Download Esson Mary 4A Journal 2

Running Head: Journal 2
Journal 2
Mary Esson Sn, Uwm
University of Wisconsin Milwaukee
September 26, 2012
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Running Head: Journal 2
This week I was in the transplant unit. I had a patient who had end stage renal failure, and
underwent other major organ surgeries including a heart transplant and kidney transplant. She
had a bypass graft on her left arm an ostomy bag, as well as on telemetry. She had a history of
cardiac catherization, cerebral infraction, fluid overload and hypertension. Due to her kidney
failure, my understanding of what was causing the fluid overload and her hypertension was the
fact that her kidneys were not being able to filter out her blood. Due to the failure and luck of
proper kidney functions, there was accumulation of electrolytes and other substance for example
albumin and creatinine and glucose circulating in her blood. Due to the lack of filtration of these
toxins which are usually excreted in the urine, the toxin especially sodium attracts the water and
causes an increase in blood volume which leads to hypertension and fluid overload.
Through communication with my nurses, I learnt a general medication pattern for
patients on the transplant unit. Each transplant patients received a dose of 3 medications, which
they referred to as cocktails. The transplant patients received prograph, prednisone and cellecept.
These 3 medications are to prevent organ rejection which might occur, due to the new organ that
has been placed. After the cocktail drugs, the patients received antibiotics and antifungal
medications to prevent any infection due to the suppression of the immune system from the
cocktail drugs. My nurse and I went through my patient’s medications and she made sure I know
what the medications were, the reason why my patient is getting the medication, the side effects
and the pharmacodynamics of the drug.
Communication between me and my nurse was very effective. I gave her updates on my
patient’s progress and her vitals, and she guided me on what to focus on when taking care of
patients, which included how to prioritize care. The nurse prioritized care based on the “ABC”
guideline, (Airway, breathing and circulation). Some of the clinical judgment I made was
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Running Head: Journal 2
holding one of my patient’s insulin, since her blood sugar was under 150. I made this decision
based on her sliding scale, and she was not to be given insulin if her blood sugar was less than
150.
I learned a lot from the transplant unit this week. I learnt the effectiveness of time
management, since most of the patients on the floor have very critical conditions. One of the
most important things I learnt from the transplant floor is to be very attentive and aware of my
surroundings, since that plays an important role in my patient health. I enjoyed working with the
nurses on the floor, and the nurses I had were very knowledgeable, caring, compassionate and
had a great sense of humor.
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