G-J Tube Case Study

Plan: The patient will be admitted, kept NPO, and an appendectomy will be performed by Dr. Rogers in the morning.

Figure 1. Results recorded from experiment. After every 15 seconds for four minutes, the absorbance was recorded.

He was non-verbal and non-ambulatory, spastic quadriplegic and hydrocephalic. He had a history of asthma, and respiratory distress. Due to congenital malformation of his head, neck and trachea he suffered from obstructive apnea. He was mentally retarded with an IQ of 4 and mental age of 2 months. He could respond to his name, and was able to recognize familiar people. He was on G Tube feeding since he was two years old. He had a trach tube in place for breathing, and a sleep apnea monitor was connected to check his breathing and heart rate, while sleeping or

Proposed orders DO NOT become active until they are cosigned by the physician or resident. When placing proposed order the medical students must communicate clearly to the covering physician

The patient requests a more intensive service or test that is deemed to be medically necessary by the provider.

Form precise neurosurgery through the leg and heart valve replacement without opening the chest to robotic surgery through the belly button and custom joint replacement procedures, Tallahassee Memorial Hospital Main OR continuously provide patients with the best possible care. TMH OR offers a variety of surgical interventions. However, regardless of the surgical or interventional procedure, in most cases are required a sterile technique, a legal formed consent and administration of medications. Therefore, my goals, which I completed, for week # 3 in the TMH Main OR are:

The plan I would need in place would first to address her respiratory status and maintain a patent airway. I would also want to have the patient demonstrate how to splint while deep breathing or coughing. I would ask the Cna to help with position changes every 2 hours or more if needed for comfort for the patient. I would need to do a full assessment at this point if the patient is more stable. By having the patient deep breath will also help her return to consciousness, (Ahmed, Latif and Khan, 2013). I would want to keep her comfortable and in as little pain as possible. I would also want to try to educate her as to when to push for pain medications from her PCA pump. If there were any family I would want to try to get them involved with the education as well. The use of an incentive spirometer should be included in the teaching too. I would keep monitoring the incision site and watching for signs that the patient is in pain. While I was working on patient education with this patient, I would ask the CAN to do vitals on the 2 postop patients every 15 minutes for the first hour, reporting abnormal vital signs to myself or the other R.N. I would also ask the other R.N. if she/ he would do the discharge for that patient, while I remain with this patient and make sure she is going to stay stable.

4- What situations that patient should create a new directive? Do you think reviewing and creating a new directive is necessary? Why? Or Why not? P 2.

made exclusively and directly by the patient to the physician. The request cannot be made on

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

The Material Flow Committee (MFC) knew that there were many problems associated with this process and that they had to change. The people involved in this group were Sridhar Seshardi, who was the vice president of Process Excellence; Nick Gaich, who was the vice president for Materials Management; Candace Reed, who was the director of the Sterile Processing Department (SPD); and Joan Rickley, who was the director of the OR. The first step that was taken by this committee was a pilot project called the “Early Morning Instrument Prep.” This development would involve a neurosurgery nurse coming to the hospital in the early mornings to make sure that all supplies and instruments were where they would be required for neurosurgery. Another aspect of this project was to “Provide early data into possible sources of problems” (p. 5). Once the MFC had reviewed the data that came back from the “Early Morning Instrument Prep,” they decided the Hospital would greatly benefit from hiring an Implementation Specialist for Healthcare (ISH). The ISH is a firm that has a specialization in

This patient also had a gastrostomy tube placed due to being unable to tolerated feeding by mouth. He receives formula feedings through this tube for nutrition. Along with this patient coming in due to undetectable Tacrolimus levels, he has also come in for Failure to Thrive. With this, it means that he was either incorrectly being fed or not being fed at

The patient is alert and oriented to person, place, and time. Upon initial interaction, the patient is easy to communicate with and states she is doing well. Facial features are uneven and asymmetrical, as she has a slight left facial droop due to her stroke, which she states happened a couple of years ago. DG expresses multiple times that she has a hard time seeing and she wears prescription eyeglasses. PERRLA. Skin is pink, warm, dry; temperature is 97.5 and turgor is brisk. There is a 20 gauge IV in the right hand infusing Lactated Ringers at 20ml/hour per pump, no redness or edema noted at the insertion site. Respirations are even and non-labored at 22 breaths per minute. Lung sounds are bilaterally clear. The client has a nasal cannula infusing 2 liters of oxygen with an oxygen saturation of 96%. DG tells me she is a current smoker and she smokes

The Role of Witches in the Downfall of Macbeth In the 1500’s there was a stigma surrounding the talk of witches and their cruel behavior. Many Elizabethans at the time a type of hysteria of witches as they had a negative connotation associated with them. Witches were a great deal of topic because of their peculiar powers and they're negative affect on the human life. Witches in creatures that are witches play a substantial role in justifying Macbeth’s actions throughout the play and reflect the typical viewpoint of Elizabethans during the time of Macbeth.

In the beginning of our journey, it was clear that there were seven committee members that had seven different ideas of what personalizing education should look like. Visions from all areas of the board where created by our members. For example, there was talk about creating the perfect forest school, establishing a better form of democracy in education, and the debate of standardized testing belong in the public school systems. However, the main theme that we all had in common was our personal experiences with the lack of education being a priority for ourselves or a love ones in the past. It was also important that we made a difference in decreasing the academic expectations of teachers in some kind of way. The committee wanted to bring a refreshing way to the idea of partnership with teachers. This partnership would transform into a unique way of help students on their educational excursions.