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Nevember 27 - December 3

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1Nevember 27 - December 3 Empty Nevember 27 - December 3 on Mon Dec 05, 2011 3:57 pm


Communication used today?
My pt today was initially talkative providing information about herself. As the morning wore on and she was encouraged to move more and to ambulate she started complaining of some pain with nausea. The primary nurse provided her with Zofran and when a follow up was made with the pt to see if the medication had worked she was complaining of more nausea, curled in a fetal position and not saying a lot. I was able to restate and seek clarification with her as to her symptoms. Offering self and providing touch and comfort with a warm blanket. I was not sure what to say other than clarify if there was anything that I could get for her, if there was pain associated with the nausea, and being there to offer comfort and support.
Experience with pt unkind comments, how did I handle?
This semester I found one pt that was not necessarily unkind but did not have a lot to say, would only answer what was directly asked and then would want to roll over and close his eyes. After the doctor had spoke with him about his discharge and what he would need to do to follow up with the office I attempted to provide support and assistance with the discharge process only to be met with him closing his eyes and going back to sleep. At that point I left the room, followed up with the nurse as to any discharge steps that I could help with, and provided him with time before everything was ready for him to leave. I think sometimes I allow myself to listen to comments that the nurses make about pt’s that have either been there for a while or have just not been friendly during the current visit. This is not always good because you could be making decisions based off wrong information or not follow up on signs and symptoms that may be occurring just thinking they are trying to be difficult.
In a newborn assess whether he has passed meconium stool within 24 to 48 hours, refusal to eat, episodes of vomiting bile, and abdominal distention
Interventions Rationales
I:Position child on the side or with head elevated
R: To prevent aspiration
I:Monitor Fluids and electrolyte balance
R:Assess for deficits
I:Provide oral care after the child vomits
R:to prevent damage to teeth from hydrochloric acid contact
Preop Surgical Management
Prepare the child and family for the surgical or therapeutic procedure
Maintain good hydration by administering electrolytes and fluid replacement
Assess bowel function and characteristics of stoll, measure abdominal circumference, monitor for vomiting and respiratory distress
Postop Surigical Management
Institute incremental feedings beginning with clear liquids
Assess readiness to advance diet back to breast milk or formula
Position infants with head slightly elevated to prevent reflux

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