The following paper will be on the health status and nursing care for patient J.S. Throughout the paper, the reader will be presented with patient information such as: patient history of present illness, pathophysiology of illness, physical nursing assessment, functional health pattern assessment as discussed with patient, laboratory data, applicable nursing diagnoses, and a care plan for two diagnoses. In conclusion will be a brief summary and evaluation of what the author learned from this experience.
Patient History of Present Illness
Patient J.S was admitted to Winchester Hospital after falling at home and experiencing shortness of breath. Patient was diagnosed with a urinary tract infection and a right ureteral calculus. The patient
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However the patient was brought back in to the ED after the fall at home. The patient stated that he was siting on the edge of his bed attempting to change his Foley bag when he slid off and landed on the floor. He was found on the floor approximately three hours after and taken to the hospital. As a result of the fall the patient also has skin tear on his left upper arm. Mr. J.S. lives at home with his wife who is on hospice care for pancreatic cancer. Patient ambulates with a cane and walker. Mr. J.S has a history of GERD, HTN, MRSA-NARES, hyperlipidemia, abdominal surgery, mild myocardial infarction, chronic leukemia, enlarged prostate, sciatic or about 1 month, CLL with immune thrombocytopenia and splenectomy, diverticulosis, bowel obstruction, open cholecystectomy, lysis of adhesions, incisional hernia repair (12/12/2012), BPH with indwelling Foley. Family decided to take him off of hospice care and he will remain full code. At the beginning of the shift the patient was very tired, and did not seem …show more content…
The cause is unknown. However, there is an increased incidence in males. There are four types of stones; calcium (oxalate of phosphate), struvite, uric acid and cystine. The most common type (70-80%) is calcium stone. These stones are usually caused by an increased concentration of calcium in the blood. The causes and treatment for stones vary depending on what type of stone it is. Factors such as; high serum and urine level of stone components, urinary tract infection and the ph of the urine and dehydration all contribute to the formation of a stone. The main cause struvite stone is UTI, due to a certain enzyme that some bacteria secrete. Formation of the stone requires that the urine be supersaturated. If there is a higher concentration two ion in the urine they are more likely to precipitate. The formation of a stone usually begins with small clusters of crystals. Most crystals will pass because the force holding them together is not strong enough. Larger ion clusters however, form nuclei and become strong enough to stay together and overcome the tendency of ions to move apart. Once stable, the stone will continue to grow. The stone can become logged anywhere in the urinary tract if it is greater than 5mm, if the stone is less than or equal to 5mm the stone will usually pass on its own. Mr. J.S. has a few contributing factors to the formation of his stone. According to the book, Pathophysiology, “Obstructive
It's Rose Ann. I just want to let you know that Mr. Bogue, James in room 564, MRN 291222300018 fell yesterday around 4pm. He was Amanda's patient and she completed the voice. I notified our risk management Jodi Palmer about the incident. Apparently the patient was instructed by Amanda not to get up because he was hypotensive, but he didn't listen and grabbed the walker and fell forward. We ended up calling RRT because he was hypotensive and developed a big hematoma on his right groin surgical post angiogram from previous day. The patient was transferred in ICU12. We were short staff from 7a-7p, I called everyone with no luck. Our nurses and PCA were overwhelmed, because we kept on getting multiple admissions, including 2 cath lab patients
The Board office received a letter from Mary Fahey, MPHP via fax on 05/04/2015, advising that Dr. John Medley, M.D. a current “ILOD” status had informed her that he had relapsed over the weekend of April 25-26, 2015.
In this Assessment nursing course, one of the major things that is taught is the most important part of giving proper care to a patient. Correct patient assessment is needed before any nursing care plan or treatment can be implemented. This post-review of a person’s assessment will demonstrate the proper way to go about assessing a person’s health.
The patient is a 72-year-old gentleman who presents to the ED because of profound weakness, inability the patient is wheelchair-bound fell between the wheelchair and his bed and was unable to get himself up off the floor. He has multiple medical issues including chronic atrial fibrillation flutter, hypertension, chronic lymphedema, diabetes mellitus. On presentation is noted to be somewhat dehydrated with an elevated white count, as well as acute kidney injury. On presentation his initial white count is 11.7 with left shift and hemoglobin of 11.6 with hydration and appropriate antibiotics his white count comes down. Hemoglobin goes to 10.9. It is also to be noted his original BUN was 56 with a creatinine of 2.38 correcting upon administration
I have chosen the topic about kidney stone because my favorite comic book series featured it as a character. Kidney stones, also known as, Nephrolithiasis or Renal Calculi, are crystalized lumps formed by insoluble calcium compounds (Kidney Stones). Normally, the two kidneys in the human body are in charge of filtering blood to produce urine. The urine travel down to the ureters, then into the urinary bladder, and finally excreted through the urethra (Baxter, 2016a). When there is not enough water to dilute the waste products, they stay in the kidney and increase the risk of stone formation. As waste stayed in the kidney, it start to build up and form into a kidney stone. Depending on the size of the kidney stone, some may slide down the urinary tract without causing any discomfort. However, because of the small diameter of the ureters, large usually get stuck and block the flow of urine (Baxter, 2016c).
Nurse’s care for several patients in a day and it is important to understand the patient as a whole person to treat them effectively. The purpose of this assignment is to explore a patient’s disease to understand the nursing judgments and interventions involved, the medications for this diagnosis, and to understand the disease. The patient described in this paper will be referred to as Jonathan to ensure patient confidentiality.
Nephrolithiasis, otherwise known as kidney stones, is a painful condition in which various types of mineral deposits form inside the kidney. Typically not fatal, or even physically damaging in the short term, if left untreated for long periods of time kidney stones can lead to renal damage or even failure. There are several different types of kidney stones ranging in size from a grain of sand to as large as a golf ball. The most common type of kidney stones are calcium stones. Struvite stones are the fastes growing and usually come into formation due to an infection of some kind in the urinary system. Uric acid stones are typically causes as a
Ureteric calculi (i.e. stones in the ureters) is a medical condition that causes an abrupt onset of pain, which may be accompanied by nausea, vomiting and blood in the urine, among other signs and symptoms. The presence of stones in these tubes that allow for the passage of urine from the kidneys to the bladder is most commonly seen in the 20 – 49-year-old age bracket. Stones, in increasing order of prevalence, may be chemically composed predominantly of calcium, struvite (magnesium ammonium phosphate), uric acid or cysteine.
High concentration of calcium (200mg in 24 hour urine) in urine is called as hypercalciuria, leads to stone formation. Causes of high urine calcium include a genetic disorder known as familial hypercalciuria and hyperparathyroidism.
Kidney Stones are also called Renal Calculi. Nephrolithiasis is the condition of having Kidney Stones . These stones come about from chemicals in the urine, forming a tough crystalline mineral deposit from within the kidney, that stick together inside the kidney or urinary tract. Typically, they develop in the inner surfaces of one or both of the kidneys. Supersaturation urine is what actually creates the stones, this happens when there is an imbalance in the waste chemicals in the urine, which then causes the stones. As to under saturation urine crystals cannot be formed due to lack of calcium produced. They can be as little as a grain of sand that can be invisible to the naked eye, or as large as a golf
Other forms of kidney stones are cysteine and struvite stones which are caused by various reasons. Struvite stones are caused by kidney infection and cystine stones are due to a common disorder. The disorder called cystinuria is the defect in transporting amino acids and causes too much cystine is in the urine. The more common types of kidney stones involve calcium. Hyperparathyroidism is when the gland over produces its hormone, parathyroid hormone (PTH), that will increase the amount of calcium in the blood. However, just calcium in the blood or in the urine will not cause kidney stones, they need oxalates or phosphates and must form in the kidneys. The reason I specify the kidneys is that if you consume calcium and oxalate together and they form in the stomach. They will be dissolved and are less likely to form stones. People with too much vitamin C, probably through a supplement, will have oxalate rich urine.
The patient was referred to the Radiologist from his GP, because of ongoing pain and difficulty when swallowing. The patient was 45years old male, consumed alcohol regularly and a heavy smoker.
Kidney stones are usually composed of calcium oxalate or phosphate either. Minerals are absorbed from food and is usually disposed of through urine. When the urine is too soupy, minerals can crystallize to form stones. Drink at least six to eight glasses of water a day to keep the urine doesn't become too concentrated.
Kidney stone disease, also known as kidney calculi or nephrolithiasis, affects millions of people in the United States. As stated by Lewis, Dirksen, Heitkemper, Bucher, & In Harding (2014), this disease is more frequent in the whites than in African Americans, and has a higher incidence in people with a family history of kidney stone formation. The formation of kidney stones involves many factors, which include dietary, metabolic, climatic, genetic, occupational, and lifestyle influences. There are many theories proposed for the stone formation, but no single theory can account for all cases. The pathophysiology of kidney calculi involves the supersaturated formation of crystals that forms a stone. The elements that affect the
Some may form stone due to higher calcium levels or more uric acid in bloods. You will suffer to pass the urine as the stone size increases.