Академический Документы
Профессиональный Документы
Культура Документы
Illness
Ruth Jacobi
Ruth is a 62-year-old woman who
was hospitalized after a mini-stroke.
She has now returned to her preevent level of functioning and is being
prepared for discharge. She states, I
know that I have an increased risk for
a major stroke, so I want to do
everything possible to stay as active
and as healthy as I possibly can.
Sara Gelbart
Sara, a college freshman, is
encouraged to visit the student
health center by her roommate
because she rarely visits the dining
hall for meals, runs 5 to 8 miles a
day, and has recently lost a
significant amount of weight. Sara
states, Im plenty healthy, just a bit
nuts about being fit!
Daniel Sternman
Daniel is a 27-year-old man with history
of schizophrenia. He comes to the
mental health clinic, loudly demanding
relief from the voices who are telling him
to hurt himself. Mr. Sternman is well
known by the clinic staff. His medical
record reveals that he has had
numerous visits to the clinic and that he
has difficulty interacting and dealing with
various staff members.
REFLECTIVE
PRACTICE
Challenge to Intellectual
Skills
My first college roommate, Sara
Gelbart, seemed the ideal roommate
when I first met her. A good student,
she was thoughtful, outgoing, and
fun. By October, However. I was
really worried about her. I noticed
that she rarely wanted to come to the
dining hall with our group of friends.
CHAPTER 21
COMMUNICATOR
Susie Musashi
Susie is a 3-year-old patient with
second-degree burns on both legs
who currently is receiving
debridement. Every time a healthcare
provider enters her room, she begin to
cry, turning her body toward the wall
and curling up with her knees to her
chest. Her family lives approximately 1
hours away and can only visit her
about once of twice a week.
Irwina Russellinski
Irwina, a 75-year-old woman
transferred from the emergency
department, is diagnosed with
pneumonia. Her chart reveals that
she is hard of hearing, pleasantly
confused at times, and speaks
broken English. A nursing
assessment is needed.
Randolph Gordon
Randolph, a middle-aged man
diagnosed with end-stage liver
failure, is being cared in the
intensive care unit. He has been
comatose for several weeks. He
has numerous tubes and drainage
devices in place and is receiving
multiple therapies that require
continuous electronic monitoring.
Reflective Practice
Challenge to Interpersonal
Skills
Recently, I was accompanying a
nurse in the intensive care unit (ICU)
when I encountered some behaviors
that I found to be unprofessional and
lacking in interpersonal skills. We
were caring for Mr. Randolph Gordon,
a middle-aged patient who was in
end-stage liver failure and had been
comatose for several weeks.
TEACHER AND
COUNSELOR
Rachel Blumenthal
Alicia Bonet
Alicia is the young mother of a baby
boy; the babys physician is
recommending that he start long-term
aspirin therapy. Ms. Bonet is quite
concerned about agreeing to longterm aspirin therapy and asks, Ive
heard so much about Reyes
syndrome and aspirin. What should I
do? What would you recommend?
REFLECTIVE
PRACTICE
Challenge to Intellectual
Skills
It was during my senior practicum in
pediatrics last spring that I met Alicia
Bonet, the young mother of a baby
boy for whom I was caring. The babys
physician was recommending longterm aspirin therapy (unfortunately, I
cannot remember what condition the
child had for which long-term aspirin
therapy was being recommend).
Rehema Kohls
Stephen Wall
Stephen, a 65-year-old widower who lives
alone , is admitted to the intensive care
unit after an automobile accident in which
he sustained trauma to the head, chest,
abdomen, and lower extremities. He is
being monitored continuously via
numerous invasive devices and requires
complex care. His closet family member,
a 40-year- old son, lives approximately 75
miles away.
Jack Camp
Jack, a middle age single man with a
history of diabetes mellitus, is receiving
care for a compound fracture of his left
lower extremity being treated with an
external fixator. Compliance with his
diabetic therapy regimen is
questionable; he states, I really love
sweets! The patient frequently voices
loud complaints about his room,
Challenge to Ethical
Skills
Kara Greenwood
Kara, a high school junior class
representative and peer counselor,
comes to the local community
health center for a routine
examination. During the interview,
she says, My guidance counselor
has asked me and few of my
friends to develop talk for
Bessie Washington
Bessie, a 77-year-old woman, was
recently discharged to her home after
suffering a cerebrovascular accident
(brain attack). She lives alone in a
small one-bedroom apartment and
uses a walker to ambulate. She says,
I have so much stuff crammed into this
small apartment! I almost feel this
morning going from my bedroom to the
kitchen.
Esther Bailey
Esther, a 72-year-old female patient
on the unit recovering from
abdominal surgery and receiving
antibiotic therapy for a wound
infection, requires insertion of an
indwelling urinary catheter due to the
development of post-operative
urinary retention and inability to void.
Giselle Turheis
Giselle, a 38-year-old woman
undergoing chemotherapy treatment
for leukemia states, I know that you
risk for infection is really high because
of my poor immune status. But how to
do I respond to my Sunday school
class, who are used to greeting me
with a big hug. I want to be safe, but I
know that I need these hugs too!