The Situation That Occurred During My Med Surg Clinical

Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of

The first phase of the nursing process is the assessment of the current needs/problems presented upon Mr. Smith’s arrival to hospital. The initial assessment requires the nurse to gain consent in order to gather any information such as his contact details as well as the contact details of his next of kin who in this case his is wife Susan and also the details of his GP, any known allergies he may have and any medications he may currently be on, whether he has dentures as well as his weight and BMI. During this phase, communication with the patient and family is essential to ensure that correct information is obtained so that a proper informed decision concerning his care can be made. In this case there may be some barriers that may effect the assessment process and that is the speech of Mr. smith is sometimes slurred, therefore he may need his wife to answer some of the more complex questions that require more than a yes or no answer. Nurses need to choose their words carefully so that they match the patient’s ability to understand them avoiding the use of medical jargon (Kraszewski & McEwen 2010). The dignity of the patient must be maintained at all times through all phases of the nursing process and a comfortable environment is essential-preferably in a private room or if not ensuring that the curtain is drawn out of respect for the patient (Barnes

I spoke with the family and arranged for him to have video call his son so that he can see and talk to his granddaughter. This helped the patient’s willingness to participate in activities of daily living and reenergized him.

In 2003 during the last semester of nursing school, my life was devastated as my ex-husband was arrested as a serial rapist. This was overbearing and I thought this as being impossible to recover from. A breaking point came as I approached a red light deciding whether to deliberately run my minivan into oncoming traffic with my two young children to end our lives. Only days later, I once again felt that I was at the lowest point in my life as the reality of this event truly hit during a medical-surgical examination.

Ms. Cetiner has been an RN in the hemodialysis unit for the past 6 years. She provides excellent care to our Veterans, and consistently functions in a professional manner with staff, patients and families. She was part of a unit I CARE award presented by Dr. Mayo-Smith for quality and commitment to our Veterans. She demonstrates competency in the utilization of the nursing process as evidenced by the accurate assessment, plan, implementation, and evaluation of patient care in her daily practice. She developed a unit diabetic foot

The nurse unable to convince a physician of a patient’s failing health status, can result in harm to the patient. Nurses’ and physicians’ have different styles of communication and gender differences that play a primary role in this constraint (Burkhardt & Nathaniel, 2014). Another constraint would be nursing management’s lack of support for a staff member. The nursing supervisor could have assessed Mrs. Kelly with Joanna and suggested a more detailed assessment, and possibly contacting the house physician. She herself could have called the resident and insisted that he come evaluate Mrs. Kelly’s condition or contacted the house physician. Institutional constraints that may apply here is the hospital’s lack of shared decision making processes that promote and support the nurse as the patient’s advocate. Also, Management that does not support a culture of

The staff person did not take the correct approach in trying to communicate with the patient. The staff person should have made an effort to obtain a trained interpreter to speak with the patient. If unable to do this, the staff person could have sought to find a staff member who spoke Spanish. However, after touching basis on what the patient is seeking care for, a trained interpreter should be obtained. It is not appropriate to use family members as interpreters since this can result in a breach of confidentiality and misunderstanding of information. The patient son is also a minor, which is another reason he should not be used as an interpreter. This situation was not an emergency that required immediate need of a translator, thus an appropriate interpreter would have been the best approach.

Family members, at times, can be of great assistance, but then HIPPA comes into play. The patient may not want a particular family member to know about their health problems. The language barrier does inhibit sufficient care, and this should be addressed with the utmost of care and consideration for both the medical staff and patient.

Patient education is a must in this population, since many have limitations when it comes to lifestyle choices. An area I feel the heart team does an excellent job in addressing. As for their health literacy levels, since these clients have lived with their complex cardiac condition most of their lives, I believe their, or family’s, health literacy is relatively high. Most understand the severity of their disease and how it affects most other aspects of their lives. When it comes to an exercise regimen or planning a family, their cardiac health plays a key factor. Although, there are those minority with secondary mental disabilities that are at higher risk of errors in self-care, but what

When creating care plans for children it is so important to include the child’s family in their care as it will benefit in this case both James and his family in helping to meet his milestonesIt is especially important when creating care plans for children to include where possible the philosophy of children’s and young person’s nursing which is family centred care. (Glasper and McEwing, 2010). Family centred care does not mean that parents have to remain with their child at all-times in hospital.it Care planning is all about prioritising what is best for the patient and putting the patient first (in this scenario James) but also incorporating family centred care in the patients plan. As discussed in care plan 3, we saw how James experienced anxiety as a result of hospitalisation for the first time and how his mother also suffered from anxiety as a result of not being able to stay with James all the time. In spite of this, James’ individualised care plan alleviated this problem by assigning him a nurse that he built a trusting relationship with and by creating a home environment for him by bringing in some family photos and comforts like his blanket and favourite toys.

Discuss the nursing interventions to be utilized with a family member who is in crisis in the care setting and interfering with the healthcare team’s performance.

According to the Heart Foundation (2010), “Best-practice management of chronic heart failure (CHF) involves multidisciplinary care” (p. 3). A care coordinated with his different physicians including cardiologist, pulmonologist, and referring physicians, as well as clinical nurses, and dieticians will be an important step in Mr. P’s CHF care. As they are concerned about the mobility outside of their home, a telephonic follow-up after discharge from the hospital, and door delivery of medicines could be beneficial. It is also very important to help him to overcome his polypharmacy. Since Mrs. & Mr. P seem emotionally weak, they need emotional support to cope up with the situation. They are worried about the heaping medical bills. Provide information about the possibility of getting qualified for Medicaid/Medicare as well as grants from organizations like Patient Access Network

The patient is an 87 years old Canadian woman; she found it disheartening to talk about her condition. Understandable, since most would find being unable to control one’s bladder at any point in a person’s life embarrassing. Discussing it over with family it is a nurse’s job to reaffirm with the patient that they are here to help, as well as speak with the patient that they need as much information as possible. The patient shared, and understands she needs to overcome her embarrassment, and no one here is laughing at her. The information one can find and the discomfort they have in sharing can be eye opening to a surprising degree; the patient has diabetes, a history of Parkinson disease, stroke that has left her weak on her left side, and arthritis. Psychological predicaments and life changing events can also play a part in patient’s current problems as it was discovered that her husband recently passed away. This morbid reality has left

Patients who are diagnosed with acute renal failure go through difficult times dealing with the disease. Their families too experience psychological difficulties, not knowing the degree of suffering their loved ones are going through. Therefore, in order to provide the best of care for the patient, nurses need to be knowledgeable about the problem, and find the best professional way to educate the patient and family so that the patient does not end up into the hospital for re-admission. Family members can best relate to the situation and understand what their loved ones are going through if they are included into the care of the patients. You get a better outcome when you treat patients as a whole. It is critical for nurses and other health care workers to provide patients and their family members with the necessary information in order for them to make informed decisions.

Jones is a 64 year old well nourished man with a history of long-standing non-insulin dependent diabetes mellitus (NIDDM). He had an open heart -surgery bypass graft 7 weeks ago. The graft site got infected and had to undergo an emergency surgery to improve circulation to his left lower limb. Mr. Jones is relieved that his leg was saved and he is now being prepared for discharge. He wants to regain his strength so that he can start doing the things he loves. Currently Mr. Jones needs moderate assistance depending on his level of pain or fatigue and ambulates with a walker. Mr. Jones still needs help with activities of daily living. He has urinary and bowel control problems as side effects from multiple antibiotics. Mr. Jones is married and has 4 grown children that provide him with love, care, and support. The nursing staff is teaching Mrs. Jones how to perform sterile wound care for her husband as he will need dressing changes three times a day, blood glucose monitoring and a healthy diet. Social service is helping to keep communication channels open between Mr. Jones, his family and the nursing staff to maintain psychological and emotional health.