Mrs. Cook, a 65-year-old female, came to the hospital for a hernia repair. She is relatively healthy. Her medical history includes asthma due to a history of smoking but states she quit about 5 years ago. When Mrs. Cook arrived to the surgical unit she is complaining of moderate to severe pain. Laura, her registered nurse, medicated Mrs. Cook and oriented her to her room. After 30 minutes, Laura decided the patient is comfortable and awake enough to teach her how to use the incentive spirometer. Laura explained to Mrs. Cook that using the incentive spirometer will help open up her lungs so that she does not develop complications such as pneumonia causing a longer stay in the hospital. It also provides her body with oxygen which promotes healing and helps to clear her lungs and body from the anesthesia. Laura informed Mrs. Cook that her doctor has ordered her to do these breathing exercises 10 times every hour while awake. Mrs. Cook followed Laura’s instruction and made a tight seal around the mouth piece. She took a couple of small quick inhalations which barely registered on the incentive spirometer but did stimulate a cough. Naturally, the cough caused severe pain to her abdomen. She sneered at Laura with a look of questioning, ‘why are you making me hurt myself?’ Laura gave her a pillow
Turing and repositioning will avoid pressure from being exerted on one spot for too long (Miles, Nowicki, and Fulbrook, 2013). The nurse will also implement safety measures to prevent falling such as keeping the bed in the lowest position and hourly rounding (Crawford and Harris, 2016). The last priority nursing intervention for this patient is to get a set of vital signs before and after physical activity and prevent orthostatic hypotension. The patient can prevent orthostatic hypotension by adequate fluid intake, slow position changes and dangling the feet off the side of the bed before standing up (L. Schimke, J. Schimke,
Registered nurse: Assesses the patient’s heart rate and blood pressure before, during, and after exercise. Assesses the patient’s height and weight. The RN monitors the patient’s rhythm strips during and after the exercise session. They monitor the patient’s rate of exertion throughout the exercise using a numeric scale. The RN also assesses many different aspects of the patient’s life using different indexes and tools. On the first and the fourth week of cardiac rehab, the registered nurse assesses the patient’s quality of life using the Dartmouth Index. The nurse also assesses the patient
Education provided must be specific to the patient’s needs and appropriate to the care, treatment and services provided. Initial teaching for Incentive spirometry is failing to be documented in all cases in the hospital’s electronic health record.
An incentive spirometer is a tool that measures how well you are filling your lungs with each breath. This tool can help keep your lungs clear and active. Taking long, deep breaths may help reverse or decrease the chance of developing breathing (pulmonary) problems, especially infection, following:
Being in a hospital is strenuous on anyone and without the proper support systems in place; it could potentially worsen their condition. With enjoying the ability to be active in my life, I do yearn for those years where I could travel without the weight of my health being on my shoulders. That is why, I am delighted at the fact that physiotherapists can come in to help with muscle strengthening and getting me back to a state that perhaps I will be able to do yoga again, or sit long enough to finish a puzzle. I truly value the time that I spend meeting people in my care center, and without being able to be active, I do believe that my motivation to participate in the most basic activities would decline. Access to
teaching is a very important aspect to nursing. It is vital to provide the patient with knowledge and information. Educating the patient and family with help with anxiety and ensure the patient receives the best care. The teaching process should be continued and constant throughout the patient’s entire stay. You should educate them on medications, diet, positioning, signs and symptoms of infection, incision care etc. Keeping the patient updated on plan of care will help the patient and nurse to achieve the overall goals.
Position the patient in the most comfortable position. Positioning has a large effect one pain. The patient preferred to be sitting upright in her chair.
A patient who was admitted for altered mental status, when did her physical assessments I heard that her lung sounds were diminished throughout and that from morning report that she rarely gets out of bed. I instructed her to take deep breaths and to sit up right more. She said that she could not do both. I asked the asked what prevent her from able to do so. She explained to me that she pain in her throat and abdomen incision. I told her that I could provide her with pain medication to relieve the pain. After pain medications were given I educated her on how to use the incentive spirometer (IS) and it purpose. I asked her demonstrate to me a couple of times. I checked on her every hour to make sure that she was using it and would provide her
There are two main categories of diseases that can affect the lungs, which are obstructive diseases and restrictive diseases. These lung diseases can have detrimental effects on the lung because they can result in decreased airway size, swollen or loss of alveolar sacs, and ultimately reduced gas exchange. Lung diseases, as well as the overall function of the lung can be evaluated using a method known as spirometry. Spirometry is a tool used to evaluate the breathing mechanisms of a patient and allow doctors to detect pulmonary diseases in patients displaying abnormal lung function. Spirometry can consist of static and dynamic tests to measure variables such as vital capacity, which is the highest volume of air that can be exhaled out of the
Nurses and other healthcare providers strive to keep the patient stable and help progress healing; however extended patient immobility reduces and complicates timely recovery. Muscle strength
Physicians were asked which medication they would typically prescribe for such patients. In this survey most primary care physicians and respiratory specialist reported that professional guidelines for COPD diagnosis and management informed their practice. This was reflected by the frequent self-reported use of spirometry (80%-100%) to establish a diagnosis of COPD. However, a large proportion of both Primary care physicians and respiratory specialist chose non-concordant treatments for different patient scenarios. Despite the fact that respiratory specialists were significantly more likely to report knowledge of the GOLD global strategy (93% of respiratory specialists versus 58% of PCPs, P,0.001), they did not perform better than Primary
Here, I add points in d, and e. I can select interventions based on EBP. For example, for patient who on magnesium then we should monitor for urine output, reflex, and homan’s sign. Check for toxicity and keep them bed-rest. Patient who is on insulin drip, we should monitor their glucose and their potassium and administration potassium when the potassium is below certain level. Other intervention--If the FHR is absent to minimal then we should change the patient position, preferably to the patient left. Finally, evaluate patient progress---The rating of pain before the administration of medication such as Flexeril, Motrin, Percocet etc. and the evaluation of pain 1 hour later. We can determine the effectiveness through pain rating.