Symptoms And Treatment Of Hospital Survivors

M.G., a “frequent fl ier,” is admitted to the emergency department (ED) with a diagnosis of heart failure

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

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.

the mitral valve 16 months ago and a Streptococcus mutans infection of the aortic valve 1 month ago.

Original research related to sedation management occurred in the year 2000 by Kress, Pohlman, O ' Connor, and Hall. Their findings served as a landmark study and initiated the impetus related to improving our sedation practices. According to Kress et al. (2000), daily interruption of sedation led to a decrease in the number of days on the ventilator in the intensive care unit. Several studies since this time have focused on the influence of sedation protocols, and outcomes. This paper will review the synthesis of the discovered studies and highlight the noted contraindications and inconsistencies. Also, explanations including a preliminary conclusion will be discussed.

L.H. report no concurrent or severe headaches; There was no head trauma, syncope or vertigo. Patient wears corrective lens with no difficulty of vision or diplopia; absent of inflammation, discharge or lesion. Last eye exam was in September of 2016 with no history of glaucoma, cataracts. L.H. denies having any frequent colds, sinusitis, epistaxis and trauma. Patient reports having obstruction stating, “it happens when I am lying down” with an occasional postnasal drip.

With a quantitative approach, a descriptive, prospective, cross-sectional method was used to collect data. Utilizing medical records from 51 patients hospitalized between February and April of 2013, data such as age, Braden Scale scores, comorbidities and length of stay were collected. Clinical data obtained was then organized in an Excel table and input into the statistical software, Epi Info, to be arranged for statistical analysis (Oliveira de Carvalho et al.,

Patients were assessed at admission and discharge of ICU and assessed using Braden Score and APACHE II score.

Keywords: intensive care, patient scenario, clinical practicum, pathophysiology, disease processes, interventions, diagnoses, assessments, health prevention, promotion, health outcomes

patients averaged 6.6 days total length of stay. ICU care was needed for only 30.4% of

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.

Post-Acute Care (PAC) facilities have different reporting guidelines looking at the data set for the Home Health Agency (HHA) that provides services such as personal care by home health aides, skilled nursing care, physical therapy, speech therapy, and occupational therapy in the patient’s home.

For the hospital, there is a lower risk than the reference population. The indicator measures in-hospital deaths per every 1000 hospital discharges with a principal diagnosis of acute myocardial infarction for patients above 18 year of age. This measure excludes all obstetric discharges and any transfers to other hospitals. The numerator is the number of deaths and the denominator is the number of discharges with a ICD-9 code for AMI.

A: Janie is a 60 year old Female with PMH of A-Fib, COPD, Hypothyroidism, HTN, Lung Cancer and recently diagnosed Pulmonary Embolism. Janie presents to ER for evaluation on SOB, cough with greenish sputum, sore thoart, hoarseness and generalized weakness. Janie lives at home with her husband, use to smoke ½ pack per week, but quit many years ago, denies alcohol or drugs. Family history is non-contributory. Allergies: NKDA. Differential diagnosis includes worsening Lung Ca, PE, COPD and CHF. Janie uses home O2 at 4 L/NC. V/S: T=98.7, HR=89, R=16, B/P=132/56, O2 sats=100% on 4L/NC, Pain=6/10. Labs: WBC=7.6, H&H=8.5/27, Na=141, Troponin=0.08/0.06, BNP=495, INR=4.2, UA=3+ protein, 1+ blood and 6-10 RBC. CXR: Impression:1). COPD with nonspecific coarsening of the basilar interstitium. 2). Mild cardiomegaly with borderline cardiac compensation. 3). Right

This study is a retrospective chart review of 360 patients with definite or possible Infective Endocarditis according to modified Duke Criteria [1-2] who were admitted to Detroit Receiving Hospital and Harper University Hospital in Detroit from 2006 to 2014. Both hospitals are teaching hospitals in Detroit, Michigan. For a patient with repeated episodes of Infective Endocarditis, one episode was only included at our institutions. Clinical, microbiological, and echocardiographic data of all patients with definite IE were collected using a standard data collection form.