Mr. Estroga Case Study

A is an 87 year old women, with a long history of health troubles including chronic kidney disease, congestive heart failure, coronary artery disease, a pacemaker insertion for her atrial fibrillation, type 2 diabetes, dyslipidemia, colon cancer, breast cancer, mild cognitive impairment and most recently paranoid psychosis.

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 went as far to admit that she currently is having a hard time breathing, but has an appointment with her gynecologist on Monday. This writer advised the patient that if she has difficulties breathing she will need to go to the ER immediately and be medically assessed by Nursing. The patient started crying about she does not want to be medically assessed as she needs to return her boyfriend vehicle so that he can work. This writer informed the patient about the seriousness of her health comes first. This writer called Nursing Chrystal, but no response. Then this writer and the patient went to the Nursing Director office to be medically assessed. According to the Nursing Director, she advised the patient to go to the ER first and will not be dosed today unless she provides proof of documentations of her visit. Again, the patient fussed and then says, " I am fine, it's not serious," however, the patient was advised to follow medical

As a result, nurses were running behind trying to get their regular and stat blood work, assessments, vitals and charting done on time. Hence, it was unfair to the patient as well as a nurse taking care of the patient. If he was given lorazepam as ordered, he would not have gone to DT and this would not have created any unnecessary stress on the nurses, doctors and patient care techs. This clinical case is related to the emancipatory knowledge. Emancipatory knowing is the ability to identify social and political problems of injustice and adds all the elements of experience and context to change a situation (Chinn, 2010, p. 63). As soon as charge nurse noticed that the patient had a change of status and tachycardia, she looked at the doctor’s note, assessment data and MAR to figure out what was wrong with this picture and what needs to change. Also, she found out that the nurse who had this patient during the day had all higher acuity level patient along with 1 code patient. In addition to this, patient was assigned to the room far from nurses’ station. Also, charge nurse immediately called hospitalists as soon as patient had a change of

Waters, Renita Apr 4 2017 12:21PM Waters, Renita April 4,2017 10:05 AM TC Beth Orrick RN nurse from Bent Wood Nursing for information on Mr.Allen Union who was in Bent Wood for a wound on his feet. Ms. Beth explained Allen was getting OT, and PT and was on a walker. Beth stated Mr. Allen wanted to leave and go pay his rent and other bills yesterday he didn't return back. Beth stated she TC Mr. Allen at home and he refuse to come back for any more therapy. Beth explained to Allen he must have more treatment on the wound on his feet to heal and he did take Bent Wood walker back he took. I asked Beth was Allen on any medicine she commented he left all his medication. Beth stated Allen is a diabetic and has high blood pressure including a open

Our client, Ertha Williams is a 99 year old female who lives alone in a low-income apartment complex on the second floor in Monroe, Michigan. Ertha suffers from chronic kidney disease and has a history of hypertension and type one diabetes. Due to her chronic kidney disease Ertha has regular scheduled dialysis appointments three times a week, but since the death of her son and husband and her inability to drive it is difficult for Ertha to get to her dialysis appointments. She also has difficulties preparing the multiple medication she is required to take to manage her hypertension and diabetes. After her last dialysis appointment the nurse reported that Ertha appeared frail and emaciated. Ertha herself also stated that she worries about financial issues frequently and has good and bad days occasionally. Based on these findings Ertha is in need of some assistance to help alleviate some of the problems and stresses she is undergoing. Several nursing diagnoses can be established based on Ertha’s current situation and through these diagnoses it will be easier to establish what kind of services Ertha will need from the surrounding community of Monroe and what types of barriers she might encounter in attempting to access these services.

Introduction: Jessie Buchanan, an 80-year old female, was admitted to Bethany Care Society in room 3088-1 at the center unit. She is an extensive assist, requires 1 staff assistance and uses the transfer belt to transfer from bed to her wheelchair. She was admitted here because none of her family members can look after her because they are all busy with their own personal life. Jessie prefers to stay at Bethany because she receives full-time care from the health care providers. Jessie had a history of edema on her right ankle because she was experiencing hyponatremia. Currently, she is on fluid restriction and every morning I would put her compression stockings to prevent the occurrence of edema. Her condition worsens when she was diagnosed with osteoarthritis(OA), delirium, depression, type 2 diabetes mellitus, schizophrenia, hypertension, and urinary tract infections. Her recent urine culture shows that she is positive for urine nitrite and urine leukocyte which caused the UTI. Jessie is incontinent and she wears an indwelling catheter. Jessie said that sometimes her knees are painful. She takes an analgesic to relieve the pain that she feels. Jessie 's blood sugar level is within the range. She is not taking insulin or any oral medications like metformin because she knows how to control it, by following the proper diet. Jessie always have a good sleep and never complains about her sleeping pattern. She is taking medications for GERD, iron supplement, bone health,

R/s Henry Lykes is a double above the knee amputee and has congestive heart failure, COPD, arthritis, hypertension, and diabetes. R/s Mr. Lykes caregiver Tapeka (niece) recently moved out of the home. R/s there is no lights and water in the home. R/s Mr. Lykes has nowhere to go and generator is no longer working.

It was reported the facility admitted a resident requiring insulin injections. Resident Gregory Regosin DOB: 6/4/61 was admitted 30 day ago and was diagnosed with diabetes and diabetic neuropathy. According to the reporting party the facility had been administering the resident's medication due the resident inability to self-administer due to the neuropathy. On 7/21/16 the administrator Maria Manimeo became angry with the resident regarding an unrelated issue and declared "you can give it to you yourself" referring to the insulin. The resident disclosed that the facility is administering the medication (insulin), however at time the facility refuses to administer the injection. The resident stated he is unable to administer in injection due

Within this assignment it will be exploring the care of a patient using evidence based practice. The patient being explored is one met during a community nursing placement, though all identifying evidence will either be changed or not used to keep the patient’s confidentiality (as with the nmc code). The patient is currently residing in a residential home in Derbyshire. The patient is a man who is in his fifties. He had been put into the residential care following a hospital admission for a brain tumor, a family member living with the patient had flagged patient safety issues at home and social workers thought it be best for the family to have a respite period and to give the patient more care in a residential home for an undetermined amount of time. The patient themselves seemed very happy to accept this. The patient’s current medical history is that he suffers from diabetes which is kept under control through two insulin injections a day, morning and afternoon. As previously mentioned above he also suffers from a brain tumor, at the moment the effects of this on himself are unknown. It has been recorded that the patient has some difficulties in maneuvering himself and needs some assistance as well as assistance and prompting to eat and drink. Due to the patient’s current medical history three care aspects have been chosen to explore that are considered relevant to this patient. The following are - Infection control / standard precautions, medicine

The Defendant, JUAN ESPARZA, is believed to be located in Albuquerque, New Mexico. Plaintiff’s counsel has hired the service of a process server who has been attempting service on the Defendant at the address on the Summons.

They present to the ED believing they are having a heart attack, but also because they know that they cannot be turned away. After ruling out a cardiac event and treating the blood pressure, the patient admits to feeling better. The emergency nurse know that if they do not provide adequate discharge instruction, the patient is likely to remain untreated, then develop other comorbidities. Therefore, during the discharge phase of treatment, the nurse and doctor discuss medications that would be least expensive, especially medications that are on the Walmart four dollar list. The instructions will also include a referral to the Transitional Care Program which works on a sliding scale. The patient will receive a phone call in two days to arrange for follow up care. Lastly, the instructions will include a list of low cost clinics in the county. Yet, despite all these efforts, there remains a likelihood that the patient will not receive care. Other determinant factors such as transportation, education level, life style and social support all play a role in the follow through of care

While administering 2200hr. medication for patient #3, I knew that she needed some food to take with her potassium to prevent stomach upset. Unfortunately, there was no cafeteria service around that time. I discovered that the patient did not have any food by her bedside. I quickly assessed patient’s diet, which was recorded in the cardex as “ poor diet” I also double-checked with her if she had any food allergies. Patient mentioned that she was lactose intolerant. I wondered why it was not recorded in the cardex. However, she said that she wanted cheese and crackers, even though cheese usually contains lactose. I consulted with the nurse and discovered that during the patient’s long stay in the hospital, it has been clear

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.

Jones is a 64 year old well nourished man with a history of long-standing non-insulin dependent diabetes mellitus (NIDDM). He had an open heart -surgery bypass graft 7 weeks ago. The graft site got infected and had to undergo an emergency surgery to improve circulation to his left lower limb. Mr. Jones is relieved that his leg was saved and he is now being prepared for discharge. He wants to regain his strength so that he can start doing the things he loves. Currently Mr. Jones needs moderate assistance depending on his level of pain or fatigue and ambulates with a walker. Mr. Jones still needs help with activities of daily living. He has urinary and bowel control problems as side effects from multiple antibiotics. Mr. Jones is married and has 4 grown children that provide him with love, care, and support. The nursing staff is teaching Mrs. Jones how to perform sterile wound care for her husband as he will need dressing changes three times a day, blood glucose monitoring and a healthy diet. Social service is helping to keep communication channels open between Mr. Jones, his family and the nursing staff to maintain psychological and emotional health.