Leo From The Crutches Case Study

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

It's Rose Ann. I just want to let you know that Mr. Bogue, James in room 564, MRN 291222300018 fell yesterday around 4pm. He was Amanda's patient and she completed the voice. I notified our risk management Jodi Palmer about the incident. Apparently the patient was instructed by Amanda not to get up because he was hypotensive, but he didn't listen and grabbed the walker and fell forward. We ended up calling RRT because he was hypotensive and developed a big hematoma on his right groin surgical post angiogram from previous day. The patient was transferred in ICU12. We were short staff from 7a-7p, I called everyone with no luck. Our nurses and PCA were overwhelmed, because we kept on getting multiple admissions, including 2 cath lab patients

CP is a retired, 89-year-old male of upper-middle socioeconomic status. CP earned a degree in law to become an attorney. Prior to retirement he had 35 years of experience and his own practice. He had a right posterior hip replacement following a fall that fractured the right femoral neck. The fall occurred when he was walking from his home to the end of the driveway to throw away linens. Part of the linens slipped out from underneath the pile he was carrying, he stepped on it, fell and rolled down the driveway. He was taken to the hospital where he was to have a right hip replacement. The surgery went well, but he had to receive a blood transfusion. He has been transferred from the hospital and is currently at an inpatient rehabilitation center.

The patient is an 85-year-old female who is brought to the ED by her family because of increasing confusion and supposedly she had a degree of altered mental status of two hours previous to presentation. In the ED she is completely worked up. CT shows advanced atrophy with microvascular changes and several lacunar infarcts nothing acute. Specific gravity in the urine reveals her to be markedly dehydrated. She culture completely, started on IV antibiotics, IV fluids and B12. On the day after admission she still presents as persistently confused. She is evaluated by PT. The patient who was formerly ambulating with a walker and allegedly driving a car is unable to be ambulated. Before the history indicates that she has a slow downward

Patient also advised that she had broken both her ankles just 2 weeks prior and her doctor expressed concern over her lack of perfusion in both feet.

At today’s visit she is found sitting in her room in her wheelchair. She is awake, alert and oriented. She reports that she has had multiple falls over the weekend. She denies pain, shortness of breath and chest pain. The facility staff reports that she has had multiple falls and seems to be falling more lately. The patient uses a wheelchair;

Pt is seen in the ER room and states that he is tired and had tremors so he came to the ER to be on the safe side. Daughter also states that he had tremors in the morning and. Patient's CC is that was tired and had tremors in the morning. States that he stays alone, was worried, and has no past history. Assessment of the head shows no sign of deformities or trauma. Neck shows no sign of deformities or trauma. Chest shows no sign of

Dr. Jones examined a patient in his office who needed dialysis access procedure on her arms. Prior to Dr. Jones review, Ms. Smith the med tech/secretary examined the patient and documented that the patient blood pressure in both arms were equal. After Dr. Jones examined the patient to compare it with Ms. Smith evaluation he noticed discrepancy in the physical exams. The patient radial pulse in the left arm felt diminished compared to the right. The systolic blood pressure in the left arm was 60mm/hg less than the right, therefore the left hand is most suitable for an access procedure because the patient was right handed. Dr. Jones followed up with the patient and discovered that blood pressure readings were performed only on the right arm. Thus, he confronted the employees about the medical data and she admitted that she falsified the information because she was busy. If Dr. Jones relied on this data he would have conducted an access procedure in the left arm. Dr. Jones applying access procedure to

Johnny O’Brien is a 78-year-old man who suffered a fall in a RSL club and was promptly admitted to the emergency department. Clinical reasoning will be applied to Mr O’Brien’s situation, Clinical reasoning is a process which incites clinicians to think critically when attempting to solve a problem that may occur with a patient. It is imperative to health professionals as inadequate clinical reasoning skills can jeopardize a patient’s safety and reduce the effectiveness of how a situation is dealt with this can occur due to bad decision making, ignorance to multiple possibilities and failure to act on the information that is provided clinical reasoning aims to avoid these issues (Levett-Jones, 2013).

The patient is also under work restrictions and may not be able to return to his full and customary work duties ever and potentially is a candidate for medical retirement. However, MD would like an objective finding of his physical capabilities before this determination is made. Based on findings, he will need these restrictions permanently.

A guilty conscience allows the mind to think irrational thoughts. Sometimes guilt can be so hard on a person that the mind begins to imagine things that refer that person back to what they are feeling guilty from. In William Shakespeare’s, Macbeth, blood, whether imaginary or real, is a common occurrence as the play progresses. The imagery of blood is mostly referenced to when it is imagined on an object such as hands, dagger, or the floor. Guilt can be demonstrated differently on each person. For Macbeth, he imagines blood before he even commits a crime that would lead him to feel remorse, whereas his wife, Lady Macbeth feels the guilt long after crimes have been committed. Both imagine blood, but it is important to examine how each one deals

A’s friends should be assigned as the temporary substitute decision makers in creating a plan for care. Although it is only one person that signs the consent; it is encouraged that group of friends come together on a mutual agreement with Mr. A’s health values in mind. A meeting has been scheduled for the friends and the health care team to come together in discussing what Mr. A’s health values may be; if he had expressed any wishes to his friends. This can be a difficult task if there are conflicting values and un/willingness for one person to take on responsibility as temporary decision maker. The overall goal is to provide the appropriate care and to determine what Mr. A’s health wishes would be. By determining his care wishes we are able to adjust the medical plan and prevent any treatment that would be against his wishes or cause any harm to his

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

This case study and the following questions pertain to Mr. Londborg, who came into the hospital with trouble breathing. Through his health history, they found out that he has a history of seizures, hypertension, and chronic obstructive pulmonary disease (COPD). His stay was extended in the hospital due to a respiratory tract infection, decreased kidney function, a blood clot in his leg, and a fall that could have been fatal. The following questions addressed throughout this paper will discuss what happened, why it happened and how it should now be prevented.

Joanna is an experienced nurse taking care of Mrs. Kelly, who was Joanna’s patient many times in the past for her primary problem which is COPD. This time Mrs. Kelly was admitted with complaints of abdominal pain what was different from her primary diagnoses. Her vital signs were with normal limits and no significant changes from privies results, but for the nurse she looks sick, and Joanna know that something is wrong. She calls the resident doctor, but he tell her to watches and calls back with series changes. Joanna multiple attempts to report that something needs to be done to evaluate the cause of Mrs. Kelly pain was ask to calm down. However nobody took patient symptoms series and the next day patient died.