from getting oral piercings include pain, swelling of the piercing site, bleeding, and infections.7 Following, late complications consist of localized periodontitis, irreversible gingival recession, fractured or chipped teeth, and difficulty

with advancing heart failure based in a North West hospital. In order to abide by the Nursing Midwifery Councils Code of Conduct (NMC), throughout this assignment the patient will be referred to as ‘Patient Y’ this is ensure that her true identity remains private. The assignment will begin by giving a brief overview of the patients past medical history, including biological and psychological factors that could have exacerbated the illness, it will then conclude by explaining the condition in further depth, incorporating all relevant details to the case.

Myocarditis is inflammation of the middle wall of the heart that is caused by infection. The causes of this infection is other infections such as upper respiratory infections, lime disease, cocaine use or other toxic chemical exposure such as spider bites, metal poison, or snake bites but all of which are uncommon except for upper respiratory infections. There may be no signs or symptoms or they may cause heart murmurs or abnormal heart rhythms or shortness of breath or swelling. Myocarditis can affect the muscles as well as the hearts electrical system or a clot could form causing heart attacks or strokes. This is a very dangerous infection. There are treatments for this infection such as beta blockers and diuretics for less severe cases or IV antibiotics or intra-aortic balloon pumps for the more severe cases. However if left untreated it can cause CHF and or

triggered a sepsis alert during the first 8 months of the program had a discharge diagnosis of

Monitoring of the vital signs should be closely monitored (pulse, blood pressure, respiration and pulse oximetry

We must approach the patient and their family with an attitude of caring, empathy, and respect. We can explain that we would be happy to learn of the patients’ needs and concerns, and of any accommodations we can make so they will feel comfortable