... 2. Once the patient has been diagnosed with infective endocarditis, important patient teaching should include understanding of and adherence to the planned treatment regimen. The patient should understand the need to avoid persons with infection, especially upper respiratory tract infection, and to report cold, flu, and cough symptoms. The importance of avoiding excessive fatigue and the need to plan rest periods before and after activity should be carefully explained to the patient. Good oral hygiene, including daily care and regular dental visits, is also important. The patient must also inform all health care providers performing dental, medical, or surgical procedures of the history of IE. The patient should also be taught the significance of the prescribed prophylactic antibiotics therapy before any invasive procedure. 3. A patient with IE has many problems that require nursing management. IE generally requires treatment with antibiotics for 4 to 6 weeks. After initial treatment in the hospital, the patient may continue treatment at home. Patients who receive outpatient IV antibiotics will require vigilant home nursing care. The patient and or the family also need instruction by the nurse about the importance of monitoring body temperature because a persistent and prolonged body temperature may indicate that the drug therapy is ineffective. The nurse should also teach the possible complications (stroke, pulmonary emboli, and heart failure) and its signs and symptoms...
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...In medicine, compliance (also adherence or capacitance) describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions. Both the patient and the health-care provider affect compliance, and a positive physician-patient relationship is the most important factor in improving compliance,[1] although the high cost of prescription medication also plays a major role.[2] Compliance is commonly confused with concordance. Concordance is the process by which a patient and clinician make decisions together about treatment.[3] Non-compliance is a major obstacle to the effective delivery of health care. Estimates from the World Health Organization (2003) indicate that only about 50% of patients with chronic diseases living in developed countries follow treatment recommendations.[1] In particular, low rates of adherence to therapies for asthma, diabetes, and hypertension are thought to contribute substantially to the human and economic burden of those conditions.[1] Compliance rates may be overestimated in the medical literature, as compliance is often high in the setting of a formal clinical trial but drops off in a "real-world" setting.[4] Major barriers to compliance are thought to include the complexity of modern medication regimens, poor "health literacy" and lack of comprehension of treatment...
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...of (American Academy of Pediatrics; American Academy of Family Physicians, 2004) or inappropriate Filtered Appropriate: This article establishes diagnosis and management guidelines for the treatment of AOM. Additionally, the authors make recommendations regarding treatment options for the symptoms of AOM and address the concept of watchful waiting as opposed to immediate antibiotic therapy. Recommendations are provided for clinical practice and were created using a systematic review of clinical research, making it an appropriate source for nursing practice. Research Evidence based guideline (Block, 1997) Unfiltered Appropriate: Primary research This article contains evidence up to date research...
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...once threaded through arteries. These are repairs that used to be made by cracking open the chest, and a very major surgery, now it is a simple surgery. In recent years cancer meds make the promise of diseases treatable (Skinner, 2013). Technology makes storing all the records in electronic systems easily accessible and highly convenient. However not all new technology is electronic based. So we will look at some different technological discoveries and how they differ from our normal thoughts of technology and still bottom line save lives. Looking at all the studies and ways of technology are important as it makes a difference on how and what the patient needs. Studies show that the category with the greatest benefit is low-cost antibiotics for bacterial infections, a cast for a simple fracture, or simply an aspirin and certain medications for heart attack patients (Skinner, 2013). CPR or cardiopulmonary resuscitation is simply human based and that saves as many lives as open heart surgeries ever have. Not all treatments in this category are inexpensive, things like antiretroviral drugs for people with HIV (Aids) may cost as much as $20,000 per year, but they are still an awesome technology based treatment because they save lives (Skinner, 2013)! The only electronic to patients for these treatments are the lab testing to see if they worked. Technology also includes procedures whose use are beneficial for some patients, however not all benefit from these treatments...
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...Urinary Tract Infection in the Geriatric Population Elizabeth Shultz Abstract The geriatric population is very vulnerable to Urinary Tract Infection (UTI) and its negative consequences. If left untreated, UTI in the elderly patient can have negative consequences such as delirium or even death. UTI can also contribute to the onset of acute or chronic kidney infections, which could permanently damage the kidneys and result in renal failure. In view of this, the purpose of this paper is to review related literature to find current evidence or best practices related to UTI in the geriatric population and to objectively critique the evidence. CINAHL and MEDLINE computer databases were mainly searched from January, 2005 to January, 2015 using a combination of manual and computer-based methods. Keywords: elderly, urinary tract, elderly infection management, urinary tract infection prevention, elderly and UTI. Introduction By convention, a Urinary tract infection (UTI) is defined either as a lower tract (acute cystitis) or upper tract (acute pyelonephritis) infection (Nicolle, 2014). Urinary tract infection (UTI) is the most common infectious problem among older adults both in the community and institutional settings (Midthun, Paur, Bruce, & Midthun, 2005). The elderly population is most likely to experience UTI due to many reasons, not the least of which is their overall susceptibility to all infections...
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...Swoboda, RN, MS;3 Wendy Ziai, MD;3,6 Sara E. Cosgrove, MD, MS1 objective. Diagnosing ventilator-associated pneumonia (VAP) is difficult, and misdiagnosis can lead to unnecessary and prolonged antibiotic treatment. We sought to quantify and characterize unjustified antimicrobial use for VAP and identify risk factors for continuation of antibiotics in patients without VAP after 3 days. methods. Patients suspected of having VAP were identified in 6 adult intensive care units (ICUs) over 1 year. A multidisciplinary adjudication committee determined whether the ICU team’s VAP diagnosis and therapy were justified, using clinical, microbiologic, and radiographic data at diagnosis and on day 3. Outcomes included the proportion of VAP events misdiagnosed as and treated for VAP on days 1 and 3 and risk factors for the continuation of antibiotics in patients without VAP after day 3. results. Two hundred thirty-one events were identified as possible VAP by the ICUs. On day 1, 135 (58.4%) of them were determined to not have VAP by the committee. Antibiotics were continued for 120 (76%) of 158 events without VAP on day 3. After adjusting for acute physiology and chronic health evaluation II score and requiring vasopressors on day 1, sputum culture collection on day 3 was significantly associated with antibiotic continuation in patients without VAP. Patients without VAP or other infection received 1,183 excess days of...
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... D. Between fourth and seventh day E. Between twelfth and sixteenth day 2) The following is an example of Class III surgical wound: A. Urinary bladder surgery B. Herniorrhaphy C. Gastrectomy D. Resection of obstructed bowel E. Surgical drainage of pelvic abscess 3) A 70 yr old victim of an auto-pedestrian accident develops manifestation of severe sepsis 14 days after a Splenectomy. The organism most likely to be involved is: A. Staph. aureus B. Strep. Pyogenes C. Hemophilus influenza D. E. coli E. Klebsiella sp. 4) The most reliable protection for the surgeon against Hepatitis B infection is by: A. adherence to universal precautions B. administration of gamma globulins C. active immunization D. double gloving E. administration of interferons 5) Pro-inflammatory mediators in shock, EXCEPT: A. IL-4 B. IL-2 C. TNF D. IL-6 E. IL-8 6) Hypotension occurs in healthy patients if blood volume is decreased by: A. 15-30% B. More than 40% C. Up to 15 % D. 30 – 40% E. Any of the above 7) This type of shock is characterized by hypotension, decreased peripheral vascular resistance and bradycardia: A. Traumatic shock B. High output septic shock C. Low output septic shock ...
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...Pneumonia Case Study August 27th, 2014 Mrs. Yolanda Bone South University Pneumonia Case Study A major cause of morbidity and mortality is Pneumonia. Pneumonia is a lung infection caused by bacteria, fungi or viruses (Center for Disease Control, 2014).The infection is classified into two categories; community-acquired pneumonia (CAP) or health care-associated pneumonia (HCAP). The classification is determined by the environment in which the infection develops (CDC, 2014). HCAP develops during or following a stay in a healthcare facility. In contrast, patients who are diagnosed with CAP have had no contact within a health care setting prior to presenting with the infection (Driver, 2012). Pneumonia may be present as a mild illness but has the potential to be life-threatening. Despite advances in research, pneumonia remains a common illness contributing to the death of young children in developing countries and the elderly population of developed countries throughout the world (Ruuskanen, et al., 2011). In 2010, approximately 50,000 people in the U.S. died after developing the infection (CDC, 2014). From a global perspective, 450 million cases of pneumonia are recorded annually and roughly 4 million of those diagnosed will die from this illness (Ruuskanen, et al., 2011). CAP is the eighth-leading cause of death within the U.S. and is the leading cause of death from infection in the developed world (Brown, et al., 2012). While anyone is susceptible to contracting...
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...1.1.12 patient factors: Health susceptibility to side effects (eg, organ damage, reduced physiological reserve) Current medical therapy with drugs likely to interact adherence to therapy or follow-up monitoring risk beliefs and attitude to history of previous adverse reactions 1.1.13 Prescriber factors: Familiarity with the prescribing decisions Simple sequence: may depend on resources 1.1.13 pharmacokinetics: Drugs in the same class (or different formulations of the same drug) can have different bioavailability, dose-concentration curves and half-lives. These factors will determine the dosage regimen. Once daily dosing is convenient and promotes compliance. The pharmacokinetic properties may also affect inter-individual variability in dosage requirements. For example, some drugs: •...
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...HIV/AIDS & HOMELESSNESS Recommendations for Clinical Practice and Public Policy Developed for The Bureau of Primary Health Care and The HIV/AIDS Bureau Health Resources and Services Administration by John Song, M.D., M.P.H., M.A.T. November 1999 Financial and other support for the development and distribution of this paper were provided by the Bureau of Primary Health Care and the HIV/AIDS Bureau, Health Resources Services Administration, United States Department of Health and Human Services, to the National Health Care for the Homeless Council, Inc., and its subsidiary, the Health Care for the Homeless Clinicians’ Network. The views presented in this paper are those of the author and do not necessarily represent those of the United States government or of the National Health Care for the Homeless Council. Nothing in this paper should be construed as providing authoritative guidelines for the practice of medicine or for treatment of medical conditions. This paper may be reproduced in whole or in part with appropriate recognition to the author, John Y. Song, MD, and the publisher, the Health Care for the Homeless Clinicians’ Network, National Health Care for the Homeless Council, Inc. Second Printing February, 2000 National Health Care for the Homeless Council Health Care for the Homeless Clinicians’ Network Post Office Box 60427 Nashville TN 37206-0427 Phone 615/226-2292 Fax 615/226-1656 council@nhchc.org or network@nhchc.org http://www.nhchc.org i PREFACE HIV/AIDS...
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...Microscopic studies of the human body have found that microbial cells greatly outnumber somatic cells with National Institutes of Health estimating the figure to be around 90%; these either being bacterial, fungal or otherwise non-human. Even though DNA sequencing techniques have allowed scientists to analyse the structures components and functions of some of these normal microbiota, a large fraction of them still remain unstudied and so therefore we have not yet understood the full extent as to the influence that they have on our physiology and development thus how effective our immunity and nutrition is. Some of these microorganisms, known as microbiomes live in the body in areas covered by epithelial cells and exposed to the external environment (the skin, oral cavity respiratory tract, gastrointestinal tract, and the genitourinary system); these commensal microorganisms (normal microflora) such as bacteria, yeast and some virus co-evolved with their hosts, meaning they don’t cause any harm and are also beneficial. Commensal bacteria are important as they help us digest food, nutrient metabolism, tissue development as well as maintain a good mucosal immune system to prevent the colonization of bacterial pathogens in order to protect us from diseases. A variety of factors such as health, age, diet, lifestyle and hormonal state mean the numbers and types of these microorganisms present in and on the body continuously change and may disrupt the balance of heterogeneous organisms...
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...This occurs when the local anesthetic solution is accidentally deposited into the parotid gland. During this time patient is unable to control the facial muscles and may appear lopsided. The eyes can also be affected where the client is unable to close the eyes, but reflex is present and the eye gets continuous lubrication by the tears. This loss of motor function is temporary and subsides after a few hours. The prevention of facial nerve paralysis includes, adherence to the techniques recommended for the inferior alveolar nerve block, needles should contact the bone. Ask the patient to close the eyelid by hands to keep the eyes lubricated. Patient should be explained that the paralysis only lasts a few hours. If the needle does not contact the bone, the needle should be taken out of the tissue entirely and reinsert with keeping the barrel of syringe more...
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...Evidence Based Practice: Aseptic Technique for Peripheral IV Insertion Name: Course: Instructor’s Name Date: Introduction The significance of asepsis in the intravenous IV therapy is integral in the modern patient care because of the increased patients number requiring IV therapy due to changes in patterns of prescription and the today’s illnesses which has acute nature (Bofah et al, 2012). Peripheral Intravenous Cannulation according to Bofah et al (2012), is a procedure in which patent’s skin is punctured with a needle allowing a device to be temporarily inserted into the hand or forearm veins in administering intravenous medications or fluids, although other body sites can be used. It is vital to use intravenous drugs in the management of the patients who are hospitalized. The infections linked to the intravenous therapy may affect the blood stream or the skin around the insertion site of the catheter (Bofah et al, 2012). For this reason, Bofah et al (2012) suggested that general infection control and universal precautions measures need to be taken into considerations when undertaking a clinical procedure. However, specific measures need to be taken into consideration when administering intravenous therapy especially those in the home setting and the vulnerable patients. Kampf et al (2013) conducted an observational intervention study on “Improving Patient Safety during the Insertion of Peripheral Venous Catheters. The aim of the study was to determine...
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...Evidence Based Practice: Aseptic Technique for Peripheral IV Insertion Name: Course: Instructor’s Name Date: Introduction The significance of asepsis in the intravenous IV therapy is integral in the modern patient care because of the increased patients number requiring IV therapy due to changes in patterns of prescription and the today’s illnesses which has acute nature (Bofah et al, 2012). Peripheral Intravenous Cannulation according to Bofah et al (2012), is a procedure in which patent’s skin is punctured with a needle allowing a device to be temporarily inserted into the hand or forearm veins in administering intravenous medications or fluids, although other body sites can be used. It is vital to use intravenous drugs in the management of the patients who are hospitalized. The infections linked to the intravenous therapy may affect the blood stream or the skin around the insertion site of the catheter (Bofah et al, 2012). For this reason, Bofah et al (2012) suggested that general infection control and universal precautions measures need to be taken into considerations when undertaking a clinical procedure. However, specific measures need to be taken into consideration when administering intravenous therapy especially those in the home setting and the vulnerable patients. Kampf et al (2013) conducted an observational intervention study on “Improving Patient Safety during the Insertion of Peripheral Venous Catheters. The aim of the study was to determine the...
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...prescriber throughout the process. The aim of the case study is to display the implications involved in issuing a nurse prescription if deemed appropriate. With regard to writing a prescription as a qualified practioner, the author will adhere to the guidance within the Nursing and Midwifery Council (NMC 2006a) standards for safe prescribing. To protect this patient’s identity and maintain confidentiality, she will be referred to as Mrs X throughout the case study in accordance with the code of conduct (NMC 2008a). GENERAL BACKGROUND Originally, Mrs X had presented to her General Practioner (GP) with signs and symptoms of infection in her ulcer, which had not responded to systemic antibiotics, therefore admission to hospital was arranged for further investigations and intravenous therapy. It was during her inpatient stay that further...
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