Chapter 57 Nursing Management Acute Intracranial Problems

It can be very frustrating at times dealing with the family members of the older patient that I see in the emergency room. I have such limited time to take care of everyone’s needs before the next patient comes in by ambulance that I often forget how the family feels seeing their parent on an emergency room cart in pain and confused. My definition of the comfort I can provide in the emergency room are often very different from the family’s expectations. According to Gerontological Nursing (Tabloski, 2014), the attending nurse needs to understand the patient and family’s goals, wishes and values to attend to their

Patients and their families visit health facilities for countless reasons; from common colds to serious life threatening illnesses. Providers must be cautious in their approach to patients. You can never be sure what may be a delicate subject to a patient or their underlining emotions. Being

Family and friends are expected never to leave a patient alone and to constantly shower care and

Health and illness affect all families and are experienced by each individual uniquely. Each one has the right to culturally competent nursing care. All nurses should recognize cultural diversity and integrate this knowledge, as they provide appropriate care in a professional, respectful manner. Communication is essential. Asking appropriate questions about the patient and his family while obtaining an accurate history are essential when establishing a nurse/patient relationship. This knowledge enables nurses to be more effective in assessing and possibly saving a patient’s life.

Mr. Humphrey agrees since nurses are caregivers; this implies that they are the ones in charge of taking care of the patients through providing them with food, administering drugs to them, and even ensuring that the hygiene of the patients is maintained at all time. Apart from being caregivers, they also make decisions pertaining the patients. In doing so, the nurses will determine the measures that should be taken to improve the patients’ health in case it is on the decline. This is a vital role as it is upon this that the patients’ recovery is determined. Moreover; nurses are also in charge of making communications with the patient and even their family members (Institute of Medicine (US), 2011). This aspect greatly determines the direction of the treatment as the opinion of the family members is not only integral but also vital in some instances. The hospital can avoid being put into an awkward position if the nurses communicate effectively with their

O- Outline the options. Work within the scope of practice and establish a firm boundary or violate numerous laws and policies to help one patient.

Receiving information is the third family need. The critical care nurse should assess the knowledge the family has and needs. Let the family members know that it would be best to choose a designated family member to inform everyone of any changes and keep everyone in the family circle informed of the patient’s progress. Giving the patients family information will give them a sense of control and help reduce their anxiety.

of Mr. J’s physical, social, and psychological needs. The nurse should have also shared Mr. J’s plan of care to support staff that are providing care to Mr. J. Given his admission diagnosis of fall, history of mild dementia and the procedure he underwent, the plan of care should have included key interventions such as closer room assignment to the nurses’ station, frequent assistance to the bathroom, use of a bed alarm and frequently turning to prevent pressure ulcer formation.

Respect the physician's professional responsibility to discontinue some treatments when appropriate, with consideration for both patient and family preferences;

It is important to include the family of the patient in the care. The reason is that the patients are sometimes not in a position to comprehend and answer the necessary questions to the caregivers due to their medical condition. Also, the family members personally know the patient better than the caregivers.

D-The patient arrived on time for his appointment to meet with this writer. The patient immediately discussed some issues with his employment situation and housing. According to the patient, he is currently not living in his current apartment due to mice infestation. The patient was clearly upset that his landlord is not doing anything to address the matter. Furthermore, the patient is planning to call the Health Department and at this time, searching for another apartment. In the meantime, the patient is currently staying with his girlfriend, but then discussed some of the issues within the relationship as the patient been in the relationship with his girlfriend off and on. This writer validated the patient's feelings and also, support.

In the treatment of a patient, the medical team not only consists of doctors and nurses but also includes family members,

To keep good communication with the family as well as the patient and respect each role that the family members play. It is imperative to remember that families may deal with a crisis in many ways and as a nurse it important to respect that.

A 70 year old man had twice suffered bilateral cerebral haemorrhages. Patient has complained that he was very much depressed and has suicidal tendencies. He had no relatives, due to that his thinking was there was no hope in the life and "nothing to live for". His third haemorrhage left him paralyzed completely, and become semi-conscious, need to get all the basic care. Treated the patient more than three months, there was no recovery of positive signs. Medical staff has already agreed with the senior nurses on the ward that they will discontinue nourishing tube feeds and start a three hourly regime of restricted water. After three weeks the patient had a chest infection and was only producing very small quantities of offensive urine.

Once I have gathered the specifics related to the current illness, I would then move on to the patient’s medical, family