Assessment
The most relevant objective assessment data include the patient’s age (65) and the presence of plus one pitting edema in both feet with the right greater than the left side. He also experiences shortness of breath on exertion, bruises with long healing times, and increasing doses of Lasix administered. Further assessment also points to a lengthy stay in the hospital due to edema in which Furosemide (Lasix) has had minimal effect. Seeing as the patient also presented with chronic cardiomyopathy, there is also the presence of insufficiency in his circulatory system. These assessments, in conjunction with my communication with the patient’s doctor, lead me to conclude that he is at risk of an imbalance in his fluid volume. In addition to this diagnosis, this patient also experiences shortness of breath on exertion which affects his ability to ambulate. Likewise, low ventilation increases his oxygen demand in the evenings and at night which delays weaning and extends
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Activity therapy for this patient would involve having the patient walk twice a shift with the oxygen attached until his oxygen is weaned off at rest. Fluid monitoring would involve strict intake and output recordings for all fluid facilitated by communicating with the physician to insert an order to maintain continuity of care. Skin care and surveillance would involve the use of topical care products to maintain skin integrity as well as data collection on any changes to the integumentary system. In addition to these, I would also (a) contact the physician about lower dosing on blood pressure medication; (b) work with patient to plan an exercise regime that would help with perfusion to maintain a healthy blood pressure; (c) collaborate with physiotherapist about working in some exercise training program to increase oxygen use and
Being a nursing student, I understand that Mr. John suffer hemiplegia resulting in weakness and also have limited ability to move, he cannot eat by mouth which restricts to have enough nutrition for the body, these are the some of the reason that make Mr John prone to have pressure injury as limited mobility and sickness causes the blood vessels to collapse easily so when for hours or days continuously pressure remains on the skin it leads to pressure sore and these pressure sore increases the risk of infection (Reddy, Cottrill, & Cansino, 2011). Usually, sustained pressure causes injuries over a bony prominent area especially in those who are malnourished and immobilized or limited mobilized. Routine assessment of skin is recommended to observe any sign of infection, 2 hourly position helps to relieve the pressure on the area (Barret, Kevin, James,
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
Our Session Long Project (SLP) for Module 1 transforms the evaluation essay into a job evaluation. The type of job evaluation used in this SLP identifies the responsibilities of the job and bases the individual’s performance on these responsibilities. What does this mean to the employee; it means that if they understand the responsibilities of their job they are better able to perform it to the satisfaction of the evaluator. However employees who are not informed of their responsibilities can invalidate your evaluation process very quickly and wreck havoc in any organization.
DiClemente (2013) stated, “Although no evaluation is perfect, evaluation research can have a high degree of rigor” (DiClemente, Salazar, & Crosby, 2013, pp. 298). The result of a high degree of rigor can lead to the utilization by program planners and policy experts which would in turn could impact public health policy and promotion practice (DiClemente et al., 2013). This is obtained by a step by step, all equally important, process in what is known as the “Nine Step Stairway to Effective Evaluation”.
Furosemide (Lasix) 40 mg daily in the morning: Loop diuretic used to treat edema associated with congestive heart failure (CHF).
-The patient was having pitting edema and inspiratory rales because the increase of sodium caused an increase of fluid in the vascular system and lungs.
Lasix is known as the “water pill” it’s a diuretic administrated orally.(1) The active ingredient of Lasix is furosemide, but also includes a number of inactive ingredients including lactose monohydrate NF, magnesium stearate NF, starch NF, talc USP, and colloidal silicon dioxide NF. (1) The peak effects of furosemide are typically seen within the first hour of two after a dose of the medication. (1). Lasix is prescribed for individuals to treat edema that may arise from congestive heart failure, liver cirrhosis or renal disease. (1) In adults, furosemide may also be taken to treat hypertension itself.(1) Furosemide comes in 20, 40, and 80mg tablets as well as oral suspensions.(2) Furosemide is absorbed rapidly from oral suspension at 50 minutes, and from tablets at 87 minutes.(2) Food may slow down the absorption of the drug and alter the bioavalibitly.(1) Furosemide binds to plasma proteins, albumin being the main plasma protein that furosemide binds to, at 91-99%, and peak plasma concentrations increase with the increase of a single dose.(2) Furosemide is excreted through the urine and the remainder is excreted in the feces. (2) The half-life for furosemide is approximately 2 hours but the diuretic effects last 6-8 hours. (2)
Assessing the environment is the second part of step four in the strategic planning process. The organizational internal assessment is important in identifying the strengths and weaknesses of Brendel Elementary School. By providing an organizational assessment, the planning team can clarify the aspects that help in accomplish the mission and fulfill the mandates in the organization. This part of step four enriches the management information system (MIS) with more qualitative data in order to make MIS more effective. Moreover, the organizational assessment clarifies the organization’s competencies, distinctive competencies, and core competencies. (Bryson 2011, 166)
Oxygen is widely used in both chronic and acute cases, in emergency medicine, at hospital or by emergency medical services (Nicholson, 2004 ). Just like any other form of medication oxygen is a drug that if used incorrectly could cause potential harm, even death (Luettel, 2010 ). Oxygen is admitted to the patient with chest pain for two main rationales. The first is by increasing arterial oxygen tension, which in opposing causes a decrease to the acute ischemic injury, and thus over time the entire infarct area (Moradk...
Cardiovascular System: He does not experience any chest pain or palpitation. He does not have dyspnea or leg swelling.
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
I always help students identifying their learning and progress and give them feedback. Students need to be aware of their achievement and progress. I adapt practice and plan further learning, this will make the assessment meaningful and effective as it will answer to the learner needs. 6.3 Use types and methods of assessment, including peer and self-assessment, to: - Involve learners in assessment - Meet the individual needs of learners - Enable learner's to produce assessment evidence that valid. Reliable.
According to Grevells (2012), assessment should be planned for and carried out on an individual basis. Assessment planning should be a two-way process (Shannon & Wavers, 1949) between me and my learners. I plan what I am going to do and learners need to know what is expected from them. If my learners are all working towards the same assignment or an assessment strategy, I agree on target dates or criteria for completion and discuss any specific requirements my learners may have. The Principles of assessments are consistent, accessibility, detailed, earned and transparent. Think about these theories and principles of assessment I designed my assessment strategies. For example, in my teaching practice I use assessment strategies resembling to
Self assessment is a process in which you examine yourself in attempt to discover and learn more about yourself. Your likes, dislikes, behaviors, attitudes and habits can be found during this process. You can use the discoveries to your advantage by accepting or changing strengths and weaknesses. I plan on using this course to enhance my personal skills to become a better student and find success in earning my Bachelor of Arts degree at Ashford University in Social Science. Self Assessment is the first step in my successful future.
As I reflect on my past assessment process, I realized how much my assessments have changed over the years. In my early years, I used tests for informational recall as my assessments. I felt these were appropriate guidelines in which I needed to follow in order to substantiate a student’s grade. Every assignment or tests was given a point value and then based on the amount of points, a grade was given. Every student’s assessment was exactly the same, and the assessments did not contain any subjectivity. I felt confident in giving the grade based on a valid point system. However reflecting back, I see that I did not include any performance-based assessments or individual learning styles in my early assessment. I also did not take into consideration the individual needs of my students. My assessment approach was awful. I am embarrassed that I use to assess students in this manner.