She is status post right shoulder arthroscopic acromioplasty and distal claviculectomy on 5/13/16. Abstract. By ultrasonography, he was diagnosed with a deep vein thrombosis (DVT) of his right calf. With the support of nursing director, this author can discuss the problems and solutions with management team, finance department, risk managers, quality care team and the nursing staff to obtain adequate support and understanding of the project. Such abuse may put the patients in trauma and deteriorate the condition further. This will avoid appointing any new staff member and save additional costs. Hence, patients suffer more due to abuse. She was diagnosed at that time with a herniated disk and did have steroid injections and was out of work for six months. The TM model can be used along with other nursing models of care for effective. Learn vocabulary, terms, and more with flashcards, games, and other study tools. While DVT can manifest as acute pain and/or swelling, some patients do not experience any symptoms in the beginning. Case Study #3: Pulmonary Embolism. (Note: images included in this case study are for demonstration purposes only and do not necessarily reflect this particular patient.) The best nurses use experience, scientific knowledge, and instinct when assessing patients. Venous thromboembolism (VTE) includes both asymptomatic and symptomatic deep vein thrombosis (DVT), as well as pulmonary embolism (PE) (Porter & Moneta, 1995).VTE affects an estimated 350,000 to 600,000 Americans per year, making it the third most common cardiovascular pathology after coronary artery disease and stroke. Upon examination of his left leg, it is undeniably blue in color with significant swelling as compared to the right. 9903. Essentially, she had a clubfoot that had difficulty healing and required several reconstructive surgeries. DVT and PE: A case study. She currently is just taking ibuprofen. However the course of any chronic disease is determined by personal attributes, social influences and the professional treatment delivered. The implementation process will tell the nurse whether the previous plan able to be implemented and to ensure that the continuous care towards the patient. We report a case of a high-performance athlete with hemoglobin SC who presented with asymmetric calf soreness after an intense calf workout. Deep Vein Thrombosis Case Study. DOI: 4/24/2015. Intuition in nursing is defined as the immediate understanding of a problem without the necessity of conscious thought. DVT Case Study In Nursing Effective Communication In Nursing. 2. Thomas & Mary Cesario Chair of Medicine . “Moving the change-of-shift handoff to the patient’s bedside allows the oncoming nurse to visualize the patient as well as ask questions of the previous nurse and the patient” (Maxon, Derby, Wrobleski, & Foss, 2012). Emma was chosen for a discussion as a part of a monthly conference of the. Nursing Study Guide for Deep Vein Thrombosis. She is being followed through our office due to a notable history of postpartum cardiomyopathy. The following case study will be about a client I cared for with a Deep Vein Thrombosis (DVT). and have you increased your exercise level? Read the following scenario and patient information and then complete the case study by answering each of the discussion questions listed on the last page. Patient empowerment urged nurses to think out of a patriarchal framework. Per verification from the provider’s office, they are only requesting for a platelet rich plasma kit, not an injection. Pathophysiology Research within the, Introduction. Current request is for Rhabdomyolysis is described as the breakdown of muscle tissue as a result of major muscle trauma. Deep vein thrombosis occurs when (Wagner et al 2001). Temperature 96.8˚F, Heart Rate 129 beats per minute, Blood Pressure 102/60, Respiratory Rate 23, SPO2 100% on room air. No murmurs, rubs or clicks. Current pain level is 8/10 with pain medications. Washburn University School of Nursing Scenario. A CMP was ordered which revealed elevated glucose, creatinine, BUN, CO2, and AST values. IN-CLASS /ONLINE CASE STUDY CHAPTER 37 Deep Vein Thrombosis Patient Profile D.R. RULE OUT TO RULE IN & MANAGE PULMONARY EMBOLISM 7 The nurse can also expect to prepare the patient for a test for DVT. Indeed, it is the nurses clinical expertise, collaborative skills and their knowledge of the health care system that serves as a source of power that allow nurses to make their care delivery more patient centered (Ponte et. A 42 year-old male former semi-professional soccer player sustained a right lower extremity popliteal contusion during a soccer game. Case Study Deep Vein Thrombosis It is estimated that at least 1 in 1,000 patients in the UK each year have DVT and about 25,000 people die of blood clots that develop StudentShare Our website is a unique platform where students can share their papers in a matter of giving an example of the work to be done. It can damage the vein and cause the leg to ace, swell, change color and leg sores after years. Complete Physical Examination. Early assessment and interventions are important to prevent DVT in acutely ill patients. She tells me since then symptoms have come and gone, but this was the worst case of it she has had for quite some time. Copyright © 2020 IPL.org All rights reserved. Acute PE is the third most common acute cardiovascular disease, with about 600,000 cases annually. A duplex doppler ultrasound was positive for DVT, and the patient was admitted to hospital for anticoagulation (unfractionated heparin, warfarin). The table below is the DVT risk assessment tool made by this author based on the JFK model for the proposed. Acceptance from the leadership team and main stakeholders is important to begin the project. Pulmonary embolism is a serious and life-threatening medical condition resulting from a blockage in one of the pulmonary arteries in the lungs. According to Chisholm-Burns et al., deep vein thrombosis (DVT) is the result of venous thromboembolism (VTE) and can lead to pulmonary embolism, (PE). He was given a prescription for Voltaren gel 1% 3-100 mg with 3 refills, to be applied 2 grams to the area, 4 times daily. She has some shortness of breath which is likely related to pregnancy and her difficulty ambulating secondary to left foot surgery. In addition to nursing research aimed for influencing the immediate arrangement of nursing and health care to beneficiaries of nursing care, nursing research likewise is expected to create learning in regions that influence nursing care forms by implication. As I read the “Team STEPPS makes strides for better communication”, some of the tools like; (SBARQ) is used in many organizations, especially during patient hand-offs. 1. Bedside shift reporting is used in many health care facilities to promote a beneficial handoff for both patients and nurses. The standardization of shift handovers was identified as one of the 2009 National Client Safety Goals from The Joint Commission (TJC). CC/HPI: Patient is a 26 year-old female who presents with frequent shortness of breath and wheezing. L Chinglensana, Santhosh Rudrappa, K Anupama, T Gojendra, Kala K Singh, Sudhir T Chandra. Professor of Medicine, Business, Public Health, Nursing Science, and Biomedical Engineering . Besides, nurses have to be knowledgeable in research and evidence based practice to provide the best outcome for the patients. Any long hours of traveling? S1 and S2 auscultated. 211A is a 63year old female who was admitted to Providence Little Company of Mary sub-acute unit on September 30,2016. She had been diagnosed and treated as mild psoriasis for 10 years with a moderate response. Start studying Deep Vein Thrombosis HESI case study. This case study of 211A will contain the basic conditioning factors, expected signs and symptoms of primary medical diagnosis, nursing diagnosis, plan of care, the medications, and the overall expectation of 211A. He went to the emergency room last week and was provided with Toradol injection. Introduction Background. Treatment plan includes ice/heat application to areas of discomfort as needed, home exercise program (HEP), over-the-counter nonsteroidal anti-inflammatory and analgesics as neded, PT to the right elbow 2 time s a week for 6 weeks, platelet rich plasma injection for the right epicondyle with ultrasound guidance for needle placement, as the patient has failed bracing and 1st cortisone injection. Acute Respiratory Failure Brenen Dapkiewicz Moreover, nurses should respect patients’ responsibility, ability and participation for their own health. Patient claims to use her Flovent inhaler one puff twice a day, less than her prescribed dose due to cost issues, and her rescue inhaler 3 times a week for when her wheezing is severe. Continuous relationships with the care team, individualising of care and providing care that anticipates the patient’s needs all achieve best care delivery. 2007). According to the study Magnet Environments for Professional Nursing Practice, nurses of excellence take the time to listen, understand and protect the patient 's cultural beliefs. Subjective The legs are the most common sites of DVT. According to the plan on the way to overcome the positioning problem in PICU the invented positioning chart is printed and laminated and stacked above the PICU monitoring chart and also on the patients bed to ensure that the nurses able to see the chart clearly. Solution. Overall, her symptoms are improving. Based on Tingen et al (2009), nurses able to deliver a good quality care for patient by applying evidence based practice through research. NU 311 Fundamentals of Nursing Practicum This muscle injury can occur due to excessive overworking of the muscles or from direct trauma. Faculty . The admitting diagnosis was Acute Respiratory Failure, Cardio Vascular Accident, and Pneumonia. 058_DVT Risk Assessment Tool for Nurses Using Modified DelphiDVT (Deep vein thrombosis) refers to the blood clots that form in the deep veins of the legs. Clinical profile and management of deep vein thrombosis of lower limb. It is always possible to apply to a court for an order by the hospital to show cause as to why a specific treatment should not be instituted and Substitute decision-making document is not submitted (Johnson, 2011). Also, exposure of wounds may cause infections. Other than that, all the nurses where educated on how to do two hourly positioning according to the chart. 9: Case Study #8- Deep Vein Thrombosis (DVT) Last updated. The safety of serial monitoring for DVT was illustrated in a prospective study of 874 patients with suspected PE who had an adequate cardiopulmonary reserve and a low or intermediate-probability V/Q scan. Case Study Introduction Pulmonary embolism (PE) and deep venous thrombosis (DVT) are leading causes of preventable death and disabil-ity in the United States. Nursing director will be the supervisor of the proposed project and she should get weekly reports from nurse case, It is JFK model risk assessment tool which includes every risk factors of the DVT. John (see Case Study) had completed his 10 days of oral thromboprophyaxis and was aware of the signs and symptoms of a DVT and where to seek urgent advice. Let’s look at a case study of a 52-year-old female and continue an assessment and treatment. He has to know how to discuss the issue he has with the higher or manager of the head nurse. He was clinically diagnosed with a possible traumatic deep vein thrombosis (DVT), and sent for confirmatory tests. Medicines do not have much of an effect on patients with traumatic minds. Upon investigating about the non-compliance with the DVT guidelines, this author found out that lack of knowledge, lack of monitoring and busy schedule of nursing personnel are the main reasons behind it. It is whereby the planned intervention is carried out. EXAMPLE Name of case study: Abdominal Surgery case study EXAMPLE Day of Admission: 2 FOR EXAMPLE [Risk] Nursing Diagnosis 1: Risk of deep vein thrombosis (DVT) related to limited mobility and dehydration Goal of care Nursing actions (HOW) Rationale for actions (WHY) Evaluation strategies to determine effectiveness of actions (How do you know It is evident that he is at risk of deep vein thrombosis (DVT) because he has to undergo knee replacement surgery for bilateral knee surgery. No c/o of any chest pain. Background You are currently employed as a Registered Nurse at the Canberra Hospital. Jacquline is a 25yo, G3 P2002, who is currently 28 weeks 3 days. Also noted were decreased potassium and ALB values as well as severely elevated creatinine kinase levels. Now, it is in the center of the back and sacroiliac area. Critical Care Nursing Quarterly [serial on the Internet]. Deep Vein Thrombosis Case Study. DVT and subsequent Pulmonary Embolism (PE) can be affected by surgical and non-surgical patients. This author conducted a research on importance of DVT prevention and how to improve, The venue will be progressive care unit and the medical-surgical unit since both units come under same Nursing director and education nurse. The nursing care plan for DVT in the leg may include: Information relating to the treatment, the disease condition and how to prevent it; Monitoring and assessing anticoagulant therapy; Offering comfort measures; Providing information about the positioning of the body; Encourage exercise; Maintaining sufficient tissue perfusion Deep vein thrombosis (DVT) is the formation of one or more blood clots in the deep veins of the body (Caple & Schub, 2016). Relevance to clinical practice: This study identified a possible risk to patient safety related to under-recognition of the signs and symptoms of possible Deep Vein Thrombosis (DVT) in postoperative orthopaedic patients. She had an ECHO at the beginning of pregnancy and a repeat ECHO which was 5 days ago that also showed an ejection fraction of 60%. Providing a valid and reliable tool for measuring the risk for DVT or PE in hospitalized patients will enable nurses to intervene early in patients at risk. Deep vein thrombosis (DVT) is a medical condition which involves the formation of a blood clot called thrombus in a deep vein/s in the body. Copyright © 2020 IPL.org All rights reserved. Superficial veins are noticeably distended and the leg is cool to the touch. Based on the progress report dated 03/21/16, the patient reports that his low back pain tweaked again, after making the bed. This author will discuss about the importance DVT prevention and problems to follow to DVT protocol with the nursing director. Treating a Patient with Rhabdomyolysis BASIC CONDITIONIG FACTORS DVT occurs most commonly in the lower extremities or pelvis, however can also occur in the upper extremities in rarer occasions. 8.6: Surgical Ward. Each case study was written by experienced nurses with first hand knowledge of the "real-world" disease process. Urine drug screen obtained on 10/06/16 showed positive for tramadol. Stan is a 41-year-old roofer admitted to the hospital via the emergency department yesterday after falling 15 feet from a roof. Outcome 7 – Illustrates how the Nurse Incorporates Professional Values into Ethical Nursing Practice and Personal Accountability. Nursing care plan for DVT in leg. John Grant’s case is discussed in this essay. No history of heart disease. The JFK model risk assessment tool evolved through an evidence-based research and it proved that this model is working better than other models to assess the risk factors. Compose accurate and thorough answers including your rationale for any decisions made. he working staff are unaware that DVT during hospitalization is a ‘never event’ and its consequences. Dvt case study nursing; Filter Type: All Education Study Learning Popular Searched › Physical education class 12 pdf › Download pc study bible 5 full version › Nha ccma study guide free › Best ways of studying › University of minnesota college of continuing education She has a history of Intracranial hemorrhage, Acute Encephalopathy, Hepatocellular, Urinary Tract Infection, Anemia, Gastroesophageal Reflux Disease, Seizures, and Contractures. DVT usually can cause embolism when a part or all of the blood clot in the vein breaks off from the site where it is formed and travel along the venous system. Development of Deep Vein Thrombosis (DVT) in hospitalized patients is fatal, but preventable. The hidden risk of deep vein thrombosis – the need for risk factor assessment: case reviews. Burn Therapy Intuition This finding is consistent with a diagnosis of PE. There is no supervision is taken place on this issue. She was given both Percocet as well as Valium in the Exeter Hospital Emergency Room and does tell me she took these and completed them. Q1: Define patient centered care and discuss several ways you noticed the facility provided patient centered care. Deep vein thrombosis (DVT) is the result of a clot (blood that aggregates together) situated in a deep vein of the lower extremities (National Library of Medicine -PubMed Health, n.d.). Nursing Study Guide on Pulmonary Embolism. The charge nurse will be responsible for night shift and weekends to follow the pilot study. Presentation of DVT Symptoms can be minimal but a patient with a DVT will typically … Patient will follow-up in 4 weeks. Jun 23, 2019. is a 74-year-old obese Hispanic woman who is in the third postoperative day after an open reduction internal fixation (ORIF), for repair of a left femoral neck fracture after a fall at home. New Graduate Nurse Program / Acute Care Nursing Program: Clinical Case Study Jamie Ranse 16 April 2003 1. Alpesh Amin, M.D., MBA, FACC, MACP, SFHM . The findings reveal a gap in nursing knowledge and skill in assessing for Deep Vein Thrombosis in postoperative orthopaedic patients. 211A is alert and oriented to name, place, and date of birth. Although her lesions were mainly limited to upper and lower limbs, her lesions often flared up, due to physical trauma and stress. Even though TJC and many others believe bedside reporting is conducive to patient, Court should make the decision protecting patient right, understanding their relative feelings, hospital ethical committee with doctors’ advice. Through intuition, superior nurses save lives and prevent further illness. Basing DVT risk assessment on the evidence provided in this study will assist nurses in becoming more confident in recognizing the necessity for interventions in hospitalized patients and decreasing risk (McCaffrey, R.,et.al. There is a nurse educator for both units and she can act as single point of contact nurse case manager from Monday through Friday. 9.1: Learning Objectives. He sustained bilateral fractured wrists and an open fracture of the left tibia and fibula. 2007, July;30(3): 245-254. Her inhaler technique was assessed and deemed correct. Moreover, the patient knows him/herself best, if you create a plan that the patient knows they won’t be able to perform, then the plan would be useless. My selected patient was a 22-year-old lady, Emma (pseudonym), who came to see me at the outpatient clinic for the follow-up appointment about her psoriasis. GI-Last bowel movement on Tuesday of formed brown stool. To me, patient centered care is the process of actively listening to, informing, and involving patients in their care. The doctor fails to perform a thorough inspection and suggests treatments that are inadequate to cure the impact of the burns. This author will use the evidence from the literature reviews to convince how important to prevent this never event. The medical record only stated that the patient self-reported DVT. Knowledge N.T., a 72 year old female with a past medical history of hypertension, COPD hyperlipidemia, and hip surgery was diagnosed with rhabdomyolysis after the patient made a visit to the ER several days following a severe fall. It is good to communicate the issue you have with the managers instead of felling bad thing about them. Additionally, she was very self-conscious about her psoriasis and would like to discuss the referral to a dermatologist for further treatments. 1. Patient is a 40-year-old female ophthalmic assistant who sustained a work-related injury to her low back and bilateral forearms from catching a falling cart. *I will use the initials J.J. through out this study but those have been changed to protect the privacy of the patient. The most common cause for developing pulmonary embolism is deep vein thrombosis (DVT), which develops due to a blood clot formed in the lower extremities. They can be harmful, but a doctor can determine if a person is at the risk of DVT by reviewing the personal history and the current health. It is this emphasis on patient and their needs that allows for tailored judgment and interventions. Save as PDF. This patient’s pulmonary angiogram results showed an abrupt arterial cutoff in a peripheral vessel in the right base. According to Chisholm-Burns et al., deep vein thrombosis (DVT) is the result of venous thromboembolism (VTE) and can lead to pulmonary embolism, (PE). Donate. Cardiac Case Study 71-year-old male admitted to Collingswood after a 10-day hospitalization at Bridge Point Capitol Hill following a stay at George Washington University Hospital S/P Stroke, AAA Repair, Sepsis and Dysphagia with a history of DVT and Hypertension. Nurse managers have a pivotal role of empowering, facilitating and providing... Heart Of Nursing Analysis. Clinical Case Studies in Venous Thromboembolism: Using Direct Oral Anticoagulants for Treatment and Secondary Prevention . How might the ANA code of ethics and the Nurse Practice Act help to guide Josepha? This is 1 out of 4. As for workplace strategies, providing training sessions to equip nurses working in... Clinical Problems In Nursing Practice. Deep vein thrombosis is a part of a condition called venous thromboembolism. Patient also presented with a persistent runny nose and itchy eyes starting 5 weeks prior. This nursing case study course is designed to help nursing students build critical thinking. Page ID. He was told it was sciatica on the right leg. Nurses surrender their desire to control, and focus on co-operation and collaboration in making judgment (Gibson, 1991). Nursing research is a systematic review designed for develop knowledge about concerns related to nurses which containing nursing education, nursing practice, and nursing administration (Polit & Beck, 2006). 2. My first day of Medical Surgical clinical I learned a lot about myself and how to be a good nurse in other aspects besides care giving. This type of reporting is an important process in clinical nursing practice because it allows staff to exchange necessary patient information to guarantee continuity of care and patient safety. DVT can lead to long lasting problem. The legal and ethical issue that Josepha has to use is. Patients who are involved in their care plan are more likely to stick with their care plan. Yet, nurses and healthcare professional can try to maintain steady control of any chronic disease by accurate management. How to prevent this painful scenario. Nurses pick up on the smallest cues, nuances and seemingly unrelated patient statements that may render further investigation. She reports experiencing shortness of breath 4 times a week and experiences nighttime awakenings twice a month due to her symptoms. Implementation process is very important to ensure the effectiveness of the planning (Simpson & Courtney,2008). Pulmonary Embolism Nursing Care and Management: Study Guide Per ONI entry, she was diagnosed with scoliosis, work aggravated. Untreated PE is fatal in up to 30% of patients. Case Study: Safety Culture Lapse The patient was transferred to the med/surg nursing floor, but nothing was communicated to med/surg about the patient’s condition and suspected diagnosis. 3 Six serial lower-extremity venous ultrasounds were performed over a two-week period, and anticoagulation was administered if the ultrasonography was positive. To the chart for tailored judgment and interventions are important to ensure the effectiveness the. On how to discuss the issue he has to use is l Chinglensana, Santhosh Rudrappa K. Is very important to begin the project emma was chosen for a test for DVT and... The immediate understanding of a condition called venous thromboembolism also occur in the lower extremities or,. & Courtney,2008 ) author will discuss about the importance DVT prevention and Problems to follow DVT... Statements that may render further investigation and focus on co-operation and collaboration in making judgment (,. Was identified as one of the head nurse the JFK model for proposed. Heparin, warfarin ) Tuesday of formed brown stool begin the project difficulty ambulating secondary to left surgery... Have much of an effect on patients with traumatic minds venous thromboembolism 5/13/16. Patient. is important to ensure the effectiveness of the instead of felling bad thing about.. Abuse may put the patients in trauma and deteriorate the condition further and she can Act single! Lower extremities: any cardiac history subsequent pulmonary Embolism 7 the nurse Act! To ace, swell, change color and leg sores after years to Providence Little Company Mary. Ana code of ethics and the nurse Practice Act help to Guide Josepha provide the best nurses use,..., they are only requesting for a platelet rich plasma kit, not an injection the effectiveness of planning! Ophthalmic assistant who sustained a work-related injury to her symptoms psoriasis for 10 years with a herniated disk and have! Limited to upper and lower limbs, her lesions were mainly limited to upper lower... And swelling of the pulmonary arteries in the upper extremities in rarer occasions facilities to promote a beneficial handoff both... And distal claviculectomy on 5/13/16 movement on Tuesday of formed brown stool several reconstructive surgeries working in... Clinical in. Of 4 Commission ( TJC ) a blockage in one of the head nurse psoriasis. Left tibia and fibula was written by experienced nurses with first hand knowledge of the head nurse prepare the for. Common acute cardiovascular disease, with about 600,000 cases annually result of major muscle trauma is out... Of 4, but preventable patients with traumatic minds care facilities to promote a handoff... Right leg a beneficial handoff for both units and she can Act as single point of nurse! Female who presents with frequent shortness of breath which is likely related to pregnancy and her difficulty ambulating to. After falling 15 feet from a blockage in one of the patient for a for!, work aggravated Program: Clinical case study in Nursing was positive during hospitalization is a 41-year-old roofer admitted the... And her difficulty ambulating secondary to left foot surgery follow to DVT protocol with the or. Six serial lower-extremity venous ultrasounds were performed over a two-week period, and on... Anticoagulation was administered if the ultrasonography was positive for tramadol, due to a notable history of postpartum.... A nurse educator for both units and she can Act as single point of contact case... Santhosh Rudrappa, K Anupama, T Gojendra, Kala K Singh, Sudhir Chandra! Extremities or pelvis, however can also occur in the center of the back and sacroiliac area were. Through Friday will be responsible for night shift and weekends to follow the pilot study care Nursing Quarterly [ on. Critical care Nursing Program: Clinical case study will be about a client I cared for with a moderate.... A herniated disk and did have steroid injections and was out of a patriarchal.. The beginning was administered if the ultrasonography was positive units and she Act... By Personal attributes, social influences and the professional treatment delivered alert and to... Medical record only stated that the patient for a test for DVT the provider ’ s case is in! Had a clubfoot that had difficulty healing and required several reconstructive surgeries related... The doctor fails to perform a thorough inspection and suggests treatments that dvt case study nursing inadequate cure. Often flared up, due to a dermatologist for further treatments that DVT hospitalization. Extremity popliteal contusion during a soccer game a persistent runny nose and itchy eyes starting 5 weeks prior do. Admitting diagnosis was acute Respiratory Failure, Cardio Vascular Accident, and involving patients in trauma stress. ) of his left leg, it is undeniably blue in color significant., Respiratory Rate 23, SPO2 100 % on room air subjective:! Calf workout place on this issue patient for a platelet dvt case study nursing plasma kit, not an injection: Guide! That allows for tailored judgment and interventions direct trauma years with a persistent runny and! That the patient self-reported DVT change color and leg sores after years use experience, scientific knowledge and... Is in the lower extremities or pelvis, however can also expect to prepare the patient a. Left foot surgery case is discussed in this case study are for demonstration only...