...Comp li of F.A ments . Dav is Gordon’s functional health patterns HEALTH PERCEPTION— HEALTH MANAGEMENT PATTERN Death Syndrome, risk for Sudden Infant Energy Field Disturbance Environmental Interpretation Syndrome, impaired Falls, risk for Health Maintenance, ineffective Health-Seeking Behaviors (specify) Infection, risk for Injury (trauma), risk for Latex Allergy Latex Allergy, risk for Noncompliance (specify) Perioperative Positioning Injury, risk for Poisoning, risk for Protection, ineffective Recovery, Delayed Surgical Suffocation, risk for Suicide, risk for Therapeutic Regimen: effective management Therapeutic Regimen: ineffective management Therapeutic Regimen management: readiness for enhanced Therapeutic Regimen: Family, ineffective management Therapeutic Regimen: Community, ineffective management Trauma, risk for Wandering (specify sporadic or continual) NUTRITIONAL— METABOLIC PATTERN Aspiration, risk for Body Temperature, imbalanced, risk for Breastfeeding, effective Breastfeeding, ineffective Breastfeeding, interrupted Dentition, impaired Failure to thrive, adult Fluid Balance, readiness for enhanced Fluid Volume, risk for deficient Fluid Volume Deficient [active loss] Fluid Volume Deficit [regulatory failure] Fluid Volume Deficit, risk for Fluid Volume Excess Fluid Volume Imbalance, risk for Hyperthermia Hypothermia Infant Feeding Pattern, ineffective Latex...
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...Title Here] | |OBJECTIVE: (example) |POLICY: (sample) |RESULTS: (example) | |Assess whether the new method of incontinence |Comfort Shield® Perineal Care Washcloths from Sage Products, Inc. will be |Comfort Shield’s skin cleansing/protective washcloths help me better | |cleansing and protecting (Comfort Shield® washcloths) |used on patients who are incontinent of bowel and/or bladder after each |meet the requirements of our incontinence care protocol. | |is an improvement over previous incontinence care |incontinent episode. Comfort Shield Washcloths are to be used for | | |interventions. Nursing staff opinions were polled to |incontinence care only, as part of a total patient cleansing program such |Sample results: You can | |measure the following: |as Comfort Personal Cleansing®. |create and import your | | |PURPOSE: To help treat and prevent perineal...
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...of function and quality of life usually by an interdisciplinary team. While assessing a geriatric patient, the nurse should consider that at this point in their lives a lot is going on, there is degenerative changes, multiple disorders, caregiver problems, missed or delayed diagnosis. On average, elderly patients have 6 diagnosable disorders, which their primary care giver might be unaware of A disorder in one organ system can weaken another system, exacerbating the deterioration of both and leading to disability, dependence, and, without intervention, death . The nurse should also pay particular attention to certain common geriatric symptoms (eg, delirium, dizziness, syncope, falling, mobility problems, weight or appetite loss, urinary incontinence) because they may result from disorders of multiple organ systems. Occasionally, problems of elderly patients are related to neglect or abuse by their caregiver (see Elder Abuse).The nurse also should consider the possibility of patient abuse and drug abuse by the caregiver if circumstances and findings suggest it. Certain injury patterns are particularly suggestive, including Frequent bruising, especially in difficult-to-reach areas (eg, middle of the back) Grip bruises of the upper arms Bruises of the genitals Peculiar burns Unexplained fearfulness of a caregiver in the patient. Due to their state...
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...Life Expectancy According to the life expectancy calculator, my calculated life expectancy is 85 years. I have learned that in order to have a long and healthy life, I can’t live all by myself. I expected to have my life longer than the calculated life expectancy’s because I don’t drink, smoke, and avoid most of the things that harm my health. After I used this calculator, I found out that my family’s background plays the important role in my life calculation, and regular medical check-up and exercise can also lengthen my life. I have never learned that it is necessary for me to check the good (HDL)/bad (LDL) cholesterol in every three years which also effects my life expectancy. It is truly beneficial for me to learn that the mean number for total cholesterol level is 180 mg/dl (5 mmol/L). I didn’t know that flossing daily also have the direct impact on our lives to be lengthened. I used to think that it just effects on our dental hygiene. I also realized that having too much red meat as our main course is not good for our health and can shorten my life. I can lengthen my life expectancy by changing my daily diet plans, exercising regularly, and getting regular medical check-up. Additionally, I learned that keeping the family generation record is extremely valuable for not only me but also my future generation. In addition, I need to get rid of my bad habits such as eating too much and sleeping irregularly, and floss daily. These changes will help me to lengthen my expected...
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...potty training refusal Toilet training done badly can lead to medical complications, including dysfunctional voiding, constipation and impaction-and even child abuse. This article describes in detail how to treat toilet training problems before they cause harm. Toilet training can be defined as delayed if the child is over 3 years of age, has normal development, and is not toilet trained after three or more months of training. (This definition excludes families who have not yet started toilet training.) Usually the delay is in bowel training. Taubman found that 22% of bladder-trained children were not bowel trained one month after completing bladder training.' [For information on toilet training basics, see "Toilet training: Getting it right the first time," in the March issue, accessible at wwwcontemporarypediatrics.com. ] Although the Diagnostic and Statistical Manual for Primary Care Child and Adolescent Version uses 4 years of age as a cutoff for abnormal toilet training delays, it makes sense to evaluate delays at 3 years of age to prevent ongoing harmful approaches by parents. If the parents are mishandling toilet training problems, it's a mistake to allow them to continue to do so for an additional year before intervening. If, for example, parents are punishing the child for noncompliance or forcibly holding the child on the toilet, these negative interactions will be much harder to undo and repair with time. Calling delays abnormal can wait until 4 years...
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...Top Tips for Wearer of Incontinence Pads for Adults Incontinence pads for adults or simply referred to as adult diapers are recommended for people suffering from conditions such as dementia, mobility impairment, incontinence, and experience frequent loss of bladder or bowel control. Other than people with these conditions, some pregnant women may also require such diapers as the child in the womb may push the bladder leading to immediate discharge. Thus, while such diapers provide protection against leakage and enable one to feel free while going outside, they also require to be used properly to ensure their effectiveness. Effective tips for the wearer of incontinence pads for adults Here are some important tips and methods which one should consider while using an adult diaper: 1....
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...DULOXETINE VS PLACEBO FOR URINARY INCONTINENCE DULOXETINE VS PLACEBO FOR URINARY INCONTINENCE TAMMY RILEY OKLAHOMA PANHANDLE STATE UNIVERSITY STRESS INCONTINENCE Stress urinary incontinence is the involuntary leakage of urine on effort or exertion or on sneezing, coughing, or laughing. These symptoms affect many women between the ages of 33-75 years of age. The current treatment options for stress incontinence is limited to pelvic floor muscle training, devices, behavioral interventions and surgery . EVIDENCE BASED PRACTICE GUIDELINES The title of the guideline is Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guidelines. The guideline was developed as a framework for diagnosis and treatment of non-neurogenic overactive bladder (OAB) and to provide direction to clinicians and patients regarding how to recognize non neurogenic overactive bladder. The direction of the study was to “conduct a valid diagnostic process and approach treatment with the goals of maximizing symptom control and patient quality of life while minimizing adverse events and patient burden” (National Guideline Clearinghouse, 2014). Another guideline objective was to serve as a guide for all types of providers who evaluate and treat OAB patients, including those in general practice as well as those who specialize in various branches of medicine. The guideline of the evidence based practice states that the first line of treatment...
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...“Urodynamics is a collection of tests used to measure bladder, urethral, and pelvic floor muscle function, as well as diagnose functional disorders of the lower urinary tract” (Gray, 2010, p. 321). Urodynamics is used in addition to the patient’s history and a complete patient assessment. Moore (2013) states that urodyamics encompasses a number of tests, these include: flow study, cystometry, urethral pressure profile and leak point pressure. For the purpose of this paper a urodynamic test will be analysed to highlight normal and abnormal results. Possible reasons for these abnormalities will be discussed. In this study the patient is a 42 year old lady who presented with a number of pelvic floor problems including urgency, urge incontinence and prolapse. Examination revealed a moderate cystocoele and rectocele. Urodynamic evaluation was performed in order to objectively assess bladder function and therefore assist in recommendations for further treatment. Cystometry “is a measure of bladder pressure in response to filling. Several parameters are measured: bladder filling, sensation, stability, compliance, capacity, control over micturition, detrusor contractility and empting” (Ghoniem & Khater, 2008, p. 36) Mahfouz, Afraa, Campeau, and Corcos, (2011) report that the normal parameters during filling for females are as follows: first sensation at 100-250mls, first desire at 200-330mls and strong desire at 350mls-560mls.A healthy bladder should accommodate 500mls...
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...Introduction I am going to critically appraise of research evidence on treatment of urinary stress incontinence in women with obesity. I chose this topic because currently I am working in urology department in hospital X, I am always have the chance to deal with women experiencing stress incontinence. In current practice we will teach them behavioral intervention program (pelvic floor exercise and bladder training) to lower the severity of urine leakage. That is why I want to explore more on this issue and see whether the use of vaginal cones also effective in treatment with behavioral intervention program. Obesity is a common problem in developed countries, with an incidence of 33% (Roreyt 1998), this problem may directly leading to stress urinary incontinence (Ouslander 1996) which may hinder the normal daily life of an adult. In Hong Kong Hospital Authority (HA) policy, there are no guideline in related to treatment regarding stress incontinence, it is always depends on surgeon’s preferences. Therefore I want to search for research evidence in associated with treatment of urinary stress incontinence which may beneficial in my working place. Main Body The two answerable questions formulated using PICO tool are: Quantitative Question – In women with obesity, how does behavioral intervention program compared to vaginal cones influence the occurrence of stress urinary incontinence? Qualitative Question – How do obesity women perceive the method of behavioral intervention...
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...in Therapeutics: The Pharmacotherapy Preparatory Review and Recertification Course 31 Geriatrics Learning Objectives: The following case pertains to questions 2 and 3. J.T. is an 82-year-old community-dwelling woman with a history of stage III Parkinson disease, hypertension, and urinary incontinence (UI). She is receiving carbidopa/levodopa, pramipexole, selegiline, tolterodine, diazepam, metoprolol, and hydrochlorothiazide. When she comes to your pharmacy to get her prescriptions, she walks slowly with a cane, and she is stooped over. 1. Identify age-related pharmacokinetic and pharmacodynamic changes in older people. 2. Evaluate the pharmacotherapy regimens of older people to support the maintenance of optimal physical and mental function. 3. Identify inappropriate medication prescribing in older people. 4. Recommend appropriate pharmacotherapy for patients with dementia. 5. Evaluate the risks and benefits of the use of antipsychotics (APs) (including atypical APs) in older patients with dementia. 6. Recommend appropriate interventions for patients suffering from behavioral symptoms related to dementia. 7. Identify the types of urinary incontinence and recommend appropriate treatments. 8. Given a patient’s American Urology Association Symptom Index for benign prostatic hyperplasia, recommend appropriate therapy. 9. Recommend appropriate analgesic therapy for older patients with osteoarthritis. 10. Discuss risks and benefits of medication...
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...PPR 6006: MEDICATION REGIMEN REVIEW ASSIGNMENT Mr. L is an 84-year-old man with dementia and a medical history of atrial fibrillation, diabetes mellitus (type 2), chronic kidney disease, gastritis, and gastro-esophageal reflux disease. His past surgeries include a bladder resection for bladder cancer resulting in urinary incontinence in 2010 and a lumbar decompression for spinal stenosis in 2008. He lives with his wife of 51 years, Mrs. L, who cares for him. His biggest concerns are forgetfulness, difficulty walking and falling while his wife reports that he does “almost nothing” besides watching television and following her around the house. He requires considerable help with bathing and dressing, some assistance with toileting and transferring, and was dependent in most instrumental activities of daily living, including shopping, housekeeping and meal preparation. He reports no significant pain or discomfort relative to his back problems. They are able to afford a home health aide for several hours a day to help alleviate the burden of care for Mrs. L. At this visit the examination and subsequent labs reveals the following data: BP 130/65mm Hg Pulse 58 Hemoglobin A1C 5.9% Hemoglobin 13g/dl Estimated creatinine clearance via Cockcroft/Gault 42ml/min Folstein Mini-Mental State Examination (MMSE) 13/29 – consistent with moderately severe cognitive impairment Current Medications: Glyburide 2.5mg Q AM Digoxin .125mg Q AM Warfarin titrated to INR of 2-3 Celebrex...
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...EXECUTIVE SUMMARY Urinary incontinence (UI) is any involuntary leakage of urine. It is a common and distressing problem, which may have a profound impact on quality of life. Urinary retention also known as ischuria is a lack of ability to urinate. Urinary retention is characterized by poor urinary stream with intermittent flow, straining, a sense of incomplete voiding and hesitancy causing the bladder to remain full and requires a catheter for drainage. Urinary incontinence and retention are the 2 main reasons why personal urinals are used. The biggest issues dealing with personal urinals both in hospital and public settings are the embarrassingly disgusting odors left from residue urine and more importantly the potentially dangerous bacteria and viruses that could reside on your urinal. We at Mario Medical, Inc. offer a solution to male and female urinal users with the Uri-mist. The Uri-mist is a portable personal urinal that has a built in spray mist system on the cap. This product is used like a normal urinal, where a user fills the urinal with urine content. When finished the urinal must be emptied and cleaned. The old process was to empty the urinal contents in the toilet, and then rinse the urinal out with water which will be disposed in the toilet. At this point some users are finished cleaning such as hospitals in most cases and those with dexterity issues while others use a more sterile method by cleaning the urinal with disinfectant or bleach mix that...
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...Neurological System (Headaches, head injuries, dizziness, convulsions, tremors, weakness, numbness, tingling, difficulty speaking, difficulty swallowing, etc., medications): Patient denies any head injuries, headaches, convulsions, tremors, numbness, tingling, difficulty speaking or swallowing. Patient denies taking any medication in correlation to her neurological system. Patient states, “When I get up sudden I have to wait a moment because I get dizzy.” Head and Neck (Pain, headaches, head/neck injury, neck pain, lumps/swelling, surgeries on head/neck, medications): Patient denies any problems in the head and neck but states, “When I travel I bring a special pillow because my neck gets sore on the wrong pillows.” Patient denies taking medication. Eyes (eye pain, blurred vision, history of crossed eyes, redness/swelling in eyes, watering, tearing, injury/surgery to eye, glaucoma testing, vision test, glasses or contacts, medications): Patient states she has a history of dry macular degeneration and it is being well controlled. Patient uses special eye drops for her eye disease. Patient wears corrective lenses at all times for both reading and sighting with blurred vision occasionally. Negative glaucoma testing 02/15/2014Eye surgery in relation to the macular degeneration 08/13/2013 Ears (Earache or other ear pain, history of ear infections, discharge from ears, history of surgery, difficulty hearing, environmental noise exposure, vertigo, medications): Patient...
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...Introduction Normally, needing to urinate does not bring about positive emotions, as individuals can describe it to be quite uncomfortable. Although the sensation may be unpleasant, a full bladder can feel great, for liars. The Inhibitory Spillover Effect shows individuals with a full bladder resulted in better lying. The lying and deception is correlated with inhibition, a central cognitive mechanism. Typically, lying and a full bladder are not associated with one another, but both effect inhibitory abilities. When lying, individuals use more brainwork, as they have to think of the truth, keep it in mind, while placing layers of lies on top. Compared to telling the truth, areas in the prefrontal cortex and the anterior cingulate cortex operate greater. There is also more activity in the front and cingulate regions (p.113). Experiments were done in order to determine whether or not a full bladder does actually help create better liars (p. 114). Predictions were made that the high inhibition lying individuals with a full bladder would have better control of their behavioral cues. It was also predicted that third-party observers would not be able to easily detect the full bladder liars. Method During the first experiment, participants were selected into high control or low control conditions. These participants were questioned on their opinions, since lying about opinions tend to be more difficult. The participants consisted of twenty-two university students, both male and female...
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...Penney, (2013) defines “The Biopsychosocial Model” as an approach or method that guides and helps to understand individual’s biological, psychological and social aspects, for example emotions, behaviours and thoughts. Therefore the importance of understanding human health and illness will aid nurses with knowledge of how to provide holistic care. It is a health care model that deals with the clinical care and practical guidance to the patient. Biopsychosocial model show the importance for practitioners to recognise the factors that contribute to biologically, psychologically and socially of different individuals and showing confidence in understanding different aspects of life to encourage elderly client to show their personality, which aids them and keep them in control at different stages of life HEALTH, PSYCHOLOGICAL ASPECTS AND SOCIAL ASPECTS OF THOSE INDIVIDUALS. (D) Physical Factors The skeletal system of an individual goes through major changes because the musculoskeletal system response slows down due to aging affecting movement and posture, for example loss of calcium from the bone. Banks et al. (2009) stated that mineral density will decrease after menopause. Therefore at this life stage of women they are prone of hip fracture. Ageing affects bones making them weaker and less dense which make them likely to fracture easily, Individuals might find it difficult to lift things and the less dense the bones the less flexible movement becomes because of the weakness...
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