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Sepsis Is A Poisoning Of The System By Disease Carrying...
Sepsis was known in the old days as "blood Poisoning" because it is " A poisoning of the system by disease carrying bacteria and their toxins
absorbed into the bloodstream, as from festering wounds," according to the World Book Encyclopedia Dictionary. 1 Because Sepsis is a severe and
often fatal disease and thought to cause 44,000 deaths a year, it is most important that it be recognized early and treated aggressively with utmost and
urgent care. If not treated early it can lead to shock and multiple organ failure and even death. It kills more people than breast, bowel, and prostate
cancer combined; however, it can be treated successfully if detected early on. 2. Erin Dean Sepsis does not arise on its own. It stems from another
medical condition such as an infection in the lungs, urinary tract, skin, abdomen (such as appendicitis) or other part of the body. Invasive medical
procedures like the insertion of a vascular catheter can introduce bacteria into the bloodstream and bring on the condition. Many different types of
microbes can cause sepsis, including bacteria, fungi and viruses, but bacteria are the most common culprits. Severe cases often result from a
body–wide infection that spreads through the bloodstream, but sepsis can also stem from a localized infection. All healthcare professionals should treat
suspected sepsis with the same urgency as a heart attack, according to the National Institute for Health and Care Excellence. (NICE) 3. Patients who are
at higher
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Assessing Fall Risk Of Older Adults Living
Assessing Fall Risk of Older Adults Living in the Community
Rachael McCowen
Epidemiological Design and Statistics
University of West Florida
I.Background
In the absence of evidence to support a population–based approach to prevention and the imperative to deliver cost–effective and efficient services,
health care providers need risk assessment tools that reliably identify at–risk populations and guide intervention by highlighting remediable risk factors
for falls and fall–related injuries. Such tools typically consist of a rating or scoring system designed to reflect the cumulative effect of known risk
factors for the purpose of identifying those at greatest risk for sustaining a fall or fall–related injury [*]. Historically, fall risk tools have focused on
institutional settings with little attention to tools tested in community settings. Of the reviews that do include community dwelling seniors, tools are
typically limited to the assessment of balance with little consideration of other risk factors [*].
Since 2000, three reviews have been published that detail a cross–section of fall–risk assessment tools [*]. The focus has been on institutional settings
with little attention to tools tested in community settings. Most falls occur as a result of a dynamic interaction between intrinsic and extrinsic factors,
and as such interdisciplinary and multiagency intervention is likely to have the greatest impact. Lack of a simple cause and effect relation in
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Elderly Dehydration Essay example
Most people don't think about dehydration; let alone elderly dehydration. It is a common problem, in the aging, and often recognition along with
treatment may be delayed; contributing to a high mortality rate. (Lavizzo–Mourey, 1987) By recognizing a potential problem early, you may save an
older adult from a debilitating complication. (Hamilton, 2001) The prevention of elderly dehydration will deter illness and increases life expectancy,
along with decreasing unnecessary hospitalization and cost.
There are several causes to elderly dehydration, which can be broken down into four groups: physiological factors, psychological factors, functional
impairments, and mechanical impairments. (Hamilton, 2001) The physiological factors are: natural ... Show more content on Helpwriting.net ...
(Hamilton, 2001)
If, these signs and symptoms go undetected, for a long period of time, they will result in chronic dehydration and cause several other medical issues.
(Vasey, 2002) One of the results of chronic dehydration is fatigue or energy loss which resembles depression. (Vasey, 2002) Constipation is another
result chronic dehydration, by removing too much excess liquid from stool making it hard to expel. (Vasey, 2002) Chronic dehydration also
contributes to digestive disorders such as: poor digestion, gas, bloating, pain, nausea, ingestion, and loss of appetite. (Vasey, 2002) The average body
produces 7 liters of digestive juices daily; but a dehydrated individual will secrete less, thereby causing improper digestion. (Vasey, 2002) Chronic
dehydration causes high blood pressure due to low blood volume and the vessels sharply contracting. (Vasey, 2002) It can also cause low blood
pressure in individuals, with weak vasoconstriction, who again, have a low blood volume. (Vasey, 2002) Chronic dehydration is also the culprit of
gastritis and
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Total Knee Replacement
Nifedipine (Adalat,Procardia,others) Prototype Drug / .Therapeutic Class: Drug for hypertension and angina Pharmacologic Class: Calcium channel
blocker. ACTIONS AND USESNifedipine is CCB generally prescribed for HTN and variant or vasospastic angina. It is occasionally used to treat
Raynaud's phenomenon and hypertrophic cardiomyopathy. Nifedipine acts by selectively bloking calcium channels in myocardial and vascular smooth
muscle, including those in the coronary arteries. This results in less oxygen utilization by the heart, an increase in cardiac output, and a fall in blood
pressure. It is available as extended–release tablets (XL).ADMINISTRATION ALERTSDo not administer immediate
–release formulations of
nifedipine if an... Show more content on Helpwriting.net ...
Ensure proper use and functioning of any home equipment obtained.| Ensuring therapeutic effects:Continue frequent assessments as described earlier
for therapeutic effects.(Blood pressure and pulse should be within normal limits or within parameters set by health care provider. If drug is given for
angina and /or dysrhythmias, significant improvement in reports of pain, palpitations, or ECG demonstrates improvement)| Encourage the patient to
adopt a healthy lifestyle of low–fat food choices, increased exercise, decreased alcohol consumption, and smoking cessation.| Encourage appropriate
lifestyle changes. Provide for dietitian consultation as needed. (Healthy
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Hypotension Essay
Patients with hypotension usually manifest with lightheadedness, weakness, fatigue, anxiety, vertigo, frank syncope, seizure like episodes, paleness,
sweating, abdominal and chest pain, muscle cramps, nausea, vomiting, and dyspnea, although occasionally some patients may be asymptomatic. Vagal
symptoms, encompassing yawning, sighing, and hoarseness may be observed before the fall in blood pressure is noticed (3 of 1).
Quality of life and patient's sense of well–being are also adversely affected by hypotension. As a consequence of the undesirablesymptoms of
hypotension, patients may tend to discontinue their hemodialysis treatment prematurely. Cerebrovascular insufficiency (transient ischemic attacks,
cerebrovascular accidents) and cardiovascular instability (myocardial ischemia, arrhythmias) may further complicate hypotension during dialysis. It
may also contribute to chronic overhydration owing to an inability to attain a proper target ... Show more content on Helpwriting.net ...
The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) and European Best Practice guidelines define IDH as the
presence of a decrease in systolic BP ≥ 20 mm Hg or a decrease in mean arterial pressure (MAP) ≥ 10 mm Hg, provided that the decrease in BP
is accompanied with clinical symptoms and need for nursing interventions (1 of 1). In the Hemodialysis Study (HEMO Study), IDH was defined as
hypotension requiring either saline infusion of ultrafiltration (UF) rate or blood flow reduction (HEMO STUDY NEJM).
IDH occurs in in 15–30% of conventional dialysis treatments and in 35% of other extracorporeal procedures like therapeutic apheresis. Given the
increasing number of elderly and diabetic patients in the HD population, the incidence of acute IDH has reached up to 50%. Prevalence of the chronic
form of dialysis hypotension, specific for long–term dialyzed patients, is estimated to occur in 3–5% of treated individuals
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Thermoregulation Mechanism in the Human Body
Previous studies have not considered the temperature control mechanisms of human body when a conflicting information is received from peripheral
and central thermoreceptors. Our experiment was designed to investigate how the thermoregulation mechanism was activated when there was a
passive heating to the human body and to find out how the body would react to the situation when the human was experiencing the heating and
cooling simultaneously. Our first hypothesis was accepted, where the body regulated cutaneous vasodilation to enhance heat loss through sweat
evaporation and all the respiratory parameters were increased in order to supply the higher demand of oxygen. However, the second hypothesis was
rejected, as the peripheral control had more influence than central control when the body received increased temperature to the leg and decreased
temperature at the same time. Heating period The results have clearly demonstrated that during the heating period, there was a decrease in skin
resistance and total peripheral resistance (TPR) alongside an increase in heart rate (HR), cardiac output (CO) and peripheral skin temperature, as
compared to the relatively stable core and oral temperature, shown in figures 6, 7, 9 and 12. The metabolic rate and respiratory parameters
(Respiratory rate, oxygen consumption, tidal volume and minute ventilation) were also increased as seen in figures 1, 2, 3, 4 and 5. A significant
decrease in respiratory rate and minute ventilation at 30 min of
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Trendelenburg Position Essay
Abstract
Hypotension is one of the top three most frequent causes of cardiac arrests in the United States. One early intervention used in treating hypotension is
placing patients in Trendelenburg position. The purpose of this research was to review information on the use of the Trendelenburg position or
variations of it to determine whether this position has an impact on hemodynamic status, to describe historical practices of the Trendelenburg position,
state the reasons and need for possible change, described current best evidence, and define pros and cons for making the practice changes. Research
material included scholarly peered articles, Internet Resources, and nursing textbooks revealing many studies which question the benefit of ... Show
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Modifications of the original posture have been used in diverse situations, with applications found for "high," "low," and "reverse–Trendelenburg."
Over the past 50 years, laboratory and clinical studies have described the physiologic effects of the Trendelenburg position in normal and hypotensive
states. Because of conflicting results, differing opinions thrive with regard to the usefulness of the position in various medical applications. Some of
these applications include hypovolemic or septic shock, abdominal surgery, patients under general or regional anesthesia and patients with spontaneous
or controlled ventilation. More specifically, the usefulness of the Trendelenburg position comes into question in the field of anesthesia for central
catheter placement, and the administration of certain drugs at the spinal level. Even though numerous studies have proven no significant evidence
showing the Trendelenburg position to be effective, a considerable number of present–day clinical protocols and guidelines developed by the health
administration and natural scientific societies do, in fact, include leg raising in the decubitus supine position as a standard procedure for hypotension.
However, the utility attributed to the Trendelenburg position in this situation is in severe contrast with most of the studies reviewed, which include
that, despite possible improvement in cardiac output,
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Orthostatic Hypotension Case Paper
I have selected case number 1. An 85 year old man came to the emergency room with palpitations for a few days. He states that he sometimes feels
light headed and dizzy. The patient's heart rate is elevated and irregular. As he goes from a sitting position to a standing position he becomes light
headed and dizzy. In taking orthostatic blood pressure you notice that they are positive.
Orthostatic hypotension or postural hypotension happens when blood pressure drops as you stand from a lying position. This drop in blood pressure
causes the patient to become dizzy and light headed. This condition happens more frequent in people of advanced age. His heart rate is fast and irregular.
I suspect the rhythm of his heart is atrial fibulation (afib).
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Vasovagal Syncope
Generally, before fully losing consciousness, presyncopal symptoms include feeling faint, dizzy, lightheaded, hearing ringing, darkened or faded vision,
and decreased hearing ability. The victim is overpowered by unsteadiness and weakness before blacking out. Inevitably, symptoms of the episodes
continue until the vertigo (dizziness) overwhelms the victim, literally sending them into a whirl. One can know when to worry if symptoms like chest
pain, dyspnea (difficulty breathing), low back pain, heart palpitations, severe headache, ataxia (loss of body movement control), or slurred speech
occur. After the victim wakes up from fully losing consciousness, he or she feels a sensation of warmth, nausea, lightheadedness, temporary visual
changes, ... Show more content on Helpwriting.net ...
If there is no obvious or known cause, a non–invasive cardiac test, echocardiography, ambulatory monitoring, stress test, and tilt–table test are
necessary. If the fainting is triggered by a certain position or movement like stretching or valsalva, it would be very helpful to do that specific
maneuver to trigger the symptoms while being monitored by a doctor (Hain). Valsalva is a forceful exhalation, like one might do if their ears are
plugged. While performing a tilt–table test, the doctor will record the patient's blood pressure at a 70 degree tilt using a motorized bed. The results are
considered abnormal if there is a neurally mediated response like a sudden onset of hypotension (very low blood pressure), bradycardia (very slow
heartbeat), or both when the patient is kept in the upright position which is the most common abnormality. The doctor will also monitor if there is
positional orthostatic tachycardia or dysautonomia, which is a gradual decrease in blood pressure with little or no change in heart rate while moving
from a lying down position to an upright position.. The tilt–table's main purpose is to confirm autonomic dysfunction. Autonomic function is the term
used to describe the processes in our body that we do not control ourselves, like blood pressure, heart rate, and digestion. Another test called
ventilation–perfusion scanning is used for suspicions of pulmonary embolism, which is a large blood clot blocking blood flow to organs. The last
experiment doctors may use is called Holter monitoring. This requires that a small device that records every single heartbeat is to be worn for 24 hours
along with a written log of any symptom.There are many variations of Holter monitoring which extends the time and strictness
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A Reflection On Clinical Placement
Look Back Another day of my clinical placement 420 in orthopaedic unit began on July 4, 2015. I received my patient and started to research a
patient history and medications. At 0700 a shift report started, I received information that my patient had fall at night shift without witnesses. By
the policy of Providence Healthcare a patient who had fall without witnesses should be automatically monitored for head injury therefore, a
Glasgow Coma Scale was initiated by previous nurse: every 15 minutes, then every hour, every two hours, and every 4 hours. This scale is to check
and monitor level of consciousness which possibly may decline after head injury. At this day we had a student as a "nurse in charge", she volunteered
to come with me to patient room and to supervise my work. For this particular patient close monitoring of vital signs and neurologic assessment
required. I explained to the patient the purpose of frequent health assessment and started to work. Close patient monitoring in addition to all daily
routine activities was challenging to me because I never had a patient with this diagnosis. Despite my explanation of the purpose of frequent
assessments patient stated that "I am fine, do not feel any discomfort, there is no need for that". While assessing patient she keep asking a lot of
questions such as why so many time why do I need to drink more than one mouthful of water with my tablets, what these tablets for, why do I need to
wait few minutes after
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The Effect Of Exercise On The Body
Introduction
The purpose of this lab was to measure resting heart rate and blood pressure as well as during submaximal exercise to see the effects of exercise has
on the body. Submaximal graded exercise test is any physical activity whose intensity increases at regular intervals up to but never exceeding 85
percent of an individual's maximum heart rate. Testing the submaximal level is ideal because all subjects can participate and it is safer. Heart rate is
the number of beats per minute measured by either at the radial or the carotid. This gives you the beats per minute which ideally needs to stay around
60–80 BPM. The difference in heart rate between males and females vary. Males tend to have a higher heart rate because they are bigger and it takes
more force to send blood throughout their body and the males heart are bigger than a female. Heart rate can also decrease in trained individuals, this is
because the heart enlarges and strengthens which leads to larger heart chambers that can pump twice as much blood than an untrained individual.
Blood pressure is the measure of heart work or pressure exerted against the walls of the various vessels of the circulatory system by the heart as it
pumps blood to the body. This can be measured in mmHg by using a sphygmomanometer and a stethoscope. When measuring blood pressure, you will
get two numbers, the first one is the systolic pressure and the second one is the diastolic pressure. The systolic blood pressure measures the
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Classification Of Medication By Sarah Jennings
Stuti Patel
Unitek College
Ms.Brooks
Classification Of Medication
Sarah Jennings is a 45 years old female, 5 feet 6inches tall, 130lbs. Today she came in to see Dr. Wallace for 3
–month appointment. She has been
diagnosed with hypertension, diabetes, and cholesterol. Due her cholesterol medication she was asked to come in to get her liver function checked.
During her visit today she mentioned to the doctor she has had knee pain for the past few days. It started after she tripped while hiking last week.
Sarah also suffers with bipolar disorder, but she has been doing well with the anti–depressant she is on. She is a very sweet, tiny, determined lady who
is trying her best to keep up with all her health issues. She has changed her diet and has been good with exercising daily. Sarah has been taking
prazosin for hypertension which a alpha blocker. It blocks receptors in the arteries in smooth muscle. This helps relax theblood vessels and leads to an
increase in blood flow and a lower blood pressure. The most common side effects of are dizziness, drowsiness, fatigue, headache, nervousness,
irritability, stuffy or runny nose, nausea, pain in the arms and legs, hypotension, and weakness. Also another side effect is first–dose orthostatic
hypotension because initially the patient has more sensitive to the blood pressure–lowering effects. As patients continue to take the medication they
become less sensitive and have fewer problems with hypotension. There
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Anti Hypertensive Drugs Essay
Anti–hypertensive Drugs: The concern on whether anti–hypertensive's should be withheld in patients who are hypertensive has been debatable in the
recent past. Generally, the treatment of hypertension among hospitalized patients is basically an opportunity to enhance the recognition and treatment
of blood pressure (Axon, Nietert & Egan, 2011, p.246). This is mainly because hypertension is a basic risk factor for heart diseases, stroke, and death
whose impact is widespread to nearly 70 million adults in America. There have been numerous educational initiatives and publication of treatment
processes to address this condition in the past few decades. Despite these measures, nearly 39 million Americans are at risk of hypertension because
they have not reached their desired or optimal blood pressure. The concern regarding the use of anti–hypertensive medication as a treatment procedure
for hypertension has mainly been centered on the optimal choice of these agents. The other factors include the side effects of these drugs on a
hypertensive patient, especially coughing. While three categories of these drugs are linked with cough as a side effect, they have varying casual
explanations though angiotensin–converting enzyme (ACE) inhibitors play a crucial role (Van Amburgh, 2011). The main objective for the use of
anti–hypertensives in dialysis patients is to obtain and sustain an optimal blood pressure or lessen it by the least intrusive measures possible. While this
is not
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Life Changing Moment : What Is A Life Changing Moment?
Life Changing Moment On Tuesday morning November 8, 2016, I woke up with extreme pain in my lower abdomen. When I got out of bed I was
dizzy and had a hard time walking. I made it to the bathroom and sat down on the toilet. When the pain did not start to feel any better, and all I
could see was black I yelled for my mother. When my mother got to me she just stared at me and asked me what was wrong because my head was
hanging and I could not speak. When she lifted my head, she noticed my face was very pale and then I passed out. At this point she called for my
father and when he saw me he said we need to take her to the hospital. My father carried me to the car and they rushed me to the hospital. On the way
to the hospital I was lying down in the backseat crying and screaming in excruciating pain, and did not know where I was. My then, twelve–year–old
brother began to cry because he had never seen me in so much pain. When we arrived at the hospital my father carried me through the emergency
room doors and the emergency room staff got me a wheel chair. By this time, I was still in pain and lucid. My mom gave the clerk the minimal
information needed, described my condition, then I was immediately taken to an examine room. The nurse pushed me to a room in the emergency
area. This room was not like the regular hospital rooms. This room did not have a door it just had a giant curtain to separate the room from the
hallway. When they got me in the room the nurse assisted me from the wheelchair to the bed. The pain was still severe and I could barely lay still.
The nurse kept telling me that I needed to be still so she could get accurate vital signs. It was difficult to be still with the pain I was experiencing.
Immediately, the nurse asked me questions such as "where do you hurt?", "how long have you been hurting?", and "when did the hurting begin?". I
answered those questions as precisely as I could, so the nurse and doctor would have a better understanding of what was happening. While the nurse
was asking questions, another nurse was sticking probes on my chest and connecting them to a machine; they were doing an EKG (electrocardiogram).
After this the nurse gave me an IV (intravenous therapy) for them to
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The Anti Hypertensive Properties Of Doxazosin
Pharmacology
Doxazocin is an "alpha–adrenoceptor blocking drug" and it is used in both hypertension and benign prostatic hyperplasia (Joint Formulary Committee,
2014). For the purpose of this essay, the main focus will be on the anti–hypertensive properties of Doxazosin.
Selective О±1 antagonists work on the post–synaptic О±1 adrenoreceptors predominantly found in vascular smooth muscle. These receptors are
normally bound by norepinephrine or epinephrine to mediate regulation of the cardiovascular system by the sympathetic nervous system. As can be
seen in Figure 1, these receptors are bound to Gq–proteins which have two signal transduction pathways. One of the pathways forms IP3 (Inositol
triphosphate) which then stimulates the release of Calcium from the sarcoplasmic reticulum in a cardiac monocyte (Klabunde, R.E., 2013). The release
of calcium then stimulates contraction in the heart. By selectively inhibiting these adrenoceptors, vasodilation occurs which in turn causes a decrease
in arterial pressure (Rang and Dale).
With a mean half–life of 22 hours (Martindale, 2013), Doxazosin is considered to be a long acting hypertensive drug. This means that it can be
administered once daily, rather than multiple times. With a good absorption when administered orally, the maximum plasma concentration happens two
to three hours after a dose (Martindale, 2013). It also states that doxazosin is roughly "98.3%" bound to plasma, which means that it has an excellent
distribution around
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Hypotension: A Case Study
7.Describe complications that can occur as a result of dialysis and identify nursing measures that are designed to prevent these complications.
Hypotension
Hypotension that occurs during hemodialysis primarily results from rapid removal of vascular volume (hypovolemia), decreased cardiac output, and
decreased systemic vascular resistance (Lewis, 2014, pp. 1122–1123). The patient may experience a drop in blood pressure during dialysis process. As a
result of cardiac ischemia the patient may also exhibit symptoms of light– headedness, nausea, vomiting, seizures, vision changes, and chest pain. To
combat these complications of hypotension the volume of fluid being removed is decreased and administering 0.9% saline solution through IV therapy
(Lewis, 2014, pp. 1122–1123).
Muscle Cramps Muscle cramps are a complication associated with hemodialysis but, the pathogenesis is not quite understood. The causes that evoke
the development ... Show more content on Helpwriting.net ...
This will help them plan according to manage times around ADLs and get them more involved with proper medication management. Next, explain the
risk of misuse of over–the–counter analgesics, such as NSAIDS, and how they may further reduce kidney function and increase risk for chronic kidney
disease. Also, caution the patient about angiotensin–converting enzyme (ACE) inhibitors. ACE inhibitors are commonly prescribed to prevent high
levels of protein in urine (proteinuria) and progression of kidney disease, especially in diabetic patients. (Lewis, 2014, pp. 1106–1107) However, Ace
inhibitors also have an adverse effect of decreasing perfusion pressure and causes electrolyte imbalance of excessive potassium (hyperkalemia). As a
caution, if diet modification, diuretics, and sodium bicarbonate cannot control the hyperkalemia, ACE inhibitors may need to be reduced or
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Sepsis: Early Detection and Implementation of Sepsis...
Sepsis: Early Detection and Implementation of Sepsis Resuscitation Bundle
Introduction
Sepsis is defined as the body's inflammatory response to an infection and can quickly lead to multiple organ failure and death. Early, goal–directed
therapy using the sepsis resuscitation bundle introduced in the "Surviving Sepsis Campaign" is the treatment used throughout the world for sepsis
treatment (Winterbottom 2012, pp 247). There are approximately one million cases of sepsis in the United States annually and deaths total more than
prostate cancer, breast cancer, and HIV/AIDS combined. Also, more than one–fourth of patients that develop sepsis will develop it on a
medical–surgical unit and severe sepsis is the most common cause of ... Show more content on Helpwriting.net ...
Assessment
The priority assessment for sepsis is identifying patients at highest risk for sepsis, although all patients should be monitored for clinical
manifestations. Patients at increased risk include those with chronic illnesses, under one year old or older than 85 years old, the immunosuppressed,
postoperative patients, and those debilitated or with poor nutrition (Bernstien 2013, pg 25). To identify sepsis early the nurse will need to look for a
respiratory rate of >20, heart rate >90, temperature >100.4 or < 96.8*F, and a white blood cell count of >12,000 cells/mm3 or < 4,000 cells/mm3.
Assessments after the resuscitation bundle has begun would include respiratory, cardiovascular, integumentary, urinary, and neurological systems, as
well as laboratory values. Respiratory would be assessed for rate and oxygen saturation. Central venous pressure, mean arterial pressure, systolic
blood pressure, pulse quality and peripheral pulses would be assessed for the cardiovascular system. Skin would be assessed for warmth, color, and
whether it is clammy or dry. Skin would also be assessed for petechiae, ecchymosis, or bleeding of mucous membranes to ensure disseminated
intravascular coagulation (DIC) has not begun. Urinary output would be monitored to ensure adequate perfusion to the kidneys and for signs of
urinary tract infections. Neurological would be assessed for any changes from baseline mental status. The most important
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How Does Anorexia Affect Teens
The Assigned Life To Teens With Anorexia Stop, anorexia is not making teens look good, it is killing them off one by one! Anorexia is a very
serious eating disorder. Teens that have this disorder are beginning to harm themselves and people around them. Also, many teens are feeling
uncomfortable in their own body. They are even dying due to this eating disorder. Anorexia is a very dangerous eating disorder that has a
dangerously high chance of negative side effects, causes teens to criticize their body, and has psychological patterns. The health effects of
anorexia is very severe and painful. One health defect that happens to teens who are anorexic is "abnormally slow heart rate and low blood
pressure, which mean that the heart muscle is changing. The risk of heart failure rises as the heart rate and low blood pressure sinks lower and
lower" (wexler). Another defect that comes with anorexia is "severe dehydration, which an result in kidney failure" (Wexler). Another type of health
defect that happens to anorexics is "fainting, fatigue, and overall weakness" (Wexler). These effects from anorexia can really make teens weak and
die. Teens do not see that this a serious problem and the population of teens is decreasing. This problem needs to be resolved quickly or there will not
be a lot of teens left in the world... Show more content on Helpwriting.net ...
Even though some may say anorexia is beautiful, it is still not stopping teens from dying. The solution to the problem is an app for teens with
anorexia that gives teens advice and true stories from people who had anorexia or knows someone close to them that had anorexia. Teens do not need to
change for no one and they do not need to look like anyone other than themselves. All teens everywhere are perfect in their own way and look beautiful
in the inside and
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Nursing Mobility And Safety
Mobility and safety are two nursing topics that are very related. Safety is the key to ensure that the patient can remain mobile. It is important that the
patient has ways to move around without fear of falling. It is also imperative that the patient knows how to move safely and use mobility devices. The
nurse needs to understand how these two topics go together to ensure that the patient will remained unharmed at the hospital and in the home. As stated
earlier, safety is so important to make sure that patient keeps their mobility. The surroundings need to be safe to prevent falls. When falls are
prevented, the patient remains mobile. One safety precautions to ensure that falls do not happen is to have a clear area for the patient to be able to
walk around. This means not having objects in their pathway or rugs in their walkway. Having these objects in the way can cause the patient to have
a fall. Having rooms well lit will prevent falls. If they are able to see ... Show more content on Helpwriting.net ...
There might be certain movements that can affect mobility in the future or could re–injure they surgical site. For example, after a hip replacement
surgery patients are given and abduction pillow. According to "Hip Rehab After Surgery", the pillow is used to prevent the patient from dislocating
their new hip. After the surgery for safety reasons their mobility must be restricted while it heals. When they do the surgery, they cut through muscles
and those have to grow back. This will prevent further injury and the patient will be able to get back their normal mobility after it is healed. Although
there are certain actions that post operation patients cannot do they still need to be mobile. The patient is moved as soon as the patient is able to
handle it. Getting the patient up will prevent blood clots in their legs and promote blood circulation. Proper blood flow to the legs will mean that they
can remain mobile and stay
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The And Eye Opening For My Future Nursing Career
The past two days have been very educational, and eye opening for my future–nursing career. I was able to complete a health interview on my own,
suggest resources in the community to help individuals with their needs, and interact with a population that we don't usually get to work with
while in school. I came into this clinical day with a decent amount of experience working with the homeless population, so I wasn't too nervous
but more so excited to meet them and talk with them in a place where they are most more comfortable, then compared to in a hospital. This
experience was very beneficial in the sense that it pushed us all out of our comfort zones of doing interviews in the hospital setting and really
made us become flexible as nurses. I believe I was able to provide culturally sensitive care to these individuals because I was able to see them on
the same level as myself. One way that I was able to do this, as well as the rest of the students in my group, was by having this clinic in their
environment. The CARING clinic is a great resource for them because it is very available to them. According to Stanhope and Lancaster (2016) "It is
important to evaluate clients and populations in the context of the environment to develop effective nursing interventions", meaning we as nurses
need to reach out more to people where they are comfortable or living (p.733). The CARING clinic really allowed us to assess these individuals as a
whole, instead of just focusing on one medical
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Hypotension: Low Blood Pressure
Hypotension, commonly as low blood pressure, is the condition of having low blood pressure. Hypotension occurs when the systolic blood pressure
reading is 90 mmHg or below, and the diastolic reading is 60 mmHg or less. The main symptoms of hypotension include lack of concetration, blurred
vision, nausea, cold and clammy skin, shallow breathing, fatigue, depression, and thirst. There are many different causes of low blood pressure, which
includes dehydration, serious medical or surgical disorders, blood loss, severe allergic reaction, heart problems, certain medications, lack of nutrients in
your diet, pregnancy, and severe infection. Low blood pressure that either doesn't cause any signs or symptoms or only causes only mild symptoms
rarely
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Symptoms And Treatment Of A Call
On Thursday, the 4th of December 2014 at 0730hrs, a call was received of a forty one (41) year old female whose chief complaint was abdominal
pain with nil other symptoms. The call was assigned Code Two, and the crew was dispatched to the private residence the call originated from. On
arrival, the patient was found in the main bedroom laying supine, guarding the lower abdominal area and as the crew entered the room, the patient
curled up onto her side. The patient stated eight out of ten (8/10) pain located inferior to the umbilical region to right iliac, that came on suddenly after
urination. Pain was worse on movement and palpation, and nausea followed pain. On initial examination, the patient was well perfused, all vital signs
were within normal ranges and nil further complaints. Abdomen was soft, non–tender on palpitation, non–distended, and patient denied any blood or
dark coloured stools, nil urinary symptoms, nil constipation. Patient was given 3mL of methoxyflurane to assist with extrication to vehicle, with partial
effect until patient became non–compliant with use. Patient was then given 50mcg of Fentanyl with good effect, bringing pain down to two out of ten
(2/10). Enroute to the hospital, the patient became pale, diaphoretic, nauseous and dizzy with continuous abdominal pain. Patient became hypotensive,
however all other vital signs remained stable. Upgraded to code one enroute to the hospital as the patients vital signs deteriorated, from a blood
pressure of
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Chronic Hypotension Case Study
A review of her medical records indicates that she went to the ER on 12/4/16 with complaints of back pain as a result of her fall she had 2 days
prior. She was prescribed Norco 5/325 mg p.o every 4 hours prn. She has an extensive history of falling at home due to her Parkinson disease which is
progressive. She suffers from Parkinson with resulting tremors. She is receiving physical therapy from signature home health. She suffers from
co–morbidities of chronic HTN, which is managed with medication, CAD which is stable, Chronic hypotension which is managed with medication,
depression which is stable. I received a call from the office staff stating that the home health nurse had call the office and reported that the patient was
having an adverse
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Hypotensive Effect of Aqueous Extract of the Leaves of...
Acta Poloniae Pharmaceutica Г± Drug Research, Vol. 64 No. 6 pp. 547Г±552, 2007
ISSN 0001–6837 Polish Pharmaceutical Society
HYPOTENSIVE EFFECT OF AQUEOUS EXTRACT OF THE LEAVES OF PHYLLANTHUS AMARUS SCHUM AND THONN
(EUPHORBIACEAE).
*FABIAN C. AMAECHINA and ERIC K. OMOGBAI Department of Pharmacology and Toxicology, University of Benin, Benin City, Nigeria
Abstract: The plant of Phyllanthus amarus is used as diuretic and to lower blood pressure in traditional medicine practice. The effect of the aqueous
extract of the leaves of Phyllanthus amarus on blood pressure was evaluated in normotensive male rabbits. Intravenously administered aqueous doses (5
mg to 80 mg/kg) of the extract to anaesthesized normotensive male rabbits produced a ... Show more content on Helpwriting.net ...
The infusion of the aerial parts has been reported to be used to manage non–insulin dependent diabetes mellitus, for the relief of stomach ache and to
treat dysentery (5). The plant extract has also been reported to have antitumor and anticarcinogenic activity (6). As a con–
* Corresponding author: amaefabs@yahoo.co.uk; phone: +2341–0802–3303–138.
547
548
FABIAN C. AMAECHINA and ERIC K. OMOGBAI
Effect of extract on blood pressure and heart rate Each rabbit was anaesthetized with pentobarbital at the dose of 40 mg/kg, administered intravenously
through the marginal ear vein, previously canulated with 21–G butterfly canula. The trachea was canulated with a plastic canula to ease respiration.
The vagus nerve was located and separated from the carotid artery, which was cleared of connective tissues and canulated with a plastic canula
connected to a pressure transducer via a three–way tap. The pressure transducer transmitted the blood pressure to Ugo Basile twin channel recorder
(model 7090), which recorded the blood pressure and heart rate. The channel recorder was always calibrated before and after each experiment, using
a mercury sphygmomanometer. When the animal had stabilized and the blood pressure and heart rate had remained constant, the extract was
administered in graded doses of 5 mg/kg, 10 mg/kg, 20 mg/kg, 40 mg/kg and 80 mg/kg. The effects of the graded doses of the extract on blood pressure
... Get more on HelpWriting.net ...
Speech On Drugs In Sports
Drugs In Sports In sports, many of the Olympic winners have been found in taking drugs to gain advantage from other participants with would help
them to perform better in their competition. Drugs come in different form, e.g. pills, injection or powder. The participants who take drugs only think
that the drugs will only give them positive results, but they don't think what are the after results and what happened if they got caught. Some athletes
don't even know that they are taking drugs because their trainer has been giving them supplements by telling them that they are vitamin pills but for
the people who actually are intentionally taking drugs, is it actually fair for the drugs to be banned because they naturally don't have as much strength
and power that the other participants have naturally? "A drug is a medicine or other substance which has a psychological effect when digested or
otherwise introduced in the body (Dictionary)." There are many different types of drugs, e.g. anabolic steroids, diuretics and stimulants (performance
enhancing drugs). These drugs are not the only ones used but these are one of the most common ones. Anabolic Steroids is used for allowing muscle
to grow quicker, work harder and recover faster form any... Show more content on Helpwriting.net ...
I also think that there should also be some types of awareness campaigns so people would be able to know what is going around the world because I
think that many people don't know about what is actually happening in the sports
... Get more on HelpWriting.net ...
Orthostatic Hypotension Essay
In this scenario, the subjected data is chest palpitation, lightheadedness and dizziness, the objective data is elevated heart rate with irregular rhythm,
orthostatic blood pressure readings, lying 135/90, sitting 120/80, standing 100/60, and the client becoming dizzy and light–headed as he moves from a
sitting to a standing position while taking the blood pressure. The subjective and objective data indicates that the patient has orthostatic hypotension. To
determine what is causing the orthostatic hypotension a more in–depth health history, physical assessment, labs and diagnostic testing would need to be
done.
Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure ... Show more content
on Helpwriting.net ...
It is difficult to do a cardiac assessment on someone who is uncooperative and in handcuffs with multiple officers standing in a small room. When
someone is uncooperative it is almost impossible to complete an assessment also the assessment is usually being rushed by the officers because the
uncooperative patient is still a danger to others. By assessing the scene, I realized that when one officer got near this particular patient it seemed to
escalate his uncooperative behavior. I asked the officer if he could leave the room, he stepped outside the room but the patient could still see him. I
asked the officer to please step out of the door way and explained to the patient that the officer had left the room and would not be coming back this
helped to calm the patient down enough so I could compete my
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The Effect Of Water Ingestion Improved Haemodynamic...
4. Discussion
Previous studies found that water ingestion improved haemodynamic responses to gravitational stress serving as therapeutic relief against hypotension
that can be debilitating for most patients. We hypothesized due to the fact that vitamin water is hypotonic in nature like water then it is likely to illicit
the OPR to fuel inadequate sympathetic drive and help with symptoms like dizziness upon standing. However the effect of 500ml of water and vitamin
water from the current study did not entirely agree with the effect of water seen in patients with baroreflex dysfunction or autonomic failure patients
from previous investigations. 500ml of vitamin water had consistently shown a lack of significant difference in blood ... Show more content on
Helpwriting.net ...
Our results showed a significant difference between 50 ml and 500ml of vitamin water at baseline level in the normal order (n=10) of consumption.
The crossover also gave a significantly different systolic reading (n=8) between 50ml and 500ml of water. This suggests that the average basal
haemodynamic state for the pooled data was different for different experimental runs highlighting haemodynamic variability.
4.1 Vitamin water composition
Dragonfruit Vitamin water contains predominately 160mg of vitamin C per 500ml as the main ingredient. There is evidence to show the benefit of
vitamin C as adjuvant therapy for the treatment of hypertension. Doses of vitamin C supplements ranging between 60–400mg were shown to have a
useful role in lowering blood pressure (both SBP and DBP). The corresponding averages of SBP and DBP were declining after the ingestion of 50ml
of vitamin water amongst 10 participants in our pooled data (SBP: –1.40В±2.35mmHg, DBP: –0.10В±3.85mmHg). Likewise the same decrease in SBP
was evident with 50ml of water, which gave a decrease by 0.90В±4.17mmHg. It may be possible that vitamin C content negated the OPR. Blood
pressure changes are sensitive to ascorbic acid levels until a certain threshold; the effect of vitamin C was lowered in trials where the population had
already taken supplements due to renal
... Get more on HelpWriting.net ...
The Stages Of Clinical Reasoning
Clinical reasoning can be defined as, 'the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding
of a patient's problem or situation, plan and implement interventions, evaluate outcomes and reflect on and learn from the process' (Levett–Jones &
Hoffman 2013, p.4). It requires health professionals to be able to think critically and ensures better engagement and results for the patient (Tanner 2006,
p.209). The Quality in Australian Healthcare Study (Wilson 1995, p.460) discovered that 'cognitive failure' resulted in approximately 57% of
unfavourable clinical events involving the failure to produce and act correctly on clinical information. It also recognises that often nurse's
preconceptions and assumptions can greatly affect patient care and by going through such a process, one can take into account the holistic nature of
the patient and provide the best, most appropriate care. Process Information The third stage in the clinical reasoning cycle is process information. This
involves the gathering of signs and indications and the recognition of patterns (Levett–Jones & Hoffman 2013 p.5). It is also when one can begin to
form hypotheses and predict potential outcomes. In regards to Mrs Checkett's case, there are many cues that need to be taken into consideration in
order to best care for her. According to Chester and Rudolph (2012, p.2), vital signs in the elderly change due to the reduction of function of homeostatic
... Get more on HelpWriting.net ...
Meaning Of Orthostatic Hypotension
Orthostatic hypotension is defined as reduction of systolic blood pressure by at least 20mmHg and diastolic blood pressure by at least 10mmHg when
changing the posture from supine to erect position. The ability to regulate blood pressure declines with age. It leads to a delay in blood pressure
adjustment with posture among elderly people. As a result orthostatic hypotension is more common among elderly people. (Hajjar, 2005) The
prevalence of orthostatic hypotension is around 5% – 30% among institutionalized patients. (Tilvis et al., 1996)(Rutan et al., 1992)(Masaki et al., 1998)
The differences in these estimates varies due to a number of factors such as definition of orthostatic hypotension, composition of the population, the
segment of the
... Get more on HelpWriting.net ...
Alcohol Syncope
Abstract Alcohol consumption may be linked to syncopal events. The mechanism by which alcohol may induce syncope is not well understood.
Impairment of the response to orthostatic stress may be involved. A growing body of medical evidence suggests that short–term alcohol consumption
elicits hypotension during orthostatic stress because of impairment of vasoconstriction. These findings have implications for understanding of
hemodynamic effects of alcohol and, in particular, for understanding syncopal events that occur in association with alcohol intake. A 27–year–old
African American female with a previous syncopal event following alcohol consumption was brought to the Emergency Department by ambulance
after a witnessed ... Show more content on Helpwriting.net ...
It results in dizziness or syncope from transient diminished cerebral perfusion.
Case Report A 27–year–old, well–appearing African American female was brought to the Emergency Department by Emergency Medical Services
after a witnessed syncopal episode. The only medical history is a previous alcohol–induced syncope 2 years ago. The patient does not have any past
surgical history. The patient only drinks socially. She does not smoke, and she denied any drug use. The patient lives with mother, and works as a
nursing assistant in a nursing home. The patient admitted to drinking "a shot of vodka" approximately 10 minutes prior to syncopal episode. The
patient fell upon standing and hit the back of her head on the floor. Patient's significant other who witnessed the syncopal event reported that loss of
consciousness (LOC) lasted about 2 minutes. EMS was consequently called. According to EMS, the patient was still on the floor, alert and oriented
only to self upon their arrival. She was lethargic. The patient did not remember passing out. She was subsequently transported to the Emergency
department. Patient did improve remarkably on the way to the hospital. Upon arrival to the Emergency Department, patient was alert and
... Get more on HelpWriting.net ...
The Prevalence Of Low Blood Pressure
With the global population suffering from an unprecedented distortion of the traditional age distribution, discussion and scientific inquiry surrounding
the nature and impacts of dementia among the aging and the elderly is becoming increasingly prevalent within the public eye. One such story,
conducted by the Erasmus Medical Center and reported in a BBC News online report, examines the prevalence of dementia in relation to preceding low
blood pressure (Mundasad, 2016). The article, as reflected in its concluding professional recommendations, aims to indicate low blood pressure
complications as a potential factor in developing dementia, thus informing consumer healthcare decisions and contributing to an expanding body of
medical knowledge. In describing this study, BBC health reporter Smitha Mundasad explains the nature of the original endeavor. Researchers from the
Erasmus Medical Center in the Netherlands posed a topic of inquiry indulging the research question of whether frequent incidents of low blood pressure
have any impact on one's likelihood of contracting dementia over their lifetime (Mundasad, 2016). Their suspected alternate hypothesis states that
frequent low–blood pressure incidents will increase the occurrence of dementia within their sample participants. It is important to note that this
hypothesis is directional, as Mundasad mentions that previous research has linked high blood pressure to various forms of dementia (2016). Thus,
researchers had grounds to
... Get more on HelpWriting.net ...
Hypotension And Hypertension
Discussion:
Part 1
1. Include your results and discuss each measurement below, using the questions as a guide:
a. Weight / frame size / BMI
What were your measurements and in which categories do you fall?
My measurements are 137 pounds in weight, 26.75 BMI and my frame size is 9.67 which is considered large.
Are you at risk for any health problems?
I fall in the overweight and large category.
What is normal or healthy for you?
I think that this is normal for me because I have a lot of muscle on my lower body due to performing heavy compound movements at the gym such as
squats and deadlifts.
b. Waist circumference
What was your measurement?
My waist circumference measurement is 27.75 inches.
What do the "apple" and "pear" shapes ... Show more content on Helpwriting.net ...
During my workout, my body pumps oxygen throughout my body. This action alone prevents arteries from clogging up, while sedentary lifestyles
increase their chances of creating plaque. When there is movement, the blood moves freely throughout the body. When one sits most of their day,
blood and nutrients are less likely to travel effectively. Nutrients begin to settle into arteriole walls. One example to think about is comparing the
oxygen an active person expends compared to another person that lacks physical activity. Who needs to take in more breaths to complete a brisk walk
on an incline hill? The active individual does not need to maximize their energy nor stop to catch a breath, while the sedentary individual may tend to
lose their breath and utilize maximum effort to complete that incline
... Get more on HelpWriting.net ...
Elective Caesarean Hypotension
Caesarean delivery is the method by which a baby is born through an incision in the abdominal wall and uterus. Statistics show that 166,081 caesarean
deliveries were carried out within NHS hospitals in England during 2013/2014, of which 50% were elective. This represents a 2.5% rise over the
previous year, continuing the trend of increasing elective caesarean rates (Health & Social Care Information Centre, 2015). Indications for a caesarean
section (CS) can include foetal distress, previous CS, breech presentation, abnormal progress during labour, etc. (Vacca, 2013).
This segment will explore and discuss the role of the Operating Department Practitioner (ODP) within the perioperative care of a 35 year old patient,
undergoing an elective caesarean ... Show more content on Helpwriting.net ...
The practitioner ensured that the patient was dry and was covered to maintain dignity and privacy. The anaesthetist accompanied the practitioner to
the PACU to observe and establish that the patient was physiologically stable during transfer. On arrival to PACU the scrub staff and anaesthetist took
part in the PACU handover. It is imperative that a formal handover of the patient care is given with all relevant details about anaesthesia and surgery
verbally communicated, in order to aid the continuity of care and minimise the risk of omissions (Hamlington, 2012). One study (Kluger and Bullock,
2002) observed that 14% of adverse recovery events was contributed by inadequate handover procedure. The patient was observed on a one–to one
basis by the recovery ODP whilst observations and monitoring was recorded. Recordings of respiratory rate, heart rate, NIBP and pulse oximetry were
made at 5 minute intervals as laid out in AAGBI's guideline for postoperative recovery (Association of Anaesthetists of Great Britain and Ireland,
2013). Sedation and mobility recordings were also needed due to the intrathecal anaesthesia, as well as temperature, pain intensity, blood loss,
... Get more on HelpWriting.net ...
Orthostatic Hypotension: A Case Study
Everyday there are countless admissions to hospitals throughout the world for injuries due to falls. More often than not, patients who suffer falls are
elderly patients who have lost their balance. One study states that in the United Kingdom, the number one cause of emergency room admissions to the
hospital is for those 65 years and older who have fallen.1 In order for this issue to be addressed and corrected, one must take into consideration the
variety of precipitants for falling. One of the major reasons for falls is referred to as orthostatic intolerance. Orthostatic intolerance is defined as "the
development of symptoms such as lightheadedness and blurred vision when a subject stands up and clears when sitting back down."2 There ... Show
more content on Helpwriting.net ...
The first test, which may be performed, is referred to as autonomic reflex screening. The screening is composed of three test which ultimately
examine the patients blood pressure and heart rate fluctuation in response to the valsalva maneuver. Another test that may be used is referred to as the
thermoregulatory sweat tests. The particular pattern an individual sweats can be indicative of a possible neuropathy. Neuropathy is then suggestive
that a lesion is present in the nerve causing a fault in the circuitry responsible for maintaining the bodies postural blood pressure.2,16 The last test
may be performed to determine the cause of the orthostatic hypotension is a 24 hour urine sodium. This test can be explained by the basic principle
of osmosis. Water will always follow in the direction of the sodium or salt. Thus, if the urine sodium is elevated, the kidneys are excreting sodium, as
well as, water. If the kidneys are excreting large amounts of water, the plasma volume will be low, contributing to the occurrence of orthostatic
hypotension.2,17 A urine excretion of sodium ~170 mmol/24 hours is indicative of a normal plasma volume. Using these three screening tests the
provider should be able to determine if the cause of the orthostatic hypotension is neurologically related, due to hypovolemia or venous
... Get more on HelpWriting.net ...
Sepsis a Case Study
The aim of the essay is to analyse the care of a septic patient. While discussing the relevant physiological changes and the rationale for the treatment the
patient received, concentrating on fluid intervention. I recognise there are other elements to the Surviving Sepsis Bundles, however due to word
limitation; the focus will be on fluid intervention. The essay will be written as a Case Study format.
To maintain patient confidentiality any identifying features have been removed in keeping with the Nursing and Midwifery Council (NMC) Code of
Professional Conduct (NMC, 2008) the patient will be referred to as Mr X.
Mr X was an 80–year–old male admitted to ITU, from the Medical Assessment Unit, with increasing respiratory failure.
His ... Show more content on Helpwriting.net ...
Table 2Nutbeam et al 2009 mediators, causing increasing capillary permeability and widespread fluid shift into the interstitial space, which was no
longer functioning to maintain vascular volume (known as third spacing) in addition, causing further vasodilation to occur.
This caused Mr X to become increasingly hypotensive and tachycardic.
Table 2 shows some of the chemical mediators involved in Mr X's inflammatory process, causing it to become more severe and uncontrolled, resulting
in a further decline in his clinical presentation.
His clinical observations were now: Blood Pressure: 80/50mmHg
MAP: 55mmHg
Heart Rate: 130 beats per minute
The patient was now diagnosed as being in septic shock. His skin was mottled with an increasing capillary refill time. Schmidt and Mandel (2008)
suggest this is a sign of hypoperfusion as the skin is vasoconstricting due to the redirection of blood flow to the core organs.
I informed the doctor and expressed my concerns regarding the patient's hypotension.
A 250ml fluid bolus of colloid was given as an attempt to improve Mr X's blood pressure and MAP.
The early intravenous fluid administration for resuscitation of the critically ill hypovolemic patient is the corner stone of shock therapy (Kruemer
&amp; Ensor 2012). The Surviving Sepsis recommends early optimization in the first six hours, followed with fluid challenges in the case of persistent
hypo
... Get more on HelpWriting.net ...
Intraoperative Hypotension
INTRODUCTION : perioperative hypotension is a common problem, incidence is largely unknown. There are evidences suggesting that incidence of
myocardial adverse events in the postoperative outcome may be linked to the prolonged episodes of perioperative hypotension. There are few
comprehensive resources available in the literature regarding diagnosis and management of these common clinical outcomes, especially in non–cardiac
surgery.[1] Perioperative myocardial ischemia is associated with significant morbidity and mortality, 50% of postoperative deaths are due to cardiac
complications, the ischema is the major problem amongst.[1] It is an emergency crisis which poses a unique challenge for the anaesthetist in its
management. We report a case of Intraoperative myocardial ischemia in an elderly patient with multiple comorbidities who underwent orthopaedic hip
surgery . Intraoperative myocardial ischemia was diagnosed on time and was managed successfully. Key words: Echocardiography, myocardial
ischemia, perioperative hypotension, perioperative myocardial ischemia CASE REPORT:... Show more content on Helpwriting.net ...
Dopamine and nor adrenaline were tapered and stopped 2 days before surgery. He was posted for right proximal femur nailing after optimisation of his
general
... Get more on HelpWriting.net ...
Orthostatic Hypotension Case Study Essay
Case Study
Julia Atungsiri
Purdue University Global
Case study
1.What is the significance of the orthostatic hypotension, tachycardia, abdominal tenderness, hematuria, joint pain, and petechiae? What is splinter
hemorrhages and what is their significance?
Orthostatic hypotension is the reduction of the systolic pressure of at least 20mmHG or the dropping of diastolic pressure of at least 10mmHg within
three minutes of standing as compared to baseline as such, the body is often unable compensate for the changes in the blood pressure values (Fournier
et al., 2016). The fall in the blood pressure is attributes to the fact that a small amount of blood collects in the leg veins when a person stands as a
result of gravity hence reducing ... Show more content on Helpwriting.net ...
What are the major causes of infections?
References
Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Tleyjeh, I. M., Rybak, M. J., ... & Bolger, A. F. (2015). Infective endocarditis in adults:
diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart
Association. Circulation, 132(15), 1435–1486.
Fournier, P. E., Watt, G., Newton, P. N., Lamas, C. C., Tattevin, P., & Raoult, D. (2016). Blood culture
–negative endocarditis. In Infective Endocarditis
(pp. 245–258). Springer, Cham.
Morton, P. G., Fontaine, D., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a holistic approach (p. 1056). Lippincott Williams & Wilkins.
Pettersson, G. B., Coselli, J. S., Hussain, S. T., Griffin, B., Blackstone, E. H., Gordon, S. M., ... & Woc–Colburn, L. E. (2017). 2016 The American
Association for Thoracic Surgery (AATS) consensus guidelines: surgical treatment of infective endocarditis: executive summary. The Journal of
Thoracic and Cardiovascular Surgery, 153(6), 1241–1258.
Thuny, F. (2016). Diagnostic Criteria for Infective Endocarditis. In Infective Endocarditis (pp. 81–86). Springer,
... Get more on HelpWriting.net ...
Unit 4222-335 Undertake physiological measurements
Unit 4222–335 Undertake physiological measurements
1.1 We should always check equipment which we are going to use if it is safe and working properly, we should wear PPE every time we are
undertaking any task, ensure that we are trained to do the task, we should keep the working place safe and clean. When we are about to take
measurement from an person we need to make sure that the person know exactly what we are going to do and asking permission for the task we are
about to do. Recording the task in the chart and keep it confidential to protect personal information during the course of our work.
2.1 To have an blood pressure maintenance we should maintain a healthy lifestyle, doing some exercises daily and eating healthier,... Show more
content on Helpwriting.net ...
We can find pulse oxymetry on the fingertips, except on the thumb as our own pulsation or ear lobe and also on the toes.
2.5 Body Mass Index,BMI, is a measure of our weight compared to our height. BMI can help determine whether they are at a healthy weight,
overweight or obese individuals are at increased risk for many diseases, such as: heart disease, high blood pressure, high cholesterol, type–2 diabetes,
and some types of cancer. With high BMI the individual would need to perform further assessments, start with a diet, physical activity, family history,
change lifestyle.
2.6 Several factors can influence changes in physiological measurements such as illness, infections, stress, lifestyle, deterioration.
2.7 Monitoring physiological measurements itВґs important to make sure the individual health status and also necessary after surgery, as patients in
intensive care units require continuous monitoring, and sometimes have medications that requires physical measurements taken. These are
measurements we take to ensure that they are functioning in the way they are supposed to. When we carry out physiological measurements, such as
measuring temperature, pulse and respiration, we are monitoring for signs of abnormality. Then be able to draw conclusions about the health status of
the individual and any treatments they may
... Get more on HelpWriting.net ...
Complete Fiv Descriptive Analysis
Study Outcome: Physical activity:
Physical activity was quantified as steps/day. Steps/day were determined using a uniaxial accelerometer (Actigraph GT1M, Pensacola, FL, USA). The
accelerometer measures vertical acceleration and deceleration, providing valid and reliable physical activity data in free–living conditions.10,11 Each
person was fitted with accelerometer fastened with a belt worn above participant's right hip, and were instructed to wear the belt during waking hours
for 7 consecutive days. A valid wear day consisted of at least 10 hours of wear, and all individuals with 4–7 valid wear days were included12. For this
analysis, we categorized people who walked less than 6000 steps/day as inactive. This cutoff was chosen as it was previously shown to be the minimum
threshold needed for individuals with knee OA to protect against developing the functional limitation such as difficulty inwalking etc.9
Study Exposures: Physical function
Physical function was quantified with three clinical tests.
1.The sit–to–stand test (STS) was calculated by time needed to complete ... Show more content on Helpwriting.net ...
We calculated Pearson correlation coefficients to describe the strength of association of steps/day with physical function. We then calculated specificity
over a range values of the each physical function test in order to be active (walk ≥6000 steps/day). To illustrate this process, consider a test value of
10 seconds to complete STS test. Since a slower time is indicative of worse physical function on this test, those who performed the STS in >10
seconds were identified with poor physical function. Likewise, those who performed the test in <10 second were identified as good physical function.
We constructed a 2x2 contingency table (Table 1), and calculated specificity as shown in Equation 1.This process was repeated to determine the
specificity over a range of possible physical function
... Get more on HelpWriting.net ...

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Sepsis Is A Poisoning Of The System By Disease Carrying...

  • 1. Sepsis Is A Poisoning Of The System By Disease Carrying... Sepsis was known in the old days as "blood Poisoning" because it is " A poisoning of the system by disease carrying bacteria and their toxins absorbed into the bloodstream, as from festering wounds," according to the World Book Encyclopedia Dictionary. 1 Because Sepsis is a severe and often fatal disease and thought to cause 44,000 deaths a year, it is most important that it be recognized early and treated aggressively with utmost and urgent care. If not treated early it can lead to shock and multiple organ failure and even death. It kills more people than breast, bowel, and prostate cancer combined; however, it can be treated successfully if detected early on. 2. Erin Dean Sepsis does not arise on its own. It stems from another medical condition such as an infection in the lungs, urinary tract, skin, abdomen (such as appendicitis) or other part of the body. Invasive medical procedures like the insertion of a vascular catheter can introduce bacteria into the bloodstream and bring on the condition. Many different types of microbes can cause sepsis, including bacteria, fungi and viruses, but bacteria are the most common culprits. Severe cases often result from a body–wide infection that spreads through the bloodstream, but sepsis can also stem from a localized infection. All healthcare professionals should treat suspected sepsis with the same urgency as a heart attack, according to the National Institute for Health and Care Excellence. (NICE) 3. Patients who are at higher ... Get more on HelpWriting.net ...
  • 2. Assessing Fall Risk Of Older Adults Living Assessing Fall Risk of Older Adults Living in the Community Rachael McCowen Epidemiological Design and Statistics University of West Florida I.Background In the absence of evidence to support a population–based approach to prevention and the imperative to deliver cost–effective and efficient services, health care providers need risk assessment tools that reliably identify at–risk populations and guide intervention by highlighting remediable risk factors for falls and fall–related injuries. Such tools typically consist of a rating or scoring system designed to reflect the cumulative effect of known risk factors for the purpose of identifying those at greatest risk for sustaining a fall or fall–related injury [*]. Historically, fall risk tools have focused on institutional settings with little attention to tools tested in community settings. Of the reviews that do include community dwelling seniors, tools are typically limited to the assessment of balance with little consideration of other risk factors [*]. Since 2000, three reviews have been published that detail a cross–section of fall–risk assessment tools [*]. The focus has been on institutional settings with little attention to tools tested in community settings. Most falls occur as a result of a dynamic interaction between intrinsic and extrinsic factors, and as such interdisciplinary and multiagency intervention is likely to have the greatest impact. Lack of a simple cause and effect relation in ... Get more on HelpWriting.net ...
  • 3. Elderly Dehydration Essay example Most people don't think about dehydration; let alone elderly dehydration. It is a common problem, in the aging, and often recognition along with treatment may be delayed; contributing to a high mortality rate. (Lavizzo–Mourey, 1987) By recognizing a potential problem early, you may save an older adult from a debilitating complication. (Hamilton, 2001) The prevention of elderly dehydration will deter illness and increases life expectancy, along with decreasing unnecessary hospitalization and cost. There are several causes to elderly dehydration, which can be broken down into four groups: physiological factors, psychological factors, functional impairments, and mechanical impairments. (Hamilton, 2001) The physiological factors are: natural ... Show more content on Helpwriting.net ... (Hamilton, 2001) If, these signs and symptoms go undetected, for a long period of time, they will result in chronic dehydration and cause several other medical issues. (Vasey, 2002) One of the results of chronic dehydration is fatigue or energy loss which resembles depression. (Vasey, 2002) Constipation is another result chronic dehydration, by removing too much excess liquid from stool making it hard to expel. (Vasey, 2002) Chronic dehydration also contributes to digestive disorders such as: poor digestion, gas, bloating, pain, nausea, ingestion, and loss of appetite. (Vasey, 2002) The average body produces 7 liters of digestive juices daily; but a dehydrated individual will secrete less, thereby causing improper digestion. (Vasey, 2002) Chronic dehydration causes high blood pressure due to low blood volume and the vessels sharply contracting. (Vasey, 2002) It can also cause low blood pressure in individuals, with weak vasoconstriction, who again, have a low blood volume. (Vasey, 2002) Chronic dehydration is also the culprit of gastritis and ... Get more on HelpWriting.net ...
  • 4. Total Knee Replacement Nifedipine (Adalat,Procardia,others) Prototype Drug / .Therapeutic Class: Drug for hypertension and angina Pharmacologic Class: Calcium channel blocker. ACTIONS AND USESNifedipine is CCB generally prescribed for HTN and variant or vasospastic angina. It is occasionally used to treat Raynaud's phenomenon and hypertrophic cardiomyopathy. Nifedipine acts by selectively bloking calcium channels in myocardial and vascular smooth muscle, including those in the coronary arteries. This results in less oxygen utilization by the heart, an increase in cardiac output, and a fall in blood pressure. It is available as extended–release tablets (XL).ADMINISTRATION ALERTSDo not administer immediate –release formulations of nifedipine if an... Show more content on Helpwriting.net ... Ensure proper use and functioning of any home equipment obtained.| Ensuring therapeutic effects:Continue frequent assessments as described earlier for therapeutic effects.(Blood pressure and pulse should be within normal limits or within parameters set by health care provider. If drug is given for angina and /or dysrhythmias, significant improvement in reports of pain, palpitations, or ECG demonstrates improvement)| Encourage the patient to adopt a healthy lifestyle of low–fat food choices, increased exercise, decreased alcohol consumption, and smoking cessation.| Encourage appropriate lifestyle changes. Provide for dietitian consultation as needed. (Healthy ... Get more on HelpWriting.net ...
  • 5. Hypotension Essay Patients with hypotension usually manifest with lightheadedness, weakness, fatigue, anxiety, vertigo, frank syncope, seizure like episodes, paleness, sweating, abdominal and chest pain, muscle cramps, nausea, vomiting, and dyspnea, although occasionally some patients may be asymptomatic. Vagal symptoms, encompassing yawning, sighing, and hoarseness may be observed before the fall in blood pressure is noticed (3 of 1). Quality of life and patient's sense of well–being are also adversely affected by hypotension. As a consequence of the undesirablesymptoms of hypotension, patients may tend to discontinue their hemodialysis treatment prematurely. Cerebrovascular insufficiency (transient ischemic attacks, cerebrovascular accidents) and cardiovascular instability (myocardial ischemia, arrhythmias) may further complicate hypotension during dialysis. It may also contribute to chronic overhydration owing to an inability to attain a proper target ... Show more content on Helpwriting.net ... The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) and European Best Practice guidelines define IDH as the presence of a decrease in systolic BP ≥ 20 mm Hg or a decrease in mean arterial pressure (MAP) ≥ 10 mm Hg, provided that the decrease in BP is accompanied with clinical symptoms and need for nursing interventions (1 of 1). In the Hemodialysis Study (HEMO Study), IDH was defined as hypotension requiring either saline infusion of ultrafiltration (UF) rate or blood flow reduction (HEMO STUDY NEJM). IDH occurs in in 15–30% of conventional dialysis treatments and in 35% of other extracorporeal procedures like therapeutic apheresis. Given the increasing number of elderly and diabetic patients in the HD population, the incidence of acute IDH has reached up to 50%. Prevalence of the chronic form of dialysis hypotension, specific for long–term dialyzed patients, is estimated to occur in 3–5% of treated individuals ... Get more on HelpWriting.net ...
  • 6. Thermoregulation Mechanism in the Human Body Previous studies have not considered the temperature control mechanisms of human body when a conflicting information is received from peripheral and central thermoreceptors. Our experiment was designed to investigate how the thermoregulation mechanism was activated when there was a passive heating to the human body and to find out how the body would react to the situation when the human was experiencing the heating and cooling simultaneously. Our first hypothesis was accepted, where the body regulated cutaneous vasodilation to enhance heat loss through sweat evaporation and all the respiratory parameters were increased in order to supply the higher demand of oxygen. However, the second hypothesis was rejected, as the peripheral control had more influence than central control when the body received increased temperature to the leg and decreased temperature at the same time. Heating period The results have clearly demonstrated that during the heating period, there was a decrease in skin resistance and total peripheral resistance (TPR) alongside an increase in heart rate (HR), cardiac output (CO) and peripheral skin temperature, as compared to the relatively stable core and oral temperature, shown in figures 6, 7, 9 and 12. The metabolic rate and respiratory parameters (Respiratory rate, oxygen consumption, tidal volume and minute ventilation) were also increased as seen in figures 1, 2, 3, 4 and 5. A significant decrease in respiratory rate and minute ventilation at 30 min of ... Get more on HelpWriting.net ...
  • 7. Trendelenburg Position Essay Abstract Hypotension is one of the top three most frequent causes of cardiac arrests in the United States. One early intervention used in treating hypotension is placing patients in Trendelenburg position. The purpose of this research was to review information on the use of the Trendelenburg position or variations of it to determine whether this position has an impact on hemodynamic status, to describe historical practices of the Trendelenburg position, state the reasons and need for possible change, described current best evidence, and define pros and cons for making the practice changes. Research material included scholarly peered articles, Internet Resources, and nursing textbooks revealing many studies which question the benefit of ... Show more content on Helpwriting.net ... Modifications of the original posture have been used in diverse situations, with applications found for "high," "low," and "reverse–Trendelenburg." Over the past 50 years, laboratory and clinical studies have described the physiologic effects of the Trendelenburg position in normal and hypotensive states. Because of conflicting results, differing opinions thrive with regard to the usefulness of the position in various medical applications. Some of these applications include hypovolemic or septic shock, abdominal surgery, patients under general or regional anesthesia and patients with spontaneous or controlled ventilation. More specifically, the usefulness of the Trendelenburg position comes into question in the field of anesthesia for central catheter placement, and the administration of certain drugs at the spinal level. Even though numerous studies have proven no significant evidence showing the Trendelenburg position to be effective, a considerable number of present–day clinical protocols and guidelines developed by the health administration and natural scientific societies do, in fact, include leg raising in the decubitus supine position as a standard procedure for hypotension. However, the utility attributed to the Trendelenburg position in this situation is in severe contrast with most of the studies reviewed, which include that, despite possible improvement in cardiac output, ... Get more on HelpWriting.net ...
  • 8. Orthostatic Hypotension Case Paper I have selected case number 1. An 85 year old man came to the emergency room with palpitations for a few days. He states that he sometimes feels light headed and dizzy. The patient's heart rate is elevated and irregular. As he goes from a sitting position to a standing position he becomes light headed and dizzy. In taking orthostatic blood pressure you notice that they are positive. Orthostatic hypotension or postural hypotension happens when blood pressure drops as you stand from a lying position. This drop in blood pressure causes the patient to become dizzy and light headed. This condition happens more frequent in people of advanced age. His heart rate is fast and irregular. I suspect the rhythm of his heart is atrial fibulation (afib). ... Get more on HelpWriting.net ...
  • 9. Vasovagal Syncope Generally, before fully losing consciousness, presyncopal symptoms include feeling faint, dizzy, lightheaded, hearing ringing, darkened or faded vision, and decreased hearing ability. The victim is overpowered by unsteadiness and weakness before blacking out. Inevitably, symptoms of the episodes continue until the vertigo (dizziness) overwhelms the victim, literally sending them into a whirl. One can know when to worry if symptoms like chest pain, dyspnea (difficulty breathing), low back pain, heart palpitations, severe headache, ataxia (loss of body movement control), or slurred speech occur. After the victim wakes up from fully losing consciousness, he or she feels a sensation of warmth, nausea, lightheadedness, temporary visual changes, ... Show more content on Helpwriting.net ... If there is no obvious or known cause, a non–invasive cardiac test, echocardiography, ambulatory monitoring, stress test, and tilt–table test are necessary. If the fainting is triggered by a certain position or movement like stretching or valsalva, it would be very helpful to do that specific maneuver to trigger the symptoms while being monitored by a doctor (Hain). Valsalva is a forceful exhalation, like one might do if their ears are plugged. While performing a tilt–table test, the doctor will record the patient's blood pressure at a 70 degree tilt using a motorized bed. The results are considered abnormal if there is a neurally mediated response like a sudden onset of hypotension (very low blood pressure), bradycardia (very slow heartbeat), or both when the patient is kept in the upright position which is the most common abnormality. The doctor will also monitor if there is positional orthostatic tachycardia or dysautonomia, which is a gradual decrease in blood pressure with little or no change in heart rate while moving from a lying down position to an upright position.. The tilt–table's main purpose is to confirm autonomic dysfunction. Autonomic function is the term used to describe the processes in our body that we do not control ourselves, like blood pressure, heart rate, and digestion. Another test called ventilation–perfusion scanning is used for suspicions of pulmonary embolism, which is a large blood clot blocking blood flow to organs. The last experiment doctors may use is called Holter monitoring. This requires that a small device that records every single heartbeat is to be worn for 24 hours along with a written log of any symptom.There are many variations of Holter monitoring which extends the time and strictness ... Get more on HelpWriting.net ...
  • 10. A Reflection On Clinical Placement Look Back Another day of my clinical placement 420 in orthopaedic unit began on July 4, 2015. I received my patient and started to research a patient history and medications. At 0700 a shift report started, I received information that my patient had fall at night shift without witnesses. By the policy of Providence Healthcare a patient who had fall without witnesses should be automatically monitored for head injury therefore, a Glasgow Coma Scale was initiated by previous nurse: every 15 minutes, then every hour, every two hours, and every 4 hours. This scale is to check and monitor level of consciousness which possibly may decline after head injury. At this day we had a student as a "nurse in charge", she volunteered to come with me to patient room and to supervise my work. For this particular patient close monitoring of vital signs and neurologic assessment required. I explained to the patient the purpose of frequent health assessment and started to work. Close patient monitoring in addition to all daily routine activities was challenging to me because I never had a patient with this diagnosis. Despite my explanation of the purpose of frequent assessments patient stated that "I am fine, do not feel any discomfort, there is no need for that". While assessing patient she keep asking a lot of questions such as why so many time why do I need to drink more than one mouthful of water with my tablets, what these tablets for, why do I need to wait few minutes after ... Get more on HelpWriting.net ...
  • 11. The Effect Of Exercise On The Body Introduction The purpose of this lab was to measure resting heart rate and blood pressure as well as during submaximal exercise to see the effects of exercise has on the body. Submaximal graded exercise test is any physical activity whose intensity increases at regular intervals up to but never exceeding 85 percent of an individual's maximum heart rate. Testing the submaximal level is ideal because all subjects can participate and it is safer. Heart rate is the number of beats per minute measured by either at the radial or the carotid. This gives you the beats per minute which ideally needs to stay around 60–80 BPM. The difference in heart rate between males and females vary. Males tend to have a higher heart rate because they are bigger and it takes more force to send blood throughout their body and the males heart are bigger than a female. Heart rate can also decrease in trained individuals, this is because the heart enlarges and strengthens which leads to larger heart chambers that can pump twice as much blood than an untrained individual. Blood pressure is the measure of heart work or pressure exerted against the walls of the various vessels of the circulatory system by the heart as it pumps blood to the body. This can be measured in mmHg by using a sphygmomanometer and a stethoscope. When measuring blood pressure, you will get two numbers, the first one is the systolic pressure and the second one is the diastolic pressure. The systolic blood pressure measures the ... Get more on HelpWriting.net ...
  • 12. Classification Of Medication By Sarah Jennings Stuti Patel Unitek College Ms.Brooks Classification Of Medication Sarah Jennings is a 45 years old female, 5 feet 6inches tall, 130lbs. Today she came in to see Dr. Wallace for 3 –month appointment. She has been diagnosed with hypertension, diabetes, and cholesterol. Due her cholesterol medication she was asked to come in to get her liver function checked. During her visit today she mentioned to the doctor she has had knee pain for the past few days. It started after she tripped while hiking last week. Sarah also suffers with bipolar disorder, but she has been doing well with the anti–depressant she is on. She is a very sweet, tiny, determined lady who is trying her best to keep up with all her health issues. She has changed her diet and has been good with exercising daily. Sarah has been taking prazosin for hypertension which a alpha blocker. It blocks receptors in the arteries in smooth muscle. This helps relax theblood vessels and leads to an increase in blood flow and a lower blood pressure. The most common side effects of are dizziness, drowsiness, fatigue, headache, nervousness, irritability, stuffy or runny nose, nausea, pain in the arms and legs, hypotension, and weakness. Also another side effect is first–dose orthostatic hypotension because initially the patient has more sensitive to the blood pressure–lowering effects. As patients continue to take the medication they become less sensitive and have fewer problems with hypotension. There ... Get more on HelpWriting.net ...
  • 13. Anti Hypertensive Drugs Essay Anti–hypertensive Drugs: The concern on whether anti–hypertensive's should be withheld in patients who are hypertensive has been debatable in the recent past. Generally, the treatment of hypertension among hospitalized patients is basically an opportunity to enhance the recognition and treatment of blood pressure (Axon, Nietert & Egan, 2011, p.246). This is mainly because hypertension is a basic risk factor for heart diseases, stroke, and death whose impact is widespread to nearly 70 million adults in America. There have been numerous educational initiatives and publication of treatment processes to address this condition in the past few decades. Despite these measures, nearly 39 million Americans are at risk of hypertension because they have not reached their desired or optimal blood pressure. The concern regarding the use of anti–hypertensive medication as a treatment procedure for hypertension has mainly been centered on the optimal choice of these agents. The other factors include the side effects of these drugs on a hypertensive patient, especially coughing. While three categories of these drugs are linked with cough as a side effect, they have varying casual explanations though angiotensin–converting enzyme (ACE) inhibitors play a crucial role (Van Amburgh, 2011). The main objective for the use of anti–hypertensives in dialysis patients is to obtain and sustain an optimal blood pressure or lessen it by the least intrusive measures possible. While this is not ... Get more on HelpWriting.net ...
  • 14. Life Changing Moment : What Is A Life Changing Moment? Life Changing Moment On Tuesday morning November 8, 2016, I woke up with extreme pain in my lower abdomen. When I got out of bed I was dizzy and had a hard time walking. I made it to the bathroom and sat down on the toilet. When the pain did not start to feel any better, and all I could see was black I yelled for my mother. When my mother got to me she just stared at me and asked me what was wrong because my head was hanging and I could not speak. When she lifted my head, she noticed my face was very pale and then I passed out. At this point she called for my father and when he saw me he said we need to take her to the hospital. My father carried me to the car and they rushed me to the hospital. On the way to the hospital I was lying down in the backseat crying and screaming in excruciating pain, and did not know where I was. My then, twelve–year–old brother began to cry because he had never seen me in so much pain. When we arrived at the hospital my father carried me through the emergency room doors and the emergency room staff got me a wheel chair. By this time, I was still in pain and lucid. My mom gave the clerk the minimal information needed, described my condition, then I was immediately taken to an examine room. The nurse pushed me to a room in the emergency area. This room was not like the regular hospital rooms. This room did not have a door it just had a giant curtain to separate the room from the hallway. When they got me in the room the nurse assisted me from the wheelchair to the bed. The pain was still severe and I could barely lay still. The nurse kept telling me that I needed to be still so she could get accurate vital signs. It was difficult to be still with the pain I was experiencing. Immediately, the nurse asked me questions such as "where do you hurt?", "how long have you been hurting?", and "when did the hurting begin?". I answered those questions as precisely as I could, so the nurse and doctor would have a better understanding of what was happening. While the nurse was asking questions, another nurse was sticking probes on my chest and connecting them to a machine; they were doing an EKG (electrocardiogram). After this the nurse gave me an IV (intravenous therapy) for them to ... Get more on HelpWriting.net ...
  • 15. The Anti Hypertensive Properties Of Doxazosin Pharmacology Doxazocin is an "alpha–adrenoceptor blocking drug" and it is used in both hypertension and benign prostatic hyperplasia (Joint Formulary Committee, 2014). For the purpose of this essay, the main focus will be on the anti–hypertensive properties of Doxazosin. Selective О±1 antagonists work on the post–synaptic О±1 adrenoreceptors predominantly found in vascular smooth muscle. These receptors are normally bound by norepinephrine or epinephrine to mediate regulation of the cardiovascular system by the sympathetic nervous system. As can be seen in Figure 1, these receptors are bound to Gq–proteins which have two signal transduction pathways. One of the pathways forms IP3 (Inositol triphosphate) which then stimulates the release of Calcium from the sarcoplasmic reticulum in a cardiac monocyte (Klabunde, R.E., 2013). The release of calcium then stimulates contraction in the heart. By selectively inhibiting these adrenoceptors, vasodilation occurs which in turn causes a decrease in arterial pressure (Rang and Dale). With a mean half–life of 22 hours (Martindale, 2013), Doxazosin is considered to be a long acting hypertensive drug. This means that it can be administered once daily, rather than multiple times. With a good absorption when administered orally, the maximum plasma concentration happens two to three hours after a dose (Martindale, 2013). It also states that doxazosin is roughly "98.3%" bound to plasma, which means that it has an excellent distribution around ... Get more on HelpWriting.net ...
  • 16. Hypotension: A Case Study 7.Describe complications that can occur as a result of dialysis and identify nursing measures that are designed to prevent these complications. Hypotension Hypotension that occurs during hemodialysis primarily results from rapid removal of vascular volume (hypovolemia), decreased cardiac output, and decreased systemic vascular resistance (Lewis, 2014, pp. 1122–1123). The patient may experience a drop in blood pressure during dialysis process. As a result of cardiac ischemia the patient may also exhibit symptoms of light– headedness, nausea, vomiting, seizures, vision changes, and chest pain. To combat these complications of hypotension the volume of fluid being removed is decreased and administering 0.9% saline solution through IV therapy (Lewis, 2014, pp. 1122–1123). Muscle Cramps Muscle cramps are a complication associated with hemodialysis but, the pathogenesis is not quite understood. The causes that evoke the development ... Show more content on Helpwriting.net ... This will help them plan according to manage times around ADLs and get them more involved with proper medication management. Next, explain the risk of misuse of over–the–counter analgesics, such as NSAIDS, and how they may further reduce kidney function and increase risk for chronic kidney disease. Also, caution the patient about angiotensin–converting enzyme (ACE) inhibitors. ACE inhibitors are commonly prescribed to prevent high levels of protein in urine (proteinuria) and progression of kidney disease, especially in diabetic patients. (Lewis, 2014, pp. 1106–1107) However, Ace inhibitors also have an adverse effect of decreasing perfusion pressure and causes electrolyte imbalance of excessive potassium (hyperkalemia). As a caution, if diet modification, diuretics, and sodium bicarbonate cannot control the hyperkalemia, ACE inhibitors may need to be reduced or ... Get more on HelpWriting.net ...
  • 17. Sepsis: Early Detection and Implementation of Sepsis... Sepsis: Early Detection and Implementation of Sepsis Resuscitation Bundle Introduction Sepsis is defined as the body's inflammatory response to an infection and can quickly lead to multiple organ failure and death. Early, goal–directed therapy using the sepsis resuscitation bundle introduced in the "Surviving Sepsis Campaign" is the treatment used throughout the world for sepsis treatment (Winterbottom 2012, pp 247). There are approximately one million cases of sepsis in the United States annually and deaths total more than prostate cancer, breast cancer, and HIV/AIDS combined. Also, more than one–fourth of patients that develop sepsis will develop it on a medical–surgical unit and severe sepsis is the most common cause of ... Show more content on Helpwriting.net ... Assessment The priority assessment for sepsis is identifying patients at highest risk for sepsis, although all patients should be monitored for clinical manifestations. Patients at increased risk include those with chronic illnesses, under one year old or older than 85 years old, the immunosuppressed, postoperative patients, and those debilitated or with poor nutrition (Bernstien 2013, pg 25). To identify sepsis early the nurse will need to look for a respiratory rate of >20, heart rate >90, temperature >100.4 or < 96.8*F, and a white blood cell count of >12,000 cells/mm3 or < 4,000 cells/mm3. Assessments after the resuscitation bundle has begun would include respiratory, cardiovascular, integumentary, urinary, and neurological systems, as well as laboratory values. Respiratory would be assessed for rate and oxygen saturation. Central venous pressure, mean arterial pressure, systolic blood pressure, pulse quality and peripheral pulses would be assessed for the cardiovascular system. Skin would be assessed for warmth, color, and whether it is clammy or dry. Skin would also be assessed for petechiae, ecchymosis, or bleeding of mucous membranes to ensure disseminated intravascular coagulation (DIC) has not begun. Urinary output would be monitored to ensure adequate perfusion to the kidneys and for signs of urinary tract infections. Neurological would be assessed for any changes from baseline mental status. The most important ... Get more on HelpWriting.net ...
  • 18. How Does Anorexia Affect Teens The Assigned Life To Teens With Anorexia Stop, anorexia is not making teens look good, it is killing them off one by one! Anorexia is a very serious eating disorder. Teens that have this disorder are beginning to harm themselves and people around them. Also, many teens are feeling uncomfortable in their own body. They are even dying due to this eating disorder. Anorexia is a very dangerous eating disorder that has a dangerously high chance of negative side effects, causes teens to criticize their body, and has psychological patterns. The health effects of anorexia is very severe and painful. One health defect that happens to teens who are anorexic is "abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk of heart failure rises as the heart rate and low blood pressure sinks lower and lower" (wexler). Another defect that comes with anorexia is "severe dehydration, which an result in kidney failure" (Wexler). Another type of health defect that happens to anorexics is "fainting, fatigue, and overall weakness" (Wexler). These effects from anorexia can really make teens weak and die. Teens do not see that this a serious problem and the population of teens is decreasing. This problem needs to be resolved quickly or there will not be a lot of teens left in the world... Show more content on Helpwriting.net ... Even though some may say anorexia is beautiful, it is still not stopping teens from dying. The solution to the problem is an app for teens with anorexia that gives teens advice and true stories from people who had anorexia or knows someone close to them that had anorexia. Teens do not need to change for no one and they do not need to look like anyone other than themselves. All teens everywhere are perfect in their own way and look beautiful in the inside and ... Get more on HelpWriting.net ...
  • 19. Nursing Mobility And Safety Mobility and safety are two nursing topics that are very related. Safety is the key to ensure that the patient can remain mobile. It is important that the patient has ways to move around without fear of falling. It is also imperative that the patient knows how to move safely and use mobility devices. The nurse needs to understand how these two topics go together to ensure that the patient will remained unharmed at the hospital and in the home. As stated earlier, safety is so important to make sure that patient keeps their mobility. The surroundings need to be safe to prevent falls. When falls are prevented, the patient remains mobile. One safety precautions to ensure that falls do not happen is to have a clear area for the patient to be able to walk around. This means not having objects in their pathway or rugs in their walkway. Having these objects in the way can cause the patient to have a fall. Having rooms well lit will prevent falls. If they are able to see ... Show more content on Helpwriting.net ... There might be certain movements that can affect mobility in the future or could re–injure they surgical site. For example, after a hip replacement surgery patients are given and abduction pillow. According to "Hip Rehab After Surgery", the pillow is used to prevent the patient from dislocating their new hip. After the surgery for safety reasons their mobility must be restricted while it heals. When they do the surgery, they cut through muscles and those have to grow back. This will prevent further injury and the patient will be able to get back their normal mobility after it is healed. Although there are certain actions that post operation patients cannot do they still need to be mobile. The patient is moved as soon as the patient is able to handle it. Getting the patient up will prevent blood clots in their legs and promote blood circulation. Proper blood flow to the legs will mean that they can remain mobile and stay ... Get more on HelpWriting.net ...
  • 20. The And Eye Opening For My Future Nursing Career The past two days have been very educational, and eye opening for my future–nursing career. I was able to complete a health interview on my own, suggest resources in the community to help individuals with their needs, and interact with a population that we don't usually get to work with while in school. I came into this clinical day with a decent amount of experience working with the homeless population, so I wasn't too nervous but more so excited to meet them and talk with them in a place where they are most more comfortable, then compared to in a hospital. This experience was very beneficial in the sense that it pushed us all out of our comfort zones of doing interviews in the hospital setting and really made us become flexible as nurses. I believe I was able to provide culturally sensitive care to these individuals because I was able to see them on the same level as myself. One way that I was able to do this, as well as the rest of the students in my group, was by having this clinic in their environment. The CARING clinic is a great resource for them because it is very available to them. According to Stanhope and Lancaster (2016) "It is important to evaluate clients and populations in the context of the environment to develop effective nursing interventions", meaning we as nurses need to reach out more to people where they are comfortable or living (p.733). The CARING clinic really allowed us to assess these individuals as a whole, instead of just focusing on one medical ... Get more on HelpWriting.net ...
  • 21. Hypotension: Low Blood Pressure Hypotension, commonly as low blood pressure, is the condition of having low blood pressure. Hypotension occurs when the systolic blood pressure reading is 90 mmHg or below, and the diastolic reading is 60 mmHg or less. The main symptoms of hypotension include lack of concetration, blurred vision, nausea, cold and clammy skin, shallow breathing, fatigue, depression, and thirst. There are many different causes of low blood pressure, which includes dehydration, serious medical or surgical disorders, blood loss, severe allergic reaction, heart problems, certain medications, lack of nutrients in your diet, pregnancy, and severe infection. Low blood pressure that either doesn't cause any signs or symptoms or only causes only mild symptoms rarely ... Get more on HelpWriting.net ...
  • 22. Symptoms And Treatment Of A Call On Thursday, the 4th of December 2014 at 0730hrs, a call was received of a forty one (41) year old female whose chief complaint was abdominal pain with nil other symptoms. The call was assigned Code Two, and the crew was dispatched to the private residence the call originated from. On arrival, the patient was found in the main bedroom laying supine, guarding the lower abdominal area and as the crew entered the room, the patient curled up onto her side. The patient stated eight out of ten (8/10) pain located inferior to the umbilical region to right iliac, that came on suddenly after urination. Pain was worse on movement and palpation, and nausea followed pain. On initial examination, the patient was well perfused, all vital signs were within normal ranges and nil further complaints. Abdomen was soft, non–tender on palpitation, non–distended, and patient denied any blood or dark coloured stools, nil urinary symptoms, nil constipation. Patient was given 3mL of methoxyflurane to assist with extrication to vehicle, with partial effect until patient became non–compliant with use. Patient was then given 50mcg of Fentanyl with good effect, bringing pain down to two out of ten (2/10). Enroute to the hospital, the patient became pale, diaphoretic, nauseous and dizzy with continuous abdominal pain. Patient became hypotensive, however all other vital signs remained stable. Upgraded to code one enroute to the hospital as the patients vital signs deteriorated, from a blood pressure of ... Get more on HelpWriting.net ...
  • 23. Chronic Hypotension Case Study A review of her medical records indicates that she went to the ER on 12/4/16 with complaints of back pain as a result of her fall she had 2 days prior. She was prescribed Norco 5/325 mg p.o every 4 hours prn. She has an extensive history of falling at home due to her Parkinson disease which is progressive. She suffers from Parkinson with resulting tremors. She is receiving physical therapy from signature home health. She suffers from co–morbidities of chronic HTN, which is managed with medication, CAD which is stable, Chronic hypotension which is managed with medication, depression which is stable. I received a call from the office staff stating that the home health nurse had call the office and reported that the patient was having an adverse ... Get more on HelpWriting.net ...
  • 24. Hypotensive Effect of Aqueous Extract of the Leaves of... Acta Poloniae Pharmaceutica Г± Drug Research, Vol. 64 No. 6 pp. 547Г±552, 2007 ISSN 0001–6837 Polish Pharmaceutical Society HYPOTENSIVE EFFECT OF AQUEOUS EXTRACT OF THE LEAVES OF PHYLLANTHUS AMARUS SCHUM AND THONN (EUPHORBIACEAE). *FABIAN C. AMAECHINA and ERIC K. OMOGBAI Department of Pharmacology and Toxicology, University of Benin, Benin City, Nigeria Abstract: The plant of Phyllanthus amarus is used as diuretic and to lower blood pressure in traditional medicine practice. The effect of the aqueous extract of the leaves of Phyllanthus amarus on blood pressure was evaluated in normotensive male rabbits. Intravenously administered aqueous doses (5 mg to 80 mg/kg) of the extract to anaesthesized normotensive male rabbits produced a ... Show more content on Helpwriting.net ... The infusion of the aerial parts has been reported to be used to manage non–insulin dependent diabetes mellitus, for the relief of stomach ache and to treat dysentery (5). The plant extract has also been reported to have antitumor and anticarcinogenic activity (6). As a con– * Corresponding author: amaefabs@yahoo.co.uk; phone: +2341–0802–3303–138. 547 548 FABIAN C. AMAECHINA and ERIC K. OMOGBAI Effect of extract on blood pressure and heart rate Each rabbit was anaesthetized with pentobarbital at the dose of 40 mg/kg, administered intravenously through the marginal ear vein, previously canulated with 21–G butterfly canula. The trachea was canulated with a plastic canula to ease respiration. The vagus nerve was located and separated from the carotid artery, which was cleared of connective tissues and canulated with a plastic canula connected to a pressure transducer via a three–way tap. The pressure transducer transmitted the blood pressure to Ugo Basile twin channel recorder (model 7090), which recorded the blood pressure and heart rate. The channel recorder was always calibrated before and after each experiment, using a mercury sphygmomanometer. When the animal had stabilized and the blood pressure and heart rate had remained constant, the extract was administered in graded doses of 5 mg/kg, 10 mg/kg, 20 mg/kg, 40 mg/kg and 80 mg/kg. The effects of the graded doses of the extract on blood pressure
  • 25. ... Get more on HelpWriting.net ...
  • 26. Speech On Drugs In Sports Drugs In Sports In sports, many of the Olympic winners have been found in taking drugs to gain advantage from other participants with would help them to perform better in their competition. Drugs come in different form, e.g. pills, injection or powder. The participants who take drugs only think that the drugs will only give them positive results, but they don't think what are the after results and what happened if they got caught. Some athletes don't even know that they are taking drugs because their trainer has been giving them supplements by telling them that they are vitamin pills but for the people who actually are intentionally taking drugs, is it actually fair for the drugs to be banned because they naturally don't have as much strength and power that the other participants have naturally? "A drug is a medicine or other substance which has a psychological effect when digested or otherwise introduced in the body (Dictionary)." There are many different types of drugs, e.g. anabolic steroids, diuretics and stimulants (performance enhancing drugs). These drugs are not the only ones used but these are one of the most common ones. Anabolic Steroids is used for allowing muscle to grow quicker, work harder and recover faster form any... Show more content on Helpwriting.net ... I also think that there should also be some types of awareness campaigns so people would be able to know what is going around the world because I think that many people don't know about what is actually happening in the sports ... Get more on HelpWriting.net ...
  • 27. Orthostatic Hypotension Essay In this scenario, the subjected data is chest palpitation, lightheadedness and dizziness, the objective data is elevated heart rate with irregular rhythm, orthostatic blood pressure readings, lying 135/90, sitting 120/80, standing 100/60, and the client becoming dizzy and light–headed as he moves from a sitting to a standing position while taking the blood pressure. The subjective and objective data indicates that the patient has orthostatic hypotension. To determine what is causing the orthostatic hypotension a more in–depth health history, physical assessment, labs and diagnostic testing would need to be done. Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure ... Show more content on Helpwriting.net ... It is difficult to do a cardiac assessment on someone who is uncooperative and in handcuffs with multiple officers standing in a small room. When someone is uncooperative it is almost impossible to complete an assessment also the assessment is usually being rushed by the officers because the uncooperative patient is still a danger to others. By assessing the scene, I realized that when one officer got near this particular patient it seemed to escalate his uncooperative behavior. I asked the officer if he could leave the room, he stepped outside the room but the patient could still see him. I asked the officer to please step out of the door way and explained to the patient that the officer had left the room and would not be coming back this helped to calm the patient down enough so I could compete my ... Get more on HelpWriting.net ...
  • 28. The Effect Of Water Ingestion Improved Haemodynamic... 4. Discussion Previous studies found that water ingestion improved haemodynamic responses to gravitational stress serving as therapeutic relief against hypotension that can be debilitating for most patients. We hypothesized due to the fact that vitamin water is hypotonic in nature like water then it is likely to illicit the OPR to fuel inadequate sympathetic drive and help with symptoms like dizziness upon standing. However the effect of 500ml of water and vitamin water from the current study did not entirely agree with the effect of water seen in patients with baroreflex dysfunction or autonomic failure patients from previous investigations. 500ml of vitamin water had consistently shown a lack of significant difference in blood ... Show more content on Helpwriting.net ... Our results showed a significant difference between 50 ml and 500ml of vitamin water at baseline level in the normal order (n=10) of consumption. The crossover also gave a significantly different systolic reading (n=8) between 50ml and 500ml of water. This suggests that the average basal haemodynamic state for the pooled data was different for different experimental runs highlighting haemodynamic variability. 4.1 Vitamin water composition Dragonfruit Vitamin water contains predominately 160mg of vitamin C per 500ml as the main ingredient. There is evidence to show the benefit of vitamin C as adjuvant therapy for the treatment of hypertension. Doses of vitamin C supplements ranging between 60–400mg were shown to have a useful role in lowering blood pressure (both SBP and DBP). The corresponding averages of SBP and DBP were declining after the ingestion of 50ml of vitamin water amongst 10 participants in our pooled data (SBP: –1.40В±2.35mmHg, DBP: –0.10В±3.85mmHg). Likewise the same decrease in SBP was evident with 50ml of water, which gave a decrease by 0.90В±4.17mmHg. It may be possible that vitamin C content negated the OPR. Blood pressure changes are sensitive to ascorbic acid levels until a certain threshold; the effect of vitamin C was lowered in trials where the population had already taken supplements due to renal ... Get more on HelpWriting.net ...
  • 29. The Stages Of Clinical Reasoning Clinical reasoning can be defined as, 'the process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient's problem or situation, plan and implement interventions, evaluate outcomes and reflect on and learn from the process' (Levett–Jones & Hoffman 2013, p.4). It requires health professionals to be able to think critically and ensures better engagement and results for the patient (Tanner 2006, p.209). The Quality in Australian Healthcare Study (Wilson 1995, p.460) discovered that 'cognitive failure' resulted in approximately 57% of unfavourable clinical events involving the failure to produce and act correctly on clinical information. It also recognises that often nurse's preconceptions and assumptions can greatly affect patient care and by going through such a process, one can take into account the holistic nature of the patient and provide the best, most appropriate care. Process Information The third stage in the clinical reasoning cycle is process information. This involves the gathering of signs and indications and the recognition of patterns (Levett–Jones & Hoffman 2013 p.5). It is also when one can begin to form hypotheses and predict potential outcomes. In regards to Mrs Checkett's case, there are many cues that need to be taken into consideration in order to best care for her. According to Chester and Rudolph (2012, p.2), vital signs in the elderly change due to the reduction of function of homeostatic ... Get more on HelpWriting.net ...
  • 30. Meaning Of Orthostatic Hypotension Orthostatic hypotension is defined as reduction of systolic blood pressure by at least 20mmHg and diastolic blood pressure by at least 10mmHg when changing the posture from supine to erect position. The ability to regulate blood pressure declines with age. It leads to a delay in blood pressure adjustment with posture among elderly people. As a result orthostatic hypotension is more common among elderly people. (Hajjar, 2005) The prevalence of orthostatic hypotension is around 5% – 30% among institutionalized patients. (Tilvis et al., 1996)(Rutan et al., 1992)(Masaki et al., 1998) The differences in these estimates varies due to a number of factors such as definition of orthostatic hypotension, composition of the population, the segment of the ... Get more on HelpWriting.net ...
  • 31. Alcohol Syncope Abstract Alcohol consumption may be linked to syncopal events. The mechanism by which alcohol may induce syncope is not well understood. Impairment of the response to orthostatic stress may be involved. A growing body of medical evidence suggests that short–term alcohol consumption elicits hypotension during orthostatic stress because of impairment of vasoconstriction. These findings have implications for understanding of hemodynamic effects of alcohol and, in particular, for understanding syncopal events that occur in association with alcohol intake. A 27–year–old African American female with a previous syncopal event following alcohol consumption was brought to the Emergency Department by ambulance after a witnessed ... Show more content on Helpwriting.net ... It results in dizziness or syncope from transient diminished cerebral perfusion. Case Report A 27–year–old, well–appearing African American female was brought to the Emergency Department by Emergency Medical Services after a witnessed syncopal episode. The only medical history is a previous alcohol–induced syncope 2 years ago. The patient does not have any past surgical history. The patient only drinks socially. She does not smoke, and she denied any drug use. The patient lives with mother, and works as a nursing assistant in a nursing home. The patient admitted to drinking "a shot of vodka" approximately 10 minutes prior to syncopal episode. The patient fell upon standing and hit the back of her head on the floor. Patient's significant other who witnessed the syncopal event reported that loss of consciousness (LOC) lasted about 2 minutes. EMS was consequently called. According to EMS, the patient was still on the floor, alert and oriented only to self upon their arrival. She was lethargic. The patient did not remember passing out. She was subsequently transported to the Emergency department. Patient did improve remarkably on the way to the hospital. Upon arrival to the Emergency Department, patient was alert and ... Get more on HelpWriting.net ...
  • 32. The Prevalence Of Low Blood Pressure With the global population suffering from an unprecedented distortion of the traditional age distribution, discussion and scientific inquiry surrounding the nature and impacts of dementia among the aging and the elderly is becoming increasingly prevalent within the public eye. One such story, conducted by the Erasmus Medical Center and reported in a BBC News online report, examines the prevalence of dementia in relation to preceding low blood pressure (Mundasad, 2016). The article, as reflected in its concluding professional recommendations, aims to indicate low blood pressure complications as a potential factor in developing dementia, thus informing consumer healthcare decisions and contributing to an expanding body of medical knowledge. In describing this study, BBC health reporter Smitha Mundasad explains the nature of the original endeavor. Researchers from the Erasmus Medical Center in the Netherlands posed a topic of inquiry indulging the research question of whether frequent incidents of low blood pressure have any impact on one's likelihood of contracting dementia over their lifetime (Mundasad, 2016). Their suspected alternate hypothesis states that frequent low–blood pressure incidents will increase the occurrence of dementia within their sample participants. It is important to note that this hypothesis is directional, as Mundasad mentions that previous research has linked high blood pressure to various forms of dementia (2016). Thus, researchers had grounds to ... Get more on HelpWriting.net ...
  • 33. Hypotension And Hypertension Discussion: Part 1 1. Include your results and discuss each measurement below, using the questions as a guide: a. Weight / frame size / BMI What were your measurements and in which categories do you fall? My measurements are 137 pounds in weight, 26.75 BMI and my frame size is 9.67 which is considered large. Are you at risk for any health problems? I fall in the overweight and large category. What is normal or healthy for you? I think that this is normal for me because I have a lot of muscle on my lower body due to performing heavy compound movements at the gym such as squats and deadlifts. b. Waist circumference What was your measurement? My waist circumference measurement is 27.75 inches. What do the "apple" and "pear" shapes ... Show more content on Helpwriting.net ... During my workout, my body pumps oxygen throughout my body. This action alone prevents arteries from clogging up, while sedentary lifestyles increase their chances of creating plaque. When there is movement, the blood moves freely throughout the body. When one sits most of their day, blood and nutrients are less likely to travel effectively. Nutrients begin to settle into arteriole walls. One example to think about is comparing the oxygen an active person expends compared to another person that lacks physical activity. Who needs to take in more breaths to complete a brisk walk on an incline hill? The active individual does not need to maximize their energy nor stop to catch a breath, while the sedentary individual may tend to lose their breath and utilize maximum effort to complete that incline ... Get more on HelpWriting.net ...
  • 34. Elective Caesarean Hypotension Caesarean delivery is the method by which a baby is born through an incision in the abdominal wall and uterus. Statistics show that 166,081 caesarean deliveries were carried out within NHS hospitals in England during 2013/2014, of which 50% were elective. This represents a 2.5% rise over the previous year, continuing the trend of increasing elective caesarean rates (Health & Social Care Information Centre, 2015). Indications for a caesarean section (CS) can include foetal distress, previous CS, breech presentation, abnormal progress during labour, etc. (Vacca, 2013). This segment will explore and discuss the role of the Operating Department Practitioner (ODP) within the perioperative care of a 35 year old patient, undergoing an elective caesarean ... Show more content on Helpwriting.net ... The practitioner ensured that the patient was dry and was covered to maintain dignity and privacy. The anaesthetist accompanied the practitioner to the PACU to observe and establish that the patient was physiologically stable during transfer. On arrival to PACU the scrub staff and anaesthetist took part in the PACU handover. It is imperative that a formal handover of the patient care is given with all relevant details about anaesthesia and surgery verbally communicated, in order to aid the continuity of care and minimise the risk of omissions (Hamlington, 2012). One study (Kluger and Bullock, 2002) observed that 14% of adverse recovery events was contributed by inadequate handover procedure. The patient was observed on a one–to one basis by the recovery ODP whilst observations and monitoring was recorded. Recordings of respiratory rate, heart rate, NIBP and pulse oximetry were made at 5 minute intervals as laid out in AAGBI's guideline for postoperative recovery (Association of Anaesthetists of Great Britain and Ireland, 2013). Sedation and mobility recordings were also needed due to the intrathecal anaesthesia, as well as temperature, pain intensity, blood loss, ... Get more on HelpWriting.net ...
  • 35. Orthostatic Hypotension: A Case Study Everyday there are countless admissions to hospitals throughout the world for injuries due to falls. More often than not, patients who suffer falls are elderly patients who have lost their balance. One study states that in the United Kingdom, the number one cause of emergency room admissions to the hospital is for those 65 years and older who have fallen.1 In order for this issue to be addressed and corrected, one must take into consideration the variety of precipitants for falling. One of the major reasons for falls is referred to as orthostatic intolerance. Orthostatic intolerance is defined as "the development of symptoms such as lightheadedness and blurred vision when a subject stands up and clears when sitting back down."2 There ... Show more content on Helpwriting.net ... The first test, which may be performed, is referred to as autonomic reflex screening. The screening is composed of three test which ultimately examine the patients blood pressure and heart rate fluctuation in response to the valsalva maneuver. Another test that may be used is referred to as the thermoregulatory sweat tests. The particular pattern an individual sweats can be indicative of a possible neuropathy. Neuropathy is then suggestive that a lesion is present in the nerve causing a fault in the circuitry responsible for maintaining the bodies postural blood pressure.2,16 The last test may be performed to determine the cause of the orthostatic hypotension is a 24 hour urine sodium. This test can be explained by the basic principle of osmosis. Water will always follow in the direction of the sodium or salt. Thus, if the urine sodium is elevated, the kidneys are excreting sodium, as well as, water. If the kidneys are excreting large amounts of water, the plasma volume will be low, contributing to the occurrence of orthostatic hypotension.2,17 A urine excretion of sodium ~170 mmol/24 hours is indicative of a normal plasma volume. Using these three screening tests the provider should be able to determine if the cause of the orthostatic hypotension is neurologically related, due to hypovolemia or venous ... Get more on HelpWriting.net ...
  • 36. Sepsis a Case Study The aim of the essay is to analyse the care of a septic patient. While discussing the relevant physiological changes and the rationale for the treatment the patient received, concentrating on fluid intervention. I recognise there are other elements to the Surviving Sepsis Bundles, however due to word limitation; the focus will be on fluid intervention. The essay will be written as a Case Study format. To maintain patient confidentiality any identifying features have been removed in keeping with the Nursing and Midwifery Council (NMC) Code of Professional Conduct (NMC, 2008) the patient will be referred to as Mr X. Mr X was an 80–year–old male admitted to ITU, from the Medical Assessment Unit, with increasing respiratory failure. His ... Show more content on Helpwriting.net ... Table 2Nutbeam et al 2009 mediators, causing increasing capillary permeability and widespread fluid shift into the interstitial space, which was no longer functioning to maintain vascular volume (known as third spacing) in addition, causing further vasodilation to occur. This caused Mr X to become increasingly hypotensive and tachycardic. Table 2 shows some of the chemical mediators involved in Mr X's inflammatory process, causing it to become more severe and uncontrolled, resulting in a further decline in his clinical presentation. His clinical observations were now: Blood Pressure: 80/50mmHg MAP: 55mmHg Heart Rate: 130 beats per minute The patient was now diagnosed as being in septic shock. His skin was mottled with an increasing capillary refill time. Schmidt and Mandel (2008) suggest this is a sign of hypoperfusion as the skin is vasoconstricting due to the redirection of blood flow to the core organs. I informed the doctor and expressed my concerns regarding the patient's hypotension. A 250ml fluid bolus of colloid was given as an attempt to improve Mr X's blood pressure and MAP. The early intravenous fluid administration for resuscitation of the critically ill hypovolemic patient is the corner stone of shock therapy (Kruemer &amp; Ensor 2012). The Surviving Sepsis recommends early optimization in the first six hours, followed with fluid challenges in the case of persistent hypo ... Get more on HelpWriting.net ...
  • 37. Intraoperative Hypotension INTRODUCTION : perioperative hypotension is a common problem, incidence is largely unknown. There are evidences suggesting that incidence of myocardial adverse events in the postoperative outcome may be linked to the prolonged episodes of perioperative hypotension. There are few comprehensive resources available in the literature regarding diagnosis and management of these common clinical outcomes, especially in non–cardiac surgery.[1] Perioperative myocardial ischemia is associated with significant morbidity and mortality, 50% of postoperative deaths are due to cardiac complications, the ischema is the major problem amongst.[1] It is an emergency crisis which poses a unique challenge for the anaesthetist in its management. We report a case of Intraoperative myocardial ischemia in an elderly patient with multiple comorbidities who underwent orthopaedic hip surgery . Intraoperative myocardial ischemia was diagnosed on time and was managed successfully. Key words: Echocardiography, myocardial ischemia, perioperative hypotension, perioperative myocardial ischemia CASE REPORT:... Show more content on Helpwriting.net ... Dopamine and nor adrenaline were tapered and stopped 2 days before surgery. He was posted for right proximal femur nailing after optimisation of his general ... Get more on HelpWriting.net ...
  • 38. Orthostatic Hypotension Case Study Essay Case Study Julia Atungsiri Purdue University Global Case study 1.What is the significance of the orthostatic hypotension, tachycardia, abdominal tenderness, hematuria, joint pain, and petechiae? What is splinter hemorrhages and what is their significance? Orthostatic hypotension is the reduction of the systolic pressure of at least 20mmHG or the dropping of diastolic pressure of at least 10mmHg within three minutes of standing as compared to baseline as such, the body is often unable compensate for the changes in the blood pressure values (Fournier et al., 2016). The fall in the blood pressure is attributes to the fact that a small amount of blood collects in the leg veins when a person stands as a result of gravity hence reducing ... Show more content on Helpwriting.net ... What are the major causes of infections? References Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Tleyjeh, I. M., Rybak, M. J., ... & Bolger, A. F. (2015). Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation, 132(15), 1435–1486. Fournier, P. E., Watt, G., Newton, P. N., Lamas, C. C., Tattevin, P., & Raoult, D. (2016). Blood culture –negative endocarditis. In Infective Endocarditis (pp. 245–258). Springer, Cham. Morton, P. G., Fontaine, D., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a holistic approach (p. 1056). Lippincott Williams & Wilkins. Pettersson, G. B., Coselli, J. S., Hussain, S. T., Griffin, B., Blackstone, E. H., Gordon, S. M., ... & Woc–Colburn, L. E. (2017). 2016 The American Association for Thoracic Surgery (AATS) consensus guidelines: surgical treatment of infective endocarditis: executive summary. The Journal of Thoracic and Cardiovascular Surgery, 153(6), 1241–1258. Thuny, F. (2016). Diagnostic Criteria for Infective Endocarditis. In Infective Endocarditis (pp. 81–86). Springer,
  • 39. ... Get more on HelpWriting.net ...
  • 40. Unit 4222-335 Undertake physiological measurements Unit 4222–335 Undertake physiological measurements 1.1 We should always check equipment which we are going to use if it is safe and working properly, we should wear PPE every time we are undertaking any task, ensure that we are trained to do the task, we should keep the working place safe and clean. When we are about to take measurement from an person we need to make sure that the person know exactly what we are going to do and asking permission for the task we are about to do. Recording the task in the chart and keep it confidential to protect personal information during the course of our work. 2.1 To have an blood pressure maintenance we should maintain a healthy lifestyle, doing some exercises daily and eating healthier,... Show more content on Helpwriting.net ... We can find pulse oxymetry on the fingertips, except on the thumb as our own pulsation or ear lobe and also on the toes. 2.5 Body Mass Index,BMI, is a measure of our weight compared to our height. BMI can help determine whether they are at a healthy weight, overweight or obese individuals are at increased risk for many diseases, such as: heart disease, high blood pressure, high cholesterol, type–2 diabetes, and some types of cancer. With high BMI the individual would need to perform further assessments, start with a diet, physical activity, family history, change lifestyle. 2.6 Several factors can influence changes in physiological measurements such as illness, infections, stress, lifestyle, deterioration. 2.7 Monitoring physiological measurements itВґs important to make sure the individual health status and also necessary after surgery, as patients in intensive care units require continuous monitoring, and sometimes have medications that requires physical measurements taken. These are measurements we take to ensure that they are functioning in the way they are supposed to. When we carry out physiological measurements, such as measuring temperature, pulse and respiration, we are monitoring for signs of abnormality. Then be able to draw conclusions about the health status of the individual and any treatments they may ... Get more on HelpWriting.net ...
  • 41. Complete Fiv Descriptive Analysis Study Outcome: Physical activity: Physical activity was quantified as steps/day. Steps/day were determined using a uniaxial accelerometer (Actigraph GT1M, Pensacola, FL, USA). The accelerometer measures vertical acceleration and deceleration, providing valid and reliable physical activity data in free–living conditions.10,11 Each person was fitted with accelerometer fastened with a belt worn above participant's right hip, and were instructed to wear the belt during waking hours for 7 consecutive days. A valid wear day consisted of at least 10 hours of wear, and all individuals with 4–7 valid wear days were included12. For this analysis, we categorized people who walked less than 6000 steps/day as inactive. This cutoff was chosen as it was previously shown to be the minimum threshold needed for individuals with knee OA to protect against developing the functional limitation such as difficulty inwalking etc.9 Study Exposures: Physical function Physical function was quantified with three clinical tests. 1.The sit–to–stand test (STS) was calculated by time needed to complete ... Show more content on Helpwriting.net ... We calculated Pearson correlation coefficients to describe the strength of association of steps/day with physical function. We then calculated specificity over a range values of the each physical function test in order to be active (walk ≥6000 steps/day). To illustrate this process, consider a test value of 10 seconds to complete STS test. Since a slower time is indicative of worse physical function on this test, those who performed the STS in >10 seconds were identified with poor physical function. Likewise, those who performed the test in <10 second were identified as good physical function. We constructed a 2x2 contingency table (Table 1), and calculated specificity as shown in Equation 1.This process was repeated to determine the specificity over a range of possible physical function ... Get more on HelpWriting.net ...