Foundations of Nursing Practice - Essay Example

Foundations of Nursing Practice Name: Instructor: Course Institution: Date: Part 1 Congestive Cardiac Failure Congestive cardiac failure is the “inability of the heart to keep up with the demands on it and, specifically, failure of the heart to pump blood with normal efficiency” (Hellberg, 2009, p. 34). Congestive heart failure is mainly caused by: diseases that make the heart muscle weak, diseases that cause hardening of the heart muscle or illnesses that increase oxygen demand by the body tissue beyond the capability of the heart to transport sufficient oxygen-rich blood (Association of Operating Room, 2010). Weakened heart muscles fails to supply enough blood to the kidneys hence loosing the ability to excrete salt and water. Malfunction of the kidney can eventually cause the body to keep more fluid. Key congestive cardiac failure includes lung congestion, shortness of breath, wheezing and dry hacking cough. Other symptoms comprises of fatigue, dizziness confusion and swelling in abdomen, ankles and feet (Brooker, 2007). Stress urinary incontinence According to international continence society committee (2010), SUI can be defined as “the sequence of symptoms, aerodynamic observations, signs, and conditions corresponds well to the ascending levels of patient evaluation”. These conditions involve the heterogeneous character of Patho-physiology of the condition and the character of female urinary incontinence. Symptoms of this illness are common in women of varied ages. Even some healthy young women who are vulnerable to significant forces to overcome urethral resistance experience stress incontinence symptoms (Clement, 2007). The symptoms of stress urinary incontinence may comprise a spontaneous leakage on exertion, efforts, sneezing or coughing. Stress incontinence may involve leakage of a drop of urine or even relatively large amount of urine. Other symptoms include bedwetting, very strong urge to urinate if that a person feels like it will leak, inability to stop urine from coming out and urgent need to urinate when a person is stressed up, nervous or when in a hurry (Daly, Speedy, & Jackson, 2009). According to Markel (2006), pelvic muscle exercises are effective in reducing stress urinary conditions.There usually there levels of prevention - primary, secondary, and tertiary. Primary prevention brings about a change through risk factors preceding the beginning of the condition; secondary prevention brings about change by establishing and curing people suffering from preclinical illness, while tertiary prevention brings about change by curing and managing patients suffering from clinical disease to put off complications (Heit et al, 2001). As regarding SUI and women bearing children, the prevention is centered on reducing trauma to the patient during delivery. Prevention could also centre on the environmental and general factors that influence the development of stress urinary incontinence. Women could then focus on recognizing these factors and either avoid or modify them with the goal of decreasing their potential risk of SUI development (Delucia, Ott, & Palmieri, 2009). Part 2 A definition of a pressure ulcer Pressure ulcers can be defined as “an inflammation, sore, or ulcer in the skin over a bony prominence, most frequently on the sacrum, elbows, outer ankles, inner knees, hips, shoulder blades, and occipital bone of high-risk patients, elderly, or suffering from chronic diseases, infections, injuries” (Heit et al, 2001, p.34). Pressure ulcers are a product of ischemic hypoxia of the tissues resulting from a prolonged pressure. 5 strategies and rationale for each strategy to prevent Muriel experiencing a pressure ulcer Risk assessment The patient should be evaluated to establish the level of risk of contracting pressure ulcers. In case of evidence of any risk, interventions should be affected to reduce the potential for pressure ulcers. A care plan should be put up by ensuring that the risk assessment and pressure reduction initiatives are revised on regular basis (Radcliffe, 2000). Skin assessment Skin should be inspected on regular basis. This can be done at least daily because pressure ulcers occur even within seconds. Inspection should focus on the skin over the bony premises because it is the most vulnerable. Communication To prevent pressure ulcers for the patient, it is critical that communication is done regularly with other members of the health team. This comprises patients and their families, health professionals, and the management team. The essence of communication is that prevention of pressure ulcers cannot happen in isolation, different groups need to get involved. The process can be ineffective where everyone is not involved (Sally& Dallas, 2005). Continued learning about pressure ulcers Education on this condition is continuous. The more people continue to learn about the condition, as well as how to implement what they know, the more successful the ulcers will be prevented. In continuing the education, a nurse can request the facility to grant constant in service take courses, session, go to conferences and read articles (Tau & International Honor Society of Nursing, 2001). Be gentle and patient It may take quite some time for the pressure ulcers to heal. Gentle repositioning and turning and helps prevent pressure ulcers and accelerates the covering of present ulcers. A fall According to The Victorian Quality Council Guidelines for Minimizing the Risk of Falls & Fall-related Injuries (2004), Fall can be defined as “a sudden, unintentional change in position causing an individual to land at a lower level, on an object, the floor, the ground or other surface” This includes “slips, trips, falling into other people, being lowered, loss of balance, and legs giving way” (Tinetti & Baker, 1997, p.24). 5 strategies and rationale for each strategy to prevent Muriel experiencing a fall Rehabilitative strategies These include wearing proper footwear, therapeutic exercise and use of ambulation services to assist with movements. Elders with mobility difficulties as a result of medical disorders may be encouraged to participate in physical exercises. Exercise programs can involve general physical activity and specific physical activity. If the patient is suffering from balance gait disorders, walkers and canes can be used to improve or maintain mobility of the elderly person (VanBurskirk, 2005). Ambulation devices such as or walker or a cane augment the elder's walking and standing stability and support. Environmental strategies The objectives of environmental intercession are to, establish and get rid of hazardous states and, make simpler or optimize mobility of the person. For example, if the impairment transfer is identified in person, the objectives would be to sustain safe toilet and bed transfers. Environmental alterations put in place might include; facilitating the alderfly’s bed with a transfer bar to support safe transfers, installation of toilet grab bars to support the patient and maintenance of a suitable height of the bed. Hazardous environmental state, such as poor illumination, low seats, faulty stairways and slippery floors, can increase the possibility of falling hence altering safety. Vitamin D supplement: deficiency in vitamin D can cause fall in elderly person. As such, the elderly should increase vitamin D uptake. Healthy diet. If the elderly is overweight, additional burden can be put on the bones joints and heart, which increases the chance of falling. The food should be eaten at regular intervals instead of overeating or skipping meals. This helps the elderly to stay alert, energetic and less likely to fall. The elderly should ask their pharmacists or to evaluation their medicines, to reduce interactions and side effects which can result to drowsiness or dizziness. The elders eyes should be at least once a year and eyeglasses be updated to improve vision and avoid falling Part 3 An explanation if Muriel has a positive or negative balance for the shift and the difference. Muriel has a significant negative balance for the shift. An explanation of what actions the nurse should follow based on the findings. Part 4 Using the downloaded chart, students are to document their findings, based on what Muriel states using the correct documentation principles. Include the elements of subjective and objective from the SOAP acronym. Subjective and Objective The subjective segment of a medical report is where the times gone by of the patient's sickness is recorded. This typically comprises of incidences that led up to the current illness, span and severity of signs and a discussion of what improves or worsen the condition. The elderly required to disclose medical history and sometimes smoking as well as family history and eating and drinking habits. Some of the details may be sourced from the past medical record if the elderly is not able to provide it due to unconsciousness or poor memory (White, 2005). A family member, friend, or guardian may also provide the information. Assessment and Plan In the assessment, the elderly present condition is noted with the likely analysis based on the subjective and objective details that have been given. Past illnesses may also be noted at this point, particularly if they have some posture on the current condition and the prevailing conditions for the patient. The plan prepares for the actions to be taken for treatment. This comprises of additional lab tests and remedy given. If a visible cause cannot be identified for the prevailing symptoms, the plan will disclose that as well as likely consultations required with experts References Association of Operating Room, 2010. Nursing publication. AORN journal (online) 55, 23-26. Available from http://books.google.co.ke/books?id=x6sTAQAAMAAJ&q=How+communication+skills+can+be+used+to+facilitate+safe+patient+care (Accessed on 1/04/2011) Brooker, D., 2007. Person-centred dementia care: making services better. Philadelphia: Jessica Kingsley publishers. Availablefromhttp://books.google.co.ke/books?id=TCwVAQAAMAAJ&q=How+communication+skills+can+be+used+to+facilitate+safe+patient+care (accessed on 1/4/2011) Clement, J., 2007. Basic concepts on nursing procedures. New Delhi: Jaypee Brothers Publishers. Daly, J., Speedy, S., & Jackson D., 2009. Context of Nursing: an introduction. Melbourne: Elsevire Chatswood. Delucia, R., Ott, E., & Palmieri A., 2009. Performance in Nursing. Reviews of Human Factors and Ergonomics (online) 5, 1–40. Available from http://www.ingentaconnect.com/content/hfes/rhfe/2009/00000005/00000001/art00002?token=00571bb82e8d9c715ba383a4b3b2570497b5f5f6c382d384b67282a726e2d58464340592f3f3b57df63bdd3(accessed 24/03/2011) Radcliffe, M., 2000. Doctors and nurses: new game, same result. British Medical Journal(online) 320 (1085), 1085. Available from http://www.bmj.com/content/320/7241/1085.1(accessed 24/03/2011) Sally, P., & Dallas J., 2005. Essential communication skills for nursing. Amsterdam: Elsevier. Tau, S., & International Honor Society of Nursing, 2001. Facts about the Nursing Shortage. Nurses for Health Tomorrow (online). Available from http://www.nursesource.org/facts_shortage.html (accessed 24/03/2011) VanBurskirk, S., 2005. The American Nurses Association designates Nephrology Nursing as a recognized nursing specialty. Nephrology Nursing Journal (online). Available from http://findarticles.com/p/articles/mi_m0ICF/is_6_32/ai_n17211712/?tag=content;col1#comments(Accessed 30/03/2011) White, L., 2005. Foundations of Nursing. Stamford: Cengage. Read More