Pulmonary Rehab Case Study
67-year-old admitted to Spring Grove Healthcare and Rehabilitation Center from St. Clare’s RRC Unit after a prolonged hospitalization (1 year) for Chronic Respiratory Failure requiring Trach and Vent. Patient has a history of Scoliosis and Charcot Marie Tooth Disease. Patient admits with a Tracheostomy.
Nursing Interventions
Maintain Adequate Nutrition – Double portion – support weight gain
Aspiration Precautions – downgraded mechanical soft diet
Routine Oral Care – remain free from infection
Respiratory Interventions – AIRWAY SUCCESSFULLY WEANED
Maintain Adequate Oxygenation – Wean as Tolerated – GOAL MET
Maintain Patent Airway – Wean as Tolerated – GOAL MET
Secretion Clearance and Bronchodilation – DuoNeb
Deep Breathing and Cough – Incentive Spirometry
Under the leadership of our In-House Pulmonologist, Dr. Nick Maglaras and our In-House Respiratory Therapist, the team managed this fragile patient’s stay. Respiratory Therapy and Speech Therapy collaboration was instrumental in successful trach weaning. He was able to regain strength and endurance needed to return to home.
Patient returned home AFTER ONE YEAR with help with his supportive brother. He is ambulating 200 feet with Rollator and contact guard. He is climbing 4 stairs x 3 reps. He will continue to follow in the community with PCP Dr. Robert Alexander, and pulmonologist Dr. Paul Pechman.
Cardiac Rehab Case Study
79-year-old male admitted to Spring Grove Rehabilitation and Healthcare Center from Overlook Medical Center after a hospitalization S/P Fall secondary to Sepsis, Acute on Chronic CHF with Pleural effusions, Ouonic AFIB, CKD Stage 3 and LLE Cellulitis. Patient arrived to center new to wearing a Life Vest AICD.
Nursing Interventions
General Understanding and Care of a Life Vest ATCD – Change battery daily at 6am
Maintain Nutrition – Heart Healthy Diet and understanding of Sodium Restriction
Wound Healing – Left lower extremity Cellulitis
Weight Management – increased weight monitoring
Medication Management – Lasix dosing titration; Spironolactone
Monitor Labs – CBC, CMP, Mg
Patient learned how to provide general care of his Life Vest. He was educated on self-assessment of his heart failure allowing him to be best prepared to for the daily care for himself upon his return to home. With the assistance of our on-site Physiatrist, Dr. Michelle Robalino-Sanghavi, the patient was able to gain the strength to ambulate 150 feet with a roller walker and supervision and able to climb 4 steps x 2. Prior to his return home, our on-site dietitian provided the patient sample diet choices for his Heart Failure Diet. After an uninterrupted, continued stay in short term rehab, he returned home alone with the assistance of Atlantic Home Health. He will follow with cardiologist, Dr. Steven Furer in the community for his continued cardiac needs.
Pulmonary Rehab Case Study
49-year-old, Unfortunate Construction Worker (A.M.) admitted to Spring Grove Healthcare and Rehabilitation Center from Overlook Medical Center after an extensive 95-day hospitalization S/P Covid 19 Pneumonia resulting in Vent Dependent Respiratory Failure and Anemia.
Patient arrived to center NPO, Tracheostomy and Oxygen Dependent with a Stage 4 Sacral Decubitus
Nursing Interventions
Monitor Patent Airway and Secretion Clearance: Airvo Warmed Humidification provided on admission
Maintain Adequate Oxygenation: Patient requiring 8 liters per minute on admission
Maintain Adequate Nutrition: Patient arrived NPO with Peg tube for feedings
Wound Healing: Sacral Decubitus Stage IV
Medication Management
Monitor Labs and CXR’s: status post Anemia and Bilateral Pneumothorax in hospital
Patient is followed by our In-House Respiratory Therapist who worked closely with our Nursing and Therapy Staff to Develop a Patient Specific Care Plan. Speech Language Pathology Slowly upgraded diet to regular and thin liquids, Capping trials progressed, and Trach Tube was weaned. Oxygen and Tube Feeds were next to be discontinued. Wound Healing Continues.
Therapy
Upon admission a note from the hospital read “Only motion noted was slight squeezing of his Right hand”. Patient required maximum assistance with all self-care tasks and after 45 days of Short-Term Rehab, Patient was able to ambulate 250 feet with roller walker and 100 feet with supervision and no adaptive device. He was independent with all self-care tasks and anxiously awaited returning home with his wife and children.
Patient returned home with his Wife and Children after 45-day LOS in STR. He has PCP appointment secured with Abraham Vera and Pulmonary Appointment Secured with Pulmonary and Allergy Associates, Summit NJ.
