...line above the diaphragm.(89) This "V-line sign" can help to differentiate between fluid and air as the cause of the dark echo-poor area seen above the diaphragm with normal lung and with pleural effusions. The V line should be used in conjunction with previously described sonographic signs of pleural fluid such as, the sinusoid sign, representing the inspiratory movement of lung line toward pleural line; clearer visualization of the diaphragm and abdominal organs during inspiration; less echogenic scatter at the diaphragm; and visualization of lung tissue ‘floating’ in the pleural fluid. (Fig. 17.) (89) Easy quantification of pleural fluid in patients on mechanical ventilation may help to decide about performing thoracentesis in high-risk patients, although thoracentesis under ultrasound guidance appears to be a safe procedure. The amount of pleural fluid volume can be estimated with the simplified formula: V (ml) = 20 × Sep (mm) where V is the volume of pleural fluid, and Sep is the maximal distance between parietal and visceral pleura in end expiration. (Fig. 18.)(90) ...
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...Since the underlying cause is a viral infection, the treatment would just be waiting for the body’s natural defenses to get rid of the virus. This wait can be made more comfortable with the use of an acetaminophen to reduce fever and giving the infant lots of fluid. A pain reliever is also recommended (“How”). However, because the pleurisy is paired with pleural effusion, the pleura must be drained of the fluids to prevent further complications such as a collapsed lung. Thoracentesis is the procedure used to remove excess fluid in the pleural space by inserting a needle or tube. After the procedure a chest X-ray is performed to check if all the excess fluid is gone and if there is any lung damage from the procedure (“Thoracentesis” Lechtzin; “Thoracentesis”...
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...cause of an airway emergency? Tongue 3)How should an unresponsive casualty be positioned? Back 4)What technique should be used to open the airway of a casualty with a suspected neck injury? Jaw thrust 5)What type of lubricant do you want to use for the NPA? Water based 6)If the casualty has a broken jaw, mouth wound or his jaw is slightly closed by spasms, use the_mouth_____to__nose____method. 7.How many lobes are in the right lung? 3 8.A moist sucking or bubbling sound as air moves in and out of a hole in the chest is a sign/symptom of? Sucking chest wound 9.Which is the appropriate treatment for a sucking chest wound? Occlusive dressing 10.Which is the treatment for a tension pneumothorax? Perform needle thoracentesis 11.Which type of hemorrhage is characterized by a steady, even flow, and the blood will be dark red in color? Venous 12.The small battle dressing holds__300_____ml of blood. 13.What is the purpose of a tourniquet? Controls life-threatening extremity hemorrhage 14.What is used to treat a non-life threatening extremity hemorrhage when a pressure dressing is not effective? Quickclot 15.Which organ is the pump of the cardiovascular system? Heart 16.In which class of shock is a patient with a systolic pressure of 80/P? II 17.What is the most important step in treating shock? Treat Life threatening hemorrhage 18.What is the recommended size of a catheter used on a trauma patient? 18 19.If your patient is alert and...
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...Patient was prescribed opioids which may depress the CNS, saturation of the opioid receptors decreases the perception of pain by binding to the Mu1 and Mu2, and opioids may cause drowsiness and sedation to a certain level. Patient must be monitored to make sure that they are not too sedated due to much of dose/ saturation of opioid receptors. Patient may be unstable and unable to ambulate without assistance’ therefore patient poses as a fall risk. Optimal pain relief vary, depending type of pain, intensity and duration. Each individual patient reacts uniquely to different drugs and dosages. Each patient will absorb, metabolize, and excrete different dosages differently (LeMone, 2015, p. 163). Allergies pose a risk to the patient if he is exposed...
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...Nancy Richardson January 17, 2012 Envh 300-50 Dr. Ulirsch Better Protection Against Asbestos in the Workplace What is asbestos? Asbestos is a family of naturally occurring silica compounds (similar to, but not the same as, the silica of window glass and computer chips). These substances form fibers with varying shapes and sizes and are found throughout the earth. There are three commonly available types of asbestos; chrysotile (white asbestos) comes mainly from Canada, and has been very widely used in the US, amosite (brown asbestos) comes from southern Africa, and crocidolite (blue asbestos) comes from southern Africa or Australia. All three have been associated with cancerous and non-cancerous lung disease. Asbestos has been used often in a variety of building materials for insulation and as a fire retardant. Asbestos is usually found in older homes in pipes, furnaces, roof shingles, millboard, textured paints, coating materials, and floor tiles. However, the presences of asbestos containing products in the area in which you live, work, or go to school at is not necessarily a hazardous condition. It is only hazardous when asbestos containing products break down and become airborne then a hazardous condition is created. The clinical symptoms usually include pain in chest or abdomen, coughing up blood, difficulty swallowing, bone pain or tenderness, weight loss, slowly progressing shortness of breath and cough, often 20 to 40 years after exposure to asbestos(Medicine...
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...recommended to find the cause of the payment. These may include tests of the lung, blood tests, taking a sample of the liquid and pleura for examination in the laboratory. Essential is a fair and accurate diagnosis that identifies the cause that has caused the pleurisy. On the basis of this diagnosis is modulated therapy. If the cause is a bacterial infection they will be given appropriate antibiotics, but if it is of immunological need a corticosteroid therapy. In any case the treatment is based on: 1. NSAIDs accompanied by elastic bandage chest to relieve chest pain. It is good to note however that chest compression can have the side effect risk of lung collapse or pneumonia. 2. Bronchodilators and cortisones help relieve cough. 3. Thoracentesis for drainage of pleural fluid. The growth of pleural emissions might often be prevented by the early treatment of the early reasons listed above. Nonetheless, in specific cases, the growth of pleural effusions may not be preventable. Some pleural radiations may be kept from having so as to reoccur people experience pleurodesis, a strategy that seals up the pleural space. ...
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...Non-Small Cell Lung Cancer ENG/147 12/1/2014 Although doctors normally have the patience well-being in mind, their advice might not always be correct. Non-Small Cell Lung Cancer (NSCLC) affects many Americans every year. Most are not aware of the symptoms or what will happen after being diagnosed; knowledge is power even when facing a deadly disease. In 2011, Non-Small Cell Lung Cancer (NSCLC) has caused more than 160,000 deaths in the United States. (CDC, 2011) NSCLC is the leading cause of deaths when compared to other deadly cancers. Day after day doctors works tirelessly looking for cures with little success. While most cancers are treatable in early stages, that is not the case with NSCLC. Most patients are not aware of the symptoms until it is too late. There are many symptoms that can mirror NSCLC, making it difficult to diagnose. These symptoms are coughing, shortness of breath, wheezing and fatigue. Many Doctors will assume that you have pneumonia. It is likely they will not run any other tests unless you start having symptoms of, double vision, loss of appetite, loss of weight, and fatigue. When having these symptoms it can be unnerving not knowing what is going on. They will then begin with the fallowing tests. * Chest x-ray: This will show abnormalities in the lungs. * Complete Blood Count (CBC): This is a test that is used to calculate the “cellular or formed elements of blood.”(“MedicineNet”, 2014) * Computed Tomography...
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...plan for them, and they will except whatever he may give them. God has surrounded me with people who remind me everyday ….. My name is Alexandra Morrison. I was born and raised in Kaiserslautern, Germany and was brought to the United States by my stepfather and mother as a teenager. I currently live in Broadway, North Carolina, with my husband, daughter, and our four dogs. I have been a registered nurse for going on six years and work in a hospital one hour from where I live. I work in the Outpatient Department where we get patients ready for surgery and discharge patients after same day surgery. We also care for patients undergoing a variety of procedures such as biopsies, infusions, bronchoscopies, paracentesis as well as thoracentesis. I am one of four nurses certified to give...
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...Discussion Investigating pleural effusion which is evident on chest radiographs should follow a stepwise approach to diagnosis. Diagnosis should always begin with the clinical history, physical examination, chest radiography and followed by thoracentesis. The next step is to differentiate the pleural fluid into transudate and exudates. Analysis of the pleural fluid can narrow the differential diagnosis. Establishment of diagnosis with the analysis of pleural effusion can be done in approximately 75 percent. The gross appearance of the fluid and biochemical parameters can be key to a direct diagnosis or can be process indicating the next step. If underlying cause can be sought with the help of biochemical...
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...If a distinct mass is detected on an X-ray film or by CT or MRI, the next step is to visualize the mass using a bronchoscope. This step makes sense if the tumor is located near the large airways or main stem bronchi. If the tumor involves the lung parenchyma, meaning the small airways and alveoli, the next step is usually a biopsy. A detailed description of a lung biopsy procedure is beyond the scope of this article. Briefly, samples of the tumor may be obtained by CT guided needle aspiration, thoracentesis of a fluid pocket, and/or collection and analysis of BAL (bronchioalveloar lavage)...
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...Autonomy and Terminal Illness “Make Me Less Short Of Breath” Sally was a competent 62-year-old, who called paramedics because she was becoming more short of breath. The paramedics brought Sally to emergency room because she wanted to be “less short breath.” (Section 6 of the Hippocratic Oath, right base ethics: Sally should be treated as an individual person and not as a cancer patient.) People get scared and panic when they cannot breathe. Sally has the right to informed consent in treatment decisions. The attending physician should not sign the DNR without informing Sally. The attending physician should inform Sally that CPR is a potential treatment option, and that it entails certain benefits and risks (informed consent). CPR manually performs to maintain oxygenate blood flow to keep vital organs alive. Sally has the right to make decision about own care and the outcome of the treatment. “Sally wants to live.” I would suggest consult a pulmonologist on Sally case (Section 4 Hippocratic Oath). “A physician should act only in the patient's interest when providing medical care, which might have the effect of weakening the physical and mental condition of the patient” (World Medical Association Declaration of Helsinki). Ethical rules bind you to your duty (deontological ethics). The rights and responsibilities of the physician and the oncologist is to improve the quality of life for Sally, “make her less short of breath”, Sally should have the tharacentesis and...
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...Pulmonary tuberculosis Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs. Causes Pulmonary tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis (M. tuberculosis). You can get TB by breathing in air droplets from a cough or sneeze of an infected person. The resulting lung infection is called primary TB. Most people recover from primary TB infection without further evidence of the disease. The infection may stay inactive (dormant) for years. In some people, it becomes active again (reactivates). Most people who develop symptoms of a TB infection first became infected in the past. In some cases, the disease becomes active within weeks after the primary infection. The following persons are at high risk of active TB: * Elderly * Infants * People with weakened immune systems, for example due to AIDS, chemotherapy, diabetes, or medicines that weaken the immune system Your risk of catching TB increases if you: * Are around people who have TB (such as during overseas travel) * Live in crowded or unclean living conditions * Have poor nutrition The following factors can increase the rate of TB infection in a population: * Increase in HIV infections * Increase in number of homeless people (poor environment and nutrition) * The appearance of drug-resistant strains of TB Symptoms The primary stage of TB does not cause symptoms. When symptoms of pulmonary TB occur...
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...annoying, pleurisy tend to autorisolversi in a few days, without necessarily resorting to medications or specific treatment. The main goal of therapy is pleurisy ward off the pathogen involved in ill and resolve - in case of inflammation non-infectious - the disease that arises to basics. to relieve pain during breathing available therapeutic aids (NSAIDs), while antitussives (especially CODEINE and dextromethorphan ) are given to relieve cough. If ascertained bacterial pleurisy, the treatment of choice is made by antibiotics , as AMOXICILLIN and moxifloxacin . Even the corticosteroids are particularly suitable to alleviate the serious pleural inflammation. In the case of pleural effusion, it is recommended to proceed with the thoracentesis that, in addition to being a valuable diagnostic examination, proves to be an excellent therapeutic intervention to evacuate the pleural fluid and thus restricting the times of pleurisy healing. ...
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...This wealth of experience allows the surgeon to assimilate radiologic and laboratory studies, physical exam findings and a complicated patient course. Rapid identification and appropriate treatment of critically ill patients improves the outcomes of many conditions, including sepsis, acute myocardial infarction and hemorrhagic shock [2–5]. This requires a clinician who is comfortable reacting quickly, and often with limited data. Surgeons develop this skill early in their careers. Modern ICU care involves invasive procedures in many body regions; surgeons develop many of these basic techniques (thoracentesis, diagnostic peritoneal lavage, tube thoracostomy, percutaneous tracheostomy, decompressive laparotomy, and compartment release of the lower extremity. The surgeon who has operated on the patient has unique knowledge of the patient’s anatomy and physiology; the physician who has done the best to restore functional anatomy and physiology is best poised to guide the patient’s postoperative treatment. Furthermore, the surgeon is qualified to orchestrate surgical ICU care with operating-room management, and correlate perioperative course with later multiple organ system...
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...Nursing is a diverse and dynamic profession, with many layers that influence how care is ultimately delivered. This paper will explore some of these influences, and outline a Professional Nursing Mission Statement, with a keen look at nursing organizations, ethics, accountability, and professional practice. Mishel’s Theory of Uncertainty in Illness will be explained as a support to the mission statement and support of my personal professional practice. Additionally, two personal anecdotes will be shared regarding the ethical principles of respect for autonomy and beneficence. Functional Difference between Regulatory Agency and Professional Nursing Organization The major functional difference between a regulatory agency like a board of nursing and professional nursing organization is that a regulatory agency governs the education and licensing of nurses; actual nurse practices on the job, and discipline if the nurse falls short of governing practices (National Coumcil of State Boards of Nursing, 2015). The rules and regulations enacted by the board of nursing, after public review, “have the full force and effect of law.” (National Council Board of Nursing Nurse Practice Act 2) In contrast, a professional nursing organization is comprised of voluntary groups of nurses which provide educational opportunities, share information, and promote the profession. (Matthews, 2012) According to the National Council of State Boards of Nursing website, each state board of nursing...
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