Multisystem Failure in Geriatrics

Through basic observations, health professionals are able to evaluate the performance of an individual’s health status. In relation to Casey, it is noted in her Observation Chart that in the time span of two hours the patient’s health status had changed from being relatively normal (to the patient) to an increased respiratory rate, heart rate and temperature as well as a decrease in blood pressure. It is also noted that the patient has a score of 8 in the pain scale (compared to the score of zero two hours previously), relating to the lower abdomen. Programs such as Between the Flags acknowledges the fact that the early recognition of deterioration of patients can reduce harm to patients through designing and implementing systems which provide a structural response in the event of a deteriorating patient, such as Rapid Response and Clinical Review. There are two phases involved in the rapid response, which includes the afferent phase and the efferent phase. The afferent phase focuses on the overall monitoring and recognising the deteriorating patient whereas

Assessment of a patient is a big process of decision making, it is about the collection of information which will contribute to an overall judgement of a person and the illness they may have. Lloyd (2010) states that assessment is one of the first steps which is needed to be done in the nursing process, it is a building block for a relationship and an ongoing process which lets health professionals gather the correct information to help them understand the problems and needs that the patient is going through. Most of the nursing assessment which are in use today will all have very similar aims. The difference is that how the assessment’s are carried out is where the differences come from.

In this Assessment nursing course, one of the major things that is taught is the most important part of giving proper care to a patient. Correct patient assessment is needed before any nursing care plan or treatment can be implemented. This post-review of a person’s assessment will demonstrate the proper way to go about assessing a person’s health.

According to the provider, the claimant's cough has been improved. His review of systems was positive for fatigue, malaise, sleep difficulty, shortness of breath, wheezes, and a cough. His blood pressure was 115/71 mmHg and his BMI was 30.35 kg/m2. The physical examination revealed wheezes. Clonazepam was prescribed for agitation. Atorvastatin, Nystatin, Citalopram, and a probiotic were prescribed. Continued use of Aspirin and a regular inhaler were suggested. Further, a follow-up visit with Endocrinology, Cardiology, and Pulmonology. As it relates to a spot in his lung, a repeat CT scan was recommended. The bronchial washes were negative for

That performance outcome system would be analyzed to see if there is room for improvement, or if any changes in treatment are required.

I am concerned with the drug to drug interaction with Mrs. Cynthia. She has hypertension, type II diabetes, and she is old. Her body mechanism metabolism the medication at a slower rate or it may metabolism too quickly. Cynthia labs result closely because she is also diabetic and is taking Lisinopril. I am concerned with her taking a potassium-sparing diuretic, potassium supplement, and aspirin. Patients who are taking potassium-sparing diuretics, potassium supplements, potassium-containing salt substitutes should not be placed on Lisinopril (mmm ) Lisinopril is

He tells her that she believes that the patient has two issues on hand. The first being that the he has been taking too much Acetaminophen and the second the Oxycodone in the Percocet and the high amounts of Diphenhydramine Hcl in his sinus medication is causing increased sedation. According to www.fda.gov the recommended amount of Acetaminophen in 24 hrs is not more that 4000mg or 4 grams. (Use a conversion factor) Taking more that this has been linked to liver disease, which could be the reason for the yellow skin color. Jt has been taking 325mg of Acetaminophen in his Percocet every 4 hrs as well as 650mg of Acetaminophen in his Equate allergy. In combination this places his Acetaminophen dosage at 5,850mg a day which is 1,850mg over the recommended maximum dose. Jt has also been taking 50mg of Diphenhydramine or Benadryl every 4 hrs as well as the narcotic Oxycodone in the Percocet. Both medications are known to make people sleeping, but in combination there will be as increased risk of sedation. While the doctor waits for the lab results he has the staff start and IV and infuses Normal Saline 1000ml over 1 hrs to help dilute the medication in his

Assessing and giving a diagnosis has a range of things taken into consideration like how often, how

The first stage of the process is assessment. Roper et al (2001) refer to this process as ‘assessing’ indicating an ongoing activity; this encourages nurses to recognise the on-going nature of this initial phase. The assessing stage includes gathering information about a patient, reviewing this information, identifying actual and potential problems and prioritising (Roper et al 2001). Roper et al (2001) explain the importance for assessing, as early as possible in the patient’s stay. Extensive, in-depth information may not be gathered on an initial assessment, however any information obtained contributes towards individualised care (Roper et al 2001). Ambrose and Wittig (1998) explain that the initial assessment becomes a foundation for ongoing assessing and holistic care. Barrett, Wilson and Woollands (2009) concord with Roper et al and Wittig in that assessing is an ongoing process and elaborate on this explaining that assessment should not be confused with admission. They state “an admission tends to be a one-off process when you first meet the patient, whereas assessment carries on throughout your relationship with the patient” (pg22). Assessment enables the nurse and patient to identify actual and potential problems. Although, some problems can be directly related to biological needs, holistic needs must be considered, i.e. psychological state and cultural/social standing

Neurological Assessment: patient is awake and alert times 4. Denies head injury, seizures or seizure disorder, paralysis, or abnormalities of sensation and gait coordination. Denies syncope dizziness, vertigo, memory loss, speech coordination, frequent headaches, or tremors. Denies problems with speaking.

A major component of the care Paramedics provide is the assessment of a patient’s physical status, which is the ground for any further treatment. The assessment method that an Advanced Care Paramedic follows is a systematic assessment referred to as the Primary Survey. The aim of this fundamental assessment is to give an initial diagnosis of the patient as well as identifying any imminent threats to the patient. This assessment is used so that a Paramedic can decide how to treat the patient while staying within the boundaries of their scope of practice. Throughout this essay the concept of a primary survey within the scope of practice of an Advanced Care Paramedic will be understood. Additionally

Disability – Assessment of disability involves evaluating the patient’s central nervous system function. Assess the patient’s level of consciousness using the AVPU scale. Talk to the patient if they are alert and talking they are classified as A. If the patient is not fully awake establish whether they respond to the sound of your voice (opening their eyes, making any sounds) if they do they are classified as V. If the patient does not respond to voice administer a painful stimulus (gently rubbing the sternum bone). If they respond they are a P on the AVPU scale. And finally if they do not respond to any of the above they are a U, you should then move onto the more detailed Glasgow Coma Scale (GCS). You will assess the patient’s pupils (eyes) and motor responses (arms and legs) among other things to give the patient a score out of 15 (15 being the highest). A GCS of fewer than 8 is a medical emergency and you would then have to go back to assessing the patient’s airway.

Assessment is described as”The first stage of the nursing process, in which data about the patient’s health status is collected” (Oxford dictionary of nursing, 2003, p23), following this phase a care plan can be devised.

Adverse effects for lisinopril include a constant non-productive cough, hypotension or low blood pressure, fetal malformations up to and including death, and also anaphylaxis (Gutierrez, 2008, p713). One potential safety concern for this patient is the fact that Mr. P lives alone. In the rare event that lisinopril causes hypotension, he would be there alone, and may not be able to call for help. Another safety concern for this patient is how the lisinopril will react when administered through a PEG tube versus by mouth. There is potential that this medication will affect this patient more than it might another patient. For this reason, a low dose of lisinpril will be initiated and carefully titrated as needed. The education provided about lisinopril included checking a blood pressure every day prior to taking the next dose. If the blood pressure is low, the dose is to be held and Mr. P should contact the office to discuss further plans. The patient was also informed to take the lisinopril each morning so he would know how if affected

Assessment is the accurate collection of comprehensive data pertinent to the patient’s health or the situation (“American Nurses Association,” 2010). Assessment is the first step in the nursing process and the most important. Assessment is the accurate collection of the patient’s health date