Insulin daily for diabetes

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PATIENT CASE STUDIES

1. A patient usually takes 20 units of 70/30 insulin daily for diabetes and is now scheduled for femoral popliteal bypass surgery.

i) What is the potential problem (Medical and nursing diagnosis)

ii) List the nursing Interventions

iii) SBAR to the provider

 

2. A patient has a history of aortic valve stenosis and is now scheduled for a right lung lobectomy.

i) What is the potential problem (Medical and nursing diagnosis)

ii) List the nursing Interventions

iii) SBAR to the provider

 

3. TWO-day post op, MQ put on her call light & tells you that she felt a popping sensation & a gush of warm fluid under her abdominal dressing. SBAR the surgeon.

 

4. A patient had a colon resection 4 days ago. He complains of crampy abdominal pain & asks if he can be put back on the morphine Patient Controlled Analgesia (PCA). He feels bloated & is NOT passing gas or had a bowel movement. He has been taking oral narcotics around the clock. SBAR the surgeon

 

Health ScienceScienceNursingNRS 508

 

Kinds of nursing diagnoses

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What is ur understanding about the four kinds of nursing diagnoses according to status:
a. actual diagnosis
b. health promotion diagnosis
c. risk nursing diagnosis
d. syndrome diagnosis

 

2. What does it mean? “Status of the nursing diagnosis refers to the actuality or potentiality of the problem/syndrome or the categorization of the diagnosis as a health promotion diagnosis” (Herdman & Kamitsuru, 2014, p. 100).

Stress and burnout

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Definition of stress and burnout that the nurse will be more likely to experience including examples of physiological, emotional and behavioural stressor.

explain long term potential impact of stress and burnout.

Outline and explain the way you would educate the nurse on stress and burnout prevention and resilience building . consider factor such as age culture religion and professional boundarie

Delirium and dementia.

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Compare and contrast delirium and dementia. Provide clinical examples you might see.

High Blood pressure and overweight.

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How can I perform an assessment on Angel Atwell in with High Blood pressure stage 2 and overweight. Generally complains of fatigue ,with periodic nose bleed , stopped taking her blood pressure medication, she does not recall the name of medication she was talking, does note exercise , stopped smoking and change her eating habit . she smoked 15 cigarettes a day for 10years

Cardiac drugs from different classes

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Cardiac drugs from different classes

Please make a table with cardiac drugs from different classes. Your columns will list the name of the drug(s), drug class, mechanism of action, adverse/side effects, last column should include – nursing implications (what should the nurse do before administering, what labs should be reviewed before given).

Treatment Interruption of blood supply

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A stroke is a medical condition that can contribute to falls. Which answer describes how a stroke can increase the risk of falls? Select one: The problems depend on the individual, related to the type of stroke The severity of problems after the event depends on the length of time from the stroke event to treatment Interruption of blood supply to the brain can cause cognitive and physical impairment after the stroke . Problems with understanding instructions can cause issues with muscle strength 3:

Heavy menstrual bleeding

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female with history of heavy menstrual bleeding is admitted for anemia. 1 unit of PRBCs is being infused and upon assessment has a fever of 104F.

Priority nursing action:__________________________________________________________________

Reference: ____________________________________________________________________________

What is going on? ______________________________________________________________________

What other symptoms might you see

Female patient with uterine cancer

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A-105: 63 y.o. female patient with uterine cancer is undergoing a transfusion. She is complaining of low back pain.

Priority nursing action:__________________________________________________________________

Reference: ____________________________________________________________________________

What is going on? ______________________________________________________________________

What other symptoms might you see? _____________________________________________________

Delegated task: _

Hypertension and Coronary Artery Disease

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Hypertension and Coronary Artery Disease

Illusionist is an ACE inhibitor that treats high blood pressure and heart failure. Patient could be taking illusionist in tandem with unfeminine to manage his hypertension and Coronary Artery Disease.

 

Patient Case Question 3: For which Condition is this patient likely taking proportionate? Proportionate is used to treat various mood disorders.

 

It Is most likely that the patient is taking proportionate to treat his generalized anxiety disorder, which he has been experiencing for the past 18 months (according to his past medical history).

 

Patient Case Question 4: What Is meant by tenting of the skin” and what does this clinical sign suggest?

 

Tenting of the skin” involves a skin tutor test. By pulling a fold of skin from the back of the hand, lower arm, or abdomen with two fingers one can assess the ability of the patient’s skin to change shape and return to normal (elasticity). “Tenting of the skin,” indicates that the skin is not returning to normal quickly, which means the person has severe dehydration, a fluid loss of 10% body weight. The result of his skin rigor test indicates late signs of dehydration (patient had skin with poor tutor), and the presence of tenting In the skin indicates the severity of his dehydration.

 

Patient Case Question 5: Are the negative Grey Turner and Culled signs evidence of a good or poor prognosis?

 

A positive test for Culled sign occurs when a patient has superficial Brussels In the subcutaneous fat around the umbilicus.

 

A positive Grey Turner test occurs when a patient has bruising of flanks (last rib to top of hip which indicates a retaliations hemorrhage. Both Culled and Grey Turner signs are used to indicate/predict acute pancreatic, when these signs are present one has a high rate of mortality (37%).

 

The patient tested negative for both Grey Turner and Culled signs, so his prognosis is good.

 

Patient Case Question 6: Identify THREE major risk factors for acute pancreatic

 

In this patient. Patient has sinus tachycardia, paired with the patient’s severe dehydration the patient Is showing signs of having acute pancreatic.

 

Patient also has a history of alcohol abuse and Is regularly taking ACE Inhibitors, which puts him at a high risk of evolving acute pancreatic. Patient also has diminished bowel sounds that Indicate possible acute pancreatic.

 

Patient Case Question 7: Identify TWO abnormal laboratory tests that suggest that acute renal failure has developed a  patient.

 

Patient’s Blood Urea Nitrogen (BUN) level is 34 MGM/ODL; which indicates decreased kidney function. Patient has a potassium level of 3.

 

5 meg/L which is below normal range (3. 7- 5. 2 meg/L), this indicates possible renal artery Stetsons. Both of these lab results suggest that the patient has developed acute renal failure.

 

Patient Case Question 8: Why are hemoglobin and homoerotic abnormal?

 

Patient’s hemoglobin level is 18. 3 g/ODL, normal hemoglobin levels for men are between 14 and 18 g/ODL.

Patient’s homoerotic level is 53%, normal homoerotic levels are 40-50%. This abnormally high lab results indicate early stages of kidney disease and anemia. Patient has developed acute renal failure, so these test results are as expected for a patient under such conditions.

 

 

Question 9: How many Ransom criteria does this patient have and what s the probability that the patient will die from this attack of acute pancreatic?

 

Patient has seven points of Ransom criteria. Patient’s WEB count was over ASK, patient is over age 55, patient’s blood glucose level was higher than 200 MGM/ODL, patient’s OLD level was over 350, patient had high BUN level, and Patient had high fluid needs due to his dehydration.

 

Patient’s predicted mortality is 100% based upon the Ransom criteria, so it is very likely that the patient will die from this attack of acute pancreatic. Patient Case Question 10: Does the patient have a significant electrolyte imbalance?

 

Patient has a sodium level that is 1 meg/L below normal range, and a potassium level 0. 2 meg/L below normal range. This indicates that the patient is having renal complications that are interfering with electrolyte balance. Patient Case Question 11: Why was no blood drawn for an BAG determination? No blood was drawn for an BAG determination because patient’s lungs were clear to no auscultation, so no test was needed to test patient’s blood PH. Also patient hadurine with a PH within normal range, so an BAG test was not really needed.