Nursing Case Study African American Hypertension

The district nursing team were now to be responsible for the wound care of an ulcer on the sole of her right foot on her impending discharge. She had previously attended the practice nurse and a podiatry service based within her local clinic. Due to a change in circumstances, she was now clearly housebound for the near future due to mobility issues. Prior to an arranged visit, the patient had called the nurse to advise her that she was pyrexial and was experiencing a pain in her right foot that was different from her normal neuropathic pain, which was often problematic. She was also finding it difficult to mobilise and was disinclined for diet but was taking oral fluids.

It’s the nurse's duty to advocate for her patient and to make sure that the patient understands and ask questions if necessary.

Can you imagine back when you were a child and the feeling you had that was associated with going to the Doctor? Do you remember the image of that long, skinny needle that the doctors would have in their hand in preparation to stick you with? If so, you may remember those memories not always being pleasant ones. However, as adults looking back, we may think to ourselves how important that it was to go to the doctor and how important it is now. Despite the importance of the medical profession, nursing in particular requires a tremendous amount of training and further education. However, it is known that becoming a nurse is not an easy task to accomplish which means a greater shortage of nurses. As Lisa Seldomridge and Mary DiBartolo ,two professors of nursing notes in 1998 that “ The current shortage of nurses. . .” led up to the conclusion that precautions need to be taken to determine students that are likely to fail which does not benefit the nurse shortage(361).

I was just two weeks into my internal medicine rotation at Suez Canal University in Egypt, when I encountered a case that I still remember to this day. Ms. Rafat was an elderly diabetic patient that came into our clinic complaining of a persistent wound on the sole of her foot. Upon removing her boots, her complaint turned out to be a foot ulcer with an infection extending to the first and second metatarsal bones .Unfortunately for her, we had to break the news to her and her family that her foot would need amputation. Ms. Rafat was understandably upset but took the news in stride. Following up on her case, I learned that after the surgery, the blood flow to her leg became increasingly poor and she had to return to have a below the knee amputation. Ms. Rafat ended up dying of pulmonary embolism as a complication of her second surgery. This case stayed with me not only because it

The first phase of the nursing process is the assessment of the current needs/problems presented upon Mr. Smith’s arrival to hospital. The initial assessment requires the nurse to gain consent in order to gather any information such as his contact details as well as the contact details of his next of kin who in this case his is wife Susan and also the details of his GP, any known allergies he may have and any medications he may currently be on, whether he has dentures as well as his weight and BMI. During this phase, communication with the patient and family is essential to ensure that correct information is obtained so that a proper informed decision concerning his care can be made. In this case there may be some barriers that may effect the assessment process and that is the speech of Mr. smith is sometimes slurred, therefore he may need his wife to answer some of the more complex questions that require more than a yes or no answer. Nurses need to choose their words carefully so that they match the patient’s ability to understand them avoiding the use of medical jargon (Kraszewski & McEwen 2010). The dignity of the patient must be maintained at all times through all phases of the nursing process and a comfortable environment is essential-preferably in a private room or if not ensuring that the curtain is drawn out of respect for the patient (Barnes

HISTORY AND PHYSICAL EXAMINATION_______________________ Patient Name: Chapman Robert Kinsey Patient ID: 110589 Room No.: 322-B Date of Admission: 23 February ---Admitting Physician: Martha C. Eaton, MD, Geriatrics Chief Complaint: Admitted from Dr. Max Hirsch’s office due to deep ulcer on left toe. Admitting Diagnoses 1. Severe peripheral vascular disease, status post deep ulcer on left toe. Rule out thrombolysis. The patient was admitted to a regular floor. Condition is serious. 2. ALLERGY TO PENICILLIN, which puts patient into anaphylactic shock. 3. Continue with home medications. DETAILS OF PRESENT ILLNESS: Mr. Kinsey is an 87-year-old white gentleman with history of (1) Chronic atrial fibrillation, on Coumadin. (2) Chronic deafness,

The nurse must initially evaluate the patient’s charts for any bacterial precautions and fall risks. As the nurse walks into the patient’s room, the nurse begins by making sure the environment is clean and safe. The nurse would do this by gathering equipment, washing hands thoroughly, and wear gloves. The nurse is then to greet the patient, introducing self, then let them know exactly what you came to do. The nurse should first ask the patient for his or her name, birthdate, location of where the patient is currently at, and the reason as to what

African Americans have traditional health and illness beliefs. They also are known to use folk medicine; the folk healers are root workers. Some African Americans, particularly of Haitian background, may believe in sympathetic magic. Sympathetic magic assumes everything is interconnected and includes the practice of imitative and contagious magic. Contagious magic entails the belief that once an entity is physically connected to another, it can never be separated. This type of belief is seen in the practice of voodoo, when an individual will take a piece of the victim’s hair or fingernail and place a hex, which they believe will cause the person to become ill (Campinha-Bacote, 2009).

I am a second year nursing student in my third week of the practicum placement on a surgical ward with my co-student and the morning shift registered nurses. We had just finished analysing the patients handover report (Levett-Jones & Bourgeois, 2015) and I had been assigned to work with the registered nurse. I was looking after Mrs. Brown (pseudonym) is 82 years old New Zealander was admitted to surgical ward on the 08/06/16 for multiple SCC removals from L) hand and L) foot with skin grafts.

Hypertension is a major health condition which affects many Americans. This health condition may increase the risk of cardiovascular disease and stroke. A normal blood pressure consists of systolic blood pressure divided by diastolic blood pressure, 120/80mmHg (millimeters of mercury). High blood pressure is defined as systolic pressure which is greater than 140mm Hg, and diastolic pressure which is over 90mm Hg. Hypertension influences the health outcomes of black Americans more than other races in the United States. Racial discrimination and socioeconomic status are two major factors which influence the rate of high blood pressure in the black American population.

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to

In the professional setting, knowing the patient through his or her diagnosis, name, history of present illness, laboratory results or reason for staying in the hospital only contributes to the manner of physical care of the patient. However, recognizing the patient 's spiritual needs such as emotional support, mental positivity, and intellectual understanding of his or her situation gives a better assessment, as well as a trusting relationship between the nurse and the patient, as per personal experience. In the ward, it is evident that most of the staff nurses spend their time doing documentations, preparing medications, following-up laboratory requests, as well as reading through the patients ' charts to affirm the physician 's order. Throughout the duration of our shifts as student nurses, I see that the most that the staff nurses get to be conversant with the patient is when certain procedures (such as feeding through nasogastric tube, taking

A surgical nurse is responsible for monitoring and ensuring quality healthcare for a patient following surgery. Assessment, diagnosis, planning, intervention, and outcome evaluation are inherent in the post operative nurse’s role with the aim of a successful recovery for the patient. The appropriate provision of care is integral for prevention of complications that can arise from the anaesthesia or the surgical procedure. Whilst complications are common at least half of all complications are preventable (Haynes et al., 2009). The foundations of Mrs Hilton’s nursing plan are to ensure that any post surgery complications are circumvented. My role as Mrs Hilton’s surgical nurse will involve coupling my knowledge and the professional

the Nurse and coming to a decision on what she is going to do. At the

Urgency of acute care varies depending on the situation but can range to anything from emergency surgeries, to injuries, chronic illnesses, and also for the recovery of those procedures. Majority of the patients in acute care settings are critically ill. Nursing responsibilities in acute care settings are vital to patient’s recovery due to the front line position nurses play as well as the wide variety of tasks carried out. Assessments are made during every encounter the nurse has with the patient along with monitoring the patient’s progress. Nurses are responsible for recognizing symptoms the patient may be experiencing due to illness or injury and whether they fall in the spectrum of normal reactions. Vital signs are measured routinely and can be indicators of the patient’s current status. When vitals are questioned diagnostic tests can be arranged to further assess possible comorbidities the patient may have. Care plans are made to plan interventions the health care team can take to help patients through challenges they face, both physical and mental. Nurses administer medications as well as first aid as needed. They are responsible for maintaining special equipment patients may require including monitors and ventilators are well.