nursing care plan

 

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left total knee arthroplasty care plan.

assessment : 3 subjective data , 3 objective data.

3 nursing diagnoses.

3 outcome/goal measureable.

2 planning.

2 rationale.

2 implementation

2 evaluation.

and DAR note.

 

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Ms Nancy Huang is a 29 year old university student undertaking her honour’s year in physics.  Nancy was diagnosed as a type 1 diabetic three years ago.  She normally manages her diabetes reasonably well. She made a number of lifestyle changes and uses regular insulin therapy.   Nancy has been very stressed, as she has not been able to finish her thesis on time due to having to recently return to China unexpectedly to attend a family funeral.  Since returning to Australia a few days ago, she has seen her GP, as she was unwell. She was diagnosed with a viral chest infection that was managed conservatively. She subsequently fell further behind in her studies.  Nancy decided to pull a few ‘all-nighters’ to get her thesis finished and consumed excessive amounts of coffee and soft drinks in order to stay awake to get finished.  The next day her husband noticed Nancy was particularly irritable and becoming emotional. She explained that she could not concentrate enough to finish her thesis.  Nancy was insisting on being driven to the university to speak to her lecturer.  On the drive in, they had to stop 4 times for Nancy to use the bathroom.  She became even more irritable and her husband decided to call an ambulance once they arrived at the university. After assessment by the paramedics, Nancy was transported to hospital.

You undertake additional assessments to gather new information, recording the following new data:  Vital signs:  BP: 90/50 Pulse: 120 bpm RR: 20, coarse air entry, moist productive cough Sp02: 94% Temp: 37.9 ° C Other data: BGL: 24 mmol/L GCS: 13 (confused) Poor skin turgor Frequent urination Urinalysis: glycosuria, specific gravity 1.000, no ketones present Abdomen soft, no rebound tenderness. Bowel sounds present. Patient irritable and agitated. Speaking in a confused mixture of English and Mandarin. Husband in attendance

Log book: Ms Huang’s husband gives you a logbook that Nancy has been provided with by her endocrinologist. It shows that Nancy has been diligently recording her blood glucose levels and insulin regime for several months. You note there are no entries for the last few days.

 

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1. Just think about your life in the upcoming years, where and how do you see yourself advancing your nursing career and developing your leadership skills?

2. Now reflect on your first year as a registered nurse and prepare a written summary. In sharing you’re your story, be sure to answer the following questions: 

Tell us how you have develop as a professional nurse? 

How has the care you deliver to your patients and families changed? 

Tell us what are you most proud of?

3. Tell me what advice would you give to the next Cohort as they transition into their new role?

 

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S.C. is a 21-year-old college student. She presents with intermittent wheezing. She has a history of asthma as a child but had been free of symptoms until this year. She has symptoms 1 to 2 days per week but denies nocturnal wheezing. Her symptoms do not interfere with her normal activities. She has never taken systemic corticosteroids and has never been hospitalized for asthma. On physical exam, you observe soft end-expiratory wheezing at the bases bilaterally. Pulmonary function tests today show an FEV1/FVC of 80% with an FEV1 90% of predicted. She has no other medical conditions and and is not taking any nonprescription, prescription or complementary alternative medicines. She has no known environmental or drug allergies.

DX: Asthma

1. List specific goals for treatment for S.C.

2. What drug therapy would you prescribe? Why?

3. Write prescription for drug therapy prescribed.

4. What are the parameters for monitoring success of the therapy?

5. Discuss specific patient education based on the prescribed therapy.

6. List one or two adverse reactions for the selected agent that would cause you to change therapy.

7. What would be the choice for second-line therapy?

8. What over the counter and/or alternative medications would be appropriate for S.C.?

9. What lifestyle changes would you recommend for S.C.?

10. Describe one or two drug-drug or drug-food interactions for the selected agent.

MUST USE REFERENCE IN TEXT CITATIONS, NURSING JOURNALS ONLY WITHIN 5 YEARS

 

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