Patient Background:
• Gender: Male
• Age: 18 months
• Height: unknown
• Weight: unknown
Medical History:
• Circumstances causing visit: Came into CRG for x-rays of his right hand to determine surgery options for removal of the extra digit.
• Symptoms: no symptoms
• Procedures ordered: 3 view hand x-ray which included PA, oblique, and lateral
Diagnosis: Polydactyl
Description of the Disease:
• Classification: Congenital
• Etiology: Mutations of chromosome 7. Rare genetic causes: Laurence-Moon-Bardet-Biedl Syndrome (LMBBS), Ellis-van Creveld syndrome, and Acrocallosal syndrome.
• Physiological Effects: Range of motor skills- completely immobile, limited dexterity, fully functional
Appearance on Radiograph:
• Location:
• Neither an additive or subtractive disease
• Need to decrease in density due a pediatric hand but not because of pathology.
Any Special Accommodations made:
• Technique: I decreased technique to 55 @ 1.5 for all views to accommodate for the decrease patient thickness.
• Positioning: I had the patient’s father hold him with both of them shielded. I told the father where and how I wanted his son’s hand to be put on the cassette and instructed him to try to keep his own finger out of the way of the anatomy. I also used a sponge for the oblique view to help with more accurate positioning.
• Alternative views: no alternative views.
Follow- up and Prognosis: Patient will have surgery to remove the extra digit since it has no function or purpose. Prognosis is a
Health teaching will be providing information on disease process and management strategies. Encourage caregiver to set aside time for himself. This could be as simple as a relaxing bath, a time to read a book, going out with friends. Acknowledge to caregiver the role he is carrying out and its value. Teach caregiver to identify how important it is to feel appreciated for their efforts. Encourage care recipient to thank caregiver for care given. Provide time for caregiver to discuss problems, concerns, and feelings. Ask caregiver how he is managing, Inquire about caregiver’s health. Refer to social worker for referral for community resources and/or financial aid, if needed.
Patient profile system gives all the information related to the patient. By entering the patient’s name, his or her date of birth or the Rx number all the patient history appears. It includes patient full identification detail by which you can confirmed patient’s identity. It includes patient’s name, date of birth, address, phone number, allergies, snap cap and insurance details.
CHIEF COMPLAINT: This is a post op note from a procedure performed July 21, 2015 by David Lin, MD.
steps in the preparation and is unsuccessful with the needle two times before. He uses this
Everyone had suggestions for him on how to make it better but he was angry and disappointed in his lack of ability to succeed at the central line. (20) Finally, Gawande was forced into doing a central line on a patient that was “morbidly obese, weighing more than three hundred pounds. He could not tolerate lying flat because the weight of his chest and abdomen made it hard to breathe. Yet he absolutely needed a central line.” (20) The patient was unsure how long he could lay on his back, so Gawande found a way so they could take breaks so the patient could sit up, and they would wait until the last moment to lay him down. (21) Gawande “went through [his] preparations: checking the labs, putting out the kit, placing the towel roll, and so on. I swabbed and draped his chest while he was still sitting up.” (21) As the procedure progressed, Gawande offered to S. to take over. She declined because she had faith in him. Gawande went through the steps and got the guidewire in then they took a break so the patient could breathe. When they got back to it, Gawande “got the entry dilated and slid the central line in.”(21) Before leaving S told him he did a “Nice job”
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The exact cause of this condition is not known. The condition may be passed down through families through an abnormal gene.
Following are the damage elements involved in this case and our estimates based on the information we have at this time. Please note that our estimates most likely would require revision as discovery develops.
As a nurse executive leading an accountable care organization (ACO), I lead monthly patient-centered medical home (PCMH) meetings that involve interprofessional clinical experiences. During these meetings, primary care office staff present patient cases that currently are, or have been, challenging to manage. The registered nurse (RN) case manager will usually start the discussion, but anyone on the team can present a patient case. Round robin type discussions between the physicians, certified registered nurse practitioners (CRNPs), physician Assistants case manager, front office staff, medical assistants and pharmacists, and students of any of these disciplines, are conducted to find solutions or to provide success stories about how patients
As per AORN 's Correct Site Surgery Tool Kit, the site of surgery has to be marked prior to surgery and with the collaboration of patient and family by the person who is conducting the surgery. A blue band will be applied on the patient 's wrist and site of surgery will be written, in cases of surgery to conduct on mouth, lip, and eye. During "Time Out" the circulating nurse will read the site on the wrist band and the team will agree prior to surgical incision (AORN, 2001).
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