An experience nursing a patient with dengue hemorrhagic fever

The case report presented a patient with dengue hemorrhagic fever after being bitten by an insect in a suburban area. The author observed and interviewed the patient and utilized Gorden's functional health scale to collect information, from Nov., 08 to Nov., 15 2002. Thrombocytopenia, febrile, and pain accompanied with dengue hemorrhagic fever were recorded during nursing evaluation. Lack of associated medical information contributed to the patient's anxiety status. The major nursing problems were changing of protection/ thrombocytopenia, hyperthermia, pain, and inadequacy of knowledge. The gum bleeding, fevers, and generalized bone pain were relieved by sincere listening and nursing intervention. In addition, medical information was delivered by way of a health information booklet to improve the understanding of the patient and ease the latter's anxiety status. Amid an increase in cases of dengue hemorrhagic fever in Taiwan, this case report might provide some valuable information to the nursing staff in order to enhance their ability to provide comprehensive care.     

Using complementary therapy with a hemodialysis patient with colon cancer and a sense of hopelessness

Hemodialysis patients usually have a sense of hopelessness. This can affect their physical, mental and spiritual health, and can even be life- threatening. This article discusses a nursing experience involving a dialysis patient who also suffered from cancer had and a sense of hopelessness due to the distress caused by the two severe illnesses. The author assessed the patient by means of Roy's theory during the nursing period (5/7/2005-6/18/2005). Data were collected through physical assessments, interviews, observation of interaction with family members and a medical history review. The patient had characteristics of hopelessness, such as pessimism, moodiness, frequent sighing, frowning, eye-closing and negative thinking. The author applied a safe, easy, and non-invasive complementary therapy program including music therapy, aromatherapy and massage with essential oil to improve the patient's physical and mental states. Through these approaches, the patient learned to release stress, and to express his feelings, so that he could adapt to his current life, changed as it was by the illnesses, and face the impact of those illnesses with a positive attitude. The author would like to share this case report to provide nursing professionals with a source of reference for healthcare quality improvement.     

The nursing process according to Orem. A concrete very simple example explains how to follow this nursing process]

The author shows how Orem's theory, based on self care, can be applied to the nursing care of a patient with severe cardiac illness. To do so, she explains in detail what is looked for in the patient's history to delineate problems, and then uses a systematic care plan approach to solve them. In the patient's history, the nurse looks for information on each need, and on the specific factors in the patient's life and health history that will have an impact on the patient's capacity to meet Orem's goal of self care. Inabilities are labelled self care deficits. When the self-care deficit is well understood, it is important then to determine the source of the patient's difficulty. Orem states that there are two main phases to self-care: the decision and the action. The author illustrates this through a discussion of the patient's difficulty to stop smoking. She then explains a particular method to write a nursing diagnosis that directs the nurse to work, not on the deficit itself, i.e. in this case smoking, but rather on the patient's lack of knowledge. The "SMART" approach to writing nursing care objectives (specific to the patient and the current situation, measurable, attainable by the client in a reasonable period of time, realistic for the current situation, and truthful or having clear significance for the patient at the moment) is detailed along with interventions that respect Orem's concept of nurse-patient contracts. The nursing process based on Orem's conceptual framework is not difficult to manage.(ABSTRACT TRUNCATED AT 250 WORDS)     

The nursing experience of applying MRM model to personality disorder

This article describes the nursing care of a schizophrenia patient with DSM-IV axis II diagnosis of borderline personality disorder. The patient presented psychiatric symptoms and signs, such as poor emotional control, manipulative behaviors, low self-esteem, and poor interpersonal relationships. The core symptoms of the personality disorder led to the admission of the patient, so this article mainly deals with the problem of borderline personality and its management. Through holistic nursing assessment, the author confirmed the diagnosis and found that the patient had some related mental health problems, such as, ineffectiveness of coping skills, impairment of social interaction, disturbance of self-concept, and low self-esteem. The author therefore applied the Modeling and Role Modeling model during the process of interpersonal mutual interaction, in order to establish the nurse-patient relationship, to accept the patient's point of view, to promote the patient's capacity for positive thinking, to establish healthy goals, to enhance the sensation of control, to make behavioral contact with the patient, to teach the patient proper conduct to deal with difficulties of emotional control, to improve the patient's interpersonal relationships, and to improve the process of self-identity. During the period of care (Feb. 14th, 2003 - June 6th, 2003), there was marked improvement in the patient's emotional control, adaptive abilities, and self-identity. The results revealed that, from the point of view of the patient, the nurse can improve the patient's willingness to participate in health promotion, to receive help from others, to learn and grow from past experiences and to develop the ability of self-control and mastering of one's own life.     

The art of nursing. "Frank's story": student response.

The author of this article explores her definition of the art of nursing through a response to an interview by Dr. Kathryn Gramling with a patient named Frank. She determines that nursing, although it also requires technical skill and a strong knowledge base, becomes art when the practitioner adopts the caring skills of compassion, touching, and empathy. The poem Dr. Gramling wrote in response to her contact with Frank reinforces the definition created by the author. When some patients enter a hospital, they experience certain feelings, such as fear, uncertainty, and helplessness. They are placed in a strange setting and are not in the best of health, but each patient deals with sickness differently. Some may act frightened, while others may act impatient and uncooperative. Often, it is a nurse's duty to help ease a patient through this difficult transition. The way a nurse does this makes all the difference to a patient's stay at the hospital. A nurse's impact on the patient can affect the patient either positively or negatively. A nurse must go above and beyond the technical part of nursing in order to make nursing an art.     

Nursing experience with an lymphangioleiomyomatosis patient with chylothorax

This article discusses experience providing nursing care to a patient suffering from Lymphangioleiomyomatosis who was re-hospitalized for recurrence of chylothorax complications, which caused dyspnea, sterility and mental instability. Based on parameters provided by Roy's adaptation model, the patient was identified as suffering from respiratory impairment, acute pain, sleep pattern disturbance and low self-esteem. Data was collected through interviews, observation and physical assessments. During the course of providing nursing care, the author established a good relationship with the patient through devoted attention to the patient's needs and by actively caring, listening and accompanying. Increased family member visits and interaction, resulting from the author's urgings, gave the patient added support and consolation. Eventually, the author gained the trust of the patient, who, in turn, regained self-control as well as physical and sociopsychological adaptabilities. Clinical nursing must attend to the physical care needs of patients as well as patient mental wellness, the latter of which extends beyond the disease itself, in order to achieve a truly comprehensive quality of nursing care. We are glad to share this successful experience with others in the nursing profession.     

动力髋螺钉内固定术治疗股骨粗隆间骨折患者的护理

笔者报道48例股骨粗隆间骨折患者采用动力髋螺钉内固定手术治疗的护理。认为术前做好心理护理,正确评估手术耐受性,做好术前健康教育,积极治疗原发病,加强营养支持;术后密切观察病情,加强并发症的预防,早期正确地进行患肢及全身的功能锻炼,指导早期离床活动：是保证手术治疗取得满意疗效的关键。     

宫内合并子宫瘢痕妊娠减胎术的护理

总结1例宫内合并子宫瘢痕妊娠减胎治疗的护理经验.术前对患者和家属进行护理指导及做好各种抢救准备,缓解患者的焦虑、紧张情绪,术后严密监侧生命体征及病情,早期发现失血性休克,保证患者的生命安全,使患者度过危险阶段,确保子宫瘢痕妊娠减胎治疗成功.出院后给予正确安胎指导及定期B超复查,以确保宫内胎儿顺利分娩.     

Complications of the myeloproliferative system: Infection and sepsis

Living with cancer has become a more realistic hope for many patients as a result of newer combination-treatment modalities. However, impairment of the immune and inflammatory responses is a serious consequence of both aggressive disease and treatment.

Comprehensive nursing care during periods of granulocytopenia is critical to the survival of myelosuppressed patients. The primary nursing goals for these patients include (1) prevention of infection through promotion of the patient's optimal health status and reduction of environmental factors contributing to infection; and (2) early detection of infection through diligent assessment of the patient's health status, with prompt initiation of medical and nursing interventions.

Sepsis in the compromised cancer patient poses a major challenge in oncology nursing care. The importance of thorough nursing assessment and interventions to minimize exposure of the patient to potential pathogens during granulocytopenic periods cannot be overstated. The patient's life may well depend on it.     

The McGill model of nursing: a practice-derived model

This article describes the salient features of the McGill model of nursing, (ie, health, family, collaboration, and learning), within the health, person, environment, and nursing paradigm. According to the model, the central goal of nursing is to maintain, strengthen, and develop the patient's health by actively engaging him or her in a learning process. Because health is a learned phenomenon and the family is considered the primary socializer in this learning, the family is the focus of nursing. The nurse strives to structure a learning environment that enables the patient to participate as fully as possible. The nurse and patient together set goals and, building on the patient's strengths and resources, devise means of achieving them.     

结肠造口病人的健康教育

目的：研究健康教育在直肠癌结肠造口病人生存质量中的作用。方法：按健康教育的内容进行讲解；利用书籍、图片、录像带等器具教育；开展造口访问者的工作；成立造口联谊会。结果：增加了病人自我护理的知识，提高了病人的生活质量；明确术后各项治疗护理的重要性，减少了术后并发症的发生；密切了护患间的关系，提高了病人对护理人员的满意度。结论：健康教育在提高结肠造口病人生存质量中起着非常重要的作用，应引起广大护理人员的高度重视。     

A nursing experience in a patient with antipsychotics-induced overweight

The purpose of this article is to describe a nursing experience with a patient with schizophrenia who had antipsychotics-induced overweight. The authors assessed the patient's health condition and provided weight management to reduce her hallucinations as well as her body weight between May 1 and June 10, 2004. Three nursing problems had been identified as follows: disturbed sensory perception, imbalanced nutrition, and ineffective health maintenance. During the nursing process, the authors established a rapport relationship with the patient and her mother, educated them in skills for reducing hallucinations, and designed an individual body weight management program. After the interventions, the patient was able to positively face her illness, effectively use methods to reduce the impact of hallucinations, and successfully lose 5.5 kg. From this perspective, an individual body weight management program can be an effective intervention for nurses to care for this group of patients.     

病人满意度调查在护理管理中的应用

目的:把病人满意度调查应用于护理管理实践,提高护理质量,从而更好地满足病人健康的需要。方法:自制病人满意度调查表,把日常护理工作尽量较全面地设计到表格中,并通过满意度调查及时发现并解决护理工作中出现的问题,指导护士的日常工作。结果:病人对护理工作的总体满意度以及护士对护士长管理的满意度有了一个明显的提高。结论:病人满意度地调查应用于日常护理管理,取得了很好的效果。     

Creating a tool to evaluate patient performance

Patient education is a nursing responsibility that is often impromptu, spontaneous, and poorly documented. In many cases the patient's ability to perform a skill or task in the management of an illness or disease process affects the patient's outcome. A tool designed to evaluate patient performance guides the teaching process, promotes communication between the patient and nurse, and promotes communication among health care providers as it relates to patient performance. Nurses are in key positions to develop patient performance tools to ensure that the patient, or a patient's family member, can manage the health care requisites.     

The nursing case management computerized system: meeting the challenge of health care delivery through technology.

Does nursing case management compute? In this article, the author attempts to explain how computerizing the team plan of care and critical pathways decreases paperwork, makes it easier to develop standardized team care plans, enhances quality improvement trending, and is flexible enough to update the plan of care according to the patient's changing needs. The Nurse Case Management Computerized System puts the patient care team plan into an interactive computer program. The computer does the work of presenting the nurse with care plan options and printing a hard copy ready to implement. Use of the computer program enhances the health care team's ability to individualize the team plan of care while maintaining patient care standards. The system is also used to collect patient care data automatically and to trend for quality improvement.     

Patient with borderline personality disorder and intellectual impairment. Case report

The care of patients with behavioral problems presents many challenges to emergency unit staff. This case report describes the authors' experience caring for a patient with borderline personality disorder and intellectual impairment, whose frequent emergency unit (EU) visits were characterized by severe behavioral difficulties. The authors describe the use of an emergency care contract that helped improve the quality of the patient's required EU visits. Comments regarding the usefulness of functional health pattern assessment and nursing diagnoses in emergency nursing practice are also given.     

Applying back massage protocol to promote an intensive care unit patient's quality of sleep

This case report concerns the nursing experience of applying back massage to a patient in an intensive care unit (ICU) from 10 May, 2005, in order to improve the patient's quality of sleep. In order to collect information about his quality of sleep of the patient, the author used observation, interview and a Richards-Campbell sleep questionnaire (RCSQ). It was observed that, before massage, the patient's sleep quality was poor, which wa why the protocol with back massage was proposed. The results after back massage was applied that heart beat, respiration. oxygen saturation and blood pressure were not significantly improved. This was probably related to the patient's worry about having his endotracheal tube removed. The patient's perception of sleep, indeed, was obviously improved, a result which may have been related to his/her perception of comfort and care from the nurse. Applying back massage to an ICU patient may therefore be regarded as helpful improving the patient's sleep quality. It is hoped that this case report may serve as a positive reference for health care providers so that it may help patients to recover fully through rest and sleep. Since this report concerned only one patient, however, to understand the real outcome of how back massage could improve the quality of sleep of ICU patients, research is planned on the use of back massage protocol on a large number os such patients.     

服用奥氮平所致比萨综合征的护理

总结1例服用奥氮平所致比萨综合征的护理体会。护理要点包括:评估跌倒危险等级,加强巡视观察,指导肢体功能锻炼,并应用放松训练、阅读疗法等心理护理方法稳定情绪,保障安全。患者住院111d痊愈出院。