Twin Transfusion Syndrome Clinical Report

Specifically, the pre-op nurse who acquired the parental contact information, or upon being informed that the mother would be leaving the facility did not document it in the patient chart or pass it along to the O.R. nurse.

Mr. and Mrs. Trosack have decided to carry their infant to full term and care for their child due to their religious beliefs. At this time the RN would be responsible to clarify and document the parents’ wishes. The RN would be responsible for coordinating appointments with the specialists that

After the recovery process was completed, the patient was placed in the care of the discharge nurse. She was given a report and was aware that the mother had not showed up to collect her child and several overhead pagers had been performed. While the interview was taking place the nurse stated that she was unsure how to proceed, with the mother not being located, the nurse stated that she was relieved when she was informed that the patient father was there, the discharge nurse stated that the

In the hospital environment there are several resources for the nurse to partner with to address nursing sensitive indicators and ethical issues that may arise. In this scenario, to help resolve the issue with meal trays a partnership with dietary could be made to come with an appropriate solution for the correct delivery at meal time. The nurse could have brought this information forward and apologized to the patient and his daughter rather than trying to keep it quiet. The nursing supervisor

There comes a time in any health care worker’s life where they have to make difficult decisions. Many physicians have to make tough calls when they try to do what is in the best interest for the patients, and sometimes there are points where the physicians have to ask for help from the patient’s family members and ask what the is in the best interest for the family. This example shows up in the case of Dr. Benitz, the chief neonatal physician at Stanford University which explains that some of the children that show up in his clinic have a very slim chance of surviving he then goes on to explain that one baby that was in the clinic on the day of this interview was born pre mature and “weighed only 13 ounces. This is where Dr. Benitz says he

Twin-to-twin transfusion syndrome (TTTS) is a rare disease occurring in 10-15% of monochorionic-diamniotic twin gestations in which vascular connections are shared between the fetuses via a common placenta1, 2, 3. A theoretical imbalance in the vascular distribution creates a shift in circulation causing one fetus to receive a surplus in volume, the recipient, and the other to be deficient, the donor4, 5. TTTS can present at any gestational age6 and can progress in severity causing significant morbidity, especially to the recipient, and even demise of one or both twins1, 2, 6. Classic ultrasonic markers of TTTS have been well-described as an amniotic fluid imbalance between the twins2. Several staging systems have been

During my clinical rotation during my last semester of nursing school, I was able to work one on one with a BSN degree nurse named Judy in the ICU. Judy had three years of experience in the ICU setting. She had been a medical surgical nurse prior to her ICU transfer. The ICU at this hospital consisted of two associate degree level nurses and two BSN level nurses on my shift. I rotated three days in this particular ICU. I worked with Judy all three days of my rotation. I was excited about being placed with her for she seemed knowledgeable and skilled. We were given a male post trauma patient to work with all three days. This patient was a 30 year old male admitted for trauma related injuries and was considered unstable and was to be monitored in ICU. This patient had been involved in a motor vehicle accident and

Today I shadowed a registered nurse. I saw a variety of appointments. The first pt was in for a well child check up. The nurse recorded her vital signs and asked several safety concern questions about her lifestyle and home life. The pt also received a portion of the HPV vaccine. The HPV vaccine can cause fainting spells or an allergic reaction, so the pt had to wait 15 minutes after receiving the vaccine for observance purposes(S). Between each pt, the rooms were cleaned and a new sheet of paper was stretched out over the bed(IC). The next pt was a 6-week-old baby who had been hospitalized for respiratory syncytial virus (RSV). RSV(D) is a common and very contagious virus that affects the respiratory tract. RSV in babies can lead to serious problems like breathing rapidly and cause the lips and fingernails to become cyanotic(MT1). The last pt has a history of repeated ear infections. The doctor suggested a

When first beginning my shift, I decided to take vitals on both of my patients. While I was taking the mothers vitals I asked her if she was in any pain and she had verbalized that she was having some pain in her perineum due to her laceration. Therefore, before beginning my assessment I administered Tylenol/codeine along with providing her with some tucks to assist her providing some relief from pain. I also ensured to document my administration of medication and followed up with an evaluation of her pain approximately forty-five minutes later. After evaluation, she had reported a level of pain of 1/10. Furthermore, I also performed ongoing shift-assessments of both the newborn and mother followed by documentation on CPN. One of my main highlights

As teams of two we were requested to complete a number of tests on a client my clients name in this scenario will be called Mrs. R (NMC 2015) patients name will remain confidential as detailed in nmc code. she was a female 50years old who came into the general practitioner with a complaint of not feeling very well, I and my team member and fellow student nurse was given the job of working together to assess Mrs. R’s vital signs

Ethically it is not always clear what the answer is. Ethics allow us to view issues from a moral perspective. In the instance of the video the midwife has not only legally breached confidentiality but ethically she placed the other midwife in not only a professional, but personal moral dilemma. Utilitarianism looks at the end justifying the means for the greater good, therefore taking the bigger picture into consideration. The issue with this theory is that ‘good’ is not defined, and the interest of one person may differ greatly from that of another (Buka, 2008). The ethical approach taken for different circumstances can differ depending on the people involved. Their individual opinions and feelings surrounding that particular issue will also have an impact, however only one theory would be correct. It is expected for midwives to take a deontological approach, duty following and law abiding (Clarke,

So I kindly, asked the nurse if we are supposed to look under the patient to assess for any blood pooling under her. Because of this reminder, the nurse realized she forgotten this step and thanked me. We looked under the patient, and thankfully there was no blood pooled under her. Another example, of having an EVP mind, was when I watched a labor. I noticed that the residents kept putting their fingers in the patient’s vagina. In lecture, we learned that we want to limit the amount of times that we assess the patient’s cervix due to the risk for infection. Because I don’t know about deliveries, and how many times the doctor is supposed to assess the cervix; I didn’t say anything. I also didn’t feel comfortable, as this delivery team, offered for me to watch. I didn’t know these employees or patient from earlier. In the second half of the semester, I plan to speak up, if I see something that doesn’t seem right, regardless, of the employee’s title, and how long I’ve been working with

I was working night shift in a level 3 Neonatal Intensive Care Unit facility and my 10 days orientation was over. It was my first day working without my preceptor. Since I was a new staff, the charge nurse allocated two stable babies for me. One was Baby Zahra, a 33 weeks preemie, on room air, with nasogastric tube, with peripheral intravenous line to keep the vein open and feeding with expressed breast milk every 3 hours. I started my shift with a bit of nervousness knowing that I am on my own and wondering if I can remember everything that my preceptor had taught me during our orientation. I started my assessment and observed Baby Zahra to be pale, her skin was slightly mottled. I checked her vital signs. The cardiac monitor showed that she

Twins are at a greater risk to be diagnosed with cerebral palsy than singletons. If one twin dies during infancy or a fetal death, the surviving twin has a higher potential of being diagnosed with cerebral palsy. A survey was conducted in England and Wales to compare birthweight specific cerebral palsy and to analyze was there a connection between cerebral palsy and like-sex and unlike-sex twins, also did the death of a twin sibling increase the chances of the surviving twin having cerebral palsy. The birth weight was a factor in the survey due to a higher occurrence of preterm births in twins. If a child is born pre-mature, he or she is at a higher risk of hypoxic ischaemic cerebral impairment.

In connection with the Nursing and Midwifery Council Code of Conduct (2015) which states that people’s right to confidentiality must be respected at all times. It is essential that in this report all