ICU: Clinical Analysis

This week I found myself in the Intensive Care Unit assigned to a Progressive Care Unit patient. Things are becoming a little more relaxed for me. Not quite comfortable as of yet but I am feeling more confident. In the ICU there is no struggle for equipment such as a dynamap for vitals and there are plenty of supplies. The computer system is also more familiar making charting smoother. The ICU nurse supported the assessment being done with her, almost mirroring her. I had instant validation as I found pulses and abnormalities. The patient enjoyed helping in this way without having to be subjected to a more lengthy second assessment when she would rather be resting. Mimicking the nurse's rhythm educated my mindset and movements. My slower student pace seemed to get a push. Hopefully, I can maintain the pace next week. …show more content…
More likely, she has been declining and she is now at the turning point where the weaknesses are observable. The other thought was that she may have kidney cancer. Until the rule out, she has acute renal failure potentially caused by large proteins not easily filtered by the kidneys. These proteins could be a result of multiple myeloma cancer (plasma cell Ca). The appropriate tests had been taken; results had not returned. In the meantime, she required hemodialysis. I learned about tempory dialysis access catheters. There was a system created using a chest tube that’s name was not clear to me. Perhaps, tunneled cath dialysis? That had been misplaced, punctured the lung or pleural area causing a pneumothorax. It was removed and a femoral cath placed. She refused dialysis. The nephrologist mentioned that he would have liked her to have had the dialysis in case the kidney failure was acute. This would give the kidney a chance to