Case Studies

Pulmonary Case Study

A 61-year-old female admitted to Woodbine Rehabilitation & Healthcare Center from Virginia Hospital Center after a long course of Pneumonia and Acute Hypoxemic Respiratory Failure Secondary to Covid 19. She has a history of Pulmonary Fibrosis. She has a trach and PEG tube in place at the time of admission. She was bed bound requiring total assistance.

Nursing Interventions:

Respiratory Interventions:

Accomplishments:

Under the Direction of Pulmonologist, Dr. Alkhouri, Patient Successfully Weaned from Ventilator 2 weeks into stay and trach weaned on week three, Wounds Resolved, Advanced to PO Diet with Regular and thin liquid resumed and Peg Tube removed.

Therapy:

Resident benefited extensively from skilled physical, occupational, speech, and respiratory therapy under the multidisciplinary approach to care. Patient was moderate assist of 2 for bed mobilities. Her strength improved. Upon discharge, she was moderate assistance of one to roll and to sit EOB for 20 minutes. She returned home with family and is followed in the community by a PCP in the community.


Pulmonary Case Study

This unfortunate 52-year-old female (D.V.) admitted to Woodbine Rehabilitation & Healthcare Center from Henrico’s Doctors Hospital with Vent Dependent Respiratory Failure S/P Overdose and Aspiration Pneumonia. She was admitted with a trach and PEG tube in place.

Nursing Interventions:

Respiratory Interventions:

Accomplishments:

Successfully weaned from ventilator 2 weeks into the stay and trach weaned on week three. FEES testing with Thin Liquids and Regular Diet Advancement; Peg Tube removed

Therapy:

Resident benefitted extensively from skilled physical, occupational, speech, and respiratory therapy. Daily Collaboration with the Care Team assisted to #CareSafely for her allowing for a rapid discharge to home. Her strength improved daily, and progress was made. She was discharged to home ambulating 20 feet with a Roller-walker stand by assist. The team’s multi-disciplinary approach to care allowed for an expedited successful discharge to home. She returned home with her husband and will continue to be followed by PCP in the community.


Pulmonary Case Study

A 27-year-old male admitted from the hospital to Woodbine Rehabilitation & Healthcare Center with Chronic Hypoxemic Respiratory Failure Secondary Drug Overdose. His medical history also included complications from kidney injury, pulmonary embolism and myoclonus dystonia with a questionable vocal cord paralysis. Thus, he had a trach and PEG tube in place at the time of admission.

Nursing Interventions:

Respiratory Interventions:

Accomplishments:

Successfully weaned from trach after 3 weeks of admission • Oxygen Discontinued prior to Discharge • Wounds resolved • PO Diet with Regular and thin liquid Resumed, and Peg Tube removed

Therapy:

Upon admission resident was bedbound requiring total assistance; he was NPO- medications and nutrition provided via PEG tube; he also had dysphagia and dysphonia with tracheostomy tube in place. Resident benefitted extensively from skilled physical, occupational, speech, and respiratory therapy and the multidisciplinary approach to care. His strength improved greatly and soon he was able to transfer off TCU to step down and shortly after was ambulating independently in the halls with a walker.


COVID 19/Pulmonary Case Study

59-year-old male admitted to Woodbine Rehabilitation & Healthcare Center from Bridgepoint Hospital National Harbor with Acute Hypoxemic Respiratory Failure secondary to Covid 19. He suffered from complications from Pseudomonas Pneumonia, Hypertension, and Sacral Decubitis. He has a trach and PEG tube in place at the time of admission. He was bed-bound requiring total assistance.

Nursing Interventions:

Respiratory Interventions:

Accomplishments:

Patient successfully weaned from ventilator 2 weeks into stay and trach weaned on week three. He benefitted extensively from skilled physical, occupational, speech, and respiratory therapy and the multidisciplinary approach to care. His strength improved and quickly he was ambulating 50 feet with a roller walker independently in the halls.

Therapy:

Resident benefitted extensively from skilled physical, occupational, speech, and respiratory therapy and the multidisciplinary approach to care. His strength improved and quickly he was ambulating 50 feet with a roller walker independently in the halls.

Patient was determined to return home as quickly as possible. The team worked to develop a personalized care plan to free him of ventilator as quickly as possible. The patient expressed sincere gratitude to the staff at Woodbine.

“One thing I have learned from the team is to be patient and wait for the Lord’s time. Whenever I would get anxious, they would say for me to relax. Now that I am going home, I can relax well.”


COVID 19/ Pulmonary Case Study

This is a 61-year-old female admitted to Woodbine Rehabilitation & Healthcare Center from Virginia Hospital Center after a long course of Pneumonia and Acute Hypoxemic Respiratory Failure Secondary to Covid 19. She has a history of Pulmonary Fibrosis. She has a trach and PEG tube in place at the time of admission. She was bed bound requiring total assistance.

Nursing Interventions:

Wound Healing- DTI to Heels
Maintain Proper Nutrition- Wean Peg Tube and Advance PO trials
Treat Infection- IV Antibiotics for Pseudomonas Pneumonia
Monitor Labs and Vitals

Respiratory Interventions:

Ventilator Weaning
Maintain Patent Airway and Trach Wean trials under direction of Pulmonologist, Dr Khouri
Maintain Adequate Oxygenation
Secretion Management
Aspiration Precaution- Enteral Nutrition on admission
Bronchodilatation

Accomplishments:

Under the Direction of Pulmonologist, Dr. Alkhouri
Patient Successfully Weaned from Ventilator 2 weeks into stay and trach weaned on week three, Wounds Resolved, Advanced to PO Diet with Regular and thin liquid resumed and Peg Tube removed.

Therapy:

Resident benefitted extensively from skilled physical, occupational, speech, and respiratory therapy under the multidisciplinary approach to care. Patient was moderate assist of 2 for bed mobilities. Her strength improved. Upon Discharge, she was moderate assistance of one to roll and to sit EOB for 20 minutes.

She returned home with family and is followed in the community by her PCP, Dr. J Ortiz Perez.


Pulmonary Rehab Case Study

This unfortunate 52-year-old female admitted to Woodbine Rehabilitation & Healthcare Center from Henrico’s Doctors Hospital with Vent Dependent Respiratory Failure S/P Overdose and Aspiration Pneumonia. She was admitted with a trach and PEG tube in place.

Nursing Interventions

Maintain Proper Nutrition- Wean Peg Tube and Advance diet as tolerated- MET
Treat Infection- Pseudomonas Pneumonia- Resolved
Monitor Labs and Vitals
Maintain Safety

Respiratory Interventions

Ventilator Weaning- MET
Maintain Patent Airway and Trach Wean trials under the direction of Pulmonologist, Dr. Khouri- MET
Maintain Adequate Oxygenation- MET
Aspiration Precautions- downgraded diet- Advanced

Accomplishments:

Successfully weaned from ventilator 2 weeks into the stay and trach weaned on week three. FEES testing with Thin Liquids and Regular Diet Advancement; Peg Tube removed

Therapy:

Resident benefitted extensively from skilled physical, occupational, speech, and respiratory therapy. Daily Collaboration with the Care Team assisted to #CareSafely for her allowing for a rapid discharge to home. Her strength improved daily, and progress was made. She was discharged to home ambulating 20 feet with a Roller-walker stand by assist.

The Teams Multi-Disciplinary Approach to Care Allowed for an Expedited Successful Discharge to home.

She returned home with her husband and will continue to be followed by PCP in the community, Dr. Manu Gadani.


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