Evaluation Of A Patient With Mental Status

My mentor also informed me that due to having dementia Mrs. Lewis did not understand why she had a tube into her stomach and that she had tried to remove it herself in the past which had caused some trauma to the abdomen (this resulted in the patient being very anxious whenever her PEG tube was touched, as she anticipated pain) and that sometimes the patient did not want her PEG tube touched and could be combative occasionally, using her left arm to hit out at staff. At this point I felt as though administering medication to Mrs. Lewis was beyond my capabilities as a student because of the mental health issues the patient had, I had no experience or knowledge at this point in my training in working with

This episode of care occurred in a community setting. Sara has a diagnosis of Alzheimer's disease. She live alone, has no children and is a diabetic. Sara does not speak English and her first language is Polish. Sara support worker developed a close relationship with Sara but said recently her dementia as gotten wrong and she sometimes does not remember who she is. Sara has cellulitis on her legs and was refusing to let the support worker change her dressing. She kept saying it was ok and she didn't want it to be changed. The student nurse and the district nurse tried reassuring Sara and explaining why it was importance to treat her leg but she just became more agitated and aggressive. The district nurse and support worker knew it was important

During my first day of clinical, I encountered an issue that I believe is very significant. As a student nurse, our duty for this day was to follow our health care aide around the ward and assist in completing resident care. The resident required assistance in many of her daily tasks. The health care aide asked if I would perform one of those and do perineal care for her. I turned down her offer because I did not feel comfortable with my skill level. The resident had a bowel movement during the night. There was a significant odour in the room that overwhelmed me. I really wanted to leave the room because it was so unpleasant, but I stayed in the room so that the resident would not be embarrassed. This feeling of embarrassment, I assume,

When I arrive to the facility this morning I was informed that one of the patients had passed away during the night, which was quite sad. Today I was in the acute ward all day and was able to watch the RN perform an ECG on a man that was bought in via ambulance who was complaining of chest pain. I watched as she placed the ECG leads on different positions of the chest. The RN showed me what a normal heart rate should look like. I also went around the ward taking OBS and notice that one of the patient's O2 levels were very low at 73%, the RN then gave the patient some ventolin through a mask to increase oxygen levels and they rose to 95%. The RN also showed me the medication charts and how they are to be read. I went around with her watching

During my clinical competency placement, I was working on a surgical ward when a registered nurse on duty asked me to assist Mr. A with his shower. This incident happened on the fifth day of my clinical practice. He was a dementia patient and had undergone right knee total joint replacement. She also informed me that the patient did not like too many people in his room because of his dementia. When I went into his room, his wife was there with him. I talked to the patient about having a shower and getting dressed to look smart and he agreed to have a shower. The patient got out of the bed and walked to the bathroom and sat on the shower chair to have his shower. Then I asked his wife if I needs to stay with him to assist with shower, she said she can help him as she was taking care for him at home since he has been diagnosed with dementia. Therefore, I left the patient with his wife to help with his shower and told her to ring the bell if she needs any help. After some time I left the room, the wife rang the bell. As soon as I entered the room, I heard him shouting at his wife and she started crying and left the hospital. So I had to stay with him. He was very capable of washing himself and I just had to help him wash his back as he requested. After he had washed, I asked him if he was ready to get out of the bath, he started shouting at me.

The Sarah self-referred for assessment at am outpatient clinic. She subsequently requested a referral to a psychologist in Chicago, IL. Sarah is a 24-year-old adult Caucasian female who identified as a lesbian. She reported a history of depressive symptoms that have worsened in the last few months. She is seeking treatment for these intensified depressive symptoms. She described having “depression” many years ago, but became evasive when asked to clarify. In addition, she noted a concern with experiencing anger and hostility towards others; she stated that these emotions are “uncomfortable” for her. She clarified that in the past three months she has perceived herself as “grumpier than usual.” She reported having experienced anhedonia, fatigue, and insomnia.

In a hospital I worked at recently, I was told in report that a patient I was taking was demented and didn’t know where she was or what her situation was. The patient admitted for a post knee replacement was 86 years of age, fragile, very hard of hearing and mute. The pain in her knee was excruciating and she often cried out asking for pain medication. Moving her in the bed also caused her pain, because she was said to have dementia no one explained to her what they were doing so, she fought the staff when they moved her or changed her brief. After I came on shift I assessed her, I attempted to take her knee immobilizer off to assess her knee and she cried out in pain and smacked my hand aside. I felt so bad for her, I decided to try to yell

Patient falls occurs frequently in the hospital setting due to various reasons such as a patient being confused, starting a new medication, and impaired gait. The incident of the fall I will describe occurred around 2:15 P.M. in the evening and the unit had five registered nurses and two certified nursing assistants. I was making my hourly rounds on my patient’s to check to see if they needed anything. When I entered the room I found the elderly client on the floor moaning and screaming for help. I remained with the client and call for help from the staff on the unit. When the patient’s nurse arrived to the room she did a physical assessment and asked the patient questions. The patient was a self-care patient and very independent. She had on her non-skid socks and shoes from home. The patient stated, “ I was on my way to the restroom, while walking I begin to feel dizzy and light headed and before I knew it, I was falling to the floor and screaming for help, hoping someone would hear me to come and help me.” The injuries the patient sustained from the fall were a broken right hip and bruises on her arms. This incident is critical to me because my passion for nursing is helping others and preventing other injuries that cause bodily harms such as falls. When patients’ who are independent and use to doing things on their own at home are admitted to the hospital they feel helping them is like handicapping them. My concerns at the time of the incident were was the patient

MENTAL STATUS EXAMINATION: Ss F 23 The subject is a slender and adequately groomed female who appears stated age. No observed abnormalities in terms of posture, gait or motor movement. No visible scars, tattoos or physical irregularities. Rapport was appropriate.

Reporting party (RP) stated that her husband Russell Briko (11/25/57) suffered from Parkinson's disease and diagnosed with Altered Mental Status. While residing at this facility (Mid June thru August 2017) the resident disclosed to RP that he was abused by the staff. The resident reported that staff would laugh at him and say mean things to him such as, "We don't like you" and " Your wife does not like you.:" RP was also incontinent and needed assistance with suppositories; however, there were times where staff did insert the suppositories when the resident became "frozen." RP stated that there were times that staff assisted with the catheter insertion. It was reported that the resident was given a baby monitor for his room so that he could

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to

Choose 3 different diagnoses and discuss symptoms, risk factors, any cultural influences, assessment, and diagnostic tools that you would use to reach this diagnosis.

Hi, Kristen! The mental status exam is an important part of the clinical process. The mental status describes the behaviors of the clients being seen in fell detail. Kristen you did a great job outlining Janell progress through the mental status exam. Kristen The mental status examination is a snapshot of what the client is dealing with. Kristen I thought it was helpful having the form or guide to give a more detailed description of the case. Great Post!

Urine which is formed in the kidneys is one of the major avenues of fluid loss, so an inadequate urine output or excessive loss is potentially critical and requires attention from the nursing team as this could affect a patient’s other vital signs like temperature, pulse, blood pressure.

The incident happened at the first few weeks of my practicum. One day, a few minutes before off duty, a patient’s heart rate increased suddenly from eighty something to hundred thirty while the cardiac monitor kept on ringing. One of the group mates discovered and reported immediately. Looking at the patient and the cardiac monitor, at that moment, I was frightened and did not know what I could do to help.