...Parental Preoperative Anxiety Walden University NURS4000, Section 01, Research and Scholarship for Evidence-Based Practice October 6, 2013 Management of Parental Preoperative Anxiety When a child requires surgical intervention, the process can be a stressful and frightening experience for the entire family. Some parents express feelings of guilt along with anxiety over having to subject their child to invasive procedures. Though our facility offers a preoperative program for families, it is limited in age for those 4 – 12 years old and healthy. The purpose of this assignment is to give information on a change in practice aimed at adequately managing preoperative anxiety of patients and families not eligible for the traditional preoperative preparation offered. The Problem As part of preoperative preparation in the pediatric population, healthy children ages 4 - 12 and their families are offered a developmentally appropriate Child Life preparation class. Given by the certified Child Life Specialist, this is an interactive program aimed at helping children and families understand what to expect during the preoperative, operative and postoperative periods, it consists of hands-on medical play, educational games, and a tour of the operating and recovery rooms. A week before the scheduled surgery, a Registered Nurse will contact the all families via telephone and conduct a health review along with giving preoperative and arrival instructions. Children with co-morbidities...
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...Management of Parental Preoperative Anxiety Andrea Brown Walden University NURS4000, Section 01, Research and Scholarship for Evidence-Based Practice October 6, 2013 Management of Parental Preoperative Anxiety When a child requires surgical intervention, the process can be a stressful and frightening experience for the entire family. Some parents express feelings of guilt along with anxiety over having to subject their child to invasive procedures. Though our facility offers a preoperative program for families, it is limited in age for those 4 – 12 years old and healthy. The purpose of this assignment is to give information on a change in practice aimed at adequately managing preoperative anxiety of patients and families not eligible for the traditional preoperative preparation offered. The Problem As part of preoperative preparation in the pediatric population, healthy children ages 4 - 12 and their families are offered a developmentally appropriate Child Life preparation class. Given by the certified Child Life Specialist, this is an interactive program aimed at helping children and families understand what to expect during the preoperative, operative and postoperative periods, it consists of hands-on medical play, educational games, and a tour of the operating and recovery rooms. A week before the scheduled surgery, a Registered Nurse will contact the all families via telephone and conduct a health review along with giving preoperative and arrival instructions...
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...RESEARCH DETAIL TITLE : Effectiveness and Appropriateness of Therapeutic Play Intervention in Preparing Children for Surgery: A Randomized Controlled Trial Study. RESEARCHER: 1. Cheung Li, PhD, is an Assistant Professor, Department of Nursing Studies, University of Hong Kong, Pokfulam, Hong Kong. 2. Violeta Lopez, PhD, is a Professor and Head of School, School of Nursing (NSW and ACT), Australian Catholic University, North Sydney, NSW, Australia. SUBMITTED DATE : January 25, 2007 ACCEPTED DATE FOR PUBLICATION : July 21, 2007 PUBLISHED DATE : April, 2008 JOURNAL : Journal for Specialists in Pediatric Nursing INTRODUCTION It can be observed today that nursing is a dynamic profession,both internally and externally due to constant change occurring in the profession. As a dynamic profession, nursing is responsive and is adapting to meets the needs of patients and the public.Nursing is a practice discipline, which is dependant upon a high level of professionalism,ethics and human values that demand for intellect, skills and a high sense of social responsibility.The knowledge and essential skill that increased dramatically make nurses leading and developing new services in health care delivery. Nurses roles and resposibilities will continue to change in line with the health reforms that are improving care for patients.Therefore, nurses need to be encouraged...
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...of Manic (opposite of depression) Depression • Monitor lithium lab level PP 24 • Tx of bipolar disorder involves variety of drugs used to stabilize mood. Lithium, valproate, divalproex, carbmazepine, olanzapine, oxcarbazepin, lamotregine, quetiapine, and risperidone are examples of drugs used. Only lithium is approved by FDA for use in those 12-18 years. Early treatment is key to preventing chronic, serious mental illness. Nurses are instrumental in identifying children with this disorder, providing info to families and monitoring drugs and psychotherapy. Nurses should observe for side effects to specific drug regimen used and assist parents to find resources for health care since meds and other treatments may be costly. Jepardy • Only drug approved by FDA for use in those 12-18 years diagnosed with bipolar disorder. Ativan (lorazepam) Ther. class. analgesic adjuncts, antianxiety agents, sedative/hypnotics Pharm. class. benzodiazepines Indications • Anxiety disorder (oral) • Preoperative sedation (injection) • Decreases...
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...First, you must use language that the pediatric patient can understand and accommodate the needs of the age you are dealing with. Neonates and infants are startle easily, so keep the environment as quiet as possible. For preschool and school aged children, you may need to manipulate them, but also listen to them. Second, anxiety of the separation from the parent is a big issue in pediatric surgery. There is a very short period of time to bond with the child, you must gain their trust as soon as possible. Tools to help gain the pediatric patient’s trust include: * Let the child bring their favorite toy, stuffed animal, or blanket with them. * Introduce the child to the entire surgical team. * Let the child ask questions, and be honest with answers. * Let the child make as many decisions as possible. * Allow the child’s parents to accompany them to the surgical suite if possible. Third, the child will probably have the fear of anesthesia. Most likely the pediatric patient will not understand the term unconscious, they will probably fear that they will go to sleep and never wake up. A preoperative visit can help with this, it would give the child a change to see the anesthesia equipment, touch, and play with it. Children often may notice deception and you will lose their trust quickly, even though some need to be deceived, this should only be done if absolutely necessary. Rapid induction of anesthesia should be done if possible, this decreases the long induction...
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...08 Fall Test One, Take Home Test 1,2,3 Jamella Aljumail [JAljumail@mercycollege.edu] Mercy College of Ohio REL 250:01- Death, Dying, and Bereavement Dr. Karen Elliott, C.PP.S. September 15, 2013 Question 1: Chapter 3 discusses the understanding of death in the Native American, African, Mexican, Asian, Celtic, and Hawaiian cultures. Choose ONE of the cultures discussed and state specifically what, in that culture’s understanding of death, is particularly meaningful to you. Explain in detail WHY it is meaningful. Mexican cultures “joked about death and poke fun at it in their art, literature and music”. In early times Aztecs believed in the sacrificial rights. Aztecs believed that a person who was a sacrificial victim was known to be the “divine dead”. Mexicans also believed a way a person lives, that’s the way a person will die. “Tell me how you die and I will tell you who you are” (DeSpelder and Strickland, 2005). Mexicans decorate graves and death is apart of everyday life in the Mexican culture. Mexican cultures have a day to celebrate the dead called El Dia de los Muertos. The celebration begins the evening of November 1st and goes into the next morning. Mexican also believe that “shedding to many tears and excessive grief may make the pathway traveled by the dead slippery” (DeSpelder and Strickland, 2005). In Islam, we follow the Quran and the beliefs that the prophet passed on to us (it states in the hadith). In my Muslim belief that the prophet (peace...
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...Single extends from nipple line to include pelvis and one thigh while double includes both thighs and lower legs. 8 Cast-brace: External support about a fracture that is constructed with hinges to permit early motion of joints, early mobilization, and independence. 9 Cylinder Cast: Can be used for upper or lower extremity e.g. fracture or dislocation of knee or elbow dislocation. Complications of Casts * Pressure of cast may cause necrosis, pressure sores, and nerve palsies. * Compartment syndrome * Cast syndrome associated especially of body cast, resulting to nausea, vomiting, and abdominal distention; superior mesenteric artery syndrome, resulting in diminished blood flow to the bowel and intestinal obstruction; Acute anxiety reaction symptoms associated with confinement in a space. * Thrombophlebitis * Psychological reaction (e.g., depression) associated with immobility, dependence, and loss of control. Nursing...
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...Children are more susceptible to postoperative airway complication, during the period of extubation, to post anesthesia recovery phase. AT surgery combined with anesthetic implications on swallowing reflex and blood and secretions in the airway places the children at higher risk for adverse airway events during the postoperative period. Any airway complications, regardless of the severity, can lead to morbidity and mortality among children. The airway is the most critical safety issue among children, and any adverse events can result in prolonged recovery time or even inpatient hospitalization. The anesthesia provider and PACU personnel carry a high level of vigilance to minimize airway complication among postoperative children. Anxiety is one of the most challenging aspects of pediatric surgical patients, and apart from behavioral and psychological therapy, midazolam plays an enormous role during the preoperative period. Apparently, midazolam sedation impairs the swallowing reflex under therapeutic doses.10 The cerebral centers have some degree of voluntary control over the laryngeal reflexes during conscious state, resulting in regaining control of respiration after a potential aspiration episode...
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...History and Physical Assessment: a. Biographical Data: A.G. is a 56 year old Hispanic male who is married with three children. All three children are young adults and living at home. He completed the sophomore year of high school, and works in the fields. Patient can communicate efficiently in English, but more articulate in Spanish. He is insured by Blue Cross. The patient’s primary diagnosis is ascending colon polyp. The operative procedure is DaVinci assisted Laparoscopic right colon resection possible ostomy. Patient was able to answer most of the questions. His wife translated whatever needed more explanation. Client’s Current Health Status b. Chief Complaint: Patient stated his chief complaint was that the doctor advised surgical removal of a polyp. “I went to the doctor because of my age {56} for a colonoscopy and the doctor said I had 3 polyps. The doctor got the other two polyps but said he must cut out the polyp or it will rupture in the colon” c. Presenting Symptoms: No apparent evidence of pain. The onset of his diagnosis began when A.G. was having a diagnostic test done. A.G. went to the doctor on January 23 for a routine colonoscopy and found out during the test that the third polyp was too big, but benign. A.G. states “The location of the polyp was in the right side. It is localized in a small area, a couple of inches of the bowel” A.G. states he feels no pain. Due to the location of the bowel, there are no signs or symptoms that A...
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...Immediate Post Operative Care 2 The following essay will use a systematic approach to critically evaluate the care and treatment delivered to a non-elective paediatric orthopaedic patient within the Post Anaesthetic Care Unit (PACU) by a student Operating Department Practitioner at a local trust hospital. The assessment and management of the patients care will be examined and rationale provided for strategies employed during delivery of individualised patient care. In accordance with Health and Care Professional Council’s standards of conduct, performance and ethics (HCPC, 2012) the confidentiality of the service user will be up held at all times. The service user shall be referred to as “Daisy” to protect her confidentiality. Daisy was received to the PACU after surgical stabilisation of her left fibula and tibia with flexible intramedullary nails following a fall. A specified paediatric bay was utilised enabling the patient to be cared for separately from the adults in the PACU (RCOA, 2013). Anaesthetic and surgical handover was received (RCOA, 2013) which detailed that she was 14 years old with no known allergies. She had no significant medical history. She had a general anaesthetic with 140mfg of Propofol used on induction followed by Sevoflurane as a maintenance agent. 30mg of Atricurium, 4mg Dexamethasone, 4mg Ondansatron, 10mg Morphine and 1g Paracetemol had been administered intraoperatively. 1 litre of Hartmanns solution had been administered during surgery and...
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...Introduction The last few years have seen an increase in research in the treatment of childhood cancer. Such research is essential for understanding common challenges that arise after the difficult cancer diagnosis experience and may lead to better strategies and interventions for anticipating and mitigating the adverse impact of cancer on the child and his or her family giving a more holistic approach to care. From this case study, one can immediately notice that family Cauchi have passed through a lot of hardships over a short period of time. Over three weeks they have faced the diagnosis of cancer, prolonged hospitalisation, and a disrupted routine, together with surgical and invasive procedures, intensive treatment along with adverse side-effects, as well as changes in the child’s body image and in his habitual personality. In its first section, this assignment will give an overview of the initial diagnosis and acute phase of the leukaemia treatment. In light of literature, the following section will discuss and evaluate interventions carried out to prevent, reduce and manage adverse side-effects, in order to maintain the overall physical health of the child. Subsequently, the impact of the illness experience on the child, sibling and the parents is addressed from a psychological, social and spiritual point of view. The nurse’s role in providing support, information and education throughout hospitalisation, as well as in preparation for discharge, is outlined...
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...hidden maxillary tooth in infra-orbital space following trauma. Pediatric dental injuries leading to traumatic tooth displacement is common in children, although it very rare and sometimes challenging to diagnose and treat traumatically embedded tooth in vital tissue spaces which may lead to serious complications if ignored. Case report- A 4-year old male child was brought with injuries on his face and mouth and swelling over left side of face, resulting from fall. The intra-oral examination revealed absence of all maxillary incisors. The paranasal sinus view showed a vague tooth-like object embedded in the floor of left orbit. The correct location and type of tooth could not be ascertained till the end of procedure. Comments- The above case is about the importance of seeking every tooth lost in trauma. It discusses complications of not following standard protocol for diagnosis and treatment in such rare cases. Key Words: dental trauma, embedded tooth, hidden, infra-orbital space, seeking, standard protocol. Introduction...
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...WRITING AN EFFECTIVE RESEARCH PROPOSAL The purpose of this handout is not to teach you how to design a research project. Rather it is to help you translate your research plans into an effective research proposal. A well-written proposal will ease the process of obtaining institutional and ethical approval and will increase your chances of obtaining funding for your project. The writing of this booklet was guided by our experience writing proposals but also on our experiences as reviewers on institutional and granting agency review panels. The booklet is designed for health sciences researchers conducting quantitative, clinical research. However, the general concepts are applicable to most areas of inquiry. Writing an Effective Research Proposal 2 ELEMENTS OF A RESEARCH PROPOSAL ∗ ∗ ∗ ∗ ∗ ∗ ∗ Title Abstract Study Problem Rationale/Relevance of the Project Literature Review Specific Study Objectives Research Methods I. Study design II. Subjects Inclusion/exclusion criteria Sampling Recruitment plans Method of assignment to study groups III. Data collection Variables: outcomes, predictors, confounders Measures/instruments Procedures IV. Intervention V. Statistical considerations Sample size Data analysis Ethical Considerations Consent form Privacy of information Work Plan Budget Research team Dissemination Plan 3 ∗ ∗ ∗ ∗ ∗ Writing an Effective Research Proposal KEYS TO SUCCESS TO WRITING A GOOD PROPOSAL Overall Quality of the Study ∗ Good research question...
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...SITUATIONAL ANALYSIS OF THE ROLE OF THE STAFF NURSE IN THE CONTEXT OF INTER-PROESSIONAL WORKING. The aim of this assignment is to discuss the role of the nurse in the context of the inter-professional team. Discharge planning will be discussed and analysed incorporating relevant knowledge such as teamwork and role enhancement. Relevant social, economic and health policies such as clinical governance will be discussed. Perspectives of each of the principle professional groups including myself as a third year student nurse, will be incorporated and collaborative team working addressed. The Department of health (2002) describes discharge planning as a pathway used to decide patient needs, for a smooth move from one level of care to another (Hunt 1996) and is the process through which patient’s needs are identified and plans are written, facilitating continuity of health care (Jackson 1994). According to the department of health (2000) discharge planning illustrates well, the role of the nurse within the inter-professional team the balance between goals set, care delivered and evaluation of care from a nurse and team perspective. Nurse involvement is considered integral and, aims to provide effective discharge plans (Department of Health 2000). The Royal College of Nursing (RCN 2002) supports the concept of nurses taking the lead and recommends the development of nurse led protocols in discharge planning. However the NMC (2004) highlights the importance of nurses being able...
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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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