Charles Lewis
INSTRUCTOR: Professor Planillo
Patient initials: M,A
Date of assessment: 12/13/2014
Date submitted: 12/17/2014
Mr. M is a 67 year old Hispanic male, and is 5’7 216 pounds. Mr. M is married and has two grown children . He is a retired warehouse worker after a 30 year career. Mr. was unsure of his family history of disease processes, however, was able to accurately describe his current medical diagnoses. Patient was oriented to place, time, date, and time. Mr. scored an 18 on the Braden sale, The patient showed no signs and symptoms of sensory
Impairment, skin was occasionally moist, client walks occasionally with the assistance of a walker, mobility was slightly limited, nutrition was
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order and be asymptomatic.
Long term goal: Blood gas analysis results will be within normal limits by discharge. 1). Patient will be placed in bed in semi-fowlers position. (Rationale: Proper body positioning assists with respiratory excursion. 2). Provide oxygen according to patient need as directed by Physician.
(Rationale: Patient oxygen levels will assist with clearing the airways. 3). Assist patient with chest physiotherapy (Hinkle 2014 pg. 493) (Rationale: Chest physiotherapy will assist patient with clearing secretions.
4). Promote therapeutic relaxation imagery. (Rationale: Patient anxiety will lessen with guided imagery and music therapy. Mr. M’s. was taught to find the asthma irritants that exacerbate an asthma episode such as dust mites, animal dander, pollen, mold, and smoke. Mr. M. was also encouraged to cough and deep breath to keep his lungs and airways clear and free of secretions.
Risk for Falls: Short term goal: Patient will verbalize an understanding after being oriented to surroundings and instruction of safety measures. Long term goal: Patient will be injury free during hospital stay. 1). Complete a fall risk assessment (Rational: Fall risk assessment
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(Rationale: Communication with staff will ensure the patient will not have a fall. 3). Encourage the patient to use a walker or cane. (Rationale: A walker or cane will assist patient with ambulation. (Taylor. 2011 pg. 473-475). 4). Keeping call bell within reach and room free of clutter. (Rationale: Patient will be able to communicate with staff and safely ambulate. Mr. M. was encouraged to use a walker or cane when possible. Keeping a room from clutter, wearing nonskid shoes, and proper lighting will help Mr. M. in staying free from falls. Mr. M’s home should be assessed for safety prior to discharge.
References
Hinkle L. Janice, Cheever H. Kerry, (2014) Brunner & Suddarth’s textbook of Medical Surgical Nursing (13th Edition) Philadelphia: Lippincot, Williams & Wilkins.
Lynn, Pamela, (2011) Taylor’s Clinical Nursing Skills A Nursing Process Approach (3rd Edition) Pennsylvania: Lippincot, Williams & Wilkins.
Dewit, C. Susan, (2010) Medical Surgical Nursing Concepts & Practice, Philadelphia: Evolve Saunders, Elsevier
Buenzil, Wendy MSN, RN, Fauber, PHD, RN, Jones, Jackie, EdD, RN (2008) Nutrition
This work has significance because staff and patient education can help prevent falls. Specific interventions decrease falls. Nurses have a responsibility to their patients and their facility to be competent and confident in their abilities to do all that they can to prevent falls. Facilities have the responsibility to provide the tools and the training that is required to carry out fall prevention
R.J. is a 15-year-old boy with a history of asthma diagnosed at age 8. His asthma episodes are triggered by exposure to cats and various plant pollens. He has been using his albuterol inhaler 10 to 12 times per day over the last 3 days and is continuing to wheeze. He normally needs his inhaler only occasionally (2 or 3 times per week). He takes no other medications and has no other known medical conditions. Physical examination reveals moderate respiratory distress with a respiratory rate of 32, oximetry 90%, peak expiratory flow rate (PEFR) 60% of predicted, and expiratory wheezing.
Anyone with limited mobility should be assisted to change positions by the care providers on a regular schedule to help
2. Demonstrate 3 different postural and walking exercise to help the patient with his walking and learning.
Provide mandatory, up-to-date education related fall prevention. Every single one in this facility can have the adequate capacities to prevent falls and offer education to patients, family members and caregivers regarding skills and knowledge of fall prevention. Develop policies in multifaceted and tailored strategies with evidence-based practice (Breimier, Halfens, & Lohrmann, 2015). Have more awareness and "need for individualizing the care plan and communicating the plan to those working with the patient becomes evident when implementing a fall reduction program" (Ambutas, Lamb, & Quigley, 2017, p 179). In addition, maintain consistency or accuracy in risk identification and action planning, as well as obtain patient and caregiver’s commitment to adhere to the safety plan on the daily basis (Silva, & Hain, 2017). Everyone is in the same page and conduct measures effectively and efficiently. Evaluate and assess the implementation of strategies monthly. Change and correct properly and timely to reach the aim of zero falls.
Once a resident has improved with their mobility its down to the care staff to help encourage them to continue using this daily life skill by encouraging them to be as independent as possible with things they are known they are able to do reporting any
Mrs. Cabrera is a 64 years old women with history of high blood pressure, vertigo, and bilateral meniscectomy 3 years ago. Client is currently taking medication on a daily basis for her health conditions. Patient takes pain killer medication at least 3-4 times a week if knee pain is present after ambulating around the home for household activities. Client lives with daughter, grandchildren, and other family members. Patient has a supporting family nucleus, they agreed to make arrangement if necessary to avoid and prevent any potential fall risk.
Falls are highly common amongst the elderly, particularly those who lack mobility, are in hospital, or are living in a nursing home. When an elderly person falls, their activities of daily living may be impacted due to injuries sustained from the fall. It is essential that precautions are put in place to prevent falls in all settings. This essay will discuss the statistics surrounding falls, prevention strategies, and the impacts of a fall on a patient’s ability to complete activities of daily living.
6.2 you must always follow an individuals care plan and engage with them with assisting with mobility to ensure they are as relaxed as possible, not frightend. You must tell them step by step what is happeneing or going to happen. All equipment must be used as directed by care plan to ensure the client is safe and as pain free as possible whilst moving them, use of the correct equipment will also prevent any further injuries to the client and also to the staff doing the move.
The lack of proper education on identification of falls risk and falls prevention measures impact patient falls. Staff turnover and the use of temporary staff contribute to miscommunication or lack of communication on processes such as fall prevention measures. Experience levels vary on any given unit. Educational needs assessments should be routine and include temporary and new staff. Authors Manojlovich, Sidani, Covell, and Antonakos (2011) define nurse dose as “the level of nurses required to provide patient
A patient who is admitted to a facility may be alert, oriented, and independent in ambulation. Add on intravenous (IV) tubing attached to a pole, a telemetry monitor, a foley catheter, and new medications for the patient. This patient now has fall risk factors. The purpose of this paper is to describe and evaluate change in preventing falls in the hospital setting.
Inform and educate patients and /or family members regarding a plan of care to prevent falls.
Patient falls is one of the commonest events within the healthcare facilities that affect the safety of the patients. Preventing falls among patients requires various methods. Recognition, evaluation, and preventing of patient falls are great challenges for healthcare workers in providing a safe environment in any healthcare setting. Hospitals have come together to understand the contributing factors of falls, and to decrease their occurrence and resulting injuries or death. Risk of falls among patients is considered as a safety indicator in healthcare institutions due to this. Falls and related injuries have consistently been associated with the quality of nursing care and are included as a nursing-quality indicator
*I need to walk with a cane or close to something/someone I can hold onto.
Most hospitalized patients of 65 years and above have been established to be more vulnerable to falling within their homes or in a facility. These falls have been attributed to various causative agents that need to be assessed and managed in an attempt to completely avert falls (Wilbert, 2010). Prevention of falls should be mandatory since they cause more danger to patients, including breakage of the main bones and even death. As a result, the patient may develop a more serious condition such as decrease functional immobility in addition to that which caused hospitalization. Most of these falls have been found to be caused by therapeutic impacts and ignored diagnostic information (Naqvi, Lee & Fields, 2009). For instance, a great number of elderly people who are hospitalized are diagnosed with dementia at the time of admission; hence, such information needs to be taken into consideration during the care of such a patient. Dementia is likely to cause disorientation and confusion which may result in recurrent falls. Therefore, falls may be described as the abrupt and unintended loss of uprightness that leads to body displacement towards the ground falls (Wilbert, 2010). The purpose of this paper is to develop a falls prevention, management program that will reduce the number of falls occurring within an organization.