Myasthenia Gravis Case Analysis

worsened. The nurses tried to comfort me, but nothing they did helped. I was a

ICU to the floor. She has essentially stabilized. Again, she is having some type of

Banting and Best went from bedside to bedside, injecting the unconscious patients with their new discovery, and before reaching the last few in the ward, the first were already waking up. The patients would gradually get better, gaining their appetites back, and gathering the strength to get up out of their beds.

Ms. Sunshine immediately was placed on oxygen, sitting upright, an IV infusing, had blood work sent for numerous labs, including cardiac markers, had a chest x-ray and an electrocardiogram (EKG) performed. A clinical nurse leader is able to teach patients and patients regarding health promotion, disease prevention, or disease management (American Association of Colleges of Nursing, 2011). It is important to understand the pathophysiology behind disease processes in order to help facilitate better outcomes for Ms. Sunshine.

admitted from the ED today for a GI bleed. She¶s had one unit of packed RBCs

Patient “DD” is a 56-year-old woman who was admitted to a nearby hospital for respiratory failure. With the only previous medical history being chronic bronchitis, she was diagnosed upon admission with COPD, anemia, hypoxia, moderate anxiety, and dyspnea.

Marie is pale, weak, and anxious, but no longer disoriented. Her fundus is firm and is 1 cm above the umbilicus. She is receiving O2 per nasal cannula at 4 liters/minute and has an O2 saturation of 88%. Her vital signs are: BP 74/44, pulse 116 and respirations 26. Her bleeding has slowed considerably. The nurse asks the UAP to bathe Marie and change the bed linens.

The unresolved infection has landed the patient on septic shock. Sepsis is the body’s response to inflammation of a particular or unknown infection. The presence of hypotension despite adequate fluid infusion and inadequate tissue perfusion is the result of septic shock. The treatment of shock is centered on the restoration of blood pressure to normal, the presence of adequate tissue perfusion, making sure organs return to functioning well, and avoiding further complications (Lewis, Dirksen, Heitkemper, Bucher, & Harding,

c. 34 years old male who complained of shortness of breath. He was obese and had a history of COPD. He was on two liters nasal cannula. After admitting at the ER, he was tranfered to med-surge floor for further evaluation.

A 62-year-old white male presented to the hospital for a scheduled ventriculoperitoneal shunt removal. The patient had developed cysts in the brain seventeen years ago in 1998 leading to increased intracranial pressures from accumulation of cerebrospinal fluid. After discovering the brain cysts, the patient underwent a ventriculoperitoneal shunt placement. Two years after the shunt was placed, the patient underwent another procedure for shunt revisions due to complications with infection. Now, the patient is presenting for removal of the shunt. In the pre-op holding area, the patient’s vital signs were taken. The patient’s blood pressure was 153/75, heart rate 80, respirations 18, oxygen saturation 93% on room air, and temperature was 36.5 degrees Celsius. Prior to the patient’s surgery, lab work was performed consisting of a CBC and CMP. The patient’s white blood cell count was 11.7, platelets 379, hemoglobin was 10.8 and hematocrit was 33. The patient’s potassium level was 3.7, calcium 9.1, sodium 145, BUN 35, and creatinine 2.21.

She has an ostomy. She was fresh from surgery yesterday, so they gave her pain meds to manage the pain. When I first walked into the room, I learned that she was making snore-liking sounds when she was breathing. From what I have learned, it is called rhonchi. She had many secretions going on. What I was concerned of was how much oxygen she was getting in. I looked at her last vital signs and found that she was had a 92 percent o2 sat level. I was also concerned about her aspirating. Therefore, we had to make sure her HOB 30-45 degrees. I made sure the side rails were up x3 because of fall precaution. She was comfortable most of the time but I taught her but the risk for pressure sores. She understood the need turn frequently to prevent pressure sores. Later I looked in her labs and found that her hemoglobin at 7.1. She was a candidate for blood transfusion. The nurse was teaching me how blood transfusions are done. Before they give her blood, they have to get her last vital signs. We were consistently checking her vitals as we were giving her a blood transfusion. After giving her blood, we had to monitor her and her vital signs for any transfusion reaction. The symptoms of transfusion reaction is shortness of breath and depressed vital signs. Later we found that her oxygen level was at a 93 percent. Afterwards, I looked into her chart and found that he had an XRAY done, which revealed

Two wide bore cannula, were inserted and a full set of bloods was taken including blood cultures. 15 litres O2 via a rebreather mask was applied. Intravenous fluids were commenced and rapidly infused. An ECG was done by the intern. She was checked and rechecked for any signs of bleeding and an internal examine was done by the consultant to check for any retained products. Intravenous antibiotics were also started and given. All drugs such as anaesthetic drugs or analgesia that Susan had been given that day were also checked to see if it had been an adverse reaction. Over the next 40 minutes she began to improve and was transferred to the labour ward for closer observation.

I was also surprised to see a comatose patient gain consciousness after 35 days. As a part of a team caring for this comatose patient in the ICU, I was involved in monitoring his vital signs, airway, nutrition and urine output. I worked closely with other members of the health care team to maintain his physical health. Swithching him form oropharyngeal ventilation to cricothyrotomy for airway management was another challenging task caring for this patient. I built a good rapport with his family members as I communicated

The case I will discuss comes from the Journal of General Internal Medicine and is as follows: the patient is an 80-year-old woman who suffers from nonresectable lung cancer and has been diagnosed with lobar pneumonia. Other conditions present are: hypertension, diabetes, chronic renal insufficiency and severe degenerative joint disease. While improvement was seen with initial treatment, the patient suffered worsening hypoxemia, level of consciousness obtunded, and developed acute renal failure. Thus, the only means to prevent death was intubation with

What began as seemingly innocent muscle weakness and cramping has lead to this patient’s fatal diagnosis. He is one of 2.5 per 100,000 people worldwide who have been