3. Figure 1: MRI images of glioblastoma in a 69-year-old man before (A) and after (B) complete resection. It helped me pass my exam and the test questions are very similar to the practice quizzes on Study.com. mannitol q6 hours prn for elevated ICP as well as orders to keep the EVD at continuous drainage. Chamberlain . The pupillary changes are due to the subdural hematoma on the right side Chances are you can add-on the K and Mag test to the blood vial you sent earlier for the serum sodium. The patient is drooling from the right side of her mouth and coughs periodically. Patient-Centered Care, Safety, Teamwork and Collaboration, Learner Level(s) 1700: You give your mannitol, clear your pumps and spend the next hour catching up on charting. If you are looking to see the full variety of neurologic content, the AACN Clinical Resources for Neurology page is full of resources on different assessment, management, research and quality outcomes on neuro topics. and the NCS Podcast Series will provide the listener with an in-depth exploration of hot topics in neurocritical care. lessons in math, English, science, history, and more. A lack of English language skills will not be a barrier to admission and participation in the career and technical education programs of the District. edema. NUR463 Neuro Case study Filled in case study assignment University University of Rhode Island Course Advanced Medical-Surgical Nursing (NUR 463) Uploaded by RO Rebecca Order Academic year2017/2018 Helpful? Your hourlyneuroexam shows no changes as your EVD continues to drain drain drain. ACC is a quarterly journal that requires a subscription. The best idea is for you to explore what resources will be meaningful to your practice. An innovative final assignment that asks students to. episode 135 of the Straight A Nursing podcast. The team leading an AACN Clinical Scene Investigation (CSI) project improved day- and night-shift relationships and reduced falls on their neuro telemetry and neurosurgery unit by 40%. By Julie Miller, BSN, RN, CCRN-K With manual ventilation, Ricks sats come up to 98%, but he is still non-responsive. Your 0900 neuro exam goes off without a hitch. Always refer to your hospital's policies and . Case Study: Sean Head Injury. Pt is able to hold left arm up for 10 seconds with only slight drift notedimprovement! Your patient is a 28-year-old woman in the neuro (brain) ICU who was in a motor vehicle accident and sustained a head injury. As an academic medical center, we embrace a multidisciplinary, collaborative commitment to excellence in patient care and advanced professional practice. Looks like hes going to have a pretty impressive recovery. I bet many of you are like me searching for content to learn more so you can continue to take the very best care of your patients. Youre happy to see that the mannitol works quickly to reduce ICP and you make a mental note to keep an eye on urine output as you expect it to drastically increase due to the osmotic diuresis effect of this medication. Anatomically, what is the cause of his pupillary changes? You are caring for a 38-year-old woman in the surgical ICU who had surgery to remove the gallbladder two days ago. Are you a nurse in an ER, ICU or PCU who doesnt routinely care for patients with neurologic disorders? Because his heart rate and blood pressure are elevated, he needs medications to bring those down to normal levels. You know hes going to do awesome on his swallow eval, so you call Speech Therapy to see when they might be by. How about this one? This strategy allows graduate APRN students to practice principles of palliative communication for patients with chronic illness disease trajectory through an unfolding, two-scenario high fidelity simulation of the same patient.Continue reading, The think, pair, share learning activity allows students to identify appropriate vaccinations by utilizing high-quality sources of information, such as the Centers for Disease Control and Prevention (CDC) website. You start bagging the patient and ask your nurse friend to call RT and the MD. The elevated WBCs and fever tell us she has some type of infection. Pre-Licensure ADN/Diploma, Pre-Licensure BSN, Identify the need to activate the emergency response system in critical situations (PCC knowledge), Identify risk factors for an acute ischemic stroke (PCC knowledge), Evaluate and apply critical thinking to determine expected assessment, laboratory, and diagnostic findings for a patient with an acute ischemic stroke (PCC skills), Design a plan of care, including prioritizing nursing interventions, and modify as the scenario unfolds (PCC skills), Demonstrate effective therapeutic communication with the patient and family member while respecting the patients values and autonomy (PCC attitudes), Address and support the patient and caregivers emotional well-being (PCC attitudes), Compare and contrast the roles and responsibilities of the interdisciplinary team in emergent situations (T&C knowledge), Explain when to collaborate with the provider regarding patients care (T&C skills), Articulate risk factors and safety considerations for commonly prescribed thrombolytic medications for patients with acute ischemic stroke (safety knowledge), Identify safety concerns for the patient when they return home and design a plan of care to reduce safety risks to improve patient outcomes (safety skills). As a member, you'll also get unlimited access to over 88,000 This website helped me pass! Author: Crista Reaves, PhD, RN The material is presented by our medical experts in an easy-to-understand way for the learner. Why is the 3% saline ordered, and how will the nurse know if it is Once you have reviewed the case study, you can view the teacher comments. Create your account, 26 chapters | All other trademarks and copyrights are the property of their respective owners. Its a way of life. most likely pressing on the cranial nerve III, the oculomotor, which would Na 140; K 3.2; Mg 1.6; Ca 8.2; Ph 1.1; Cr .90; BUN 12, WBC 8.5; Hgb 9.5; Hct 37%; PLT 130; INR 1.2, A banana bag (an IV infusion of vitamins and thiamine that we give to ETOH patients), PO blood pressure meds (pending your swallow eval), Diabetic educator (based off his super high HbA1c), ETOH protocol (includes anti-anxiety meds and librium to help control DTs), BS coverage with an aggressive sliding scale. After two years in The Johns Hopkins Hospital Neurosciences Nursing Department, nurses are eligible to sit for the Certified Neurosciences Registered Nurse (CNRN) exam. All is well in Ricks world and he is performing components of the exam without even being asked. Hi, Im Nurse Mo and I love mentoring nursing students! unrestrained driver in a motor vehicle crash. Weve got problems. Perform a 12-lead electrocardiogram (ECG) to assess the heart and see if anything is out of the ordinary. No content on this website is intended to guide nursing practice and does not supersede any individual healthcare providers scope of practice or any nursing school curriculum. This video clip shows a comprehensive physical assessment c. is caused by destruction of the peripheral nerves after exposure to a viral infection. 5. Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. Your morning continues in this vein until 0900. http://www.med-ed.virginia.edu/courses/pom1/videos/HEENT.cfm, University of Virginia: neurological Exam The Johns Hopkins Hospital Department of Neurosciences Nursing provides a rich environment of learning and professional growth. Blood cultures need to be drawn to identify the microorganism causing the infection. Correct Answer: B. That new resident is on top of her game! You decide not to run anything concurrent with this potent calcium channel blocker and realize you need to start another PIV (those banana bags are not compatible with ANYTHING and you want to get the Mag going now). The Maricopa County Community College District (MCCCD) is an EEO/AA institution and an equal opportunity employer of protected veterans and individuals with disabilities. You update the medical team on Ricks condition and ask for the following: Just then, the speech therapist comes in to conduct an evaluation of Ricks ability to swallow. GCS? His heart rate and blood pressure are elevated. You spot Doc Waters and ask her to please review the x-ray for OGT placement so you can use it. 1315: CT scan shows Rick has now bled into his brain. Infection! Neurological. He received a one for being What were some of your strengths and weaknesses throughout the scenario? New nurse orientation includes: In orientation, you will also receive instruction on the technology you will encounter in daily practice, including: TheJohns Hopkins Hospital Neurosciences NursingFellowship is a six-month specialty nurse training program in Neurology and Neurological Surgery for our newly hired neurosciences nurses. AACN Clinical Resources for Neurology page. VSS on nicardipine gtt. To unlock this lesson you must be a Study.com Member. It is one of the known risks of TPA and you are crushed that it has happened to your patient, especially one so young and who was doing so well. Neurological patients have always been challenging and time saved is brain saved. The challenges this patient presented sparked my interest to learn more about patients with neurologic disorders. 15 the best possible outcome. Nursing Case Studies by and for Student Nurses by jaimehannans is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, . You can be proud of the work you did today. This program will provide you with both didactic and clinical skill-building opportunities. When You Start to Panic During an Exam: Episode 269, BONUS! You notice more frequent ectopy on the monitor and attribute it to his low K and Mag levels. Currently featuring 22 topics, Neurocritical Care ON CALL is applicable to physicians, pharmacists, APPs, nurses, and trainees. You had a busy day and you had to prioritizebut better do that now, just to be safe! http://www.wisc-online.com/objects/index_tj.asp?objid=OTA1104, Nervous system diseases and mental disorders The neurosurgeon orders prophylactic Ancef (after all, she just performed a neurosurgical procedure!) Theyll know if the treatment has been effective based on his vital Skip to content FacebookInstagramPinterestYoutube Menu Blog Clinicals Fundamentals Maternal-Newborn Med Surg Mental Health Pharmacology Pre-Nursing Pediatrics Tips and Advice Podcast 26. Her heart rate has dropped and her blood pressure is elevated. 0700: You head in to the room with the main goal of assessing Ricks neurological status and BP. Deep Dive into the New ATI TEAS Exam: Episode 262. hematoma with cingulate herniation from right to left, as well as right-sided Your heart sinks as you fear the worst has happened to your patient. Do you know what this indicates? This site offers a crossword puzzle for learning. Because youve recently reviewed the management of elevated ICP, you know that mannitol requires you to monitor your patients serum sodium and serum osmolality. The purpose of this assignment was to createContinue reading, Email & Social Media Marketing by VerticalResponse, Information About the Coronavirus (COVID-19), Violet and White Modern Sales Presentation, QSEN Institute Regional Center at Jacksonville University, Jane Barnsteiner & Joanne Disch QSEN Innovation Award, Home Health Nursing: A QSEN Approach With Resources, TeamSTEPPS Resources for QSEN from AHA Team Training, Just Culture Assessment Tool Nursing Education, Chasing Zero: Winning the War on Healthcare Harm, The Lewis Blackman Story Student Feedback, 2020 QSEN International Forum Postponed, Start-up for Healthcare Quality and Safety, 1ST ANNUAL SUMMIT ON LEADERSHIP AND QUALITY IMPROVEMENT, Nurse Leadership and Management: Foundations for Effective Administration, High-Fidelity Simulation to Teach the Role of the Advanced Practice Nurse in Palliative Communication, Just Call Me Amy: An Immersive Role Play to Discuss Appropriate Patient-Centered Care for Transgender Patients, Case Study: Focus on Teamwork/Collaboration, Quality Improvement, and Safety in Caring for a Newly-Diagnosed Schizophrenic Patient, Escape Game for Postpartum Hemorrhage for Nursing Education, Gertrude Smith: A Neuro Unfolding Role-Playing Case Study, Maintaining Quality and Safety During a Disaster, Unfolding Case Study to Teach Assessment and Care of the High-Risk Newborn. Expand your skills with Care of the Acutely Ill Pediatric Patient Respiratory Bundle. The healthcare provider should be notified immediately of these findings. She is complaining of abdominal pain and nausea. And yes it is240. QSEN-302-Case-Study-Neuro-Unfolding-Role-Playing-Case-Study-and-Evaluation.docx. What do you think is going on here? An error occurred trying to load this video. Caring for critically ill patients requires assessment, intervention, communication, and treatment. As a Magnet hospital, certification is recognized and rewarded. Unfortunately, with a head injury, there's not much room for swelling other than the opening at the base of the skull, the foramen magnum. His ICP is 24, when the normal is 5-15. This website uses cookies to ensure you get the best experience. classroom or clinical pre-/post-conference discussion), or work-place (i.e. 24 mm Hg, BP 130/67 mm Hg, mean arterial pressure (MAP) 88 mm Hg, First of all, it's important to complete an assessment. Its like a teacher waved a magic wand and did the work for me. uncal herniation. Imagine walking into the first day of class already understanding things like nursing diagnoses, care plans and dosage calculations. Download the MyInfo App on the App Store. Once youve explored, stop back and, in the following comment section, share the top three neuro items that you found to be the most helpful for improving patient care! 1800:Your hourlyneuroexam shows no changes as your EVD continues to drain drain drain. pressure (BP) was 158/72 mm Hg, heart rate (HR) 46 beats per minute, Though Rick didnt fare well, you did everything you could, followed protocol and kept the team updated. Institution: Michigan State University College of Nursing Deep Dive into the New ATI TEAS Exam: Episode 262, https://media.blubrry.com/straightanursing/ins.blubrry.com/straightanursing/Straight_A_Nursing-EP135_NERUO_CASE_STUDY.mp3, https://www.straightanursingstudent.com/neuro-case-study/, https://learn.straightanursingstudent.com/crucial-concepts. N-Case CE Bundle. When I had a patient who could have developed neurostorming, I wish this journal article was available.
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