Nursing Case Study

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).

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.

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.

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

I value your capstone project. I work in long-term acute care with clients who are on the vent with compromised pulmonary and cardiovascular problems, and I agree with you that there is limited evidence- based intervention to guide clinicians who work in acute care. It is imperative that OTs take the leadership role and train nurses and CNAs on the importance of bed mobility and transfers to eradicate problems with decreased functional mobility with bedsores and severe sacral wounds secondary to prolonged bed rest.. In addition, lack of physical activity and prolonged bed rest have significant consequences on musculoskeletal, cardiovascular, respiratory, (Parry & Puthucheary, 2015).

Karen Meunier, is the education consult for New Orleans’s Childrens Hospital Ventilator Assisted Care Program (VACP). Mrs. Meunier educated the audience on the history of ventilators. Next, Mrs. Meunier stated the criteria for the children who are enrolled in the Ventilator Assisted Care Program. Overall, these children either have a neuromuscular, brain and/or spinal cord injury, and/or birth related diagnosis. The children in the program live at home in Louisiana, under the age of 26, Medicaid eligible, and require daily mechanical support of respiratory efforts. Lastly, Mrs. Meunier informs the audience about each member in the VACP staff. The VACP staff includes an education consultant, respiratory therapist trainer, two case managers,

Out of the 53 subjects, twenty six patients were recruited to the hospital at home care and twenty seven were hospitalized. The two groups were similar in demographic, clinical, and pulmonary function characteristics, however pneumonia as a cause of acute decompensation was most frequent in the hospitalized group versus the hospital at home group. In the hospital at home group 18 subjects or 69.2% responded well and eight required hospitalization. These eight subjects were all older and suffered from ALS which is an advance form of NMD and also had a history of more hospitalization during the last three years. Three out of those eight subjects required intubation due to mucus encumbrance and severe hypoxemia and eventually needed a tracheotomy. Three other subjects required full time ventilatory dependence and a 24 hour surveillance in respiratory ICU.

The American Journal of Critical Care is a bi-monthly, peer-reviewed journal focused on improving the care of critically ill patients and their families. The authors provide resources in the form of research studies, case reports, reports on new techniques, clinical/basic science reviews, guest editorials and clinical studies. The editors strongly encourage works focused on collaborative practice and research targeted at health professionals caring for critical care populations.

For the past 50 years acute respiratory distress syndrome or better known as ARDS, has been an issue in hospital intensive care units all around the world. The first “documented published scientific description dates back to 1821 when Laennec described the gross pathology of the heart and lungs and described idiopathic anasarca of the lungs; pulmonary edema without heart failure in a treatise on diseases of the chest.”1 Cardiac and non-cardiac issues were not taken into consideration as part of the cause at that time. The first definition dates back to Ashbaugh and colleagues in 1967.2 Though modern medicine has been around for hundreds of years, it wasn’t until hospitals designed intensive care units and began using mechanical ventilation

My role as an Advanced Critical Care Practitioner (ACCP) involves me working with patients with multi-organ failure and more often respiratory failure following prolonged periods of ventilation and lung insult. ARDS has been studied in a variety of settings since it was first introduced by Dr Ashbaugh (Ashbaugh et al, 1967), at which time mortality was between 60% and 70%, however, the most effective way to ventilate patients with ARDS is still being researched. Despite this ongoing research into the management of ARDS, mortality remains at 35-40%. It is thought this is linked to lack of knowledge and evidence regarding the pathological process of ARDS.

Keefe (2011) describe case as a safe way for nurses to utilize theoretically and real knowledge to an actual or possible scenario. Case study also examines the in-dept of a nursing situation and apply decision-making skills as well as critical thinking to analyze the situation, and develop a cognitive reasoning abilities without harming a patient. According to Billing and Halstead (2012) case study is beneficial in that it stimulate critical thinking, retention, and recall. Case study also aid students in recalling pertinent information by associating the practical with theoretical. Developing a case study may be difficult and time consuming and may be deemed as disadvantages for faculty. Students may also desire the more traditional lectures

Betty has been an RN for two years and is the charge nurse of the medical unit on the evening shift of a small rural hospital. During her two years as a nurse, she has floated to many other areas of the hospital, but most of her experience has been on her medical unit. On the evening shift the medical unit is usually staffed with an RN, LPN, and an aid.

A patient experiencing ARDS requires extensive ongoing nursing management. Some treatments anticipated would be treating the underlying causes, promoting gas exchange, supporting tissue oxygenation, and preventing complications (Urden et al., 2014, p. 523). Some nursing interventions can focus on optimizing the oxygenation by positioning the patient in a prone position (Urden et al., 2014, p. 524) as it is shown to improve the oxygenations in patient with ARDs. Also frequent reassessment of secretion clearance and suctioning the patient to assist with the pulmonary edema the patient is experiencing. Another medical management is administering medications as orders and utilizing PRN medications such as bronchodilators to facilitate the decrease

In the given case study the patient presented with complaints of nausea, vomiting, severe dehydration and syncope .Nausea and vomiting are not diseases they are symptoms caused by many conditions such as motion sickness, gastrointestinal diseases, circulatory diseases such as congestive heart failure, central nerve system disorders such as meningitis, brain tumor or injury, or it could be due to metabolic disorders like uremia (McCance & Huether, 2014, Chapter 3). Conditions like early pregnancy, food poisoning, infections, bulimia, over eating also causes nausea and vomiting .Side effects of most medications includes nausea and vomiting. Most times timing of the nausea and vomiting could indicate the cause. In order to rule out the causative factors for nausea and vomiting a thorough assessment, and review of most of the

The following is a case study of a 45-year old female patient; presented with a one-month history of sharp upper back pain. Consequently, this pain was felt at the hand of a motor vehicle accident. In the paper, I will recount the means of what take place in the by-product of an X-ray image; which fell outside acceptance limits for the designated view. The investigation described here will contrive the methodology necessary to succeed an X-ray image to fall under acceptance limits.