1. The appropriate interventions and their rationales in response to L.S. respiratory rate increase, difficulty in breathing and wheezing.
As soon as you have discovered that L.S. is having difficulty breathing and respiratory rate increasing, it is critical to act quickly to avoid further deterioration in his condition. Below are some of the appropriate interventions that should be taken and their rationales: Elevate the head of the bed: Elevating the head of the bed is beneficial in decreasing the workload on L.S.'s respiratory system.
It promotes optimal chest expansion and reduces shortness of breath. It is beneficial to keep L.S. in a semi-Fowler's position as it helps the chest muscles relax and improve oxygenation. Sit him in an upright position: This will facilitate his breathing by allowing his chest muscles to work efficiently and decreasing the work of breathing.
Oxygen administration: The oxygen should be given through a face mask at the rate of 6-8 L/min to L.S. since his SpO2 is low. Adequate oxygen administration will help L.S. breathe and increase oxygen delivery to tissues.
Bronchodilators administration: Since L.S. has a history of asthma, bronchodilators (such as albuterol) should be administered to him through a nebulizer to help alleviate the wheezing and restore normal breathing patterns. Bronchodilators work to dilate the airways and allow better ventilation.
Periodic assessment: Continuous monitoring of his vital signs, especially the respiratory rate, heart rate, and blood pressure, will help detect any deterioration in his condition early and prompt intervention.
Frequent assessment of breath sounds is essential to evaluate the effectiveness of interventions and adjust them accordingly.
2. The nursing responsibilities associated with giving bronchodilators:
Bronchodilators are medications used to help dilate airways in the lungs and ease breathing. Below are the nursing responsibilities associated with giving bronchodilators:
Verify the correct medication: It is essential to check the medication name, dose, and expiry date before giving it to the patient.
Ensure that it is the correct medication and dose that has been prescribed.
Administer the medication as per the doctor's orders: This involves placing the medication into the nebulizer cup and administering it via a nebulizer. You must monitor the patient's vital signs and observe for any adverse reactions that may occur.
Documentation: It is essential to document the administration of medication and any adverse reactions that may occur. The documentation should include the date, time, medication, dose, route of administration, and patient's response to the medication. This documentation will help track the patient's progress and adjust the medication regimen accordingly.
Inform the patient:
Before administering bronchodilators, you must inform the patient about the medication, its purpose, and any potential side effects that may occur.
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Case Study - This case study should be completed on your own prior to clinical. John Ringer, a 32-year-old patient, is admitted to the medical-surgical unit following a debridement of a right lower leg wound secondary to a gunshot wound. The wound is infected with Staphylococcus aureus. The patient is diagnosed with osteomyelitis. The patient's right lower leg is warm to touch and edematout, and the patient states that the extremity has a constant pulsating pain that increases with any movement of the leg. The patient's sedimentation rate and leukocyte rates are elevated. The primary provider prescribes the following for the patient: Orders: Admit to medical unit with -Vital signs every 4 hours -Elevate affected leg on pillows above the level of the heart Warm sterile saline sooks for 20 minutes three times per day with wet-to-dry dressing change -Levofloxacin, 750 mg VPB every day Renal profile, CBC with differential in the morning Regular diet with high-protein supplement shakes Vitamin C, 250 mg po twice a day -Hydrocodone, 1 tablet po every 4 hours as needed for pain -Docusate sodium 100 mg bid *Docusate sodium 100 mg b.i.d. (Learning Outcome 5) Answer These Questions: a. What is Osteomyelitis? What is Staphylococcus aureus nd how is it treated? b. What part of this assessment is missing? (Think subjective and objective information) c. The patient asks the nurse why he has to stay in bed. The nurse should provide what rationale for this measure? d. Document the rational for each of the orders above? e. What nursing interventions should the nurse provide the patient? f. Complete a SOAP note on your assessment and interventions. g. Describe your evaluation of your interventions and your teaching for this patient who will go home. During post-conference discuss as a group your findings. Collect additional data from your peers at this time that will be helpful to studying this material
The nursing interventions were successful in managing the patient's pain, promoting wound healing, and providing necessary support. The patient's pain was effectively managed with hydrocodone, and wound care was performed appropriately.
A. Osteomyelitis is an infection of the bone, usually caused by bacteria. It can occur as a result of direct contamination from an open wound, such as in the case of John Ringer's gunshot wound.
Staphylococcus aureus is a common bacterium that can cause osteomyelitis. It is a gram-positive bacterium that often colonizes the skin and mucous membranes. In terms of treatment, Staphylococcus aureus infections are typically managed with antibiotics.
B. The missing parts of the assessment include further details about the patient's medical history, specifically any comorbidities or previous episodes of infection.
It would also be helpful to assess the patient's pain level using a standardized pain scale and to document any factors that aggravate or alleviate the pain.
C. The nurse should explain to the patient that bed rest is necessary to promote healing and prevent further complications. By keeping the affected leg elevated and immobile, it helps reduce swelling, improve blood circulation, and minimize pain.
D. Rational for each of the orders:
Vital signs every 4 hours: Regular monitoring of vital signs help assess the patient's overall condition and identify any signs of infection or deterioration.
Elevate the affected leg on pillows above the level of the heart: Elevation helps reduce swelling by promoting venous return and reducing fluid accumulation.
Warm sterile saline soaks for 20 minutes three times per day with wet-to-dry dressing change: Warm saline helps cleanse the wound and promotes healing. Wet-to-dry dressings are used to facilitate wound debridement.
Levofloxacin, 750 mg IV daily: Levofloxacin is an antibiotic prescribed to treat Staphylococcus aureus infection.
Renal profile, CBC with a differential in the morning: These lab tests help monitor the patient's renal function and assess the progress of the infection.
A regular diet with high-protein supplement shakes: Adequate nutrition, particularly high protein intake, is essential for wound healing and overall recovery.
Vitamin C, 250 mg PO twice a day: Vitamin C promotes collagen synthesis and enhances the body's immune response.
Hydrocodone, 1 tablet PO every 4 hours as needed for pain: Hydrocodone is a pain medication prescribed to manage the patient's pain.
Docusate sodium 100 mg bid: Docusate sodium is a stool softener prescribed to prevent constipation, which can be caused by the use of pain medications.
e. Nursing interventions for the patient may include:
Assessing and documenting the patient's pain level regularly using a standardized pain scale.
Providing wound care, including dressing changes, as ordered.
Monitoring vital signs and reporting any abnormalities.
Educating the patient on the importance of rest and elevation to reduce swelling and pain.
Administering medications as prescribed and monitoring for their effectiveness and potential side effects.
Encouraging and assisting with nutritional intake, including high-protein supplement shakes.
Assisting the patient with activities of daily living and mobility, as tolerated.
Providing emotional support and addressing any concerns or questions the patient may have.
f. SOAP Note:
Subjective: The patient, John Ringer, reports constant pulsating pain in his right lower leg, which increases with leg movement. He states that the extremity feels warm and appears edematous. No other complaints were reported. The patient expresses frustration with bed rest.
Assessment: The patient was diagnosed with osteomyelitis secondary to a gunshot wound. Staphylococcus aureus infection present. A patient experiencing constant pulsating pain, edema, and warmth in the affected leg.
Plan: Admit the patient to the medical unit. Implement orders as prescribed, including vital signs monitoring, the elevation of the affected leg, and warm sterile saline soaks with wet-to-dry dressing changes.
Levofloxacin administration, renal profile, CBC with differential, regular diet with high-protein supplement shakes, Vitamin C supplementation, hydrocodone for pain management, and docusate sodium for prevention of constipation.
G. Evaluation: The nursing interventions aimed at managing pain, promoting wound healing, and providing necessary support were implemented successfully.
The patient's pain level was assessed and managed with the prescribed hydrocodone. Wound care was performed according to the prescribed protocol.
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quizlet: Which of the following manifestations is least likely to effect the MS patient's ability to ambulate
Multiple Sclerosis is a disease of the central nervous system that causes a variety of symptoms. Symptoms of MS can be both physical and emotional, and can include muscle weakness, muscle stiffness, balance problems, fatigue, depression, cognitive difficulties, and more.
As the disease progresses, symptoms may become more severe, making it difficult for patients to perform everyday tasks, including walking. Some of the manifestations that can affect an MS patient's ability to ambulate include muscle weakness, spasticity, ataxia, and fatigue.
However, the manifestation that is least likely to affect an MS patient's ability to ambulate is depression. Depression is a mental health condition that affects a person's mood, thoughts, and behavior.
It is a common symptom in people with MS and can be caused by the physical changes that occur in the brain and nervous system as a result of the disease. Depression can lead to feelings of sadness, hopelessness, and lack of energy, but it does not usually cause physical impairments that would affect a person's ability to walk.
However, depression can still have a significant impact on a person's quality of life and should be addressed by a healthcare provider. MS patients may be encouraged to participate in cognitive and emotional therapies, along with medical management, to help them manage their symptoms and improve their overall well-being.
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Which of the following could cause respiratory acidosis? A. Prolonged emesis for more than 72 hours B> Patient that has been given a high dose of narcotic medication for the first time
C. Diabetes mellitus
D. Type Improper ventilator setting which is forcing respirations faster than needed
Prolonged emesis for more than 72 hours could cause respiratory acidosis. Respiratory acidosis occurs when there is an excess of carbon dioxide (CO2) in the blood, leading to an increase in carbonic acid (H2CO3) and a decrease in pH. Prolonged emesis, or vomiting, can result in the loss of gastric acid from the stomach. This loss of acid leads to a decrease in the bicarbonate (HCO3-) levels in the blood, disrupting the acid-base balance and potentially causing respiratory acidosis.
Patient that has been given a high dose of narcotic medication for the first time would not directly cause respiratory acidosis. Narcotic medications can suppress the respiratory drive and lead to respiratory depression, but this alone would result in respiratory alkalosis, not respiratory acidosis.
Diabetes mellitus does not directly cause respiratory acidosis. Diabetes mellitus is a metabolic disorder that affects the regulation of blood glucose levels and can lead to metabolic acidosis due to the production of ketones. However, it does not directly affect the respiratory system.
An improper ventilator setting that forces respirations faster than needed could cause respiratory alkalosis, not respiratory acidosis. Respiratory alkalosis occurs when there is a decrease in carbon dioxide levels in the blood, leading to a decrease in carbonic acid and an increase in pH.
In conclusion, among the options provided, the most likely cause of respiratory acidosis is prolonged emesis for more than 72 hours. This condition can result in the loss of gastric acid and disrupt the acid-base balance, leading to an accumulation of carbon dioxide in the blood and subsequent respiratory acidosis.
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Mr. Jones, a 70-year-old professor, is 7 days post–laparoscopic cholecystectomy. He denies any pain at the surgical site, but he is complaining of fatigue, heart palpitations, and some shortness of breath. He says the palpitations started 2 days ago and last a few minutes. He denies fever, chest pain, nausea, vomiting, and diaphoresis. Past medical history: anterior wall MI 3 years prior. Social history: drinks three to four glasses of liquor a day, which he has done for 20 years; quit smoking after MI 3 years ago. Medications: metoprolol 50 mg once daily; simvastatin 40 mg once daily; aspirin 81 mg once daily. He forgets to take his aspirin often and misses a dose of other medications about once a week. Allergies: no known drug allergies. Physical examination: vital signs—temperature 97.5°F; pulse 118/minute and irregular; respirations 20/minute; blood pressure 126/74 mmHg. General: alert and oriented. Neck: no jugular vein distention, no bruits. Cardiovascular system: irregular rhythm, no gallops or murmurs. Lungs: bibasilar, fine crackles. Skin: warm and dry with no edema, cyanosis. Other: 12-lead EKG with evidence of anterior wall MI and atrial fibrillation with a ventricular rate of 118. Answer the following questions: 1. What are possible reasons for Mr. Jones’s new-onset atrial fibrillation? 2. Describe atrial fibrillation. 3. What are risks associated with atrial fibrillation? 4. What is Mr. Jones’s CHA2DS2-VASc score? What are treatment recommendations based on this score?
Possible reasons for Mr. Jones's new-onset atrial fibrillation include his history of myocardial infarction, age, and alcohol consumption.
Mr. Jones's new-onset atrial fibrillation can be attributed to several factors. Firstly, his history of anterior wall myocardial infarction increases his risk of developing arrhythmias. Secondly, his age of 70 years is also a risk factor for atrial fibrillation. Additionally, his chronic alcohol consumption, three to four glasses of liquor daily for 20 years, can contribute to the development of atrial fibrillation. Alcohol is known to disrupt normal cardiac electrical activity and increase the risk of arrhythmias. These factors collectively increase his susceptibility to atrial fibrillation in this case.
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A 26-year-old woman develops chills, nausea, tremor, myalgia, increased pain, and anxiety after being given pentazocine for analgesia following an appendectomy. She has been enrolled in a methadone maintenance program for the past 2 years. Which of the following is the most likely cause of these adverse effects of pentazocine therapy?
A. Action of a toxic metabolite
B. Cross-dependence with methadone
C. Cross-tolerance to pentazocine
D. Pentazocine agonism at k (opioid) receptors
The answer to the question is that B. Cross-dependence with methadone is the most likely cause of these adverse effects of pentazocine therapy.
What is Pentazocine?
Pentazocine is a type of medicine known as a narcotic (opioid) analgesic that is used to treat moderate-to-severe pain. It functions by altering the perception of pain in the brain. However, when used for an extended period of time or in large doses, it has a higher potential for abuse and addiction.
Possible adverse effects of Pentazocine: Difficulty breathing, itching, flushing, sweating, swelling, and vomiting are all symptoms of an allergic reaction (swelling of your face, lips, tongue, or throat).Weak or shallow breathing, slow heart rate, severe drowsiness, cold or clammy skin, pinpoint pupils, confusion, and seizures are all symptoms of an overdose.
In the given case, a 26-year-old woman develops chills, nausea, tremor, myalgia, increased pain, and anxiety after being given pentazocine for analgesia following an appendectomy. She has been enrolled in a methadone maintenance program for the past 2 years. It is known that Pentazocine and methadone share cross-dependence and cross-tolerance properties with each other. That is, if one is addicted to either drug, the other can be used to treat the addiction, and tolerance to one can result in tolerance to the other. Since the patient was enrolled in a methadone maintenance program, she developed chills, nausea, tremor, myalgia, increased pain, and anxiety after being given pentazocine for analgesia following an appendectomy.
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In general, screening should be offered for diseases with the following characteristics:
1. Diseases with a very low prevalence in the population.
2. Diseases that are serious, and have a detectable preclinical phase.
3. Diseases with a natural history that cannot be altered by early medical intervention.
4. Diseases that do not have a detectable preclinical phase
5. Treatment is readily available
Please choose the correct statements
The correct statements regarding screening for diseases are 2 and 3. Diseases that are serious, and have a detectable preclinical phase. Diseases with a natural history that cannot be altered by early medical intervention.
Diseases that are serious and have a detectable preclinical phase.
Screening is beneficial for diseases that have a serious impact on health and can be detected before symptoms manifest. Identifying the preclinical phase allows for early intervention and improved outcomes.
Diseases with a natural history that can be altered by early medical intervention.
Screening is effective for diseases where early detection and intervention can modify the course of the disease. Timely medical interventions, such as treatments or lifestyle changes, can lead to better outcomes.
Treatment is readily available.
Screening is most valuable when treatment options are available. Identifying a disease early is only beneficial if there are interventions that can be implemented to improve health outcomes.
Therefore, the correct statements are 2 and 3. Diseases that are serious, and have a detectable preclinical phase. Diseases with a natural history that cannot be altered by early medical intervention.
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What are some non-reassuring signs in fetal heart rate patterns? (For example: late decelerations and variable decelerations.) - What are the causes? - What nursing interventions should be implemented
Some non-reassuring signs in fetal heart rate patterns include late decelerations, variable decelerations, and prolonged decelerations. These patterns may indicate potential fetal distress and require further evaluation and appropriate interventions.
1. Late Decelerations: Late decelerations are characterized by a gradual decrease in the fetal heart rate that occurs after the peak of a uterine contraction. They are typically symmetrical and have a uniform shape. Late decelerations may indicate uteroplacental insufficiency, which means there is inadequate oxygen supply to the fetus. Causes of late decelerations include maternal hypertension, placental abruption, placental insufficiency, or maternal hypotension.
Nursing Interventions for Late Decelerations:
- Reposition the mother to a left lateral position to improve blood flow to the placenta.
- Administer oxygen to the mother via a face mask to increase oxygen supply to the fetus.
- Increase intravenous fluid administration to improve maternal blood volume and placental perfusion.
- Notify the healthcare provider for further evaluation and possible interventions.
2. Variable Decelerations: Variable decelerations are abrupt and temporary decreases in the fetal heart rate that occur irregularly in relation to uterine contractions. They have a variable shape and duration. Variable decelerations may indicate cord compression, which can compromise blood flow to the fetus. Causes of variable decelerations include cord around the fetal neck, cord prolapse, or a short umbilical cord.
Nursing Interventions for Variable Decelerations:
- Change the mother's position, such as moving her to the side or knee-chest position, to relieve pressure on the umbilical cord.
- Administer oxygen to the mother via a face mask to improve fetal oxygenation.
- Discontinue any uterotonic medications that may be increasing uterine contractions.
- Notify the healthcare provider for further evaluation and possible interventions, such as amnioinfusion (infusion of sterile fluid into the amniotic sac) to relieve cord compression.
Non-reassuring fetal heart rate patterns, such as late decelerations and variable decelerations, can be indicators of fetal distress. It is crucial for healthcare providers to monitor fetal heart rate patterns closely during labor and delivery. Prompt recognition and appropriate nursing interventions are essential to optimize fetal well-being. The specific interventions will depend on the underlying cause of the non-reassuring pattern and may include repositioning the mother, administering oxygen, increasing intravenous fluids, and notifying the healthcare provider for further evaluation and possible interventions.
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Which of the following is not consistent with damage to the
oculomotor nerve?
A. Diplopia
B. Ptosis
C. Strabismus
D. Mydriasis
E. Lacrimal dysfunction
Lacrimal dysfunction is not caused due to damage to the oculomotor nerve.
The oculomotor nerve is the third of the twelve cranial nerves. The main function of the oculomotor nerve is to supply nerves to the majority of the extraocular muscles that control eye movements including the opening and closing of eyes and opening of the pupil.
Damage to the oculomotor nerve causes abnormalities like ptosis, diplopia, strabismus, and mydriasis.
Lacrimal dysfunction is not consistent with damage to the oculomotor nerve. Therefore, the correct answer is option (E) Lacrimal dysfunction.
Ptosis refers to drooping of the upper eyelid.
Strabismus is the deviation of one or both eyes from the normal position.
Diplopia refers to double vision.
Mydriasis refers to the dilation of the pupil.
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Consider to what extent you observed a balance, if any, between patient choice and provider-prescribed treatment. Elaborate on your perception of the degree to which the providers and nurses exercised respect for cultural values and autonomy
During my observation, I noted a balance between patient choice and provider-prescribed treatment to a large extent. However, there were instances where healthcare providers had to enforce treatment methods that they deemed necessary for the benefit of the patient despite their opposition to the prescribed treatment method.
At times, the providers had to intervene and make recommendations based on the patient's current condition or previous medical history. There were also cases where patients requested specific treatments or refused certain treatments based on their cultural beliefs, which caused some conflicts in care delivery.
Based on my observations, healthcare providers and nurses exercised respect for cultural values and autonomy by providing care that was culturally sensitive, and they also acknowledged the patient's beliefs and values. They ensured that they provided care that was acceptable and in line with the patient's culture, which allowed the patient to have control over their treatment process. In conclusion, there was a balance between patient choice and provider-prescribed treatment to a large extent, and healthcare providers and nurses demonstrated respect for cultural values and autonomy.
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Many older drug therapies, e.g. penicillin in streptococcal sore throat, have never been submitted to rigorous trials such as a randomized controlled trial (RCT). Do you think they should be? Question 15 Please explain why some drugs are teratogenic in the first trimester and some in the second?
1. Regarding the question of whether older drug therapies should be subjected to rigorous trials such as randomized controlled trials (RCTs),
2. The second trimester (weeks 13-27) is considered the fetal period.
What are the therapies?The fetal period is thought to last from weeks 13 to 27 of the second trimester. By this time, the majority of the major organs have developed, and the fetus is largely growing and maturing.
While this is happening, some organs, like the central nervous system, continue to grow and improve. The development and functionality of these developing organs may be impacted by exposure to teratogenic substances in the second trimester.
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Yes, older drug therapies such as penicillin in streptococcal sore throat, that have never been subjected to rigorous trials like randomized controlled trials (RCT) should be tested with the most rigorous scientific method possible.
This helps to remove any chance of inconsistencies that can arise due to variations in the procedure of testing. Teratogenic drugs are those drugs that can cause harm to the unborn baby. They can cause birth defects in babies whose mothers are exposed to them during pregnancy. Drugs have different effects at different times in the pregnancy period because the fetus develops through various stages and organs form at different periods, making them susceptible to harmful effects of different drugs at different times.
The reason why some drugs are teratogenic in the first trimester and some in the second is due to the stage of fetal development. For instance, in the first trimester, the nervous system is developing rapidly. The formation of the neural tube, which is the precursor of the central nervous system, is complete within four weeks of pregnancy. Therefore, drugs that can interfere with the formation of the neural tube such as valproic acid are teratogenic in the first trimester, resulting in neural tube defects such as spina bifida. In the second trimester, the fetus is developing organs such as the heart, and the skeleton. Drugs that interfere with these developmental processes, such as thalidomide, are teratogenic in the second trimester and can cause limb defects.
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Mr. Menendez is a 65-year-old man presenting with 2–3 days of coughing up thick yellow sputum, shortness of breath, and fever (he did not check the actual temperature) and chills. He states his chest hurts when he breathes. He denies headache, rhinorrhea, sinus pain, and nausea. He reports no exposure to sick individuals. Medications: lisinopril 10 mg a day by mouth. Allergies: no known drug allergies. Past medical history: hypertension Social history: smokes 1 pack of cigarettes per day (has done so for 30 years); denies alcohol use; works as a landscaper. Physical exam: Vital signs: temperature 101°F, pulse 98 per minute; respiratory rate 22 per minute, blood pressure 140/86 mmHg, pulse oximeter 93%. General: ill and tired appearance, coughing during visit with thick yellow sputum noted. HEENT: unremarkable. Neck: small anterior and posterior cervical nodes. CV: unremarkable. Lungs: right basilar crackles with dullness to percussion in right lower lobe. Abdomen: unremarkable. A) What is the most likely diagnosis and pathogen causing this disorder? B) Discuss the mode of transmission. C) Discuss the data that support your decision. D) What diagnostic test, if any, should be done? E) Develop a treatment plan for this patient.
The most likely diagnosis for this patient is community-acquired pneumonia (CAP) with a suspected bacterial etiology, possibly caused by Streptococcus pneumoniae.
A) The most likely diagnosis for this patient is community-acquired pneumonia (CAP) with a suspected bacterial etiology.
The potential pathogen causing this disorder could be Streptococcus pneumoniae, given the typical presentation of cough with thick yellow sputum, fever, chills, and chest pain. S. pneumoniae is a common cause of CAP in adults.
B) The mode of transmission for S. pneumoniae is typically through respiratory droplets. It can spread from person to person through close contact with respiratory secretions from infected individuals, such as coughing or sneezing.
C) The data supporting this decision include the patient's symptoms of productive cough with thick yellow sputum, fever, and chest pain, which are consistent with pneumonia. The crackles and dullness to percussion on the lung exam indicate consolidation and infection in the right lower lobe, further supporting the diagnosis.
D) A diagnostic test that should be performed is a chest X-ray to confirm the presence of infiltrates or consolidation in the lungs, which is characteristic of pneumonia. Additionally, a sputum culture can be obtained to identify the specific pathogen causing the infection.
E) The treatment plan for this patient with suspected community-acquired pneumonia would typically involve empirical antibiotic therapy. In this case, a suitable choice would be a respiratory fluoroquinolone or a combination of a beta-lactam antibiotic plus a macrolide.
However, the patient's history of smoking and working as a landscaper may increase the risk of resistant pathogens. Therefore, a broader-spectrum antibiotic such as levofloxacin or moxifloxacin may be considered.
Treatment duration is typically 7-10 days, and close monitoring of symptoms and response to therapy is essential. Additionally, smoking cessation counseling should be provided to the patient.
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A nerve signal transmitted by a sensory neuron reaches (the)
_____ of the spinal cord. Choose one:
a. spinal nerve
b. posterior (dorsal) horn
c. anterior (ventral) horn
d. white matter
When a nerve signal transmitted by a sensory neuron reaches the spinal cord, it specifically reaches the posterior (dorsal) horn.
The spinal cord is a long, cylindrical structure that serves as a pathway for nerve signals to travel between the peripheral nervous system and the brain. It is composed of gray matter and white matter. The gray matter is located in the center and is shaped like a butterfly, while the white matter surrounds the gray matter. The sensory neurons transmit nerve signals from the periphery to the spinal cord, and when these signals reach the spinal cord, they enter the posterior (dorsal) horn of the gray matter. This is where sensory information is processed and integrated before being transmitted to other parts of the nervous system.
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II. PESILAD and Group Project Work
This is the last PESILAD. Your clinical case is on "Did Franklin Roosevelt really have Polio?"
P = Franklin Roosevelt, 39 years old, at that time (Aug. 10, 1921), went to bed, tired and complaining of back pain, fever and chills.
Vital Signs
Heart Rate = 88 per minute
Respiratory Rate = 24 per minute
Blood Pressure = 120/80
Temperature - 38.5°C
E = Extrinsic?
S = weakness, back pain, fever, chills, abnormal sensations of his upper extremities and face, inability to voluntarily urinate and defecate.
I = Viral Infections (Poliomyelitis)?
L = CBC, urinalysis
A = nerve studies
D = _______________________
Group Project Work
2- identify the four general regions of a neuron using a color-coded diagram.
3-Describe the dendrites, cell body, axon, and telodendria with evolutionary medicine concepts.
The missing PESILAD term is "I = Imaging studies."
Explanation:
The given PESILAD acronym stands for:
P: Patient or Population
E: Exposures or Interventions
S: Study Design
I: Imaging studies
L: Laboratory tests
A: Analysis
D: Conclusion
Thus, the missing term that corresponds to "I" in PESILAD is "Imaging studies."
Now, let's identify the four general regions of a neuron using a color-coded diagram. The four general regions of a neuron are dendrites, cell body, axon, and telodendria. The following diagram shows a color-coded representation of these four regions:
[Diagram not provided]
As per the evolutionary medicine concept, dendrites and cell bodies primarily serve to receive input, axons serve to conduct output signals, and telodendria form connections with other neurons. Additionally, dendrites and cell bodies are more susceptible to oxidative stress, while axons are vulnerable to damage from inflammation and ischemia. Therefore, these different regions of neurons may vary in their vulnerability to different types of stresses.
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Your protocols states you must administer 0.2mg/kg of atropine. The vial comes
supplied as 8mg in 5 milliliters. Your patient weighs approximately 55 pounds.
How much will you withdraw into your syringe?
3.11842 ml of atropine needs to be withdrawn into the syringe.
We need to calculate the amount of atropine that needs to be withdrawn into the syringe. Here are the steps to calculate the answer.
Step 1: Convert the weight of the patient from pounds to kilograms.
1 pound = 0.453592 kilograms
Therefore, the weight of the patient is 55 × 0.453592 = 24.94736 kg (approx)
Step 2: Calculate the amount of atropine that needs to be administered.
Atropine dose = 0.2mg/kg × 24.94736 kg
Atropine dose = 4.989472 mg (approx)
Step 3: Calculate the volume of the vial that corresponds to the calculated dose.
The vial comes with 8mg in 5 milliliters.
Therefore,1 mg of atropine = 5 / 8 milliliters
4.989472 mg of atropine = (5 / 8) × 4.989472 = 3.11842 ml (approx)
Therefore, 3.11842 ml of atropine needs to be withdrawn into the syringe.
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The client has an order for lidocaine to infuse at 3 mg/min IV. The fluid available is lidocaine 1 g/358 ml dextrose 5%. At what rate will the
nurse set the infusion?
The nurse can set the infusion at 64.3 mL/hr.
Lidocaine infusion at 3mg/min IVA medication order is an order given by a physician to administer medication for a patient. Before administering the medication, the nurse needs to verify the order with the physician and check the medication’s correct dosage and administration techniques.
Here is a step-by-step method on how to calculate the flow rate for the given lidocaine infusion order:Given:Lidocaine 1g/358mL Dextrose 5%The formula to calculate the flow rate is: mL/hr = total volume to be infused (mL) ÷ total time (hr)
Step 1: Calculate how many mg per ml the lidocaine solution has1g = 1,000mg1000mg ÷ 358 ml = 2.8 mg/mL
Step 2: Determine the rate (mL/hr) required to deliver 3mg/min to the patient(3mg ÷ 2.8 mg/mL) x 1 minute x 60 minutes = 64.3 mL/hr
Step 3: Check if the rate is safe to administer.Check the maximum dose of lidocaine to be infused in an hour. The maximum recommended infusion rate for lidocaine is 4mg/min or 240mg/hr.
To check if the rate is safe: Maximum infusion rate (mg/hr) = 240 mg/hr
Maximum volume to be infused in an hour = maximum dose ÷ strength of the solution (mg/mL)240 mg/hr ÷ 2.8 mg/mL = 85.7 ml/hrThe calculated rate, 64.3 mL/hr, is within the safe range of infusion rate.
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Which of the following is not an effective way to battle antibiotic resistance?
A- Control the use of antibiotics
B- Create new antibiotics
C- Prescribe antibiotics for viral infections
...
The largest consumer of antibiotics is:
A- General practitioners
B- Agriculture
C- Aged care facilities
D- Local hospitals
T he following is not an effective way to battle antibiotic resistance C- Prescribe antibiotics for viral infections .The largest consumer of antibiotics is B- Agriculture.
C- Prescribe antibiotics for viral infections is not an effective way to battle antibiotic resistance. Antibiotics are ineffective against viral infections, such as the common cold or flu, as they only target bacteria. Prescribing antibiotics for viral infections contributes to the overuse and misuse of antibiotics, which can lead to the development of antibiotic-resistant bacteria.
B- Agriculture is the largest consumer of antibiotics. In many countries, a significant portion of antibiotics is used in agriculture for promoting growth and preventing disease in livestock. This widespread use of antibiotics in agriculture can contribute to the development and spread of antibiotic-resistant bacteria.
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Tirofiban (C H N O S MWt = 440.6) is present as tirofiban HCl monohydrate (C H N O S.HCl.H O MWt=495.1) at 0.281 mg/mL in a concentrated solution. A solution for infusion is prepared by extracting 50 mL from a 250 mL bag of 5% glucose solution and adding 50 mL of concentrated solution. Jackson who weighs weighs 108 kg requires a tirofiban dose of 0.4 mcg/kg/min for 30 minutes. What would the infusion rate be? (Answer to 2 decimal places.)
The infusion rate is 0.021 mL/min (to 2 decimal places).
Tirofiban (C H N O S MWt = 440.6) is present as tirofiban HCl monohydrate (C H N O S.HCl.H O MWt=495.1) at 0.281 mg/mL in a concentrated solution.
A solution for infusion is prepared by extracting 50 mL from a 250 mL bag of 5% glucose solution and adding 50 mL of concentrated solution.
Jackson who weighs 108 kg requires a tirofiban dose of 0.4 mcg/kg/min for 30 minutes.
Infusion rate can be calculated as follows: Infusion rate = (Dose required × Body weight in kg) / (Concentration of the drug × 60 min)
Given that: Tirofiban dose required = 0.4 mcg/kg/min
Body weight of Jackson = 108 kg
Concentration of tirofiban solution = 0.281 mg/mL
Therefore, Concentration of tirofiban solution in mcg/mL = 0.281 × 1000 = 281 mcg/mL
Infusion rate = (0.4 × 108) / (281 × 60)
Infusion rate = 0.021 mL/min
Thus, the infusion rate is 0.021 mL/min (to 2 decimal places).
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Describe the main therapeutic use of b, adrenoceptor agonists
B-adrenoceptor agonists are medications that are used in the management of various respiratory diseases such as asthma, bronchitis, and chronic obstructive pulmonary disease (COPD). They bind to the β-adrenergic receptor in the body, which are located in the lungs, heart, and blood vessels.
By doing so, they cause bronchodilation, which is the relaxation of the smooth muscle cells lining the airways, thus resulting in increased airflow to the lungs. They also promote the clearance of mucus from the airways, and reduce airway inflammation and swelling.
B-adrenoceptor agonists can be administered via inhalation using metered-dose inhalers, dry powder inhalers, or nebulizers. They are classified into two main groups, short-acting and long-acting β2-agonists. Short-acting β2-agonists are used for quick relief of asthma symptoms such as wheezing, coughing, and shortness of breath, whereas long-acting β2-agonists are used for maintenance therapy to prevent symptoms and improve lung function in patients with chronic respiratory diseases.
B-adrenoceptor agonists can also be administered intravenously for the management of severe asthma exacerbations or acute bronchoconstriction. However, they should be used with caution in patients with cardiovascular diseases such as hypertension, coronary artery disease, and arrhythmias, as they can cause tachycardia and increase blood pressure. They should also be avoided in patients with hypersensitivity or allergy to these medications. In conclusion, b-adrenoceptor agonists are important medications in the management of respiratory diseases, and they should be used appropriately based on the patient's condition and symptoms.
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Write a journal entry for clinical describing the
following:
Discuss at least one instance in which you set priorities or
your preceptor set priorities in the delivery of safe nursing care.
(1 page pa
Journal Entry for Clinical Placement Nursing is a challenging and demanding profession that requires the right balance of skills and knowledge to ensure the provision of safe and quality healthcare.
As a nursing student, clinical placement is an opportunity to apply theoretical knowledge and learn practical skills that will be beneficial in future nursing practice. During my clinical placement, I had the opportunity to work with my preceptor and set priorities in the delivery of safe nursing care.As a nursing student, prioritizing nursing care is crucial in ensuring the effective delivery of care to patients. During my clinical placement, my preceptor and I encountered a situation where we had to prioritize nursing care to ensure the safety of the patient. We had a patient who had been admitted to the medical ward for abdominal pain. The patient had a history of peptic ulcer disease and had been complaining of upper abdominal pain for the past two days. Upon examination, the patient had severe abdominal tenderness, and his vitals were slightly elevated.After reviewing the patient's medical history, my preceptor and I agreed that the patient required immediate attention to prevent the worsening of his condition. We set priorities in the delivery of safe nursing care by first ensuring that the patient was comfortable and had adequate pain relief. We then prioritized the patient's hydration needs by administering intravenous fluids.
The patient was also monitored closely for any signs of complications, and appropriate interventions were implemented.Within an hour, the patient's condition had improved significantly, and he was no longer complaining of severe abdominal pain. This situation taught me the importance of setting priorities in the delivery of nursing care and the impact it can have on patient outcomes. As a future nurse, I will ensure that I prioritize patient needs to ensure the delivery of safe and quality care.
As a nursing student, prioritizing nursing care is crucial in ensuring the effective delivery of care to patients. During my clinical placement, my preceptor and I encountered a situation where we had to prioritize nursing care to ensure the safety of the patient. We had a patient who had been admitted to the medical ward for abdominal pain. The patient had a history of peptic ulcer disease and had been complaining of upper abdominal pain for the past two days. Upon examination, the patient had severe abdominal tenderness, and his vitals were slightly elevated.After reviewing the patient's medical history, my preceptor and I agreed that the patient required immediate attention to prevent the worsening of his condition. We set priorities in the delivery of safe nursing care by first ensuring that the patient was comfortable and had adequate pain relief. We then prioritized the patient's hydration needs by administering intravenous fluids. The patient was also monitored closely for any signs of complications, and appropriate interventions were implemented.Within an hour, the patient's condition had improved significantly, and he was no longer complaining of severe abdominal pain. This situation taught me the importance of setting priorities in the delivery of nursing care and the impact it can have on patient outcomes. As a future nurse, I will ensure that I prioritize patient needs to ensure the delivery of safe and quality care.
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Compare differences in categories of drugs (controlled
substance, generic, chemical and brand
names, pregnancy categories).
There are various categories of drugs such as controlled substances, generic, chemical, and brand names, and pregnancy categories and each one has its own specifications.
The description and difference of each category are as follows-
Controlled substances are those substances that are illegal unless used by a doctor’s prescription. Some examples of these types of drugs are marijuana, heroin, and cocaine. Because they are illegal, these substances are strictly regulated by the government.
Generic drugs are drugs that contain the same active ingredients as brand-name drugs. They are generally cheaper than brand-name drugs. For example, Acetaminophen is the generic name for the brand name Tylenol.
Chemical drugs are drugs that are made in a laboratory by chemists. These drugs are often used to treat serious illnesses like cancer. They can also be used to treat less serious conditions like allergies and headaches.
Brand names are names that are given to drugs by the companies that make them. They are often more expensive than generic drugs because they have more money invested in advertising.
Pregnancy categories
Pregnancy category A & B: Drugs which are considered safe to consume during pregnancy.
Pregnancy category C: These drugs are considered safe to use during pregnancy, but may cause problems for the developing baby.
Pregnancy category D: These drugs are considered dangerous to use during pregnancy because they can harm the developing baby.
Pregnancy category X: These drugs are considered extremely dangerous to use during pregnancy because they can cause birth defects or other serious problems.
Apart from these, some common types of these drugs include prenatal supplements, antiemetics, anticoagulants, antihypertensives, antibiotics, anti-diabetics, progesterone supplements etc.
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Attributes of Clinical judgment include: Holistic view of patient need h Circular process orientation O Reasoning and interpretation of data O All of the above OA and C only оо
Attributes of Clinical Judgment include a holistic view of patient needs, circular process orientation, reasoning, and interpretation of data. The correct answer is option D, "All of the above."
Clinical judgment is defined as the process by which nurses or other healthcare providers draw conclusions from data collected through observation, questioning, and analysis. Clinical judgment involves a wide range of cognitive and affective skills, including the ability to reason, interpret, and synthesize data, as well as the ability to recognize patterns and make connections between different pieces of information.
Clinical judgment is an iterative, circular process that involves ongoing assessment, planning, implementation, and evaluation. Nurses must be able to balance competing priorities, anticipate potential problems, and make decisions in complex, rapidly changing situations. They must also be able to communicate effectively with other members of the healthcare team and with patients and their families.
Finally, clinical judgment requires a holistic view of patient needs, including consideration of the physical, emotional, social, and spiritual aspects of care. Nurses must be able to recognize and respond to the unique needs of each patient, and to tailor their care accordingly. Hence, D is the correct option.
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Benzodiazepines have been prescribed for anxiety for decades. What is the effect of taking this medication?
A. they decrease GABA activity.
B. they relax muscles.
C. they make people more alert.
D. they activate the vagus nerve.
The effect of taking benzodiazepines is that they relax muscles.
Benzodiazepines are a class of medications commonly prescribed to treat anxiety disorders. They work by enhancing the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits the activity of neurons in the brain. By increasing GABA's inhibitory effects, benzodiazepines promote muscle relaxation and relieve symptoms of anxiety. This relaxation of muscles can help reduce tension and physical symptoms associated with anxiety, such as muscle stiffness or tension headaches. It's important to note that benzodiazepines have various effects on the body and should only be taken under the guidance of a healthcare professional.
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Knowing the impact of acidosis and alkalosis on synaptic transmission, critically analyze the following statement: "Hyperventilation may lead to seizures in epileptic patients."
Acidosis and alkalosis both affect the synaptic transmission in the body. Acidosis is a condition that occurs when there is a higher concentration of hydrogen ions in the blood, making the blood more acidic.
On the other hand, alkalosis is a condition that occurs when there is a lower concentration of hydrogen ions in the blood, making the blood more alkaline.In response to the statement “Hyperventilation may lead to seizures in epileptic patients,” it is true that hyperventilation can trigger seizures in epileptic patients.
This is because hyperventilation causes the blood pH to increase, which leads to respiratory alkalosis.Respiratory alkalosis, which occurs due to hyperventilation, is a condition in which there is a lower concentration of carbon dioxide in the blood.
This leads to a decrease in the concentration of hydrogen ions in the blood, which increases the pH of the blood. This can cause the nervous system to become more excitable and can trigger seizures in epileptic patients.
Therefore, the statement “Hyperventilation may lead to seizures in epileptic patients” is true, and this is due to the impact of alkalosis on synaptic transmission.
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Which of the following are best practices when communicating information about medicine for a sick child?
a)
Write or type the instructions on the label.
b)
Email the parent two to four hours after medication has been picked up.
c)
Spend extra time explaining the directions.
d)
Offer the pharmacist’s time for questions.
Best practices for communicating information about medicine for a sick child include: writing or typing the instructions on the label, spending extra time explaining the directions, and offering the pharmacist's time for questions.
When communicating information about medicine for a sick child, it is important to follow best practices to ensure effective and safe administration.
Firstly, writing or typing the instructions on the label provides clear and easily accessible information for the parents or caregivers. This helps in avoiding any confusion or misinterpretation of the medication instructions.
Secondly, spending extra time explaining the directions is crucial. This allows parents or caregivers to fully understand how to administer the medicine, including dosage, frequency, and any specific instructions or precautions.
Lastly, offering the pharmacist's time for questions is valuable. Pharmacists are highly knowledgeable about medications and can provide additional clarification, address concerns, and answer any questions related to the medication.
This helps parents or caregivers feel more confident and informed about the medicine they are giving to their sick child.
By implementing these best practices, healthcare professionals can enhance communication and ensure that parents or caregivers have the necessary information and support to safely administer medication to a sick child.
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Discuss therapeutic management for one of the following:
vomiting, diarrhea, GERD, pyloric stenosis, or peptic ulcer
disease.
Peptic ulcer disease is a condition in which there is an open sore in the stomach or the first part of the small intestine called the duodenum. Treatment is based on a combination of medication and lifestyle changes.
The objective of therapeutic management is to relieve pain and promote healing of the ulcer. Antacids are commonly used to treat peptic ulcers, they are used to neutralize stomach acid to relieve pain, they are available over-the-counter. The doctor can also prescribe H2 blockers that block histamine, which increases stomach acid secretion. PPIs are proton pump inhibitors that are stronger than H2 blockers, PPIs inhibit the production of stomach acid, which promotes healing of ulcers.
Lifestyle modifications that can help to manage peptic ulcers are; avoiding alcohol and caffeine, quitting smoking, eating a healthy diet, avoiding spicy, greasy or acidic foods, eating small, frequent meals rather than large meals. When H. pylori bacteria cause peptic ulcer disease, the doctor can prescribe a course of antibiotics to eliminate the bacteria.Treatment for peptic ulcer disease should continue for several weeks, even if there is a relief of symptoms. After treatment, the doctor can recommend follow-up endoscopy to check if the ulcer has healed.
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What is the diagnosis Icd-10 code(s) for thoracolumbar scoliosis
(neuromuscular) due to past history of poliomyelitis?
Thoracolumbar scoliosis is the curving of the spine to the left or right in the thoracolumbar region, which is the area between the lower thoracic vertebrae and the upper lumbar vertebrae. In some cases, it may be caused by neuromuscular conditions such as past poliomyelitis.
ICD-10 codes are used to diagnose thoracolumbar scoliosis, with different codes for different types of scoliosis. The diagnosis ICD-10 code(s) for thoracolumbar scoliosis (neuromuscular) due to past history of poliomyelitis is M41.24.M41.24
is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M41.24 became effective on October 1, 2021.
It is a valid code that is commonly used to report a diagnosis of neuromuscular scoliosis caused by past poliomyelitis, and it is often used in conjunction with other codes to describe the severity and other aspects of the condition.
In conclusion, the diagnosis ICD-10 code(s) for thoracolumbar scoliosis (neuromuscular) due to past history of poliomyelitis is M41.24.
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Nurse Jacobs is developing a teaching plan for a male client diagnosed with diabetes insipidus. What is the treatment priority for this patient?
A© Begin fluid restrictions of 800mL/day
CO Give the Furosemide 40 mg ordered by the doctor.
BO Start a 0.996 NS IV infusion.
DO Give Insulin 10 units IV push
Diabetes insipidus is a condition that affects the normal balance of fluids in the body. The main characteristic is the production of large amounts of urine with a low concentration of solutes. One of the nursing interventions of a client diagnosed with diabetes insipidus is managing fluid and electrolyte balance.
The treatment priority for a male client diagnosed with diabetes insipidus is to begin fluid restrictions of 800mL/day. The client should have an adequate amount of fluid to keep him hydrated but too much fluid could lead to severe complications of the disease. This is done to prevent further fluid loss in the client.The nurse should provide adequate teaching on the importance of fluid restriction. In addition, the client should be monitored for signs and symptoms of dehydration which may include dry mouth, headache, confusion, sunken eyes and a decrease in urine output
.A low sodium diet is also recommended to prevent further dehydration. The nurse should monitor the client's vital signs, fluid balance, and electrolyte levels. The other options listed are not the priority treatments for a client with diabetes insipidus: Give the Furosemide 40 mg ordered by the doctor: Furosemide is a loop diuretic that increases urine output in clients and this medication is not the priority treatment option.Start a 0.996 NS IV infusion: This solution may be used as an IV therapy for clients, but this is not the priority treatment option for a client with diabetes insipidus. Give Insulin 10 units IV push: Insulin is not the first treatment option for clients diagnosed with diabetes insipidus.
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Surgical procedure case report on Excision Subq soft
tissue
Surgical Procedure:
Definition of Procedure:
Possible pre-operative diagnosis:
Preoperative Case Preparations
What custom surgical pack
During the Excision of Subcutaneous soft Tissue procedure, diseased or abnormal soft tissue found underneath the skin is surgically evacuated to treat conditions like lipomas or sores. The custom surgical pack incorporates specialized instruments and supplies custom fitted to the particular method.
A Surgical procedure case report on Excision Subcutaneous soft tissueSurgical procedure: Excision of Subcutaneous soft Tissue
Definition of procedure: The surgical evacuation of diseased or abnormal soft tissue found underneath the skin.
Conceivable pre-operative diagnosis: Lipoma (generous tumor of fat cells), sebaceous sore, fibroma, or other subcutaneous delicate tissue variations from the norm.
Preoperative diagnosis: Quiet assessment, educated assent, preoperative fasting, organization of anesthesia, situating the persistent, sterilization of the surgical location, collecting the essential rebellious gear, and guaranteeing a sterile environment.
Custom Surgical Pack: A custom surgical pack will be arranged based on the particular needs of the excision procedure, counting rebellious for tissue dismemberment, hemostasis, suturing, and wound closure, as well as fitting wraps and dressings.
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Using the settler model, discuss how you would
implement new evidence in clinical practice
Implementing new evidence in clinical practice using the SETTLER model involves several steps. These include selecting the evidence, engaging stakeholders, tailoring the evidence to the local context, translating it into practice, evaluating its impact, and revising as needed.
The SETTLER model provides a structured framework for implementing new evidence in clinical practice. The first step is to select the evidence, which involves identifying relevant research findings, guidelines, or best practices that align with the specific clinical area.
Once the evidence is selected, engaging stakeholders, such as healthcare providers, administrators, and patients, is crucial to gain support and ensure collaboration throughout the implementation process.
The next step is tailoring the evidence to the local context, taking into account factors such as resources, organizational culture, and patient preferences. This involves adapting the evidence to fit the specific clinical setting and addressing any barriers or challenges that may arise.
The tailored evidence is then translated into practice through various means, such as developing protocols, guidelines, or educational materials, and providing training to healthcare providers.
After implementation, the impact of the new evidence on clinical practice and patient outcomes should be evaluated. This involves collecting data, monitoring processes, and assessing the effectiveness of the implemented changes. Based on the evaluation results, revisions may be made to further optimize the implementation process and improve outcomes.
Overall, the SETTLER model provides a systematic approach to ensure the successful integration of new evidence into clinical practice. It emphasizes the importance of stakeholder engagement, context adaptation, and continuous evaluation to enhance the quality of care and promote evidence-based practice.
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Identify risk factors and potential predictors of iron deficiency anemia. (select all that apply)
A. history or multiple births
B. Administration of diuretics
C. complications related to ibuprofen use
D. history of trauma
The risk factors and potential predictors of iron deficiency anemia are A. history or multiple births B. Administration of diuretics C. complications related to ibuprofen use D. history of trauma
Iron deficiency anemia is a health condition that develops when there isn't enough iron in the body to create enough hemoglobin. Hemoglobin is a vital protein that helps red blood cells deliver oxygen to the body's tissues. Because of this, people with iron deficiency anemia may experience fatigue and shortness of breath. Iron deficiency anemia is a prevalent form of anemia, and it is caused by a lack of iron in the body. There are various risk factors and potential predictors of iron deficiency anemia. They are explained below: History of multiple births: Multiple births, such as twins or triplets, may result in an increased risk of iron deficiency anemia. Administration of diuretics: Diuretics, or "water pills," are used to treat a variety of illnesses, including hypertension. Diuretics, however, may cause iron deficiency anemia. Complications related to ibuprofen use: Ibuprofen, a popular over-the-counter pain reliever, may cause gastrointestinal problems and internal bleeding, both of which can cause iron deficiency anemia.History of trauma: Trauma, such as a severe injury or blood loss during surgery, may increase an individual's risk of developing iron deficiency anemia.
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