...Delirium in the Older Adult Population Delirium is a common issue found in older adults in the hospital and often not recognized until the illness develops, showing more evident and severe symptoms. Delirium is most commonly seen in the intensive care unit (ICU) and its frequency suggests an evident need for increased prevention. This paper will review an article by Susan Seliger, Another Hospital Hazard for the Elderly (see Appendix for more information), and look at various other perspectives focussing on the main arguments, as well as looking at personal understandings and biases, to better relate to and work with delirious older adults. Summary of the Article To summarize Susan’s article, “Another Hospital Hazard for the Elderly”, it...
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...explores one published article that reports research concerning the perception of nurses and physicians communication at night about intensive care patients’ pain, agitation, and delirium. The authors are concerned with the level of accuracy to which interdisciplinary communication occurs in the intensive care unit. Nada Al-Qadheeb et al’s objective is to determine the perceptions of nurses and physicians communication in the intensive care unit at night, as communication between ICU caregivers can often times be complicated by the varying nature of illnesses, frequent assessments, frequent interruptions, and invasive procedures that occur in the ICU. “Ineffective nurse-physician communication in the ICU during the day can compromise patients’ safety, increase length of stay, and boost health care costs” (Al-Qadheeb et al, 2013). The article discusses the “perception” of communication between nurses and physicians at night while maintaining high-quality care to the critically ill patient. Evaluation of such perceptions has not been previously performed. The results of the study “highlights the importance of further qualitative and quantitative investigations on nocturnal ICU communication” (Al-Qadheeb et al, 2013). Further studies on this subject may help to improve nighttime communication between ICU clinicians and continue to impact interventions on outcomes that could improve patient safety, as well as quality of care. Keywords: Perception, communication...
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...Chamberlain library, search for the article, and view the article. Included search terms used. Keep in mind that this needs to be a scholarly article that relates to one of the listed topics. | Log onto www.chamberlain.edu and click the online library link, then sign in. Click on CINAHL link and type in “Evidence based practice in nursing” into the search key. In the refine search click English language, limit publish date between 2010-1014, in the geographic subset click USA, in special interest click evidence based practice and critical care, in the source types click academic journal, and under limits check full text and blind peer review. Last, click search and 16 options appear. The first option is Do Earplugs and Eye Masks Affect Sleep and Delirium Outcomes in the Critically Ill. Clicking on the title will bring up details about the article. On the left side of the screen the option to open up the full text is available. | Authors and Credentials: State authors’ complete names with complete credentials as listed on article. | By Ann Alway, RN, MSN, CNRNMargo A. Halm, RN, PhD, ACNS-BCMisti Shilhanek, RN, BSNLeanne St....
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...This showed that being allowed to participate in the care of their loved one in the ICU is essential. The meaning of participating and some benefits would be described as “ participation in the care of and being close to the patient; confidence in the care the patient receives; support needed for the involvement in caregiving; and vulnerability.” The care is not only for the patients but also for the family. The ways this is done needs to be further...
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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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...| | Prepared by: SHRUTI GULATI | | | | | | DEXELEX To assess the existing clinical practice of INTENSIVISTS & ANAESTHESIOLOGISTS for the management of sedation and analgesia while taken into consideration “dexmedetomidine” ACKNOWLEDGEMENT I would like to express my sincere gratitude towards RANBAXY Laboratories Limited, Mumbai for selecting me as a summer trainee and giving me an opportunity to work on this project and also for providing a good working ambience for successful completion of this project. I also thank the MARKETING RESEARCH TEAM for giving me an opportunity to conduct market research for DEXELEX belonging to INTENSIVA division of RANBAXY. I would like to express my special gratitude towards my guide Mr. Shoreb Khanduri, who throughout my project has been teacher and supporter for me showing me the right direction during my project. I am highly grateful to all summer interns and friends for their support and cooperation, owing to which I have successfully completed and compiled this report Last but not least, I would like to express my sincere thanks to my institute NIPER for providing me all kind of support in my summer project placement at RANBAXY Laboratories Limited. Shruti Gulati Certificate This is to certify that the dissertation submitted in partial fulfillment for the degree of M.B.A. in Pharmaceutical Management of National Institute of Pharmaceutical Education and Research (NIPER) is a result of the bonafide research work...
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...Content Frame Skip Breadcrumb Navigation Home arrow Chapter 2 arrow Nursing Care Plan Nursing Care Plan Nursing Diagnosis Impaired Verbal Communication r/t sedation, presence of artificial airway, or decreased level of consciousness Long Term Goal: Patient is able to use a form of communication to get needs met and relate to his environment Short Term Goals / Outcomes: Patient and nurse will establish a means of communication Patient will be able to effectively communicate and needs Intervention Rationale Evaluation Assess the patient’s primary and preferred means of communication (verbal, written, gestures) Communication can be frustrating for both the nurse and patient. It is critical that the nurse and patient determine the best method for each patient. Patient can write words clearly on paper Assess the patient’s preferred language and ability to understand written words, pictures and gestures The nurse can not assume that the patient is grasping the information that is provided. In recognition of the vast array of cultures and physical challenges that patient’s face, it is the nurse’s responsibility to communicate effectively Patient speaks and reads English. Recognize that the presence of an artificial airway will hinder the patient’s ability to communicate When air does not pass over the vocal cords, sounds are not produced. Other methods of communication will have...
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...Medical/Surgical Intensive Care Unit Emilee Snider Historical Trends in Nursing Critical Care Nursing Critical care nursing can be traced back to the battlefield and recovery room of the earlier decades and has evolved into the modern intensive care units today. The early 1950s through the 1990s is an era in which unpredicted and radical changes occurred in the care of all patients with the development and growth of intensive/critical care units in hospitals. The reasons for initiating these units was multi-factorial and complex; the factors included the acute shortage of civilian registered nurses (RNs) during and following World War II, innovative surgical procedures developed in caring for wounded servicemen that later carried over to civilian hospitals, vastly overcrowded hospitals, and the unacceptably high mortality rate among postoperative patients. During this time nursing care wasn’t either standardized or organized. The nursing staff consisted of registered nurses, licensed practical nurses, and unlicensed nurse’s aides, each doing what seemed best for that patient at that given moment. There have always been critically ill patients; critical care nursing itself is fairly new. Patient care is more complex as the technology and medicine have advanced. The first intensive care unit opened in the 1950s, allowing the patients to get the specialized care and continuous monitoring and treatment (A Community Of Exceptional Nurses, 2013). Dr. William McClenahan, in...
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...TOP TEN CAUSES OF POISONING Section 2-D |Roña, Diandra Krystle B. | |Rosales, Aileen L. | |Rosaura, Franz D. | |Roxas, Marie Florence S. | |Rubio, Hannah Alexis O. | |Rugay, Jesus Emmanuel R. | February 1, 2012 POISONING Poisons are substances that cause disturbances in living organisms and do so by some biologic or chemical reaction in nature. For decades, the use of different substances for various applications lead to the discovery of potential toxic substances that may have caused injurious effects. Poisoning commonly occurs thru ingestion and usually, it was unintentional. Acute toxicity is the single exposure or multiple exposures for short periods to the substance causing the injury. Symptoms may be rapid and are in close relation to the toxic agent. On the other hand, chronic toxicity are caused by repeated or multiple exposure for longer periods to the poison. Signs and symptoms of chronic toxicity may appear even after several years upon the initial exposure. ADULT TOP TEN TOXICITIES 1. CAUSTICS Caustics are strong acids and alkali that when ingested can cause tissue injury by chemical reaction. They damage the tissues by accepting a proton (alkaline substance)...
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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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...Burns (relates to Chapter 24, “Nursing Management: Burns,” in the textbook) Burns Occur when there is injury to the tissues of the body caused by heat, chemicals, electrical current, or radiation Types of Burn Injury Thermal Burns Chemical Burns Smoke Inhalation Injury Electrical Burns Cold Thermal Injury Full-Thickness Thermal Burn Partial-Thickness Burn to the Hand Partial-Thickness Burns Due to Immersion in Hot Water Types of Burn Injury Thermal Burns Caused by flame, flash, scald, or contact with hot objects Most common type of burn Types of Burn Injury Chemical Burns Result from tissue injury and destruction from necrotizing substances Most commonly caused by acids Alkali burns cause protein hydrolysis and liquefaction Types of Burn Injury Chemical Burns Respiratory and systemic problems Eye injuries Clothing containing the chemical should be removed Tissue destruction may continue for up to 72 hours after a chemical injury Types of Burn Injury Smoke Inhalation Injuries Result from inhalation of hot air or noxious chemicals Cause damage to respiratory tract Important determinant of mortality in fire victims Types of Burn Injury Smoke Inhalation Injuries Three types: • Carbon monoxide poisoning • Inhalation injury above the ...
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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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...Task 1 : introduce your business a. Briefly describe the type of business size and number of employees . Bankstown Lidcombe Hospital is a principal referral group A1B hospital with tertiary affiliations to the University of NSW, University of Sydney and University of Western Sydney providing a wide range of general medical and surgical services and sub-specialty services to a local Bankstown/Canterbury community. It is part of South Western Sydney Local Health District.it has 454 beds and over 1400 emloyes between doctors , nurses , radiolgiest , administration , and other services . b. Laws are put into place to protect everyone - the customer, the employee and the company. You are not expected to be a lawyer, but being aware of the relevant legislations will help your organisation run more smoothly and avoid complications in the future, such as getting tied up in lengthy legal battles for unfair staff dismissal etc. Some of the common legislations applicable to traders include the Consumer Protection Act 1987 and the Consumer Protection from Unfair Trading Regulations 2008. These regulations are put into place to protect the consumers' rights and ensure they receive good quality products or services at all times. Duty of care : The responsibility or the legal obligation of a person or organization to avoid acts or omissions (which can be reasonably foreseen) to be likely to cause harm to others. Accessible parking Bankstown-Lidcombe Hospital has a number...
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...014CRNA Interview Preparation Q: Tell me about a time when you had to manage a difficult clinical situation. Q: Tell me about a time when you were working with someone who wasn't pulling their weight, and they had a different value system than yours. How did you deal with this person? Q: Tell me about a time when you failed. What happened, and how did you recover? Q: Tell me about a time when you had an ethical dilemma at work. What did you do? Q: Tell me about a time when you felt it was you against everyone else. You thought you were right and that everyone else was wrong. What did you do? Q: Why do you want to be a CRNA?** Q: What would make you a successful CRNA?** Q: How do you handle stress? Q: What kind of patients do you take care of? Your favorite and why?** Q: Tell us about your work experience.** Q: How do you describe success? Q: Do you foresee any barriers to your education? (finances, time commitments) Q: What does a CRNA do? How do you think your role as a CVICU nurse relates to the role and responsibilities of a CRNA?** Q: Where do you want to be in 5 years?**. Q: Why our program? Q: What questions do you have for us?** A: What do you look for in potential students? How does your program facilitate student research? I am very interested in teaching and education, how does your program prepare me to be an educator? What do you see as your school's strong points? On avg. how many intubations, art lines...
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...PATHO Exam 3 Study Guide * Define KEY WORDS (terminology) listed in the syllabus * Answer the OUTCOMES in the syllabus as if they are questions * Review all Activities, Games, extra videos, journal articles, etc. posted in course contents * Review the handouts from class: case studies, matching, charts, etc. Normal Values | Intracranial pressure | 5-10 mm Hg | Blood glucose | 70-130 | Hgb A1c | <5.7% | Thyroid levels | | Parathyroid levels | | Types of bone cells | Osteoblasts | Bone forming cellsThey are responsible for bone growth and repair | Osteocytes | Osteoblasts that have become trapped, imprisoned within mineralized bone matrix (MATURE BONE CELLS) | Osteoclasts | Reabsorb or remove bone during growth and repair (also assist in the release of calcium and phosphate)**bone reabsorption; bone destroying cells | *So, if one is immobilized then the osteoclastic activity is greater than the osteoblastic activity in bone marrow decreases. This is why we have debone mineralization during immobilization. Maintenance of bone integrity | This occurs through remodeling and it is a 3 phase process where existing bone is resorbed and new bone is laid down [repairs bone, does not heal bones] | Phase 1 | Activation phaseThis is where a stimulus occurs, such as a weight baring exercise, causing the formation of osteoclasts | Phase 2 | Resorption This is where osteoclasts form a cutting zone and resorb or remove bone | Phase 3 | Formation...
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