Patent Ductus Arteriosus: A Case Study

The nurse should have never allowed the doctor to proceed in that state. If she would have stopped him the injuries to Mr. Hicks would not have happened. No doctor should ever be allowed to operate in that state he was in at that time. Not only is it dangerous it in ethically wrong of the doctor to perform such a reckless act.

The district nursing team were now to be responsible for the wound care of an ulcer on the sole of her right foot on her impending discharge. She had previously attended the practice nurse and a podiatry service based within her local clinic. Due to a change in circumstances, she was now clearly housebound for the near future due to mobility issues. Prior to an arranged visit, the patient had called the nurse to advise her that she was pyrexial and was experiencing a pain in her right foot that was different from her normal neuropathic pain, which was often problematic. She was also finding it difficult to mobilise and was disinclined for diet but was taking oral fluids.

Gloria has a strong desire for independence and in health care this is fully supported and promoted. As carers we should support the resident/patient to help themselves as much as possible. Using verbal prompts I guided Gloria round to the toilet and then asked her if she required any help to remove her clothing, which she declined. I understand that everyone has the right to decline treatment or care of any kind. I stepped back slightly acknowledging her decision and allowed to her continue in the removal of her clothes. I placed by hand behind her back while she did this just to support her in case she became unsteady. Once Gloria was seated on the toilet I asked her if she would like some privacy to which she agreed. I placed the emergency pull cord in her hand and explained to use it if she needed any help or when she needed us to come back in. The supervising healthcare assistant and I stepped out of the room and closed the door over. Whilst Gloria was in the bathroom I used this as my opportunity to put on Gloves and an apron. Disposable latex gloves and aprons are essential personal protective equipment (PPE) and the use of them is regulated by the Personal Protective Equipment at Work Regulations 1992 The Health and Safety executive state “The main requirement of the PPE at Work Regulations 1992 is that personal Protective equipment is to be supplied and used at work wherever there are risks to

The OR is naturally a high risk environment, surgery naturally exposes staff to patient blood and body fluids, involves the handling of sharp instruments, and the close interactions of the surgical team within a limited amount of space (Jagger et al., 2011). Operations involve the types of sharps; trocars, some surgical instruments, saws, drills, reamers, and some suture needles and scalpel blades that may not easily be replaced with Safety Engineered Devices (SED’s) (Guest, Kable, & McLeod, 2010). The majority of sharps injuries within the OR result from handling sharps, such as needles, blades and sharp instruments hand-to-hand (Jagger et al., 2011).

Maria Niceforo, a 75-year-old woman receiving in-home nursing care, had died of infection due to numerous pressure wounds (Le May, 2016). She was admitted to the hospital presenting with a bleeding pressure wound across her back and legs that had penetrated through the bone (Le May, 2016). It was also observed that the wounds were soiled with urine and dried faeces (Le May, 2016). She was receiving in-home support from registered nurses, who according to her son, were not consistent nor reliable in their care of Mrs. Niceforo (Le May, 2016). Another contributing factor to her death was inadequate communication and documentation of her treatment (Menagh, 2016). For example, one of the nurses had reported not providing treatment to Mrs. Niceforo's bottom as she was not aware of it (Menagh, 2016). I was quite

The negligence of this incident had a negative impact on the patient’s family members. Approximately 25% of cases involving medical negligence involve poor nursing care. Another negative aspect was patient’s family follow up was poor resulting in lack of importance highlighted on the pressure wounds. Ashley (2003) states nurses can be sued for malpractice, this means he or she is being sued for “negligence”. Furthermore, the nursing health professionals can lose its credibility among a community as they failed to provide a holistic care for the patient. However, a positive outcome was nurses were able to reflect among this evidence based practice to assist in better quality in patient

Once the dressings were securely on and the procedure had been finished, I removed my apron and gloves and disposed of them in the plastic bag, along with everything thing else I had used and then washed my hands again. After leaving the patients home I discussed my practical experience with the Nurse who informed me that I although I had carried out the procedure well it was actually carried out using a clinically clean technique rather than the Aseptic Non Touch Technique as I had thought. As I had used the same gloves to remove the dirty dressings from the leg ulcer and then apply new sterile dressings I had not maintained the Aseptic Non Touch Technique. The Nurse informed me that this was perfectly suitable for the procedure I carried out as the wound was still kept as clean as possible and dressings and equipment used were sterile.

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.

While during round today on Thomas Unit Justine P disclosed that she had been collecting sharps all day. Justine were able to pull several pieces of plastic ware (Spoon/ Fork), a stitch from her injured wound, from her bra also and a rubber band. Campus Supervisor was able to retrieve all items from her. Also Justine disclosed that she removed all the stitches from her wound and began to embed new items into her wound. Nursing was contacted for assessment.

The procedure was done emergently because of the patient’s critical condition. His right IJ area was prepped in the usual fashion. It was very difficult to visualize his right IJ vein, even though his habitus should have allowed us to do so, but the patient was, I believe, severely intravascularly volume depleted, and his vein was collapsing. I have attempted to access the right internal jugular vein multiple times, both under real-time ultrasound guidance and even later on blindly. I was able to get blood return and hit the vein; however, I was not able to advance the guidewire. I was able to advance it one time and put the catheter in, and it was nonfunctioning. I had to take the catheter out and tried multiple other times on the right IJ vein without success. That procedure was terminated. Pressure was applied. There was no cervical hematoma whatsoever. The patient was uncomfortable because of the length of the procedure but did well otherwise. Hemodynamically, he was unchanged, and his oxygen saturations remained stable.I prepped the IJ vein area in the usual fashion. One percent lidocaine was used for local anesthesia. Again, the left IJ vein was collapsing. With deep inspiration, the vein could be well visualized on the real-time and ultrasound guidance, after which I could get access to the left IJ vein. A wire was advanced without difficulty while the

Uncle Jake and Aunt Leah were playing golf last week. On the sixth hole, Jake told Leah that he was having unusual pain in his left arm and chest. All of a sudden he felt weak and complained that his shirt was much too tight. A dentist playing one hole behind them examined Jake and found he was short of breath, pale, and sweating. He called 911 on his cell phone and told Jake to lie down and wait for the ambulance. The paramedics rushed Jake to the hospital where he was evaluated by a cardiologist. The tests showed that he had four clogged arteries. He was scheduled for surgery the next day.

I am a second year nursing student in my third week of the practicum placement on a surgical ward with my co-student and the morning shift registered nurses. We had just finished analysing the patients handover report (Levett-Jones & Bourgeois, 2015) and I had been assigned to work with the registered nurse. I was looking after Mrs. Brown (pseudonym) is 82 years old New Zealander was admitted to surgical ward on the 08/06/16 for multiple SCC removals from L) hand and L) foot with skin grafts.

Indications: The patient is a 69 year old black female who fell landing on her right hip. She was seen in the Emergency Room where physical exam and x-ray revealed an intertrochanteric right femoral fracture. She was admitted to Dr. Loyd’s service .

Mr. J.’s daughter noticed a red mark on her father who then reported this to the nursing assistant and her concerns were immediately dismissed. If the nursing assistant was properly trained in the use of restraints and had knowledge of patient outcomes, this patient would not have developed a pressure ulcer. The nursing assistant should have immediately informed the nurse and measurements should have been taken to prevent further breakdown of the patient’s skin which was not done. It is evident in reading this case that Mr. J developed a Stage I pressure ulcer from being retrained in one position with no assessment or release for an undetermined amount of time.

Vascular closure devices following cardiac catherization through the femoral artery have been gaining significant traction since its use in the mid-1990s. Compared to the previous gold standard of manual compression, VCDs allow for shortened time to ambulation, decreased duration of hospitalization post procedure, and increased patient comfort. The devices have also shown safeness comparable to manual compression. Despite the many advantages and variety of devices available, there are still complications to take into account. More common issues include device failure, bleeding, and hematoma. Less common but more serious complications include infection, ischemia, limb loss, and death.