This can be done mainly through eliciting the history in fair detail. As a nurse practitioner in the community, I will be facing many cases of chest pain. Recently I had to manage such a case and I believe that the experience has equipped me with confidence. I adopted a structured approach to evaluate the case and progress through a mental checklist for eliciting the essential historical details (Reigle, 2005). The collected relevant data helped the decision- making and subsequent management. Case Presentation Respecting the confidentiality and privacy of the patient, I met her in the emergency department where I was working. With her consent, as she was conscious and answering, I elicited the history of the chest pain from Mrs John. Mrs John, 81 years old and weighing 85 kg., had been brought to the Emergency Department by her son. I followed the mnemonic TROCAR for eliciting the history of the presenting complaint of chest pain. She had a sudden but mild chest pain while she was in bed. Time of onset was when she woke up with it at 6a.m. and first dismissed it as indigestion. As it was not giving way after her antacid liquid, she called her son. Also experiencing shortness of breath, the duration of pain had lasted for the past forty minutes. Mrs. John had fatigue since the previous night, something she was not accustomed to. Radiation of the left-sided chest pain was to the back. Onset was sudden. The character of the pain was a dull aching sensation. There was no particular aggravation or relief. The severity remained constant as a dull pain. It was a left sided chest pain. The excessive sweating worsened her fatigue. She was reluctant to go to hospital but her son insisted on it. She had then been brought to my department where I was on duty. Past History revealed that she had been a hypertensive on treatment for the past twenty years. There was a history of irregularity in treatment at times. The mild senile dementia with partial loss of memory that the lady suffered from was the cause of the irregular treatment. Now her son was in charge of giving her the medicine. She became diabetic fifteen years ago and was on oral anti-diabetics since then. Seven years ago she had a fall injuring her left trochanter which was managed accordingly. She now walks with a limp. There was no history of allergies but she had been taking antacids on and off presumably for acid-peptic disease. Smoking was not her weakness and she had not travelled for a long time. Before retirement she was working as a personal secretary in an industrial concern. Family history revealed that two brothers had died of myocardial infarction but at a later age of around 85 years. Obesity was in the family too. Mrs. John’s mother had diabetes and died of renal failure. Nursing care plan This has been elaborated upon the mnemonic ADPIE (assessment, diagnosis, planning, implementation and evaluation). Assessment On inspection, obviously obese Mrs. John appeared dyspnoeic taking short breaths with the respiratory rate being 28 per minute but regular. Her heart rate was 90 per minute and irregular at times due to ectopic beats. Her supine blood pressure was 200/120mm Hg. Palpation of abdomen did not reveal any abnormalities. Percussion ruled out fluid in the chest or abdomen. Auscultation elicited an irregular heart and tachypnea. During the general physical examination, I enumerated and eliminated non-cardiac causes; her symptom details helped me to distinguish her illness
Case Study CHEST PAIN CASE STUDY of CHEST PAIN The high incidence of chest pain makes it a common symptom seen in the Emergency Department in acute and primary care centres. This complaint has been found to be the presenting symptom for about 5 million people in the US (Reigle, 2005)…
Chapter Two: Methodology 11 2.1 Introduction 11 2.2 Research Strategy 12 2.3 Choice of Index and Database 13 2.3.1 Key Words 13 2.3.2 Databases Used 13 2.4 The Search and Output 14 2.5 Selection Criteria: Inclusion and Exclusion 14 2.5.1 Inclusion 14 2.5.2 Exclusion 14 2.6 Reading and Evaluation 15 2.6.1 Critical Appraisal 15 2.6.1 Data Analysis 16 2.6.2 Data Extraction 16 Effect of aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery.
Nevertheless, efficiency of its application in patient care still needs to be continuously evaluated and monitored. Thus, review of relevant studies and previous researches are presented in this paper to create a collaborated idea of pain management in post-cardiac surgery patients, its application in nursing care, and suggested strategies to improve future nursing care practice.
Management of pain following a surgical procedure is one of the major challenges and source of concern for health care providers. However, surveys have revealed that hospital postoperative pain management, such as opioid intramuscular injections are frequently inefficient, resulting in unrelieved pain in approximately 50% of patients
According to recent studies, there has been a significant rise in the incidences of medical emergencies and related injuries in the last ten years (Cowen & Moorhead 2011, p.149; Weller et al. 2012, p.594). In all these, trauma and chest injuries from wound, gun shots and thrust injuries among others have critically increased the prevalence of thoracic medical emergencies of different kind.
Most often the meaning of such acute chest pain and the feelings associated with such pains when the patients face such symptoms are critical in that the patients suffer fear of death (Hamilton et al., 2008). This means these groups of patients need special support from the nursing professionals and measures to relieve these pains as soon as possible, at least in order to decrease these feelings.
Infact, reflection is a very important tool for development which challenges the practitioner to think in new ways, raise doubts about effective clinical practice and explore various new methods of solving problems encountered in day-to-day practice.
The functions of the modern day psychology began with institutions and individuals who existed before the emergency of the profession of psychology. Religious groups, the clergy, physicians and social welfare promoters have
Working as an emergency department nurse comprises of numerous professional life experiences. Emergency department nurses deals with patients whose health condition has not be known. Normally, an emergency department nurse work in emergency department where one is supposed to interact with the patients whose condition has not been ascertained.
Clinical psychology can be defined as a study that deals with diagnosis and treatment of diseases of the brain, emotional disturbance and also behavioral problems. Clinical psychology often deals with two objectives it first
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