Deep Vein Thrombosis Case Study

The patient did not receive standard treatment to prevent the formation of a DVT. What are some possible reasons why this error occurred? The first reason was that the nurses and staff on the floor were so focused on his admitting problem being related to COPD, which caused his respiratory infection, which then caused his kidneys to not function properly. Since his kidneys were not up to par, the staff wanted to make sure that he was not going to go into kidney failure, so that was their number one priority at the time. Secondly, the admitting doctor did not order DVT (deep vein thrombosis) prophylaxis. Based on his thrombosis risk factor assessment, the patient would have scored as a high risk. He should have been placed on sequential compression devices (SCD), and either heparin or lovenox (University of Michigan Health System, n.d.). The most alarming reason was that the nurse did not

A) There are several issues in the case of Mr. J that need to be examined. Using nurse sensitive indicators “reflect patient outcomes that are determined to be nursingsensitive because they depend on the quality or quantity of nursing care” (American Sentinel University, 2011). Mr. J. was not receiving acceptable care, because his daughter noticed a red, depressed area over Mr. J’s lower spine, similar to a severe sunburn. This skin condition is the first stage of a developing pressure ulcer. a. Nurses should be aware that a patient with limited mobility is at risk for skin breakdown, and pressure ulcers.

The knowledge of nursing sensitive indicator can be helpful in providing the patient care which meets the quality and ethical standards. Nursing sensitive indicators rely on evidence to take patient care decisions (Patrician, 2010). According to Patrician (2010), Evidence Based Nursing is the use of personal expertise and research to take decisions on patient care. In case of Mr. J, there is a clear lack of evidence based nursing. Mr. J was kept in restraint without considering that Mr. J was not trying to get out of bed by himself. When the pressure ulcer was identified, the nurse

As Jane was presenting with a symptom of a life threatening event it was important that treatment was immediate. Priority was initially made from assessment of the airways, breathing and circulation, level of consciousness and pain. Jane’s respirations on admission were recorded at a rate of 28 breaths per minute, she looked cyanosed. Jane’s other clinical observations recorded a heart rate of 105 beats per minute (sinus tachycardia), blood pressure (BP) of 140/85 and oxygen saturation (SPO2) on room air 87%. It is important to establish a base line so that the nurse is altered to sudden deterioration in the patient’s clinical condition. Jane’s PEWS score (Physiological Early Warning Score) was 4 and indicated a need for urgent medical attention (BTS 2006). Breathing was the most obvious issue and was the immediate priority.

S first, because of the worsening back pain, which can be indicative of a potential rupture and therefore be life threatening. The RN would have the UAP take vitals and report within specific parameters to maintain a close watch over Mr. S. This is the only thing the UAP would be able to do within their scope of practice but she would be alleviating the workload. Next, the RN would assess Mr. R who is reporting severe pain due to an arterial ulcer. She would use the universal pain scale and would ask what his pain level is from a 0-10. Depending on his response, the RN would then proceed by administering pain medication depending on the rating of the pain and the physicians order. The RN would then ask the LPN/LVN to administer the pain meds but only if they are PO. If it were an IV pain medication, the RN would have to administer due to the scope of practice. In 2009, Chornick found that the scope of practice for each staff member needs to be clear and delegation needs to be administered to the competent individuals who are able to perform each task according to the current situation. After administering the pain medication, the RN would need to return to Mr. R within 30 minutes to reassess the pain level and make sure the pain had subside. After treating Mr. R, the RN would assist Ms. A by providing teaching of the Doppler study that would be performed and answer any questions she may have prior to the

DVT (deep vein thrombosis) is a blood clot that develops in the leg, thigh or pelvis. Although it is not common during pregnancy (only 1-2 pregnant women out of 1,000 experience it), pregnant women are 5 times more likely to have DVT than non-pregnant women.

This essay sets out to discuss the importance of comprehensive and accurate assessment on a registered nurses’ ability to make excellent clinical decisions. It will examine what factors can change a nurses’ capability to be aware of, and act on abnormal assessment findings. As well as assessment being part of the nursing process that is used in every day nursing, it is also a critical part of patient safety (Higgins, 2008). Assessment findings are used to determine what needs to be done for the patient next. Early warning scoring systems currently exist to aid in the early detection of patient deterioration (Goldhill, 2005). The rationale for the use of these systems is that early recognition of deterioration in the vital signs of a

A DVT is a thrombus or blood clot that most commonly occurs in deep veins in the leg or pelvis. DVTs usually start distally in the veins of

A focused assessment is an assessment that centers directly on the chief complaint that a patient presents with when they arrive to seek out care. In this case, our assessment is focused on a potential deep vein thrombosis (DVT). A DVT is a essentially a ball of blood cells that are clumped together impeding blood flow which can cause irritation to the vein and potentially more dangerous problems. If the thrombus moves, it can travel through the body and into the lungs and impeded breathing which is not good. Therefore, it is essential to catch DVT’s right away and treat them to prevent them from moving. The first thing that needs to be assessed when a patient presents with a suspected DVT is their level of consciousness and their vital signs including the heart rate, blood pressure, respirations, temperature and oxygen saturation. Next, assess the site of the expected DVT, and perform a neurovascular assessment which comparing to the same site on the opposite side of the patients body. Check for adequate circulation by assessing for pink color distal to the site. While performing this assessment, you want the area distal to the site to be pink to ensure there is adequate blood flow. If it is whitish in color, this is a sign of a DVT and needs to be documented. While assessing color, also assess the site directly for any color deviation from the clients natural skin color. If the

In the dynamic healthcare environment, healthcare leaders (those who motivate and mentor others to incentivize positive change) are needed to enhance a newfound level of VTE cognizance. Reducing the incidence of VTE will take a collaborative interprofessional effort, and this begins with the delivery of evidence-based education: the knowledge driving the impetus towards positive change. This educational exercise will modify an existing VTE prevention protocol in a Magnet hospital’s intensive care unit (ICU), and employ recommendations from the information-rich AHRQ VTE prevention guide to achieve quality improvement and reduce HA-VTE incidence. Furthermore, this change project will utilize the SWOT (internal strengths/weaknesses and external opportunities/threats) analysis decision-making tool to appropriately plan for successful VTE protocol modification (Yoder-Wise, 2015, pp. 108–109). Additionally, this assignment will concisely describe the newly implemented VTE protocol, progress towards illustration of the resources that are needed to devise and manage change, and elucidate the evaluation strategy (continual analysis/measurement of progression and implementation of necessary revisions) to preserve VTE prevention gains.

Internal method will be the interdisciplinary team such as hospitalist, therapists, dietician, pharmacist, case managers, discharge planners and house supervisors. These stakeholders performed a thorough discussions about patient’s admission, transfer, and discharges. Upon discussing with the patient’s overall health concerns, the evidence-based practices of bedside reporting can be part of the daily discussions because this is where the basis of patient’s health outcomes can be obtained. The goal of bedside reporting is to promote safety and highest quality of care. Therefore, the input and opinions of the whole team is very essential for the successful implementation of the bedside reporting. The bedside reporting will be more stronger tools

McHugh, M. D., Kutney-Lee, A., Cimiotti, J. P., Sloane, D. M., & Aiken, L. H. (2011). Nurses’

Deep vein thrombosis (DVT) is a disorder that occurs when a blood clot forms in a vein that is deep inside the body. It is mainly associated with veins in the legs, usually in the lower leg and thigh, but may occur in other parts of the body. About half of the people who have DVT show no symptoms, but people who sit for long periods, are over 60 and smoke are at higher risk, and should be aware of possible signs of a problem.

The third standard of practice is outcomes identification. During this phase, the registered nurse identifies expected outcomes for a plan individualized to the patient or the situation (“American Nurses Association,” 2010). During this step outcomes must be derived from the nursing diagnosis and must be measurable, realistic and attainable by the patient. The registered nurse involves the patient, family, heath care providers, and others in formulating expected outcomes when possible and appropriate. The registered nurse must also consider associated risks, benefits, costs, current scientific evidence, expected trajectory of the condition, and clinical expertise when formulating outcomes (“American Nurses Association,” 2010). Example of an

We present a case of a 31-year-old Caucasian woman with a massive recurrent venous thrombosis, including central venous thrombosis and vena cava thrombosis. She presented to our emergency department with persistent headache. Neurologic examination revealed bilateral papilledema. Brain computed tomographic venography confirmed venous thrombosis. Headaches were improved after treatment of heparin and warfarin. One month later the patient was readmitted with facial edema and venous engorgement with extensive collateral circulation. The Computed tomography angiography revealed signs of extensive cervical, thoracic and abdominal collateral circulation as well as superior vena cava thrombosis superior. A composed heterozygosity mutations were found