CC
Amy is a 29-year-old here today for a followup regarding her anxiety and depression. She would also like to talk about some dysuria she is having and a breast lump she has noticed.
HPI
The patient tells me overall she is feeling better from an anxiety and depression standpoint. She thinks the Lexapro has been helpful. She has been on a regimen of 10 mg daily since mid August. She tells me that her mood seems better. She is less irritable. She is less anxious about everything all the time, in her words. She initially had some nausea, as well as some tiredness, but those have resolved. Her energy level is good, except that she awakens in the night with her son which makes her somewhat tired. Her appetite is good. She is eating and drinking normally. Her weight is stable from her last visit. She is feeling well enough on this dose that she does not feel she needs to make any changes. She would describe herself as feeling 90+ percent improved. She still does struggle some with sleep. When we discussed this initially, it was unclear what the cause was, but with more discussion, it seems as though if her son were not waking her up, she would be able to sleep through the night. She is going to monitor that. They are going to work on trying to help him with his sleep issues and will
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She says just for last couple of days she has noticed that there is some burning with urination and perhaps an odor in her urine as well. She does have a history of kidney stones about five years ago and passed them on her own. She knows that she has some residual kidney stones and is not sure if that is the issue. She is not having any urgency. She has not noticed frequency. She does not feel as though she is incompletely emptying her bladder. She has not had a discharge. No concerns for STDs. She is about a week away from the start of her menstrual cycle. No concerns for pregnancy at this time or STD at this
Mrs. Wilson is seen in her room at Glenbridge Nursing Home on 02/28/2018. She had an episode last night of chest pain. She is so ebullient and distracted that it is hard to get a straight history, it came on when she was asleep but she may been sitting up. She was seen by a nurse, a sat was taken. I am not sure if there were other orders taken, but there is none on the chart. She says that she spent most of this morning in the bed and still feels tired, but she does not think she broke out in a sweat. She was more short of breath. She is calling it is a "stroke." I had tried to begin tapering her diazepam by discontinuing the morning dose and apparently all daytime clorazepate was discontinued by error and she gets it only at night.
Burkhardt, M. & Nathaniel, A. (2008). Ethics & issues: In contemporary nursing, (3rd ed.) Clifton Park, NJ: Delmar
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.
PMHx: No history of chronic illness. She was recently treated for strep throat with a 10-day course of penicillin. Has been hospitalized two times for childbirth, no surgeries.
2. If a healthcare team member didn’t wash their hands before assessing my loved one, I would kindly ask them to please wash their hands before they start in order to keep my loved one from getting any possible germs that might be on their hands.
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.
Although most people think they can get away with picking an easy topic for their senior projects it turns out to be a little more complex than that. Growing up my ideas and passions would always seem to be changing but when I finally became set in my ways at least in knowing what I would like to pursue the Nursing Program was up to par. I chose to do mine on Nursing in the ED (emergency department) because this is a field I would love to go into so I can be of service to those in need of any medical care, to always have a stable job to rely on, and further more to be able to excel in the field of medicine. I would love to be one of the people on call to respond to the needs of another individual in their time of need. Anyone could only
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine
Fred (W.E. Bowman) gave a brief progress update: Flooring down today and tomorrow, after that, trimming everything out on 1 South. The cabinet installers are ready but having are having a man power issue trying to find people to install the cabinets. They are hoping to be here in the next couple of days. There is a massive labor shortage.
Jennifer Edwards – Target population of A1C greater than 9. She wants to check it out at one clinic and see how it turns out, even though Dr. Gardner does not like to use just one clinic. Jennifer Edwards was asked to find out what clinic Hope Galvan wants to use.
DOI: 4/12/1994. Patient is a 62-year old female upholstery seamstress who sustained injuries to her upper extremity due repetitive sewing and reaching. Per OMNI, the patient underwent a left leg below the knee amputation on 08/12/12 and was fitted with prosthesis on 02/04/13.Per AME report dated 11/01/2010, the patient is at Permanent and Stationary status. She is to have regular visits with a rheumatologist and Food and Drug Administration (FDA)-approved medications. She will need continued treatment for her diabetes, as well as osteoporosis. She also needs to participate in a weight loss program such as Lindora. As per office notes dated 6/22/16, the patient complains of back pain, neck pain, shoulder pain, elbow pain, wrist pain, hand pain, finger pain, low back pain, hip pain, knee pain, ankle pain, foot pain, and toe pain. The patient has pain for20 years. Pain rating is 6/10 at least and 8/10 at worst. She reports
The application of either an AP glide or LAT glide to the lower cervical spine in subjects with acute unilateral neck pain resulted in a significant decrease (P < .001) in self-reported level of pain at worst. This reduction in pain across all subjects almost reached clinical significance. Additionally, the reduction in worst pain reported from pre- to post-treatment was significantly different (P = .027) between the two groups with the AP group experiencing a greater reduction in pain than the LAT group. Therefore, the AP glide may be a better treatment option for reducing pain in individuals with acute neck pain. The improvement in pain in the AP group was clinically significant, as indicated by exceeding the MCID for
This is a house call I made on this 94-year-old individual, multiple medical problems including chronic obstructive pulmonary disease, recurrent exacerbations of COPD with recurrent hospitalizations for pneumonia. Past medical history also includes that of recurrent hyponatremia intermittent atrial fibrillation,coronary disease, heart failure, pulmonary edema, hypertension, chronic constipation. The last time I saw her was in 01/2017. She had a previous hospitalization one year ago at Rex Hospital for respiratory failure from COPD. CPAP was used for rescue and family apparently got a CPAP machine at home for intermittent use. Since the last time I saw her in January, the patient has become non ambulatory. The last time I saw her
A female patient seeking contraception options needs to select a method that is best for her and her partner. What questions and/or discussions would be important for the nurse practitioner to ask the patient when counseling her about contraception methods?
This assignment will present a nursing care study of a patient on a cardiac ward. The patient will be referred to as Ann to maintain confidentiality (NMC, 2008). Ann’s consent was gained prior to starting this care study. The care study will be developed using the Nursing process and the Roper, Logan and Tierney model. These will both be outlined. The assignment will focus on the assessment process and one problem identified during the assessment and the nursing care which followed this.