Phulbotomist Case Studies

For Mrs Jones’ case, the immediate management to slow the progress of deterioration would include initiating treatment measures to increase oxygen levels and consciousness and review of regular assessments (Culter, 2002). If further deterioration persists into abnormal observations reflecting the rapid response criteria, then escalation to notify the nurse in charge and the medical emergency teams (MET) would be required (Knox Private Hospital, 2013) as per noted in escalation protocols and policies. Escalation to review may also arise when the clinician’s intuitive sense purely identifies the patient as at risk of deterioration (Lyneham et al., 2008). The MET calls are Australia’s earliest initial initiative to prevent severe deterioration, which involves the deployment of Medical Fellow and Intensive Care Unit staff to review patients at risk (Swartz, 2013; Chan et al., 2010). Timely and effective intervention of medical emergency response was conducted in a trial study conducted where 23 randomised Australian hospitals were introduced to MET (Hillman et al., 2005). MET calls were significantly increased which improved mortality as

As Jane was presenting with a symptom of a life threatening event it was important that treatment was immediate. Priority was initially made from assessment of the airways, breathing and circulation, level of consciousness and pain. Jane’s respirations on admission were recorded at a rate of 28 breaths per minute, she looked cyanosed. Jane’s other clinical observations recorded a heart rate of 105 beats per minute (sinus tachycardia), blood pressure (BP) of 140/85 and oxygen saturation (SPO2) on room air 87%. It is important to establish a base line so that the nurse is altered to sudden deterioration in the patient’s clinical condition. Jane’s PEWS score (Physiological Early Warning Score) was 4 and indicated a need for urgent medical attention (BTS 2006). Breathing was the most obvious issue and was the immediate priority.

Patient within this category, such as cardiac arrest, respiratory arrest, extreme respiratory distress are imminent risk of deterioration. Thus, these types of patient must be seen immediately. (Hodge et al., 2013)

The patient did have black soot around his nose and mouth. Thats when first responders started manual ventilation's via BVM and 02 at 15 LPM. At this time Medic 1 assumed patient care. Medic 1 assigned first responders to obtaining vitals signs that are stated in the vital section of the report. It was at this time that Medic 1 applied a OPA after first measuring on what size to use. First responders also applied fast patches to the patients right upper chest and left midaxillary line At this time Medic 1 assigned first responders to start chest compressions a 15:2 ratio. Medic 1 at this time started a IO in the patients plateau region of the right leg. The Plateau region is inferior and lateral to the knee cap. At this time Normal Saline bolus was started with a 60 drop per ML set. Medic 1 found the patient to be in a sinus rhythm At this time miscommunication with Medic 1 and first responders happen with chest comparisons started. We then secured the patient on the cot via 4 straps and transported a code red patient to the nearest hospital. While enroute to hospital radio report was given with chief compliant and treatments listed in the appropriate category of the report. Vitals was continued to be taken every 5

Technology in my field of chose is being a phlebotomist. Being a phlebotomist is one of the most important jobs in the hospitals, labs, blood banks, and clinics. Being able to run the correct tests and lab draws is very important part of technology. Working in a different environment is very difficult , every place is different. More fast paste places will have a lot of on your feet job then working in a lab or clinic. Being a phlebotomist you will have to work with a lot of different machines that do different things. One single machine as a purpose , and function. If it was not for technology we wouldn’t have electronic health records or E prescription which is the order of draw. In clinics or blood banks they would have limited technology

Gloves snapping, needles pricking, and blood gushing are often thought of when it is time to have one’s blood tested for various reasons. With a patient’s anxiety already running high, the slightest mishap can have a serious aftermath. If the venipuncture was painful or left horrible bruises, the patient may think of the procedure negatively in the future. More importantly, it is the Phlebotomist’s responsibility to obtain quality blood specimens to produce the most accurate laboratory results. (Garza, 2010) The School of Allied Health states, “It is widely accepted that the quality of a laboratory test is only as good as the specimen that was obtained.” (Allied Health, 2014) For this reason, a Phlebotomist

It is important that a patient with CHF be monitored for signs of distress. Vital signs like high blood pressure, rapid pulse, irregular respirations and fluid intake/output should be monitored. All of these vitals will already have expected irregularities, which lead to initial diagnosis. After care is started, the vitals should be monitored for additional changes.  In the event of an emergency such as inability to breathe, a nursing assistant should call an ambulance right away and begin life-supporting measures such as CPR (Carter, 2012).

"Medic respond, stoppage," chirped the intercom. The call went out for an adult male found down, pulseless and apneic, by family at approximately 2200 hours. EMS personnel arrived on scene, performed quality CPR and followed appropriate ACLS algorithms, and found an organized rhythm with matching peripheral pulses at the third check. Per 2010 AHA guidelines, medics performed a 12 lead EKG, managed the patient 's hypotension with a fluid bolus, and managed the patient 's airway by endotracheal intubation (American Heart Association, 2011). The patient displayed no neurological response, the EKG revealed significant ST segment elevation in anterior and septal leads, and intubation was performed successfully without induction or paralytic

On admission to ICU, the patient should be positioned in fowler 's position, vital signs checked, oxygen is very important since her saturation is 82%. A non-rebreather mask is advisable at this time. Reassurance is very important to calm the patient and the plan of care explained to allay anxiety, calm the patient and ease breathing. Cardiac activities should be monitored continuously in every 10 to 15 minutes with pulse oxymeter, IV assess initiated, medications Beta blockers (Lopressor), Angiotensin-converting enzyme (ACE) inhibitors (Vasotec), diuretics (Lasix), and Morphine Sulphate giving. Laboratory work should be done such as levels of electrolyte, serum creatinine levels, weight and fluid balance. Other serum tests such as BNP, liver function, D-dimer, and CBC should also be done. Telemetry monitoring maintained continued for 24-48 hours after entrance into ICU. Signs and symptoms of congestion should also be monitored daily, intake and output, weight, if there is fluid restriction it should be adhered to, and diet should be according to dietician order such as 2g sodium and no added salt, turn and repositioned to avoid tissue breakdown, exercise according to patient tolerance.

5:13 p.m.: heart rhythm is normal sinus, B/P is 110/70, and pulse is palpable. Patient not breathing on his own and is fully dependent on the ventilator. Pupils are fixed and dilated. No spontaneous movements and not responding to noxious stimuli. Air transport is called. Patient is transferred to a tertiary facility for advanced care.

Collaborate with your preceptor to interpret your patient’s EKG rhythm and list your patient’s rhythm.  Discuss the implications this patient’s heart rhythm has for circulation.   How does your patient’s specific rhythm impact the physical assessment findings?  What if the rhythm changes:  what would happen if the rhythm became slow, fast, or irregular?  How could these changes manifest in the patient assessment and how would you, as the nurse, proceed?

Our initial evaluation includes assessment of vital signs, assessment of the cardio-pulmonary status including work of breathing, breath sounds, perfusion, and pulses for circulatory assessment (Jevon, 2012, p. 193).  Assessment of consciousness, using the paediatric Glasgow Coma Scale (GCS) (ANZCOR, 2016), Level of consciousness using Alert, Verbal, Pain, Unresponsive scale (AVPU) (Jevon, 2012, p.194). Neurological observations, EDOES and CEWT to determine deterioration (PMH, 2013).

Should a 12 year old boy, with mild behavior, be given a lobotomy to fix his “problems”? I don’t think howard should’ve gotten a lobotomy for a number of reasons. First, his behavior wasn’t that bad for a typical 12 year old. Most of the time the rebellious acts were because of his controlling stepmother,who insisted he go through with the procedure. Another is that doctors diagnosed howard and said there was nothing wrong with him, but that his stepmother was the issue.

In conclusion, the health care practice is structured with evidence-based practices in order to deliver a safe and quality care to patients. In this case, Giovanni’s fluid overload and impaired oxygenation would improve knowing that the intervetions provided are supported with evidences. The efficiency of Frusemide and low sodium diet would help restore and maintain Giovanni’s fluid balance while relieving his edema, dyspnea, and crackles. Additionally, the decrement in Giovanni’s cardiopulmonary edema would also affect his oxygen status. The integration of CPAP and deep slow breaths in his care would result to improvement of his shortness of breath, breathlessness, fatigue, and normalization of his heart rate and respiratory

The primary nursing diagnosis for this patient was impaired tissue perfusion (cerebral) related to increased intracranial pressure secondary to subdural and subarachnoid hemorrhage. S.C. was unconscious upon his arrival to the emergency department. He was intubated in the field as a result of depressed breathing. He had a craniotomy and ventriculostomy placed to relieve and monitor intracranial pressure and redirect CSF. His pupillary reflex was diminished with uneven +sluggishly reactive pupils that became unreactive by day three of his time in the ICU. He had a gag reflex and cough reflex that remained throughout his time in the ICU, and he had an absent corneal reflex.