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.

Following exposure to epinephrine, the heart was allowed to return to its resting state determined in procedure 1. This same procedure was repeated with the following chemicals: 1) Acetylcholine, 2) Atropine, 3) Calcium solution, 4) Nicotine solution, and 5) Caffeine solution.

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

It was noted that the patient has neck pain, facet arthropathy and spondylosis, suggestive of facer joint origin, 80% relief from previous facet nerve injection/block, prior rhizotomy more than 6 months and cervical/thoracic facet medial branch nerve block which has been helpful, failed conservative treatments with nonsteroidal anti-inflammatory medications (NSAIDS), PT, chiropractic care and home exercises.

Carey reported that she experienced occasional numbness of the upper extremities and that she would occasionally drop objects from both hands. Upon physical examination, Dr. Abiera noted that Ms. Carey’s range of motion of the cervical spine was decreased on flexion and tenderness on palpation of posterior cervical muscles with spasms and trigger points was present. In addition, Dr. Abiera noted that the range of motion of lumbar spine was within normal range, however there was still some tenderness on palpation of thoracic paraspinals muscles.

Mr. Brann is a 42-year-old male here today for followup from his left cerebellar stroke and left vertebral artery dissection, status post hospitalization in May of 2015

B.T. has a nursing diagnosis of ineffective airway clearance that requires nurse management with prescribed beta 2 adrenergic agonists, and teaching effective coughing and breathing techniques. The respiratory therapist will assist by performing nebulizer treatment and teaching the patient about home nebulizer. The nurse will emphasize on the importance of adhering to medication regimen and taking the right medication at the right time.

----- 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.

The patient was compliant to all aspects of treatment and the home exercise program. There are no known alternate explanations of the outcomes of this case report. However, in comparison to the case report by Caldwell et al25., the patient in this case report displayed a faster decrease in pain and return to normal function indicated by 0/10 VAS, 0% neck disability and ability to perform all tasks for work at the last day of treatment, 3 weeks from the first day of physical therapy. Possible explanations for the faster recovery could be due to the slight difference of impairments as well as the addition to grade IV and V manipulations to the cervical and thoracic spine as suggested to have high correlation with decrease in pain and normalization

The complainant, Nursing Service, RN John Allen alleges on August 18, 2015 that Patient Mr. Ulysses Grant Jr. checked in for his appointment without checking in with VA Police personnel. In addition, Mr. Grant was not accompanied by a uniformed VA Police Officer as directed. by XXXXLETTER???XXX dated XXXX.

Topic: Nurse Practitioner the Role they hold in our Health Care, how changing their scope of practice may help with the demand.

My new role as an adult/gerontology nurse practitioner (AGNP), will be part of team that provides care for Long-term acute care LTAC, Skilled Nursing Facilities (SNF), or Rehabilitation hospital. After gaining considerable experience, my focus in future will be working in home healthcare and primary care clinics. My scenario will involve an organization that provides innovative, collaborative, health care team for one hundred bed LTAC Hospital. Working as an LTAC registered nurse, I noted that, despite the variety of diagnosis, majority of patients’ presents to LTAC hospital have wounds that require complex wound care management. The wounds can range from pressure ulcers to non-healing illness/injury wounds such as diabetic foot ulcer, venous leg ulcers, and post-surgical wounds among others. For this assignment, my scenario will focus on the role of Nurse Practitioner (NP) on skin care and wound managements.

Chronic neck pain is common, costly, and a leading cause of disability. Literature suggests that ascending pain pathways (i.e. pain pressure threshold or PPT) and/or descending pain pathways (i.e. CPM) may be impaired in those with chronic pain [please see Appendix for illustration of ascending and descending pain pathways]. Spinal mobilization (SM), a form of MT, is a common treatment that has been effective in relieving neck pain according to Cochrane Review (Gross et al 2015). A recent systematic review (Coronado et al 2015) concluded that although the pain relief from MT seems to improve PPT; the pain relief, however, is not associated with PPT, a measure of the ascending pain pathways. Whether the pain relief from SM is due to its effects on the descending pain pathways (e.g. CPM) is not known at this time.