Nursing Case Study : Jane Jackson's Case : Janet Jackson

* Personnel Issues: One of the key barriers to effective interaction for the pre-op nurses is that they are not getting any information from the registrar or the surgeon related to the patients unique circumstances. There is not a communication process in place for the pre-op nurse to actively communicate with the surgeon or his office regarding a patient’s care during their day of surgery. An additional factor in this situation was the pre-op nurse documented the mother’s contact information in her notepad, but not on the

Fibroids are becoming more and more common in women in the United States. It is estimated that 171 million women in the U.S. were affected by this condition in 2013(6). About 20% to 80% of women develop fibroids by age 50 (6). As many as three out of four women may have uterine fibroids in her lifetime (4). Fibroids, also known as uterine leiomyoma, are benign tumors that can be found in women of childbearing age due to its dependence on estrogen and progesterone (7). They are made of muscle cells and other tissues that can grow around or in the uterus or womb. With fibroids, a single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue (2). Some fibroids even go through growth spurts where they grow and shrink on their by itself. There are women with fibroids who have no symptoms at all. If they do, it may consist of heavy or painful periods, frequent

Joshua is a 31-year old who presents from CRU from UPC. He is ACOT for wanting to leave valley hospital against medical advice. He was admitted to Valley Hospital on voluntary basis for increased depression and anxiety. BHR have a hx of OD and hanging. He is allergic to vicodin. Upon admission, his vital signs were within normal limits. He is partially cooperative, he stated, "I just want to go to bed." He will benefit from meeting with the provider and discussing medication management.

During my rotation in the operating room at Community medical center, I observed the preoperative, intraoperative, and postoperative care for a patient who underwent a laparoscopic hysterectomy. I believe that an appropriate preoperative plan of care for this patient would have included a full physical exam and an interview for patient history, a pelvic exam to look over and understand the nature of the patient’s complications, blood testing including a CBC and WBC to note any signs of infection or contraindications for the procedure, and a urine test to rule out any urinary tract infections or pregnancy. It would be important to interview the patient and ask questions to determine how the patient is feeling about their procedure and to better assist with any anxiety or pain they may be dealing with preoperatively. It is important to consult with the patient well before the procedure to ensure that she knows to refrain from smoking for at least 8 weeks before the procedure because this reduces the risks of complications such as infections, issues with blood pressure, heart rate, blood flow, and respirations when under anesthesia, and promoting overall health and risks associated with smoking after the procedure. (ASAHQ) It is also important to educate the patient to consume no food or drinks after midnight the night before the scheduled procedure. (Health Communities) During my rotation I observed that the patient did indeed have labs drawn and a urine test run. Her lab

When addressing the needs of a patient, a thorough assessment of all body systems should be performed. In the case of Mrs. P, a patient with a history of diabetes, hypertension and chronic obstructive pulmonary disease (COPD) who was recently diagnosed with Stage IIIB, large cell, undifferentiated lung cancer, an assessment of her respiratory status is to be performed. During this assessment the nurse should evaluate the airway for patency and assess the quality of respirations, a pulse oximeter reading should be obtained. Should she have inadequate respirations and show signs of dyspnea, the nurse should begin interventions such as repositioning and delivering oxygen. The nurse should promote coughing and deep breathing, particularly if secretions

During my third year of nursing clinical placement on 3B surgical unit, I met a client, Mr. X, who was 75 years old Caucasian male with a diagnosis of small bowel obstruction/ perforated bowel. He had a surgery of laparoscopic right hemicolectomy with ileostomy and the laparoscopic incision closure of JP drainage three days after the first surgery. His past health histories were class one obesity, hypertension, asthma and chronic obstructive pulmonary disease (COPD), over 30 years of smoking, chronic lymphocytic leukemia (not on any chemo agents). Mr. X had previously independent activity daily living and remains slow to respond, they lived in bungalow with three dogs. Their daughter and son live out of

A fibroid is “a tumor or lump made of muscle cells and other tissue that grow within the wall of the uterus” (Illinois Department of Public Health, 2015). According to the UCLA Obstetrics and Gynecology team, “fibroids are the most frequently seen tumors of the female reproductive system… twenty to fifty percent of women of reproductive age have fibroids, although not all are diagnosed. Some estimates state that up to thirty to seventy-seven percent of women will develop fibroids sometime during their childbearing years… in ninety-nine percent of fibroid cases, the tumors are benign” (UCLA Health, 2016). Uterine fibroids are the most common cause for a hysterectomy. A hysterectomy is the surgical removal of the uterus. “Hysterectomy is the second most frequently performed surgical procedure (after cesarean section) for U.S. women who are of reproductive age… By the age of sixty, more than one third of all women have had a hysterectomy” (National Women’s Health Network, 2015).

The plan I would need in place would first to address her respiratory status and maintain a patent airway. I would also want to have the patient demonstrate how to splint while deep breathing or coughing. I would ask the Cna to help with position changes every 2 hours or more if needed for comfort for the patient. I would need to do a full assessment at this point if the patient is more stable. By having the patient deep breath will also help her return to consciousness, (Ahmed, Latif and Khan, 2013). I would want to keep her comfortable and in as little pain as possible. I would also want to try to educate her as to when to push for pain medications from her PCA pump. If there were any family I would want to try to get them involved with the education as well. The use of an incentive spirometer should be included in the teaching too. I would keep monitoring the incision site and watching for signs that the patient is in pain. While I was working on patient education with this patient, I would ask the CAN to do vitals on the 2 postop patients every 15 minutes for the first hour, reporting abnormal vital signs to myself or the other R.N. I would also ask the other R.N. if she/ he would do the discharge for that patient, while I remain with this patient and make sure she is going to stay stable.

The patient on which the care plan will be assessed will be a 72 year old female, May Watters who I assisted in the care of during clinical placement in the Emergency Department (ED). May Watters is a pseudo name to ensure confidentiality to An Bord Analtrais standards (ABA 2000). May was brought in by ambulance which was called by her husband Jimmy. May was brought into the ED for Diarrhoea and Vomiting 5/7 days and generally unwell and weakness and non productive cough. Mays’ husband who is her next of kin was concerned about her deterioration

Fibroids are non-cancerous tumors of the uterus (womb). Fibroids grow out of the cells that make up your uterus. Uterine fibroids (also called myomas or leiomyomas) are benign (noncancerous) tumors of muscle tissue that can change the shape or size of the uterus and sometimes the cervix. They start in the smooth muscle cells inside the wall of the uterus (myometrium). Fibroids usually occur in the form of multiple tumors, although single fibroids are sometimes possible. Fibroids can be as small as a pea or as large as a football. Having uterine fibroids does not increase your risk of cancer. They are almost always benign, no matter how large they get.

Stromal tumors of the ovary include thecoma and fibroma, yet as differentiation between these two types may be difficult, the term fibrothecoma has emerged. The exact incidence of fibrothecoma is unknown, although they have been described as rare ovarian neoplasms1. Here we present an unusual clinical manifestation of ovarian fibrothecoma with abdominal distension in a young female. Grossly, the resected left ovarian mass measured 16x16x10 cm and right ovarian mass measured 3.5x2x0.4 cm. Cut surface of both was firm, grayish white fascicular pattern with few yellow areas (Fig.1). No normal ovarian tissue was identified. Fibrothecomas are round, oval or lobulated solid tumors that cast stripy shadows and are associated with fluid in the pouch of Douglas, and most manifest minimal to moderate vascularization. A fibrothecoma with atypical ultrasound appearance may be

He finally responded to the treatment, regained his conscious after in ICU for two days. The patient transferred to our floor, which is Medical Surgical, before being discharged to go back home. The patient wife was constantly at his bedside, she participated in the patient care, but she appeared very anxious. I spoke with the wife calmly and in private with my nurse care manager. We found out that the wife was very concerned about caring for her spouse when he is discharged. She did not want to go through another episode of hypoglycemia. The wife explained how terrified she felt when the event occurred and she thought her husband was going to leave this world. She expressed the need for help with meal preparation for her husband. We were able to get a nutritionist to speak with the wife and husband, regarding the importance of balancing his meals and what types of foods to include in his meal plan. The social worker also became involved in the patient care and she was able to set up home health service to assist the patient and spouse. Studies have shown that patients’ who are discharged home with home health nutrition services, the physicians noted an improvement in the patient health after receiving nutrition education (Clement, Cook, Benefield, &

Uterine Fibroids are non-cancerous growths that develops in the myometrium layer of the uterus. A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue (EA, 2013). There are different types of growth patterns to uterine fibroids. Sometimes they are small and in some cases they are extremely large. Woman between the ages of 30-and 40 years old are more at risk of developing uterine fibroids. They develop mostly in the child bearing years of a woman’s life. African American women have a greater risk of developing uterine fibroids at a younger age than any other race. Uterine fibroids are also called leiomyomas or myomas. Uterine Fibroids can develop on the inside or outside of the uterus.

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.

According to the Mayo Foundation for Medical Education and Research, doctors aren’t certain what the cause of fibroadenoma is but they figure it’s from the reproductive hormones during the young age. This has been assumed because fibroadenoma appear during the reproductive years. In addition, they also assume that the increased risk of fibroadenoma occurs or get bigger during pregnancy or use of hormonal therapy. (Mayo Clinic Staff 2014) Later on during the postmenopausal stage, when your hormone levels are decreased, the tumor may shrink in size.