Nursing Shock Case Study

This request is for a new SSRT for a Certified Registered Nurse Anesthetist (CRNA) at the GS12-13 level. This is to employ a CRNA for a new position at Keller Army Community Hospital (KACH), West Point, New York. The current GS-12 West SSRT salary range is $82,309 to $103,270 and $94,114 to $122,346 for GS-13.

7. A patient with cardiogenic shock has the following vital signs: BP 102/50, pulse 128,

Meanwhile, elsewhere in Habersham County, Tom was feeling slightly nervous as he exited the staff lounge and entered the hustle and bustle of County Hospital’s ER to begin his first shift as an RN. The first few hours of his shift passed slowly as Tom mostly checked vital signs and listened to patients complain about various aches, pains, coughs, and sniffles. He realized that the attending physician, Dr. Greene, who was rather “old school” in general about how he interacted with nursing staff, wanted to start him out slowly. Tom knew, though, that the paramedics could bring in a trauma patient at any time.

Mrs. Wilson is seen in her room at Glenbridge Nursing Home on 02/28/2018. She had an episode last night of chest pain. She is so ebullient and distracted that it is hard to get a straight history, it came on when she was asleep but she may been sitting up. She was seen by a nurse, a sat was taken. I am not sure if there were other orders taken, but there is none on the chart. She says that she spent most of this morning in the bed and still feels tired, but she does not think she broke out in a sweat. She was more short of breath. She is calling it is a "stroke." I had tried to begin tapering her diazepam by discontinuing the morning dose and apparently all daytime clorazepate was discontinued by error and she gets it only at night.

----- 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.

I prepare the case study with different scenario for nursing diagnosis to take place under varied situations mainly to disseminate the knowledge to stimulate critical thinking on code sepsis. The evaluation of teaching and learning will be conducted through questionnaire at the end of the day, as nurses find their own time to go through the case study for assimilation by means of reading references or discussion with colleagues. Periodical reminder for benefits of revision on subjects which are vital in patient safety and care will help nurses to accustomed to practice. The encouragement and feedback will render change in practice. In case of Sepsis, the clinical nurses are responsible in prevention of infection by means of hand hygiene, wound care, caring chronic conditions, prevention of Hospital acquired infections and communication to respective physicians. Patient education play the key role in inpatient as well at home with following the facts in identifying and seeking medical attention at once. The clinical educator is not only responsible for teaching in the unit but also act as patient navigator in educating the patients in preparation of reading materials and providing the guidelines and

The evolution of this project cultivated from the need of improvement for patients suffering from sepsis at MacNeal Hospital. Sepsis is a potentially fatal host response to infection that occurs as a systemic inflammatory response syndrome (Schub & Schub, 2013). I felt it was very important to re-evaluate what I can do as a nurse to improve the expected outcomes of sepsis patients and decrease their length of hospitalization. If a patient is admitted with severe sepsis, it places the patient at a higher level of risk than if he/she was admitted with an acute myocardial infarction or acute stroke (Robson & Daniels, 2013). I became interested in sepsis as my project when I became informed that MacNeal had started a Patients With Sepsis Orders Daily Reports, I decided I could enhance and develop an educational tool to help the case managers, emergency room nurses, and staff nurses with early recognition of sepsis and decreasing the length of stay. Angus and Van der Poll (2013) stated that the United States reported 2% of patients that were admitted to the hospital suffered from severe sepsis.

Observations that indicate an acute condition requiring immediate attention from the nurse include but are not limited to: Severe pain fall or accident signs of shock seizures anxiety confusion odor swelling mood swings depression loss of control hemorrhage any sudden change in condition skin tears or bruises loss of consciousness difficulty

Hypovolemic shock is an urgent condition of rapid reduction of circulatory volume in the body, which can be created due to blood or plasma or body fluids loss (Kettley & Marsh, 2016, p. 31; Perner & Backer, 2014, p. 613). Blood loss can be induced by internal or external injuries, excessive perspiration or diuretics (Craft & et al, 2015, p. 852). Maureen Hardy’s hypovolemia has been precipitated by hematemesis.

When I arrive to the Trauma ICU 4800 unit, all of the nurses were already being followed by other students. The nurse in charge had me follow several different nurses, so I was able to observed several different patient cases. The first patient had received a triple bypass open-heart surgery. The patient had received a creatinine blood test. The patient had a dialysis machine next to them, which was used to function as the kidneys since the patient’s kidneys were not functioning correctly. Also, the patient’s body temperature was lowered from having a taken cool liquids so the nurses were keeping him warm with a bair hugger, which was a machine that helped regulate the patient's’ body temperatures.

Shock is a life-threatening condition with a variety of underlying causes. Shock is caused when the cells have a lack of adequate blood supply and are deprived of oxygen and nutrients. In cases of shock, blood is shunted from peripheral areas of the body to the vital organs. Hemorrhage and decreased blood volume are associated with some, but not all, types of shock.

The nurses receive brief report from the paramedics and sign the report. Because the patients normally have multiple signs and symptoms, the ER nurses need to perform a focused assessment and head to toe assessment. They find out the causes of the chief complains and conduct several tests. The nurses ask pertinent questions in regard to additional signs and symptoms. In trauma, they perform immediate treatment and to prevent respiratory distress by following ABC’s rule.

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.

Bulling, physical and nonphysical abuse are multifaceted persistent occupational problems facing the nursing profession. This includes Register Nurses(RN’s) and Licesnse Nurses (LPN’s) Although these problems at the workplace has been recognized globally, a culture of silence still prevails and abuse gets overlooked in many institutions in the United States and worldwide . This paper provides a quantitative review that estimates exposure rates by type of violence, setting, source, and world region and nurses responses. Nurses suffer abuse not only from some of the healthcare personal including coworkers but from patients and their family as well. This phenomenon needs to be looked closer and find ways to eliminate this problem that affects

Describe the five different types of shock and include for each, its pathophysiology, clinical manifestations and treatment.