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Renal Rehab
CaseStudy
A male, 67-year-old patient was admitted to Crest Pointe Rehabilitation & Healthcare Center from HMH Ocean University Medical Center with admitting diagnoses of renal failure, urinary retention, and severe anemia. On evaluation in the hospital, it was noted he had required blood transfusions. The patient has a history of anemia, gastric ulcers, and hydronephrosis with obstructions requiring a Foley catheter.
Nursing Interventions:
Medication Management – Urinary retention medication, uric acid reducer, antacid, and multivitamin.
Pain Management – including therapy modalities and medication.
Diagnostic Testing and Labs – Frequent labs, in-house x-ray capabilities, bladders scan.
Foley Catheter Management and Education.
The patient is followed by Primary Care Physician Dr. Sanjay Kumar, Manjinder Sahi APN, Nephrologist Dr. Joseph Albanese, Physiatrist Dr. Stacey Miller-Smith, and the in-house specialty program nurse, along with the internal clinical team.
Therapy Interventions:
Upon initial assessment, the patient required moderate assistance for bed mobility, transfers, and self-care tasks. He was able to ambulate 10ft with a rolling walker with moderate assistance. The therapy team worked with the patient to gain strength and independence with mobility. On discharge, he was independent of all self-care tasks, bed mobility, and transfers. He was able to
ambulate 300 feet with no assisted devices and ascend/descend 16 stairs.
The patient was discharged to Keifer’s Quarters Senior Citizens’ Residence along with the support of HMH at Home Care Services. All follow-up appointments were made before discharge including Nephrologist Dr. Joseph Albanese of Jersey Coast Nephrology and Hypertension Service Associates.
Cardiac / Orthopedic Rehab
Case Study
A male, 82-year-old patient was admitted to Crest Pointe Rehabilitation & Healthcare Center from HMH Ocean University Medical Center with an admitting diagnosis of S/P Fall with noted Atrial Fibrillation. On evaluation, it was noted he had an intertrochanteric fracture of the proximal left femur. The surgery was performed by Orthopedic Surgeon Dr. Sunil Thacker. The patient has a history of Parkinson’s disease, HTN, Hyperlipidemia, and Aortic Value Replacement.
Nursing Interventions
Medication Management – Ace Inhibitor, diuretic, blood thinner, statin, dopamine promoter, multivitamins, and supplements.
Surgical Wound Management – WBAT, daily surgical wound care and assessment.
Pain Management – including Therapy modalities and medication.
Diagnostic Testing and Labs – Frequent labs, in-house x-ray capabilities.
The patient is followed by Primary Care Physician Dr. Sanjay Kumar, Cardiologist Dr. Leonard Sandler, Physiatrist Dr. Stacey Miller-Smith, and the in-house specialty program nurse, along with the internal clinical team.
Therapy Interventions
Upon initial assessment, the patient required moderate assistance for bed mobility, transfers, and self-care tasks. He was able to ambulate 10ft with a rolling walker with moderate assistance. The therapy team worked with the patient to gain strength and independence with mobility. On discharge, he was at a supervision level for all self-care tasks, bed mobility, and transfers. He was able to ambulate 300 feet with a rolling walker and ascend/descend 16 stairs.
The patient returned home with the support of his wife and HMH Meridian at Home Care Services. All follow-up appointments were made before discharge including his community primary care physician Dr. Monika Finer, and Orthopedic Surgeon Dr. Sunil Thacker.
CKD/Cardiac/Pulmonary Case Study
77-year-old Female (A.W.) admitted to Crest Pointe Healthcare and Rehabilitation Center from Ocean Medical Center with admitting diagnosis of Acute on Chronic CHF, CAD, Hypertension and AFIB. Patient has a history of Stage 3 CKD, Diabetes and COPD.
Clinical Interventions:
Medication Management: IV Ampicillin, Spironolactone, Digoxin, Midodrine, Metoprolol, Prednisone Taper
Monitor Vitals: Hypotension Management
Monitor Labs: CBC, CMP weekly
Maintain Adequate Oxygenation: Oxygen 2-3 lpm continuous
Wound Healing: Stage 3 Sacral Wound
The Complexity of this patient makes Crest Pointe’s Campus of Excellence the right choice to be closely monitor followed weekly on Nephrology, Pulmonary and Cardiac Rounds.
The combined efforts of Dr. Albanese, Shore Pulmonary Group and Dr. Sandler allow for titration of medications and the dosing necessary to continue care at the current level, avoiding an unplanned hospitalization.
