...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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...There are eight things that I learned when reviewing the patient safety goals of 2008. The first important lesson that I learned was about improving the accuracy of patient identification. It is always important to use at least two patient identifiers when providing care, treatment or services. No matter how silly it may seem, having the correct patient is tantamount. The next patient safety goal is regarding how to improve the effectiveness of communication among caregivers. I found it to be critical to understand the proper way in which to transfer information from one person to the next. Having a standardized system for information sharing is a key part of patient safety. The third principle that I learned was in regard to improved safety of using medications. It is crucial to label medication containers, as well making an annual list of drugs that look alike or sound alike. Making sure that drugs do not get confused or mixed up is definitely going to keep patients more safe. Another concern regarding patient safety is the concept of reducing the risk of health care-associated infections. This can be achieved by maintaining a high level of hand hygiene and by closely monitoring unexpected deaths or major loss of function associated with health acquired infections. The subject of accurately and completely reconciling medications across the continuum of care is pertinent to keeping patients safe. In order to accomplish this, a process needs to be in place...
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...Baderman Island Resort Executive Summary Baderman Island is accepting design bids for its seasonal annual marketing campaign. Team B is asked to design the following: * An 11” x 14” poster designed for print delivered as an unflattened PSD file smaller than 10 MB. * A 300 x 300 pixel web advertisement delivered as an unflattened PSD file smaller than 10 MB and a flattened JPEG of no more than 200 KB. * The color scheme must be consistent with the color scheme established on the Baderman Island website. * Both the poster and web advertisements to include the Baderman Island logo, located in the banner at the top of the Baderman Island home page. * Designs to include at least three different examples of text to include: The Baderman Island motto. A new additional slogan created by Design Team B. The company name Baderman Island, modified from text into a graphic. In order for Team B to create these designs, it is beneficial for them to learn more about the Baderman Island Resort, such as the accommodations, amenities, and restaurants. The site also has a blog that could be useful in finding out what guests look for most when coming to visit Baderman Island Resort. History “Welcome to Baderman Island: where paradise is reality.” "Established in 2004, leisure and convention center focused Baderman Island is dedicated in providing unique and quality experiences to Island guests and daily visitors. The Board of Directors and operational...
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...Club Med 'The Club Med (A) case is a big-picture case that examines the strategy of an international chain of all-inclusive vacation resorts. It outlines the forces that shape the industry's structure, and presents the particular factors that contribute to Club Med's success. Of critical concern are the potential areas where Club Med can establish a defensible competitive advantage. What are the essential ingredients of Club Med’s service-delivery system? Can the process be appropriated? We think the Club Med has diverse unique service-delivery system such as AI(all-inclusive) vocation package Unique concept to GM that means nothing to worry about except relaxing and enjoying themselves Guest-friendly talented Staff Advance distribution network for example indirect sales through travel agencies as well as direct sales to customers “Word of Mouth” of market strategy Location for eco-friend resort environment Customer centralized information: easy to use and share for future opportunity What are the determinants of service quality at Club Med? We think the Club Med has diverse unique systems. For example The Club Med has a lot of talented GO having passion and energy for customer’s satisfaction The Club Med rotate its GOs from one resort to another every 6 months, resulting in new ideas and better practices In pricing strategy, the Club Med provide a service with all-inclusive approach and provide membership programs. The Club Med think Word...
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...Baderman Island HM/486 02 December 2013 University of Phoenix Professor Lequrica Gaskins Baderman Island Baderman Island offers guests an all-inclusive vacation, destination wedding, or conference experience. Part of the Baderman Island mission statement includes offering price ranges for all budgets while providing a premium guest experience. The property, on an island in the Kelsey River boasts a size of approximately 930 acres. The lodging options include The Tenney, a couple’s retreat featuring only suites, The Melancon Conference Center, equipped to handle groups of nearly any size, and The Baderman Main Hotel, which accommodates the largest variety of guests. The main hotel caters primarily to family vacationers, and the facility is designed to accommodate all ages. In addition to the various lodging options, Baderman Island also hosts food services including several fine dining restaurants, cafes, and bistros. Currently reservations for dinner at any of the fine restaurants can be made online. The island features spas, art galleries, and boutiques as well as gift shops. The convention center offers full event services including access to recreational pursuits popular with conference attendees. These include an 18-hole golf course, water sports, and a botanical garden. The garden property alone consists of nearly one third of Baderman Island’s total acreage. At 375 acres, the Botanical Gardens offer some of the most intriguing of...
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...Case Analysis Club Med Luya Li (999651880) Lec 02 Professor Tarun Dewan 23rd January 23, 2015 OVERVIEW Club Mediterranee, or Club Med, is a corporation in the hotel and travel industry. It was originally founded as a sports association by a group of French sports enthusiasts in 1950, as the customer demand and business opportunities increased, it transformed from an association into a travel company with the help of the managing director Gilbert Trigano. Club Med created the all-inclusive vacation concept and later became the market leader in the resort industry. Throughout the years, the corporation had enjoyed financial growth and geographically expanded its business throughout the world. In 1984 and 1985, both Club Med S.A and its subsidiary, Club Med. Inc. went public and offered their shares on major stock exchange. However, the company should pay close attention to its potential weakness given the pace of commerce and heated competition. This report will list the comparative advantages of Club Med and explain the reasons for its success over the past years. It will also highlight the company’s unique corporate culture. Moreover, the report will point out Club Med’s potential problems, and provide recommendation in regards to Club Med’s future strategy. ANALYSIS Club Med’s success can be measured both financially and non-financially. After transforming into a travel and hotel company, Club Med further expanded its business by forming the U.S. subsidiary...
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...Rehabilitation of Acromioclavicular Joint Separations: Operative and Nonoperative Considerations Mark P. Cote, PT, DPTa, Karen E. Wojcik, MSPT, ATCb, Gregg Gomlinski, MSPT, CSCSb, Augustus D. Mazzocca, MS, MDa,* Acromioclavicular joint (AC) separations are one of the most common injuries seen in orthopedic and sports medicine practices, accounting for 9% of all injuries to the shoulder girdle.1–3 Various operative and nonoperative treatment schemes have been described for the management of AC joint injuries.4–33 Although considerable controversy exists over the efficacy of surgical reconstruction versus nonoperative intervention for grade III type injuries, grade I and II separations seem to respond favorably to conservative management. Conversely, grades IV, V, and VI often require surgical reconstruction. Regardless of the type of injury, rehabilitation as a part of conservative management and postoperative care plays an important role in the management of these injuries. This article presents the authors’ rehabilitation approach to treatment of acromioclavicular separations pre- and postoperatively. CONCEPTUAL FRAMEWORK To provide instruction and insight for rehabilitation clinicians, protocols are often provided for a specific injury or procedure. A protocol is a system of rules or procedures for a given situation. Although intended to be informative, protocols often result in a restrictive list of exercises and arbitrary time frames that a clinician...
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...IMPLANT DENTISTRY / VOLUME 20, NUMBER 5 2011 331 Identification and Treatment of Bisphosphonate-Associated Actinomycotic Osteonecrosis of the Jaws Cameron Y. S. Lee, DMD, MD, PHD,* Francis D. Pien, MD, MPH,† and Jon B. Suzuki, DDS, PHD, MBA‡ isphosphonates (BPs) are a pharmacologic class of synthetic analogs of inorganic pyrophosphate that has an affinity for calcium.1 They are used in the treatment of various malignant and benign metabolic conditions, such as hypercalcemia of malignancy; Paget’s disease of bone; multiple myeloma; and metastases from distant sites such as breast, thyroid, prostate glands, and lung. The oral form of BPs is indicated in the management of osteoporosis, fibrous dysplasia, and most recently, osteogenesis imperfecta in the pediatric population.2,3 Currently, there are 5 bisphosphonates in clinical use: alendronate (Fosamax; Merck, Whitehouse Station, NJ), risedronate (Actonel; Proctor & Gamble Pharmaceuticals, Cincinnati, OH), ibandronate (Boniva; Roche Pharmaceuticals, Nutley, NY), zoledronate (Zometa; Novartis Pharmaceuticals, East Hanover, NJ), and pamidronate (Aredia; Novartis Pharmaceuticals). All 5 medications differ in their binding affinity to bone, potency, and duration.2–5 B Osteonecrosis of the jaws (ONJ) is a condition characterized by necrotic exposed bone in the jaws of patients receiving intravenous or oral bisphosphonate therapy. A review of the medical and dental literature reveals that the pathoetiology of ONJ remains...
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...Family Health Nursing and a Healthy Environment Family health nursing provides the “conceptual foundations of family nursing across the life span” (Garwick, 2002, p. 284). “The Family Health Nurse (FHN) concept was developed by the World Health Organization (WHO) in Europe in order to provide a means to strengthen family and community-oriented health services” (West and Macduff, 2006). WHO defines family health nursing as presenting a “key contribution within a multi-disciplinary team of health care professionals in the attainment of the 21 health targets” produced by the World Health Organization 21-policy outline. Family systems frequently change as the members of a family adapt to the stress that is inherent to illness and/or injury. Families adapt to the stress, making use of family resources and capabilities, but they often need help in making these adjustments (Servonsky and Gibbons, 2005). In aiding families, nurses employ care that is culturally competent care that uncovers a family’s personal story that reveals both the strengths and the deficits of a family, illuminating where they require assistance within a specific health care system (Servonsky and Gibbons, 2005). Denham (2003) points out that a great deal of nursing concentrates on the individual. However, it is the family and the home that should garner more attention from healthcare professionals because it is within the home "where health is learned, lived, and experienced),” as well as being the "niche...
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...Review Article Knee Surg Relat Res 2012;24(4):193-200 http://dx.doi.org/10.5792/ksrr.2012.24.4.193 pISSN 2234-0726 · eISSN 2234-2451 Knee Surgery & Related Research Patellofemoral Osteoarthritis Young-Mo Kim, MD, PhD and Yong-Bum Joo, MD, PhD Department of Orthopedic Surgery, Research Institue for Medical Sciences, Chungnam National University School of Medicine, Daejeon, Korea Patellofemoral arthritis is a fairly common disease, and it has been gaining interest with increasing number of studies due to its diverse treatment methods. Patellofemoral arthritis has a broad range of management options according to the characteristics of individual diseases. Identifying whether patellofemoral arthritis is the primary cause of knee pain and is compartment arthritis is necessary for establishing an adequate treatment method. rough investigation of the literature, the issues of recent knowledge of femoropatella arthritis and the diagnosis and treatment of which were studied. Key words: Patellofemoral arthritis, Diagnosis, Treatment. Introduction Unicompartmental arthritis of the knee generally refers to not only tibiofemoral arthritis but also to disorders of the patella and the cartilage. In particular, isolated patellofemoral arthritis is a relatively common disorder for which there has been increasing research regarding its treatment methods. Patellofemoral arthritis occurs due to the loss of the cartilage of the patella and the trochlear groove in approximately half...
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...Benchmarking Productivity in Nursing is Useful Benchmarking is a quality improvement tool that determines who the best is, who sets the standard, and what the standard is. There are two main purposes for benchmarking. The first is to identify best practices to be applied in measuring and improving performance in an organization. The second purpose is to seek ways to improve the delivery of service through the efficient use of staff. For health care managers who are responsible for a variable expense cost center or department, maintaining appropriate levels of productivity is one of the greatest and ongoing challenges of the management process and requires constant research and advice regarding relevant productivity standards. Comparing one’s departmental operations with other successful operations of another organization is a useful source of benchmarking data and many health care managers depend on associates or outside consultants to provide data to assist in implementing new and effective strategies to improve staff productivity. There are three sources of productivity standards. The first source is internally developed historical standards where standards are based on past performances but do not provide information about relative efficiency. The second source is engineered standards where internal staff or outside consultants conduct a study of the work environment and define normal standards of productivity. The third source is a comparative group standard...
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...Effective Communication Techniques in the Health Care Team Preceptor Experience Week One In this assignment I will throw light on my first clinical week that I had to observe the effective communication skills on the med surgical floor. As I started my day, the charge nurse was assigning patients to the dayshift. As the patients were assigned, the nurses started their shift report from the night shift in the break room. In this report, they discussed the patients diagnosis, previous medical history, labs and all pertinent information about each assigned patient. On the med surg floor, we get the opportunity to experience all areas of patient care with patients coming from surgery, emergency department, direct admit, and transferred from other floors. The main focus on the med surg floor is providing a wide variety of patient care which includes taking vital signs every four hours, administering medications, treatments such as dressing changes and evaluation of all the treatments. The nurses have to interact with the doctors, respiratory therapists, physical therapists, pharmacists, laboratory and all members of health care team in order to give better patient care. After the shift report, the LPN gets the patients vital signs, the RN checks the patients lab reports, and calls the doctors to tell them about their patients abnormal lab values. The doctor gives a verbal order over the phone, which the nurse documents on the patients chart, and reads the order twice to the doctor...
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...------------------------------------------------- BROCHURE ON CALIFORNIA STATE MANDATED NURSE PATIENT RATIO. Does mandating Nurse-Patient ratio improve care? Information for nurses and patients. BY SHINY EDWARD RN UNIVERSITY OF PHOENIX JULY 8, 2012. ------------------------------------------------- BROCHURE ON CALIFORNIA STATE MANDATED NURSE PATIENT RATIO. Does mandating Nurse-Patient ratio improve care? Information for nurses and patients. BY SHINY EDWARD RN UNIVERSITY OF PHOENIX JULY 8, 2012. Explanation of the facts, history, legislative regulations, controversial aspects and opinions Explanation of the facts, history, legislative regulations, controversial aspects and opinions MANDATED NURSE PATIENT RATIO How does it affect you and your loved ones? Nurse patient ratio for safe care means when the staffing between the nurses and the patients are safe to provide the care patients need to get well in the hospital or nursing homes. Why is this important? Several studies have shown that patients get well faster and safer when they receive more nursing care. Even more importantly according to Linda Aiken study (2003), mortality rates and staffing ratios are closely tied. Each additional patient per RN after four patients, chances of dying in the hospital is increased by 7%.Patient on a surgical unit with patient –RN ratio of 8:1 were 31% more likely to die within 30days than those on surgical units with ratios of 4:1.Studies have shown...
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...Knee Surg Sports Traumatol Arthrosc (2013) 21:1510–1515 DOI 10.1007/s00167-012-2149-5 KNEE Patient recall of surgical information after day case knee arthroscopy R. E. da Assuncao • J. Neely • J. Lochab • ¸˜ N. Mizumi-Richards • A. Barnett • H. Pandit Received: 29 November 2011 / Accepted: 19 July 2012 / Published online: 2 August 2012 Ó Springer-Verlag 2012 Abstract Purpose Day case knee arthroscopy is frequently performed on dedicated lists designed to optimise the throughput of patients. This could affect patient recall of clinical information with clinical, ethical and medicolegal consequences. The purpose of this study was to assess patient recall after knee arthroscopy and identify potential contributory factors. Methods Seventy-two patients undergoing day case knee arthroscopy were provided with information about their surgery post-operatively and tested for recall of the information prior to discharge. All patients underwent cognitive assessment when information was delivered and again when tested. Patient recall was correlated with demographic and anaesthetic factors and a multivariate regression model was used to identify risk factors for reduced recall. Results Recall overall was poor. Significant independent risk factors for reduced recall were reduced cognitive state at the time of information delivery and a shorter time between surgery and information delivery. Duration of R. E. da Assuncao (&) Á J. Lochab Á N. Mizumi-Richards ...
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...Peritoneal Dialysis International, Vol. 23, pp. 523–527 Printed in Canada. All rights reserved. 0896-8608/03 $3.00 + .00 Copyright © 2003 International Society for Peritoneal Dialysis IS MEDICAL PROFESSIONALISM STILL RELEVANT? T reestablishing medical professionalism in the new environment (1). PROFESSION, PROFESSIONAL, AND PROFESSIONALISM: DEFINITIONS Profession is a “calling requiring specialized knowledge obtained after a long and intensive academic preparation” (Webster’s dictionary). However, the concept of profession is linked to an ethical ideal without which it cannot exist. This ideal requires an effacement of self-interest when it is required for the good of the person seeking assistance. Clearly, a profession is much more than a job. It is more an identity. Individuals give much of themselves to their professions and they receive much in return. The giving, however, always precedes and supersedes the receiving (6,7). Professional is the individual conforming to the technical and ethical standards of the profession, and exhibiting a courteous, conscientious, and generally business-like manner in the workplace. Particular obligations of the professional include respect of the individual’s human worth, trustworthiness, and protection of important values (8). As professionals, physicians should profess their values (2). They do so when they recite the Hippocratic oath, which stresses the importance of acquisition of knowledge and skills...
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