Chapter 67 Nursing Management Shock Systemic Inflammatory R Essay

Evidence suggests that pressure ulcers greatly increase mortality rates in both hospitals and nursing homes (Thomas, 2001). Patients who develop a pressure ulcer within six weeks of admission to an acute-care facility are three times more likely to die than patients who do not develop pressure ulcers (Thomas, 2001). Moreover, patients who develop a pressure ulcer within three months of admission to a long-term care facility are associated with a 92% mortality rate compared with a 4% mortality rate for patients who do not develop them (Thomas, 2001). This evidence alone shows how significant this problem is to the overall health status of patients. In my personal nursing experience, I have heard many complaints voiced from patients and their family members concerning the development of new pressure ulcers. Patients and family members have expressed dissatisfaction because of the increased stress and prolonged hospital stay often associated with the treatment of pressure ulcers.

Hypovolemic shock is an urgent condition of rapid reduction of circulatory volume in the body, which can be created due to blood or plasma or body fluids loss (Kettley & Marsh, 2016, p. 31; Perner & Backer, 2014, p. 613). Blood loss can be induced by internal or external injuries, excessive perspiration or diuretics (Craft & et al, 2015, p. 852). Maureen Hardy’s hypovolemia has been precipitated by hematemesis.

Assessment of a patient is key in preventing a pressure ulcer from occurring as well as keeping a pressure ulcer from getting progressively worse. A history of the debilitated patient can often determine the cause and risks. Some risk factors include bed rest/immobility, incontinence, diabetes mellitus, inadequate nutrition/hydration, and altered mental status. (Ignatavicius, 2013) Nurses must meticulously assess a patient history to determine the severity of developing an ulcer. The Braden Scale is a widely used tool for predicting a patient’s risk for developing a pressure ulcer. It uses 6 categories that include sensory perception, moisture, activity, mobility, nutrition, and friction and shear and rates the risk of 1-4 for each category. A patient with a score of <11 is at severe risk, 12-14 puts a patient at moderate risk, and a score >14 is at low risk. (Ignatavicius, 2013) When physically assessing a patient, the nurse must inspect the entire

The patient is a 72-year-old female who arrived to the emergency department in cardiac arrest. Emergency medical services reports the patient was last seen eating breakfast at her nursing home and was found an hour later face down and unresponsive. After it was determined the patient was in asystole, an intravenous catheter was started and two rounds of Epinephrine was administered. Upon arrival to the emergency department the patient had pulseless electrical activity with sinus tachycardia on the monitor. Airway management was in process with a bag valve mask on 100% oxygen and chest compressions in progress. After intubation and stabilization the

2. Upon admission to the hospital, Allen’s breathing was rapid and shallow, can you explain why? Pg. 969

What should the nurse suspect when hourly assessment of urine output on a postcraniotomy patient exhibits a urine output from a catheter of 1,500 mL for 2 consecutive hours?

Most patients who end up in intensive care unit are most of the time so unstable that any little movement will put them at risk for further complications which can lead to death. However, finding a way to prevent pressure ulcer in the most critical ills patients in the healthcare system is very crucial.

Under the Core measures, Sepsis is one of the problem-focused trigger for systemic infection and if untreated which can lead to death. In United States, it is the 11th leading cause of death and consumes the large amount of costs about $20.3 billion in 2011 (Jones et al.,2016). According to Centers for Disease Control and Prevention (CDC), more than 1.5 million people diagnosed with sepsis, and at least 250,000 patients die from that yearly (CDC, 2017). The evidence-based research revealed with results of certain pre existing conditions, pathophysiological studies, preventive measures and sepsis bundle for treating and preventing sepsis to save the life of the patients.

Hadjiliadis, D. (2012, January 2). Septic Shock. New York Times. Retrieved November 23, 2013, from http://www.nytimes.com/health/guides/dise

Patient 2: For DVT, I would contact the physician for surgical or anticoagulant intervention, manage pain, and apply a warm compress to leg. For hypoxia, I would sit the patient up in the bed, maintain oxygen administration via nasal cannula or BiPAP, have patient cough and deep breath, give medications as order, and call the physician if the patient does not improve after

Safety. Mr. Stewart is 80 years old and was admitted due to traumatic injury from falling off a ladder causing fractured hip, ankles and ribs, and generalized bruising and skin tears. Throughout the shift, Mr. Stewart continually complains of pain in different areas. Mr. Stewart says he is in pain and his first set of vitals were blood pressure (BP) 200/110, heart rate (HR) 130, respiration rate (RR) 44 and shallow, SaO2 72% on room air. His second set of vitals after the second dose of Lasix was BP140/50, HR 84, RR 30, SatO2 97% on 35% O2 via mask, and Temp 38.0. He is currently on IV NS at 150cc/hr. We would also ensure that we check the safety equipment such as an oxygen mask and crash cart is nearby in case of emergency.

19) The nurse is running an IV on a patient and notices a large welt forming where the IV is

Pressure Ulcers are a common issue for hospitals and long-term nursing facilities nationwide. Annually an estimated cost of $143 million is spent on hospital acquired conditions which include pressure ulcers (Kandilov, Coomer, & Dalton, 2014). Hospital acquired pressures ulcers are among the top five conditions (Kandilov, Coomer, & Dalton, 2014). Ultimately the first line of defense is prevention and therefore this paper will focus on a clinical practice guideline for deterring the pressure points that progress tissue breakdown and patient harm.

110/62, a pulse oximetry reading (Pox) of 92%. At this time Mr. B should have been placed on

The INTACT trial showed a significant reduction in pressure ulcers (PU) incidence in the intervention group at the hospital (cluster) level, but this difference was not significant at the