Nursing Reflection

A nurse can learn and become confident through reflecting on an incident. When a procedure has not gone to plan, they can reassess and improve on their skills the next time they carry out a procedure. The nurse can also reflect on

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

Critical reflection is an indispensable tool used in evidence based nursing practice. Critical reflection is often a difficult concept to define as all health professionals interpret it in diverse ways. However, one definition of critical reflection is the revision of nursing practice experience so that it can be described, analysed and evaluated to use that knowledge to improve on future practice (Bulman & Schutz, 2013). Critical reflection is essential for nursing practice because it ensures patient safety and provides holistic care. This assignment will discuss in further detail a description of an event, a reflection of thoughts and feelings and an evaluation of the positive and negative sides of the incident from both the nurse's and the patient's viewpoint and the consequences. Followed by an analysis of what can be taken away from the event to further improve future nursing practice as well as what can be done to improve one's own learning and develop an action plan using new knowledge.

Robert Johnson noticed blood in his stool. For several months , he had experienced pain in his abdomen and diarrhea. What endoscopic procedure will his physician order?

Mr BW had a surgical history of anterior resection for bowel cancer and had undergone a colectomy post iatrogenic perforation. He had known hypertensive and non-compliant with his medication. At the same time, he was known to be alcoholic abuse, seizure and had prostate cancer, which was treated with brachytherapy that was well controlled.

Sorry to say, some colon cancers might be present without any signs or symptoms. For this reason, it is very important to have regular colon screenings or (examinations) to detect these problems early. The best screening evaluation is a colonoscopy. On the other hand, most colon cancers are connected with signs or symptoms. One of the early signs of colon cancer is bleeding. Most of the time , tumors often bleed only small amounts, off and on, so that evidence of the blood is found only during chemical testing of the stool, which is called a fecal occult blood test. Other signs and symptoms include:

During the capstone simulation experience, I believe I performed well in quickly reporting the perforated bowel to the provider. This is an urgent issue that needs to be addressed quickly to prevent many serious complications such as: peritonitis, sepsis, hypovolemia, and low H&H due to excessive bleeding. The routine procedure of a colonoscopy is not without risks and this simulation experience was a great example of how an adverse event can go undetected until after discharge or when the physical symptoms appear and start ailing the patient.

In this essay I will be discussing the current recommendations for large bowel screening, to diagnose bowel cancer, including those categorised as high risk. I will also be discussing the role of imaging in the initial diagnosis and the subsequent follow up.

After extubation, the patient endured acute delirium. The attempt to control agitation using ativan, haldol, and thorazine was not successful. Consequentially, dexmedetomidine was used to sedate the patient. Seroquel was started and dexmedetomidine was in the process of weaning off when he developed a fever to 102.7 degree Fahrenheit (°F), worsening acute kidney injury (AKI), leukosytosis, hypotension on post-operative day (POD) five. He underwent CTA chest and Computed tomography (CT) of the abdomen and pelvis with and without contrast which revealed cecal and ascending colon pneumatosis. IC was suspected. Since Mr. S was sedated, assessing for symptoms of IC were not possible. However, he had three bowel movements (BM) on POD four and one BM on POD five without melena or hematochezia.

Chweyah, dated 08/11/2017, indicated that the claimant presented for a follow-up visit after his discharge from the hospital on 08/08/2017. He was admitted on 08/04/2017 due to normocytic anemia, pain in both knees, starvation ketoacidosis, hypertension, gout with tophus, and duodenitis. The esophagogastroduodenoscopy revealed erythematous duodenopathy, erythematous mucosa in the antrum, and small hiatal hernia. He had a colonoscopy which revealed internal hemorrhoids. Objective findings showed blood pressure of 112/86 with a pulse of 105. He was diagnosed with quadriceps weakness, pain in both knees, normocytic anemia, type 2 diabetes mellitus, hypertension, stable chronic kidney disease stage III, and bilateral impacted cerumen. It was noted that he can return to work on 08/16/2017 with limitations of not standing for more than 10 minutes at a time for 1

The colonoscopy is similar to the flexible sigmoidoscopy, however, this scope is inserted into the anus and through the entire colon. It is recommended to get a colonoscopy every 10 years who are at average risk and every two years for those at high, such as individuals with IBD or HNPCC (ACS, 2017). Before the test occurs a bowel prep at home is done in order visualize the lining of the colon during the test (ACS, 2017). Specific instructions regarding medications, bowel prep and eating before the night before the test will be determined by the health care provider

D/A: Maurice Brown had one appointment this week. On 12/14, he was seen by Doctor Nat Ramani of the GI Associates of Delaware. According to Doctor’s note, consumer tolerated procedure well. He did not have fever, rash, or chills post procedure, but still complains of having periumbilical abdominal pain frequently for 2-3months. He describe pain as sharp in nature, rates it 7 out of 10, wakes him up from sleep at night, no exacerbating factors, radiates to both sides of his abdomen, alleviating on passing gas and having a BM. On 12/14, 12/17, Mr. Brown went for his dialysis. On 12/17, he went twice, in the morning at 10:00 a.m. and in the afternoon at 4p.m. when this writer his Case Manager asked him how his treatment was going? He said ‘’fine,

While everyone should begin obtaining regular colonoscopies once they reach the age of 50 (or earlier if there is a history of colon problems in the family), you may need one at a much younger age if your doctor suspects you may have a colon disease, such as ulcerative colitis. If you are experiencing any of the signs of ulcerative colitis, then a colonoscopy is an important part of obtaining an official diagnosis, so you can begin treatment to help control this chronic disease. Read on to find out what to expect when your doctor suspects you have ulcerative colitis.

During the small bowel series, the radiologist was not able to determine the exact area of obstruction. The study was terminated after two hours and the patient was returned to her room. Following the small bowel series, the patient complained of abdominal pain and cramping. The patient’s tube was leaking bowel from the side of the tube and onto her abdomen. It was also noted that her parenteral nutrition was not adequate (LWR radiology, 2015).

The objective of this reflection is to explore and reflect upon a situation from a clinical placement on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care for my patient when the oxygen saturation was low. Furthermore, this reflection will include a description of the incident, and I will conclude with explaining what I have learned from the experience and how it will change my future actions.