Case Studies , Chapter 1 - Chapter 19

Case Study, Chapter 1, Health Care Delivery and Evidence-Based Nursing Practice 1. Suzanne Jones, a 76-year-old patient with COPD is admitted to the ICU. Mrs. Jones is placed on mechanical ventilation to assist with her breathing. After 2 days on the ventilator, Mrs. Jones is extubated and then transferred to a medical-surgical unit. The medication regimen is adjusted during the hospitalization. Mrs. Jones is discharged home after 6 days. She and her family are pleased with the care she receives in the hospital. (Learning Objectives 3 and 6) a. Describe the quality performance tools that may be used to demonstrate that the care and treatment rendered are both cost-efficient and of high quality. ANSWER: As a long course of chronic disease, COPD is characterized by remissions as well as repeated exacerbations (Foster et al., 2007). This disease in most cases leads to the deterioration of one's health if not well cared for and monitored. There is a broad range of quality performance tools that may be employed with the aim of demonstrating the treatment and care that is rendered is both affordable and of high quality. These include the number of nurses, bed capacity of a hospital, and health insurance. Additionally, section machine, mechanical ventilation, and utilized symptom measurement tool play an important role. b. Describe the quality performance tools that may be used to demonstrate that the nursing care utilized is evidence-based care and high quality, resulting in patient satisfaction and good patient outcomes. ANSWER: A broad range of performance tools that are employed to demonstrate that the nursing care used is evidence based include high-quality care and evidence-based care ranging from the treatment teams placing much emphasis on resources on symptom control and energies contributed to the effectiveness of her well-being. Patient assessment skills can as well play a critical role. Ventilations are of vital importance since they assist in improving breathing. The patient needs to be suctioned in case of increased secretions with the aim of maintaining patient way, including reducing the risk for SOB (Bloodworth et al., 2018). Additionally, the effective medication regime adjusted in the course of hospitalization led to good patient outcomes and patient satisfaction. Case Study, Chapter 2, Community-Based Nursing Practice 1. Mr. Jones, who is 74 years of age, is being discharged home after having a right knee replacement. The discharge orders from the orthopedic surgeon include continuous passive motion (CPM) at the current setting of 0-degrees extension worn when walking with crutches (no weight-bearing post discharge day 1, and may begin weight-bearing post discharge day 2); and home nurse visits, as needed. Physical therapy should begin the day after discharge at an orthopedic center. The orders will be faxed to the center. The following medications with prescriptions attached include Lovenox (enoxaparin) 70 mg subcutaneously once daily for 7 days, Vicodin (hydrocodone bitartrate) 10 mg every 4 hours PRN, and Colace (docusate sodium) 100 mg every day. The patient is to follow up with the orthopedic surgeon in 3 weeks. His daughter plans to stay with him for several weeks to assist him with meals and household chores, and take him to physical therapy and the orthopedic surgeon for follow-up. Mr. Jones has three other children who live in other states. He is a widower and attends a local church. (Learning Objective 4) a. What preparations should the nurse make in advance before attaining necessary community resources and referrals before the patient is discharged? 1. There is a broad range of preparations needed by the nurse in advance prior to achieving necessary referrals and community resources before discharging a patient (Graham et al., 2015). These preparations encompass environment and support system, limitations and assessing strength. Identifying patient’s needs, assessing the effectiveness of care, as well as developing plan to meet them. b. What necessary communit