Norco's Adjustment To His Pump Case Study

I was really proud of myself yesterday. I finally got the chance to get practice using IV pumps. I have been wanting to get practice with them for a long time, but never had the opportunity to. I was definitely nervous about it because I’ve never used the IV pumps, and I had no idea of what to expect. I think I did well with them pumps, and I think I didn’t show my nervousness. This week I do believe I made some improvements in areas where I needed to improve in. This week when my patient received a new medication, I was on top of getting the medication administered. The last time I was in Newberry I did not make my patients new order a priority like I should have. I am learning how to receive information from my nurse and determine its prority.

After surgery, Mr. Baker is taken to a room on the medical-surgical floor. He has an IV infusing at 125 ml/hr, a PCA pump, and a nasogastric tube connected to low suction. He is receiving oxygen through a nasal cannula.

hypotensive with a blood pressure of 82/44 mm Hg. His respiratory rate is 28 breaths/min

Throughout my clinical rotation, the only concern for this patient was pain management and discomfort from the chest tube site. The patient was given Ketorolac for a pain of 4/10 using the numeric pain sale. The patient was also at risk for pneumonia and pressure ulcers from immobility and not coughing/deep breathing. Nursing interventions were getting the patient up to the chair and using the incentive spirometer ten-times per hour. Another concern was SOB and fatigue with activities.

DOI: 09/12/2014. Patient is a 45-year-old male vacation relief route sales representative who sustained a work-related injury to his lumbar spine from bending and pulling a bread product. Per OMNI entry, he was initially diagnosed with disc herniation at L4 to L5 with radiculopathy. He is status post extraforaminal L4 to L5 discectomy on 04/09/2015. He has been off work for nearly 2 years.

Per medical report dated 01/23/15, the patient reported of middle and lower back pain and bilateral leg pain with tingling. He was diagnosed with thoracic compression fracture and lumbar spondylolisthesis.

DOI: 12/19/2012. Patient is a 52-year-old female laborer who sustained injury to her neck, back, and right shoulder due to motor vehicle accident. Per OMNI, she underwent an emergency neck surgery with 5 screws at C5-7 and back fusion and rod placement at T8-10.

DOI: 12/3/2012. The patient is a 49-year-old male route sales representative who sustained a work-related injury to his lumbar spine and shoulders while lifting a bread rack out of his truck. Patient is status post bilateral L4-5 laminotomy, complete facetectomy and foraminotomy on 01/14/15.

DOI: 11/24/2011. The patient is a 48-year-old female home health aide who sustained injury while turning a patient in bed to put a clean pad when the bed moved. Per OMNI, the patient is diagnosed with L4-5 disc herniation with annular tear and left knee radicular syndrome. She has undergone posterolateral and interbody fusion at L4-5 on 02/18/2013.

The patient is a 50 year old male construction worker who sustained a work-related injury while lifting heavy boxes of metals. In an office visit dated 12/14/13, patient complaints of intermittent severe low back pain which radiates to bilateral lower extremities. The claimant had an epidural injection, which significantly alleviated right leg pain for a short period of time. Unfortunately pain has returned. It is in the right leg as well as severe pain in the lower back. The claimant wishes to consider surgical intervention due to severity of pain. Objective examination reveals weakness in the right extensor halucis longus and anterior tibialis which are 4+/5. The claimant has diminished sensation along the dorsum of right foot. The claimant has a positive straight leg raise.

DOI: 9/30/2011. Patient is a 41-year-old male information technology computer support specialist who sustained injury while he was walking through a lobby when he slipped and fell. Per OMNI, he was initially diagnosed with lumbar intervertebral disc syndrome, myofasciitis and right arm strain. He underwent a right shoulder surgery on 07/16/13 and 12/22/15.

DOI: 06/23/2011. This is a case of 41-year-old male maintenance worker who sustained injury to the low back while taking off a sliding door of a patio. As per OMNI notes, patient is diagnosed with lumbar disc disorder with myelopathy. MRI of the lumbar spine dated 6/28/15 revealed recurrent left paramedian L4-5 disc herniation with caudal extrusion of a 10 mm fragment into the left L5 lateral recess. As per office notes dated 7/25/16, the patient is status post redo left L5-S1 discectomy performed on 4/20/16. It was also noted that the patient had a prior L5 laminotomy several years ago. He subsequently did well. However, he had recurrence of his pain. Pain is radiating into his left leg worse on the right leg. This was unresponsive to conservative

DOI: 2/11/2014. This is a case of 37-year-old male production worker who sustained a work-related injury to his back when he bent over to scan the rack tracking bar. As per OMNI, he was initially diagnosed with lumbar spine sprain/strain and gastritis secondary to non-steroidal anti-inflammatory drugs. Patient is status post left-sided L4-5 discectomy on 03/11/2015.

DOI: 3/2/2016. Patient is a 28-year-old male pipe fitter who sustained a work-related injury to his lower back when he stood up after kneeling down, molding a pipe. As per OMNI entry, he was initially diagnosed with low back pain. Patient is status post right L5-S1 microdiskectomy with use of microscope on 7/13/2016.

Initially the nurse explained him about the need for the fluid therapy, the route of administration and attained the consent from him (NMC, 2015). The nurse also informed him about the need for keeping the measurement on his fluid intake and output. In an adult, the normal urine output is .5ml/ kilogram body weight (Campbell, 2011). Moreover, the nurse assessed his vital signs at regular intervals, which is a clear indication for his health status. In addition to the intravenous fluid, the nurse encouraged him to drink more water for the fast recovery. Furthermore, as the nurse also made him aware of the needs for blood test on the next morning, he felt more informed and respected and made him more adhere with the