D/A: Mr. Brown had two appointments this week. Consumer was transported to his appointment with Dr. Mulligan in Newark. Disk from consumer CAT scan was taken along with him to his appointment. According to the Nurse’s notes states that static pulmonary nodules enlarged mediastinal right axillary lymph node. Mr. Brown was supported to his appointment with Dr. Ramani on 02/27/17 at 9:30 am. Mr. Brown met with his Psychiatrist Dr. Capiro on 02/26/17. Dr. Capiro provided Mr. Brown a direct service at the Residential Program. The service included a comprehensive psychiatric evaluation, medication review and an assessment of his needs. The review and assessment determined that medications were appropriate and consistent with his current health conditions. On 01/26/17, consumer refused to eat breakfast and …show more content…
However, consumer later came out and ate his breakfast. Staff stated that consumer blood sugar was low at 87; so staff encourages the consumer to eat his breakfast. On 02/26/17, consumer refused to eat dinner, but asked for a bowl of cereal instead. Mr. Brown asked for pain medication and staff overheard him telling his roommate that he needs “Anastazia ‘’ the Nurse to come and get him a stronger medication. The consumer was given his medication at 1: 00 am on 03/01/17 for his medical procedure in the morning. On 03/01/17, Mr. Brown refused to shower when prompted, stating that he “washed up the other day.” Staff reported that on 03/01/ 17 that the consumer was getting up frequently late at night. When asked why? He said “Nothing.” On 02/26/17, Mr. Brown was incontinent with feces; his linen was covered in blood. The consumer told staff that there is blood also in his stool. The consumer bed linen was changed and made. Staff reminded Mr. Brown to be using the bathroom when he felt an urge, but immediately Mr. Brown became furious at staff and stated that “Staffs are paid to clean up my poop.” Staff reported that that Mr. Brown
Case introduction: A 19 year-old gentlemen, SS, presented to station 20N through the emergency department, following what was described by friends and family as “bizarre behavior.” SS had recently begun college at a local liberal arts school. He had done well during the first semester, but began to struggle academically during the second semester. Family attributed the decline in academic success to an increase in class size, which made SS uncomfortable. Several weeks prior to hospital admission, SS became increasingly isolated, spending the majority of his time in the dorm room and less time in class. Friends and roommates reported that SS was exhibiting bizarre behavior, often confiding in friends that he was being “spied on” by others and that people around him could “read his thoughts.” SS also endorsed a strange delusion in which those around him would blink simultaneously as a form of communication. All of the aforementioned events became overly distressing to SS and his family, so they sought medical help. SS had a limited psychiatric history for which he had seen a psychiatrist. The psychiatrist had put him on an anti-psychotic medication some months prior, but SS self-discontinued the medication after just a several week trial. As a result of the above, and a lack of explanation regarding the past psychiatric referral, the events were described as “first-episode psychosis.” Discussion regarding the diagnostic work-up followed.
A registered nurse (RN) is someone that went through a university or college and studied nursing; and then passed the national licensing exam to obtain a license to practice nursing. The degree earned by an RN at the need of the program is deemed a professional nursing degree. The RN top nursing staff and they usually works independently. On the hand, an LPN only earns a practical nursing degree after completion of the program. LPNs are mostly recognized only in USA and Canada; they are also named as License Vocational Nurse (LVN) in the state of California and Texas. LPN work under the supervisor of an RN or a physician.
P arrived at Dr. Sacks office he seemed like any other well-mannered individual but Dr. Sacks noticed that Dr. P didn’t focus on his face only some small features around it. Dr. Sacks asked Dr. P what was wrong only to be told that nothing was wrong but he just makes mistakes every now and then. After talking to Dr. P’s wife Dr. Sacks performed a neurological exam which he noticed something wrong with his left side. After doing a reflex test on Dr. P’s foot he asked him to put his shoe back on while prepared the ophthalmoscope. When Dr. Sacks returned Dr. P did not put his shoes back on because he confused his foot with his shoe and visa-versa.
“We can’t turn away from a patient’s pain just because it’s difficult” (chapman, 2015, p. 88). I know the path of least resistance is taking a path of ignorance. Easy, is to ignore or neglect the true pain patients experience in times of crisis. As caregivers I believe we all want to heal others or we wouldn’t be in the field of nursing, but there are only handfuls willing to be present during the healing process because sharing one’s pain hurts. As a surgical nurse, I find being genuinely present takes hard work on my behalf, not only mentally but emotionally. On a unit where patient’s needs and conditions are changing at astonishing rates, being present requires mental strength in order slow down enough to recognize the value presence
A confused man presents into the Emergency Department in a dishevelled and unkempt state, the nurse assigned to this patient recognises the following; the man is in his mid-sixties, confused and disorientate, anxious, has an acetone breath odour, also at examination locates a haematoma on the right side of his forehead while the patient also states repeatedly that he wants to pass urine. As acknowledged previously the nurse responded in an inappropriate manner therefore making a significant impact on the care of this patient for the upcoming shift, the nurse presented signs of neglect thus actions need to be taken to keep the patient safe with the best suitable care possible.
Age: Mrs. Hudson is a 37-years old Haitian American woman who lives with her husband of 10 years and two children, ages 8 (son) and 2 (daughter).Mrs. Hudson worked as primary care doctor . Mr. Hudson is a firefighter. She has come to therapy to discuss recent problems; she has been having when leaving her home. Mrs. Hudson describes a pattern of behavior that began four months ago while shopping with her children. She began to experience the following symptoms: heart racing, shortness of breath, sweating palm, and tightness in the chest.
The physician will question the patient about any stressors she may be contending with at home or work prior to her entering the hospital. The physician will order lab tests and speak with the patient to understand the psychological factors; a referral will be made for making a final diagnosis. After the physician reviews both lab tests and the psychological factors, a referral will be made for the patient to see a clinician. The referral will focus on obtaining support and stabilization. The clinical assessment will gather information using written forms as a first step, including releases to speak with family members. The second step would be to invite the family along with the client in an effort to obtain a better understanding of existing medical conditions along with any past mental disorders. Abuse as a child or abuse as an adult will be determined. The clinician will evaluate if the client is portraying any signs due to alcoholism or a drug addictions. An example of one question her clin...
• Blocking contact with previous and current doctors, family and doctors • Strong comprehension of textbook descriptions of illness, effective medical terminology, and extensive experience of hospitals • Presence of numerous surgical procedures and procedures • scars or a gridiron abdomen • Evidence of self-induced physical signs or artificial symptoms • Symptoms that appear only when the patient is not being observed or alone • New signs that materialize after test results come back negative • Willing and eager to have medical tests, operations or other procedures, demanding medical tests or procedures • Conditions become obviously worse when undergoing an active examination than he or she is with a casual interacting with healthcare providers or other patients • Inconsistent findings on neurologic examinations • Attitudes change from being cooperative to treatment to evasive and vague concerning the patient details • Mood and concern are cheerier than would be expected on the findings of the patient’s medical circumstance Diagnosis It is difficult for doctors to diagnose factitious disorder due to the dishonesty and inconsistencies that are involved with the diagnosis. The patient becomes very skilled with medical knowledge and terminology and becomes familiar with routine tests that are performed, and at pretending to have any real illnesses. The doctor has to follow the basic procedures for responding to the patients' signs and complaints and rule out any real physical conditions.
Nine days later Andrew’s health conditions worsens and he is seen covered with lesions. He is feverish, vomiting, etc. He works hard at home to conceal the severity of his illness. Even with his illness, he manages to pull the case documents together and is ready to go to court. His friends help...
1. What is the difference between a. and a. Which K, S, and A pertain to the care you provided to the patient you have chosen? Why do you need to be a member? K- Describe the limits and boundaries of therapeutic patient-centered care. S- Assess levels of physical and emotional comfort.
One night ,while working as usual, Jane Doe injects nasal spray butorphanol (Stadol) to a couple women who are in labor. Some of the women did not require the full dosage of the drug so she slipped the leftovers in her pocket. Once her shift had ended that night, Jane was getting ready to leave when she decided to use the restroom. When she was there she remembered that she had some leftover drugs in pocket. Jane cautiously looked around and checked every stall to make sure no one was there. She then took the drugs out and injected herself. Thirty minutes later a colleague finds Jane passed out in the restroom. She is immediately treated and once awake, is taken to a drug-testing facility to provide a urine sample. At the drug-testing facility Jane admitted to stealing the drug and justified herself by saying it helped her cope with the stress of taking on extra shifts, and caring for her two young children and her severely disabled mother. Jane said “I thought I could stop any time but I was wrong.”
The purpose of this paper is to analyze, diagnose, and to determine a proper treatment plan to work toward the beneficial prognosis for the individual indicated within the case study.
Registered Nurse John, Registered Nurse Jane and Director of Nursing Ms Day are all entitled to self – determination and to be motivated by their own actions. The actions of John, Jane and Ms Day are their own undertakings even though nurses are not considered autonomous decision makers (Butts, 2013). Nurses are still required by law to follow the instructions given to them by physician authority and to refute this needs a strong case for argument (Arnold & Boggs, 2013). RN John displays a sense of duty of care to protect the weak and vulnerable. An impression of doing the greater good is conveyed by John in his actions of stealing medical supplies. He believes he is not doing any harm to those around him as the supplies were meant for the disposal unit anyway and are meant for a good cause (McPherson, 2011). Rn Jane wants to prot...
Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for " atypical chest pain and hemoptysis". V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit.
The patient has also been suffering from frequent fevers in the past two months. He has also suffered from frequent headaches but has always taken painkillers (Bloland & Williams, 2003, p. 58). On fevers, the patient has frequently visited a local health clinic that has never done any diagnosis but has given medication, which reduces the fever.