...This case presents a diabetic patient with right calf cramping after walking one block. The pain is relieved after cessation of walking for a few minutes. The patient is then able to walk approximately the same distance. These signs and symptoms are similar to that of a patient with intermittent claudication. The term claudication comes from the Latin word “to limp”. Claudication can refer to an impairment in walking, pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing. According to Aronow (2012), “peripheral arterial disease may cause intermittent claudication which is pain or weakness with walking that is relieved with rest” (p. 375). PAD is a chronic arterial occlusive disease of the lower extremities caused by atherosclerosis. Just distal to the arterial obstruction is usually where the muscle pain or weakness may occur after exercise. PAD is a type of peripheral vascular disease, which also includes carotid artery disease, renal artery disease, aortic disease, and venous problems. An appropriate exam that may be ordered for these symptoms is an ankle-brachial index (ABI). Intermittent claudication caused by...
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... Cardiovascular Disease affects all aspects of Heart function, from the arteries that supply it with blood to the valves, to the heart muscle itself. It is one of the most common chronic illnesses in the world and it causes about half of the deaths today. Starting with a heart attack or sudden death of Congestive heart failure. Strokes are also very common symptom of Cardiovascular Disease and a final one is called intermittent claudication which is a disease to the leg blood vessels that may lead to an amputation of the legs if its severe. Causes of Cardiovascular Disease can refer to many different types of heart or blood vessel problems, the term is often used to mean damage caused to your heart or blood vessels by atherosclerosis a buildup of fatty plaques in your arteries. This is a disease that affects your arteries. Arteries are blood vessels that carry oxygen and nutrients from your heart to the rest of your body. Healthy arteries are flexible and strong. Overtime too much pressure in your arteries can make the walls thick and stiff, sometimes restricting blood flow to your organs and tissues. This process is called hardening of the arteries. Atherosclerosis is the most common form of this disorder. Atherosclerosis is also the most common cause of cardiovascular disease, and it’s often caused by an unhealthy diet, lack of exercise, being overweight, and smoking. All of these are major risk factors for developing atherosclerosis and in turn cardiovascular disease...
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...Cardiovascular Pharmacology Quiz (25 Questions) Protamine sulfate: antidote for heparin (use is when patient’s aPTT is very high) Vitamin K: antidote for coumadin (uses PT/INR); both work slowly. Why are Coumadin and Heparin given together? If you have DVT treatment, it can keep existing blood clots from getting larger or prevent new ones from forming. They do this by preventing the production of certain proteins needed for blood to clot. Lipitor Atorvastatin is used along with a proper diet to help lower "bad" cholesterol and fats (such as LDL, triglycerides) and raise "good" cholesterol (HDL) in the blood. It belongs to a group of drugs known as "statins." It works by reducing the amount of cholesterol made by the liver. Lowering "bad" cholesterol and triglycerides and raising "good" cholesterol decreases the risk of heart diseases and helps prevent strokes and heart attacks. other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Take this medication by mouth with or without food as directed by your doctor, usually once daily. Example: mevacor Questran Take this medication by mouth as directed by your doctor, usually 1 to 2 times a day. This medication comes as a powder with doses measured by the scoopful (using the provided scoop) or in individual dose packets. Do not take your dose in the dry powder form. Mix the medication in at least 2...
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...occur intermittently and so can be difficult to diagnose. * Can present with palpitations, chest pain, presyncope/syncope, hypotension, pulmonary oedema. Some are asymptomatic e.g. AF. * History taking make sure include: * Precipitating factors, onset, nature (fast/slow, regular/irregular), duration, associated symptoms (chest pain, dyspnoea, collapse). * Causes: * CARDIAC: * MI. * CAD. * LV aneurysm. * Mitral valve disease. * Cardiomyopathy. * Pericarditis. * Myocarditis. * Aberrant conduction pathways. * NON-CARDIAC: * Caffeine. * Smoking. * Alcohol. * Pneumonia. * Drugs (β2 agonist, digoxin, L-dopa, tricyclics). * Metabolic imbalance (K, Ca, Mg, hypoxia, hypercapnia, acidosis, thyroid disease, phaeochromocytoma). * Tests: * Bloods: FBC, U&E, glucose, Ca, Mg, TSH. * ECG: look for signs of IHD, AF, short P-R interval, long QT interval, U waves. * If ECG normal consider doing 24 hour tape. * Echo: look for structural heart disease. * Others: exercise ECG, cardiac catheterisation etc. * Types of Arrhythmias: * Bradycardias: * If asymptomatic and rate >40bpm then no treatment. * Look for cause and stop any drugs that may be the cause or contributing. * If rate <40bpm and patient’s symptomatic give atropine (consider external...
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...present status of all Ongoing chronic illnesses: If patient presents with a symptom, use symptom analysis (see next page) to elicit the details of the health history. I f patient presents for follow up of a chronic illness, ask about chronology, present status (see next page). SIMMONS COLLEGE GRADUATE PROGRAM IN PRIMARY HEALTH CARE NURSING Theory and Practice: Primary Health Care Nursing I The Health History Symptom Analysis Format 1. Onset a. Date of onset b. Manner of onset (gradual or sudden) c. Precipitating and predisposing factors related to onset 2. Characteristics a. Character (quality, quantity, consistency, or other) b. Location and radiation (of pain) c. Intensity or severity d. Timing (continuous or intermittent, duration of each, temporal relationship to other events) c. Aggravating or alleviating factors f. Associated symptoms 3. Course since onset a. Incidence 1. Single acute attack 2 Recurrent acute attacks 3. Daily occurrences 4. Periodic occurrences 5. Continuous chronic episode b. Progress (better, worse, unchanged) Chronology of Chronic...
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... I. Race/Ethnic Origin * Asian Indian J. Occupation * House Wife K. Employer * N/A L. Financial Status * Her income comes from Social Security. Currently has Medicare as her health insurance. She lives with her son, allowing her to be able to support her lifestyle and health concerns. M. Source and Reliability of information * Client herself, who seems reliable. II. Reason for Seeking Care * The client came to the hospital because o to consistent back pain which is interfering with ADLs. The pain has been present for the past two weeks. Back pain is located in the lower lumbar area. It is a throbbing like pain that occurs through out the day. The severity of pain on a scale of 1-10, client rated 8. The pain causes her to sit down or lay down until pain improves. Pain lasts for about 15 minutes. Not standing up usually relieves the pain. 1. When did symptoms appear? - Pain began two weeks ago when she was cleaning. 2. How often? - Pain has reoccurred everyday. 3. Type of activity when patient’s symptoms occurred. - The problem happened when the patient was cleaning. III. Past Health History * Client has borderline blood pressure and cholesterol, controlled by medication 1. General Health - Feels tired and likes to lie down in between. The patient wakes up at least two times at night to go to bathroom. She does not eat junk food. Overall her health is good. She likes to move around and not depended on others for...
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...Health History and Screening of Save this form on your computer as a Microsoft Word document. You can expand or shrink each area as you need to include the relevant data for your client. Student Name | Date: April 20, 2013 | Biographical Data | Patient/Client Initials: MT | Phone No: | Address: | Birth Date: 10/19/1994 | Age:18 | Sex Female | Birthplace: Richmond, VA | Marital Status: Single | Race/Ethnic Origin: African American | Occupation: Cashier | Employer:VCU Health System | Financial Status: (Income adequate for lifestyle and/or health concerns. Is there a source of health insurance? Employment disability?)Patient works part-time as a cashier and requires assistant to supplement her income. She receives monthly food stamps and funds from her maternal grandmother to help with living expenses. Medical, dental and vision insurance coverage is available through the patient’s mother. She has no disability limiting her from working or engaging in other activities | Source and Reliability of Informant:Information obtained from patient who is a good historian and is well informed about her health history | Past Use of Health Care System and Health Seeking Behaviors:She uses the health care system for episodic illnesses and recently sought medical care for UTI. Patient understand the importance of obtaining health care when necessary as demonstrated her recent visit to the doctor to for UTI | Present...
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...Accord Healthcare Limited | | Sage House, 319 Pinner Road, North Harrow, Middlesex, HA1 4HF, UK Telephone: +44 (0)208 8631 427 Fax: +44 (0)208 863 1426 WWW: http://www.accord-healthcare.eu Medical Information Direct Line: +44 (0)208 901 3370 Medical Information e-mail: uk@accord-healthcare.com Customer Care direct line: +44 (0)208 863 1427 Medical Information Fax: +44 (0)208 863 1426 Before you contact this company: often several companies will market medicines with the same active ingredient. Please check that this is the correct company before contacting them. Why? | | Summary of Product Characteristics last updated on the eMC: 01/08/2013 SPC | Atenolol 100 mg Tablets | Table of Contents * 1. Name of the medicinal product * 2. Qualitative and quantitative composition * 3. Pharmaceutical form * 4. Clinical particulars * 4.1 Therapeutic indications * 4.2 Posology and method of administration * 4.3 Contraindications * 4.4 Special warnings and precautions for use * 4.5 Interaction with other medicinal products and other forms of interaction * 4.6 Pregnancy and lactation * 4.7 Effects on ability to drive and use machines * 4.8 Undesirable effects * 4.9 Overdose * 5. Pharmacological properties * 5.1 Pharmacodynamic properties * 5.2 Pharmacokinetic properties * 5.3 Preclinical safety data * 6. Pharmaceutical particulars * 6.1 List of excipients * 6.2 Incompatibilities * 6.3 Shelf life * 6.4 Special precautions...
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...Hispanic Birth Place: Cienfuegos, Cuba Address: 1110 SW 154 AVE, Miami FL 33194. Phone Number: 305 764 4934 Marital status: Married Occupation: Software developer Religion: Catholic 3. Source of referral and reliability: Patient himself who seems reliable. 4. Chief Complain: Patient states that he had a headache for 2 hours. 5. History of Present Illness Patient states that he had a headache for 2 hours 3 days ago. He states that pain started after working for more than 12 hours in front of the computer around 9.00 PM on September 16, 2012. The headache was localized behind his eyes. It was deep, constant and sharp that he had to stop working and went home. Patient states that computer use aggravates his headache and sleep improves it. The intensity of the headache was 8 in the scale of 0 to 10. He states that this headache was not associated with any head injury, dizziness or vertigo. It disappeared about 2 hours after he took 2 Tylenol pills of 500mg. Patient thinks this headache meant that his body was exhausted, and he needed to rest. 6. Past Medical History General state of health: Healthy 38 years old male. Childhood Illnesses: Patient states he had Varicella when he was 10 years old. Adult Illness: Patient states that he had Hepatitis B at age of 24. Psychiatric Illnesses: None Accidents and Injuries: Patient denies having had any accident or injury. Operations: Patient denies having being operated through his entire life. Hospitalizations: Patient denies...
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...Running head: PAIN CASE STUDY Case Study: Pain Amit Dhir, Omeid Heidari, Sean Mayer, Ololade Ikuomola & Adam Boyce NR110.542 Physiological/Pathophysiological Basis for Advanced Nursing Practice I 09/29/2015 Johns Hopkins University School of Nursing On our honor, we pledge that we have neither given nor received any unauthorized assistance on this assignment. 1 Running head: PAIN CASE STUDY CASE STUDY Pain Use this document in documenting your response to the Patient Case Questions. CHIEF COMPLAINT “My back is killing me. The pain is mostly sharp and stabbing, and sometimes it’s a dull ache. You’ve got to do something. Those Tramadol pills aren’t cutting it and they’ve bound me up.” “I am not sleeping because of the pain.” MEDICAL HISTORY P.M. is a retired, 81yearold male being seen for a routine health maintenance visit. He has a history of lower back pain, morbid obesity, hypertension, hypothyroid, occipital lobe stroke, bilateral total knee arthroplasty, GERD and sleep apnea. Now reporting pain in feet. He has been a smoker for the past 64 years, reporting 12 ppd. He is accompanied by his wife of 62 years. CURRENT MEDICATIONS Tramadol 50100 mg p.o. Q 12 hrs prn back pain Atenolol 25 mg p.o. Q a.m. Levothyroxine sodium 125 mcg p.o. Q a.m. Clopidogrel 75 mg p.p. Q a.m. Ibuprofen 600 mg ii p.o. prn knee pain Aspirin 650 mg p.o. prn “when I can’t get to sleep” ...
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...& & & & & Diastolic (mm Hg) < 80 < 85 85-89 90-99 100-109 > 110 *Not taking antiHTN drugs & not acutely ill. When SBP & DBP fall into different categories, highest classification should be used. Isolated systolic HTN defined as SBP > 140 and DBP < 90 and staged appropriately. In addition to classifying accordingly, clinicians should specify presence or absence of target organ disease & additional risk factors + Optimal BP with respect to CV risk is < 120/80; unusually low BP’s should be evaluated for clinical significance. ++Based on avg. of 2 or > readings taken at each of 2 or > visits. Why treat hypertension? • Increased risk of the following with increased BP – CVD (nonfatal and fatal) – CHD – Stroke – Renal disease – All cause mortality THE HIGHER THE BP THE HIGHER THE RISK Why treat hypertension? • Major risk factor for CHD – Accelerates atherosclerosis – Atimulates...
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...MEDICAL-SURGICAL NURSING NERVOUS SYSTEM Overview of structures and functions: Central Nervous System Brain Spinal Cord Cranial Nerves Spinal Nerves Sympathetic nervous system Parasympathetic nervous system AUTONOMIC NERVOUS SYSTEM Peripheral Nervous System Autonomic Nervous System Sympathetic Nervous System (ADRENERGIC) - Involved in fight or aggression response. - Release of Norepinephrine (cathecolamines) from adrenal glands and causes vasoconstriction. - Increase all bodily activity except GIT EFFECTS OF SNS - Dilation of pupils(mydriasis) in order to be aware. - Dry mouth (thickened saliva). - Increase BP and Heart Rate. - Bronchodilation, Increase RR - Constipation. - Urinary Retention. - Increase blood supply to brain, heart and skeletal muscles. - SNS I. Adrenergic Agents - Give Epinephrine. Signs and Symptoms: - SNS Contraindication: - Contraindicated to patients suffering from COPD (Broncholitis, Bronchoectasis, Emphysema, Asthma). II. Beta-adrenergic Blocking Agents - Also called Beta-blockers. - All ending with “lol” - Propranolol, Atenelol, Metoprolol. Effects of Beta-blockers B – roncho spasm E – licits a decrease in myocardial contraction. T – reats hypertension. A – V conduction slows down. Should be given to patients with Angina Pectoris, Myocardial Infarction, Hypertension. ANTI- HYPERTENSIVE AGENTS 1. Beta-blockers – “lol” 2. Ace Inhibitors – Angiotensin, “pril” (Captopril, Enalapril) 3. Calcium Antagonist – Nifedipine (Calcibloc)...
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...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. The diagnosis was Osteoarthritis. 6. As a nurse, you instructed Mr. Rojas how to use a cane. Mr. Rojas has a weakness on...
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...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 or for impaction 3. any of the mycin's..check for tinnitus or hearing loss 4. cloudy dialysate...always futher assess and call doctor 5.osteoporosis prevention and mgt. choose weight bearing (walking) instead of calcium if both are choices 1. Dilantin can cause gingival hypoplasia, advise good oral hygiene and freq. dental visits, IVP 25-50 mg/min...
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...American Thoracic Society ATS Statement: Guidelines for the Six-Minute Walk Test THIS OFFICIAL STATEMENT OF THE AMERICAN THORACIC SOCIETY WAS APPROVED BY THE ATS BOARD OF DIRECTORS MARCH 2002 CONTENTS Purpose and Scope Background Indications and Limitations Contraindications Safety Issues Technical Aspects of the 6-Minute Walk Test Required Equipment Patient Preparation Measurements Quality Assurance Interpretation References PURPOSE AND SCOPE This statement provides practical guidelines for the 6-minute walk test (6MWT). Specifically, it reviews indications, details factors that influence results, presents a brief step-by-step protocol, outlines safety measures, describes proper patient preparation and procedures, and offers guidelines for clinical interpretation of results. These recommendations are not intended to limit the use of alternative protocols for research studies. We do not discuss the general topic of clinical exercise testing. As with other American Thoracic Society statements on pulmonary function testing, these guidelines come out of a consensus conference. Drafts were prepared by two members (P.L.E. and R.J.Z.) and were based on a comprehensive Medline literature search from 1970 through 2001, augmented by suggestions from other committee members. Each draft responded to comments from the working committee. The guidelines follow previously published methods as closely as possible and provide a rationale for each specific recommendation. The final recommendations...
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