Posted at 11.28.2018
Cerebrovascular damages (CVA) are brought on by hypertension mainly and subsequently it causes many issues making controlling the CVA patients particularly difficult. In this article, I'll cover my reflective accounts on the individual and justify the actions that I took.
The Patient and the Events that Occurred
Mr. Nelson, a 66 year old male, had been experiencing hypertension for six years. He's hitched with two children and his partner is at geriatrics ward suffering from diabetes mellitus. The symptoms of the disease had been observed fourteen days prior when he previously had expressive aphasia. He had had sudden onset of head pain two days before. On entrance at the hospital, Mr. Nelson lost engine co-ordination or feeling on the right area of the trunk and limbs. These features suggested a CVA. Diagnostic assessments have been done including a Carotid ultrasound, an echocardiogram, Electroencephalogram, CT check of the head, and blood works for clotting disorders.
On my placement, I was supposed to ensure that the individual is adequately taken care of so I got into the area to see how he was doing. The patient looked distressed and irritated. I unveiled myself. The patient experienced difficulty in speaking. The patient complained to be neglected and being limited in the same place for a long period.
Before I possibly could discuss more to the individual, I assessed his blood pressure. Measuring blood pressure in patients with CVA is essential and really should be the essential thing to be achieved. The patient had been managed for blood circulation pressure and on this day it was somewhat increased (190/115 mmHg). I gave the individual Labetolol IV 20mg over 2 minutes so that I possibly could lower his blood pressure in prep for tPA supervision. (Allen, Ruggiero & Troutman, n. d. ).
Since the patent cannot speak clearly, I called the nurse that were participating in to him, Allison and mutually we experienced his history to learn if he had possessed any recent surgery in the previous 2 weeks, any record of ICH, seizures, record of active interior bleeding, thrombocytopenia heparin supervision in 48 hour or lumbar puncture. These factors are contraindicated in tissues plasminogen activator (tPA) administration as they may lead to serious bleeding. (Allen, et al. n. d. ). We affirmed that they were all negative. Knowing the patients specific and early on acknowledgement of change is important in patient care. It is important to learn the style of the changes and relevant history of a patient to provide proper care that is well-timed and more effective. (Tube, Buchda, Hansen & Martyn, 2005).
Having reduced his blood pressure and ensuring that the patient had no contraindications to tPA administration, I validated that the individual had signed the consent to be administered with the medication. I then did the necessary computations to get the correct dosage relating t the patient's weight, dual checked for the right medication dosage. (Allen, et al. n. d. ).
I used Carper's ways of knowing whenever i was participating in to the patient. In the activities that I have stated, I used the empirical knowledge where I discovered directly or indirectly to apply evidence based nursing practice by using variables and measures which have been scientifically proven to work. It is also the Knowledge that has requirements that may be replicated by various observers. I used the ethics knowledge when I was making the various decisions in his management. I made the decisions that were morally right and valuable to support the individual. I also ensured that the individual had agreed upon the consent before administering tPA. (McKenna, Cutliffe & McKenna, 19 99).
While joining to the individual, I got also talking about some issues with him. I told him that I am aware what he was going right through since my dad acquired the same problem whenever i was young. My dad had passed away 6 moths later after he was diagnosed with CVA. I informed him I know the pain that there surely is to be unwell to the patient and the people around him. He then asked me if he was also going to die but I told him that the disease is not serious as it appears like. I informed him that I've also seen many patients as I am learning who overcame the disease and went to further their professions and join their families. By doing this, I used personal knowledge to deal with the individual. Personal knowledge entails treating the patients in a subjective manner where in fact the nurses notice themselves which constitutes utilizing their own past activities and good relations to the people around them. (McKenna et al. 1999).
Though I had been talking to the patient, he was frightened, irritated and I could note that he was crying since nobody had come to go to him. I asked him who he really wanted to visit him and I wanted to call him, and also discussed that his wife was ill so she cannot deal with. From these observations, I could note that the situation had not been managed well and which may be more was required.
The patient was used in the men geriatrics ward because of his problems. This was in an effort to reduce the boredom that the patient had for staying in one place for long. Patients can be transferred when essential to improve their health issues by providing mental health support. The individual may be used in the ward where necessary tools were to assist in management. (Phan, n. d. ).
Feelings about the Patient
Looking at the distressed patient, who definitely has more to state but can't due to aphasia, could not move one part of his body and whose CNS was at great risk, I really was merciful despite my training, and the actual fact that this reminded me of my dad made me unfortunate. But I tried all I possibly could to be empathetic so that I possibly could offer quality care. The nurse Allison who had been attending to the patient will need to have been merciful to because when she was going she explained to take good care of him and also to be careful and I possibly could see from her face that she was miserable too. The patient's wife too will need to have been distressed and irritated since she was also sick and tired and could not be there to aid her hubby.
Areas Enhanced by the Representation on the Patient
Reflection of the individual has increased my use of Carper's ways of knowing to comprehend the patient and hence provide more quality care and attention. It has trained me more about CVA, its problems and triggers and the correct course of action in its management and this of related conditions.
I need further development in rehearsing evidence based medical especially in being current with the new results in research. I also have to learn to understand the patient better so that even when he has communication problems so that I could manage similar situations better. I could do this by using the objectives which were arranged by the nursing evidence based practice seminar which includes growing skills and knowledge in critically appraised subject areas, recognizing the knowledge gaps, looking and evaluating nursing and health research books, using group discussions and I will create a culture to self-perpetuate my personal in training seminars. (Tube et al. 2005).
Evaluating the Development
I can measure the what I learn when you are enthusiastic to see easily am handling the situations better, doing consultations, doing research and case studies to clean off any regions of incompetency.