1a) Assess patient’s level of mobility, need for ambulation aids, and potential for physical injury with activity at beginning of shift (1200) to establish a baseline for the patient’s activity level.
RATIONALE: This aids in defining what the patient is capable of, which is necessary before setting realistic goals. Some aids may require more energy expenditure. Injury may be related to falls or overexertion. Obstacles such as a cluttered environment or a throw rug may impede the patient’s ability to ambulate safely (Gulanick & Myers, 2007, p. 8).
1b) Progress activity gradually beginning at 1300 and every four hours thereafter including the following: Active ROM exercises in bed, progressing to sitting and standing, dangling legs 10 to 15 minutes three times daily, sitting up in a chair for 30 minutes three times daily, walking in room one to two minutes three times daily, and walking in the hall 25 feet.
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Progressing activity gradually prevents overexerting the heart and pulmonary system and promotes attainment of short-term goals (Gulanick & Myers, 2007, p. 9). ADD
2a) Assess the patient’s cardiopulmonary status and stability for exercise every four hours beginning at 1300
RATIONALE: The patient’s heart rate should not increase more than 20 to 30 bpm above resting with routine activities. The heart rate will change depending on the intensity of exercise the patient is attempting. Older patients are more susceptible to drops in blood pressure with position changes, which can result in syncope and injury. Supplemental oxygen should be available during exercise to help compensate for increased oxygen demands (Gulanick & Myers, 2007, p. 8).
2b) Monitor vital signs (particularly heart rate, blood pressure, respiratory rate, and oxygen saturation) every four hours beginning at 1300 and before and after attempts at physical activity. Observe and document the patient’s response to activity after each
Submaximal and maximal exercise testing are two analytic methods that can be used to examine the cardiovascular, and cardiorespiratory fitness/health levels of the individual being examined. Submaximal testing is usually preferred over maximal mainly because the submaximal exam is more practical in a fitness/health environment. Both test require the individual being examined to perform controlled exercise on a(n) treadmill/ergometer until either steady state has consecutively been reached (submax), or the individual reaches their max (close to it). Being that both test are set to exceed time limits of more than 3 minutes we examine the use of the ATP-PC, Glycolytic, and Oxidative energy systems. Although a huge portion of the test involves the use of the oxidative energy system, we must remember that the three systems are co-occurrent.
...so discuss making a exercise plan that will work for the patient, and will not cause him/her any pain. If all of the correct measures are taken, and the patient is taking care of themselves, they can prevent more serious complications from occurring. They must know that they are serious complications from one not taking care of themselves, or living a unhealthy life style. It does involve a lifelong commitment to change. Medication will help, but one must also be willing to change.
Three of them are: does the patient have a history of falls, is the patient at risk of falling, and to identify the cause of a fall (Recommendations 2011). The first recommendation the healthcare team should consider is, does the patient have a history of falls? During the initial assessment the healthcare team should ask the patient and family members present about fall history. Carefully examining the patient's chart for any indicators of past falls is also recommended. These can be clear indicators of the presence of fall risks. Once a patient has fallen once, the likelihood of a second fall is greatly increased. The second recommendation the healthcare team should consider is, is the patient at risk of falling? Both extrinsic and intrinsic factors should be considered. Examination of the patient's chart for a list of current medications being taken, fall history, any underlying conditions, neurological status, and psychological status should be done. Previous studies have shown that psychotropic, diuretic, digoxin, and Class 1a antiarrhythmic medications are associated with significantly increased risks of falls (Kehinde, Pope, & Amella, 2011). An examination of environmental status should also be done. For example, looking at lightning, cords on the floor, slippery floors, whether the call light is accessible, and whether the room
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
There are several tests and measure that can be done in a physical therapy examination in order to rule out certain diagnoses, as well as come closer to a physical therapy diagnosis. First, an observation of the patient standing, walking, and sitting should be done in order to associate any visible deficits in the patient that could be associated to the ...
There are six set standards of the nursing practice; assessment, diagnosis, outcome identification, planning, implementation, and evaluation (ANA, 2010; pp. 9-10). Throughout a typical shift on the unit I work for, I have set tasks I am expected to complete in order to progress the patient’s care, and to keep the patient safe. I begin my shift by completing my initial assessment on my patient. During this time, I am getting to know my patient and assessing if there are any new issues that need my immediate intervention. From here, I am able to discuss appropriate goals for the day with my patient. This may come in the form of increasing mobility by walking around the unit, decreasing pain, or simply taking a bath. Next, I plan when and how these tasks will be able to be done, and coordinate care with the appropriate members of the team; such as, nursing assistants and physical therapists. Evaluating the patient after any intervention assists in discovering what works and what does not for the individual. “The nursing process in practice is not linear as often conceptualized, with a feedback loop from evaluation to assessment. Rather, it relies heavily on the bi-directional feedback loop...
...ts, electrocardiogram, sonogram and cardiac rehabilitation. As a clinical observer, I found an opportunity to create a solid foundation on patient diagnosis and treatment, and not to mention, long hours with charting and recording patients’ information.
An activity report can provide operational statistics such as occupancy rate, average daily census, and average length of stay (Finkler, Jones & Krover, 2013). Though these numbers are important and have a great influence on the operational budget, a nurse leader needs more information in order to justify staffing. Nurse leaders can obtain additional information from workload reports. Patient classification system measure workload by assigning each patient a classification level based on his or her unique care needs and then determine the number of care hours required per patient per day. Many organizations express this in hours per patient day (HPPD) or relative value units (RVU) (Finkler et al., 2013). Workload reports are useful because they can identify changes in patient mix that can increase or decrease the need for nursing personnel. Bi-weekly fulltime equivalent (FTE) reports are also useful because they convey to nurse leaders exactly how many man-hours were used by each FTE (Liberty University, 2015). Furthermore, the report provides a breakdown of productive time; contract hours, paid time off (PTO), and overtime. It also accounts for nonproductive time such as time spent on education, training, and orientation (Liberty University,
*Note: Each exercise does not have to be done simultaneously. Because of varied work schedule and other activities, spread exercises according to amount of free time.
... the importance of prevention of falls for the patients on the unit (Roussel, 2013). Further evaluation would establish if the plan set was successful in decreasing the amount of falls or if the plan need to be revised. If changes need to occur the written guidelines should be revised and shared with the staff so that revision that will take place.
AIM: - the aim of this experiment is to find out what the effects of exercise are on the heart rate. And to record these results in various formats. VARIABLES: - * Type of exercise * Duration of exercise * Intensity of exercise * Stage of respiration
The two major things that will help an athlete while measuring the cardiovascular drift are progression and hydration levels. The heart rate of an athlete working hard during a workout should be no more than their maximum heart rate which is found by, if you’re a female take 226-age, if you’re a male take 220-age. If while doing a workout the maximum heart rate is exceeded by too much it may be necessary to take a break or slow down greatly. This may also help with traking the hydration of an athlete. If an athlete stays hydrated their core temperature will stay regulated which means they won’t sweat as much, which also means the heart won’t be under as much stress while transporting the oxygenated blood throughout the body to the
Investigating the Effect of Exercise on the Heart Rate Introduction For it's size the heart has the huge capacity of pumping large amounts of blood, in the average adult's heart beats 60 to 100 times a minute, pumps between 70ml and 100ml of blood with each beat, circulates 5 to 6 litres of blood around the body per minute and about 13 litres of blood per minute during vigorous exercise. The heart will beat more then 2.5 billion times during an average lifetime. This investigation will be looking at the effect of exercise on the heart rate. Aim The aim of this investigation is to find out how exercise affects the heart rate, using research & experimenting on changes and increases in the heart rate using exercise. Research â— The heart The normal heart is a strong, hardworking pump made of muscle tissue.
In summary, measuring BP is an important parameter used diagnostically as well as prognostically. BP measurement not only helps to prescribe the exercise regime and gauge exercise intensity but also help maintain safe and efficacious exercise. On the other hand, measuring BP during exercise might act as a distraction disturbing the steady state exercise intensity desired for optimal exercise-induced benefits.
This reflection of vital signs will go into discussion about the strengths and weaknesses of each vital sign and the importance of each of them. Vital signs should be assessed many different times such as on admission to a health care facility, before and after something substantial has happened to the patient such as surgery and so forth (ref inter). I learned to assess blood pressure (BP), pulse (P), temperature (T) and respiration (R) and I will reflect and discuss which aspects were more difficult and ways to improve on them. While pulse, respiration and temperature were fairly easy to become skilled at, it was blood pressure which was a bit more difficult to understand.