Nursing assesment and its role in care planning Essay

Nursing assesment and its role in care planning - Essay Example ing alarm/rescue, and frequency/pattern of falls; assessment include emergency care fundamentals such as airway, breathing, circulation, disability, and exposure; locomotor problems include physiological effects of aging; loss refers to reduced or loss of vision; and social circumstances include history of social circumstances, support network people, and type of housing or social contact (Jones, Endacott & Crouch 2003, p. 82). Applying the assessment tool, the nurse has gathered the following assessment data: Patient X fell on the ground at 5:00 pm. She has been lying still on the ground for 3 hours in her house until help is sought by a concerned neighbor. Assessment of fall history revealed a misplaced placemat on the floor as a hazard for the occurrence of fall. The patient only regained consciousness when she’s in the hospital and clearly recollects incident of fall and other previous experiences. Patient X has no method of raising alarm/rescue and there were no other fre quency/pattern of falls except for the current incident. Nursing assessment revealed a patent airway and a regular breathing pattern (20 breaths /minute). Circulatory perfusion is assessed using the neurovascular examination and found a 3 seconds toe capillary time which indicate that the circulation in the lower extremity are starting to be compromised (Brunner et al. 2009, p. 2100). Neurological assessment described Patient X as lethargic upon admission and GCS scores totaled to 12 because of lapses in verbal responses due to confusion and disorientation and withdrawal of motor responses when pain is experienced. A full physical assessment were done presenting fall impact on the lateral aspect of the hip, pain the groin with radiation to the knee, pain exacerbated by movement, and inability to... The paper tells that fractured neck of the femur is more common among older people and women and affected individuals are likely to experience significant distress, physical pain, complications, and possible incapacitation. The acronym FALLS served as assessment guidelines for older people who have fallen. FALLS stands for falls history, assessment, locomotor problems, loss, and social circumstances. The Hendrich II Fall Risk Model is used in assessing the degree of risk of falls among elderly population whereas the In Ottawa knee rules identifies the need for further investigation, imaging, or X-ray. The case scenario of Patient X identified nursing care needs in peripheral circulation, safe discharge, and independent rehabilitation. To improve tissue perfusion in peripheral areas, nurses need to: perform patient assessment and monitoring which includes ABCs, C-spine and hemorrhage control to aid the nurse in discovering overt/covert changes in patient’s status at frequent i ntervals; perform neurological exam such as Glasgow Coma Scale and note vital signs at frequent intervals to early recognize changes and to provide timely and appropriate care; and perform capillary refill checks and assessment of neurovascular function of the immobilized extremity to determine status of tissue perfusion. Discharge plans follow as tissue perfusion is resolved. An effective discharge plan follows the Department of Health’s key principles in discharge planning and is holistic, promote active and equal partnership, well-coordinated, and maximized to the full potential.

Psychoanalytic Literary Analysis of Rites of Passage Essay

Psychoanalytic Literary Analysis of Rites of Passage - Essay Example Rites of Passage is a poem written by Sharon Olds that can be effectively examined by this technique. On the surface, the poem speaks of six and seven year old boys attending the birthday party of the writer’s son. These boys are beginning to show many of the aspects of adult men. However, evaluating the text from a psychoanalytic standpoint shows underlying themes of hostility, problems letting go of the writer’s son and a lack of closure. One theme that emerges as part of Rites of Passage is hostility. Although the young boys are presented as innocent and simply growing up, the author appears to show a certain level of anger towards what these boys will become. The phrase â€Å"the dark cake, round and heavy as a turret† is one example of this. This cake is an interesting aspect of the poem, as it is mentioned only once, and does not seem fully relevant to the rest of the poem, which is focused on the boys themselves. The cake appears to be an item of war and o f hostility by the use of the term turret, as well as the dullness of its description. No information is given about what type of cake it is or any other aspects of its appearance, suggesting that this was not relevant to the writer. This concept of war is further developed later in the poem, with the description of the boys clearing their throats as generals would, and of them playing war. This theme suggests that the author is uncomfortable with the concept of her son growing up, in particular of the type of man that he might grow to become. One interpretation is that the writer has had negative experiences with violent men in her past and is afraid that one day her son will become one of these. A second theme that can be observed through a psychoanalytical approach to this poem is that the writer is having a difficult time letting go of her son. She spends a portion of the poem describing his physical appearance, including the freckles on his cheeks, his narrow chest and long han ds. The first of these aspects is highly affectionate, suggesting a deep love for her son. However, the second and third appear to be more reserved and analytical. She compares the boy’s chest to the keel of a balsa-wood boat, a form of wood that is fragile and light. The consideration of him like a boat also suggests that he is moving away from her, into open waters. Finally, the third description focuses on the boy’s hands, and also of the day that the boy was â€Å"guided† out of her when she gave birth to him. The use of this term suggests a deep sense that the boy is still being guided away from her. Coupled with the hostility theme, this could indicate that the writer feels her son is being pulled away from her to be a man that she does not want him to be. Despite the progression of the poem, there is no evidence of closure. The author does not resolve any of the issues with her son leaving or his growing up, giving the impression that she does not feel th ere is any alternative to letting him grow as he will. Using psychoanalytic literary analysis techniques on the poem Rites of Passage reveals potential underlying emotions that the author had on events described in the text. The aggressive and warlike symbolism provides