Pain Assessment Report

Pain Assessment Report
Objective data that should be assessed are, pain assessment should be conducted by asking the
patient his pain levels by using the Position/Provoking, Quality Radiate, Severity, and Time
(PQRST) method, keep an eye on the patient's facial expressions they may also grimace or wince in
pain, this is to assess the amount of pain he is in and see if you may need to contact a doctor to
review his pain medication dosage. Does Mr Jones look clammy/sweaty? Is he short of
breath(SOB), monitoring the way he is breathing e.g. shallow or deep, is he struggling for breath?
he may even have noticeable cyanosis, is there anything that makes the pain better or worse?
Checking the capillary return It is used to monitor the amount of blood flow to tissues.
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Biventricular Decompression For Acute Cardiogenic Shock...
Ambulatory Central VA–ECMO with Biventricular Decompression for Acute Cardiogenic Shock
Central Message
We describe the off–pump insertion of a partial right ventricular assist device and a left ventricular
assist device with extracorporeal membrane oxygenation: a novel technique that allows for walking
central VA–ECMO with direct biventricular decompression.
Introduction
Cardiogenic shock is a life threatening emergency that results in high mortality rates 1. Inadequate
coronary and systemic perfusion are often present, and commonly lead to multi–organ failure,
which, results in further insult and injury. Initial management involves the use of vasopressors and
inotropes to improve cardiac output and systemic perfusion. Surgical ... Show more content on
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We optimized his medical therapy, inotropic support and performed a successful cardioversion.
Despite these interventions, the patient's clinical status continued to decline with worsening fluid
retention, progressive AKI (SCr 3.8mg/dl) and multiple episodes of ventricular tachycardia and
ventricular fibrillation terminated by his implantable cardiac defibrillator (SAVE score –2) 5. We
made the decision to insert a partial right ventricular assist device and a left ventricular assist device
with extracorporeal membrane oxygenation for biventricular support and oxygenation. The patient
underwent a left mini–thoracotomy, with off–pump trans–apical placement of a 31 French
ProtekDuo® cannula. We secured the device using 3.0 Prolene purse–string sutures. The cannula
provided a route for blood exchange with the inflow port located in the left ventricle and outflow
port and cannula tips situated 2–3cm above the aortic valve. The blood circulated by the cannula
passed through an extra–corporeal membrane oxygenator (TandemLung®) and pump
(TandemHeart®). We also placed a 21 French IVC–SVC venous cannula via the femoral vein and
connected the tubing to the inflow of the trans–apical ProtekDuo® cannula (figure 1). The LVAD
was up–titrated to a flow of 4.4 L/min at 7000rpm.
Within 24 hours after the procedure, we observed a vastly improved response to diuretics, the AKI
started to resolve and he was successfully extubated.

Difficult Intravenus Access Essay
Difficult intra–venous access is cauterized as multiple attempts and/or the prediction of special veins
that are easier to access and maintain peripheral venous access. Predictive issues for difficult IV
access include obesity, history of IV drug use, and edema. Factors associated with difficult IV
access in adult include chemotherapy, multiple prior hospitalization, and diabetes. [1] it is noted that
intravenous cannulation that's done by more experienced emergency medical staff was associated
with higher success rate. IV cannulas with smaller gates were commonly associated with failure
cannulation. This result was concluded to be due to the choice of person applying IV cannulation,
and the predicted difficulties of insertion. [2] Intravenous ... Show more content on Helpwriting.net
...
[3] The nurse's experience and the emergency medical care provider can explain some difficulties in
cannula insertion. Success rate and time to apply intra–venous cannula is mandatory to obtain the
best resuscitation of critical patients. Difficult intra–venous cannulation can be challenging even to
the most experienced emergency nurse. Central venous catheterization (CVC) is an alternative route
for cannulation in patients with difficult intra–venous access. CVC provides a fast effective intra–
venous access for flued resuscitation and for Central Venous Pressure monitoring. However, venous
thrombosis, catheter associated bloodstream infection, arterial puncture and pneumothorax are most
common Central Venous Catheterization (CVC)

Nursing Reflection
The objective of this reflection is to explore and reflect upon a situation from a clinical placement
on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care
for my patient when the oxygen saturation was low. Furthermore, this reflection will include a
description of the incident, and I will conclude with explaining what I have learned from the
experience and how it will change my future actions. The incident happened on Nov 21st, 2017. The
patient has sleep apnea and a health history of chronic bronchitis (no episode in recent 2 years). Her
respiration rate was 16 and all lung fields were clear upon auscultation. After I took the patient's
vital signs, I noticed that her oxygen saturation was low (83%). Then, I notified the nurse and asked
the patient to do take some deep breath. After that, we put her on 2L of oxygen and her oxygen
saturation went up to above 90s. However, the patient had a bladder control problem (was
incontinent), so I took the oxygen off because she went to the toilet for around 4–5 times in an hour.
However, I forgot to monitor her O2 saturation right away. Instead, I checked her oxygen saturation
after she finished her dinner, and it dropped to 86%. The instructor showed me how deep breathing
exercise can help the patient increase her oxygen level quickly. I notified the nurse and we put the
patient on 2L of oxygen, but again I forgot to check her oxygen saturation right away. Instead, I
checked her oxygen around 7pm later. I stayed close to the patient during this whole period, but I
was not paying enough attention to her low oxygen level. The patient was a healthcare aid and she
kept telling me that, "It's ok, I am always a shallow breather". However, I should have my own
judgement ability and provide more competent care with timely evaluation of the effectiveness of
the interventions. After being reminded by the instructor, I was aware of my mistakes and noticed
that I failed to maintain patient's safety. An oxygen below 90% can be very dangerous for the
patient, especially for a post–op day #1 patient, because prolonged hypoxemia can cause fatigue,
headache, acute respiratory failure, cardiac problems (increased heart rate,

A Study on Liposuction Surgery
Liposuction Surgery Body image has become a major concern for many Americans, and now that
there are procedures that can one's body more people are opting for surgeries to build themselves
up. One very popular form of reshaping is liposuction. This procedure, using one of several different
surgical methods, can remove fat from the body and create a more fit appearance. However, as is the
case with all operations, there are dangers associated with the procedure. This paper details the
procedure, the different types that are available, and the inherent problems that people have
encountered as a result of liposuction. The basics of this type of procedure are well known to the
general public. First the patient will choose the area of the body from which they want the fat cells
removed, and, on the day of the surgery, the surgeon will mark the area. Depending on the type of
liposuction the patient will receive either a general anesthetic or a local. Most procedures require a
general anesthetic since the procedure can be very painful and cover a wide area. The surgeon may
also inject certain fluids to assist in the procedure depending on the type of liposuction that is to be
performed. After this, the doctor will make several small incisions at the point of fat cell removal in
which cannula will be placed. The cannula is a long hollow tube used to remove the fat cells
(DocShop). During the basic type of this surgery, the doctor will move the cannula back and forth in
the

Respiratory Therapy Essay
Respiratory Therapy Respiratory therapy profession is a health specialty that treats people with
problems that is affecting their cardiopulmonary system. The therapist is involved in the treatment,
management and control, diagnostic evaluation, and the care of patients with a respiratory problem.
Respiratory patients can be found in different departments in the hospital. They can be found in
newborn nursery, surgical and medical units, outpatient, emergency room, nursing homes, or in
critical care units. A respiratory therapist is the one responsible for getting lifesaving machines, like
ventilators, ready for use and to operate them. They help people with breathing disorders and
difficulty breathing breathe. They use different types of sophisticated ... Show more content on
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The most common procedure I saw done was the continuous nebulization therapy. It is done to
patients of all ages. It is for treating patients with unresponsive or severe exacerbations of asthma. It
can offer the advantages of higher penetration of the drug into the lungs, reduced bronchospasm,
and a more rapid response. It has been said to prevent or reduce the chance of needing to go to the
intensive care unit ("Mercury Medical"). Nasal cannulas are used to deliver oxygen to people who
cannot get enough of it. It is a flexible tube that is placed under the nose with two prongs that goes
inside the nostrils of the patient. Nasal cannulas are normally used to deliver low levels of oxygens
but can deliver high levels (Heitz). Another procedure is airway suctioning which is done when
secretions in the throat is blocking the airway. Suctioning an airway may be done with endotracheal
tube, tracheostomy tube or through the nose or mouth in the trachea. The therapist will insert the
catheter through the nose with either tracheostomy or endotracheal tube. It will be enter gently and
when it is in the right depth, suction may begin. The catheter will be slowly withdrawn when
finished. When suctioning monitor the oxygen levels and heart rate to make sure the patient is
handling the procedure well ("Basics of

Case Study: Ideal Brazilian Butt Lift
Do You Qualify As an Ideal Brazilian Butt Lift Candidate? The Brazilian Butt Lift is a cosmetic
surgery procedure that is growing in popularity. In fact, since 2013 it has become 58% more popular
(statistics taken from the American Society for Aesthetic Plastic Surgery). It seems that big name
celebrities are largely to blame for this popularity surge, as many of them have enviable butts that
many people wish they could have. Which means that they turn to Brazilian Butt Lifts for help. But
what does this procedure involve and what does it take for people to be a great candidate for a
Brazilian Butt Lift Candidate? What is a Brazilian Butt Lift and what does it involve? A Brazilian
Butt Lift is a cosmetic procedure which involves a transfer

Dr. Fasching Research Paper
It's a sad fact that some body fat is just difficult to eliminate. You've already spent hours in the gym
just to burn off calories. You've stopped eating your favorite calorie–laden food just so you wouldn't
stray away from your strict diet. Yet, that fatty deposit in your waist, hips or buns just wouldn't go
away. It's frustrating, right? The good news is you don't have to feel defeated. Thanks to modern
technology, you can request a liposuction with Dr. Michael Fasching to remove stubborn fat. It's a
minimally invasive procedure that works by suctioning fat out of our body. When you visit Dr.
Fasching for a liposuction consultation, you are most likely going to encounter two liposuction
techniques, a traditional liposuction or a tumescent liposuction. Both have the same objective, which
is fat reduction, but differ in ... Show more content on Helpwriting.net ...
Back to work within one to two days with mild bruising and soreness Which one is better? From the
table above, you can probably say that tumescent liposuction is better. However, never
underestimate what traditional liposuction can do. After all, traditional liposuction has not become
the most popular procedure in the country for nothing. Both procedures can deliver the results you
want, but they do have their own pros and cons. If you want superb results, choosing who your
surgeon will be should be the weightier matter than what liposuction technique to get. Regardless of
what technique you choose, you should feel confident about your doctor's skill and experience. With
that said, the smartest move to make is to consult with a board–certified plastic surgeon. Thankfully,
Dr. Fasching is highly qualified to recommend and perform both techniques, and give the results
you desire and deserve. To know if you're a good liposuction candidate and which technique is
better for you, schedule an appointment

Long Hand Charting for Iv Insertion and Removal, Trach...
Pt requires 20 gauge IV for _______. 20 gauge catheter inserted to the right anterior forearm, first
attempt. Flushed with 10 cc normal saline. Stat lock in place, covered with transparent dressing. Pt
tolerated well with no complaints of pain or irritation upon flushing, no visible swelling or bruising.
Sharps placed in approved container, patient's bed lowered as far as possible and assisted to
comfortable position. Reassessed in 5 minutes for bleeding , none noted.
Pt requires IV discontinuation d/t: pain / infiltration / expiration of indwelling time frame.
Discontinue 22 gauge IV catheter from L hand. Cannula intact. Pressure held for 3 minutes, assess
for continue blood loss, none noted. 2 x 2 gauze dressing with paper tape ... Show more content on
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Bed rail returned to upright position and bed lowered to lowest possible position.
Order written by _____ for a 16 F indwelling catheter for _(preop)__. Pt instructed on the need and
gave consent denies iodine allergies. Pt is positioned in the dorsal recumbent position, perineal area
cleaned with warm damp cloth and dried. Labia spread and meatus cleansed with betadine.
Lubricated catheter inserted immediate return of 500 ml of cloudy

Echocardiography Essay
A routine follow up echocardiogram for an LVAD patient can help find complications that may arise
from this heart failure therapy. LVAD dysfunction can originate from the inflow cannula. The
misalignment and increase pump flow can cause the walls of the LV to be sucked down towards the
cannula resulting in obstruction of inlet flow. We will see this first from the parasternal long axis
view. When applying Doppler to the inflow cannula, the characteristic of the flow pattern can
represent obstruction or thrombus within the cannula. Flow pattern showing slow, turbulent and/or
lack of flow indicates some type of obstruction. With an LVAD, the aortic valve should remain shut
or only open once every few beats. Increase your beats on the PLAX view and putting an M–mode
... Show more content on Helpwriting.net ...
As a result of the improvement in medicine, more and more people are able to live with congestive
heart failure than ever before. With that being said, there are more patients who have lived longer
because of the opportunity to have an LVAD implantation. Seeing an LVAD patient in the
Echocardiography lab has become a common occurrence in the recent years. It is important for
sonographers to be knowledgeable and to continue their education, as echo plays an important role
in assessing the LVADs and native heart's function.
This report has allowed us to have an exceptional understanding of LVADs and the advanced
sonographic technique needed to fully evaluate its function. With this found knowledge, we can
confidently enter an LVAD exam knowing what is required of us. Before a patient receives an
LVAD, an important area to evaluate is the presence of aortic regurgitation and its severity. Post
LVAD implant, we know to evaluate the aortic valve in more ways then one to assess any aortic
valve opening. Also, the inflow and outflow cannulas need show flow as continuous and pulsatile to
show no signs of

Info Dean Kamen: The Invention Of Insulin Pump
Combined Draft
Insulin Pump
Kadiatou Konate
4/4/17
Ms. D'Agostino
Intro:
Dean Kamen is known for inventing many things, but his most important invention is the insulin
pump. An insulin pump is an electronic device that includes a cartridge of quick acting insulin. It
decreases blood sugar if it is high. Insulin pumps are for diabetics use only. (animas) An insulin
pumps purpose is to deliver insulin to people who have diabetes. People that have insulin pump uses
it so it can give insulin to their body throughout the day and take out extra doses of insulin to
decrease rises in your blood sugar. Also, it helps diabetics to have more flexibility and freedom. (
KidsHealth) Dean Kamen developed the first prototype wheelchair called iBot that ... Show more
content on Helpwriting.net ...
Next you have to attach the infusion set(tubing connected to a cannula) to the reservoir. After that
you have to prime the pump which means that you have to activate the pump by pressing the
buttons/controls on the insulin pump which then tells the pump what to do. Then you have to insert
the infusion set in places like your tummy(abdomen),thighs,buttlocks, and the arms. When you are
setting up the infusion set you have to push the cannula under your skin and hold it in place with a
adhesive patch.(diabetes.co.uk)
Purpose
People who have diabetes know the purpose of an insulin pump. But people that don't have diabetes
don't even know what an insulin pump is or what it is made out of. An insulin pumps job is to
deliver insulin for people that have diabetes. It can be worn as a belt or put into a pocket. The pump
is connected to a tube that is put under the skin and taped. People that have insulin pumps or use it,
use it so it can deliver insulin throughout the day and take out extra doses of insulin to handle
increases in blood sugar. (example: After eating) ( Nemours)

How Tracheostomy Care Is Essential For Patients
Abstract
Tracheostomy Care is essential for patients who are in respiratory distress. Nurses need to prevent
complications and promote education to care for this device. Cleanliness of this device will keep the
patient health from deteriorating, and ultimately prevent any infections that could possibly arise if
the tracheotomy is not taken care of properly. The purpose of a tracheostomy may have a myriad of
reasons. A couple of reasons to perform a tracheostomy may be due to a blocked airway,
obstruction, or to be used to extended respiratory or ventilator support. Tracheostomy care is vital
for patients because it prevents any complications. According to John Hopkins Medical Center (n.d),
"Early complications that may arise during the tracheostomy procedure or soon thereafter include:
bleeding, air trapped around the lungs (pneumothorax), air trapped in the deeper layers of the chest
(pneumomediastinum), air trapped underneath the skin around the tracheostomy (subcutaneous
emphysema), damage to the swallowing tube (esophagus), injury to the nerve that moves the vocal
cords, tracheostomy tube can be blocked by blood clots, mucus, or pressure of the airways walls".
Tracheostomy Care
Numerous research has been conducted on various reasons why tracheostomy care is gravely
important. There are several indications why a patient might need a tracheotomy. Research by
Morris, Whitmer, and McIntosh (2013), explain:
"Indications for placing tracheostomy tubes can be grouped into

Animal Lab Report
For this experiment students followed a lab protocol in spring of 2017 designed by Dr. Crespi. The
species used for this experiment were NZW female rabbits. The reason for using this particle
species is because they have larger veins and arties compared to the usual rabbit making it easier for
students during the operative procedures. The vagus nerve and the depressor are also separate in this
species which allowed for this experiment. The final reason that rabbits were used in this
experiment is because they share very similar physiological characteristics to humans. The objective
of this experiment was to isolate nerves and determine their function, signaling direction, and their
response to neurotransmitters. To begin this experiment rabbits ... Show more content on
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The cephalic portion of the right vagus was then stimulated in the same manor with responses
recorded. The cephalic stump of the right depressor nerve was then stimulated and the response was
recorded. The ligature was then tightened around the left vagus nerve by the cephalic end then the
nerve was severed anterior to the ligature. The cephalic stump was then stimulated of the right
depressor and recorded the response. Students injected 0.20 mL of epinephrine and also recorded its
response. Next, they injected 0.10 mL of 1/ 2,500 acetylcholine and noted its response. Students
were asked to observe the rabbits pupil with good light and injected 1mL of 1% atropine through the
IV drip over the course of seven to ten minutes. Students were asked to investigate the rabbit's
pupils again to observe if they were maximally dilated. Next, they stimulated the caudal end of the
right vagus once more with twice the amount of voltage and recorded the results. An injection was
given of 3mL of 1/ 2,500 acetylcholine and observed how the blood pressure was effected. Finally,
students consulted with their instructor before injecting the rabbit with pentobarbital in order to
euthanize the rabbit. All statistical data was analyzed using JMP and was analyzed using an

The Incident Of An Oxygen Mask
Nerves bubbled in my stomach as we waited for the plane to take off. Every other student in year
eight buzzed with chatter, while Mr. Whitelock took attendance. It was announced two weeks ago
that the Eton Boys Boarding School, along with many other schools, would be traveling overseas to
escape from possible atomic warfare. This information didn't set in my mind till about two days
before the flight; I was moving away from my home and the only life I knew.
"Russell Grohmann," Mr. Whitelock called interrupting my previous thoughts.
"Here," I uttered back.
After attendance, the flight attendant came out and gave us safety procedures.
"During the flight please keep your seat buckled until told otherwise and in case of emergency an
oxygen mask will come down from above your seats. Before helping anyone else, please, secure
your own mask. Thank you." she stated in a monotone voice, then walked to the back of the plane.
The plane took off and William, who constantly picked on my at school for both my appearance and
diction, decided to spark up a conversation.
"Hey Piggy, how do you feel about the move?" he asked bitterley, "I've heard Australia is amazing."
"I'm glad that we are moving to a safer place, but Australia is over 9,000 miles away and will be a
huge change from England," I replied back.
"Yeah, I guess you 're right, I'm sure gonna miss England," he said, tears formed in his eyes.
After the short conversation with William, I noticed some of the boys that

Inject Insulin Research Paper
How to inject insulin.
– Select a new stick and place
Lift a fold of skin with the help of 2 or 3 fingers.
– Insert the needle into the skin fold.
NOTE: Select the correct length of the cannula so you do not accidentally stand for deep into the
muscle.
– Count...1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010
Hold down the button on the insulin pen until the entire dose has been delivered.
Wait 10 seconds before pulling out the cannula.
Withdraw the needle and release the skin fold. If you see a drop of insulin at the needle tip or skin
when pulled out the needle should wait a little longer before you removing needle next time.
– Discard the needle "safe" so that not accidentally prick themselves on it use cannula.
Change

Empyema Case Studies
This is a 62–year–old female who required inpatient hospitalization due to ride–sided empyema.
She was transferred from another inpatient facility to Mercy San Juan due to complaints of
shortness of breath accompanied by cough and chest pain. Prior to admission, she had a chest x–ray
that showed patchy right lower lobe opacity that represents pneumonia and pleural effusion.
Moreover, her CT chest revealed right lower lobe pulmonary necrosis in the medial right lower lobe
and pleural effusion with right middle lobe atelectasis. She received azithromycin and Rocephin and
was evaluated by the Pulmonologist. Her past medical history is significant for COPD and
Hyperlipidemia. Vital signs included of a blood pressure of 144/77 mmHg and an oxygen

Liposuction Research Paper
roycroftmedicalcentre.com.au – Get Rid of Bad Fat Bulges with Liposuction When you have
unsightly fat deposits or bulges in various parts of your body, you should turn to a professional with
cosmetic medicine to receive liposuction or lipo treatments. During the treatments, the professional
utilizes special tools and procedures to break up the fat in order to suction from the intended area in
a safe, effective manner. Areas of the Body a Professional Will Treat With Lipo The lipo treatments
successfully reduce certain fat bulges in the following areas of the body: Abdomen Ankles Back
Buttocks Hips Calves Cheeks Chest Chin Inner knee Neck Thighs Upper Arm Waist Who Are Ideal
Candidates for Liposuction? Ideal ... Show more content on Helpwriting.net ...
In the second step, medical personnel will administer medications to ensure the patient's comfort
during the procedure. Incisions will be made during the third step to insert the cannula into to
remove the loosen deposits of fat. A cannula is simply a hollow tube that is connected to a surgical
syringe or vacuum. As the doctor works at removing the fat, he or she will need to move the cannula
back and forth in a controlled manner to accomplish the task. You will not realize full results until
all the fluid retention and swelling subsides over the days following the lipo procedure. Recovery
The doctor will apply elastic bandages of a compression garment on during the lipo treatment.
Patients must wear these for a specific length of time to ensure optimal body–contouring results. In
addition, the patients will need to take proper care of the surgical drains and site for a speedy
recovery. It may require several months before all the swelling dissipates to unveil the new body
contour. Turn to liposuction today to rid your body of those unsightly fat deposits. You do need to
remember, though, that lipo is not a replacement for a healthy diet and exercise

Tracheostomy Research Paper
What You Need To Know About Tracheostomy and Tracheostomy Tube Safety
A tracheostomy, or trach, is a surgically created opening in the trachea. A tracheostomy tube, or
trach tube, is a tube that is placed in this opening to help with breathing. It is important to take good
care of your trach and trach tube. This will help you stay safe and free from infection.
WHAT SAFETY STEPS SHOULD I TAKE?
General Instructions
Follow your health care provider's instructions about:
Cleaning your trach and the area around it.
Suctioning your trach.
Cleaning your trach tube.
Changing your trach tube.
Keep your trach and trach tube dry. When you take a shower:
Cover your trach with a shower shield or other protective covering. ... Show more content on
Helpwriting.net ...
Emergency phone numbers.
Sterile water.
0.9% saline solution.
Sterile gloves or hand sanitizer.
Sterile gauze pads.
If You Get Sick:

Suction your trach more often.
If you vomit:
Cover your trach tube with a towel to keep vomit out of your airway.
Suction right away if you think vomit may have gotten in your trach tube.
If You Use a Ventilator:
Check the ventilator safety and sound alarms every day to be sure they work.
Make sure the ventilator tubes are in the right place and do not pull on the trach tube.
Do not twist or pull on the trach connector more than needed. Too much pulling or twisting can
cause the ventilator tubes to disconnect.
When you hook up or disconnect the ventilator or humidification tubing, hold the trach tube in
place.
If you are using a trach tube with one or more side openings (fenestrated trach tube), always use an
inner cannula without side openings (non–fenestrated cannula) with the correct connector.
SEEK MEDICAL CARE IF:
You cannot remove your trach tube or inner cannula.
You have redness, swelling, or tenderness around your trach.
You have fluid or blood coming from your

Reflection Paper On Phlebitis
In Tabba Hospital I observed different issues, but mostly issues were related to medication errors
and phlebitis. This reflection paper will talk about the phlebitis issue that how I and the management
team of Tabba Hospital collaboratively makes efforts to resolve this problem. Phlebitis is the
complication of peripheral intravenous catheterization in which inflammation of the vein wall
occurs (Carretero, 2013). The symptoms of phlebitis appear in patient are pain, swelling, tenderness,
warmth and redness at the affected site. There are numbers of factors involved in developing
phlebitis like trauma of vein during insertion of cannula, type of cannula material used and many
others. These factors are classified into three categories such as mechanical, chemical or bacterial
phlebitis. Mechanical phlebitis depends upon location, size and material of cannula, and also cause
due to incorrect method of cannulation. Chemical phlebitis is caused by irritant drugs or solutions.
Bacterial phlebitis is ... Show more content on Helpwriting.net ...
According to the statistical data of 2012 from health care associated infection (HAIs) indicated that
60–80% patients develop phlebitis during hospitalization. The Tabba Hospital was also encountering
the problem of phlebitis in many patients so they become concerned about the root cause of this
problem. The managers call the meeting of their unit head nurses, and share this concern with them.
Then the managers asked the head nurses and me to inquire the reason of phlebitis. I was feeling
proud that the managers assign me this task, and I was happily willing to help them to reduce the
phlebitis incidence rate. Before conducting the rounds of units I review the hospital policy regarding
intravenous catheterization and also reviewed the literature about phlebitis to develop better
understanding about this

Respiratory Acidosis Case Study
Respiratory acidosis is a condition closely related to patients with Chronic Obstructive Pulmonary
Disease (COPD). According to Ranson & Pierre, respiratory acidosis is characterized by lab values
including an increased amount of carbon dioxide (CO2) in the blood and a lower, more acidic pH
level (2016). More specifically, a CO2 value greater than 26 mEq/L and a pH level below 7.35
(Ranson & Pierre, 2016). These lab values signify the lungs inability to effectively eliminate the
CO2 produced by the body. In turn, this produces "more carbonic acid H2CO3, which then increases
the acidity of the blood" (Wasserman, 2017). The patient that prompted me to research respiratory
acidosis was admitted due to an exacerbation of COPD and asthma. This patient's lab results showed
an elevated CO2 level of 31 mEq/L. The form of COPD that the patient had was chronic bronchitis.
The pathophysiology behind chronic bronchitis is inflammation and constriction of the bronchial
tubes making a perfect environment for mucus to accumulate and inhibit breathing (Pietrangelo,
2016). Because inspired oxygen cannot flow as freely to the alveoli, the diffusion of carbon dioxide
from the bloodstream into the lungs is impaired. Since CO2 is forced to stay in ... Show more
Furthermore, the nurse must identify the contributing factors to that underlying condition and make
sure that the patient thoroughly understands them. In regard to COPD, smoking is the biggest
causative factor. A nursing consideration, in this case, may include educating the patient on smoking
cessation. Incentive spirometry and deep breathing exercises can also be encouraged by the nurse.
Having the patient demonstrate proper spirometer use is a great nursing outcome that may influence
a patient to continue using it after discharge. If these actions are successful, the lab values should
reflect lower CO2 and normal

Shank3
Animals:
For this project, the Shank3–deficient rats used were generated in Dr Joseph Buxbaum's lab using
zinc–finger nucleases (ZFN) in the outbred Sprague–Dawley background. The design, cloning, and
validation of the ZFN, as well as the embryonic microinjection and screening for positive founder
rats were performed by SAGE Labs (Boyertown, PA USA). Briefly, sixteen pairs of ZFN were
designed targeting exons 4, 5 and 6 of the Shank3 gene to disrupt the Shank3 ANK domain. These
pairs were assembled by PCR and sub cloned into the pZFN expression plasmid. ZFN were then
transfected into the rat C6 cell line and tested for disruption activity using the Surveyor
endonuclease (CEL–1) assay [53].
Animal care and husbandry
All rats were kept under ... Show more content on Helpwriting.net ...
The rats were trained on a novel behavioral task designed in the ABET system from Lafayette
Instrument Company; Lafayette, IN USA. Training occurred in similar manner as described for
5CSRT, where the rat was presented a white square stimulus in the center of the screen to invoke the
touching behavior on Bussey–Saksida capacitive touchscreen through the insert window. The rats
touched the location on this 765x1024 pixel capacitive touchscreen and received a sucrose spurt as a
reward delivered through a solenoid valve (Clippard Instrument Laboratory, Inc.). The second stage
of training was to get the rats to initiate the trial by breaking the tray beam, thus controlling the trial
initiation. For every initiated trial, the rat was presented a white square of 275x275pixel to make the
approach as stereotaxic as possible. The final stage of the training involved breaking of the IR beam
passing through the insert's window, to initiate the pattern reversal of the presented stimulus on the
screen. The initial time between pattern reversal and the capacitive touch was 2sec, which was
further reduced to 1sec for criterion testing. The criterion for the task was set to ~80% of In–time
capacitive touches with less than 20% late

Is Liposuction A Cosmetic Surgery?
There are many terms that are associated with Liposuction, this includes Lipoplasty or fat modeling,
Liposculpture, or in shorter terms Lipo. Although, the terms Liposuction, Lipoplasty, and
Liposculpture differ in some ways but still they entail fat removal. Liposuction, as what we
commonly call it, is a cosmetic surgery operation that can remove fats from the different areas of the
body. Most people who want to undergo Liposuction want to extract the fat away from the neck,
abdomen, thighs, buttocks, back of the arms, and practically elsewhere where there are great fat
deposits.
Because of the popularity of Liposuction, many people especially those who find it difficult to
manage their weights and body fats want to undergo Liposuction surgery. However, Liposuction is
not accessible for everybody since the cost is not that affordable. Sometimes, there are several
factors that can limit the amount of fat that can be removed in one session, thus fat removal may
need several sessions – the more that it will become more costly.
On the other hand, no matter how costly Liposuction is, it is still one of the accessible surgeries that
some individuals want to avail. There are several benefits of Liposuction that can still encourage
people to undergo one, these are:
It is safe and effective. Liposuction compared to other fat removal and other surgery procedures is
safer and more effective and it can easily be combined with other techniques in cosmetic surgery.
It gives

HFNC Case Studies
While I was giving a patient a nebulizer treatment, she mentioned she did not like the oxygen
system she was previously on. During the conversation it was hard to understand what exact oxygen
delivery system the patient was referring to, I looked at my preceptor and she stated "a high flow
nasal cannula". When we were finished with the patient and out her room I asked my preceptor
more about a high flow nasal cannula. From my understanding nasal cannulas are low flow system
than range from 1–6lpm and 24–44% fio2. It was interesting to learn that there is a high flow nasal
cannula that can go up to 100% fio2.Later on in the evening my preceptor pointed out what a high
flow nasal cannula look like as we were on our way to see another patient. ... Show more content on
Helpwriting.net ...
HFNC appears to have a lot of benefits compared to other oxygen delivery system but when
researching I found that there were many things researchers do not know about HFNC such as "the
indication of HFNC and criteria for timing the start of HFNC, for stopping HFNC, and for
escalating treatment". Also "since HFNC is noninvasive, the PEEP (CPAP) level is not measured".
In my opinion, if HFNC is proven to be a safe high flow system, I think it's a great idea. I could not
imaging needing a high flow delivery system and having to wear a mask for hours or days at a time.
I hope to see and read more about HFNC research and other new oxygen system delivery systems in
the future. Does anyone have an opinion about HFNC? Would you prefer it over a simple mask,
non–rebreather, or partial

Case Study Hydrocortisone And Methylprednisolone
Hydrocortisone and methylprednisolone What would you suggest to try to use one drug therapy?
Can you use fludrocortisone? In theory, it would be possible to try to use one steroid that can have
the effect of the methylprednisolone as well as the hydrocortisone to target both the glucocorticoid
as well as mineralocorticoids activity. However few obstacle arise with this concept 1– There are
not enough studies that investigated the use of other corticosteroids aside from prednisone and
methylprednisolone that showed efficacy in the treatment of PCP. There have been case report using
hydrocortisone doses of up to 1000 mg to treat patient with PCP, however, the data is outdated and
has not been validated in head to head trials (Montaner JS1, ... Show more content on
Helpwriting.net ...
This decline in viral load usually continues 8 to 12 weeks and then plateau. This change is usually
accompanied by an increase in immune cells occur as well. The recovery of CD4+ T is biphasic, a
drastic increase in CD4+ cells occurs during the first three to six months of HAART. This initial rise
is primarily to an increase in the numbers of CD45RO+ memory T cells and is presumed to be due
to a combination of decreased lymphocyte apoptosis as well as a redistribution of those cells from
the peripheral lymphoid tissues into the circulation. Thereafter, a slow increase occurs in most
treated individuals. This secondary increase in CD4+ T cells is thought to be due to T cell clones
produced secondary to thymopoiesis. CD8+ T lymphocytes also increase rapidly after the initiation
of HAART, however, the total numbers of CD8+ T lymphocytes eventually stabilize as memory
CD8+ cells numbers decline and are replaced by naive CD8+ T cells. When there is a lack in T cell
in the body the macrophages will be primed with the HIV antigen and present it on the surface of
their

Ventilatory Analysis
In this article, the authors emphasise the use of noninvasive methods of providing ventilation to
neonates as they were introduced to do away with the mechanical ventilation techniques. De
Winters and Vries claim that the use of noninvasive techniques reduces the incidences of
bronchopulmonary dysplasia in neonates, a complication most common with standard ventilatory
techniques. The article discusses the best ways in which the modern noninvasive respiratory support
techniques should be administered to neonates. The authors argue that non–intubated continuous
positive airway pressure (nCPAP) is beneficial to an infant in some ways. It stabilizes the airways,
increases the volume of the lungs and decreases the effort required for respiration.

Example Of Intraoperative Complications
Results 1) Preoperative Data This study included 59 eyes of 58 patients with mean age ± standard
deviation (SD) of 54±11 years, and a range from 25 up to 70 years. The male to female ratio was
nearly 2:1. Table 1 summarizes the preoperative visual acuity and IOP. 2) Intraoperative
complications Table 2 summarizes the intraoperative complications which can be attributed to the
20–G transconjunctival trocar system. More than 75% of our cases did not develop any
intraoperative complications. Complications occurred only in 14 cases; of these, the most common
complication was slippage of the cannula, occurred in 8 cases (14%); followed by trauma to the
lens, seen in 4 cases (7%) and lastly retina incarcerated in the cannula in only 2 cases ... Show more
Suturless vitrectomies carry an increased risk of leakage from the sclerotomy site. Such excessive
leakage can raise the risk of infection and hypotony (5). So, in our study we used 20–G
transconjunctival trocar system with suturing of the conjunctiva and sclera by one suture for each
sclerotomy to avoid the risk of leakage and its complications. In our study more than 75% of cases
did not develop any intraoperative complications. Complications occurred only in 14 cases; of these,
the most common complication was slippage of the cannula, occurred in 8 cases (14%); followed by
trauma to the lens, seen in 4 cases (7%) and lastly retina incarcerated in the cannula in only 2 cases
(3.5%). This was similar to study done by Spierer et al, as in their study intraoperative
complications included premature dislodging of the cannulas in two sclerotomies. The cannulas
were reinserted with a trocar through the same opening without any additional complications (6).
Retinal incarceration in the trocar system was reported in our study (2 cases) and can be attributed
to the malfunction of the trocar valve leading to rapid flow of fluids through the trocar at the time of
instruments exchange. As we were re–sterilizing the trocar system several times by flash autoclave,
the valve system became loose and not effective. So, we concluded from this point that re–sterilized
trocar should not

Wistar Injury Research Paper
Animals and surgeries Male, 5–6 wk old Wistar rats weighing 200–250 g (Charles River Breeding
Laboratories, Montreal, Quebec, Canada) were housed on a 12–hour light/dark cycle at constant
room temperature and fed a standard commercial rat chow (120 µmol Na+/g,) and water ad
libitumFor all surgeries, rats were anesthetized with 2% isoflurane in oxygen. Effective levels of
anesthesia were maintained by observing reactions to physical stimulation such as toe–pinch, as
well as monitoring the pattern of respiration. For pain relief, slow release buprenorphine (1mg/kg)
was injected sc 1 hour before surgery which provides adequate analgesia for 3 days. . All surgeries
and experiments for the present study were approved by the University of ... Show more content on
Helpwriting.net ...
For measurement of ROS, slides were thawed at room temperature for 10–15 min, then sections
were fixed in 4% neutral buffered formalin for 10 min at room temperature to preserve tissue
morphology (Tronel et al., 2013). After washing 3 ×5 min with PBS, slides were incubated with 1
µmol/L dihydroethidium (DHE, Sigma–Aldrich Canada Ltd, Oakville, ON, Canada) for 30 min at
room temperature. After a single PBS wash, coverslips were applied with Dako fluorescent
mounting media (Dako Northe America Inc., Carpinteria, CA). The red fluorescent product resulting
from the oxidation of DHE was visualized using an excitation wavelength of 488 nm with an Axio
Imager. An A2 Upright Microscope equipped with a Colibri, 2 Illumination System was connected
to an AxioCam MRc camera and Zen AxioVision Imaging Software (Carl Zeiss Microscopy,
Thornwood, NY), under the ×10 objective with a rhodamine emission filter. DHE fluorescence was
quantified using ImageJ software. Images were first converted to 8–bit format, and the specific brain
nuclei were selected as regions of interest. Threshold discrimination was used to select the positive
staining within each region. Sections from control and Ang II treated animals were assayed in
parallel (3–6/rat for each nucleus), and the same camera, laser and detector settings were used
throughout. Identity of brain nuclei was confirmed by staining

The Body That Miami 's Premiere Plastic Surgeon Can...
Liposuction is a procedure designed to reshape and slim various areas of the body. During a this
procedure, excess fat deposits are removed; thus, improving the proportion and contours of the
patient 's body. This procedure is not intended to replace diet and exercise or to treat obesity.
Instead, liposuction is meant to address areas that are resistant to diet and exercise.
Areas of the Body That Miami 's Premiere Plastic Surgeon Can address with Liposuction
Dr. Sam Gershenbaum is a premier plastic and reconstructive surgeon in Miami who frequently
performs liposuction/liposculpture surgery to assist individuals in eliminating fat deposits from
areas of the body that remain despite a healthy diet and regular exercise.
Dr. Gershenbaum can use liposuction to address localized fat deposits in the:
Abdomen and chest area Thighs and inner knees Waist and hips Back Buttocks Upper arms Ankles
Calves Cheeks and chin Neck
Dr. Gershenbaum can perform liposuction for his patients in Miami alone or in conjunction with
other procedures. Many of Dr. Gershenbaum's patients choose to combine liposuction with a breast
reduction, a rhytidectomy (facelift) and an abdominoplasty (tummy tuck).
What Liposuction Cannot Do
Liposuction cannot effectively treat the dimpled skin (cellulite)that is commonly seen on the hips,
thighs and buttocks. In addition, this procedure does not address loose, sagging skin.
Who Should Consider Liposuction?
The best

Gynecomastia Research Paper
Gynecomastia is the medical term for female–like breasts on males. The word is derived from the
Greek language and actually translates to "womanly breasts." Most guys don't talk about it but many
more of them suffer from it than one might imagine. In fact, some estimates put the incidence of this
malady at half of the male population. To get rid of these soft appendages, guys can opt for surgical
intervention. Here are some things to think about. What causes it? There are various ways
gynecomastia can occur, including being overweight, taking drugs (recreational or prescription),
genetic predisposition or bad luck. Some evidence points to use of steroids in body builders, or
marijuana in pot smokers. Many adolescent boys exhibit these surprising mounds on their chest as
they're experiencing the hormonal changes of puberty. Luckily, those ... Show more content on
Helpwriting.net ...
The first thing a sufferer of gynecomastia should do is see his doctor. The physician will rule out
tumors in the chest and prescription medicine side effects, and may put him on a diet to get rid of
some weight. If none of these fixes alleviates the problem, his next step may be to see a cosmetic
surgeon. Other than that, his only options would be to wear a flattening garment over his man–
boobs for life or live with slight cleavage. If a man really does not like his appearance, cosmetic
surgery can be an option. – Surgical intervention: In order to return the patient's chest to a more
manly appearance, the plastic surgeon may perform a combination of liposuction and breast
reduction. These would be outpatient procedures performed in a hospital or clinic setting. –
Liposuction: Lipo is a technique which removes fatty deposits that haven't responded to dieting or
exercise. The MD will make tiny incisions in the region before inserting a medical tool called a
cannula into the openings. A cannula is a slender wand that is hooked up to a lipo machine in order
to suction away excess adipose

Breast Biopsy Video Analysis
Due to the new technology such as digital mammography and stereotactic devices, we are now able
to perform minimally invasive needle localization breast biopsy's that are more accurate and less
disfiguring to the patient's breast. This video went over the procedure, giving step–by–step
instructions on how to perform this exam. It begins with a mammogram that demonstrated an
abnormality. There are many options a patient can choose when they find out they have an
abnormality in their breast. One option is to have a breast biopsy. A minimally invasive needle
localization breast biopsy is a relatively easy for the patient. Only local anesthesia is required for
this procedure. The patient lays on their stomach with their breast falling through ... Show more
Stereotactic imaging is performed to make sure that the needle is at the correct site of the lesion. As
an extra precaution, the coordinates of the needle can be checked by using the computer. A T–
Fastener is also inserted into the breast tissue to fix the tissue in place during the biopsy. Another
stereotactic image is taken to demonstrate where the T–Fastener is at in the breast. After the
stereotactic images are taken, is it now time to begin the removal of the tissue. Before you insert the
cannula into the breast, you have to make sure the needle and T–Fastener are both locked into place
on the stage assembly. The cannula is inserted into the breast by a circular cutting blade. A
transverse incision is made and the skin flaps are folded over the cannula. The cannula is pushed
through the tissue, usually fourteen millimeters past the lesion and T–Fastener. After the cannula is
positioned, another stereotactic image is taken to verify if the lesion is contained within the

Type 1 Diabetes Case Study
There are many people all around the globe that have been diagnosed with Type 1 Diabetes. In fact,
about 1.25 million people in the United States alone suffer from Type 1 Diabetes. I happen to be one
of those people. As someone who has diabetes, I know there are many ways to regulate your insulin
levels including several different types of insulin pumps or injections. In my case, I use the
OmniPod pump. Before the pump can begin regulating your insulin and keeping you alive, there are
steps and objects you'll need to get started.
There are only three objects you're going to need to apply your OmniPod. The first two, which are
the most obvious, are the OmniPod pump and pod. The pump is the electronic device that resembles
a phone in ways and is used to check your blood sugar. The pod is the actual object that ... Show
more content on Helpwriting.net ...
Start pushing the insulin into the pod. Continue going until your syringe is empty even if you hear
two beeps. Take out the syringe and set it aside. You won't need to use it anymore. Place the pod
right next to the OmniPod. Push the button on the OmniPod that says "next." The screen will say
"priming," and the pod will begin clicking. Don't move the pod away from the OmniPod. Don't
move anything until the bar on the screen goes away and you hear a beep. After the priming, pull the
seal off the fabric that holds the pod to your body. This will reveal the sticky part of the pod. If the
fabric seems more wet than sticky, discard the Pod and start over. This is a defective Pod and will
not successfully give you insulin. If the fabric seems normal, then you can find a place to insert the
Pod. According to Placement Options in myomnipod.com, you can place the Pod on the back of
your arm, abdomen, front and sides of legs, back, or buttocks. I prefer my arm, stomach, or back
because the Pod doesn't hurt when inserted in those areas or get in the way. Press down the Pod on
the area you've

Ultrasonic Liposuction Research Paper
Unhappy With The Way Your Fat Is Distributed? Ultrasonic Liposuction Might Be The Solution
Liposuction may be the answer if you're looking for a way to contour your shape by getting rid of
pockets of fat. Ultrasonic liposuction is one method used for this purpose. The ultrasonic sound
waves break up fat, so it can be removed more easily. This allows the surgeon to give your body
better definition in problem areas such as your neck and abdomen. Here are a few things to know
about this procedure.
Not For Weight Loss
Liposuction is not the solution to obesity. Instead, it is better used for shaping your body when fat
has settled in places where you don't want it, and you can't get rid of it. If you are at a normal weight
or somewhat overweight, but you have love handles, a pouch over your stomach, or a double chin,
then you might be a good candidate for ultrasonic liposuction. This procedure destroys fat cells, and
then they are removed from your body. Since the cells are gone, your body can no longer store fat in
that area. If you gain weight, you'll store it in other locations. For that reason, it is a good idea to
have issues with yo–yo dieting under control before you undergo liposuction. ... Show more content
on Helpwriting.net ...
If you have the procedure on an area such as your neck, you may notice results right away since
there isn't much fat there to begin with. On a larger area such as your stomach, it will take longer to
see the results. That's because you experience some swelling after the procedure, and this fluid
replaces the fat cells that were removed. You'll have to wait for all the swelling to go away before
you see the final results of the procedure.
How The Procedure Is

Case Study Of Patient
This patient presented to The Heart Hospital Baylor Plano in Plano, Texas on July 13th of this year
presenting chest pain, shortness of breath and exhaustion upon exertion. Upon admission to the
hospital, patient was determined to have diabetes mellitus type 2 and presented conditions consistent
with coronary artery disease.
A physical exam revealed a 76 year old male with a blood pressure of 138/85 with an irregular and
slightly elevated pulse of 103. Patient also presented elevated cholesterol levels as well as elevated
glucose levels. No carotid bruits were present as well as no murmurs in the heart sounds.
The patient's past medical history revealed diabetes mellitus type 2, hypertension, and smoking.
Whereas the patient's ... Show more content on Helpwriting.net ...
During this time, the heart–lung machine was prepared. The Terumo system 1 was set up with a
Terumo Capiox SX25 oxygenator combined with attached hard shell venous reservoir, and Capiox
arterial line filter. The circuit was primed with 1500ml of Normosol, 10,000 units of Heparin, 40g of
Mannitol, and 10g of Amicar. The system was recirculated for an ample amount of time to debubble
the circuit and the prebypass checklist had been completed. The Terumo CDI 500 was attached,
along with bubble detector, flow probe, and level sensor fully functioning. The gas supply was also
checked, patient data was put into the System 1 computer, and baseline ACT had been completed.
The patient was systemically heparinized with a dosage of 4mg/kg, the aortic cannula was then
placed in the distal ascending aorta and connected to the heart lung machine via arterial line. A
triple–stage cannula connecting the venous line to heart–lung machine was used for venous drainage
and was placed into the right atrium. Cardiopulmonary bypass was initiated at 0944. The patient was
cooled to 34 degrees Celsius and cross clamp was place at 0947. Del Nido cardioplegia was given
both antegrade via aortic root needle and retrograde via retrograde cardioplegia cannula place in the
coronary sinus. 800ml of antegrade

Engineering Ethics Of The Engineering Profession
Engineering is a pylon of human development and technology,having a significant impact on
people's daily lives. Engineering has improved humanity in every aspect (e.g. transportation,
communication, medicine) and it has the potential to overcome the challenges that mankind still
faces. However, engineers have responsibility for their actions and they must learn to follow a set of
ethical principles relating to their work. All of which have to be followed to the letter otherwise
there can be severe consequences. '' Ethics is the study of the characteristics of morals and involves
the moral choices made by individuals as they interact with other persons. Engineers need to be
aware of ethics as they make choices during their professional practice of engineering. Engineering
ethics will be defined as the rules and standards governing the conduct of engineers in their roles as
professionals. Several cases have led to an awareness of the importance of ethics within the
engineering profession as engineers realize how their technical work has far–reaching impacts on
society. The work of engineers can affect public health and safety and can influence business
practices and even politics.''(Fledderman,2004) Exploring beyond the known frontiers of Earth is a
challenging job, this is the responsibility of aerospace engineers who are in extreme danger for
every second of these missions, therefore the job requires extreme levels of courage. Mankind has
known

Assisted Liposuction
Liposuction is one of the most popular cosmetic surgeries in the United States. The technique is
used to remove excess fat from certain areas of your body and it involves body contouring, body
sculpting or spot reduction. Most common areas that need liposuction include: hips, abdomen,
thighs, buttocks, knees, back, ankles, jowls, neck, cheeks and upper arms.
When your body stops responding to diet or exercise, then liposuction is the only option to remove
stored fat deposits. Various types of liposuction can be categorized by the fluid injections or by the
suction mechanism. These are called wetting solutions and they involve minimal blood loss and
increase the safety of the procedure. Various wetting techniques include:
Dry technique: ... Show more content on Helpwriting.net ...
The amount of fluid injected in this technique is same the amount of fat being removed.
Tumescent technique: During this method, large quantities of fluid is injected containing a local
anesthetic and lidocaine and epinephrine. It is the most popular technique and frequently used in
most instances. This technique is used in combination with most popular assistive technique like
ultrasound assisted liposuction (UAL) or laser assisted liposuction (LAL).
Types of liposuction techniques:
Traditional suction assisted liposuction: It includes insertion of suction tube or cannula by making a
tiny incision to vacuum the fat cells. Your surgeon moves the tube back and forth to break up the fat
cells and then suction out the excess fat.
Ultrasound–assisted liposuction: It also works as same like suction assisted technique but the
cannula is special that emits ultrasonic vibrations to break the fat cells and to liquefy the fat. This
method is used for the areas of the body where fat cells are more fibrous and hard to break them.
Power–assisted liposuction: In this technique, instead of moving the cannula by the surgeon, the
movement is mechanized to move back and

Essay A Closer Look at Breast Liposuction
Liposuction: Chest (women)
There might not be anyone who never wanted to have a well structured body. A good sized and
shaped breast will add attractiveness to a women's body. There are lot of women who want to resize
their large breast which gives the awkward look and appearance. As liposuction has become one of
the most common procedures nowadays, it is also considered to be the solution for people who
suffer from larger breasts. It is also said that, liposuction is one of the best methods for breast
reduction. There are a lot of cases that had proven the success of liposuction procedure in breast
reduction. Who can be the best candidate for breast liposuction? A good candidate is definitely the
one who is ... Show more content on Helpwriting.net ...
As per the standard protocol, the breasts will be prepped and draped by the surgeon. After that, an
incision will be made on the concerned area and cannula will be inserted through. The cannula will
vacuum the fat layer that lies deep beneath the skin. The excess fat will be loosened by using the
cannula. After that, the fat will be eliminated by the vacuum suction. The techniques may vary
according to the choice of the surgeon and requirements of the patient. There are numerous ways
through which liposuction can be conducted. But, every one does the same procedures of extracting
the excess fat.
Post–operative care There can be certain negligible issues after the surgery. It can be eased off with
proper care and follow–up treatments. You may even experience swelling and such issues. This will
be reduced within a few days. If you have any unusual symptoms like heavy bleeding or a sudden
pain, it should be reported to the doctor immediately and get cured.
The result It will take time to heal the incisions and gradually will get back to normal. You will be
able to walk and resume your routine activities a few weeks. But, you should avoid strenuous
activities during this period. Stitches are removed and will be dissolved within the first week or ten
days. It will take a few months to get back to the normal life when you will be able to do strenuous
activities without any

Reflective Assignment 3
Look Back: Last week, I was not feeling well thus, I decided not to come to clinical placement due
to flu symptoms. Elaborate: When I woke up, I started feeling nauseous. I started to get ready for
clinical, regardless of what I was feeling. I immediately informed my clinical instructor on what I
should do. I truly did not want to miss clinical because it is a learning opportunity and I want to take
advantage of it. When I described the symptoms I was feeling to my clinical instructor, she indicated
that it was my decision; however, policy does state that if someone is experiencing flu symptoms
they should stay home. While I was thinking of what I should do, that is when I started to
experience dizziness, fever, nauseousness followed with ... Show more content on Helpwriting.net
...
By making the decision that I was not coming to clinical, I was ensuring that client's safety was not
in jeopardy at the expense of me benefiting from a clinical experience. Even if one does not have
the flu symptoms, does not mean that the flu has subsided completely (Jinan, 2016). I decided if I
should attend placement based on two factors: would I be able to handle the task that is given to me
in the condition that I am and the possibility of me passing my flu on to patients who are already
vulnerable state/condition. I am also putting my colleagues in at risk as well. Revise: My strength in
this encounter would be, acknowledging that I was not feeling well to come to clinical. My
weakness in this situation would be feeling guilty of missing clinical, although it was not
intentional; however, it felt like I was missing out. Therefore, I learned that even though I am a
novice student nurse, however it is important to advocate for my clients. Later on, the manager on
the floor decided to move the patient's bed closer to the bathroom, and change his nasal cannula
wire so that my client will be able to ambulate with his nasal

The Procedure For An Outpatient Liposuction Procedure Is...
Liposuction is a procedure that is becoming very popular and common. Liposuction is a surgery to
remove unwanted excess fat from the body such as the stomach, hips, thighs, buttocks, face and
neck. This type of surgery is most commonly known for being a cosmetic type of surgery but is also
done to those who need it to maintain a healthier lifestyle. Liposuction can be a lengthy process but
there are also liposuctions that are done quickly and are outpatient procedures. Before you have the
procedure done you must first consult your doctor and see if this surgery is right for you. The doctor
will then conduct and interview with you and ask you simple questions regarding your daily
activities such as eating habits, amount of exercise you do, if you smoke or drink, and if you are
currently on any medications, along with many more questions. During the interview you will also
be able to ask the doctor any questions regarding the procedure and what specific procedure will be
right for you. An outpatient liposuction procedure is single procedures done in simple areas such as
the face, arms, and neck. An inpatient procedure usually take hours and afterwards you must stay in
the hospital for at least one day if there are no complications but with an outpatient procedure you
can be done and out with everything in an hour or two depending on how long it takes for the
anesthesia to ware off. The basic steps are the same with all liposuction procedures; there are several
different

Literature Review Of High Flow Nasal Cannula
Literature Review High flow nasal cannula (HFNC) therapy has become a safe, useful therapy in
many types of patients with respiratory failure, improving oxygenation and comfort levels. Oxygen
therapy is the main treatment for hypoxemic respiratory failure and has been delivered via nasal
prongs or masks. The maximum flow rates that these devices can deliver are limited due to the
insufficient heat and humidity provided to the gas that's being administered. It's accepted that flow
rates up to 15 L/min can be delivered using conventional nasal prongs or masks, and even high flow
tubing, but this flow is far lower than the inspiratory flow of a patient with acute respiratory failure.
Room air dilutes the supplemental oxygen, resulting in a significant decrease in the fraction of the
inspired oxygen (FIO2) that finally reaches the air sacks in the lungs, called alveoli. Many different
HFNC devices are available, but the technique always involves the delivery of a totally conditioned
(37 °C containing 44 mg H2O/L [100 % relative humidity]) gas admixture via a wide bore and soft
nasal prong up to 60 L/min, with a fraction of inspired oxygen ranging from 0.21 to 1 (21% to
100%). (Roca, 2016). HFNC oxygen therapy is a very effective modality for the early treatment of
adults with respiratory failure with diverse underlying diseases.
Physiological effect High flow with optimally heated and humidified gas is thought to have a variety
of physiological effects. Gas from an

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