Please follow the format below to complete this week’s Care
Please follow the format below to complete this week’s Care Plan:… Please follow the format below to complete this week’s Care Plan:Weekly Clinical Guided Reflection/Analysis(Must show reflection and analysis in answers)(Safety) How did you incorporate a standard precaution and infection control guideline? (Choose one you have not chosen before.) Which National Patient Safety Goals did you use in your practice? (Choose one you have not chosen before.) (Concept Care Map) What is the highest priority problem for your patient? What is the rationale for this choice? Client was admitted due to Dirt Bike Motor vehicle accident, which he has injury to Fracture of Cervical vertebra C7, Fracture of Sacrum, contusion of Spinal cord, Liver Angioma and urinary retention This was noted as the priority because DVT can develop to pulmonary embolism. If the blood clots become loose and travel through the bloodstream and into the lungs, which is life-threatening.(Concept Care Map) What is the pathophysiology for the highest priority patient problem for each of your patients as it applies to the patient’s situation?Status post neck brace which poses an increased risk of aspiration and skin breakdown.Urinary retention, straight catheter every 6 hours now has UTI and receiving Bactrim Antibiotics.Client receives Robaxin for pain and Gabapentin for muscle relaxant. (Concept Care Map) Evaluate the patient goals for each of your patients (from your concept care map). The goal is to treat the formation of thrombosis in the client’s lower extremity. By eliminating the blood clot, inflammation of the affected vein will be reduced, thus resulting decreased pain level as well as prevention of development of pulmonary embolism.(Clinical Judgment) What did you learn about the concepts of the week from your patient(s) and experiences at clinical?The client I chose mad the wrong choices of driving Dirt bike motorcycle to jump to another building landing with his bike, but unfortunately, he landed on his head 150 feet according to his mom. This made me realize that when assessing a client, it is important to gather as much information as possible (i.e., liver hemangioma due to the trauma, lifestyle, etc). rather than focusing one thing. Because of this, I was able to understand how one factor correlates with the other. For example, his contusion of spinal cord, C7 fracture and contusion of C3 and C4 affected his bilateral arms of inability to move. All these factors made me realize he was lucky to be survived from the accident.(Clinical Judgment) Think of one clinical decision you made which enhanced your patient’s care by addressing their cultural, developmental, and social characteristics.As a home/hospice health nurse who makes house calls. I used to have a customer who was on hospice. The client requested morphine, but the family refused to give it to him, claiming that in their culture, giving morphine to a dying person is seen as attempting to hasten death. I was first perplexed and took a few moments to speak to the family. Rather than dismissing their beliefs, I informed the patient and family that the morphine was prescribed to alleviate any discomfort and the SOB was prescribed to keep the patient comfortable throughout the procedure. The client was upset and had hard breathing before the medicine was given. They saw that after the client was administered the morphine, the patient became more comfortable and less agitated. 7.(Clinical Judgment) Share an “ah-ha” moment of insight you experienced or witnessed today in clinical.My ah-ha moment came in 2012, when I was diagnosed with thyroid cancer. Cancer. The term alone elicits a wide range of emotions, including fear and fury. I got more terrified when I was informed, I required surgery as soon as possible. I transformed into a terrified patient who was terrified of the unknown… A patient who hung on every word my surgeon said… A patient who had to study the nurses’ expressions to figure out if this was good or terrible news… I can’t image what my patient, who is just 36 years old, is thinking about all of the impending surgery and long-term therapy. His mother, who was by his bedside, began to feed him and returning to his care and responding to all of his needs. As a result of my experiences, I’ve become a better patient and a more compassionate caregiver.(Clinical Judgment) Share one thing you plan to do differently next week in clinical? – I’m going to pay greater attention to patients next week. This way, I’ll be able to learn more about their circumstances and determine how best to assist them. (Patient Education) How did you assess the readiness of your patient and family member to learn?I sought an opportunity to speak with them by asking whether they would be okay with me providing them with information on the topic at hand. Identify any learning barriers, possible resolution to barriers.- Learning is hampered by culture. The greatest way to overcome culture as a barrier is to advocate for and encourage flexibility, especially when it comes to health. What content did you identify that you should teach your patient and/or family?- I found that most family members are unaware of the true state of a patient’s health. Families should learn to communicate with one another about important concerns such as health. What teaching strategies did you use?- I utilized return demonstration as a teaching strategy. What teaching aides did you use?I used graphics and analogies (Patient Education) How did you verify their learning?My patient’s mother is a yoga instructor who is also interested in health and fitness. While at the bedside, she did ROM movements exercises.Did they learn the content? If not, why not? 11.(Communication) Describe a therapeutic conversation you had with a patient or family member. Name the therapeutic communication technique you used? – I had a therapeutic talk with his mother by using the approach of providing praise. How did the person respond to your therapeutic communication technique?The reaction was favorable since she was a highly active woman who controls her nutrition and does yoga exercises regularly to be healthy.Upon reflection, what would you have said differently?- I can see the family is very supportive, as well as the patient’s wanting to make reparations in terms of rehabilitation. Describe one communication barrier you observed. How did it interfere with the communication? Judgment from family members. It’s going to be easier for the patient to fully recover.(Professionalism) Which standard of practice from the California Board of Nursing Rule did you implement? (Choose one you have not chosen before.) I used intervention as standard of practice.How did you implement it?- By enlisting the help of a variety of caregivers 13.(Leadership & Management) List interventions from your Concept-Care Map that you could only legally delegate to unlicensed personnel (UAP).Checking of laboratory valuesObserve skin color and moistureEvaluate the patient’s reports How did you advocate for your assigned patient(s)?14.(Quality Improvement or Evidence-Based Practice) Identify and explain a quality improvement project at your hospital – or – identify an evidence-based practice used in the care of your patients.One of the hospital’s quality improvement objectives aims to reduce the rate of medical mistake from 16 percent to 12 percent by the end of the year by introducing safer practices and safer systems. Many medical mistakes occur as a result of inadequate communication, both verbal and written. Minimizing medical mistakes equals to risk reduction, which increases patient safety. (Concept Care Map) List all the interventions on your concept care map with cited scientific rationales.Administered anticoagulant medication Enoxaparin (Lovenox) via subcutaneous shots) to help with the blood clot.Administer pain medications as indicated to help alleviate the intractable pain to lower back (sacrum, Right rib and scapula fractures).Encourage patient to express is feelings of hopelessness r/t impaired physical mobility.Educated the patient about importance of taking all his prescribed medication as indicated to prevent other complications. Health Science Science Nursing NURSING 222
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