Synopsis . Patient Is A Caucasian 56Years Old Male Admitted

DKA is presented with three major physiological disturbances which are hyperosmolality due to hyperglycemia, metabolic acidosis because of the buildup of ketoacids, and hypovalemia from osmotic diuresis. Diabetic ketoacidosis is caused by a profound deficiency of insulin, its most likely occur in people with type 1 diabetes, inadequate insulin dosage, poor self management, undiagnosed type 1 diabetes, illnesses and infections. In type 1

At this point in time, I feel that the patient is gravely disabled, that he cannot provide food, shelter, or clothing for himself nor make decisions in regard3 to his medical or financial affairs in his best

As Pamela’s teacher and clinical instructor, I have had an opportunity to observe her participation and interactions with patients and to evaluate Pamela’s knowledge on mental health. Pamela displayed excellent communication skills and intrapersonal skills, which she used to interact with patients and team members in practicum. Truly, Pamela is very much respected by her peers and the nurses on the unit because she is an outstanding student in all respects; she has proven that through diligence, hard work, and perseverance, she can accomplish tasks in a courteous and timely manner.

During a shift at the hospital the student attended a manager’s ward review. The student listened as approved mental health professionals (AMHP) discussed the wellbeing of patients who were being cared for in the hospital. AMHP’s are mental health professionals who have specialist training in

In order to find the patients baseline an assessment of functionality is needed for comparison. When assessing a patient it is important to pay attention to the abilities of activities of daily living regularly. An assumption of Orem’s Self-Care Deficit Theory is that a person’s knowledge of potential health problems is needed for promoting self- care behaviors (Nursingtheory.org, 2013).

This assignment will reflect on the effectiveness of my clinical and interpersonal skills in relation to my position as a nurse in a busy critical care unit. It will primarily focus on one particular patient and the care they received by myself in their immediate post operative period. In accordance with the NMC’s code of professional conduct names will not be used to protect the patient’s confidentiality. NMC (2008).

That was very sad for this patient. I think one of the problems of this patient is knowledge deficit of the disease process. There are many cases when a patient does not know the end result of a disorder, they seldom refuse the treatment. When they finally accept to have any medical intervention, it becomes too late.

The unit is a short-stay psychiatric inpatient unit located at Virginia Baptist Hospital in Lynchburg, Virginia. Kimberly describes her role and an important part of her job description as admitting patients, completing all of the units’ discharges including writing all prescriptions that are needed, consulting on all needs for the emergency department and as well as Lynchburg General Hospital, a local neighboring hospital, and also spending the majority of her time communicating with patients’ families, nursing homes, and other essential members of the patients’ treatment team. Each morning a meeting is held with the interdisciplinary team as well as Kimberly herself and the Medical Director. At this meeting each patients’ care is discussed in detail with every member of the treatment team present. Everyone brings something to the table, as Kimberly describes and Dr. Betz, both her collaborating physician and Medical Director, always has the best interest of all patients at heart, she adds in support of her medical co-worker. With discussion centered around every patient on the unit at the daily treatment team meeting, Dr. Betz is aware of Kimberly’s patients and his ideas such as what medications might work, potential side effects of medications, and the behaviors the patients are experiencing are all conferred upon.

The care team needed not only to perform the regular duties to rehabilitate the patient, but also to be communicators, psychologists, and social workers to solve the complex situation. The patient had experienced difficult time while regaining the strength needed and required a strong encouragement and the adjustment of his habits in order to reach his functional goals. Everything he would use or do before in order be functional did not give a positive result due to his lost strength. It can be frustrating for the patient to realize that he lost the last abilities to be independent and needs the assistance with ADL's and the PTA has to find the approach to solve the functionality problem and encourage the patient psychologically. The other factor that influences the patient's care is his family, which pressures on decision for discharge when patient is not ready. The financial burden can alter the process of communication with family and the PTA has to prove to the family the opinion of the team on patients disability to function. The proper documentation on the case has to be able to prove the necessity of services and possible welfare benefit or assistance for this patient. The example of this patients has shown me that a good PTA has to incorporate all the qualities of good professional, communicator, team member, psychologist, and social worker in order to reach the goals

This patient's fundamental disease is damaging his executive capacity. If his wishes are consistent during his articulate

he lesson that I can take during patient interactions are to try find the best way to accommodate patient's needs and know my limitations. For example I cannot speak Russian and my patients are Russians with limited English, however, I know they need so much help and education. I rather talk to the nurse manager and refer them to another nurse that can speak Russian or to get an interpreter to help me. It might be seem "I am washing my hands" and try to get rid of them, but my attention was to help them better.

The nurse must assess each patient on and individual basis by performing a learning needs assessment and determining preferred learning methods. In this patient’s case, the nurse performs a learning needs assessment, which includes general screening questions to determine what knowledge the patient has regarding his disease process, how he perceives his present condition, and the patient’s preferred learning methods. Knowing the preferred learning method, specific to the patient, will determine what teaching methods should be used.

Knowing this reality, as part of a care team, I realize the necessity of being patient with this person affected and support him.

Inability to discover or look after job - which might bring about destitution and vagrancy. The patient might feel unwilling to do a reversal to work as a result of reasons for alarm of being not able adapt to obligations. Specialists say that patients who do figure out how to bear on functioning have a tendency to have a superior personal satisfaction contrasted with the person who don't.

The nurse’s role would be to evaluate first the patient’s level of understanding of their disease. It is important to also include a patient’s support system when teaching. The nurse must give the patient information about his or her condition in a form he or she can easily understand so the patient can develop a genuine comprehension of the disease process. After the patient has a good comprehension of the disease, he or she can then apply this knowledge to his or her own situation. When this knowledge is applied to a patient’s own situation, the patient is then able to ask questions and form a new way of thinking about living with the disease. When these steps are accomplished, the patient will then be able to create a plan that would help in achieving his or her goals in regards to living with the disease process. As nurses caring for patients with chronic illnesses, recognizing where patients are at in their journey with learning about their chronic illness, and meeting them where they are will help when educating and guiding them to the next step.