Incentive Spirometry Case Study

A nurse attending stated “during the morning’s second surgery, he actually dozed off. The nurse took him aside and recommended that he take a break, but he refused and returned to the operation.” The nurse here was in fault in more ways than one. This nurse should never allowed the doctor return back to operate on the patient, he should have been removed from the operating room immediately. The nurse should have

Hello all, my name is David Jamison, MHA. I am representing Marion General Hospital as the committee chairman of the ethics committee. I am currently reviewing the case involving female patient Margie Whitson. The patient is a 95 year old patient whom wishes to have her pace maker “turned off”, due to her unwillingness to live. The death of her only remaining son was the last event that, that had forced her to contemplate the reason why she still lives. Mrs. Margie Whitson is no stranger to loss. When she was younger, she lost her youngest son to a severe motor vehicle accident that took his life at the early age of 30. She injured herself over 10 years ago, and received a hip fracture. Her most recently bout was

The plaintiff in Ard v. East Jefferson General Hospital, stated on 20 May, she had rang the nurses station to inform the nursing staff that her husband was experiencing symptoms of nausea, pain, and shortness of breathe. After ringing the call button for several times her spouse received his medication. Mrs. Ard noticed that her husband continued to have difficulty breathing and ringing from side to side, the patient spouse rang the nursing station for approximately an hour and twenty-five minutes until the defendant (Ms. Florscheim) enter the room and initiated a code blue, which Mr. Ard didn’t recover. The expert witness testified that the defendant failed to provide the standard of care concerning the decease and should have read the physician’s progress notes stating patient is high risk upon assessment and observation. The defendant testified she checked on the patient but no documentation was noted. The defendant expert witness disagrees with breech of duty, which upon cross-examination the expert witness agrees with the breech of duty. The district judge, upon judgment, the defendant failed to provide the standard of care (Pozgar, 2012, p. 215-216) and award the plaintiff for damages from $50,000 to $150,000 (Pozgar, 2012, p. 242).

There was no need for this procedure at this time since Sue did not need suctioning. She was still mobile and was not showing the signs of needed to be suctioning. I came to this conclusion that she did not need to be suctioning based on his careless response. “I just want you to know what we’ll be doing when your condition gets worse” (16). Suctioning can be painful for the patient especially if the pressure setting are too high. During my time in the hospital rotations, respiratory therapists and other staff always communicated what they were going to

Melvin Fuller is a patient on the medical-surgical unit who was admitted during the previous evening for exacerbation of chronic obstructive pulmonary disease (COPD). He is an 83-year-old widower with two children who both live an hour away. He lives in a small house and is independent in his care. He has a housekeeper who comes in once a week to clean and fix some meals for him. He was brought to the hospital by his son who was visiting. His children visit him at least once a month. Mr. Fuller has COPD and type 2 diabetes. Alicia Brown is a 19-year-old nursing student in her first clinical rotation. She has been assigned to Mr. Fuller for morning care. Alicia enters Mr. Fuller’s room and notices that coffee has been spilled on his bed and

In the 25th week of her pregnancy, the mother was advised by the nurse to remain on bed rest to avoid further complications and potentially hurting her unborn baby. The mother continued to work from the hospital placing additional stress on the baby despite the nurse’s appeal that such stress can cause the baby harm. Attempts to stop premature delivery were made but failed, the mother asked the medical team not to take any extraordinary measure to save the baby. The premature baby lived but the mother showed little interest in his health and wellness. The nurse tried to the best of her ability to spark

The facts of this case are that Dr. Guiles who is self-conscious of his prostate cancer diagnosis is treated horrendously when he finally decides to have surgery ( Buchbinder, Shanks & Buchbinder, 2014). Considering that Dr. Guiles is already sensitive about his condition, his unbearable symptoms are not helping matters (Buchbinder et al, 2014). Upon arrival at the hospital, he is treated subpar. The admitting clerk is rude and unbecoming to a patient who isn’t feeling well and who is embarrassed about his sickness (Buchbinder et al., 2014). To make matters worse, he has to find his own way up to the floor by walking, which causes him to be even later in checking in because of the need to stop frequently to urinate as well as having difficulty in walking (Buchbinder et al., 2014). Once he arrives on the floor, the charge nurse is not welcoming and unprofessional (Buchbinder et al., 2014). After figuring out what to do with the paperwork; and the nurse aide delivers Dr. Guiles to his room, the nurse aide does not offer to help settle him in (Buchbinder et al., 2014). Therefore, Dr. Guiles is faced with battling obnoxious family members who are on his bed and to make matters worse someone is in the bathroom which doesn’t help his need of having to frequently urinate (Buchbinder et al., 2014). When the issues are brought up to the charge nurse, the charge nurse accuses Dr. Guiles of wanting preferential treatment

My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to

Beneficence compounded by nurse-physician communication created ethical problems in this case. Mainly, Joanna’s assessment of Mrs. Kelly being ignored by the resident physician and the nursing supervisor. Joanna worked within the scope and standards of practice, she assessed, evaluated, and monitored her patient’s condition. She then reported her findings to the resident twice, and also sought nursing support from her shift supervisor. After Joanna’s first call to the resident, and her continued concern she needed to advocate in a proactive manner. Continuing her assessment of Mrs. Kelly to include palpation and auscultation could have offered additional clinical information enabling her to articulate the problem to the resident and nursing supervisor.

This week, I was given the opportunity to care for two female patients – 205(1) and (2). The first patient, 205-1, was admitted with respiratory distress and had a past medical history of hypertension, schizophrenia and bipolar disorder. She was initially put on 2 L/min of oxygen and placed on oxygen titration protocol with orders to maintain O2 saturations between 88-92%. The patient was oriented to person and place, but had difficulty with time. She was also obese (BMI 30) and deemed a moderate assist with ambulation. Her care plan included total assistance with ADLs, smoking cessation and oxygen protocols, limited salt intake (3mg), and chronic pain management. The second patient, 205-2, was admitted with a right pelvic fracture and had

The situation happened during the author’s last day of orientation as a new medical-surgical nurse. The author was passing medications and administered aspirin to a patient as ordered. As the author approached the nurses’ station, she stopped in disbelief as the charge nurse started yelling at her, saying, “Why are you not checking your orders? Why did you give aspirin when there was an order for no anticoagulants? Do you know the patient is having a procedure tomorrow? New grads.” Several physicians and nurse practitioners, along with the author’s coworkers, witnessed

Shallow breathing and pain altered this patient’s comfort. Therefore, one of the nursing diagnoses can be stated as “Breathing Pattern, Ineffective r/t pain and anxiety, as evidenced by respiratory depth changes" (Ackley & Ladwig p. 175). We briefly discussed the specifics of incentive spirometry use before initiating the intervention. After return demonstration, the patient was ready to use his incentive spirometer.

Anna is a fifty five year old homeless, unemployed woman who was admitted to the Emergency Room (ER) at Victoria Hospital in London, Ontario for pelvic pain and postmenopausal bleeding. During the nurse’s head-to-toe assessment it was found that the patient also had presenting abdominal distention, prompting her physician to order an X-Ray to determine if a gastrointestinal issue caused this distention. Once this was ruled out, Anna’s physicians continued to search for the underlying cause of her abdominal distention, in addition to her other admitting symptoms. As a result, Anna was admitted to the hospital as an inpatient on the Acute Medicine Unit. The day following admission, Anna went for further testing to hopefully discover the cause of her symptoms. The first test completed was an

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

A systematic review undertaken by Smetana (2009) identifies postoperative respiratory failure as an example of cascade iatrogenesis i.e. serial development of multiple medical complications that can be set in motion by a seemingly innocuous first event. In this case, Mrs Hilton’s open cholecystectomy is that first event. Smetana (2009) points out that: when an older patient with postoperative pain is over-sedated, a decline in respiratory function occurs, that if not recognized, can result in respiratory failure that requires mechanical ventilation, that again, if not managed properly can culminate in ventilator-associated pneumonia and even sepsis and death (p.1529). After her upper abdominal surgery Mrs Hilton may have difficulty with deep breathing and coughing due to pain however both are essential interventions for prevention and treatment of respiratory infections and complications. Brown et al. (2008) recommend that when Mrs Hilton is awake, turning, coughing and deep breathing should be encouraged every one to two hours as this aids in the removal of secretions and prevents mucous plugs. They also encourage mobility when possible to increase respiratory excursion. Moreover, as Mrs Hilton