Cardiogenic Shock Case Study

is very pleased with the quality of care she recived during her stay, after further conversation with her I noticed a couple of things that would have improved the quality of care. there was a dicrepancy in the care she received in two different units. while in delivery unit all the call bells were answered on time and the nurses checked on her frequently, same couldn't be said about the nursing care in the recovery unit. A couple of incidences stood out that could have been handeled in a different manner. First one was that when S.D. received her meal and she wanted to confirm that it was a vegetarian meal. The nurse said that she was sure the meal ddn't have any meat in it because that’s what her chart said. but this response didn't satisfy the ptient and she decided not to eat the meal. Second incident was more of a safety concern compared to the first one. S.D. was advised to call for help before going to the bathroom because of pain and swelling around her stiches. But during one instnace while she rang the bell, a nurse came in and told the patient that because her husband was sleeping in the room he could help her to get to the bathroom. This incidence raises a serious safety concern for the pateint. If an untrained healthcare professional such as her husband helped her get in and out of the bed, he could have pulled on the stiches and caused a potential

We know that he had sustained an at home fall. We learn that he has a history of pain and a prescription for oxycodone for back pain. We know that his vital signs on admission appear stable; he was not showing any signs of respiratory distress. As we look at the staff that was listed that day we do get the sense the hospital may have been short staffed. Staffing report shows there was one MD, one RN and one LPN managing at least 4 patients including- one patient was a child. Evidence based research has proven that the nurse to patient ratio is directly related to the patient outcomes (Stanton, 2004). It is important that we consider the staffing level that this rural ED as we know short staffing can be blamed for not being able to take the full amount of time needed to do a proper health history. A detailed health history is an imperative part of the care process; it is used by the staff to accurately assess any acute changes that may take place in the patient throughout their stay.

S first, because of the worsening back pain, which can be indicative of a potential rupture and therefore be life threatening. The RN would have the UAP take vitals and report within specific parameters to maintain a close watch over Mr. S. This is the only thing the UAP would be able to do within their scope of practice but she would be alleviating the workload. Next, the RN would assess Mr. R who is reporting severe pain due to an arterial ulcer. She would use the universal pain scale and would ask what his pain level is from a 0-10. Depending on his response, the RN would then proceed by administering pain medication depending on the rating of the pain and the physicians order. The RN would then ask the LPN/LVN to administer the pain meds but only if they are PO. If it were an IV pain medication, the RN would have to administer due to the scope of practice. In 2009, Chornick found that the scope of practice for each staff member needs to be clear and delegation needs to be administered to the competent individuals who are able to perform each task according to the current situation. After administering the pain medication, the RN would need to return to Mr. R within 30 minutes to reassess the pain level and make sure the pain had subside. After treating Mr. R, the RN would assist Ms. A by providing teaching of the Doppler study that would be performed and answer any questions she may have prior to the

The nursing supervisor has multiple issues to address in this scenario, the use of restraints and formation of a pressure ulcer are of a great concern, but I believe these are easily rectified with training and follow-up audits to ensure

Fluids have gone from the body, causing a decreased quantity of Volume in the blood vessels. Venous return is decreased because of the diminishing Fluid in the vascular space, leading to decreased Ventricular filling. The decrease of Ventricle filling leads to reduced stroke

Dale Gordon has been a patient in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him.

Stephanie Clifford’s A Shot to the Heart tells the story of Peter Forcelli, a Bronx detective that had arrested and convicted Edward Garry, an innocent man. Garry was charged with the robbery of Irene’s New Hope Grocery and the murder of retired NYPD officer Oswald Potter. When the robbery occurred, Potter attempted to stop the robbery when shouting, “I am a police officer” and knocking a suspect to the ground. Later gunshots were heard coming from the grocery store as two suspects fled the scene. Potters was found collapsed in a car with a single gunshot wound to the chest and later was pronounced dead at a hospital. Forcelli the explains that the arrival of a new system called CompStat and the murder of a police officer created an immense pressure to solve the case as quickly as possible. Basing their arrest off two unconfident eyewitnesses who picked Garry out of a line up, without any physical evidence or even a confession. Not long after Forcelli joined the A.T.F. where he soon developed his interest in pursuing wrongful convictions. His new passion had reminded him of Edward Garry’s case and the idea that a man was convicted on such little evidence made him sick. Forcelli then made it his goal to exonerate Garry, an innocent man serving a life sentence. Forcelli then notes the difficulty of freeing an innocent man from his sentence is much more difficult than convicting him in the first place.

Shock is a collapse of Circulatory function caused by severe injury, blood loss, or disease, and characterized by pallor sweating, weak pulse, and very low blood pressure .There are three basic types of shock. Cardiogenic Shock [includes tension pneumothorax, cardiac tamponede and pulmonary embolism] which is caused by the heart failing to pump as designed. Distributive shock [includes septic shock, neurogenic shock, anaphylactic shock and psychogenic shock] which is caused by poor vessel function. Lastly we have hypovolemic shock [includes hemorrhagic shock and non hemorrhagic shock]. Cardiogenic shock is basically shock that is cardiac in nature. It is also the end off of the road for all other causes of shock. Cardiogenic shock

There are things that could have been done to solve the ethical issues in Mr. J’s scenario. First, the CNA needs to be educated on what to look for when it comes to pressure areas. A protocol should be in place in which a CNA notifies the nursing staff of any redness. In turn the nursing staff should then follow up with a care for the patient that requires turning every two hours. Second, a local Rabbi should be called in to educate staff on the Jewish culture and the changes in care a patient should need if they are Jewish. Teaching on Kosher diets would be one of the aspects of the education provided to all staff. Thirdly, all staff needs education about communication. Education about communication should be ongoing. Communication between staff is as important as communication between staff and patients and staff and family. The diet issue should have been brought up to management before so that the problem could have been prevented before Mr. J became a patient. The fact that it was not reported reflects a system change that needs to be made in the realm of communication. Lastly, there should be a protocol as to when restraints should be used. As discussed earlier in this paper, the patient would have benefited from a bed

Patient focused practice would be key to ensure the nursing staff in charge of her care at this stage are able to clearly explain any procedures and to administer pain relief. Frequent reassessment of the patient will identify early signs of confusion and delirium. Avoidance of the use of overly technical medical language and treating the patient as an individual can help to calm anxiety about the

Shock is a life-threatening condition with a variety of underlying causes. Shock is caused when the cells have a lack of adequate blood supply and are deprived of oxygen and nutrients. In cases of shock, blood is shunted from peripheral areas of the body to the vital organs. Hemorrhage and decreased blood volume are associated with some, but not all, types of shock.

Within this assignment it will be exploring the care of a patient using evidence based practice. The patient being explored is one met during a community nursing placement, though all identifying evidence will either be changed or not used to keep the patient’s confidentiality (as with the nmc code). The patient is currently residing in a residential home in Derbyshire. The patient is a man who is in his fifties. He had been put into the residential care following a hospital admission for a brain tumor, a family member living with the patient had flagged patient safety issues at home and social workers thought it be best for the family to have a respite period and to give the patient more care in a residential home for an undetermined amount of time. The patient themselves seemed very happy to accept this. The patient’s current medical history is that he suffers from diabetes which is kept under control through two insulin injections a day, morning and afternoon. As previously mentioned above he also suffers from a brain tumor, at the moment the effects of this on himself are unknown. It has been recorded that the patient has some difficulties in maneuvering himself and needs some assistance as well as assistance and prompting to eat and drink. Due to the patient’s current medical history three care aspects have been chosen to explore that are considered relevant to this patient. The following are - Infection control / standard precautions, medicine

In this assignment we will discuss the holistic assessment process on admission to the clinical area and the duties that the nurse has throughout this process. We will also consider the medical conditions Mr C is presenting with and the appropriate care the nurse should provide relating to specific conditions. We will also discuss the pathophysiology of each of his conditions. Within the assignment we will discuss the post-operative care Mr C will be given by the nurse and the reasoning for this care. Including airway and breathing, circulation, pain management and psychological care. Whilst still in the clinical area we will explore the process of discharge planning and the role of the nurse throughout this process. Lastly we will

He became trapped inside his car, sustaining abrasions to his face, forehead and temple, as well as lacerations to his left thigh. By the time the ambulance arrived, he had lost a litre of blood and bruising developed on both thighs, presumably from being crushed. Upon arrival at the hospital, the patient's extremities were cold, he was semicomatose, his blood pressure was low, and he was experiencing tachycardia. All of these signs, and the large loss of blood were indicators the patient could go into hypovolemic shock. Therefore, 3L of saline was administered to manage his condition.

Nurses play a vital role in healthcare. They are the patient’s advocate and act as the patient’s “eyes and ears”. Pictured here, is Mark, a Registered Nurse working in the Schulich Heart Centre at Sunnybrook Health Sciences Centre, preparing medications for his patients. Making sure the correct medication is administered at the right time is an integral part of a patient's recovery. On his unit, patients are primarily admitted under three services: cardiology, cardiac surgery, and vascular surgery. His ward in particular only has registered nurses as the patients are very acute and registered nurses have more education and training than a registered practical nurse. His daily activities include administering medications, tracking vital signs,