...I. Introduction - Shock (Chapter 11) A. Review of anatomy and physiology B. Pathophysiology Initiation | * Decreased tissue oxygenation * Decreased intravascular volume * Decreased Myocardial contractility (cardiogenic ) * Obstruction of blood flow (obstructive) * Decreased vascular tone (distributive) * Septic (mediator release) * Neurogenic (suppression of SNS) | No observable clinical indications Decreased CO may be noted with hemodynamic monitoring | Compensatory | * Neural compensation by SNS * Increased HR and Contractiliy * Vasoconstriction * Redistribution of blood flow from nonessential to essential organs * Bronchodilation * Endocrine Compensation (RAAS, ADH, glucocorticoid release) * Renal reabsorption of sodium, chloride, and water * Vasoconstriction * Glycogenolysis | * Increased HR (EXCEPT NEUROGENIC) * Narrowed pulse pressure * Rapid, deep respirations causing respiratory alkalosis * Thirst * Cool,moist skin * Oliguria * Diminished bowel sounds * Restlessness progressing to confsion * Hyperglycemia * Increased specific gravity and decreased creatinine clearance. | Progressive | * Progressive tissue hypoperfusion * Anaerobic metabolism wih lactic acidosis * Failure of sodium potassium pump * Cellular edema | * Dysrhythmias * Decreased BP with narrowed pulse pressure * Tachypnea * Cold, clammy skin * Anuria * Absent bowel sounds * Lethargy progressing...
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...Philippine Christian University Mary Johnston College of Nursing 415 Morga St. Tondo, Manila A Case Study on Acute Pancreatitis Secondary to Cholelithiasis Submitted by: Abad, Edryan Calara, Sharika Loradel Casul Mark Jury Corpuz, Trisha Dela Cruz, Marjori Gamboa, Jonalyn Lebico, Elmarie Lopez, Anica Tapawan, Ansherina Tuazon, Serleen March 09, 2012 Acknowledgement We would like to thank the following to the development of this case study. Mrs. Edna Oraye-Imperial, Dean, PCU – Mary Johnston College of Nursing, for her support and for allowing us to have our related learning experiences in the clinical area that hone our knowledge skills and attitude to be a competent, caring, Christian nurses. Ms. Ma. Lourdes Galima, Clinical Instructor, for continually guiding and supporting us throughout our duty at the Surgery ward, for helping us in enhancing and improving our skills in the area. For the patience that she showed us despite of our attitude and mistakes. Ms. Loreto Vicarme, School Librarian, for allowing us to utilize the library books and references for our case study. To the staff nurses on duty at the Surgery Intensive Care Unit and Ward of Mary Johnston Hospital for the support and providing us with enough information about the routines in the area which we were able to apply. To our fellow group members for their continuous support and sharing their knowledge and experiences for polishing this case study...
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...| Types of bone cells | Osteoblasts | Bone forming cellsThey are responsible for bone growth and repair | Osteocytes | Osteoblasts that have become trapped, imprisoned within mineralized bone matrix (MATURE BONE CELLS) | Osteoclasts | Reabsorb or remove bone during growth and repair (also assist in the release of calcium and phosphate)**bone reabsorption; bone destroying cells | *So, if one is immobilized then the osteoclastic activity is greater than the osteoblastic activity in bone marrow decreases. This is why we have debone mineralization during immobilization. Maintenance of bone integrity | This occurs through remodeling and it is a 3 phase process where existing bone is resorbed and new bone is laid down [repairs bone, does not heal bones] | Phase 1 | Activation phaseThis is where a stimulus occurs, such as a weight baring exercise, causing the formation of osteoclasts | Phase 2 | Resorption This is where osteoclasts form a cutting zone and resorb or remove bone | Phase 3 | Formation phaseThis is where there is a laying down of new bone by osteoblast | *PAGE 962 Know how bone fractures heal/callous formation (Musculoskeletal System) * Bone Fractures * A broken bone can cause damage to the surrounding tissue, the periosteum, and the blood vessels in the cortex and marrow * Hematoma formation * Bone tissue destruction triggers...
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...Final Exam Study Guide Important to Know the function of anterior and posterior pituitary gland. Anterior Pituitary Gland: (Adenohypophysis) The anterior pituitary gland regulates several physiological processes including stress, growth, reproduction and lactation (Adrenal, liver, bone, thryroid and gonads). -It is regulated by negative feedback and the hypothalamus. Major hormones: ACTH: Stimulates the adrenal cortex. TSH: Thyroid stimulating hormone, promotes secretion of thyroid hormone. FSH: Follicle-stimulating hormone, promotes growth of reproductive system. LH: Luteinizing hormone. Promotes sex hormone production GH: Growth hormone, promotes growth, lipid and carbohydrate metabolism. PRL: Prolactin, Milk production and progesterone/estrogen. -Hormones are secreted from the hypothalamus to the A. Pituitary so these hormones can be released. Posterior Pituitary Gland: Mainly axons extended from the hypothalamus. These axons contain and release neurohypophysial hormones oxytocin and vasopressin. Oxytocin: Targets the uterus, and mammary glands causing contractions and lactation. Vasopressin (ADH): Antidiuretic hormone, arginine vasopressin, argipressin. Stimulates water retention absorbs it back into blood causing raises blood pressure by contracting arterioles, and inducing male aggression. Very Important to know and understand Diabetic Ketoacidosis Pathophysiology: -In DKA, the lack of insulin prevents glucose from being utilized by the tissues...
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...Diarrhea / ORT DEFINITION | SIGNS/SYMPTOMS | Most commonly due to acute infectious diarrhea (gastroenteritis) from a variety of causative organismsAntibiotics are a common cause of acute diarrhea! | Acute inflammation of the lining of the stomach and intestines caused by viruses, bacteria or their toxins or parasitesPresents commonly with diarrhea, abdominal cramps, and vomiting.CommunicabilityOften fecal-oral route (especially viruses)Food poisoning (especially bacteria)Day care centers, crowded living conditions, poor sanitation and cleanliness | DIAGNOSTIC TESTS | MAIN TREATMENT | Stool gram stain and culture (if bloody stools)Stool for Ova & Parasites (if hx suggestive)CBC – assess for anemia/infectionUrinalysis and urine culture (r/o UTI)Electrolytes | Oral rehydration therapy (ORT) is one of the major worldwide health advances of the last decade:Safer, less painful, and less costly than IV rehydrationOral rehydration solution enhances and promotes reabsorption of H2O and NaReduces vomiting, diarrhea, and duration of illnessORT GuidelinesDiarrhea w/o dehydrationMild dehydrationMod dehydrationSevere dehydrationReplacing ongoing losses | MAJOR TEACHING POINTS | NURSING CONSIDERATIONS | Teach parents at well childcare visits in first yearKeep 24 hour supply of ORT in homeBegin with first sign of diarrheaReplace with ½ cup ORT for each diarrheal stoolSeek medical attention prn signs or dehydrationAfter re-hydration resume breast/formula feeding or normal diet...
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...ACUTE GLOMERULONEPHRITIS DISCLOSED _________________________ A Case Study Presented to The Clinical Instructors AUP College of Nursing Adventist University of the Philippines __________________________ In Partial Fulfillment of the Requirements for the Course NMCN 244, Care of Mother, Child, Family and Population at Risk ___________________________ TABLE OF CONTENTS I. Introduction Significance of the Study II. Patient DataBase A. Demographic Data B. Nursing History 1. Developmental Tasks 2. Health History 3. Medical Diagnosis & Chief Complaints III. The Disease Entity A. Review of Normal Physiology B. Theoretical Background C. Statistical Report D. Risk/Aggravating Factors E. Pathophysiology Narrative w/ Documentation F. Pathophysiology Diagram G. Prognosis of Disease IV. Assessment A. Gordon’s or Head to Toe Assessment B. Book Picture vs Patient’s Manifestations V. The Management A. Diagnostic Test Result and Significant B. Therapeutic/Medical Interventions 1. Surgeries/Treatment 2. Drugs C. Nursing Initiated Interventions 1. Nursing Care Plan 2. Discharge Plan VI. General Evaluation of the Study A. Summary B. Recommendation VII. Bibliography I. Introduction Acute glomerulonephritis is a disease that affects glomerular capillaries. Etiologic factors are many and varied; they include immunologic reactions, vascular injury, metabolic...
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...What is Sexually Transmitted Disease? What are the Common Sexually transmitted diseases? What are the Cause of Each Sexually Transmitted Diseases? What are the signs/symptoms and Diagnosis? What is the complications? What is the Effect of sexually transmitted disease? \ S exually transmitted infection is a broader term than sexually transmitted disease. An infection is a colonization by a parasitic species, which may not cause any adverse effects. In a disease, the infection leads to impaired or abnormal function. In either case, the condition may not exhibit signs or symptoms. Increased understanding of infections like HPV, which infects most sexually active individuals but cause disease in only a few has led to increased use of the term STI. Public health officials originally introduced the term sexually transmitted infection, which clinicians are increasingly using alongside the term sexually transmitted disease in order to distinguish it from the former. STD may refer only to infections that are causing diseases, or it may be used more loosely as a synonym for STI. Most of the time, people do not know that they are infected with an STI until they are tested or start showing symptoms of disease. Moreover, the term sexually transmissible disease is sometimes used since it is less restrictive in consideration of other factors or means of transmission. For instance, meningitis is transmissible by means of sexual contact but is not labeled as an STI...
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...1. Which of the following is the characteristic of the living thing? A. have specific shape B. have regular shape C. have organized body D. none of the above 2. Which of the followings includes in homeostasis? a. To maintain the shaped of the body b. To maintain the balance of the body c. To maintain the temperature of the body d. To keep the animal away from the body 3. Your hearts starts beating before seven month of your birth. The study of your body at this stage comes within: (a) Morphology (b) Embryology (c) Anatomy (d) Histology 4. A doctor is studying the contraction and relaxation of a heart. He is studying: (a) Morphology (b) Embryology (c) Anatomy (d) Histology 5. Study of different parts of eye is called (a) Histology (b) Anatomy (c) Physiology (d) None of these 6. A biologist removes some bones of dinosaurs from a rock. He is studying: (a) Morphology (b) Paleontology (c) Ecology (d) None of these 7. Darwin sys, “man has formed from monkey”. He talked about (a) Fossil (b) Evolution (c) Taxonomy (d) None of these 8. Kangaroo lives in Australia but buffaloes lives in Pakistan. The study of this distribution of animals is called (a) Ecology (b) Environmental biology (c) Taxonomy (d) Zoogeography 9. The study of structure of molecule of starch is called: (a) Molecular biology (b) Biochemistry (c) Morphology (d) None 10. The study of Amoeba comes with in the branch of biology: (a) Taxonomy (b) Ecology (c) Microbiology (d) None 11. The study...
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...Critical Thinking Paper Aubrey Lewis Grand Canyon University 11/11/11 SYSTEMATIC ASSESSMENT Biographical Data Patient, C.L, is a 52-year-old Caucasian female that was admitted to Banner Thunderbird on 09/29/11 for difficulty breathing and shortness of breath (SOB). The patient has no known drug or food allergies and is registered as a “do not resuscitate” and “do not intubate” (DNR/DNI). History of Present Illness Patient stated that she had woken up through out the night drenched in sweat and the inability to catch her breath. This is what brought her to the emergency department where she presented with difficulty breathing (dyspnea), and shortness of breath. Based upon how the patient presented and the results of the diagnostic tests that were conducted the patient was admitted to the progressive care unit of Banner Thunderbird. Diagnostic tests that were conducted was a chest X-ray, magnetic resonance imaging (MRI), and ultra sound to determine if there is a build up or either fluid and/or air in the pleural spaces of the lungs or a tumor that is causing the patient to have difficulty breathing. Non-imaging tests that are conducted would be a blood studies and arterial blood gas test. The blood studies would be able to dictate if the patient has a bacterial or viral infection, pneumonia, rheumatic fever, a pulmonary embolus, or lupus, and the arterial blood gas test will be able to show how well the lungs are taking in oxygen...
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...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
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...TENNIS RECOVERY A Comprehensive Review of the Research Editors: Mark S. Kovacs, PhD Todd S. Ellenbecker, DPT W. Ben Kibler, MD A United States Tennis Association Sport Science Committee Project Tennis Recovery: A Comprehensive Review of the Research Copyright © 2010 United States Tennis Association Inc. ISBN 978-0-692-00528-6 Editors: Mark S. Kovacs, Todd S. Ellenbecker, W. Ben Kibler TENNIS RECOVERY A Comprehensive Review of the Research A United States Tennis Association Sport Science Committee Project Editors: Mark S. Kovacs, PhD Todd S. Ellenbecker, DPT W. Ben Kibler, MD Introduction In the last two decades, physical training and competitive opportunities have increased dramatically in junior, collegiate and professional tennis. This arose due to a multitude of factors, but much of it has stemmed from an increase in knowledge and understanding of scientifically based training programs focused on improving performance. As this focus on performance has increased, the area of recovery has received relatively limited focus. Recovery is a multi-faceted paradigm focusing on recovery from training—session to session, day to day and week to week. Recovery is also vitally important during training as well as in competition between matches and between days during multi-day tournaments. As more information is needed in the area of tennis specific recovery, the Sport Science Committee of the United States Tennis Association (USTA) sponsored an extensive evidence-based...
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...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 sign and symptoms? A. Tachycardia and Hypotension B. Fever and Bradycardia C. Bradycardia and Hypertension D. Fever and Hypertension SITUATION: Mr. D. Rojas, An obese 35 year old MS Professor of OLFU Lagro is admitted due to pain in his weight bearing joint...
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...00_078973706x_fm.qxd 1/14/08 2:42 PM Page i NCLEX-PN ® SECOND EDITION Wilda Rinehart Diann Sloan Clara Hurd 00_078973706x_fm.qxd 1/14/08 2:42 PM Page ii NCLEX-PN® Exam Cram, Second Edition Copyright © 2008 by Pearson Education All rights reserved. No part of this book shall be reproduced, stored in a retrieval system, or transmitted by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. No patent liability is assumed with respect to the use of the information contained herein. Although every precaution has been taken in the preparation of this book, the publisher and author assume no responsibility for errors or omissions. Nor is any liability assumed for damages resulting from the use of the information contained herein. ISBN-13:978-0-7897-2706-9 ISBN-10: 0-7897-3706-x Library of Congress Cataloging-in-Publication Data Rinehart, Wilda. NCLEX-PN exam cram / Wilda Rinehart, Diann Sloan, Clara Hurd. -- 2nd ed. p. cm. ISBN 978-0-7897-3706-9 (pbk. w/cd) 1. Practical nursing--Examinations, questions, etc. 2. Nursing--Examinations, questions, etc. 3. National Council Licensure Examination for Practical/Vocational Nurses--Study guides. I. Sloan, Diann. II. Hurd, Clara. III. Title. RT62.R55 2008 610.73'076--dc22 2008000133 Printed in the United States of America First Printing: February 2008 Trademarks All terms mentioned in this book that are known to be trademarks or service marks have been appropriately...
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...Practice Examination One Part One You will have two hours and 30 minutes to complete Part One. 1. The nurse is instructing an unlicensed assistant on how to collect a urine specimen from an indwelling catheter. Which of the following statements indicates that the assistant understands the instructions? A. "I will empty the catheter drainage bag, have the client drink some water, and an hour later collect the urine that drains into the bag. " B. "I will get a sterile syringe and remove urine from the catheter through the collection port to place in the specimen container. " C. "I should collect urine from the catheter drainage bag at the end of the shift and place it in the specimen container. " D. "I will disconnect the drainage tube from the catheter and let urine run from the catheter into the specimen container. " 2. Linda is a 19-year-old primipara who delivered a viable male neonate 2 hours ago. She has decided to breast-feed. Her 22-year-old husband supports her decision. She tells the nurse, "My mother breast-fed all of her children, but I'm going to need lots of help with breastfeeding. I'm worried that I won't be able to do this. " Which of the following should the nurse include when assessing the client? A. Determine the client's level of motivation to breast-feed. B. Perform a complete physical examination to determine her need for help. C. Assess her body-to-fat ratio and nutritional status before beginning...
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...VELEZ COLLEGE F. Ramos St., Cebu City College of Nursing A CASE ANALYSIS REPORT ON PATIENT N.M.C., 47 YEARS OLD, FEMALE, DIAGNOSED WITH UTERINE LEIOMYOMA (s/p TOTAL ABDOMINAL HYSTERECTOMY and BILATERAL SALPINGO OOPHORECTOMY), BILATERAL OVARIAN NEWGROWTHS, METABOLIC SYNDROME, AND HYPERTENSION Submitted By: Villavelez, Carmina Anne Z. BSN III-C Submitted to: Mrs. Miraluna Echavez, RN, MN March 2013 UTERINE LEIOMYOMA/ UTERINE FIBROIDS Uterine fibroids are noncancerous growths of the uterus that often appear during your childbearing years. Also called fibromyomas, leiomyomas or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer. As many as 3 out of 4 women have uterine fibroids sometime during their lives, but most are unaware of them because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound. In general, uterine fibroids seldom require treatment. Medical therapy and surgical procedures can shrink or remove fibroids if you have discomfort or troublesome symptoms. Rarely, fibroids can require emergency treatment if they cause sudden, sharp pelvic pain or profuse menstrual bleeding. Symptoms In women who have symptoms, the most common symptoms of uterine fibroids include: * Heavy menstrual bleeding * Prolonged menstrual periods — seven days or more of menstrual bleeding * Pelvic pressure or pain *...
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