...|CognitiveLevel||3rd Ed. Page References| |Recall|Application|Analysis|Totals|| I. PATIENT DATA EVALUATION AND RECOMMENDATIONS|11|14|1|26|| A. Review Data in the Patient Record|4|||4|| 1. Patient history e.g.,• present illness• admission notes• respiratory care orders• medication history• progress notes• diagnoses• DNR status• patient education (previous)|||||pp 33, 82, 47| 2. Physical examination relative to the cardiopulmonary system e.g., vitalsigns, physical findings|||||pp 33-35, 35-45, 47, 151-153, 153-155, 155-156, 156-158, 158-163, 175-177| 3. Laboratory data e.g.,• CBC• electrolytes• coagulation studies• culture and sensitivities• sputum Gram stain|||||pp 45-47| 4. Pulmonary function results|||||pp 47, 151-153, 153-155, 155-156, 156-158, 158-163, 191-194, 194-196, 197| 5. Blood gas results|||||pp 47, 124-126, 126-127, 127-128, 151-153, 153-155, 156-158, 158-163| 6. Imaging studies e.g.,• radiograph• CT• MRI|||||pp 33-45, 47, 151-153, 175-177| 7. Monitoring data|||||| a. fluid balance|||||pp 139-140| b. pulmonary mechanics e.g., maximum inspiratory pressure, vitalcapacity|||||pp 47, 139, 191-194, 194-196| c. respiratory e.g.,• rate• tidal and minute volume• I:E|||||pp 47, 139, 191-194, 194-196| d. pulmonary compliance, airways resistance, work of breathing|||||pp 47, 137-139, 141-143| e. noninvasive e.g.,• pulse oximetry• VD/VT• capnography• transcutaneous O2 / CO2|||||pp 20-21, 47, 137-139, 167-172, 172-175| 8. Cardiac monitoring|||||pp 35-45, 158-163| ...
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...DEVON K. WILLIAMS 6649 Federal Hall Street Plano, Texas 75023 214 450 5578 or amala8799@aol.com |Objective: To be a part of an integral part of a dynamic health care team providing quality nursing care to clients and their families. | EDUCATION | Trinity Valley Community College, Kaufman, TX Associate Degree- Nursing -Expected 2012 | | Samuel Merritt College, Oakland, CA Master-Physician Assistant 2001 | | California State University, Hayward, CA Bachelor of Science - Biology 1999 | | | | | ADN Student Clinical Experience |Fall 2009 |Medical Center of Plano, Plano Texas. Clinical time split between telemetry floor and women’s services. | | |Obstetric Rotation – Labor & Delivery, newborn nursery, and postpartum rotation performed at Wilson N. | | ...
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...Tub bath taken. Patient able to bathe self, but needed assistance getting in and out of tub. Skin on both legs dry and flaking; patient reports severe itching. Emollient lotion applied after bath. Patient states itching is less now. (Tub Bath or shower) After complete bed bath, provided back massage using pétrissage and friction. Patient reported muscle tension and rated pain a 4 before back massage; reported muscle relaxation and rated pain a 2 after back massage. Skin is moist, pink, and intact with no bruises, swelling, or redness. After back massage, patient’s respirations decreased from 20 to 16 per minute and pulse decreased from 78 to 70 beats per minute. (Back Massage) Complete bed bath given. Patient unable to assist but cooperative with turning. Skin on both legs dry and flaking, complains of severe itching. Bath oil added to bath water. Emollient lotion applied after bath. States itching is less after bath. (Complete or Partial Bed Bath) Perineal care given. Patient unable to assist but cooperative with positioning. No redness, drainage, or open areas noted. Patient complained of mild itching before perineal care. Patient reports reduced itching after perineal care. (Perineal care for Female Pt) Perineal care given. Patient unable to assist but cooperative with positioning. External genitalia show no signs of redness, swelling, or drainage. Indwelling catheter is intact and draining clear amber urine. Patient denies pain but states that he feels...
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...Chronic Critical Illness Judith E. Nelson1, Christopher E. Cox2, Aluko A. Hope1,3 and Shannon S. Carson4 + Author Affiliations 1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, and Hertzberg Palliative Care Institute, Mount Sinai School of Medicine, New York, New York; 2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; 3Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York; 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, North Carolina Correspondence and requests for reprints should be addressed to Judith E. Nelson, M.D., J.D., Box 1232, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029. E-mail: Judith.nelson@mssm.edu Next SectionAbstract Although advances in intensive care have enabled more patients to survive an acute critical illness, they also have created a large and growing population of chronically critically ill patients with prolonged dependence on mechanical ventilation and other intensive care therapies. Chronic critical illness is a devastating condition: mortality exceeds that for most malignancies, and functional dependence persists for most survivors. Costs of treating the chronically critically ill in the United States already exceed $20 billion and are increasing. In...
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...Matt Fowler RES 297 11/12/13 Evidence Based Medicine Research Assignment 1) In Vitro Evaluation of Heat and Moisture Exchangers Designed for Spontaneously Breathing Tracheostomized Patients Claudia Brusasco, MD⇑ Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Francesco Corradi, MD PhD Dipartimento Cardio-Nefro-Polmonare, Sezione Terapia Intensiva Cardiochirurgica, Azienda Ospedaliero Universitaria di Parma, Italy. Maria Vargas, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Dipartimento di Anestesia e Terapia Intensiva, Università di Napoli Federico II, Napoli, Italy. Margherita Bona, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Federica Bruno, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Maria Marsili, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Francesca Simonassi, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Gregorio Santori, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università Degli Studi di Genova, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliera Universitaria San Martino, Genova, Italy. Paolo Severgnini, MD Dipartimento Scienza ed Alta Tecnologia, Sezione Ambiente Salute Sicurezza...
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...Clinical plans are prior to arrival on the scene. 4 1.2 Patient selection Criteria for RSI 5 1.3 Steps in an RSI Procedure 6 Step 1 - Preparation 6 Step 2- Preoxygenation 6 Step 3- Pretreatment 7 Step 4- Rapid sequence Induction and Paralysis 7 Step 5- Protection and Positioning 7 Step 6- Placement of the Endotracheal Tube in the Trachea 8 Step 7- Post-intubation Management 8 1.4 Risks and benefits associated with RSI 9 Case 2 10 2.1 Discussion 10 2.2 Clinic plan and initial management 10 2.3 Notification of Arrival 11 Conclusion 11 Case 3 12 Introduction 12 Incident 1 12 Incident 2 13 Incident 3 13 Incident 4 14 Case 4 15 Conclusion 16 References 17 Introduction The basic concept of retrieval medicine is a combination of transfer and care of a patient from one medical institution, site of trauma, and pre-hospital management to a medical institution to provide higher and better level of care. The transfer and retrieval of severely ill and wounded patients entail high-risk activities (Ellis & Hooper, 2010). This paper looks into various case studies to determine the various control measures that might and should be put in place in various retrieval situations so as to increase patient safety and efficiency in pre-hospital care. This comprises of communication procedures, team resource management, audit and training important event analysis and the pre-hospital operating care clinical plan...
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...Courtesy of L E K A R SPECIAL EDITION Authors: Marino, Paul L. Title: ICU Book, The, 3rd Edition Copyright ©2007 Lippincott Williams & Wilkins ISBN: 0-7817-4802-X Authors Dedication Quote Preface to Third Edition Preface to First Edition Acknowledgments Table of Contents Section I - Basic Science Review Basic Science Review Chapter 1 - Circulatory Blood Flow Chapter 2 - Oxygen and Carbon Dioxide Transport Section II - Preventive Practices in the Critically Ill Preventive Practices in the Critically Ill Chapter 3 - Infection Control in the ICU Chapter 4 - Alimentary Prophylaxis Chapter 5 - Venous Thromboembolism Section III - Vascular Access Vascular Access Chapter 6 - Establishing Venous Access Chapter 7 - The Indwelling Vascular Catheter Section IV - Hemodynamic Monitoring Hemodynamic Monitoring Chapter 8 - Arterial Blood Pressure Chapter 9 - The Pulmonary Artery Catheter Chapter 10 - Central Venous Pressure and Wedge Pressure Chapter 11 - Tissue Oxygenation Section V - Disorders of Circulatory Flow Disorders of Circulatory Flow Chapter 12 - Hemorrhage and Hypovolemia Chapter 13 - Colloid and Crystalloid Resuscitation Chapter 14 - Acute Heart Failure Syndromes Chapter 15 - Cardiac Arrest Chapter 16 - Hemodynamic Drug Infusions Section VI - Critical Care Cardiology Critical Care Cardiology Chapter 17 - Early Management of Acute Coronary Syndromes Chapter 18 - Tachyarrhythmias Section VII - Acute Respiratory Failure Acute Respiratory Failure Chapter 19 - Hypoxemia...
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...NCLEX-RN® DETAILED TEST PLAN 2010 NCLEX-RN Detailed Test Plan ® Effective | April 2010 Item Writer/Item Reviewer/Nurse Educator Version Mission Statement The National Council of State Boards of Nursing, composed of member boards, provides leadership to advance regulatory excellence for public protection. Purpose and Functions The purpose of the National Council of State Boards of Nursing (NCSBN ) is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing. ® The major functions of NCSBN include developing the NCLEX-RN and NCLEX-PN examinations, performing policy analysis and promoting uniformity in relationship to the regulation of nursing practice, disseminating data related to NCSBN’s purpose and serving as a forum for information exchange for NCSBN members. ® ® Copyright© 2010 National Council of State Boards of Nursing, Inc. (NCSBN) All rights reserved. NCSBN , NCLEX , NCLEX-RN and NCLEX-PN are registered trademarks of NCSBN and this document may not be used, reproduced or disseminated to any third party without written permission from NCSBN. ® ® ® ® Permission is granted to boards of nursing to use or reproduce all or parts of this document for licensure related purposes only. Nonprofit education programs have permission to use or reproduce all or parts of this document...
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...SITUATION : Arthur, A registered nurse, witnessed an old woman hit by a motorcycle while crossing a train railway. The old woman fell at the railway. Arthur rushed at the scene. 1. As a registered nurse, Arthur knew that the first thing that he will do at the scene is A. Stay with the person, Encourage her to remain still and Immobilize the leg while While waiting for the ambulance. B. Leave the person for a few moments to call for help. C. Reduce the fracture manually. D. Move the person to a safer place. 2. Arthur 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...
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...ETHICAL DILEMMAS FACING NURSES ON END-OF-LIFE ISSUES BASED ON CONFERENCE PROCEEDINGS HELD IN ELDORET, KENYA Author: Kamau S. Macharia: BScN (Moi), MSc (studying) Nursing Leadership & Health Care Systems Management (University of Colorado, Denver), Higher Dip. Critical Care Nursing (Nbi). Graduate Assistant, School of Nursing & Biomedical Sciences, Kabianga University College (A Constituent College of Moi University), . P 0 Box 2030 20200 Kericho, Kenya , Tel +254 722224577, Email: symomash@gmail.com ETHICAL DILEMMAS FACING NURSES ON END-OF-LIFE ISSUES BASED ON CONFERENCE PROCEEDINGS HELD IN ELDORET, KENYA ABSTRACT Problem Statement: A conference to discuss on ethical dilemmas is thought to be a good way of airing out issues. It is unfortunate that at times a patient in our care may die no matter what we do. Profound ethical questions on end of life issues confront the medical personnel as they watch and wait helplessly. This paper touches on ethics, law, social and public policy as they affect nursing practice. Setting: This is a conference proceedings report augmented with a case study of Nelly from a local setting and compares it with two others from elsewhere which were also presented during the conference. Conference was organized by Federation of African Medical Students Associations (FAMSA), Eldoret 2011. The author was a presenter...
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...Chapter 1 Nursing Images throughout History 1) The angle of mercy 2) The handmaiden 3) The battle-ax 4) The naughty nurse 5) The military image A. Nurses on the battlefield * Hospitalers – specialized soldiers who at the end of battle returned to the outposts to care for the sick and injured * Army nursing service – organize nurses and hospitals and coordinate supplies for the soldiers during the Civil War * Clara Barton a. Provided care in tents set up close to the fighting b. Did not discriminate c. Establishment of the American Red Cross * Harriet Tubman – helped slaves escape to freedom on the underground railroad * Walt Whitman – a poet * Louisa May Alcott – an author * Dorothea Dix – union’s superintendent of female nurses during the Civil War B. Nurses fighting diseases * Florence Nightingale d. Epidemiology – the study of the distribution and origins of disease e. Air, light, nutrition, and adequate ventilation and space assist the patient to recuperate * Lillian Wald & Mary Brewster f. Founded the Henry Street Settlement in NY to improve the health and social conditions of poor immigrants g. Improve health and prevent illness by promoting safe drinking water, adequate sewage facilities, and proper sanitation Florence Nightingale (1820-1910) ...
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...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash 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...
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...NCSBN ON-LINE REVIEW 1.A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. reason for the nurse to elevate the casted leg is to A) Promote the client's comfort B) Reduce the drying time C) Decrease irritation to the skin D) Improve venous return The most important D: Improve venous return. Elevating the leg both improves venous return and reduces swelling. Client comfort will be improved as well. 2. The nurse is reviewing with a client how to collect a clean catch urine specimen. What is the appropriate sequence to teach the client? A) B) C) D) Clean the meatus, begin voiding, then catch urine stream Void a little, clean the meatus, then collect specimen Clean the meatus, then urinate into container Void continuously and catch some of the urine A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires clear directions. Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating the urine specimen. As starting and stopping flow can be difficult, once the client begins voiding it’s best to just slip the container into the stream. Other responses do not reflect correct technique 3. Following change-of-shift report on an orthopedic unit, which client should the nurse see first? A) B) C) D) 16 year-old who had an open reduction of a fractured wrist 10 hours ago 20 year-old...
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...Nursing 122 Fundamentals of Neuro-Sensory nursing --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- Review major structures and functions of both central and peripheral nervous system. (Carolyn Jarvis, Physical Examination and Health Assessment, 3rd ed., pages 688-692 Structure and function of the CNS and PNS --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- --- Potter and Perry, Fundamentals of nursing (8th), Chapter 16 p. 210-211 Types of Data --There are two primary sources of data: subjective and objective. Subjective data are your patients’ verbal descriptions of their health problems. Only patients provide subjective data. For example, Mr. Jacobs's report of incision pain and his expression of concern about whether the pain means that he will not be able to go home as soon as he hoped are subjective findings. Subjective data usually include feelings, perceptions, and self-report of symptoms. Only patients provide subjective data relevant to their health condition. The data sometimes reflect physiological changes, which you further explore through objective data collection. --Objective data are observations or measurements...
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...���������������������������������������������������������������������������������� 8 Equipment��������������������������������������������������������������������������������������������������������������������������������������������������������� 11 Drugs����������������������������������������������������������������������������������������������������������������������������������������������������������������� 11 Physical Infrastructure��������������������������������������������������������������������������������������������������������������������������������������� 11 Quality Assurance in Service Delivery��������������������������������������������������������������������������������������������������������������� 16 Patient Safety and Infection...
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