...Nursing Assessment & Diagnosis | Planning & patient centered goals | Nursing Interventions | Scientific Rationale | Evaluation | 1) Diagnosis: Excess fluid volume r/t decreased urinary output Assessment: B.K is an 88 year-old female presented with acute renal failure with urinary retention. Patient was admitted into Lehigh Regional on July 5th, 2013.Previous history: Diabetes, HTN, UTI, skin cancer, TIA. Subjective: Patient states, “I feel a bit fatigued in the evenings. My doctor said it is a side effect of my dialysis sessions. I don’t like going to dialysis but I know that I have to”.Objective: Patient alert and oriented x4. Vitals signs: BP: 119/72, Temperature: 98.9, Pulse: 82 bpm, respiratory rate: 18, and displays no pain at this time. Breath sounds clear, gag and cough reflexes intact. Bowel sounds present in all four quadrants. Eyes: PERRLA. Skin integrity is not intact; stage 1 pressure ulcer located in right posterior upper thigh, below buttock. Minor bruising on both upper extremities, No signs of DVT. Patient PICC line placement in right upper arm. Patient is easily fatigued primarily after dialysis sessions. Chooses to ambulate by wheelchair due to occasional dizziness. 1 assist when walking.Diagnostic test: Recent CBC done on 07/11/13 showed an elevated WBC count with a result of 14.0.Progress notes: “ Patient readmitted to facility due to noncompliance with dialysis sessions. Experiencing fatigue and occasional anxiety between dialysis sessions. Recent...
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...Disease Prevention Paper HCS/436 April 29, 2014 Maria Libano Disease Prevention and description about the kidneys There is a common saying that “the body is a one way street”, therefore any alteration can hinder the flow and may cause damage to vital body systems and organs. The kidneys which are bean-shaped structure primary function are elimination of waste and toxins out of the body and blood filtration. Each kidney contains almost one million nephrons, which is a major aspect of the functional unit of the kidney which filters blood and urine production through the network of capillaries tubules in the glomerulus. The tubules ensure that the glomerulus filters the substances that are essential including protein and that waste exit to the bladder to the urethra. The kidneys participate in different life-sustaining duties of the body including removal of waste and any excess fluid in the body, maintenance of salt and minerals in the blood, blood pressure regulation, producing of erythropoietin through renin by stimulating red blood cells, and can also aid in the production of vitamin D. When the glomerulus is not able to meet the daily demand from the kidneys by the human body as a result of damaged, it can hinder the function causing protein and blood loss in the urine, accumulation of waste product because it can no longer filter, which will then lead to edema in the extremities, fatigue, and elevated blood pressure as a result of inflammation is named...
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...Discussion Question- Low back Pain Student’s Name Institution Discussion Question- Low back Pain The discussion question that I am handling in this paper is related to low back pain. Most patients report having encountered low back pain at one time or another. Most of low back pain cases are not related to physical injury (Dagenais, 2012). My interest in this paper is to come up with a Comprehensive Teaching Plan for a patient diagnosed with low back pain that cannot be traced to any particular injury. My teaching program will comprise of three sections, these are general information concerning acute back pain, how to diagnose back pain and how patients can manage back pain (Ferguson, 2009). The primary cause of low back pain cannot be identified. Acute back pain is mostly encountered in primary care practices. Acute back pain is a symptom that is mainly caused by injury or disease to the bones, muscles and the nerves (Swezey & Calin, 2006). Pain arising from other organs in the chest, pelvis, and abdomen may also be felt at the back. The medical term for this type of pain is referred pain as it emanates from other body organs onto the back. Other disorders of the abdomen such as kidney disease, fibroids, urinary tract infections, ovarian infections, endometriosis and pelvic also causes pain that is referred to the back (Szpalski, 2010). Expectant mothers also experience back pain that is manifest in many ways. These include irritating nerves, strains...
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...Discussion Question- Low back Pain Student’s Name Institution Discussion Question- Low back Pain The discussion question that I am handling in this paper is related to low back pain. Most patients report having encountered low back pain at one time or another. Most of low back pain cases are not related to physical injury (Dagenais, 2012). My interest in this paper is to come up with a Comprehensive Teaching Plan for a patient diagnosed with low back pain that cannot be traced to any particular injury. My teaching program will comprise of three sections, these are general information concerning acute back pain, how to diagnose back pain and how patients can manage back pain (Ferguson, 2009). The primary cause of low back pain cannot be identified. Acute back pain is mostly encountered in primary care practices. Acute back pain is a symptom that is mainly caused by injury or disease to the bones, muscles and the nerves (Swezey & Calin, 2006). Pain arising from other organs in the chest, pelvis, and abdomen may also be felt at the back. The medical term for this type of pain is referred pain as it emanates from other body organs onto the back. Other disorders of the abdomen such as kidney disease, fibroids, urinary tract infections, ovarian infections, endometriosis and pelvic also causes pain that is referred to the back (Szpalski, 2010). Expectant mothers also experience back pain that is manifest in many ways. These include irritating nerves, strains...
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...small area of the healthcare sector, it is rapidly growing and affecting more and more every day. According to the data from the CDC more than 4.4 million Americans are diagnosed with some form of kidney disease (CDC). Renal Failure is best defined when the kidneys no longer work properly. Now one might ask, what do the kidneys do? The kidney’s simply remove metabolic waste and water from the human body and maintain homeostasis. Without the kidneys functioning properly the body will no longer make urine and dangerous electrolyte abnormalities can occur. One must realize there are several categories of renal failure. The two main classifications are Acute and Chronic Renal Failure. Acute Renal Failure is best defined as rapid and new onset renal failure sometimes reversible when treated appropriately while Chronic Renal Failure long term and irreversible unless treated via transplant. Now that a basic foundation definition of Renal Failure has been established, one must gain knowledge of what causes Renal Failure. Now that there is a basic understanding to what Renal Failure is the next step is to find out causes of the disease. This is where Acute Renal Failure (ARF) and Chronic Renal Failure (CRF) start to really differ. ARF can be caused by many disease processes or injuries such as; dehydration, rhabdomyolysis, trauma, renal infection, drug toxicity, and sepsis. In fact research conducted by the staff at the...
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...Discussion This experiment was based on data that oxygenated perfusion of NHBD livers will promote cellular recovery from warm ischaemic injury. (Schon, 1994: S159-62) Without perfusion, cold storage exacerbates the injury by subjecting the organ to additional (cold) ischaemia; then, during surgical anastomosis in the recipient, another period of warm ischaemia. These consecutive ischaemic periods facilitate the progression of cellular injury to a state that is not compatible with recovery upon reperfusion. (Endoh, 1996: 110-15) It is therefore essential to restore cellular energy levels between retrieval and reimplantation for NHBD livers. Previous studies have shown that perfusion prior to harvesting of the NHBD liver can restore cellular energy levels before cold storage. Total body reperfusion with cardiopulmonary bypass (CPB) using autologous blood after 30 min without ventilation was shown to revive total adenosine 5' -triphosphate (ATP) content in porcine livers and kidneys", Conditioning the liver with 30 min of normothermic isolated perfusion in vivo, using whole blood, has been shown to increase mitochondrial ATP content after 10 min of circulatory arrest in the porcine model7. CPB for only 10 min after 30 min of arrest, at 37°C, provided functional recovery of the heart, liver and kidney in the canine models. In the porcine transplant model, CPB for systemic perfusion with cold, oxygenated Eurocollins solution restored tissue energy charge after 10 min ofarrest9....
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...Running head: EPIDEMIOLOGY PAPER - HEPATITIS B 1 Epidemiology Paper - Hepatitis B Concepts in Community and Public Health NRS-427V-0102 EPIDEMIOLOGY PAPER - HEPATITIS B Epidemiology Paper - Hepatitis B 2 ―Communicable disease‖ means an illness caused by an infectious agent or its toxins that occurs through the direct or indirect transmission of the infectious agent or its products from an infected individual or via an animal, vector or the inanimate environment to a susceptible animal or human host‖ ("CDC," 2010, p. 1). Hepatitis B is one of the communicable diseases which are a contagious liver disease that results from infection with the Hepatitis B virus (HBV). CAUSES ―Exposure may occur: After a needle stick or sharps injury - Hepatitis B is a concern for health care workers and anyone else who comes in contact with human blood If any blood or other body fluid touches your skin, eyes or mouth People who may be at risk of hepatitis B are those who: Unprotected sex with an infected partner – one may become infected having unprotected sexual contact with an infected partner whose blood, saliva, semen or vaginal secretions enter your body. Receive blood transfusions (not common in the United States) Have contact with blood at work (such as health care workers) Have been on long-term kidney dialysis Get a tattoo or acupuncture with unclean needles Share needles during drug use - HBV is easily transmitted through needles and syringes contaminated...
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...Charlinne Rivera Professor Clark ENC 1101 Research Paper 7 August 2012 Work Count: 1,227 The Unexposed Dangers of Blood Transfusions Blood is not considered the “fluid of life” without valid reason. This essential liquid is circulated throughout the human body within veins, capillaries and arteries to our heart, where it is cleaned from contaminants and waste products, then replenished with nutrients and oxygen needed to maintain life. That is the way the human body system nourishes its cells. Blood provides the necessary nutrients to our cells to keep them alive. When this process is compromised by chronic blood loss, trauma, clotting abnormalities (hemophilia, anemia, etc.), the most common treatment is the use of blood transfusions. How wise would it be to consider all of the risk factors involved with blood transfusions before making a decision to utilize one? “There is increasing evidence that blood transfusions are dangerous and often unnecessary” (Hupston, “Quality Blood Transfusion Alternatives” 1). According to the article “Blood Transfusions- Risks”, published by the Mayo Foundation Medical Education and Research (MFMER), several risks are associated with blood transfusions. Included are the possibilities of getting an allergic reaction, even when the two blood types are compatible. Such reaction can cause from hives and itching to greater problems pertaining to breathing problems and blood pressure, tachycardia, vomiting, anxiety and fever. If a reaction of...
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...What is Hazardous Waste? Hazardous Waste is a "solid waste" which because of its quantity, concentration, or physical, chemical, or infectious characteristics may: Pose a substantial present or potential hazard to human health or the environment when improperly treated, stored or disposed of, or otherwise mismanaged; or Cause or contribute to an increase in mortality, or an increase in irreversible or incapacitating illness. A "solid waste" is defined as any discarded material that is abandoned by being disposed of, burned or incinerated, recycled or considered "waste-like." A solid waste can physically be a solid, liquid, semi-solid, or container of gaseous material. A waste is classified as a hazardous waste if it has a hazardous characteristic listed below or is listed as a hazardous waste in EPA's page with the list of identifies hazardous wastes. We could only find the list for Ohio. Hazardous Characteristics: Ignitable Hazardous Waste A liquid waste which has a flash point of less than or equal to 140 degrees F (60 degrees C) as determined by an approved test method. A non-liquid waste which, under standard conditions, is capable of causing a fire through friction, absorption of moisture or a spontaneous chemical change and when ignited, the waste burns so vigorously and persistently that it creates a hazard. An ignitable compressed gas or oxidizer. Corrosive Hazardous Waste An aqueous waste with a pH ofless than or equal to 2 or greater than or equal to...
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...Tract Infection in the Geriatric Population Elizabeth Shultz Abstract The geriatric population is very vulnerable to Urinary Tract Infection (UTI) and its negative consequences. If left untreated, UTI in the elderly patient can have negative consequences such as delirium or even death. UTI can also contribute to the onset of acute or chronic kidney infections, which could permanently damage the kidneys and result in renal failure. In view of this, the purpose of this paper is to review related literature to find current evidence or best practices related to UTI in the geriatric population and to objectively critique the evidence. CINAHL and MEDLINE computer databases were mainly searched from January, 2005 to January, 2015 using a combination of manual and computer-based methods. Keywords: elderly, urinary tract, elderly infection management, urinary tract infection prevention, elderly and UTI. Introduction By convention, a Urinary tract infection (UTI) is defined either as a lower tract (acute cystitis) or upper tract (acute pyelonephritis) infection (Nicolle, 2014). Urinary tract infection (UTI) is the most common infectious problem among older adults both in the community and institutional settings (Midthun, Paur, Bruce, & Midthun, 2005). The elderly population is most likely to experience UTI due to many reasons, not the least of which is their overall susceptibility to all infections due to the...
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...NUR160 Ca Name: Jodi Wiak | Section: 160 | Instructor: Ms. Higgins | Dates of care: 4/1/14 | Week: 1st clinical | Name: Jodi Wiak | Section: 160 | Instructor: Ms. Higgins | Dates of care: 4/1/14 | Week: 1st clinical | General Survey | Age: 85 | Sex: F | Ethnicity: Caucasion | # of days since admission: 7d | Allergies: Latex PCN | Code Status: FULL CODE | Diet: TPN | Rationale: Small bowel obstruction and resection benefit TPN over tube feedings is that all the nutrition is delivered at a cellular level making it immediately available for the body to utilize rather than making the body breakdown and absorb nutrients in the GI tract. It makes it easier on the digestive tract by giving the GI a chance to rest and heal without causing more harm. The patient also has to expend energy to breakdown foods/nutrition through the GI tract. Getting it TPN conserves the much needed energy the patient needs to heal their tissues and gain strength. | Activity: bedridden w/slight mobility with a walker | Rationale: Post surgical abdominal surgery, pt age, weakness, and recent foot surgery limiting her mobility. | Behavior/Affect: My pt was anxious when I first arrived due to her elevated B/P, N&V, and pain intolerance. By the end of shift my patient was very calm and communicative. | Isolation: | Yes | No | Culture: ⦵ | Source: ⦵ | Type of Isolation: ⦰ ⦵ | Height: 5’ 7.5” | Weight: 133 | BMI: 20.5 (BSA 1.71) | General Survey | Age: 85 | Sex:...
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...Final Exam Study Guide Important to Know the function of anterior and posterior pituitary gland. Anterior Pituitary Gland: (Adenohypophysis) The anterior pituitary gland regulates several physiological processes including stress, growth, reproduction and lactation (Adrenal, liver, bone, thryroid and gonads). -It is regulated by negative feedback and the hypothalamus. Major hormones: ACTH: Stimulates the adrenal cortex. TSH: Thyroid stimulating hormone, promotes secretion of thyroid hormone. FSH: Follicle-stimulating hormone, promotes growth of reproductive system. LH: Luteinizing hormone. Promotes sex hormone production GH: Growth hormone, promotes growth, lipid and carbohydrate metabolism. PRL: Prolactin, Milk production and progesterone/estrogen. -Hormones are secreted from the hypothalamus to the A. Pituitary so these hormones can be released. Posterior Pituitary Gland: Mainly axons extended from the hypothalamus. These axons contain and release neurohypophysial hormones oxytocin and vasopressin. Oxytocin: Targets the uterus, and mammary glands causing contractions and lactation. Vasopressin (ADH): Antidiuretic hormone, arginine vasopressin, argipressin. Stimulates water retention absorbs it back into blood causing raises blood pressure by contracting arterioles, and inducing male aggression. Very Important to know and understand Diabetic Ketoacidosis Pathophysiology: -In DKA, the lack of insulin prevents glucose from being utilized by the tissues...
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...1. Why might this patient have blood in his urine? Diabetes is a major cause of end stage kidney disease in patients. Necrosis within the kidneys or diabetic nephropathy, can be caused by long standing diabetes mellitus. The necrosis in the kidneys causes bleeding into the minor calyces, therefore resulting in blood mixing in the urine. 2. What other abnormalities would typically be found in such a patient’s urinalysis? Glucosuria, Proteinuria, and ketones would all be expected. 3. What is causing the bilateral desensitization of the lower limbs? Diabetes can cause nerve damage to the patient. If the nerves are damaged, the patient would undergo desensitization due to the lack of nerves. 4. Why are this patient’s lenses cloudy? High...
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...Nursing 344 Week 1: Report Writing & GFHP Report Writing Pt records are sometimes called in evidence before a court of law in order to establish events that may have contributed to a pt’s death or injury. They may also be required as evidence for an inquiry or hearing by the NMB of NSW. ▪ Frequency of documentation relies on: - physical/ mental status of the pt. - the type of care provided (self care v. intensive care) - requirements of health care agency - any legal or other obligations that the health record must meet ▪ Content of documentation needs to be: - relevant - appropriate - accurate - requirements will vary according to pt acuity - content may be guided by framework (assessment, intervention, response) ▪ Documentation framework: - assessment: conclusions reached utilising subjective and objective data - intervention: reflects the action taken - response: reflects the pt’s response to the intervention ▪ Example of using framework to case: Mrs Pat Martin, a 28y/o lady has been admitted overnight via Casualty accompanied by husband. She is 16 wks pregnant and has been diagnosed with appendicitis by Dr Chan. At the moment she is only experiencing mild pain and has a low grade fever of 37.7. IMI Pethidine 50mgs was given at 2am, and may be repeated PRN. Shes been added to the theatre list at 9.30am. She remains NMB and has IV normal saline running over 10hrs. IV Keflin QID commenced, is next due 12md...
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...ACUTE GLOMERULONEPHRITIS DISCLOSED _________________________ A Case Study Presented to The Clinical Instructors AUP College of Nursing Adventist University of the Philippines __________________________ In Partial Fulfillment of the Requirements for the Course NMCN 244, Care of Mother, Child, Family and Population at Risk ___________________________ TABLE OF CONTENTS I. Introduction Significance of the Study II. Patient DataBase A. Demographic Data B. Nursing History 1. Developmental Tasks 2. Health History 3. Medical Diagnosis & Chief Complaints III. The Disease Entity A. Review of Normal Physiology B. Theoretical Background C. Statistical Report D. Risk/Aggravating Factors E. Pathophysiology Narrative w/ Documentation F. Pathophysiology Diagram G. Prognosis of Disease IV. Assessment A. Gordon’s or Head to Toe Assessment B. Book Picture vs Patient’s Manifestations V. The Management A. Diagnostic Test Result and Significant B. Therapeutic/Medical Interventions 1. Surgeries/Treatment 2. Drugs C. Nursing Initiated Interventions 1. Nursing Care Plan 2. Discharge Plan VI. General Evaluation of the Study A. Summary B. Recommendation VII. Bibliography I. Introduction Acute glomerulonephritis is a disease that affects glomerular capillaries. Etiologic factors are many and varied; they include immunologic reactions, vascular injury, metabolic...
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