...to no more than three sentences. | Qualitative | Quantitative | Data collection methods | This study was conducted by interview with a limited number of patients presenting to the emergency department with a chief complaint of chest pain over a three month period. The study was a spin off from a quantitative study that existed on the influence of psychosocial factors in patients. In addition, the study was designed to give quality to the numerical values of chest pain patients who were studied. | The goal of the study was to develop a baseline of how many complications there are after cardiac catheterization and after percutaneous coronary intervention. The study was a correlation of 11,119 people. With 4,010 participants the researchers compare the reactions of eptifibatide and a placebo. Nursing interventions were observed after cardiac catheterization and after percutaneous coronary intervention. The researchers took data from the patient’s records between 2001 and 2003 to conclude his or her results. | Data collection instruments | The patients interviewed by conversation consisted of 11 men and eight women. The interviewer asked three main questions of participants in Swedish and let him or her express freely his or her pain experiences. The interviews were recorded and carefully reviewed by the researcher. | Eleven thousand one hundred and nineteen patients were observed; two questions had to be answered: how many incidences of vascular complications were...
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...| Panic DisorderPsychology Assignment | Rohit Jayal | 11/20/13 | XI-C | | | Panic DisorderPsychology Assignment | Rohit Jayal | 11/20/13 | XI-C | | Contents 1 Signs and symptoms 2 Causes 3 Psychological Models 4 Medical Model 5 Mediators and moderators of panic disorder 6 Substance abuse 7 Diagnosis 8 Treatment 9 Psychotherapy 10 Medication 11 Other treatments 12 Epidemiology. 13 Panic disorder in juveniles 14 Case Study. Definition Panic disorder is an anxiety disorder characterized by recurring severe panic attacks. It may also include significant behavioural changes lasting at least a month and of ongoing worry about the implications or concern about having other attacks. The latter are called anticipatory attacks (DSM-IVR). Panic disorder is not the same as agoraphobia (fear of public places), although many afflicted with panic disorder also suffer from agoraphobia. Panic attacks cannot be predicted, therefore an individual may become stressed, anxious or worried wondering when the next panic attack will occur. Panic disorder may be differentiated as a medical condition, or chemical imbalance. The DSM-IV-TR describes panic disorder and anxiety differently. Whereas anxiety is preceded by chronic stressors which build to reactions of moderate intensity that can last for days, weeks or months, panic attacks are acute events triggered by a sudden, out-of-the-blue cause: duration is short and symptoms are more intense. Panic attacks...
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...just nine years old. I went through life with little to no memories of my early events. I struggle everyday to hang tight to my positive mentally, push through; to focus on the task at hand and most importantly ask for help. For me, I just had some bad experiences and I won’t let them define me or stifle my future. I remember several attempts in April 2015 to pull myself up from my boot straps by going to different community resource areas asking for help that I experienced crying spells, headaches, chest pains and several others affected emotional response while telling my story. I felt battered with distress and drained without any help being offered. Enough was enough. I then reached out to a veterans program at seeking employment but had to get a mental evaluation. Upon being evaluated I had to answer questions as to what brought me to their services. Again my pipes began to leak as though something had broke. I remember telling the social worker of my circumstances. My chest of aching as though I just got hit my truck. Once again, the pounding heart, tunnel vision, shaking hands, and inexplicable fear for my safety settled in. I’d suffered my first panic attack weeks prior to...
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...Chest pain is the presenting complaint of quit a few patients in general. Most of the times it represents nonlethal syndromes such as one involving muscles and gastrointestinal tract but it can be indicative of serious medical emergencies as well including heart attack and lung diseases. A differential diagnosis can be easily developed on the basis of history and examination of the patient. Questions that are help full in diagnosis are as follows: • Onset of the pain? With the help of this question GP can determine two things firstly, was patient doing anything when the pain started. Events such as stress, coughing, eating, swallowing and physical exertion can provoke specific types of pain such as pain due to acute coronary syndrome, pneumothorax,...
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...Case 16.3: Diagnosing Chest Pains One evening during the summer of 2012, a Con- necticut woman experienced chest pain (Brill 2013). She took an ambulance to a local not-for-profit hospital. After several hours in the emergency room, she was sent home with a diag- nosis of indigestion. Shortly thereafter, she received a bill of $995 for the ambulance, $3,000 for physicians’ services, and $17,000 for the hospital. A major part of the hospital bill was a $7,998 charge for a CT scan with con- trast. (The Medicare rate is $554.) The alternative to the CT scan would have been a stress test using an electrocardiograph. Its list price was $1,200 and the Medicare rate was $96. Unfortunately for the patient, she was not offered this option, was uninsured, and was a year too young to be eligible for Medicare. When questioned about the bill, a hospital representative said, “I’ve told you I don’t think a bill like this is relevant. Very few people actually pay those rates.” Nonetheless, the patient was asked to pay it. A medical billing advocate was able to negotiate a $10,000 discount but made it clear that she thought even this amount was excessive. Discussion questions: • After reading this case, would you be more or less willing to have a CT scan done if an emergency room physician recommended it? If I am going to the emergency room (ER) then for me it will be a true emergency and I will more than likely do whatever the doctor recommends no questions...
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...with unexplained chest pain Margaretha Jerlock MSc, RN, RNT Lecturer, Faculty of Health and Caring Science, Institute of Nursing, The Sahlgrenska Academy at Goteborg University, ¨ Goteborg, Sweden ¨ Fannie Gaston-Johansson PhD, RN Professor, Faculty of Health and Caring Science, Institute of Nursing, The Sahlgrenska Academy at Goteborg University, ¨ Goteborg, Sweden, and Johns Hopkins University, School of Nursing, Baltimore, MD, USA ¨ Ella Danielson PhD, RN Associate Professor, Faculty of Health and Caring Science, Institute of Nursing, The Sahlgrenska Academy at Goteborg ¨ University, Goteborg, Sweden ¨ Submitted for publication: 19 July 2004 Accepted for publication: 1 February 2005 Correspondence: Margaretha Jerlock Institute of Nursing The Sahlgrenska Academy Goteborg University ¨ Box 457, SE-40530 Goteborg ¨ Sweden Telephone: þ46 31 773 60 39 E-mail: margaretha.jerlock@fhs.gu.se 956 J E R L O C K M , G A S T O N - J O H A N S S O N F & D A N I E L S O N E ( 2 0 0 5 ) Journal of Clinical Nursing 14, 956–964 Living with unexplained chest pain Aim. The aim was to describe patients’ experience of unexplained chest pain, and how the pain affected their everyday life. Background. Chest pain is one of the most common reasons for patients to consult the emergency department. Often no clear ischaemic heart disease or any other somatic explanation is found. Exploring the pain experience and how the pain affects everyday...
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...broken heart. Throughout the story we hear about seven different partners, both men and women. The main character is currently dating Grace but looks back to past relationships. We are not told if the main character is male or female, so my interpretation is they could be gender neutral or a woman just like the author, it might be written from personal experience. She dates a lot of people, so she’s desperate for other people’s affection, but she can’t deal with the pain that comes with it, so every time she breaks up with someone she rents a new heart. She’s bisexual because she has partners that are both male and female. We don’t get any information about the setting, but it’s in the future because you can open your chest and switch out your heart for a new one. It’s a first-person narrative so we only see it from the main character's point of view. The rental hearts are a symbol of broken machinery that needs to be replaced, so the broken heart is equivalent to being heartbroken in real life. And opening your chest can be a symbol of opening your heart to other people. The whole story is a symbol of having your heart broken, wishing to replace your heart and to forget bad memories. Her first love was Jacob, and she was very in love with him. ‘Jacob was as solid and golden as a tilled field, and our love was going to last forever, which at our age meant six months.’’ The story uses flashbacks; to each person she fell in love with, as you can see in the quote above. ‘’ When...
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...certain factors such as stress, trauma, illness, or drastic life changes. Being able to recognize maladaptive and adaptive behaviors in someone, especially a client or patient, is important when I am the one responsible for the care they will receive. Educating myself on the different topics and questions that will be used during the interview portion of assessing a patient are critical for the nursing profession. The client, SR, maintains a busy schedule daily, and reflects on traumatic past events which are affecting her wellness and state of mind. SR has had complaints of severe headaches and moderate chest pains several times a week. SR stated during the interview that she does not like to take over the counter medications for pain relief, but rather tries to sleep to relieve the pain she feels. She has previously taken herbal stress supplements to relieve chest pain. SR noted many other symptoms contributing to her state of being: fatigue, difficulty sleeping, dizziness, shortness of breath, frequent urination, abnormal menstruation, and concentration problems. Looking deeper into her family history, there are no reports of neither of her parents or any of her grandparents being treated for severe headaches or migraines, but her one sibling made reports. There are several noted medical conditions in her family such as: diabetes, high blood pressure, heart disease, high cholesterol, cancer, glaucoma, and arthritis. When questioning SR, she was quite hesitant in answering...
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...(2013) to discover how localized heat effects chest pain in patients with acute coronary syndrome. This research critique critically reviews the strengths and limitations of their research study by examining the following areas: the protection of human participants, the problem statement, data collection and analysis methods, and what the implications to nursing practice and future research are. The research study was limited in the number of participants, but reported persuasive results proving that topical heat therapy makes a significant improvement in decreasing chest pain in patients with acute coronary syndrome. Protection of Human Participants Participants in this study were patients in a coronary care unit at a hospital affiliated with Gonabad University of Medical Sciences in Gonabad, Iran. Information about the goal of the research project was provided to each of them and whether or not they wanted to participate was completely voluntary. If they wished to withdraw from the study they could do so at any point. Additionally, a written informed consent form was signed by each participant. This study was approved by the Ethics Committee of Gonabad University of Medical Sciences. Benefits and risks of participation in this study were not identified by the authors. However, patients who were in the experimental group received the additional therapeutic treatment of topical heat in attempt to relieve or minimize their chest pain. Whereas participants in the placebo group...
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...tinnitus, deafness, otitis media, toothache, temero mandibular, stiffness, arthritis, sore yes. F1 - facial paralysis, toothache, mouth ulcers, excessive saliva, facial oedema, clears the head and jaws TH4 - bronchitis, asthma, pneumonia, pulmonary tuberculosis, wheezing, coughing, clears the lymphatic system TH7 & TH8 - improve circulation to the heart, heart valves problem, cardiac spasm. TH6 - hepatitis, jaundice, gallstones, cholecystitis, enlarged liver A3 - enlarged liver, hepatitis A6 - vaginal discharge, irregular menstruation, infertility, appendicitis (right side) UE3 - arthritis of the shoulder and upper extremities A5 - constipation, kidney stones, kidney pain, kidney dysfunction LE7 - knee pain, knee swelling, knee cap problems, clicking of knee joints, stiffness and calcification of knee joint, hip and thigh pain LE8 - same as LE7 and irregular menstruation, abnormal uterine bleeding LE11 and LE12 - irregular menstruation, abnormal uterine bleeding, dysmenorrhoea, nocturia, wet dreams LE13 - strengthens the spleen, improves liver function, benefits the kidneys, amenorrhoea, irregular menstruation, urine incontinence LE15 - arthritis in the lower extremities HI - migraine, psychosis, facial paralysis, blurred vision, eye pressure, trigeminal neuralgia F3 - sinusitis, rhinitis, vertigo, headaches, dizziness, nasal polyps, clears toxins from nose & eyes F2 F2 - tinnitus, deafness, otitis media, toothache, temero mandibular, stiffness, arthritis, sore yes. F4 - sinusitis, blocked...
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...PATIENT ASSESSMENT PROCESS * Scene size-up * Initial assessment * Focused history and physical exam * Detailed physical exam * Ongoing assessment A. SCENE SIZE-UP - how you prepare for a specific situation - includes dispatch information and must be combined with inspection of scene Helps identify: scene hazards, safety concerns, MOI, NOI and number of patients you may have, as well as additional resources BODY SUBSTANCE ISOLATION - Assumes all body fluids present a possible risk for infection Personal Protective Equipment (PPE) - Latex or vinyl gloves, Eye protection, Mask, Gown * Reduces your personal risk for injury or illness SCENE SAFETY Information provided by dispatch may help in determining potential hazards Potential Hazards - Oncoming traffic, Unstable surfaces, Leaking gasoline, Downed electrical lines, Potential for violence, Fire or smoke, Hazardous materials, Other dangers at crash or rescue scenes, Crime scenes Scene Safety 1. Park in a safe area - allows rapid access to your patient and your equipment (infront of the scene) 2. Speak with law enforcement first - ask to accompany you if the victim is a suspect in a crime 3. Do not enter until a professional rescuer has made the scene safe - Carefully evaluate scene & request specific help to manage the scene threats Professional Rescuer: law enforcement, firefighters, utility workers, hazardous materials crew * Remember that hazards do not need to be dramatic situations...
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...| Health History/Review of Systems(Complete and systematic review of systems) | Neurological System (headaches, head injuries, dizziness, convulsions, tremors, weakness, numbness, tingling, difficulty speaking, difficulty swallowing, etc., medications): Patient is oriented x3. No major memory deificit was noted or reported. Patient if forgetful at times due to the aging. Has BLE muscle weakness and pain due to the disease process. No history of tremors or seizures was reported. No numbness or tingling was reported. Patient speech is clear; no difficulty in swallowing was reported or observed. Patient takes Aspirin 81mg PO daily prophylactically. | Head and Neck (pain, headaches, head/neck injury, neck pain, lumps/swelling, surgeries on head/neck, medications): Per patient “I get occasional headaches but is relived with the pain medication. I have LBP less often then daily but is relieved with the medications”. On assessment no swelling or lumps were noted. No history or surgeries on the back and neck was reported. Patient takes Tylenol 500 mg 1-2 PO PRN. | 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 reported cataract surgery 10-12...
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...Health History/Review of Systems(Complete and systematic review of systems) | Neurological System:Client testifies that she has suffered migraines since puberty. Denies any head injuries, dizziness or convulsions. Visualized a small essential tremor in bilateral hands. States has some weakness, tingling, and numbness in both lower extremities due to bilateral knee replacements. Denies signs or symptoms of difficulty speaking, or swallowing. States takes Narcotic pain medications for pain management. | Head and Neck:States intermittent migraines. Denies any neck pain. Denies any abnormal lumps or swelling in her neck or head area. Sinus surgery in 1991, without complications. | Eyes:Denies eye pain, excessive tearing or blurred vision of the eyes. Last eye exam was March, 2014 which included glaucoma testing, vision testing. No visible redness of eyes. Client states she is currently wearing progressive lens glasses. States when eyes are occasionally dry she uses artificial tears. | Ears:Denies earache or other ear pain. History of childhood chronic ear infections. No lengthy exposure to loud environmental noises. Denies any vertigo or ear medications. | Nose, Mouth, and Throat: States has had cold sores of the mouth in the past. Denies any nosebleeds. States has had gingivitis in the past and was treated by dentist. Allergies to multiple medications and bee stings. Last dental check-up, states was 1 year ago. States has had many root canals and tooth implants. Rinses with...
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...appetite. Insulin was started for new diabetes problem. Her vitals were stable (T: 97.5, P:93, BP:161/74, RR: 20, O2: 93%per 2L NC). She is allergic to Codeine and Aspirin. Upon assessment of this client, I found her sleeping in bed. Client aroused easily to verbal stimuli and oriented X3. Family was at bedside. PERRLA. Mucous membranes pink and moist, no JVD noted. Her nasal cannula was in place and set at appropriate level of 2L/min. Respirations even and unlabored. Wheezes noted throughout bilateral lungs, patient reports she is a smoker. I.S. at bedside, patient reports she has not been using it. Teaching performed and patient correctly used the apparatus. Client has a dry chronic cough. Double lumen PICC noted to right upper chest. Dressing is dry and intact. Site is without redness and edema. 1/2NS is infusing at 125 ml/hr. Abdomen is soft and distended. Bowel sounds positive in all four quadrants. Skin-...
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...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 denies any ear problems Last eye infection was over 10 years ago. No discharge noted from ears Nose, Mouth, and Throat (Discharge, sores or lesions, pain, nosebleeds, bleeding gums, sore throat, allergies, surgeries, usual dental care, medications): Lips pink, mucous membranes pink and moist No discharge or foul...
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