The decision to admit Ms. Z to the hospital was made because she is experiencing shortness of breath that has not resolved with rest and one fainting spell. A benefit of admitting her to the hospital is that the provider team can assess if there are any serious problems going on, like heart failure. A risk to admitting her to the hospital is that she may not be able to afford her medical bill and being in the hospital may heighten her anxiety. I would follow through with the order to admit her to the hospital because the ST depression finding and clubbing of her nails may be indicative of heart failure. The benefit of “full code” status for Ms. Z is that anything will be done to get her heart started and lungs functioning. A risk of “full code” status is that it is automatic on her admission to the hospital and that may not be what she wishes. I would follow this order but would want to ask if she has a health care proxy to make decisions on her behalf if she becomes incapable of doing so.
An order for continuous telemetry has been made to allow for constant monitoring of her vital signs. A benefit of this is that it allows the provider team to keep an eye on any changes or potentially fatal arrhythmias and respond quickly, and it is wireless so she will be able to get up and move around. A risk of continuous telemetry is that is can cause skin irritation and may heighten her anxiety by knowing it is tracking changes in her vital signs constantly. I would follow through
This case study and the following questions pertain to Mr. Londborg, who came into the hospital with trouble breathing. Through his health history, they found out that he has a history of seizures, hypertension, and chronic obstructive pulmonary disease (COPD). His stay was extended in the hospital due to a respiratory tract infection, decreased kidney function, a blood clot in his leg, and a fall that could have been fatal. The following questions addressed throughout this paper will discuss what happened, why it happened and how it should now be prevented.
The plaintiff in Ard v. East Jefferson General Hospital, stated on 20 May, she had rang the nurses station to inform the nursing staff that her husband was experiencing symptoms of nausea, pain, and shortness of breathe. After ringing the call button for several times her spouse received his medication. Mrs. Ard noticed that her husband continued to have difficulty breathing and ringing from side to side, the patient spouse rang the nursing station for approximately an hour and twenty-five minutes until the defendant (Ms. Florscheim) enter the room and initiated a code blue, which Mr. Ard didn’t recover. The expert witness testified that the defendant failed to provide the standard of care concerning the decease and should have read the physician’s progress notes stating patient is high risk upon assessment and observation. The defendant testified she checked on the patient but no documentation was noted. The defendant expert witness disagrees with breech of duty, which upon cross-examination the expert witness agrees with the breech of duty. The district judge, upon judgment, the defendant failed to provide the standard of care (Pozgar, 2012, p. 215-216) and award the plaintiff for damages from $50,000 to $150,000 (Pozgar, 2012, p. 242).
For this interaction myself and a nurse in the cardiac/pulm rehab had to make contact with a patients cardiologist. This patient is in rehab following cardiac surgery, he currently is wearing a zoll life vest due to frequent arrhythmias. While this patient was exercising he had recorded v-tach over 10 beats, however he was asymptomatic and his zoll vest did not activate. After making contact with the patients physician he advised us that he would make contact with the patient but he did not consider it a emergency in which the patient should go to the hospital because the v-tach was corrected without a
In the case of Marion and the pace maker, like that of many cases of elderly patients, there are several factors that need to be understood by both the patient and their family before any decisions can be made, such as in her case, the surgical procedure of implanting the pace maker, the benefits,
Nursing assessment within 24 hours, Nutrition and hydration status, Functional status living, Social, spiritual, and cultural variables. Liza was admitted to the intensive care right away which wasn’t appropriate. The first step in the evaluation of a patient presenting with syncope consists of obtaining a detailed history and conducting a physical examination including blood pressure (BP) measurements and standard ECG. In this case, the nursing staff started began performing nervous system checks after 18 hours of her admission which is in my opinion was not appropriate because that should have been done right away after her arrival to the emergency room and after doing these evaluations, they should’ve decided on whether she was supposed to be admitted to intensive care or not. Also, the results of these tests would help them determine if a CT scan was needed and if needed, it should’ve been right away. In my opinion, Liza’s admission processes were not handled properly by the nursing staff at the hospital and her treatment was delayed. If all the processes were done on time and all the tests were done right away, her condition would not have worsened and she could have been started on anticoagulants for cerebral infarction. Patients have a better chance of survival and recovery if these drugs are taken within 12 hours of the incident. Most patients are administered these drugs within 90 minutes of hospital arrival.
Cardiac telemetry nurses specialize in cardiac care and in the use of electrocardiogram equipment. They must systematically apply their nursing judgment skills to perform assessments designed to evaluate pain, psycho-social background and patient education needs. Based on this information, they must identify risks, make diagnoses, generate goals and establish expectations. They must be able to continually prioritize and implement changing nursing plans according to updates or new information. They collaborate with patient team members on a daily basis to coordinate care and meet the needs of their patients.
Continuous cardiac monitoring remains the gold standard for arrhythmia detection, we would keep Mrs. Lee on continuous monitoring to provide complete uninterrupted arrhythmia monitoring of her rate and rhythm (Andrade et al,2015).
Eddy was transferred to Tucson Medical Center and placed in the cardiac unit there. When she first arrived, her room was prepared for her and the PCT was waiting to introduce herself, obtain vitals and inform her on who her nurse was. The nurse did not enter the room until about two hours after she had arrived at the hospital to perform her initial assessment. Over those couple of hours Eddy’s chest pain was at a tolerable level after the medication she received from the previous hospital, but she
All personal information has been changed and there are no identifiers that could reveal the location of the two hospitals and the staff that took care of this patient to protect the confidentiality of all involved. Adele is a seventy-two year old wife, mother of five, and grandmother of ten. Adele is happily retired and lives on a large acreage with her husband Ron and their dog Perky. Adele
For an established patient with a new or developing condition, for telemedicine to be used they must seek a follow-up with an in-person physician at a site other than the established medical site. If the symptoms of the patient persist the distant site provider is not allowed to administer care if the patient has not had a follow up with a
The heart is a vital organ that the body needs in order to survive and according to the Center for Disease Control (CDC) 5.7 million people in the United States suffer from heart failure (HF) and about half of heart failure patients die within five years of diagnosis, (CDC, n.d.). Heart failure is the inability of the heart to pump blood sufficiently in order to meet the body’s need. Heart failure is the main reason for inpatient hospitalization and readmission in adults over 65 years old (Smith, 2013). Advances in technology continue to change the practice of nursing and healthcare. Telemonitoring is one major advance in technology that is changing the role and practice of nursing today. Telemonitoring involves healthcare workers remotely monitoring patient’s vital signs daily with the goal of early detection of deteriorating conditions. This systematic review will present available data regarding telemonitoring in heart failure patients and hospitalization.
inflow of patients is higher than the available beds. You are treating an elderly man who is breathless and cyanosed. While you assess whether he has chronic obstructive pulmonary disease or heart failure, he becomes drowsy and starts gasping. You quickly intubate him with some difficulty, prolonging his period of hypoxia, and put him on ventilator support. You then get a phone call from a senior consultant in the hospital that an important social activist is about to arrive with chest pain and will need to be admitted. You are directed to
Monitoring of the vital signs should be closely monitored (pulse, blood pressure, respiration and pulse oximetry
Joanna is an experienced nurse taking care of Mrs. Kelly, who was Joanna’s patient many times in the past for her primary problem which is COPD. This time Mrs. Kelly was admitted with complaints of abdominal pain what was different from her primary diagnoses. Her vital signs were with normal limits and no significant changes from privies results, but for the nurse she looks sick, and Joanna know that something is wrong. She calls the resident doctor, but he tell her to watches and calls back with series changes. Joanna multiple attempts to report that something needs to be done to evaluate the cause of Mrs. Kelly pain was ask to calm down. However nobody took patient symptoms series and the next day patient died.