Is Brody A Brand New Patient?

Mrs. Dawn Campbell, a Caucasian female of 50 years old, is a recare patient from the clinic. She was a referral from my big sister since she was due for her routine cleaning. She weighs 170 pounds at 5 feet 9 inches tall and presents with controlled hypertension. She admits to drinking two to three beers per day and smokes one pack of cigarettes each day for the past thirty years. She expresses she loves going to the dentist and complained of calculus building up on the lower anterior teeth.

H, who had come into the emergency department two days prior for diabetic ketoacidosis (DKA) and was diagnosed with type 1 diabetes. The Mayo Clinic explains that diabetic ketoacidosis occurs when the body cannot produce insulin. Insulin is the key that allows glucose to enter cells, and provide the cells with energy. Without glucose for energy, the body begins to breakdown fats that produce harmful substances known as ketones. DKA is characterized by hyperglycemia, metabolic acidosis and ketones in the urine, (2017). That had since resolved, so for the most part of the day me and the secondary nurse were providing diabetic education. She was educated on the use of the glucometer, how to give insulin injections, and symptoms of hypoglycemia, I felt confident in this education and was surprised by how much I remembered from previous lectures. I did not have time to provide teaching on diet, exercise induced hypoglycemia, or patient specific teaching based upon her report, because we switched our roles. I can see how education can get swept under the rug in practice when you are so busy throughout the day. Instead of saving education until the end of the day, when I become a new nurse I will make sure I am taking advantage of every patient encounter as an opportunity to educate. Later in the simulation, when I had transitioned roles, Ms. H experienced a hypoglycemic episode after receiving a dose of insulin and not consuming any of her breakfast. According to Silvestri, hypoglycemia is often caused by the following, too much insulin, too little food, or excessive activity (2014, p. 653). In Dr. Johanson’s lectures I learned that carbohydrates are the main source of energy for the body and are metabolized to form glucose for the body to use. When there is no consumption of carbohydrates, there is no glucose and this results in low blood glucose known as hypoglycemia. A type 1 diabetic lacks the ability to make insulin, which is the key that

Over this last week, I have received a patient named Sherman “Red” Yoder. He is an 80-year-old male farmer, who lives alone in the farmhouse that he had grown up in. Red was married for 50 years and has been a widow now for 10 years. Red has one son, Jon, who takes care of the farmhouse and the land. He has one daughter-in-law, Judy, who is in involved with his care. Red was diagnosed with diabetes six months ago. Diabetes mellitus is a chronic condition that affects your body 's ability to use the energy found in food. As of only a few weeks ago, Red has been managing his diabetes with insulin. Insulin is a hormone that controls blood sugar. Before he began using insulin, he managed his diabetes with oral medication. After carefully assessing Red’s chronic illness, diabetes, many red flags were presented that could interfere with his management. In turn, this would cause further complications.

Patient is a high school counselor. He participates in physical activities by running 2 to 3 times a week, playing golf, and volunteering at a nursing home. The patient is married with one daughter and one son. He does not use tobacco and periodically drinks at

Past Medical History: Although the patient is Hispanic, she can speak English and provides her history to the nurse. She reports that two weeks ago she was in the hospital for a femoralpopliteal bypass graft that was performed on her right leg. She noted some drainage coming from her incision and thought she should have it checked out. She has a history of diabetes, for which she takes insulin.

HISTORY OF PRESENT ILLNESS: This is a 53-year-old black individual a patient of Dr. Shelton, who has had diabetes for at least six months, but he thinks it has been longer than that. He says his last known blood sugar was in the 300’s. He presents in the ER today with a foot ulcer since January of this year. He

I was able to check the patient in a systemic order and to make her feel comfortable around me allowing openness and honesty about medical conditions. I responded to the patient in a professional way as to not make her feel uncomfortable and to represent myself as a professional. The patient felt very comfortable with me during the interview, I had asked her upon completion if I was professional and if she felt comfortable. She said that I was very gentle in examining her and that she was very comfortable speaking to me. During the examination there were moment when the patient and I had light conversation, as I did not want the experience to feel cold and calculated. She showed me picture of her family and the books that she loves to

On my second day of clinical experience this week I focused a lot on time management and documentation for a full patient load, and also on the admission and discharge process. After taking report on all three of our patients, I began my initial morning assessments. It was clear that our 8-year-old post-operative appendectomy was ready to be discharged. My priorities were assessing her incision sites and ensuring the presence of bowel sounds, as well as making sure she did not have a fever and was tolerating a general diet. After completing my assessment and documenting in the computer, we

The first pt was a 2-week-old check up, and the second pt was a 6-month checkup. Each time, the nurses asked the mother to strip the baby to a dry diaper(IC). I thought it was interesting that the mothers were not only questioned about their child, but about themselves as well to check for depression. The 2-week-old had trouble breathing in a car seat(S) before leaving the hospital so the rn performed a few test. The next pt has a history of repeatedly being ill. The mom was worried the pts celiac disease (D) was causing it. Celiac disease is a serious autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. It can lead to the development of other autoimmune disorders like sclerosis (MT1) and anemia (MT2). The small intestine is the part of the intestines where 90% of the digestion takes place. It works to absorb nutrients and minerals(AP). The last two pts were swabbed for strep throat. Today I learned how to treat celiac

The wife reported Mr. P was diagnosed with type 1 diabetes mellitus 6 months ago. Additionally, he had the flu for one week with increased vomiting and anorexia and stopped taking insulin three days ago because he was unable to eat.

A 49-year-old, Middle Eastern male presented to the Northern Virginia Community College dental hygiene clinic for both an oral prophylaxis. He was in good health and did not use any medications or supplements and, therefore, was classified as a health status of ASA I. The patient’s vital signs included a blood pressure of 112/78 RAS, pulse of 64 beats per minute, and a respiratory rate of 14 respirations per minute, which further concluded his health status. Patient had no history of any tobacco use, nor did he consume any alcohol.

Details about the sample size, inclusion, exclusion, and the methods were appropriately stated and informed consent was given prior to the study. A statistical analysis was used to interpret the data by forming into table of the demographic, operative characteristics, and the clinical outcome (Jakkaew & Charoenkwan, 2012). The primary outcome was to measure the first passage of flatus and patients were instructed to report to flatus, defecation, and feeling of hunger and visual analog scores were used to measure the signs and symptoms of gastrointestinal disturbances (Jakkaew & Charoenkwan, 2012). The outcome assessor who was blinded to the study that helps eliminate the bias when collecting the data evaluated daily assessments. These methods were appropriate to measure the effects of gum chewing after surgery.

The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT

Today I had a great day at the clinic. For the morning section, I had Omar Lora as my patient. Last time when he came, I collected all my assessment data. Today I updated his medical history, dental history, vitals, and EIOE, then I completed filling out the gingival assessment, the treatment plan, and the SAOP. Finally, I was ready to have my assessment data checked. It went really well, and I learned ways to helped me be more efficient with my time management, for example, I did not know how to have my radiographs up in the other monitor while I was doing my assessments. It was a little time consuming having to open and minimized the window every time I needed to look at the radiographs. Also, I discovered that having a piece of paper out and taking

* Prior to performing A.’s physical assessment, I gathered information over her diagnosis tonsillectomy, adenoidectomy, and vitiligo and any passed medical problems to be aware of. I then introduced myself to A. and her family and asked her if she wanted her grandparents to stay in the room during her physical assessment. I then explained the process of starting at her head and working downward to her feet by providing privacy throughout the whole assessment. First I started, by observing her appearance and behavior and how well A. communicated with me, A.’s behavior was calm, cooperative and appropriate for her age. I assessed PERRLA in both eyes, her pupils were a 3, equal, round, reactive to light and accommodated. I assessed her mucus membranes which were pink and moist along with assessing her throat by looking at the back of throat and checking for bleeding , whitish area, and odor. I then asked her if she had any frequent swallowing and trickling of blood in her throat. A. stated she did not have any frequent swallowing or blood in her throat just some soreness and discomfort in her throat. A.’s throat had white areas on both sides where the tonsils were removed with no bleeding. I auscultated her heart and lungs, and heard S1S2 and her