...to some bad heartburn from eating too much spicy food. However, the palpitations have become progressively more prominent over the last 4-5 days and therefore the patient thought he should visit the doctor. The patient states that he has had no recent medication changes and has been on the same medication regimen for about 2-3 years now. The patient also stated that he felt similar chest pounding about 4 months ago but it seemed to go away really quick and decided he did not need to do anything about it. PMH: Meds: DM Type 2 ASA 81 mg PO daily HF (LVEF ~35%) (13 years ago) Furosemide 20 mg PO daily HTN KCL 10 mEq PO daily s/p MI (16 years ago) Lisinopril 20 mg PO daily Hypercholesterolemia Atorvastatin 40 mg PO daily Gout Metoprolol succinate XL 25 mg PO daily Glipizide XL 20 mg PO daily Allopurinol 150 mg PO daily Allergies: NKDA SH: Lives with wife; employed as a construction foreman; quit drinking alcohol after HF diagnosis; quit tobacco after MI; tries to stay active and does moderate exercise at the gym at least 3 times/week. Plays golf every other weekend. FH: non-contributory Today’s PCP Visit: ROS: Denies fever, chills, N/V, weight gain, fatigue or SOB (although admits to having some SOB with strenuous or heavy exercise; + chest palpitations PE: BP 132/84 HR 140 RR 13 Temp 37.3 Ht 6’2” Wt 87 kg Gen: A &O x 3; well-nourished male in no apparent distress Lungs: CTA CV: Irregularly irregular rhythm Abdomen:...
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...Peter Kaspersen TEKSTENS TRANSFORMATIONER En undersøgelse af fortolkningen af den litterære tekst i det almene gymnasiums danskundervisning Ph.D.-afhandling Dansk Institut for Gymnasiepædagogik Syddansk Universitet 2004 INDHOLDSFORTEGNELSE Indholdsfortegnelse Forord Første del. Forudsætninger Kapitel 1. Debatten om faget Fremtidens danskfag Litteratursynet i Fremtidens danskfag Danskfagets mangler Den litterære fronts modangreb En fagdidaktisk kritik Kapitel 2. Afhandlingens placering i debatten Samfundssyn Didaktiksyn Litteratursyn Inspirationen fra Fremtidens danskfag Inspirationen fra litteraturteorien Inspirationen fra systemteorien Dannelsessyn Utraditionel dannelse Sammenfatning af første del Anden del. Teorier Kapitel 3. Den sociokulturelle udfordring Vygotsky Bakhtin Hvorfor ikke sociokulturalisme? Kapitel 4. Amerikansk litteraturpædagogik Klasserummets dialog Fortolkningens instanser Læsercentrerede teorier – og derudover Kapitel 5. Systemteori Bruner iagttaget af Luhmann 1 1 3 4 6 9 10 13 13 16 21 22 24 28 31 34 36 38 38 39 44 48 50 50 57 61 68 68 Systemteoriens grundlæggende paradoks Kommunikationsbegrebet Meningsbegrebet Systemteoretisk uddannelsesteori Interaktionssystemet undervisning Systemteori og danskundervisning Videns- og læringsformer. Stokastiske processer Systemteoretisk kunstteori Det selvprogrammere(n)de værk Kunstsystemets historie Litteratur og undervisning Kritik af Luhmanns systemteori Kapitel 6. Pædagogisk forskning Klasserumsforskning...
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...Case Study 1 Heart Failure M.G., a “frequent flier,” is admitted to the emergency department (ED) with a diagnosis of heart failure (HF). She was discharged from the hospital 10 days ago and comes in today stating, “I just had to come to the hospital today because I can't catch my breath and my legs are as big as tree trunks.” After further questioning, you learn she is strictly following the fluid and salt restriction ordered during her last hospital admission. She reports gaining 1 to 2 pounds every day since her discharge. 1. What error in teaching most likely occurred when M.G. was discharged 10 days ago? The patient most likely failed to adequately apply the fluid and sodium restrction diet properly. Upon discharge teaching, she probably did not have an appropriate understanding of how much soidum to restrict in her diet, as well as what foods may be high in sodium. She also may not have an adequate understanding of what a "fluid" restriction diet entails. CASE STUDY PROGRESS During the admission interview, the nurse makes a list of the medications M.G. took at home. * Chart View Nursing Assessment: Medications Taken at Home Enalapril (Vasotec) 5 mg po bid Pioglitazone (Actos) 45 mg po every morning Furosemide (Lasix) 40mg/day po Potassium Chloride 20meq/day po 2. Which of these medications may have contributed to M.G.’s heart failure? Explain. a. Pioglitazone: Side effects:Severe weight gain and water retention (edema) are...
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...Mobile Telecommunications and Health Review of the current scientific research in view of precautionary health protection April 2000 ECOLOG-Institut Translated by Andrea Klein Mobile Telecommunications and Health Review of the Current Scientific Research in view of Precautionary Health Protection Commissioned by T‐Mobil DeTeMobil Deutsche Telekom MobilNet GmbH Authors Dr Kerstin Hennies Dr H.‐Peter Neitzke Dr Hartmut Voigt With the support of Dr Gisa‐Kahle Anders ECOLOG‐Institut für sozial‐ökologische Forschung und Bildung gGmbH Nieschlagstrasse 26 30449 Hannover Tel. 0511‐92456‐46 Fax 0511‐92456‐48 Email mailbox@ecolog‐institut.de Hannover, April 2000 Contents 1 1 1.1 1.2 2 Introduction 1 3 New Technologies and Precautionary Health Protection Terms of Reference and Structure of the Review 5 2.1 2.2 3 Collating and Interpreting the Scientific Data (Methodology) 5 5 Primary Reciprocal Effects between High Frequency Electromagnetic Fields and Biological Systems (Biophysical and Biochemical Processes) 3.1 3.2 3.3 3.4 3.5 4 Thermal Effects 3.1.1 Effects of Homogenous Warming 3.1.2 Microthermal Effects Direct Field Effects 3.2.1 Effects from the Electrical Component of the Electromagnetic Field 3.2.2 Effects from the Magnetic Component of the Electromagnetic Field ...
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...European Journal of Echocardiography (2011) 12, 421–430 doi:10.1093/ejechocard/jeq175 REVIEW Left atrial function: physiology, assessment, and clinical implications Gustavo G. Blume 1, Christopher J. Mcleod 1, Marion E. Barnes 2, James B. Seward 1, Patricia A. Pellikka 1, Paul M. Bastiansen 1, and Teresa S.M. Tsang 2* 1 Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN, USA; and 2Division of Cardiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC, Canada Online publish-ahead-of-print 12 May 2011 The interest in the left atrium (LA) has resurged over the recent years. In the early 1980s, multiple studies were conducted to determine the normal values of LA size. Over the past decade, LA size as an imaging biomarker has been consistently shown to be a powerful predictor of outcomes, including major public health problems such as atrial fibrillation, heart failure, stroke, and death. More recently, functional assessment of the LA has been shown to be, at least as, if not more robust, a marker of cardiovascular outcomes. Current available data suggest that the combined evaluation of LA size and LA function will augment prognostication. The aim of this review is to provide a critical appraisal of current echocardiographic techniques for the assessment of LA function and the implications of such assessment for prediction and disease prevention. ------------------------------------------------------------------...
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...(Provide reference listing using APA format) Reference List Criteria for Case Study I. Introduction – purpose of paper A. Significance B. Objectives II. Assessment a. Include date of admission; date of care; allergies; history b. Address and list analysis of Gordon’s Functional Patterns (list all 11). Integrate treatments, meds, nursing implications, and related assessments in paper. Includes nutritional analysis. III. Literature Review (at least three resources at least one professional journal) a. Disease Description b. Diagnostic Confirmation c. Signs & Symptoms (textbook vs. patient’s actual symptoms being experienced) d. Treatment and Rationale e. Disease Outcome Expectations f. Rehab needs g. Related to client situation IV. Nursing Plan of Care a. Problems Prioritized (list 3 diagnosis) b. Actual Diagnosis c. Potential Diagnosis d. Outcome e. Goals (short and long term) f. Actions/actual diagnosis g. Actions/potential diagnosis h. Rationales (resources documented) i. Evaluation/Revision V. Discharge Planning a. Resources for coping b. Knowledge/Teaching c. Referrals/Continuing Care VI. Summary VII. Format a. Length of paper should be - between 15-20 pages typed b. APA format c. Cover page, reference page, etc… d. Grammar, punctuation, sentence structure, etc… Faculty Signature_______________________________________________ Date________________________________ Name__________________________ Semester______________________ |Criteria...
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...ETHICS, PUBLIC POLICY, AND MEDICAL ECONOMICS A Systematic Review of Satisfaction with Care at the End of Life Sydney Morss Dy, MD, MSc,Ã wz Lisa R. Shugarman, PhD,§ Karl A. Lorenz, MD, MSHS,§ k Richard A. Mularski, MD, MSHS,# and Joanne Lynn, MD, MA, MS,§ for the RANDFSouthern California Evidence-Based Practice Center (See editorial comments by Dr. Jean S. Kutner, pp 160–162) The objective of this study was to systematically review the literature to better understand the conceptualization of satisfaction with end-of-life care and the effectiveness of palliative care interventions on this outcome. Data sources included Medline and the Database of Reviews of Effects. The review included relevant qualitative studies and intervention studies using satisfaction as an outcome from 1990 to 2005. Reviewing 24,423 citations yielded 21 relevant qualitative studies, four systematic reviews, and eight additional intervention studies. The qualitative literature described the domains of accessibility and coordination; competence, including symptom management; communication and education; emotional support and personalization of care; and support of patients’ decision-making. For collaboration and consultation interventions, eight of 13 studies showed a significant effect on satisfaction. A metaanalysis found that palliative care and hospice teams improved satisfaction, although most studies did not include satisfaction as an outcome. For other types of interventions, only two of six...
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...Chronic Critical Illness Judith E. Nelson1, Christopher E. Cox2, Aluko A. Hope1,3 and Shannon S. Carson4 + Author Affiliations 1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, and Hertzberg Palliative Care Institute, Mount Sinai School of Medicine, New York, New York; 2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; 3Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York; 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, North Carolina Correspondence and requests for reprints should be addressed to Judith E. Nelson, M.D., J.D., Box 1232, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029. E-mail: Judith.nelson@mssm.edu Next SectionAbstract Although advances in intensive care have enabled more patients to survive an acute critical illness, they also have created a large and growing population of chronically critically ill patients with prolonged dependence on mechanical ventilation and other intensive care therapies. Chronic critical illness is a devastating condition: mortality exceeds that for most malignancies, and functional dependence persists for most survivors. Costs of treating the chronically critically ill in the United States already exceed $20 billion and are increasing. In...
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...Oral Oncology 50 (2014) 577–586 Contents lists available at ScienceDirect Oral Oncology journal homepage: www.elsevier.com/locate/oraloncology Review ACR Appropriateness CriteriaÒ thyroid carcinoma Joseph K. Salama a,⇑, Daniel W. Golden b, Sue S. Yom c, Madhur Kumar Garg d, Joshua Lawson e, Mark W. McDonald f, Harry Quon g, John A. Ridge h, Nabil Saba i, Richard V. Smith j, Francis Worden k, Anamaria Reyna Yeung l, Jonathan J. Beitler m a Duke University, Durham, NC, United States University of Chicago Hospital, Chicago, IL, United States University of California San Francisco, San Francisco, CA, United States d Montefiore Medical Center, Bronx, NY, United States e Lexington Medical Center, West Columbia, SC, United States f Indiana University School of Medicine, Indianapolis, IN, United States g Johns Hopkins University, Baltimore, MD, United States h American College of Surgeons, Fox Chase Cancer Center, Philadelphia, PA, United States i American Society of Clinical Oncology, Emory University, Atlanta, GA, United States j American College of Surgeons, Montefiore Medical Center, Bronx, NY, United States k American Society of Clinical Oncology, University of Michigan, Ann Arbor, Michigan, United States l University of Florida, Gainesville, FL, United States m Emory University School of Medicine, Atlanta, GA, United States b c a r t i c l e i n f o s u m m a r y The ACR Head and Neck Cancer Appropriateness Criteria Committee reviewed relevant medical...
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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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...Chapter 1 The Patient Interview Sneha Baxi Srivastava, PharmD, BCACP Learning Objectives • Explain the basic communication skills needed when performing a patient interview. • Describe the components of the patient interview. • Conduct a thorough medication history. • Compare and contrast the different patient interview approaches in various clinical settings. • Adapt the interview technique based on the needs of the patient. Key Terms • Active Listening • Rapport • Empathy • Open-Ended Questions • Leading Questions • Probing Questions • Nonverbal Communication • Chief Complaint • History of Present Illness • Pertinent Positive • Pertinent Negative • Past History • Medication History • Family History • Personal and Social History • Review of Systems • Physical Exam • QuEST/SCHOLAR-MAC Introduction The patient interview is the primary way of obtaining comprehensive information about the patient in order to provide effective patient-centered care, and the medication history component is the pharmacist’s expertise. A methodological approach is used to obtain information from the patient, usually starting with determining the patient’s chief complaint, also known as the reason for the healthcare visit, and then 2 Chapter 1 / The Patient Interview delving further into an exploration of the patient’s specific complaint and problem. A comprehensive patient interview includes inquiring about the patient’s...
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...with an overwhelming number of 550,000 newly diagnosed cases each year, costing the nation roughly $32 billion dollars per year (Centers for Disease Control and Prevention, 2016). Heart failure is a complex, pathophysiological condition in which the ventricles of the heart is weakened and unable to pump effectively to meet the body’s needs for nutrients or has lost adequate filling capacity. Clinical presentations of heart failure depends on which ventricles have failed to pump blood adequately; left ventricular failure, also known as congestive heart failure (CHF) is more common than right ventricular failure (McCance & Huether, 2014). The most common symptoms of heart failure are shortness of breath, fatigue, and peripheral edema. HF is not a disease, but rather a manifestation of a diseased heart. Large number of disorders can lead to heart failure, and with the aging population and many surviving primary cardiac events, it is no surprise that the most common reason for hospitalization in patients older than 65 years old is heart failure (McClintock, Mose, & Smith, 2014). Heart failure has become a major public health problem because it is the only cardiac condition that continues to increase in prevalence (McClintock, Mose, & Smith, 2014). Organizations such as American Heart Association (AHA), National Heart, Lung, and Blood Institute (NHLBI), and Heart Failure Society of America (HFSA) are helping raise awareness and are invaluable resources to the increasing...
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...NUR160 Ca Name: Jodi Wiak | Section: 160 | Instructor: Ms. Higgins | Dates of care: 4/1/14 | Week: 1st clinical | Name: Jodi Wiak | Section: 160 | Instructor: Ms. Higgins | Dates of care: 4/1/14 | Week: 1st clinical | General Survey | Age: 85 | Sex: F | Ethnicity: Caucasion | # of days since admission: 7d | Allergies: Latex PCN | Code Status: FULL CODE | Diet: TPN | Rationale: Small bowel obstruction and resection benefit TPN over tube feedings is that all the nutrition is delivered at a cellular level making it immediately available for the body to utilize rather than making the body breakdown and absorb nutrients in the GI tract. It makes it easier on the digestive tract by giving the GI a chance to rest and heal without causing more harm. The patient also has to expend energy to breakdown foods/nutrition through the GI tract. Getting it TPN conserves the much needed energy the patient needs to heal their tissues and gain strength. | Activity: bedridden w/slight mobility with a walker | Rationale: Post surgical abdominal surgery, pt age, weakness, and recent foot surgery limiting her mobility. | Behavior/Affect: My pt was anxious when I first arrived due to her elevated B/P, N&V, and pain intolerance. By the end of shift my patient was very calm and communicative. | Isolation: | Yes | No | Culture: ⦵ | Source: ⦵ | Type of Isolation: ⦰ ⦵ | Height: 5’ 7.5” | Weight: 133 | BMI: 20.5 (BSA 1.71) | General Survey | Age: 85 | Sex:...
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...Powerware Series Eaton FERRUPS FE/QFE UPS User's Guide ® ® Class A EMC Statements FCC Part 15 NOTE This equipment has been tested and found to comply with the limits for a Class A digital device, pursuant to part 15 of the FCC Rules. These limits are designed to provide reasonable protection against harmful interference when the equipment is operated in a commercial environment. This equipment generates, uses, and can radiate radio frequency energy and, if not installed and used in accordance with the instruction manual, may cause harmful interference to radio communications. Operation of this equipment in a residential area is likely to cause harmful interference in which case the user will be required to correct the interference at his own expense. ICES-003 This Class A Interference Causing Equipment meets all requirements of the Canadian Interference Causing Equipment Regulations ICES‐003. Cet appareil numérique de la classe A respecte toutes les exigences du Reglement sur le matériel brouilleur du Canada. For Users in Germany We hereby certify that the uninterruptible power system (QFE 500 VA, 700 VA, 850 VA, 1.15 kVA, 1.4 kVA, 1.8 kVA, 2.1 kVA, 3.1 kVA, 4.3 kVA, 5.3 kVA, 7 kVA, 10 kVA, 12.5 kVA, and 18 kVA) complies with the RFI suppression requirements of Vfg. 243/1991 and Vfg. 46/1992. The German Postal Service was notified that the equipment is being marketed. The German Postal Service has the right to retest the equipment and verify compliance...
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...Structural Engineer’s Pocket Book This Page Intentionally Left Blank Structural Engineer’s Pocket Book Fiona Cobb AMSTERDAM BOSTON HEIDELBERG LONDON NEW YORK OXFORD PARIS SAN DIEGO SAN FRANCISCO SINGAPORE SYDNEY TOKYO Elsevier Butterworth-Heinemann Linacre House, Jordan Hill, Oxford OX2 8DP 200 Wheeler Rd, Burlington, MA 01803 First published 2004 Copyright ª 2004, Fiona Cobb. All rights reserved The right of Fiona Cobb to be identified as the author of this work has been asserted in accordance with the Copyright, Designs and Patents Act 1988 No part of this publication may be reproduced in any material form (including photocopying or storing in any medium by electronic means and whether or not transiently or incidentally to some other use of this publication) without the written permission of the copyright holder except in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London, England W1T 4LP. Applications for the copyright holder’s written permission to reproduce any part of this publication should be addressed to the publisher Permissions may be sought directly from Elsevier’s Science and Technology Rights Department in Oxford, UK: phone: (þ44) (0) 1865 843830; fax: (þ44) (0) 1865 853333; e-mail: permissions@elsevier.co.uk. You may also complete your request on-line via the Elsevier homepage (http://www.elsevier.com), by selecting...
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