...Maslow’s hierarchy of needs, physiological needs must be met first; * Oxygen * People need sufficient oxygen for their bodies to work … duh * However, oxygen makes fires more dangerous – they burn hotter and faster with more oxygen so supplemental oxygen is risky especially when a patient smokes * Smoking leading cause of burns… * Home hazards can cause lack of oxygen (ie, carbon monoxide) * Nutrition * FDA regulates food and drugs, duh * Food in hospitals must meet certain standards and nutritional requirements * Pregnant women, young children, older adults and immunocompromised people at most risk for low nutrition * Temperature * Most people enjoy temps between 65-75 F * Hypothermia (below 95F body temp) – Old patients, young patients, patients with cardiovascular problems, people who have ingested high amounts of drugs and alcohol and homeless people are at most risk * and hyperthermia – Young children, older adults and chronically ill patients at most risk for overheating * Physical Hazards * Car Accidents * Poison * Fires * Falls * Falls are the leading cause of death in people over 64 year of age * What increases this risk: urinary incontinence, reduced vision, orthostatic hypertension, gait and balance problems, use of walking aids, and certain medications increase fall risk * * Disasters *...
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...Breathlessness The NMC 2008 states that taking care of people should always be a nurse’s first concern, treating them as individuals and respecting their dignity. COPD is chronic obstructive pulmonary disease. Chronic indicates that this is a long term condition that cannot be cured, but it can be managed effectively. COPD is caused by damaged airways in the lungs, causing them to become narrower and making it harder for air to get in and out. Asthma is a common and chronic inflammatory condition of the airways. Chronic indicates that the condition is long term that will require life long management. The British Thoracic Society (BTS) 2005 published guidelines to help patients and health care workers on how to effectively manage asthma. The inflammation of the airways causes them to be hyper-reactive and narrow easily in response to a wide range of stimuli, such as exercise, house dust mites or pets. Dyspnoeic patients have difficulty in breathing, so when approaching a patient the nurse should consider what is best for their airway. Reading the patient’s history in their notes may help indicate why they are breathless. Observe the patients positioning on the bed or chair and be sure they are positioned to maximise respiratory function, while reducing physical effort. Communication will also be a barrier between the patients and nurse because the dyspnoea will prevent the patient from being able to communicate long sentences, so closed questions should be considered...
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...The Everest disaster took 15 lives in one expedition. An unexpected storm hit while the expedition was high up on the mountain. Your actions can affect Yourself or your team, they could be life threatening. Weather it was bringing up spare oxygen or emergency supplies to keep people in a healthy state, you must do what is right for the group. Anatoli Boukreev was selfish, when he guided without oxygen that could have helped someone else who needed it if he did not need it. It also meant he would have been more drowsy and not have a lot of oxygen going to his brain, when he should have been using it so he knew what he was doing while guiding people up the most dangerous mountain. He did not carry up and emergency supplies that could have helped...
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...mucus most days for three months in a year, two years in a row. Emphysema is a disease that damages the air sacs and/or the smallest breathing tubes in the lungs. COPD is a progressive disease that makes it hard to breathe and the symptoms will get worse over time. Most cases of COPD occur as a result of long-term exposure to lung irritants that damage the lungs and the airways. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. One of the greatest challenges for LaToya is to stop smoking. According to the Center for Disease Control (2012), the most important step a smoker can take after getting a COPD diagnosis is to quit. Not only will it make breathing easier, but it will cut down on the risk of severe exacerbations. Health History A health history contains both the subjective and objective data. Obtaining the subjective data is an important first step in treating the patient. The subjective data includes the history from the patient. It should include the client’s perception of their own health. The patient needs to be able to understand the questions being asked and communicate...
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...Home Safety Assessment Safety Assessment July 28, 2013 Safety Assessment 2 M. H. is a 74-year-old Caucasian female who lives with her husband and two grandchildren in one story modest home in a rural area in northern Texas. A safety assessment was performed on a Friday afternoon on July 26, 2013. Marian was willing to participate in the safety assessment and these finding are the result of the safety assessment. M. H. uses a walker due to Rheumatoid arthritis and shortness of breath from COPD. She uses oxygen continuously and has enough tubing to allow her to ambulate to the restroom and kitchen without moving the concentrator. When entering her home there is a ramp, which is clutter free, and in need of repair due to soft areas in the wood, with a secure handrail on the left only. Marian H. flooring has areas of ripped vinyl around the kitchen table and the carpet in the living area and bedrooms have areas that are torn. No throw rugs are noted in the house. There are secure locks on the front and back door to keep intruders out. Her husband...
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...COPD All respiratory diseases characterized by chronic obstruction to airflow fall under the broad classification of COPD, also known as chronic airflow limitations (CAL). COPD is a condition of chronic dyspnea with expiratory airflow limitation that does not significantly fluctuate. Within that broad category, the primary cause of the obstruction may vary; examples include airway inflammation, mucous plugging, narrowed airway lumina, or airway destruction. The term COPD includes chronic bronchitis and emphysema. Although asthma also involves airway inflammation and periodic narrowing of the airway lumina (hyperreactivity), the condition is the result of individual response to a wide variety of stimuli/triggers and is therefore episodic in nature with fluctuations/exacerbations of symptoms. Asthma: Also known as chronic reactive airway disease, asthma is characterized by reversible inflammation and constriction of bronchial smooth muscle, hypersecretion of mucus, and edema. Precipitating factors include allergens, emotional upheaval, cold weather, exercise, chemicals, medications, and viral infections. Chronic bronchitis: Widespread inflammation of airways with narrowing or blocking of airways, increased production of mucoid sputum, and marked cyanosis. Emphysema: Most severe form of COPD, characterized by recurrent inflammation that damages and eventually destroys alveolar walls to create large blebs or bullae (air spaces) and collapsed bronchioles on expiration (air-trapping)...
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...daytime that results in fatigue and falling asleep during the day. Other symptoms that are less frequent include fragmented sleep, sensation of chocking and sore throat after awakening, poor concentration, morning headaches, irritability and depression. (3) The diagnosis of OSA is made through a polysomnography (PSG), which is an in-laboratory test that monitors the oxygen level, brain waves activity, and breathing patterns of the patient during sleep. After the PSG, a differential diagnosis is made to eliminate other sleeping...
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...the majority of nurses stations in any location. The true value was to see how important it is to be well prepared for each home visit. The necessary knowledge, skills, documentation, and medical supplies as it pertains to a specific client. Principles learned were the importance of verification of current doctor’s orders for treatment, prescribed medications, and follow up visits required. Observations for client safety included, placement of furniture, unobstructed floor space for walking, medical equipment, cleanliness, proper food storage, compliance with medications and instructions. The practice of proper hand hygiene before and after the visit, client assessment, teaching and education. Proper documentation of the visit was written in detail and a copy provided to the client. The following factors may be considered in all areas of nursing care in any setting: level of self-care, ability for activities of daily living; level of nursing care needed; prognosis; education needs; mental status; level of compliance with instructions from healthcare professionals. Ways in which the nurse adapted care to the home setting are briefly stated in the following: Changing a Foley catheter on a male client, setting up a sterile field while kneeling on the floor as the client was sitting at the edge of the bed; setting up an IV without an IV pole or pump using a clothes hangar and a curtain rod over the bed to attain the necessary gravity flow; writing out new requests for doctor to...
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...deliver health care from providers to clients. There are certain effects of using mobile technology blood pressure monitoring, checking glucose level, oxygen level and heart rate, etc. Monitoring Patient Vital Signs via Mobile Computing Versus In-Patient Visits Vital signs are key indicators of a patient overall health status. We are at a point in time where temperature, heart rate, blood pressure, glucose levels, oxygen levels, and respiratory rates can now be taken via mobile technology. There was a time when patients had to travel to the doctor’s office or other health care facilities in order to have these vital tests done. It was also the norm to have a health care provider doing these tests in person and writing down the results. These results were input into a chart or a computer system by the provider who took them. Sometimes it was documented right away or hours later when time allow. Mistakes were also a factor because the health care provider input the wrong information and this sometimes impacted the patience in a negative way. With the introduction of technology in health care, patient stats can be a lot more accurate and yield a better outcome. The use of smart phones and wireless technology devices has allowed patients to monitor vital signs and upload this information to their health care provider’s information systems. Patience is also able to do videoconferencing using...
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...Closed circuit rebreathers will revolutionize the underwater diving industry. Individuals will enjoy extended underwater experiences and be more comfortable while diving. Instead of hearing bubbles, individuals will enjoy the natural sounds of hundreds of fish and turtles that surround them. Being engulfed with clouds of fish, they will forget that they are actually diving. Safety features built into the rebreather eliminates the risk of nitrogen narcosis when operated within recreational limits. This frees individuals to enjoy the diving experience, which was unheard of before the invention of the rebreather. By controlling and maintaining the partial pressure of the gasses, one breathes at depth, thus restricting the nitrogen loaded into his or her system. After the dive, the circulatory system is cleaner than when the diver entered the water. The air all humans breathe contains 21% oxygen, 79% nitrogen, and slight trace gases. Circulatory systems maintain these averages. However, when using a rebreather, it changes these parameters to 45% oxygen and 55% nitrogen at a prescribed depth. Imagine the consequences; divers will no longer have a "NO-FLY" restriction after diving, so the long- anticipated diving vacation can be enjoyed right up to the time the flight leaves. The only thing that stands between them and experiencing the Closed Circuit Rebreather diving vacation is training. Closed Circuit Rebreather Closed circuit rebreathers will revolutionize...
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...concentration of the hydroxide ions (Ebbing, 1990). When looking at the pH levels for aquatic life the ideal levels are a pH of 5-9 which allows most aquatic organisms to survive and thrive. Testing of pH levels along with Dissolved Oxygen (DO) levels were determined using electronic meters which were calibrated prior to each use. Dissolved oxygen is the amount of oxygen dissolved in the water for use by aquatic life. Fish and other aquatic life cannot split oxygen needed to breathe leaving DO levels very important for their survival. Numerous scientific studies suggest that 4-5 ppm will support a diverse fish population while most good fishing waters average about 9ppm (Lenntech, 2010). Other testing conducted was on the turbidity and amount of fecal coliform bacteria contained in the waters. Fecal coliform bacteria were measured using the membrane filtration method filtering different sized portions of the sample into a petri dish which was then incubated and checked for colony growth. Turbidity is the measure of water clarity meaning how much light can pass through the water due to materials being suspended. High turbidity allows less light to pass resulting in reduced photosynthesis leaving less DO for aquatic life. Turbidity was measured using a Secchi disk to determine the transparency of the water. Results: Water Quality: In looking at the macroinvertebrate results site 1 primarily contains creatures that are pollution sensitive such as Mayfly nymphs...
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...Why Quit Smoking? You can reduce your risks. Smoking is the most important preventable cause of premature death in the United States. Smokers have a higher risk of developing many chronic disorders, including atherosclerosis — the buildup of fatty substances in the arteries — which can lead to coronary heart disease, heart attack (myocardial infarction) and stroke. Controlling or reversing atherosclerosis is an important part of preventing future heart attack or stroke You can modify or control six major independent risk factors for coronary heart disease: • • • • • • Cigarette and tobacco smoke High blood cholesterol High blood pressure Physical inactivity Overweight or obesity Diabetes Smoking by itself increases the risk of coronary heart disease. When it acts with the other factors, it greatly increases your risk from those factors, too. Smoking decreases your tolerance for physical activity and increases the tendency for blood to clot. It decreases HDL (good) cholesterol. Your risks increase greatly if you smoke and have a family history of heart disease. Smoking also creates a higher risk for peripheral artery disease and aortic aneurysm. It increases the risk of recurrent coronary heart disease after bypass surgery, too. Smoking is also an important risk factor for stroke. Inhaling cigarette smoke produces several effects that damage the cerebrovascular system. Women who take oral contraceptives and smoke increase their risk of stroke many times. Cigars and pipes aren't...
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...The goal of supplemental oxygen should be a SpO2 of 88 to 92 percent or PaO2 of 60 to 70 mmHg, using titrated oxygen. (Ntoumenopoulos, 2011). Venturi masks are recommended for more precise oxygen delivery and control of FiO2. Nasal cannula may be used later in the treatment to improve patient comfort and convenience (Stoller, 2015). Arterial blood gases should be checked 30 to 60 minutes after starting oxygen therapy to ensure appropriate oxygenation without increased hypercapnia or acidosis (GOLD, 2014). Ventilatory support may be necessary during an exacerbation and can be provided by non-invasive or invasive ventilation. Bauman and Hyzy (2014) explain that non-invasive positive pressure ventilation (NPPV) is the preferred method of support for COPD exacerbation patient and has shown success in improving respiratory acidosis and decreasing respiratory rate and work of breathing. Additionally, NPPV reduces the risk of ventilator-associated pneumonia, hospital length of stay, mortality, and intubation rates. According to Allen (2014), invasive ventilation is normally avoided in the COPD population, but in situations such as respiratory distress and failure of oxygenation and ventilation it may be necessary. The decision of using invasive ventilation depends on clinical signs and symptoms, the patient’s preference for life support, and the availability of intensive...
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...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 by measuring oxygen and carbon dioxide within the arterial blood that is drawn (Pagana & Pagana, 2010). After collecting the patients medical history, and the results of all the diagnostic tests that were conducted it was determined that the patient had air and fluid accumulation in the pleural spaces in the lungs and needed to have a ultrasound guided thorocentesis to collect a sample of...
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...and metabolism. Patients can use Thermotherapy at home or in rehabilitation facilities. Thermotherapy is used to rearrange tissue temperature to create a biological response. It is designed to target, a certain tissue, without disrupting other surrounding tissues. Heat increases temperature of the skin, soft tissue, and oxygen. It can also accelerate tissue healing...
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