Nursing Clients with Medical Surgical Conditions - Comparative Analysis of a nursing practice

Studies to show which type of leg compression device is optimal for DVT prevention are not available. Knee-length SCD’s are more comfortable to patients, encourages higher levels of compliance and also provide beneficial prophylaxis against DVT.

There are various ways to prevent pulmonary embolism from occurring which includes, various leg exercises to minimize the chance for DVT to develop, the cessation of cigarette smoking in females who use oral contraceptives, and reporting any signs and symptoms to your primary health care physician to reduce the amplitude of the effects (Porth

I think you have a great capstone project idea Katrina. I didn’t realize there was such deviation in treatment either. When I researched the library I found a review by Flierl, Messina, Mitchell and Da (2015) that acknowledges the fact that orthopedic surgeons vary greatly in their treatment regimen in the prevention of DVT’s in post-operative patients (p. 253). Maybe the article will interest you Katrina as supportive literature on the subject.

The use of the preoperative huddle prior to the patient entering the operating room suite improves safety, communication, cost, and the quality of care for the surgical patient by addressing issues and optimizing the patient before he/she is on the operative table and anesthetized. The use of sequential compression device (SCD) therapy on a patient having local sedation for a procedure with a 25-30 minutes duration was brought into question during the huddle process. It was felt by some team members that all patients should have SCDs if they are to have a surgical procedure. That is how it has always been done at this hospital. Other team members felt that this was a waste of hospital resources because it was not general anesthesia and it was

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

Data sources: The search engine that was used to find three randomized controlled trial articles and support my PICOT question was PubMed. Key terms that were used to search for them included intensive care unit infections, chlorhexidine dressings, antiseptic solutions, and prevention methods for catheter-related infections. A clinical guideline for the prevention of intravascular catheter-related infection was retrieved from the Agency for Healthcare Research and Quality (AHRQ).

Compression stockings and brief walks to promote blood circulation can aid in resolving and also preventing DVTs. Findings from clinical trials have shown the effectiveness and safety of pharmacological prevention with low, fixed doses of anticoagulant drugs (Goldhaber). “Although approximately half of venous thrombotic events treated with traditional anticoagulant blood thinners resolve during a 3 to 6 month conventional duration, the risk of Post Thrombotic syndrome (PTS) persists, possibly due to acute valvular damage from complete venous obstruction (Greene). Anticoagulants have been recommended for at least 3 months, though duration of this therapy should be based on the risk of recurrence as well as whether the blood clot has

Testing for DVT consist of serum blood testing for specific enzymes called D-Dimer which is a byproduct fibrinolysis; then it would suggest recent presence and lysis of thrombi (Douketis, 2016). Other diagnostic procedures include duplex ultrasonography of the affected limb to determine blood flow in the affected area and contrast venography. Treatment of DVT consists of anticoagulant therapy intravenously, subcutaneously flowed by oral anticoagulant therapy for maintenance, insertion of inferior vena cava filters, thrombolytic medications to dissolve the blood clot (Douketis, 2016). The last option for treatment of DVT is surgery which is rarely needed; thrombectomy is the surgical procedure where the clot is removed manually from the place of

Central venous catheters (CVC) have become the most efficient means to administer long-term, vital medical treatments in hospitalized patients. These catheters are used in almost all types of medical settings for purposes related to, “hemodynamics monitoring, parenteral nutrition, chemotherapy, hemodialysis etc.” (Gorji, Rezaei, Jafari, Cherati, 2015, p.1). Its clinical relevance has become extremely significant in relation to treating patients with all sorts of medical diseases who necessitate the administration of extravasation drugs that can solely be administrated by a CVC. Therefore, CVC have “led to reduction in duration of hospitalization, increment of safety and reduction of hospital charges” (Gorji et al., 2015, p.1). Its benefits

When we came back for the procedure, Caitlin had to grab something and asked me to step in to help provide procedural support. I used the iPad that Caitlin had already engaged the patient in and continued to let him watch “PJ Masks.” I used strategic placement of my body and the iPad to help the patient turn his head so that the laceration was more visible to the MD and so that the patient was unable to touch the sterile blue towels/his face. During the procedure, I tracked the patient’s

A flexible rubber tube was used to create a path between an artery and vein known as a graft. The graft sits under the skin and is used in much the same way as the fistula, except that the needles are placed into the graft rather than the patient 's vein. Grafts are beneficial because they heal faster than fistulas and can often be used in about two weeks after they are placed. Yet, complications such as narrowing of the blood vessels and infection are more common with grafts than with fistulas and must be closely watched for these problems. Some ways of preventing such complications are as follows: “Wash the access with soap and warm water each day and always before dialysis. Do not scratch the area or try to remove scabs. Check the area daily for signs of infection, including warmth and redness. Check that there is blood flow in the access daily. There should be a vibration over the access. If this is absent or changes, notify your healthcare provider. Do not wear tight clothes or jewelry, carry heavy items, or sleep on the arm. Do not allow anyone to take blood or measure blood pressure on this arm. Rotate needle sites on the access. Use gentle pressure to stop bleeding when the needle is removed. If bleeding occurs later, apply gentle pressure; call a healthcare provider if bleeding does not stop within 30 minutes, or if bleeding is excessive.”

If you believe you are beginning to develop varicose veins or have any symptoms of venous insufficiency, compression stockings may be right for

Third, most rarely a condition called compartment syndrome can occur. This serious condition will present with swelling, pain, and decreased capillary refill. Compartment syndrome can present with infiltration of the IV, signifying that the catheter has become dislodged and is no longer in its proper place. A buildup of pressure in the extremity that was holding the IV can then insue. As pressure builds, a decrease in perfusion of the area will begin resulting in the limb being deprived of oxygen. If not promptly treated the patient can lose his/her extremity and even life. Shortening the length of tourniquet time and the pressure of the

Addition to stenosis and infection, thrombosis and high flow AVF also contributes to HD complications. Thrombosis was considered as the main reason for vascular access failure which usually evolves in near proximity of stenosis and mostly in the area of anastomosis or venous outflow, it might lead to central venous obstruction with clinical sign of chronic swelling of the upper limb (Potisek, Ključevšek & Leskovar, 2017). High flow AVF is a real risk leading to significant cardiovascular morbidity by increasing cardiac output (Chapman, Nicdao, & Kairaitis, 2016). Compare to high flow AVF, low flow AVF seems easier to be identified through cannulation related problems or pressure alarms during dialysis by nurses. High flow AVF may be not noticed by nurses for a while because it doesn’t cause difficulties with cannulation and trigger pressure alarm (Chapman, Nicdao, & Kairaitis, 2016).

Despite the successfulness of DES there are still many factors that enhance negative side effects: the risk of late-stage thrombosis, continued neointimal tissue growth, malapposition and resuced vasomotion (43). The occurrence of late-stage thrombosis is most probably due to the consistent presence of a foreign body within the vessel. This causes a chronic inflammatory response …