...What are the important points that you would review with a patient when teaching how to instill ophthalmic drops and when teaching how to instill ointment? Providing patients and care givers with information regarding administration of both ophthalmic drops and ointment it imperative to ensuring the appropriate dose of medication is received, proper hygiene is utilized and the medication is administered safely to prevent injury. First, individuals must be informed to follow the administration of either form of medication as prescribed and to administer the appropriate number of drops or size of ribbon of the ointment and ensure the patient is knowledgeable of the medication (Shaw, 2016). Next, instructing the individual in regards to appropriate hand hygiene prior to administration of ophthalmic medications is vital to lessening the risk of the introduction of the potential for increased infection (Shaw, 2016). In addition, to appropriate hand hygiene it is essential for the individual or care provider to assess the eye prior to administration of a medication for signs of allergic reaction related to excessive swelling or redness to the sclera or conjunctiva and to ensure the outer eyelid is clean and free of drainage or crust (Shaw, 2016). The individual must understand that is there is drainage present the outer eyelid should be cleaned with a clean cloth wiping from the inner eyelid out and to change the side of the cloth between wiping (Shaw, 2016). Once the area is clean...
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...Taking a Stand Barbara De Groot, RN Walden University NURS 6053, Inter-professional Organizational And Systems Leadership Barbara De Groot, RN November 14, 2014 Introduction Patient advocacy extends back to Florence Nightingale and remains relevant today. While Nightingale did not explicitly address advocacy in nursing, she did demonstrate advocacy in many ways (Selanders and Crane, 2012). Today advocacy extends beyond the individual patient to local and global populations, and nationally and globally to the nursing profession itself. The purpose of this paper is to describe this author’s role as a moral agent or advocate for a specific issue in this author’s work, and explain one or more negative outcomes that may result if this role is not fulfilled. This paper will also analyze the skills, dispositions, and strategies necessary to help this author fulfill this role, and explain this author’s motivation for taking a stand. Role as an Advocate Advocacy has been described in ethical and legal frameworks, and as a philosophical foundation for practice (Negarandeh et al., 2007). Malik (1997) states that “the core condition which demands advocacy action is the vulnerability of a patient, either personal vulnerability due to illness and/or the vulnerability to risks inherent in the institutional processes to which the patient is exposed in the health care system.” As a nurse discharge planner case manager, part of this author’s job is to identify potential...
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...Performance Improvement: Joint Care Center Matthew Arless State University of New York Plattsburgh Blood loss in a total joint replacement surgery may subject the patient to allogeneic blood transfusion. This places a patient at risk for the potential of transfusion reactions, graft-versus-host disease, hyperkalemia, fluid overload, and infections.( Qintong 2014) Not to mention the fact that most patient’s satisfaction or even more significant avoidance of the surgery increases with the fear of receiving an allergenic blood transfusion. This in all sense and purposes is an organ transplant. Cost of an allogeneic blood transfusion and having a sufficient blood supply are also a factor. Reduction of blood transfusions post operatively is an area that presents an opportunity for improvement here at the Joint Care Center Champlain Valley Physician Hospital. The procedure that was traditionally implemented by most of the orthopedic surgeons at Champlain Valley Physician Hospital to reduce blood loss was with the use of a tourniquet during surgery to slow the loss of blood and the implementation of an auto transfusion device. This auto transfusion device would collect blood draining from the surgical site into a device that the nurses would then have to attach a PALL filter to for re-infusion back into the patient. This procedure would be treated under the transfusion protocol, using up valuable nursing time and with the added expense of the devices and restriction of the patients...
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...Brittany P. Thornton Dr. Aneil Mishra MGMT 4343 02 February 2016 Dane Miller- The Maverick CEO Great leaders are all defined by different attributes, successes, and contributions made to their professions, communities, and stakeholders. The term “Leader” is subjective and varies greatly in the opinions among various individuals. In this paper, Dr. Dane Miller, my selected CEO, will undergo a leadership assessment based on the ROCC of Trust and various other qualities. Biomet Inc. is a medical device manufacturer specializing in reconstructive products for orthopedic surgery and O.R. supplies (Biomet). Dr. Dane A. Miller or “Mr. Biomet”, was the co-founder of the orthopedic company Biomet, Inc. and served as its president and chief executive officer from 1978 to 2006 (Jordan). In the United States, the medical device market remains the largest one in the world with a market size of about $110 billion (Select USA). The ROCC of trust explores the elements that restore, enhance, and build trust amongst individuals. Being a great leader involves fostering strong and enduring relationships so learning to utilize and assess the ROCC of Trust is a useful analytical tool. Using the ROCC of Trust entails being reliable, open, competent, and compassionate. Dane Miller exhibited reliability both for his products and his commitment to the company. In 2006, he was coerced by the company’s board of directors to retire after 28 years of service. Miller said he contemplated riding...
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...research uses words instead of numbers. This paper is going to analyze the planning and design of a qualitative research paper titled: Patient’s experience of pain and pain relief following hip replacement surgery, published in the Journal of Clinical Nursing on October, 2010. Research questions Although the research question or questions are not clearly labeled in the study, the research questions were as follows: 1) How do patients describe their experience with pain after hip replacement surgery?, 2) How do patients describe their pain relief following hip replacement surgery?, 3) How does pain affect patients after hip replacement surgery? Problem A research problem is “an area of concern in which there is a gap in the knowledge base needed for nursing practice” (Burns & Grove, 2011). In this research, it was identified that many patients undergo hip replacement every year and previous research has focused largely on the long-term effects of pain for these patients but not so much on their subjective, early postoperative pain experience. Purpose A research purpose is “a clear, concise statement of the specific goal or focus of a study” (Burns & Grove, 2011). The purpose of the research study was to describe patients’ experience of pain and pain relief following hip replacement surgery (Joelsson, Olsson, & Jakobson, 2010). Hypothesis A hypothesis is “a formal statement of the...
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...of the arm. The patient had radiographs made an weeks prior to our consultation that showed the glenoid uninhabited. We found an old or neglected dislocation of the left shoulder. as attitude, we decided to try in vain for a reduction (after a re- Another recent x-ray) under general anesthesia despite the time elapsed. Faced with this therapeutic impasse due to the formation of a néoarthose one hand and the filling of the glenoid by fibrous tissue on the other hand, solutions treatment remaining: Abstention when the pain is simply tolerated by the patient; In our environment resected humeral head (shoulder dangling) that will solve the problem of pain but not functional; when pain gene the patient; Or a total hip replacement (arthroplasty of the shoulder) achievable under other skies likely due to osteopenia of the head and neck already installed (ideal treatment). , April 6, 2012...
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...used to immobilize and hold bone fragments during reduction. It is made up of layers of plaster or fiberglass (water-activated polyurethane resin) bandages molded to the body part that it encases. Indications * To apply uniform compression of soft tissues * To permit early mobilization * To correct and prevent deformities * To support and stabilize weak joints Types of Casts 1 Short and long -arm cast for the upper limbs. : Extends from below the elbow to the proximal palmar crease. 2 Gauntlet Cast (thumb spica): from below the elbow to the proximal palmar crease. 3 Short and Long-leg Cast for the lower limbs. 4 Body Cast: Encircles the trunk stabilizing the spine. 5 Spica Cast: Incorporates the trunk and extremity. 6 Shoulder spica: encloses trunk, shoulder, and elbow. 7 Hip spica: encloses trunk and a lower extremity and can be single or double. Single extends from nipple line to include pelvis and one thigh while double includes both thighs and lower legs. 8 Cast-brace: External support about a fracture that is constructed with hinges to permit early motion of joints, early mobilization, and independence. 9 Cylinder Cast: Can be used for upper or lower extremity e.g. fracture or dislocation of knee or elbow dislocation. Complications of Casts * Pressure of cast may cause necrosis, pressure sores, and nerve palsies. * Compartment syndrome * Cast syndrome associated especially of body cast, resulting to nausea, vomiting...
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...thyroid gland leading to gradual destruction leading to inadequate production of the thyroid hormones the body needs (hypothyroidism) • Polyglandular autoimmune syndrome (PGA I) – Hashimoto’s w/ hypoparathyroidism, adrenal insufficiency, and fungal infections of mouth and nails • Polyglandular autoimmune syndrome (PGA II)- Hashimoto’s w/ adrenal insufficiency and type I diabetes Clinical Manifestations Depends on severity of hormone deficiency – are those of an underactive thyroid gland (hypothyroidism) • NONE • Intolerance to cold • Weight gain-occurring infrequently & rarely more than 10-20 lbs, mostly fluid • Fatigue • Constipation • Enlarged neck or presence of goiter • Pale, dry skin • Hair loss • Heavy and irregular menses • Difficulty concentrating or thinking • Pain and stiffness in joints, swelling in knees or small joints in hands & feet • Muscle aches, tenderness, and stiffness-especially in shoulders & hips Hashimoto’s Disease WHAT YOU NEED TO KNOW Signs & Symptoms – con’t • Facial swelling/moon face • Hoarse voice • Elevated blood cholesterol level • Muscle weakness, especially in lower extremities Causes • Cause is unknown...
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...March 14, 2011 Pharmacology Dr. Hutcherson PROJECT FOR NON-CLINICAL PHARMACOLOGY STUDENT BY SUZANNE NATION PART 1: THE PATIENT’S MEDICATIONS 1. INTRODUCTION a. Mrs. Jenkins is a 73 year old Caucasian widow who lives alone and is a retired school teacher of 35 years. She is fiercely independent but is looked after by oldest daughter who comes every few days to take her to appointments and shopping for groceries. Being a former school teacher Mrs. Jenkins is well educated and knows a good deal about her medical condition and medications. She always tries to follow a strict diabetic diet and take her medications exactly as prescribed, however, when her daughter stops by to see her she is shocked to find her mother confused and having difficulty breathing. She immediately calls 911 and Mrs. Jenkins is brought to the hospital. The emergency room doctor is informed of her medical history that includes insulin dependent diabetes, congestive heart failure, hypertension, osteoarthritis, and chronic obstructive pulmonary disease. Further diagnostic testing reveals Mrs. Jenkins has pneumonia and needs to be admitted for antibiotic treatment. b. Primary diagnosis is pneumonia which is an infection of the lungs caused by bacteria, virus, and sometimes fungus, characterized by inflammation of the lungs, congestion, shortness of breath, cough and fever. Symptoms may vary. Secondary diagnoses COPD Chronic obstructive pulmonary disease which is a combination of...
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... *Age/Sex (women>men), *smoking, *medication (prednisone), *limited activity. Post-surgical anticoagulation S.P. is receiving Lovenox and Coumadin as thromboprophylaxis, a common practice after surgeries. Lovenox is used to prevent clot formation and will be an injection form, while Coumadin is taken orally, interferes with the synthesis of vitamin K clotting factor. In addition, it is recommended because of increase with coagulation factor. Anticoagulation is continued for approximately 30 days. INR is measured with the use of Coumadin with a goal of 2-3. A (arthroplasty) versus O (open reduction and internal fixation) A is also known as total hip replacement. O is metal pins, screws, rods and plates are used to immobilize the fracture. A is replacement of the entire hip joint with a prosthetic (artificial) joint system. Intraoperative blood salvage a. The blood that is lost from surgery is immediately re-administered to the patient. b. The blood lost from surgery is collected into a cell saver. c. The salvaged blood must be reinfused within 6 hours of collection. Postoperative problems Dislocation of the hip, infection, shortening, blood loss, thrombotic events leg length discrepancies, reaction to medications, and tissue reaction, Monitoring postoperative blood loss The nurse will monitor for blood loss by monitoring vital signs, signs and symptoms changes. Blood pressure will drop due to excessive blood loss, profuse sweating, confusion, and shallow respiration...
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...Associate Degree Nursing Program NURS 122 Concept Care Map Evaluation Rubric: Maternal-Newborn |Value/categories |0 |1 |2 | |Assessment with Pathophysiology | < 90% data filled |> 90% data filled in |Complete with | | |incorrectly |correctly |Pathophysiology | |Lab work/rationale or reason for| | | | |labs | | | | | |0 |1 |2 | | |95% lab work and reasons | | |documented |documented |documented | |Step 3 - Care Map |0 |1 |2 | |Problem category Physiological |2 appropriate problems with|3 appropriate problems with|4 or more appropriate | |and psychological related to |Reason for admit and key |Reason for admit and key |problems with Reason for | |stages of postpartum |assessments |assessments |admit and assessments | | ...
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...Orthopaedic Surgery - Arthroscopic Surgery - Joint Replacement - Sports Medicine - Fracture Care John R. Chance, M.D., David L. Fox, M.D., Jamie L. Lynch, M.D., Brian E. Schulze, M.D., Patrick M. Simon, M.D., Rex E. Wilcox, M.D. Diplomates, American Board of Orthopaedic Surgery Kelly A. Cooper, PA-C Total Knee Arthroplasty (Replacement) Post Operative Instructions IN THE HOSPITAL AFTER SURGERY: You will stay in the hospital for 2-3 days after having knee replacement surgery. During that time you will recover from your anesthesia and the surgery itself. Right after surgery you will spend 1-2 hours in a recovery room (PACU) before going into your room. You will likely wake up very tired and groggy. You will have a large dressing (bandage) over your incision and part of your leg. A small drainage tube may be in place during surgery to help drain fluids that collect in your knee joint after surgery. After being taken back to your room you will continue receiving fluids through your IV (a catheter or tube that is inserted into your vein to give the medical staff access for medications and fluids) until you are able to drink fluids on your own. You will slowly resume a normal diet. After knee replacement, some surgeons recommend using a continuous passive motion machine (CPM) while you are in bed. The CPM bends your knee for you. Over time, the rate and amount of bending will increase. If you are using this machine, always keep your leg in the CPM when you are in bed. It may help speed...
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...Hashimoto’s Disease Rita Mujica I. Definition Hashimoto’s disease, also called chronic lymphocytic thyroiditis, is a condition in which there is inflammation of the thyroid gland as a result of the immune system attacking the gland (1, 2). Hashimoto’s disease affects women 10 times more often than men, and most often occurs between the ages of 30-50 (3). II. Tissue(s) specifically affected Hashimoto’s disease mainly affects the thyroid gland. It causes the immune system to targets cells that have the ability to make thyroid hormone (4). III. Symptoms • Fatigue and sluggishness (2) • Increased sensitivity to cold (2) • Constipation (2, 4) • Pale, puffy skin (4) • Unexplained weight gain — occurring infrequently and rarely exceeding 10 to 20 pounds, most of which is fluid (2) • Joint and muscle pain (4) • Pain and stiffness in the joints and swelling...
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...care providers treat many patients with co-morbidities. It is important for primary care providers to utilize the most current evidence-based research and guidelines to treat and manage patients with co-morbidities in order to reduce risk factors and improve overall health. The following case study will be utilized to apply current guidelines for the treatment and management of hypertension (HTN), chronic kidney disease (CKD) and hypothyroidism including patient education, monitoring, and clinical end points. Case Study A 45 year old African American male returns for a six month follow-up for blood pressure (BP) control. The patient complains of on-going symptoms over the past few months of dry cough, sleep disturbances, fatigue, constipation, weight gain, and dry skin. The patient denies pain, shortness of breath, edema, or sputum production. Pulse is 80 and regular, BP is 148/110, and BMI is 28. He is six feet tall and weighs 205 pounds. Labs reveal TSH of 5.2, free T4 of 0.8, free T3 1.8, Creatinine 2.1, BUN 22. Family history includes stroke, heart attack, and high cholesterol. Current medications are daily multivitamin, Lisinopril 10 mg once daily, over-the-counter (OTC) Robitussin, and OTC laxative as needed (University of Phoenix, 2014, Week Seven Case Study). The patient can be diagnosed with uncontrolled HTN, subclinical hypothyroidism, and may have chronic kidney disease (CKD). Untreated HTN can lead to heart attack, stroke, renal failure, and death (James et al...
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...There are many stages to aging and menopause is one of the things women go through as they become older. Menopause is a normal condition that women experience as they age, and it is a term used to describe the many changes they go through. It is a period where they stop menstruating and it marks the end of their reproductive period. This is something that typically happens around the age of 40, but it can happen sooner or later depending on the individual. If it does happen before the age of 40 it is still considered normal aging but it is referred to as premature menopause. This can occur if there is an ovarian failure, autoimmune disorders, or medical procedures. There are three known stages to menopause which include perimenopause, menopause, and post-menopause. Perimenopause lasts up until menopause and it will usually begin years before menopause when the ovaries begin to make less estrogen. In the last years of this stage is when the drop in estrogen levels drops very quickly and where women begin to experience menopause symptoms. This continues on with menopause which is the point when it has been a year since a woman last had her menstrual period. In this stage the ovaries stop releasing eggs and stop making most of their estrogen as mentioned before. The last known stage is post-menopause and this is all after menopause. During this stage most menopausal symptoms are at ease for most women such as hot flashes, but unfortunately health risks related to the loss of estrogen...
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