Nursing Care Case Studies

1. The nurse is asked to implement a new, complex, and invasive procedure and is concerned that this may violate the state’s nurse practice act.

Assessment is the initial stage of the nursing process. Roper et al consistently use the term ‘assessing’ to signify that it is an on-going process, and highlights its continuity throughout the patient’s episode of care (Aggleton & Chalmers, 2000). It is divided into two stages to allow for a holistic representation of the patient to be established (Barrett et al, 2009). Effective assessment allows the prompt identification of any changes in a patient’s health status, and if necessary; allows any action to be carried out immediately supporting the delivery of safe, effective care DH (). The formulation of an accurate assessment is a fundamental skill for a student nurse as outlined by the NMC (2004), and so it is important that a holistic approach is adopted for this skill to be achieved. An holistic approach supports the consideration of……..needs,(THEME?) which

The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health. One aspect of their care will be discussed in relation to the nursing process. The model used to provide an individualised programme of care will be discussed and critically analysed.

Before any nursing plan of care or intervention can be implemented or evaluated, the nurse assesses the

Mrs. Cote 57-year-old female here today to establish care. She is a former patient of Marni Nicholas, MD.

1. Monitor the patient's oxygen saturation frequently (once per hour) at rest and after exertion on room air

The new implementations should be individualized around the patient’s personal values and goals. A nurse should empower the patient when times are challenging and continue to consult with the patient throughout the plan of care.

Intervention for COPD is focused on managing underlying conditions. The goal is to improve airway function. Some strategies include using antibiotics to treat infection, diuretics which reduce pressure on the heart and lungs, some bronchodilators to help expanding the airways, as well as corticosteroids to reduce inflammation, and last in severe cases use of mechanical ventilation can be efficient and effective to keep oxygenation in an optimal level

Chronic Obstructive Pulmonary Disease, also known as COPD, is the third leading cause of death in the United States. COPD includes extensive lungs diseases such as emphysema, non-reversible asthma, specific forms of bronchiectasis, and chronic bronchitis. This disease restricts the flow of air in and out of the lungs. Ways in which these limitations may occur include the loss of elasticity in the air sacs and throughout the airways, the destruction of the walls between air sacs, the inflammation or thickening of airway walls, or the overproduction of mucus in airways which can lead to blockage. Throughout this paper I am going to explain the main causes, symptoms, diagnosis, and ways to reduce COPD.

However one would be lax if they didn’t take this as a serious situation. A patient with a partial airway obstruction can be presenting in a couple different ways. In the stable patient the signs may be mild and mostly just worrisome and irritating to the patient. In these cases even thou there is a need to obtain definitive care in is imperative to remain calm so as not to worry the patient. One should consider immediate administration of oxygen by non rebreather to make sure the patient remains stable along with encouraging the patient to cough if the feel the need. However in an unstable patient you would expect to hear noisy respirations, coughing and gagging. As the patient continues to deteriorate the coughing will become feeble and signs of respiratory distress such as anxiety, lethargy and even cyanosis will become apparent.[Joynt 2015] In these cases it is imperative to initiate aggressive oxygen therapy immediately. In cases such as these a paramedic could employ several different methods to ensure the patient doesn’t progress to a complete obstruction. First would be to visualize as much of the airway as possible with the naked eye and remove any obstruction visible. However this is not too be confused with the blind figure sweep of the past. One should never attempt to remove an object that they can not see. Another

DOI: 8/6/2015. Patient is a 51-year-old female licensed vocational nurse who sustained a work-related injury to her back and hips while moving a client. As per OMNI, she was diagnosed with muscle spasm, pain over the low back and thoracic region. She is status post right carpal tunnel release on 02/26/16.

Nursing care is a dynamic field of practice. The way it looks today is far out greater intense and very structured. It advances itself by the use of nursing theories and evidence based practice. Policies and procedures constantly change with the advancement of technology and science. While caring for the patient in the given case studies, a nurse involved utilizes practical knowledge, a culture care model and transpersonal caring relationship to attain a caring environment (Smith & Parker, 2015).

CHIEF COMPLAINT: This is a post op note from a procedure performed July 21, 2015 by David Lin, MD.

While doing to assessment there are focus areas of chronic condition that the nurse should assist

----- Clinic presents a black male 68 years old. Currently experiencing dyspnea and lethargy. For the past week he has been having a increase of difficulty breathing. Complains of alternating periods of sweating and chills. Other symptoms he has been experiencing is a productive cough with expectoration of thick yellow sputum. Patient is a ex- smoker, he was a 40 pack year history, denies smoking, stopped over 10 years ago. Medical history includes chronic bronchitis, hypertension, MI five years ago, has had a angioplasty, and denies chest pain since having angioplasty. Current medication combined albuterol/ipratropium MDI, nebulized albuterol prn, captopril, and hydrochlorothiazide.