The Patient with Musculoskeletal Limitations Complicated by a Medical Illness
Order Instructions:
Use a 12 font size, double space your work and use APA format for citations, references, and overall format. Information on how to use the Excelsior College Library to help you research and write your paper is available through the Library Help for AD Nursing Courses page. Assistance with APA format, grammar, and avoiding plagiarism is available for free through the Excelsior College Online Writing Lab (OWL). Be sure to check your work and correct any spelling or grammatical errors before you submit your assignment.
You are required to submit your paper to Turnitin (a plagiarism prevention service) prior to submitting the paper in the course submission area for grading. Access is provided by email to the email address on record in your MyExcelsior account during week 2 of the term. Once you submit your paper to Turnitin check your inbox in Turnitin for the results. After viewing your originality report correct the areas of your paper that warrant attention. You can re-submit your paper to Turnitin after 24-hours and continue to re-submit until the results are acceptable. Acceptable ranges include a cumulative total of less than 15% for your entire paper, and no particular area greater than 2% (excluding direct quotes and/or references).
See the videos below for instructions on how to submit your paper to Turnitin and view your Originality Report.
Video – Submitting a Paper
Video – Viewing Your Originality Report
When you’re ready to submit your work for grading, click Browse My Computer and find your file. Once you’ve located your file click Open and, if successful, the file name will appear under the Attached files heading. Scroll to the bottom of the page, click Submit and you’re done.
SAMPLE ANSWER
The Patient with Musculoskeletal Limitations Complicated by a Medical Illness
Question one
Surgical care improvement project (SCIP) is an initiative aimed at providing healthcare for patients who have just undergone surgical procedures. It is estimated that more than 40% of operative procedures normally end up in post-operative complications. However, the introduction of the improvement project serves to significantly reduce the resulting complications. The SCIP is based on several core measures to assist in the reduction of post-operative complications. The ten core measures are based on prophylactic antibiotic treatment in pre and post-operative procedures. Also, antibiotics are given to the patient during the treatment process(‘SCIP core measures’, 2011). Another measure is the use of urinary catheter and hair removal strategies for patients. Other measures involve temperature management and the elimination of blood clots that would cause thrombosis in the veins also referred to as venous thromboembolism. The major aspect that has assisted in the reduction of surgical site infection has been the use of antibiotics. It is widely known that knee procedures such as knee arthroscopy involve the exposure of the knee tissues to the environment(‘SCIP core measures’, 2011). The environment contains numerous microbes that are opportunistic and take advantage of any opening on the skin surface. However, the presence of antibiotics serves to eliminate the microbes that ultimately serve to be the major causes of disease infection after operation procedures. Certain precautions have to be taken before the administration of the antibiotics(Drake, 2011). The drugs used should not have side effect to the patients. Neither are the antibiotics supposed to evoke the immune responses.in the case of the 60 year old woman, she had associated allergies with penicillin. The woman had taken certain drugs associated with the treatment of osteoarthritis which was also being examined by the medical procedure. Lisiprinol, lebrax and Celebrex were the drugs used by the old lady in the treatment of her conditions. Lisiprinol lowers blood pressure since the patient has hypertension. The drugs are administered after six hours when their effect is non-interfered by the other drugs. Additionally, the drug used is a cephalosporin and has no effect or similar effect as penicillin since it would not evoke an allergic reaction. The use of antibiotics in the surgical care processes has significantly reduced surgical site infections(‘SCIP core measures’, 2011). Ancef is an antibiotic of cephalosporin activity. Similarly other drugs have been used to reduce chances of infection after the surgical procedures(Drake, 2011). Nurses have to administer the drugs at specific times for the drugs to be able to function effectively.
Question two
The surgical care improvement method outlines measures involved in the removal of hair. Use of shaving or clippers to remove hairs would result in skin abrasions which would ultimately result in infections of the skin. Such infections would result in complications after surgical procedures. In the case of the sixty old woman, less hair is found around the knee region and since the knee is one of the common areas where skin abrasions can result in infection sites for microbes (Anderson, 2010).
In case there was excessive hair in the knee region it would be clipped off. However, the removal of the hair in this case shall not be by the use of a razor blade or other abrasive methods to the skin which end up affecting the skin by leaving infection sites that can easily be accessible to microbes. However electric clippers can be used in the removal of hair around the knee region since they are non-abrasive(Drake, 2011). If there were previous hair removal, the data abstractors supposed to look at the alternative methods. Also if the patient had in any way clipped hair from their skin, the data abstractor should seek methods that would not complicate the current status. The data abstractor can obtain the information about the patient from previous records especially the nurse’s report and mark at the appropriate hair removal method that had been initially used. This would assist the surgeons in knowing the appropriate method of hair removal that they can rely on the removal of hair especially at the knee(Anderson, 2010).
Question three
Venous thromboembolism is one of the common surgical complications after operative surgeries. Exposure of the skin directly activates clotting factors forming clots .This mechanism is used by the body to prevent entry of foreign microbes and over bleeding that would result in high pressure and loose of oxygen in the body. However, after forming clots, it is necessary that the initial clots formed in the blood would be dissolved by plasmin via plasminogen activating factors. However, sometimes the rate of clot formation during certain surgical procedures becomes greater compared to the rate of clot dissolution. The end result in this case would be blocking of the veins by clot or thrombus. The ultimate result of this is blockage of the blood supply by the thrombus ultimately resulting in what is commonly referred to venous thromboembolism commonly abbreviated as VTE. A major common form of VTE is DVT which in full means deep venous thromboembolism( Mont et al., 2014).
Surgical care improvement project involves the use of lovenox an anticoagulant. The anticoagulant has the ability to break down all the clots that have been formed in the body making blood to flow properly through the body. As a result, major complication issues such as venous thromboembolism are all avoided. However, in the administration of lovenox timing of the drug plays a very important role. Very late delay in the administration of the drug after surgical processes would directly be of no use since the process of clot formation would have already taken place and the administration of the drug would not be effective as anticipated before. Therefore it is necessary that the nurse ensures that the patient in this case the sixty old woman takes the drug at the required time to avoid formation of clots. In this case the drug was administered earlier the day after the surgical operation. The use of the leg attached to the hose pipe in the upright direction also assist the floor of blood from the surgical site and therefore the drug would efficiently remove the clots (Drake, 2011).
In conclusion the use of surgical care improvement projects has over the years reduced the associated surgical difficulties and complications that are normally as a result of surgical processes. The use of antibiotics has significantly reduced infection via sites while the application of certain drugs which are anticoagulants have effectively removed the thrombus that are as a result of clots formed during the surgical processes. Generally use of the SCIP has reduced the number of post complications and deaths that would be as a result of procedures. Although the process is being implemented, proper care and timing is important in meeting the set objectives relating to better health for patients (Kinnier, Barnard & Bilimoria, 2014).
References
ANDERSON, J. (2010). Individual SCIP Measures Don’t Cut Infection. Hospitalist News, 3(7), 8.
Drake, K. (2011). SCIP core measures. Nursing Management (Springhouse), 42(5), 24-30.
Kinnier, C., Barnard, C., & Bilimoria, K. (2014). The Need to Revisit VTE Quality Measures. JAMA, 312(3), 286.
Mont, M., Hozack, W., Callaghan, J., Krebs, V., Parvizi, J., & Mason, J. (2014). Venous Thromboemboli Following Total Joint Arthroplasty: SCIP Measures Move Us Closer to an Agreement. The Journal of Arthroplasty, 29(4), 651-652.
SCIP core measures. (2011). Nursing Management (Springhouse), 42(5), 30-31.
We can write this or a similar paper for you! Simply fill the order form!
