Prepping Case Studies

The goal of my nurse preceptor and I was to prepare client M.E. for surgery and ensure she was in the healthiest position possible prior to entering surgery in order to prevent both intra-op and post-op complications. This includes performing a physical examination, managing pain, ensuring the patient is being compliant to being on NPO status, obtaining the patient’s health history, identifying all medications and/or dietary supplements currently taking, monitoring for signs and symptoms of infection or other complications, and ensuring the patient signs the informed consent for surgery (Hinkle & Cheever, 2014). The first task my nurse preceptor and I was to evaluate patient M.E.’s condition and level of pain. The patient had reported that

I do not understand how can someone see people be treated the way patients at Willow brook were treated and no do anything about it. Patients at Willow brook were suffering. Seen their families talk about what they went thru made me very sad. I do not blame the parents for taking their sons/daughter to this facility. They did what they thought was right. They probably never imagined that this was going to happen. They took their children there thinking they were going to get help and get the right treatment. Thankfully some of them were taken from their families just in time, before something worst happen. The students and their parents, they were all victims of the inhumane way they were treated at Willow brook.

When doing assessments of younger children, it is a good practice to allow flexibility. In doing so, I will be able to effectively communicate assessment results with parents. Developmental and behavioral tools often lack the sensitivity to screen specifically for autism spectrum disorder. Therefore, follow up screening tools are essential when a developmental screening raises concerns. To address ongoing assessment, I will use a checklist to assess how Zakai progresses with the three (3) objectives I have set for him. Additionally, I will I would observe Zakai and watch how he progresses in the classroom. By observing Zakai, I will also be able to create a portfolio for him that will allow his parents to see his progress as

Generate is one of the main sources of revenue for CEBC. Revenues from Generate help support a small staff of 3 people, a contractor, office space, and all the activities CEBC does throughout the year. The success of Generate is dependent on sponsorships, tickets sales, and booth sales. These have been declining over the last number of years, and the risk to CEBC is that the conference would not generate revenue, which could have a negative impact on core operations of CEBC going forward.

I arrived at clinical 0630 and picked up patient information the morning of. I reviewed all assigned diagnoses, medications, labs, and orders with my assigned students, and we discussed our plan for the day. We both took report from the patient's nurse and then Elizabeth presented at preconference. Kala shadowed the Nurse Lead and I helped Elizabeth with brief changes, pericare, and vital signs. I continued to check on both Elizabeth and Kala throughout the day. Last, lunch and then post-conferance.

The only goal of this meeting is to disclose the event and answer any questions the patient and/or family may have. The physician will describe what actions the hospital has taken in response to this event, any future actions that will take place, and what policies were reviewed while investigating this error. The physician and designated hospital staff member will also disclose contact information for future communications with the patient and/or family members. It is the physician’s discretion to initiate future communications and face to face meetings with the patient and/or family

On Tuesday 06/20/17 at 1158 hours I was dispatched to a physical domestic which occurred in the 2800 block of D ST SE in the City of Auburn, King CO, WA. Dispatch stated the reporting person was a school bus driver, Tamie Scholter, but she had relayed the information through her transportation center. Dispatch stated a male and female were in a physical fight on D ST SE near D PL SE, and that a male had pulled a female's hair.

Procedure for a Supra Pubic Replacement. He asked for guide wires and was given curved wires which he never uses. He told staff, they were the wrong ones and the staff insisted they were correct. He proceeded but feels the process took longer because the curved wires are harder to feed into the dilator. He was very agitated and so was the staff. In retrospect, he

The primary barrier impeding effective interaction among the personnel is a communication barrier. Information exchanges between the patient’s primary care provider and other care providers are often where errors occur or where information is lost. Two-way communication between the surgeon’s office and the hospital is necessary for effective and efficient patient care. Consequently, there does not appear to be an effective channel of communication with the surgeon’s office to obtain appropriate documentation which would have included the patient’s custodial information. Secondly, the pre-op nurse was in an emotionally charged situation due to the stress of an increased workload and additional responsibilities. Although, the appropriate

Today, I observed Dr. Koch in podiatry again. The first patient I observed had half of their right foot amputated, which might have been from osteomyelitis. The patient received an operations to amputate half of their foot. The only problem was the recovery time after the operation. Normally, patients wait at least two weeks to remove any sutures on their feet after an operation. However, one of Dr. Koch’s assistants had removed the sutures from the operation one week after the operation instead of two. So when the patient tried to put any weight on the foot after removing the sutures, the wound instantly bursted open. Some time ago, a vascular surgeon bypassed the veins in the foot and removed the right big toe along with the metatarsal.

Nurses delegate task daily in order to provide quality care to patients. Delegation is difficult for new nurses, but as new nurses gain confidence the process gets easier. Delegation is based on three major things: responsibility, authority, and accountability (Yoder-Wise, 2015). This writer worked night shift on a nephrology unit, and the unit was short staffed due to call outs. This writer was a new nurse, but precepted during school on the unit. Orientation was 6 weeks but due to the unit was short staffed orientation was cut to two weeks. The third week a full patient load was given. At the end of the third week, the charge nurse got sick and needed to go home. The house supervisor requested that this writer be relief charge. After questioning

At the direction of the patient, the provider is instructed to revoke or fill out a new

On 2/19/18 met Mr. Revis, both guardians and also the internal case manager from Rainbow at the appointment with Dr. Geffard. This was a meeting because at the last appointment which Brian only attended with the internal case manager he asked Dr. Geffard about regaining his own guardianship. Dr. Geffard wanted to speak with the co-guardians so this was today. Brian is still acting out with other clients. He also had an incident of taking pictures in the home where he stays and calling adult protective services. He claimed that it was not clean and the staff was using toxic chemicals. The home was visited and he was interviewed but nothing was found. His primary goal is to get out of Rainbow and get his guardianship taken back. He continues to be very impulsive. He continues to not be on any medications. At this point, Dr. Geffard said he needs to have some Neuropsychology testing done to go over what is TBI and what is just Brian’s normal behavior. Dr. Geffard said that yes we already know he makes bad choices by his past behaviors but that doesn't mean he has to be housed in a facility. That he may be at the point he can make his own choices even if we do not agree with them. Dr. Geffard's office will be setting up the testing then we will decide where to go from there.

She is a 20 year-old, single, heterosexual, Asian American female majoring in Health at BB. She is currently Junior.

TIPS is a less invasive procedure done to the patient who has liver disease like cirrhosis. A connection is placed within the liver and extended to the portal vein. This helps to reduce pressure between the portal vein and circulatory system. When placing tips, the right jugular vein is normally accessed and a standard catheter is inserted through the vena cava to the right hepatic vein. A puncture from right hepatic vein through the liver to the portal vein is made using a needle, and a shunt is placed.