...ambulance to the emergency room on Friday afternoon of October 7, 2011. Patient arrived to Sunrise Hospital complaining of a one-day history of headache with severe intensity that started the night before and became increasingly painful, prompting her to call 911. DS was experiencing difficulty breathing at rest, and altered mental status. In the emergency room, CT scan was done and revealed a large amount of subarachnoid hemorrhage (SAH) in the sylvian fissures and blood in the fourth and third ventricles. DS started suffering from rapid deterioration of mental state and emergency room physician elected to intubate. She was immediately evaluated by a neurosurgeon and he successfully placed a right frontal twist drill for external ventricular drain placement due to the subarachnoid hemorrhage. Pulmonologist was also consulted and aided on the ventilated patient after procedure. Her temperature had been as low as 94.8°F, and she was put on a bear hugger. She was given Propofol titrated to sedation and started on antibiotics. DS was transferred to Neuro ICU on mechanical ventilation and, so far, is currently stable. History and Physical DS has past medical history of emphysema, migraine headaches, and osteoporosis. Her past surgical history includes breast augmentation. DS drinks alcohol on occasion, but denies smoking and recreational drug use. Home medications include ProAir HFA Inhalation and Symbicort Inhalation. The patient is allergic to Flagyl and Sulfa antibiotics...
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...NM1704: Applying a model of nursing roper, logan and tierney model This essay explores the preoperative care provided to one patient in a London hospital during one shift. This care was influenced by the holistic perspective to health. Arsing from the Greek for ‘whole’ this acknowledges physiological, psychological and social factors impacting the patient’s condition. (McFerran & Martin, 2008) It seeks to offer treatment inclusive of these factors rather than treating physical symptoms of a diagnosed disease in isolation. This essay will examine this within a Model of Nursing used in my clinical placement area - the Roper, Logan and Tierney model. The identities of both hospital and patient have been altered to maintain confidentiality and comply with the NMC Code of Conduct. (Council, 2008) During my placement I worked on a coronary care unit where I cared for a patient herein called Peter, a 60 year old White British male. Peter was single, lived alone and unemployed. He had a history of low mood and was admitted to a neighbouring hospital suffering symptoms of acute alcohol withdrawal syndrome (acute confusion, delusions and tremors). This arises when an individual reduces or stops alcohol consumption after prolonged periods of excessive alcohol intake. This can lead to tolerance, physical dependence and physical disturbances upon withdrawal due to the central nervous system reacting in a hyper-excitable state. (About.com, 2010) He was transferred to my area...
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...MIDTERM EXAM (16-21) 1. Gluconeogenesis 1. The formation of glucose especially by the liver from fats(glycerol) and protein(amino acid) 2. Corisol’s prime metabolic effect is to provoke gluconeogenesis 3. Synthesis of glucose from lactic acid and from noncarboyhydate molecules-major target of glucagon in the liver 4. A reaction that occurs in the hypoglycemic state to make glucose available 2. Hypothalmic hypophyseal tract 5. A nerve bundle which runs through the infundibulm 6. Arises from neurons in the supraoptic and paraventricular nuclei of the hypothalamus 7. Neural connection to hypothalamus 8. Hypophyseal portal system a. Primary capillary plexus b. Hyophyseal portal veins c. Secondary capillary plexus 3. Posterior Pituitary a. Contains axons of hypothalamic neurons b. Stores antidiuretic hormone (ADH) and oxytocin c. ADH and oxytocin are released in response to nerve impulses d. Both use PIP-calcium second-messenger mechanism at their targets Oxytocin 9. Stimulates uterine contractions during childbirth by mobilizing Ca2+ through a PIP2-Ca2+ second-messenger system 10. Also triggers milk ejection (“letdown” reflex) in women producing milk 11. Plays a role in sexual arousal and orgasm in males and females ADH a. Hypothalamic osmoreceptors respond to changes in the solute concentration of the blood b. If solute concentration...
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...should be made to future practice. The scenario that will be used is one that was encountered while on practice placement. To protect the patient’s confidentiality in line with the Nursing and Midwifery Council’s (NMC) code of conduct a pseudonym of Mrs Smith will be used (NMC 2008). Mrs Smith was admitted to hospital following a collapse at home. An emergency craniotomy and evacuation of a blood clot following a large Posterior Fossa Haemorrhage was performed. After the surgical procedure an external ventricular drain (EVD) was inserted. An EVD is a drain that is inserted through the skull into the area of the brain that encountered the haemorrhage, this allows any extra fluid and blood to be drained, and it also assists with maintaining the intracranial pressure (ICP) within the brain at a therapeutic level. An alternative that can be used is an intracranial skull bolt, although this does not enable drainage of fluid it does provide accurate ICP readings, however the EVD drain is considered the gold standard for measuring ICP (Rickert and Sinson 2003). It is important to identify at this time that the patient had no significant...
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...I. Introduction - Shock (Chapter 11) A. Review of anatomy and physiology B. Pathophysiology Initiation | * Decreased tissue oxygenation * Decreased intravascular volume * Decreased Myocardial contractility (cardiogenic ) * Obstruction of blood flow (obstructive) * Decreased vascular tone (distributive) * Septic (mediator release) * Neurogenic (suppression of SNS) | No observable clinical indications Decreased CO may be noted with hemodynamic monitoring | Compensatory | * Neural compensation by SNS * Increased HR and Contractiliy * Vasoconstriction * Redistribution of blood flow from nonessential to essential organs * Bronchodilation * Endocrine Compensation (RAAS, ADH, glucocorticoid release) * Renal reabsorption of sodium, chloride, and water * Vasoconstriction * Glycogenolysis | * Increased HR (EXCEPT NEUROGENIC) * Narrowed pulse pressure * Rapid, deep respirations causing respiratory alkalosis * Thirst * Cool,moist skin * Oliguria * Diminished bowel sounds * Restlessness progressing to confsion * Hyperglycemia * Increased specific gravity and decreased creatinine clearance. | Progressive | * Progressive tissue hypoperfusion * Anaerobic metabolism wih lactic acidosis * Failure of sodium potassium pump * Cellular edema | * Dysrhythmias * Decreased BP with narrowed pulse pressure * Tachypnea * Cold, clammy skin * Anuria * Absent bowel sounds * Lethargy progressing...
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...Acquisitions Editor: Crystal Taylor Product Managers: Kelley A. Squazzo & Catherine A. Noonan Designer: Doug Smock Compositor: SPi Technologies First Edition © 2011 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the abovementioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market street, Philadelphia, PA 19103 USA, via email at permissions@lww.com, or via website at lww.com (products and services). Library of Congress Cataloging-in-Publication Data Lambert, Harold Wayne, 1972– Lippincott’s illustrated Q&A review of anatomy and embryology / H. Wayne Lambert, Lawrence E. Wineski ; with special contributions from Jeffery P. Hogg, Pat Abramson, Bruce Palmer. — 1st ed. p. ; cm. Includes index. ISBN 978-1-60547-315-4 1. Human anatomy—Examinations, questions, etc. I. Wineski, Lawrence E. II. Title. [DNLM: 1. Anatomy—Examination Questions...
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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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...I. INTRODUCTION A. Number of cases/Statistic data of the disease A.1 Statistics Accurate pre-eclampsia statistics are difficult to obtain because the condition ranges from extremely mild to severe. Mild cases are sometimes not included in official figures. Furthermore, mild cases may have no effect on pregnancy, which is why the figures for pre-eclampsia as a whole are higher than for those that actually complicate pregnancies. Around 10% of pregnant women develop pregnancy-induced hypertension (high blood pressure) or pre-eclampsia (high blood pressure with protein in the urine).Worldwide more than four million women per year will develop pre-eclampsia, and over 63,000 maternal deaths are due to pre-eclampsia. Action on Pre-Eclampsia estimates that every year in the UK pre-eclampsia is responsible for the deaths of six mothers and 500 to 600 babies. A 2005 to 2006 study showed a promising fall in the numbers of women developing eclampsia since 1992, from 4.9/10,000 to 2.7/10,000. This has arisen as a result of the introduction of management guidelines for eclampsia and pre-eclampsia. Pre-eclampsia is much more common in first pregnancies, and there is a reduced incidence of pre-eclampsia in the second pregnancy. The risk of women who have had pre-eclampsia developing it again in future pregnancies is 16 percent, and 25 percent if they suffered from severe pre-eclampsia, eclampsia or they delivered pre-term. This rises to 55 percent if their baby was delivered before...
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...Philippine Christian University Mary Johnston College of Nursing 415 Morga St. Tondo, Manila A Case Study on Acute Pancreatitis Secondary to Cholelithiasis Submitted by: Abad, Edryan Calara, Sharika Loradel Casul Mark Jury Corpuz, Trisha Dela Cruz, Marjori Gamboa, Jonalyn Lebico, Elmarie Lopez, Anica Tapawan, Ansherina Tuazon, Serleen March 09, 2012 Acknowledgement We would like to thank the following to the development of this case study. Mrs. Edna Oraye-Imperial, Dean, PCU – Mary Johnston College of Nursing, for her support and for allowing us to have our related learning experiences in the clinical area that hone our knowledge skills and attitude to be a competent, caring, Christian nurses. Ms. Ma. Lourdes Galima, Clinical Instructor, for continually guiding and supporting us throughout our duty at the Surgery ward, for helping us in enhancing and improving our skills in the area. For the patience that she showed us despite of our attitude and mistakes. Ms. Loreto Vicarme, School Librarian, for allowing us to utilize the library books and references for our case study. To the staff nurses on duty at the Surgery Intensive Care Unit and Ward of Mary Johnston Hospital for the support and providing us with enough information about the routines in the area which we were able to apply. To our fellow group members for their continuous support and sharing their knowledge and experiences for polishing this case study...
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...MEDICAL-SURGICAL NURSING NERVOUS SYSTEM Overview of structures and functions: Central Nervous System Brain Spinal Cord Cranial Nerves Spinal Nerves Sympathetic nervous system Parasympathetic nervous system AUTONOMIC NERVOUS SYSTEM Peripheral Nervous System Autonomic Nervous System Sympathetic Nervous System (ADRENERGIC) - Involved in fight or aggression response. - Release of Norepinephrine (cathecolamines) from adrenal glands and causes vasoconstriction. - Increase all bodily activity except GIT EFFECTS OF SNS - Dilation of pupils(mydriasis) in order to be aware. - Dry mouth (thickened saliva). - Increase BP and Heart Rate. - Bronchodilation, Increase RR - Constipation. - Urinary Retention. - Increase blood supply to brain, heart and skeletal muscles. - SNS I. Adrenergic Agents - Give Epinephrine. Signs and Symptoms: - SNS Contraindication: - Contraindicated to patients suffering from COPD (Broncholitis, Bronchoectasis, Emphysema, Asthma). II. Beta-adrenergic Blocking Agents - Also called Beta-blockers. - All ending with “lol” - Propranolol, Atenelol, Metoprolol. Effects of Beta-blockers B – roncho spasm E – licits a decrease in myocardial contraction. T – reats hypertension. A – V conduction slows down. Should be given to patients with Angina Pectoris, Myocardial Infarction, Hypertension. ANTI- HYPERTENSIVE AGENTS 1. Beta-blockers – “lol” 2. Ace Inhibitors – Angiotensin, “pril” (Captopril, Enalapril) 3. Calcium Antagonist – Nifedipine (Calcibloc)...
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...INSTRUCTOR GUIDE Human Anatomy & Physiology Laboratory Manual MAIN VERSION, Eighth Edition Update CAT VERSION, Ninth Edition Update FETAL PIG VERSION, Ninth Edition Update ELAINE N. MARIEB, R.N., Ph.D Holyoke Community College SUSAN T. BAXLEY, M.A. Troy University, Montgomery Campus NANCY G. KINCAID, Ph.D Troy University, Montgomery Campus PhysioEx™ Exercises authored by Peter Z. Zao, North Idaho College Timothy Stabler, Indiana University Northwest Lori Smith, American River College Greta Peterson, Middlesex Community College Andrew Lokuta, University of Wisconsin—Madison San Francisco • Boston • New York Cape Town • Hong Kong • London • Madrid • Mexico City Montreal • Munich • Paris • Singapore • Sydney • Tokyo • Toronto Editor-in-Chief: Serina Beauparlant Project Editor: Sabrina Larson PhysioEx Project Editor: Erik Fortier Editorial Assistant: Nicole Graziano Managing Editor: Wendy Earl Production Editor: Leslie Austin Composition: Cecelia G. Morales Cover Design: Riezebos Holzbaur Design Group Senior Manufacturing Buyer: Stacey Weinberger Marketing Manager: Gordon Lee Copyright © 2009 Pearson Education, Inc., publishing as Pearson Benjamin Cummings, 1301 Sansome St., San Francisco, CA 94111. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means...
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...LUZON STATE UNIVERSITY College of Arts and Sciences Lucban, Quezon NSC01- Biological Sciences (Lecture) Removal Examination Name: Course and Year: Date: GENERAL INSTRUCTIONS: Type your answer in a separate file, submit it one hour after you received this exam. You may open your notes. Late submission will not be accepted. Please email me: restanmarkalvin@yahoo.com. Do not answer questions in RED. Good luck. _____1. The metabolic rate of a resting, fasting, nonstressed ectotherm at a particular temperature is called A. metabolic rate B. BMR C. SMR D. budget allocation _____2. The internal environment of vertebrates is called A. blood B. interstitial fluid C. hemolyph D. plasma _____3. It allows its internal condition to vary with certain external changes A. ectotherm B. endotherm C. regulator D. conformer _____4. The mammalian trachea and esophagus both open into the A. large intestine B. stomach C. pharynx D. rectum _____5. To extract the most simplified food substance from the digestive system, it is best to study the A. mouth B. esophagus C. stomach D. small intestine _____6. The diffusion in and out of the blood of oxygen, carbon dioxide, nutrients and wastes occurs only in the A. capillaries B. arterioles C. arteries D. veinlets _____7. ____________ carry blood away from the heart. A.Capillaries B. Venules C. Vein D. Arteries _____8. The component of blood that is responsible for clotting is: A.platelets B.Erythrocytes C.neutrophils D.basophils _____9. Respiratory organs for...
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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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...LECTURE NOTES For Nursing Students Human Anatomy and Physiology Nega Assefa Alemaya University Yosief Tsige Jimma University In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education 2003 Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00. Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education. Important Guidelines for Printing and Photocopying Limited permission is granted free of charge to print or photocopy all pages of this publication for educational, not-for-profit use by health care workers, students or faculty. All copies must retain all author credits and copyright notices included in the original document. Under no circumstances is it permissible to sell or distribute on a commercial basis, or to claim authorship of, copies of material reproduced from this publication. ©2003 by Nega Assefa and Yosief Tsige All rights reserved. Except as expressly provided above, no part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission of the author or authors. This material is intended for educational use only by practicing health care workers or students and faculty...
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...NUR160 Ca Name: Jodi Wiak | Section: 160 | Instructor: Ms. Higgins | Dates of care: 4/1/14 | Week: 1st clinical | Name: Jodi Wiak | Section: 160 | Instructor: Ms. Higgins | Dates of care: 4/1/14 | Week: 1st clinical | General Survey | Age: 85 | Sex: F | Ethnicity: Caucasion | # of days since admission: 7d | Allergies: Latex PCN | Code Status: FULL CODE | Diet: TPN | Rationale: Small bowel obstruction and resection benefit TPN over tube feedings is that all the nutrition is delivered at a cellular level making it immediately available for the body to utilize rather than making the body breakdown and absorb nutrients in the GI tract. It makes it easier on the digestive tract by giving the GI a chance to rest and heal without causing more harm. The patient also has to expend energy to breakdown foods/nutrition through the GI tract. Getting it TPN conserves the much needed energy the patient needs to heal their tissues and gain strength. | Activity: bedridden w/slight mobility with a walker | Rationale: Post surgical abdominal surgery, pt age, weakness, and recent foot surgery limiting her mobility. | Behavior/Affect: My pt was anxious when I first arrived due to her elevated B/P, N&V, and pain intolerance. By the end of shift my patient was very calm and communicative. | Isolation: | Yes | No | Culture: ⦵ | Source: ⦵ | Type of Isolation: ⦰ ⦵ | Height: 5’ 7.5” | Weight: 133 | BMI: 20.5 (BSA 1.71) | General Survey | Age: 85 | Sex:...
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