Posted: February 28th, 2023

Maternal

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Case Study: Jimmy, ten years old, was admitted to the pediatric intensive care unit after a fall from the second-story townhome were sustained a fractured left femur and mild head injury. Currently, Jimmy is two days post open reduction internal fixation of the left femur. Orders were updated to transfer Jimmy out of Intensive Care Unit (ICU) after being cleared by the neurologist. He has a long leg cast, indwelling foley catheter and will require neuro checks every two hours.

· What are two priority nursing diagnoses for this child?

· What are the priority nursing interventions for this patient after being transferred from the ICU?

· What are the risks of foley catheter placement?

· Does the patient still require an indwelling foley catheter? Provide a rationale to support your answer.

Rashidat Opere

Professor Janet Hartmann

Professional Nursing 2

February 16, 2023

PICOT CLINICAL QUESTION

Clinical Problem

“The central nervous system, which includes the brain and spinal cord, is affected by multiple sclerosis (MS), a complicated and crippling condition” (Brownlee et al., 2017). The myelin sheath, which serves as the nerve fibers’ protective coating, is attacked by the immune system in the condition, causing inflammation and damage. This injury can cause a variety of symptoms, including as muscular weakness, issues with coordination, and difficulty speaking. Patient’s quality of life may be significantly impacted by the illness, particularly those between the ages of 18 and 30. Rehabilitation interventions such as physical, occupational, and speech therapy can play a vital role in helping people with multiple sclerosis (MS) manage their condition and maintain their independence (Brownlee et al., 2017). A physical therapist can help individuals with MS improve their strength, flexibility, and mobility, preventing secondary complications like falls and contractures. Occupational therapy helps individuals with MS perform daily activities, such as bathing, dressing, and cooking, more easily and safely. Occupational therapists can also modify the home environment and provide adaptive equipment to increase safety and accessibility. Speech therapy, also known as speech-language therapy, can benefit individuals with MS who experience speech and language difficulties. Providing strategies to help manage fatigue, which can negatively affect speech and cognitive abilities, is one of the many things speech therapists can do for these individuals. Maintaining independence and improving the quality of life for individuals with MS is important by implementing these practitioner-led interventions as part of a comprehensive approach to managing MS.

Reason for Choosing this Topic

The demand for efficient, patient-centered treatment for this group is expanding, which makes the subject of nurse practitioner-led rehabilitation therapies for MS patients crucial. A nurse practitioner’s involvement in delivering thorough, patient-centered care is essential since MS is a progressive condition that requires continuous management. It is possible to assess how well nurse practitioner-led treatments improve MS patients’ quality of life by contrasting them with self-induce therapy (Dobson, & Giovannoni, 2019).

PICOT Question

In patients 18-30 years old diagnosed with multiple sclerosis, how does nurse practitioner-led intervention such as physical therapy, occupational therapy, and speech therapy compare to self-induced therapy in improving quality of life over 2 months?

Possible Integration of Evidence in Clinical Practice

The creation of nurse practitioner-led rehabilitation programs for MS patients can be based on the evidence discovered via the study and then integrated into clinical practice. The best method for enhancing MS patients’ quality of life may be determined by comparing the outcomes of nurse practitioner-led treatments versus self-induced therapy. The formulation of rehabilitation programs suited to MS patients’ needs may be guided by this information, considering their age, symptoms, and general state of health.

Methods to Evaluate the Effectiveness of Implementation

Patient satisfaction surveys, outcome measures like the Multiple Sclerosis Quality of Life Inventory (MSQLI), and a comparison of the results between the nurse practitioner-led interventions and self-induced therapy can all be used to assess how well the nurse practitioner-led rehabilitation interventions are working (Dobson, & Giovannoni, 2019). While patient satisfaction surveys can offer insightful information on how the patient views the interventions and the overall care received, the use of objective measures, such as the MSQLI, offers a reliable and valid assessment of the impact of the interventions on quality of life.

Conclusion

Nurse practitioner-led rehabilitation interventions have the potential to significantly improve the quality of life of patients with multiple sclerosis. By comparing nurse practitioner-led interventions to self-induced therapy, the effectiveness of these interventions in improving quality of life can be evaluated. Integrating the evidence into clinical practice can inform the development of rehabilitation programs tailored to meet the needs of MS patients and provide effective patient-centered care.

Refrences

Brownlee, W. J., Hardy, T. A., Fazekas, F., & Miller, D. H. (2017). Diagnosis of multiple sclerosis: progress and challenges. 
The Lancet, 
389(10076), 1336-1346.

Dobson, R., & Giovannoni, G. (2019). Multiple sclerosis–a review. 
European journal of neurology, 
26(1), 27-40.