...captopril, carvedilol, nitroglycerin patch, and furosemide. Please discuss specific nursing considerations and patient teaching for each medication. (15 points) Captopril- Can cause a permanent nonproductive, dry cough. May have first dose hypotensive effect May cause angioedema, which can occur up to 1 year after taking drug. Carvedilol- Dizziness and fainting with increased activity Decrease in tolerance for exercise Teach patient to report weight gain >2lbs in 1 day or 5lbs in 1 week. SOB Edema of feet or ankles Increased fatigue or weakness Teach patient to not abruptly stop taking due to risk for angina, heart attacks, sudden death, or rebound hypertension. May have adverse effects such as bradycardia, heart failure, wheezing, bronchospasm, or impotence. Nitroglycerin- Teach to apply to skin, upper arms, and upper...
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...NUR 159 Class Information and Procedures B-1 NUR 159 Class Information and Procedures NUR159ClassInformation 3/10/2014 NUR 159 Class Information and Procedures B-2 CLASSROOM BEHAVIOR Refer to Classroom Behavior in Student Nurses Handbook TESTING INFORMATION AND PROCEDURES 1. Silent Test Reviews: Silent test reviews will be conducted after each test. Refer to Test Security in Student Nurses Handbook for further information on test reviews. Students may also schedule individual test reviews with their seminar leader. 2. Test Make-up Policy: Refer to Test Security in Student Nurses Handbook for further information on test make-up. 3. Make-up of Final Exams: In the event that a student misses the final exam for the nursing course, the student will receive a grade of incomplete or “I” for the course. Refer to the Course Grades policy found in Student Nurses Handbook. 4. Collaborative or Group testing activity: An opportunity to add a maximum of two points to individual test scores may be earned through a group testing activity. Two points will be added to individual student scores if the group activity score is 91 and above. One point will be added to individual student scores if the group activity score is 81 through 90. No points will be added to individual student score if the group activity score is 80 and less. Group testing will be conducted as follows. a. After taking the exam, individual test scantrons will be collected. The students will keep the test booklet...
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...weeks gestation with twins. Medical diagnosis: Pregnancy Induced Hypertension Past Medical History: Seizure disorder for which she takes Lamictal, infertility, 2nd. Invitro with twins, she has a sinus infection. Past Surgical History: Laparoscopy for endometriosis X3, surgery for broken jaw, tonsillectomy, Pertinent Lab Results: Most recent labs done 2/22/15, (CBC) NA+ 156, BUN- 28, Albumin- 8.0, Protein- 10.0, Creatinine- 1.3, Pertinent diagnostic results: Chest X-ray: pulmonary edema and cardiomegaly, cardiac catheterization, EKG: atrial fibrillation. Lists of Medications: Amoxicillin, Docosate sodium, Labetalol HCL, Lamotrigine (lamictal). Allergies: Macrobid Code status: Full code Vital Signs: T 99.2F, oral P 80, regular B/P 186/100 SaO2 100% Weight- 160lbs. Ht. 5’5 List 3 pertinent medications given by you on your shift. List actions and indications, side effects, and nursing considerations: |Name: |Amoxicillin | |Action and indications. |Binds to bacterial cell wall, causing cell death, spectrum of amoxicillin is broader than penicillin. Treatment of a variety of infections including skin and skin structure | | |infections, otitis media, sinusitis, respiratory tract infections, genitourinary infections. ...
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...Depolarization b. Repolarization 2. What is a dysrhythmia, how does they affect CO? 3. Define premature ventricular contraction. How is it reflected in the EKG? 4. What are the causes for premature ventricular contraction? 5. What is an electrophysiology study and what are the nursing care considerations? 6. What is V-Tach? 7. How is it diagnosed? 8. What are the nursing care considerations associated with vtach? 9. What medications would be given and how would CPR and defibrillation be done? 10. What is ventricular fibrillation, nursing care, meds, dx, CPR, defib? 11. How do implantable cardioverter defibrillators work and what are the nursing considerations? 12. Describe premature atrial contractions. 13. Define A-fib, nursing considerations, and complications. 14. What is countershock and how does it work, what should you avoid? 15. How do antidysrhythmics work, what are they? 16. What is sick sinus rhythm? 17. What is a heart block and describe the differences between the different kinds. 18. Define nursing care for bradycarida including meds. 19. What are artificial pacemakers, what are the nursing considerations? 20. What are the different pacemaker modes? 21. What are the nursing considerations for pacemakers including medications? Coronary Circulation Disturbances 1. Outline the basic coronary circulation. 2. What is atherosclerosis and what does it effect? 3. Outline the progression of atherosclerosis. 4. What are the incidence of CAD/CHD, how is it...
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...* * Fundamentals of Nursing (NSG 1355) Care Plan * * * ------------------------------------------------- Admission History * ------------------------------------------------- * ------------------------------------------------- Patient Information: Age: 60 Gender: Male Weight and Height: 390 lbs, 76” BMI: 47.47 (Morbidly Obese) * ------------------------------------------------- * ------------------------------------------------- Primary Language: English Religion: Latter-Day Saint Culture: Caucasian * ------------------------------------------------- * ------------------------------------------------- Resusiciation Status: Full Code * ------------------------------------------------- * ------------------------------------------------- ...
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...NM1704: Applying a model of nursing roper, logan and tierney model This essay explores the preoperative care provided to one patient in a London hospital during one shift. This care was influenced by the holistic perspective to health. Arsing from the Greek for ‘whole’ this acknowledges physiological, psychological and social factors impacting the patient’s condition. (McFerran & Martin, 2008) It seeks to offer treatment inclusive of these factors rather than treating physical symptoms of a diagnosed disease in isolation. This essay will examine this within a Model of Nursing used in my clinical placement area - the Roper, Logan and Tierney model. The identities of both hospital and patient have been altered to maintain confidentiality and comply with the NMC Code of Conduct. (Council, 2008) During my placement I worked on a coronary care unit where I cared for a patient herein called Peter, a 60 year old White British male. Peter was single, lived alone and unemployed. He had a history of low mood and was admitted to a neighbouring hospital suffering symptoms of acute alcohol withdrawal syndrome (acute confusion, delusions and tremors). This arises when an individual reduces or stops alcohol consumption after prolonged periods of excessive alcohol intake. This can lead to tolerance, physical dependence and physical disturbances upon withdrawal due to the central nervous system reacting in a hyper-excitable state. (About.com, 2010) He was transferred to my area...
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...Delegation Exercise in a Health Care Setting Ana Bergeron University of Phoenix Assignment After rounding on patients the RN made the following assignments. See appendix for a full description of each patient: Assignments | | Macy LPN #1 | Pod 1 | | Mr. Black (UTI) | | Ms. Johnson (Crohn’s) | | Mr. Raynor (diabetic foot ulcer) | | Mrs. Tolento (CHF) Mr. Smith (pneumonia) | | Ms. Swanson (S/P hysterectomy day 2, in pod 2) | Ana RN | Pod 2 | | Mr. Smith (GI Bleed) | | Mr. Moretz (Night sweats, neg pressure room) | | Mrs. Flanco (S/P Colectomy day 2)Mr. Reddington (GSW) | Mike LPN #2 | Pod 3 | | Mr. Smith (Atrial Fib) | | Ms. Harper (s/p breast mastectomy) | | Ms. Levin (s/p attempted suicide) | | Mrs. Walnut (aspiration pneumonia)Mrs. Stewart (Diabetic Ketoacidosis) | | | Gilda CNA | Pods 1-3 | | | Explanation The following is a detailed explanation of the assignments made for this shift: Macy LPN: Macy was given her patients based of her skill and scope. She always volunteers to take on the Spanish speaking patients since she is more comfortable speaking in Spanish. The RN, after moving patients to different pods, she gave Macy one possible discharge today and what would be consider by some a difficult patient that can be abusive and refuses to be take care of be the other LPN on shift today. Macy also had to take on a total of 6 patients instead of six, the RN will cosign her notes at of shift. The patients...
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...further damage to the brain. Symptoms include drooping of the face, numbness or weakness in the arms or across one side of the body, communication problems and headaches or dizziness 3. The blockage in an artery is often caused by an atheroma (a hard plaque) forming in the vessel, which narrows the artery’s lumen. Blood cells can then collect on the atheroma, forming a blood clot, further narrowing and sometimes completely blocking the artery, known as a thrombosis. Alternatively, blood clots can become dislodged and travel to arteries closer to the brain where they are then trapped, known as an embolism. Another common cause of an ischemic stroke is a blood clot in the heart, possibly formed from an irregular heartbeat, such as atrial fibrillation, or a heart attack. The atheroma that causes a blockage is formed when the artery wall is damaged, triggering an inflammatory response of white blood cells entering the wall. Cholesterol and fibrous tissue accumulate, hardening the atheroma into a plaque, reducing wall elasticity, narrowing the artery and raising blood pressure, known as atherosclerosis. When this narrowing of arteries, from atherosclerosis, happens in the brain, an ischemic stroke can occur 4. Factors such as smoking, obesity and lack of exercise, aging and inherited genetics can all increase the chance of having a stroke. For example, smoking increases the risk of having a stroke by three times 5. More specifically, smoking 20 cigarettes a day increases the smoker’s...
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...1 NUR 201 DRUG CARD Student: ________________________ Generic Name: Bupropion hydrobromide________ Trade Name(s): Wellbutrin, Aplenzin, Zyban_ Classification: Antidepressant – atypical (heterocyclic), Aminoketone_____________________________ Administration Routes: PO _√_ SQ ___ IM ___ IV ___ Transdermal ____ Ophth_____ Action: Mechanism of action is not known; the drug does not inhibit MAO, and it only weakly blocks neuronal uptake of epinephrine, serotonin, and dopamine. However, its action is believed to be mediated by noradrenergic and/or dopaminergic mechanisms. Exerts moderate anticholinergic and sedative effects, but only slight orthostatic hypotension. Indications: (1) Treatment of major depressive disorder (immediate-release and extended-release). (2) Major depressive episodes in those with a history of seasonal affective disorder (Wellbutrin XL only). (3) Aid to stop smoking (Zyban only); may be combined with a nicotine transdermal system. Contraindications: Hypersensitivity to bupropion or any ingredients. Seizure disorders; presence or history of bulimia or anorexia nervosa due to the higher incidence of seizures in such clients. Concomitant use of an MAOI. Use in clients undergoing abrupt discontinuation of alcohol and sedatives, including benzodiazepines. Use in clients who have shown an allergic response to bupropion or other components of the various products. Wellbutrin, Wellbutrin SR, Wellbutrin XL, and Zyban all contain bupropion; do not use together. Lactation...
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...Holistic Account of Care for a Patient or Client with Complex Needs What are complex needs? Who has them? It could be argued that everyone's needs are complex and as such, complex needs have been difficult to define (Rosengard et al., 2007). This essay intends to use literature to outline a systematic and holistic approach to care of a patient's complex needs. The nursing process and its framework of assessment, planning, implementation and evaluation will be utilised to provide a patient centred approach (Castledine, 2011). Rankin and Regan (2004) described complex needs as being a framework rather than a label that determines service eligibility. The needs of people include breadth (range of need) and depth (severity); these factors have to be taken into account when providing holistic care. Holistic care is defined as an approach which takes into consideration the physical, mental and social factors in an illness, rather than just the disease itself (Martin, 2010). The person this essay will centre around gave informed consent to have their notes consulted with the intention to write this essay, in line with the Nursing and Midwifery Council's (NMC) The Code (2008). There are seven elements to informed consent; competence to decide, voluntariness to decide, disclosure of information, recommendation of a plan, understanding of the disclosure and recommendation, decision of the plan and authorising of the plan (Beauchamp & Childress, 1994 pp. 145-146). In line with the Data Protection...
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...Physical activity recommendations for adolescents with repaired tetralogy of Fallot: review of the literature and guidelines for practitioners Adolescents living with congenital heart defects (CHDs) are a growing population in the United States. While in the 1960s and 1970s, the risk of dying after cardiac surgery was high at 30%, over the past few decades, this risk has decreased to approximately 5%, with the majority of children born with CHD living into adulthood (American Heart Association [AHA], 2006c; Jones, Willis, & Uzark, 2006). One of the most common CHDs is tetralogy of Fallot (TOF), occurring in 9% to 14% of the children born with a CHD and approximately 5 out of every 10,000 births (AHA, 2006a, b; National Heart Lung and Blood Institute [NHLBI], 2007). The need for primary care providers to manage the health of adolescents with TOF has developed as the population and lifespan of children born with TOF has increased. One of the most important roles of a primary care provider is to educate adolescents and their families to facilitate the achievement and maintenance of optimal health. This includes counseling adolescents, especially those living with TOF, of the importance of regular exercise and participation in sport activities as necessary factors for their physical, emotional, and social growth and development (Bar-Or & Rowland, 2004). Physical activity is also essential for the prevention of long-term cardiovascular and obesity-related health problems (AHA, 2006d)...
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...In Pre-Hospital Cardiac Arrest Patients, How Does Hands-Only CPR Compared To Standard CPR, Affect Neurological Outcomes? Abstract Summary Out-of-hospital cardiac arrest is the leading cause of death in the U.S. Increasing bystander-initiated CPR through “hands-only” CPR and EMS dispatcher instructed “hands-only” CPR improves survival rates. Methods CINAHL, PubMed, and OvidMD were searched for the following key terms or combination thereof: “hands-only”; “compression-only”; chest compression-only”; “bystander”; “CPR”; “dispatcher”; and “neurological affect”. We initially restricted our search to peer-reviewed studies published in English between January 2004 and June 2014, but agreed by consensus to use a 2000 study located during a manual search of included study references. Results We identified nine Level II, III, and IV studies comparing “hands-only” CPR and “standard” CPR, published between 2000 and 2013, and occurring in the countries of Japan, London, Sweden and the U.S. All but one of the study results recommend that “hands-only” CPR is at least equal or superior to “standard” CPR. Conclusions Guidelines should be established to teach bystander “hands-only” CPR nationwide, to increase public awareness of the effectiveness of “hands-only” CPR and start to teach out-of-hospital “hands-only” CPR. Introduction Sudden cardiac arrest is the leading cause of death in the United States (Neumar, Barnhart, Berg, Chan, Geocadin, Luepker,… Nichol, 2011). According...
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...researchers in France and Britain, in which they assessed the alcohol intake and the consequential coronary effects on participants (all of which were men between the ages of 50-59), on a weekly basis for a ten-year period. Considering the fact that fewer than 10% were binge drinkers yet 7% had experienced ischaemic (coronary) heart disease in the following years, it is clear the detrimental effect binge drinking has in relation to it’s development (Nursing Standard, 2011). Although the increased risk of heart disease is the main and most worrying effect binge drinking has on the heart, there are many other complications that may arise. Arrhythmia difficulties relating to the rhythm of the heart are often a consequence of binge drinking. A common example of this is holiday heart syndrome, which is the term used to describe the instance when a rhythm disturbance is experienced around the time of holidays as individuals consume excessive amounts of alcohol during this period. This quick and inconsistent rhythm is termed atrial fibrillation. An individual suffering from holiday heart syndrome may experience symptoms such as chest pain, palpitations and a light headed sensation. However treatment is not always required as once the individual reaches the end of their binge and stops drinking, the rhythm goes back to normal often by the next day (Pitman, 2004). Taking all the evidence presented into account it is clear to see and understand the serious cardiac and vascular complications...
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...NCSBN ON-LINE REVIEW 1.A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. reason for the nurse to elevate the casted leg is to A) Promote the client's comfort B) Reduce the drying time C) Decrease irritation to the skin D) Improve venous return The most important D: Improve venous return. Elevating the leg both improves venous return and reduces swelling. Client comfort will be improved as well. 2. The nurse is reviewing with a client how to collect a clean catch urine specimen. What is the appropriate sequence to teach the client? A) B) C) D) Clean the meatus, begin voiding, then catch urine stream Void a little, clean the meatus, then collect specimen Clean the meatus, then urinate into container Void continuously and catch some of the urine A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires clear directions. Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating the urine specimen. As starting and stopping flow can be difficult, once the client begins voiding it’s best to just slip the container into the stream. Other responses do not reflect correct technique 3. Following change-of-shift report on an orthopedic unit, which client should the nurse see first? A) B) C) D) 16 year-old who had an open reduction of a fractured wrist 10 hours ago 20 year-old...
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...SITUATION : Arthur, A registered nurse, witnessed an old woman hit by a motorcycle while crossing a train railway. The old woman fell at the railway. Arthur rushed at the scene. 1. As a registered nurse, Arthur knew that the first thing that he will do at the scene is A. Stay with the person, Encourage her to remain still and Immobilize the leg while While waiting for the ambulance. B. Leave the person for a few moments to call for help. C. Reduce the fracture manually. D. Move the person to a safer place. 2. Arthur suspects a hip fracture when he noticed that the old woman’s leg is A. Lengthened, Abducted and Internally Rotated. B. Shortened, Abducted and Externally Rotated. C. Shortened, Adducted and Internally Rotated. D. Shortened, Adducted and Externally Rotated. 3. The old woman complains of pain. John noticed that the knee is reddened, warm to touch and swollen. John interprets that this signs and symptoms are likely related to A. Infection B. Thrombophlebitis C. Inflammation D. Degenerative disease 4. The old woman told John that she has osteoporosis; Arthur knew that all of the following factors would contribute to osteoporosis except A. Hypothyroidism B. End stage renal disease C. Cushing’s Disease D. Taking Furosemide and Phenytoin. 5. Martha, The old woman was now Immobilized and brought to the emergency room. The X-ray shows a fractured femur and pelvis. The ER Nurse would carefully monitor Martha for which of the following...
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