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Clinical post conference post for Nov. 22.

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1 Clinical post conference post for Nov. 22. on Tue Nov 22, 2011 6:12 pm

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If I ever have to deliver bad news to a patient I hope that I can be as straight forward as possible, but I also hope that I can be a source of encouragement to my patient. I think that sometimes we fear the unknown and once we know what we are dealing with we can start the process of healing. Healing may not be in the form of recovering, but it may just be coming to terms with a prognosis that we never wanted to hear. I like to think of it as making peace with what I am facing. Patients need encouragement in facing the end of life as well as having to adapt to a new way of living. I think as a nurse we need to remember that our patients want to be treated with dignity. Sometimes we need to realize that to try and protect someone might make them feel as though we perceive them as being weak. I think to establish rapport with our patients we should show genuine concern when dealing with our patients diagnosis. We need to put ourselves in the bed and think about how we would want to be treated.
Interventions and Rationales for Diabetic patients
I. Certain conditions place clients at higher risk for ineffective tissue perfusion (hypertension, atrial fibrillation, diabetes mellitus, abdominal surgery, cardio/thoracic surgery, trauma, hypovolemia, traumatic brain injury).
R. Diabetes triples a client’s stroke risk. Monitor for changes in metal status or behavior.
I. Decreased mental status is suggestion of decreased cerebral perfusion.
R. Assess skin color, moisture, texture, and turgor. Keep accurate ongoing documentation of changes.
I. The skin is the body’s first line of defense in protecting the body for infection.
R. Use sterile technique whenever there is loss of skin integrity.
An extensive literature search revealed that sterile gloves should be used for post-operative wound dressing changes.
I. Assess client-provider relationship.
R. Clients who report trusting their health care provider have higher immunization rates.
I. Support access to health care that enables clients to access well-preventive care on a walk-in basis during times that are consistent with client schedules.
R. Lack of transportation, geographical isolation and inconvenient clinic hours were identified as barriers to successful immunization among low-income rural families.
I. Teach client risk factors contributing to surgical wound infection (smoking, and higher body index.)
R. These are some of the factors associated with risk of surgical wound infection.
I. Note and report laboratory values (white blood cell count and differential, serum protein, serum albumin, and cultures).
R. The white blood cell count and the automated absolute neutrophil count are better diagnostic test for adults and most children.
3 Classifications of drugs that will potentially cause hyperglycemia
Corticosteriods Prednisone
Antineoplastic Busulfan
Antipsychotic Olanzapine

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