What Signs And Symptoms Support Your Suspicions?

The district nursing team were now to be responsible for the wound care of an ulcer on the sole of her right foot on her impending discharge. She had previously attended the practice nurse and a podiatry service based within her local clinic. Due to a change in circumstances, she was now clearly housebound for the near future due to mobility issues. Prior to an arranged visit, the patient had called the nurse to advise her that she was pyrexial and was experiencing a pain in her right foot that was different from her normal neuropathic pain, which was often problematic. She was also finding it difficult to mobilise and was disinclined for diet but was taking oral fluids.

The nursing supervisor has multiple issues to address in this scenario, the use of restraints and formation of a pressure ulcer are of a great concern, but I believe these are easily rectified with training and follow-up audits to ensure

A solid understanding of nursing-sensitive indicators can assist the nurses in the case of Mr. J in identifying issues that may interfere with patient care. Knowledge of appropriate restraint use, as well as the care involved while caring for a patient in

Rape – e.g. a male member of staff having sex with a Mental Health client (see Mental Health Act 1983)

The patient did have black soot around his nose and mouth. Thats when first responders started manual ventilation's via BVM and 02 at 15 LPM. At this time Medic 1 assumed patient care. Medic 1 assigned first responders to obtaining vitals signs that are stated in the vital section of the report. It was at this time that Medic 1 applied a OPA after first measuring on what size to use. First responders also applied fast patches to the patients right upper chest and left midaxillary line At this time Medic 1 assigned first responders to start chest compressions a 15:2 ratio. Medic 1 at this time started a IO in the patients plateau region of the right leg. The Plateau region is inferior and lateral to the knee cap. At this time Normal Saline bolus was started with a 60 drop per ML set. Medic 1 found the patient to be in a sinus rhythm At this time miscommunication with Medic 1 and first responders happen with chest comparisons started. We then secured the patient on the cot via 4 straps and transported a code red patient to the nearest hospital. While enroute to hospital radio report was given with chief compliant and treatments listed in the appropriate category of the report. Vitals was continued to be taken every 5

As the primary nurse for the patient, I felt it was my responsibility to inform

He tells her that she believes that the patient has two issues on hand. The first being that the he has been taking too much Acetaminophen and the second the Oxycodone in the Percocet and the high amounts of Diphenhydramine Hcl in his sinus medication is causing increased sedation. According to www.fda.gov the recommended amount of Acetaminophen in 24 hrs is not more that 4000mg or 4 grams. (Use a conversion factor) Taking more that this has been linked to liver disease, which could be the reason for the yellow skin color. Jt has been taking 325mg of Acetaminophen in his Percocet every 4 hrs as well as 650mg of Acetaminophen in his Equate allergy. In combination this places his Acetaminophen dosage at 5,850mg a day which is 1,850mg over the recommended maximum dose. Jt has also been taking 50mg of Diphenhydramine or Benadryl every 4 hrs as well as the narcotic Oxycodone in the Percocet. Both medications are known to make people sleeping, but in combination there will be as increased risk of sedation. While the doctor waits for the lab results he has the staff start and IV and infuses Normal Saline 1000ml over 1 hrs to help dilute the medication in his

Safety. Mr. Stewart is 80 years old and was admitted due to traumatic injury from falling off a ladder causing fractured hip, ankles and ribs, and generalized bruising and skin tears. Throughout the shift, Mr. Stewart continually complains of pain in different areas. Mr. Stewart says he is in pain and his first set of vitals were blood pressure (BP) 200/110, heart rate (HR) 130, respiration rate (RR) 44 and shallow, SaO2 72% on room air. His second set of vitals after the second dose of Lasix was BP140/50, HR 84, RR 30, SatO2 97% on 35% O2 via mask, and Temp 38.0. He is currently on IV NS at 150cc/hr. We would also ensure that we check the safety equipment such as an oxygen mask and crash cart is nearby in case of emergency.

When deciding whether or not to give a medication to a patient, many things must be taken into account. These conditions are known as indications. The indications for a medication include the most common uses of the drug in treating a specific condition (10). Another thing to be considered are contraindications, which are conditions where the drug should not be given. Contraindications are situations in which the drug should not be administered because of the potential harm that could be caused to the patient (10). The dosage is also important. The dose simply indicates how much of the drug should be given to the patient (10). The actions of the drug must always also be taken into account. The actions are the therapeutic effects the drug will have (10). Side effects of the medications must also be considered. Side effects are actions that are not desired and occur in addition to the desired therapeutic effects. Some side effects are unpredictable (10).

There was an error that resulted in patient harm that occurred on an oncology floor. The nurse was a newer nurse who was hanging chemotherapy and was being interrupted during the chemotherapy administration. The second nurse checking in the chemotherapy with the first nurse was also interrupted. The chemotherapy administration resulted in the entire bag being given during a short period of time because the pump was not programmed properly. Once the error was realized, the patient was sent to the ICU.

Any inflammatory process that involves the skin, such as contact dermatitis, can leave areas of hypopigmentation upon healing.

This writer received a call from the dosing window by Nurse Joann while in session regards to Elizabeth and having a scar under her eye. Upon meeting with Elizabeth, she appeared to be unease that she could not dose. This writer strongly advised the patient to calm down as this writer needs to gained clarification from the Nurse as to what is going on. There is concern about the scar under the patient eye; however, the patient proclaims that she is clumsy and fell down. The nurse informed the patient about the need to speak with the on call doctor for an order to be put in place in order for the patient to dose. Based on the nurse comment, the patient was getting upset and bit emotional. This writer then questioned the patient in order for

Medication that she was receiving included amiodarone and precedex, however, a few hours after she was admitted she developed bradycardia and hypotension and those medications were stopped while an IV of epinephrine was initiated. Her vitals at this time stabilized again with a slight hypotension of 115/50. Continuous EKG monitoring still showed an irregular rhythm with a wide QRS complex. She was given lactad ringers for dehydration. The complete blood panel (CBC) was within normal limits with the exceptions of: white blood cell increased at 14.8 cells/l (normal 4-11 cells/l), hemoglobin low at 10.4 g/dl (normal 13.7 to 17.7 g/dl), red blood cell count decreased at 3.35 x 106/ml (normal 4.4-5.9 x 106 /ml), glucose high at 135 mg/dL (normal 70 – 99 mg/dL), hematocrit low at 31% (normal 40 to

There is also swelling that causes joint stiffness, brittle nails, thin skin that is cool, and trophic skin changes. It is common for X-rays to show noticeable bone loss and osteoporosis at this stage of CRPS. Stage three, also known as atrophic stage, occurs six to twelve months from the start of symptoms and can last many years. At this stage, pain continues to worsen and spread to other areas of the body. The edema begins to harden and contractures occur. The extremity affected has a decrease in temperature, and there are atrophic skin changes, such as changes to the fingers and toes, that are unchangeable. “X-rays are likely to show demineralization and ankylosis. Throughout each stage of CRPS, some motor disorders may also occur. These

Circumstances causing visit: Came into CRG for x-rays of his right hand to determine surgery options for removal of the extra digit.