...One day, a patient and his wife presented to the release of information area to pick up a copy of the patient’s recent test results to take to a specialist. The patient asked Nadia for some assistance in reading the report because he was unsure of the terminology. Nadia was thrilled to help the patient. The patient had bilateral Doppler studies done on his legs to follow up from a deep venous thrombosis (DVT). Nadia was not terribly familiar with the format of the results, but she did not want the patient or her peers to know that she was not 100% sure of her interpretation. She did not see anything that looked alarming (to her), so she told the patient and his wife that as far as she could tell, everything looked normal. The patient was an avid runner and had been on bedrest since being diagnosed with the DVT. He did not have an appointment to see the vascular specialist until next week. He and his wife discussed the fact that the woman who gave them the test results interpreted them as normal and that it should be safe for him to get out and run again. The patient and his wife went out for what they planned to be a three-mile run. However, two miles into the run, the patient developed severe chest pain and shortness of breath and collapsed. His wife called for help, and he was taken to the Anytown General emergency room (ER). Soon after arrival, he was pronounced expired due to an embolism. The ER physician discussed what happened with the patient’s wife and explained...
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...Lymphedema 77 year old J.P. has experienced many years of progressive leg swelling. Her legs always seemed disproportionately larger than the rest of her body.Her primary care physician associated her large legs to her dietary indiscretions, and often described them simply as swollen and edematous. The status-quo continued until one day she presented to our Wound Center with 3+ pitting leg edema, and blistering of her left anterolateral calf. An arterial and venous doppler ultrasound was immediately obtained and showed no deep vein thrombosis or evidence of atherosclerotic occlusive disease. Closer examination of her lower extremities confirmed characteristics consistent with the typical trophic skin changes of secondary lymphedema Note the absence of varicosities, which are often thought to co-exist with chronic venous insuffi-ciency, but frequently are absent. The patient was afebrile and preliminary blood work showed no leukocytosis or bandemia. The erythema noted was consistent with severe stasis dermatitis and not a bacterial infection. Therefore, the patient did not require hospitalization for parenteral antibiotics. A Unna Boot was applied at the time of the patient’s first visit, with resultant rapid and effective reduction in edema, venous hypertension. The Unna Boot was removed after 72 hours and the extremity inspected. The patient responded nicely to treatment, but even after her stasis ulcer had resolved, she still complained of leg heaviness, easily fatigability...
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...Implement and monitor nursing care for clients with acute health problems. Contribute to complex nursing care of clients. Administer and monitor medications. Administer and monitor IV meds. Assessment 2 Post-op Case Study Assessment 2 Question 1. Identify a minimum of 5 nursing actions, in order of priority you would perform related to above information. Mrs Abu has had a considerable change in her vital signs (blood pressure lowered, her pulse is rapid, her respirations increased and temperature has dropped) form the baseline taken before surgery. These findings alone would be reported to the Registered Nurse and monitored. But because of the changes in vital sings, coupled with Mrs Abu reporting light-headedness and nausea, plus her significant blood loss form the surgical wound, you would be assessing for hypovolemic shock which can be life threatening. As the nurse you would be seeking assistance immediately, assessing her airway, breathing and circulation. Applying oxygen, applying pressure at the surgical site and continuing to monitor (airway, breathing, circulation) and vital signs until help arrives. Mrs Abu should be given nil by mouth as she may return to surgery (Gulanick, Myers, Klopp, Galanes, Gandishar & Puzas 2003, p.329). Question 2. Complete the interventions and rationale in Mrs Abu's care plan related to the following diagnosis |Nursing Diagnosis |Interventions |Rationale ...
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...Varicose Veins Varicose veins is one of the vein diseases. With this condition, the varicose veins are usually dilated, thickened, elongated and twisted blood vessels that stop controlling blood flow as they normally would. Sometimes these varicose veins can appear like small spider veins and like thread. Sometimes in other cases they can also appear like large grape-like clusters under the skin. Varicose Veins Symptoms: Some symptoms of Varicose veins are aching pain, the legs get tired easily, you feel some heaviness in the leg, swelling in the legs, in severe cases you will notice darkening of the skin, there is also numbness in the legs and some itching or irritated rash on the legs. Some Risk Factors More often, these varicose veins will occur in women more than in men. Most times in women, varicose veins are common during pregnancy (especially in the first trimester), during the last 14 days of the menstrual cycle and also sometimes they are common in people with jobs where they have to stand for a long time. Treatment There are several procedures of treating varicose veins whether used along or in combination. These procedures include: - Sclerotherapy, this is a procedure where the doctor injects a solution in the veins causing the veins to close and then blood is redirected through to healthier veins. This is the most common known treatment option although multiple treatments may be required. This procedure is normally used or useful at least for...
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...Blood vessel Case study 1. Trace blood flow from the L popliteal vein to the lungs? Left popliteal vein to Left femoral vein to external iliac vein to common iliac vein to inferior vena cava to right atrium to tricuspid valve to right ventricle to pulmonary valve to pulmonary artery to lungs. 2. What is a DVT and why is heparin prescribed? A deep vein thrombosis (DVT) is a blood clot that forms in a vein deep inside the body which can lead to a serious condition. Typically, these blood clots form in your lower leg or thigh, but they can also form in other areas of the body. Heparin is an anticoagulant which will make her blood thinner and less of a risk for Jenny’s blood to clot. In Jenny’s case it will also keep her thrombus from growing in size and decrease her risk of developing more clots. 3. Explain what a PE is and why the physician is concerned that Jenny may develop this condition. A pulmonary embolism (PE) is a sudden blockage in a lung artery and is often a complication of a DVT. Which in Jenny’s case is a concern because her blood clot could break free and travel through the blood stream to the lungs and block an artery. If this was to happen and the clot was small, then Jenny could have some damage to her lungs. If the clot is large it could stop blood flow to the lungs and could cause death. 4. Jenny asks the physician if the DVT could lead to a heart attack and the physician says no. Explain why the physician is right. The physician...
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...Accountability of Nursing Professionals Grand Canyon University: NRS ¬- 430V 07/08/2011 Accountability of Nursing Professionals Professional accountability means “ being answerable to someone for something done ” (ANA, 2002) Professional nurse is accountable to the profession, patient population, inter- disciplinary team, community, to the employer, and to self. The individual nurse retains accountability and responsibility for excellent care and conformity with evidence based practice. That includes bedside nursing, teaching, delegation, research and administration (ANA, code of ethics 2001). Advance in technology and evidence based practice brings perfection in nursing skills in order to provide competent and safe care to the patients. The level of responsibility and accountability varies as the professional role changes. The charge nurse has more responsibility than the registered nurse. Therefore their levels of professional judgment and practices are not same, but they assume same professional accountability. According to the Agency of Healthcare Research and Quality (AHRQ) Patient Safety Network web site expands upon the definition of prevention of harm: “ freedom from accidental or preventable injuries produced by medical care” (Mitchell, 2008). In 2001 (AHRQ) has given evidence based repot in different ways to improve patient...
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...esophagus, nasopharynx, oral, tongue, breast, ovary, uterus etc are associated with smoking. Second, smoking can cause respiratory disease and more than 90% of patients with chronic obstructive airway disease (COAD). Patient with severe COAD are very disabling, can be breathless even at rest, and may need long term oxygen. Patient with COAD may eventually die from a COAD exacerbation or chest infection. It can trigger asthma, and make asthma difficult to control. Also, it can cause cardiovascular disease. Smoking causes atherosclerosis (hardening and narrowing of blood vessels), so increase risk of stroke, coronary heart disease and peripheral vascular disease. So patient may loss his life or loss his limb. Smoking increases venous thrombosis. Deep vein thrombosis can cause pulmonary embolism, and this condition can kill in short time. Third, smoking affect social impact. In financial, smokers need money to buy cigarettes and also need money to pay for smoking related illness. A substantial amount of money is used to treat smoking related illness by our In social,...
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...Coffey is a 72 year old woman that has developed a deep vein thrombosis (DVT) due to reduced mobility while on bed rest. This assignment will discuss the signs, symptoms, prevention and management of a DVT and the use of warfarin as long term treatment. The assignment will explain what a DVT is and discuss its potential implications. The nurse’s role in the prevention of DVTs will be discussed in detail as well as the nursing management of Annie. The importance of patient education will be highlighted throughout the assignment and important discharge advice while on warfarin will be explained. A DVT is a thrombus or blood clot that most commonly occurs in deep veins in the leg or pelvis. DVTs usually start distally in the veins of the calf and can extend proximally into the veins at knee level and above the knee (Bonner and Johnson, 2014). In some cases, the thrombus becomes detached from the vein and travels to the lungs. When the thrombus breaks off, it is first transported to the right hand side of the heart and from there to the pulmonary arteries. This hence gives rise to a pulmonary embolism (Rico et al. 2010). Thrombosis occurs at sites of injury to the vessel wall. This is due to inflammatory processes activating platelets which adhere to the vessel wall and also the formation of a fibrin network. The fibrin network facilitates the formation of a clot by linking activated platelets together. As well as injury to the vein wall, venous stasis and increased hyper-coagulable...
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...Syndrome can also be known as the iliac vein compression, iliocaval compression syndrome, or cockett syndrome. This is a rare condition in which the left iliac vein is compressed by the right iliac artery due to the artery crossing over the vein. May-Thurner Syndrome was first noted in 1957 when an anatomical variant was found by R May and J Thurner (Weerakkody, Y., n.d.). Most patients are asymptomatic and go unrecognized until the symptoms develop. This disease compromises the venous return and can cause a deep venous thrombosis but fortunately can be treated and prevented. May and Thurner suggested that the constant pulsations from the right iliac artery led to the development of a “spur”, which can also be called a venous lesion, in the vein wall which would result in venous obstruction. About 2 to 5% of all individuals suffering from a vein disorder in the lower extremities have been diagnosed with May-Thurner syndrome (4 Important Things You Need to Know About May-Thurner Syndrome, n.d.). There are no facts as to why this condition happens except being thought as a congenital defect. Although it can happen because of trauma, age and extreme weight gain. This disorder is common among young women between 20 and 40 years of age. May-Thurner syndrome can cause left iliofemoral deep venous thrombosis. The patients will complain of unilateral swelling and pain. About 18-49% of patients with a left lower extremity deep venous thrombosis has been diagnosed with May-Thurner Syndrome...
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...Evidence-Based Practice Initiative. Venous Thromboembolism in ICU Patients Introduction Most patients admitted to the ICU are unable to move about and are at high risk for developing venous thromboembolism in the form of deep vein thrombosis (DVT) or pulmonary emboli (PE). This paper is about an ongoing effort in the writer’s facility’s ICU to prevent occurrences of venous thromboembolism. Compliance with proper use of mechanical thrombo-prophylaxis, staff education and compliance played a major role in the decrease of DVT at this facility. This facility’s quality initiative and DVT/PE eradication program was towards prevention of these vulnerable at risk patients. Venous thromboembolism (VTE), manifested as either DVT or PE, is the most common preventable cause of hospital death. (SOURCE)? This paper focuses on the role the ICU nurses are playing to help track and prevent at risk patients from developing DVT/PE. Adherence to prophylaxis guidelines supported with regular interactive education, preprinted order sets, reminders, and computer support systems were significant. Literature Review Although there is substantial evidence that primary preventive therapy effectively reduces the risk of VTE, under-treatment, it remains a problem (Cohen et al, cited in Duggan-Keen, 2010). For patients at risk for VTE in the acute hospital care setting, studies showed that approximately 40% of at risk surgical patients and approximately 60% of at risk medical patients did not receive appropriate...
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...This could potentially cause a financial burden on the client. The average cost of this surgery is $1,000 (Ronald M. Bright, 2007). Before a surgery can even begin the veterinarian or CVT will place a catheter in each cephalic vein for rapid fluid administration. In the fluid bag, a hypertonic saline solution should be administered for immediate improvement. After this has occurred, usually the veterinarian will take another radiograph to be sure that GDV is the actual disease before they go into surgery. In serious cases, crystalloid boluses and colloid boluses would be administered immediately after arrival since GDV causes serious dehydration (Elizabeth A. Rozanski, 2007). After initial bolus of fluid is administered, Fentanyl can be added to the IV fluid. Lidocaine can also be administered, which helps manage pain and decreases the amount of injectable or inhalant anesthesia needed during the surgery. ECG monitoring is done continuously for up to 72 hours since...
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...with an oxygen mask, or an oxygen tank if she needs to be mobile. 4. Describe four potential complications that may occur whilst Carole is hospitalised, and the reasons (predisposing factors) why they would occur (8 marks). Four potential complications that may occur throughout Mrs. Gordon’s hospitalization may be the following: • Complication of Wounds – Mrs. Gordon’s wounds and incisions becoming infected due to being unhygienic and having an inadequate amount of sterile, clean dressing changed every so often. Therefore this may cause complications, pain and discomfort, and prolong the time taken for the wound site to heal. • Complication of Deep vein thrombosis (DVT)- As Mrs. Gordon has had surgery for her total hip replacement, she is high risk of suffering from DVT. “DVT is a blood clot that forms in a vein.”(Admin, NursingLife, 2012) DVT may be a potential complication for Mrs. Gordon as she is classified as obese. • Complication of Lack of sleep- Mrs. Gordon being in a hospital usually means lack of sleep. This is because a hospital environment is very loud and not dark, with a significant amount of beeping of machines and talking amongst nurses can make it difficult to get a good rest. Lack of sleep could cause complications for her personal well being, such as developing emotional stress and anxiety. (Oren Traub, MD, PhD 2016) • Complication of Urinary retention- As Mrs. Gordon has recently come out of surgery and is on bed rest for a...
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...What is Deep Vein Thrombophlebitis/Thrombosis (DVT)? It is categorized as peripheral neurovascular dysfunction. DVT generates from a thrombus, a blood clot that can result from an injury to the tissues or in a patient that has quick- clotting factors in their blood. When a thrombus is present, the body replies with an inflammatory response. The response mechanism is called thrombophlebitis. DVT occurs deeper in the veins and can be serious, potentially causing a life-threatening condition called a Pulmonary Embolus (PE). DVT prophylaxis etiology The etiology for DVT prophylaxis is typically high-risk patients, to include those who have had hip surgery, knee arthroscopy or open prostatectomy. However, other risk factors such as prolonged periods...
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...relationship between supply and demand. “The law of demand is if factors remain equal, the higher the price of the supply the less demand there will be. The law of supply is the quantities that will be sold at a certain price, and the higher the price the higher the quantity supplied” (Hekla, 2012). This in turn increases revenue because with high demand, comes high supply due to wanting or needing the product. With high supply and low price, than comes high demand due to the lower price. Demands and supply for health care products and medications continues to be in high demand as products are developed. The newer the product, the higher the demand, and the higher the price. Product Lovenox is a product used to treat and prevent deep vein thrombosis or pulmonary embolisms. This medication is given subcutaneously by a care giver or the patient may be trained to give their own. Lovenox is also known by the generic name of Enoxaparin. Lovenox is used in the treatment of many other diagnosis such as thrombophlebitis, carotid artery dissection, peripartum cardiomyopathy, pulmonary infarction, and Factor V Leiden thrombophilia. Lovenox is a low molecular weight heparin and thins the blood to prevent clotting (MEDgle, 2012). A study conducted in 176 centers, in the United States, Canada, South America, and Europe shows the cost effectiveness of...
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...Mobility Case Study NU 1326 Christopher Vang April 7 2015 Dealing with immobile patients is a big part of a registered nurse’s daily tasks. Mrs. Simmons a 78 year old patient who fell and broke her hip must be carefully monitored so that she does not develop further health problems. It is important to monitor and act accordingly with immobile patients, because failure to do so can result in health risks and complications. Not only do immobile patients require a different level of care, their rehabilitation is also different based on the reason as to why they are immobile. Besides keeping the patient safe and secure it is also important to keep the attending nurse safe by using the proper lifting and moving techniques, as well as the proper devices to assist in moving patients. Therefore to provide the best care for the patient, the nurse must be knowledgeable about the consequences on immobility and the steps to counter them. Being on bed rest has its benefits as well as its drawbacks for the patients. Prolonged bed rest can have negative impacts on the body, which if not taken care of can cause life-threatening situations. One of the biggest difficulties of prolonged bed rest is a pressure ulcer. Pressure ulcers are sores that develop from extended pressure on a bony part of the body most commonly found on the backside. Nurses can help to prevent such sores by rotating the patient on a regulated schedule, making sure the patient is clean and dry, as well as changing the sheets...
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