Patient A Case Study

Within this case study I am going to use two of the Chapelhow et al. (2005) enablers to discuss and reflect on the care of a patient I have been involved with on placement over a period of 5 weeks. ‘Enablers are the essential and underpinning skills that come together to provide expert professional practice’ (Chapelhow, C et al. 2005, p.2). These include; assessment, communication, documentation, risk, professional decision making and managing uncertainty. The enablers work together to provide a holistic approach to the care of patients in health care settings. I am going to focus on and discuss two of the enablers, linking them both together, which will be assessment and communication as I believe these two enablers can be related most to my patient.

Hi, Karen, I attempted to send the invite again for patient 326270. I checked our email server to see if it was delivered and it shows an immediate block on her side as rejecting this our invitation email. I understand that her coworker is using the same domain but each email setting(s) can be individual. The message we are getting back on our email servers when trying to send her an invite to this email address is:

In this assignment I am going to deliberate the care of a patient that I have looked after when working in placement on a hospital ward .I will use the Chapelhow framework to discuss two of the perspectives in relation to the patients care needs. In the Chapelhow framework there are six perspectives that are used to help reflect and discuss patient care. These six perspectives are assessment, communication, documentation, risk management, professional decision making and managing uncertainty(Chapelhow, 2005).The two perspectives I am going to use in this assignment are assessment and communication.

As seen in this case study, TM was listed as a full code and no GOC conversation was had between the physicians and the patient until the day of his discharge to home. This led to an unnecessary swallowing study in which the patient needed to be uncomfortably scoped. Due to the lack of GOC conversation the patient also chose to go home with general nursing services instead of end-of-life (EOL) hospice support. In the inpatient medical oncology floors of a large teaching hospital like this one, most patients are covered by rotating interns and residents that are not comfortable having GOC conversations with patients and leave it up to the primary physician to come and discuss.

SC received a call from Pa and completing monitoring telephone call. Pa reported that she is having difficulty securing transportation to her medical appointments because her doctor did not complete the necessary paperwork the insurance company needs to continue to provide door to door pick up. Pa reported that she missed three important appts with her Nephrologist, pulmonologist and rehab for lungs. Pa reported that her lungs are really bad and she was offered lung therapy because she is experiencing SOB more and more so she is unable to help completing her ADLs and IADLs. Pa reported medication changes she now takes Benzonatate 200 mg to help with severe coughing and Prednisone. Pa confirmed that she is receiving her services as specified

Damian is 18-year-old Hispanic male arrived at CRU 2 via ambo from UPC. Patient is NCOT, he was escorted to UPC voluntary by police. He is restless, agitated and uncooperative with the intake assessment. He started crying uncontrollably, stating, "I want a joint, I want marijuana." He denies DTO/DTS. Patient appears to be responding to internal stimuli and scanning the room. His vital signs are within normal limits. He is alert and oriented to time and place. Patient will benefit from meeting provider and access to an outpatient treatment.

At your request I have reviewed the Boards electronic case folder in the above-referenced matter, paying particular attention to the resumption of treatment in 2017.

In spite of nursing’s vital importance to hospitals, nurses face excessive paperwork, managerial responsibilities, and supervision of lesser-trained aides -- tasks that require an inordinate amount of time spent in functions other than direct patient care. These frustrations, combined with long work hours, stagnant salaries, and other difficulties, have resulted in fewer entrants to schools of nursing and increasing numbers of nurses leaving the profession. Discuss possible solutions to this growing

When a patient is no longer or unable to feed themselves orally a feeding tube must be ordered. Specifically, when a patient has prolonged bleeding, facial trauma, upper GI blockage and cancer. An enteral tube feeding can be placed nasally for a short period of time. The NG tube catheter tip normally resides inside the stomach or in the small intestine past the pylorus. The number one complication involved with the use of NG tube feeding is incorrect placement. A nurse can unintentionally place an NG catheter into the lungs, most notably when a patient has little to no gag reflex. Completing a test for gastric contents, pH or performing a chest x-ray after inserting an NG tube for confirmation of proper insertion. Another major complication when using NG tubal feeding is aspiration within the lungs due to gastric substances enter the trachea and into the bronchial spaces of the lungs. Keeping the head of the bed elevated greater than 30 degrees will reduce aspiration to least possibility. Applying a gastrostomy or jejunostomy tube for enteral feedings when NG tube has interference with therapy or ensues intolerance. The gastrostomy tube, PEG, tip situated in the stomach and exits the body through the left upper quadrant of the abdomen where a bumper holds it into location. Internally positioned by a doctor during an endoscopy, radiology or surgery. A jejunostomy tube is set while in surgery, radiology or endoscopic. If done endoscopic, the PEJ tube goes

I understand what you are saying, professor. I may have a patient that may come into my office that may suffer from anxiety that stem from a phobia like heights, but I may also be involved with another patient suffering from anxiety that stem from socializing. Patient A and patient B both suffer from similar forms of anxiety, yet both patients' anxiety are triggered from different sources. I am not sure if that is a good example, but I am sure you will let me know.

The client is a Caucasian American Male who is 18 years old. His name is Conrad Keith Jarrett who is called “Con" or "Connie" by his family and friends. He lives in Lake Forest, Illinois with his parents, Beth Jarrett and Calvin Jarrett. The client 6’1” and is of slim build. He reports that he makes healthy choices and he does not appear to be malnourished. Conrad prefers to be contacted by his home telephone. Conrad reports he is a Senior in high school and is set to graduate at the end of May. Conrad has had a previous intervention this year and was admitted a psychiatric hospital for a suicide attempt. He stayed there for four months. Conrad reports he has a healthy relationship with his father but Conrad states that his relationship with his mother is strained.

My patient is a 25 years-old, with a high school education, and is not currently employed. She is a gravida 3, para 2, term 1, preterm 1, abortion 0, and has 2 living children. Her estimated due date is August 24th, 2016, and she is currently 37 weeks gestation. She is not a smoker, she does not have gestational diabetes, and is at risk for preterm labor due to a previous birth at 25 weeks. She does not have high blood pressure, bleeding problems, or placenta previa. She is Group Beta Strep positive, and does not have any infections. She is at a high risk for postpartum hemorrhage due to that fact that she is currently on Heparin for a previous DVT. Her first child was born at 25 weeks due to maternal bleeding and reverse diastolic flow.

When the patient approaches hospital she undergoes the process of registration in which all the information about the patient is stored in the hospital database which doctor can view later on, Moreover if patient has any previous cases regarding her health then that report is also updated on the server. Afterwards patient is allocated a doctor and all information is shared with respective doctor. Patient is given a unique identity and asked her to register herself on an android

A total of 100 subjects were included in this study, including 50 patients presenting with B-CLL, and 50 healthy subjects as a control group matched in age and sex.

Mrs. J. arrives at the emergency department with her 6 year old son, PJ, who has a history of Cystic Fibrosis (CF). He is febrile (101.7° F orally), BP 98/66, HR 122, RR 32 with the use of accessory muscles. Mother states PJ has, for the last five days, exhibited signs and symptoms of upper respiratory infection, runny nose, low grade fever, cough, and fatigue. He has lost 2 pounds over the past 5 days due to anorexia though he has not had vomiting. He weighs 36 pounds and height is 3’2”. Today, PJ became more lethargic and his fever was difficult to control with pyretics.