Question:
This week's graded discussion topic relates to the following Course Outcomes (COs).
Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities.
Utilize effective communication when performing a health assessment.
Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient's room for report.
Approximately 1 hour later, you return to Ms. Jackson's room with her morning pills and find her slumped over the bedside stand in tears. The patient states, "I don't know what is wrong, I don't feel right. My back hurts and I'm just so tired. What is wrong with me?" The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach.
Just then the nursing assistant comes into the patient's room to record Ms. Jackson's vital signs, you take this opportunity to quickly research the patient's medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn't get the patient's pulse because "it is all over the place."
Please address the following questions related to the scenario.
What do you suspect is the cause of the patient's symptoms?
Describe the course of action that you will take to confirm this suspicion and prevent further decline.
What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so.
While you are caring for this patient, how will you ensure that the needs of your other patients are being met?
Answer:
1. Symptoms of Patient
On the basis of Ms. Jackson’s condition, it seems that she is suffering from the congestion in the tissues of the muscles because she is complaining of severe pain in the back, along with nausea, fatigue and unstable rate of heart as she is oversensitive and she will be having the operation after (EASTERN, 2013). It seems that women don’t often feel this much pain in the chest but fatigue is often the symptom of a disorder of critical heart issues (Lewis, Heitkemper, & Dirksen, 2011).
2. Steps to Take for Confirmation
Probably the first step to be taken is to manage and regulate the pain because it might elevate stimulation as well as consumption of oxygen (Jarvis, Lauer-Pfrommer & Schartz, n.d.). So, in the case mentioned, the patient will be operated and is anesthetic. In addition, high dosage of ASA and to increase the perfusion of tissue and ischemia with some dose of oxygen.
3. Assessments Needed
For assessment investigation of history is significant. Other steps would be checking the harshness, level, and location of pain. Beside that some tests including STAT EKG, impulse rate of heart like troponin, CXR, protein production levels (Jarvis, Lauer-Pfrommer & Schartz, n.d.).
4. Keeping Track of Other Patients as Well
Create a System to remind for the provision of health and to ensure the track of all patients with these types of the cases, a system of the remainder can be appropriate to trigger the doctors and related staff to schedule all the patients according to their condition of health and history including data maintenance, email and appointment plan at the time mentioned (EASTERN, 2013)..
References
Jarvis, C., Lauer-Pfrommer, M., & Schartz, K. Physical examination & health assessment.
