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NGR 7767 - Personal Practice Improvement, Advancing Transitions to Nursing Practice

An assessment on the patient situation of an 85-year-old male with shortness of breath and confusion, including his medical history and current condition.

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University of South Florida

   

Practice Management, Quality Improvement, and Patient Safety (NGR 7767)

   

Added on  2020-03-04

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In the NGR 7767 Individual Reflection, we will discuss Personal Practice Improvement. This step mainly involves important steps like reviewing the current information like patients’ history, results of the investigation, and others. It also includes gathering new information and recalling knowledge to develop an association of Physiology, Pathophysiology, pharmacology, and others with that the patient’s condition. The patient has been seen to be obese which is a harmful condition such as old age as obesity is the main reason for different diseases like osteoarthritis and hypertension.

NGR 7767 - Personal Practice Improvement, Advancing Transitions to Nursing Practice

An assessment on the patient situation of an 85-year-old male with shortness of breath and confusion, including his medical history and current condition.

   

University of South Florida

   

Practice Management, Quality Improvement, and Patient Safety (NGR 7767)

   Added on 2020-03-04

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Running head: PERSONAL PRACTICE IMPROVEMENTPERSONAL PRACTICE IMPROVEMENTName of the student:Name of the university:Author note:
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1PERSONAL PRACTICE IMPROVEMENTCONSIDER PATIENT Mrs. Brown was admitted to the emergency ward after she had a fall in her own house inthe absence of her carer. When the carer had fetched to prepare her lunch, she heard a sound andcam to back to Mrs. Brown’s room tofind her lying on the floor. She had a fracture in her hopportion and was immediately admitted the orthopedic ward by her son and the carer. She is 67years old and is suffering from extreme obesity, hypertension and osteoarthritis. She had lost thepower of mobility and spends most of the time on bed only. She had also developed pressureulcers and had been suffering for pain as well. Her ADL are carried by the carer andmedications are provided on time. However, she often tries to walk and perform activitiesindependently as he cannot take the fact that she has become dependent. Her falls are mainly dueto the fact that she tries to do her activities independently. Carer and son both revealed that shehas become aggressive and does not properly converse with them making the situation moretensed. After immediate admission, she had undergone hip replacement and is currently underobservation. She is quite stressed and anxious at the moment and is quite aggressive with thenursing professionals.COLLECT CUES This step mainly involves the important steps like reviewing the current information likepatients’ history, results of investigation and others. This step also includes gathering newinformation and recalling knowledge to develop an association of the physiology,pathophysiology, pharmacology and others with that of the patient’s condition (Alfaro-LeFevre2015). The patient has been seen to be obese which is a harmful condition at such an old age asobesity is the main reason for different diseases like osteoarthritis and hypertension. Her BMI is
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2PERSONAL PRACTICE IMPROVEMENTquite high making her prone to the mentioned diseases. Moreover, she had also undergoneseveral episodes of falls which however do not seem to be fatal unlike this time. in the lastepisode, she had fallen on her buttocks and the heavy weight had resulted in huge pressure on herparts resulting in the fracture of the bones. Moreover, she had also suffered bruises in arms andknees. Her pain quotient n analysis had been found to be quite high as 8/10. Moreover her bloodpressure is also found to be quite high (145/95 mmHg) which has become one of the concern forher treatment as such high pressure often call for threat for lives. Moreover as she is not in acomfort zone with both her carer and her son, she is also mentally at unrest and this might haveresulted in the development of anxiety and stress in her.PROCESS INFORMATION The step mainly involves the steps like analyzing the data to come to an understanding about thedata and symptoms noted by the nurses. These steps also involves the discrimination that wherethe nurse needs to distinguish between the relevant and the irrelevant formation followed byrelation the information to the present situation, inferring logically and making suggestionsabout the situations (Victor-Chmil 2013). This step basically helps in solving the main rationalesof the different symptoms and by relating the symptoms to specific habits and practices of thepatients. Hs is followed by the prediction step. In the case study, it is found that the reason of fallis mainly due to the attempt the patient takes repeatedly to make herself feel independent.Basically, her carer as well as her son has not been able to develop a proper connection with thepatient and therefore the patients suffered from different complexes when they helped her withher daily activities. Patient education was poorly done by the carer which had been the mainresult of her anxiety and stress (Shnayderman, Yugrakh and Levy 2016). Moreover even afterseveral fall, proper fall prevention strategies and risk assessments were not done. From the BMI
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3PERSONAL PRACTICE IMPROVEMENTrate, it is evident that her diet plan was not proper and she also conducted no exercise sessionsthat made her more bed ridden. Moreover her pressure sores had been other symptoms of herfrustration as proper rolling of her body positions and also use of proper mattresses was notprescribed by the carer (Nelson et al. 2014). Her pain for osteoarthritis also used to give hersleepless nights. Although the acre said that she provided regular medications, but absence ofany sort of exercises and lack of physiotherapy had not helped in developing the situationEmotional health was also poor as she could not connect with her son and the carer (Bliddal et al.2014).IDENTIFY PROBLEM/ISSUE This step mainly involves the proper synthesis of all the facts that had been collected andanalyzed in the previous step. By this step, the nurses who in charge of the care plan cansuccessively connect the links and can identify the main issue with the patients. The nurseusually makes a definitive diagnosis of the patient’s problems and hence can also form out aproper framework of the care plan for the patients (Brand et al. 2014). The most importantidentification that the nurse would make is the proper caring of the patient due to her surgery ofhip replacement. In this stage, the nurse should first try to recover the patient from the physicalpain after the surgery and also the pain she is having due to the bruises over her body parts, herpain of osteoarthritis is also taking hard time on her and therefore care plan should be introduced.Moreover, her aggression and anxiety is the main reason of her frequent high rise of bloodpressure (Yates et al. 2014). Proper care for the pressure sores also needs to be taken Thereforeestablishment of a proper therapeutic relationship is very important for the nurse with thepatients. A patient who is happy and content can respond to medications and other interventionsmore effectively.
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