For my clinical, I went to MD Anderson. My patient was a 67-year-old Caucasian female. The patient was a recent widow who lived with her daughter. She came in on February 10th, 2014 for shortness of breath, cough that would not go away, congestion, and fatigue. Her medical diagnosis was pleural effusion. Throughout the course of her hospitalization, the physicians found a lung mass that had caused the pleural effusion. She was getting ready to get transferred to another unit the day I had done my functional assessment (February, 15th, 2014) because her condition had improved and the pleural effusion was not present. They were waiting for the lung biopsy results to see if the mass was malignant.
The two functional assessments I decided to do on my patient were the Hendrich II Fall Risk Assessment and the DETERMINE your Nutritional Health/Nutrition Screening Index. My rationale for picking the Hendrich II Fall Risk Assessment was related to the patients’ use of a walker. I noticed that the patient could not get around without her walker and grip socks. The patient also had a history of...
What risk factors and symptoms did Jessica present with prior to the physical examination that suggested a pulmonary disorder?
As people age, they face difficulties with seeing and also with mobility, declines in their physiological systems impact balance, range and speed. These physiological problems can result in falls, which tend to be really problematic for the elderly living alone at home. The Hendrich II Fall Risk Model (HFRM) was used on Mr. T.C to assess his fall risk; this tool is used in acute care facilities to estimate the risk for falls in adults (Hendrich, 2013). The client scored a 6, any score exceeding a 5 is considered a high risk for fall. Being a male is one of the predetermined risk points that make one susceptible of falling as well their symptomatic depression, both which the client falls under. The Get-Up-and-Go Test is also a predetermined risk factor of HFRM; it determines the client’s ability to rise from a seated position. It took the client 3 attempts to fully stand up from a seated position.
Fatigue, decreased mobility and impaired balance from the rheumatoid and osteoarthritis pain also increases the risk of falls (Stanmore et al., 2013). Age related changes such as sarcopenia causes muscle tone and strength to decrease, especially in the lower limbs and as a result, balance and gait become impaired (Culross, 2008). These factors significantly influence the risk of falls and also affect the ability to carry out daily activities therefore, with a physiotherapists assistance, the nurse could introduce a personalised exercise regime to enhance muscle tone and strength (Culross, 2008). According to Neuberger et al (1997), exercise lessens fatigue and improves muscle tone and balance in older people. Recommending an exercise programme for Mrs Jones that incorporates strength training exercises and aerobics, could potentially improve muscle tone and strength and as a result improve mobility, balance and lessen the risk of falls (Bird, Pittaway, Cuisick, Rattray & Ahuja, 2013). The nurse could also suggest safety precautions such as advising Mrs Jones to use a mobility aid (Gooberman-Hill & Ebrahim,
will be referred to as ‘Peter’ in this essay which is in line with the
The first meeting between Dr. Hruby and I was delayed significantly due to the incredible length of time it took the hospitals to process my paperwork. Upon arriving at his office at Twin Cities Hospital, Dr. Hruby gave me a brief introduction to his career as a general surgeon oncologist as well as the path he took to becoming a doctor. Then I had the opportunity to listen to him make 2 phone calls to patients concerning radiographic and laboratory results for breast cancer. The first patient had an X-ray with nothing of significant concern, and she was nervous before receiving the results. The next patient had a breast biopsy that showed she did have breast cancer, but the tumor was so small in size that the biopsy was enough to remove
I wasn’t quite sure what to believe. I knew I wanted to assess the patient and speak with him first before jumping to conclusions. My preceptor and I went to go let the patient know we were going to be his nurses for the day. Once we entered and started doing our assessment on the patient, he seemed like he was fine. When I asked him to rate his pain on a scale of 1-10, he stated it was 10. I asked him where he was experiencing the pain, he stated it was where the incision site was (upper chest) and all over his body. He demanded the best pain medications we have immediately. Other than what he subjectively told us, he seemed okay. His vitals were normal, his blood work came back with nothing alarming and a urine culture was negative. He was a previous drug abuser in the past from the past medical report. I started to think he just wanted pain medication just to abuse them again. I do admit after assessing the patient, I did in fact jumped to conclusions. Was I starting to be biased towards my
Regina Geis is a ten-year old female who is diagnosed with celiac disease. No one in her immediate family has been diagnosed, including her parents and her younger sister. Celiac disease is an autoimmune disease of the digestive system that is usually indicated by long-lasting inflammation in the small intestine that occurs when a protein from the plant called gluten, which is usually found in grains such as wheat, barley, and rye, is consumed, resulting in an interference of absorption of nutrients from food (Calvo, Soriano del Castillo, & Vinuesa, 2012.) Regina was diagnosed with celiac disease when she was five. After she was diagnosed, she was put on a gluten-free diet.
This paper will show how assessment is a core part of the client’s treatment. It will show how assessment is done at the beginning of the treatment process but, will allow you to see that assessment is a continuing process. It results from a combination of focused interviews, testing, and record reviews. Assessments give the social worker a framework of reference to understand the strengths, weaknesses, problems, and needs of the client for the development of the treatment plan. It provides the social worker with a theory-based framework for generating hypotheses about the client’s experience and behaviors, which in turn helps prepare the basis for a specific treatment intervention. This paper will discuss the assessment tools
Assessment instruments are a critical component in psychological testing. Clinicians use psychological assessments as a process of testing individuals to generate a hypothesis about their behavior, personality, or capabilities. There are four primary types of psychological assessments including, clinical interviews, assessment of intellectual functioning, personality assessment, and behavioral assessments. In addition, other types of psychological testing can include, achievement, aptitude, neuropsychological, occupational, and specific clinical test that can measure current levels of depression or anxiety. For example, the assessment instrument called the Beck Depression Inventory (BDI), measures characteristic attitudes
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house.
In the geriatric population, falls remain one of the most common cause of nonfatal injuries. In the article “Fall Prevention for Older Adults” three kinds of falls are described: anticipated physiological falls, unanticipated physiological falls, and accidental falls. Anticipated physiological falls “occur among people who are at a high risk for falling.” (Lyons, 2004). For the resident BK, this is the type of fall she experiences. BK is at a high risk for falling. In the last six months, she has fallen three times. In her most recent fall on Sept. 25, 2015, she was in her room being assisted with dressing before breakfast. While she was holding her walker, she lost her balance and fell backward. This fall didn’t result in her losing consciousness, and at the time, didn’t cause her any
* L. was a 3 month old female, diagnosed with a central line infection. Prior before performing the physical assessment, I gathered information her diagnosis, in order to assess her appropriately. When I walked into the room, I introduced myself to the mother and told her that I would be assessing L. from her head to feet. I observed L. by looking at her appearance and behavior. L. was very calm because the mom was their touching her and talking to her during the assessment. The mom was very involved during the physical assessment by answering questions appropriately and being knowledgeable about L.’s diagnoses. Her face was symmetric with a normal skin color for ethnicity and anterior fontal were soft and flat along with the posterior fontal. L. L. was deaf and was unable to respond to sound or to mom’s voice. I assessed her mucus membranes, which were pink and moist. I auscultated
Overall today was extremely busy. There was a total of 21 patients seeking therapy. For each patient that was seen throughout the day, I prepared hot packs and ice packs and monitored them throughout each exercise session. Aside from supervising patients, I was able to start my Needs assessment with patients. I selected 8 patients based on their age and frequency of visit, in order to gather accurate and efficient information overtime. I was able to interview patients during their 8 minutes hot pack session, and then I introduced myself and stated the purpose of this study/intervention. Each patient was very engaged and responded to each question appropriately. I did not hand out brochures on this day because I felt it would be beneficial to
Patients’ falls are considered the number one reported adverse events in acute care facilities (Choi, et al., 2011). One study found that falls affect 40% of inpatients in acute care settings, where the prevalence is 3–6 falls per 1000 patient days and the injury rate is 40% ((Kim, et al., 2007). In addition, falls had been identified as the leading cause of nonfatal injuries and trauma-related hospitalizations in the United States (Hicks, 2015, p. 51). Studies have shown that people aged 65 years or older suffer injury from falls. Injuries from falls include fractured skull, subdural hematoma, bleeding, and even death (Kim, et al., 2007). Another known fact about falls is they are associated with extended hospital stays, increased health care costs, and litigation against hospitals (Choi, et al., 2011
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has learning disabilities it was imperative to identify any barriers with communication (Nursing standards 2006).