... 1. What error in teaching most likely occurred when M.G. was discharged 10 days ago? The patient most likely failed to adequately apply the fluid and sodium restrction diet properly. Upon discharge teaching, she probably did not have an appropriate understanding of how much soidum to restrict in her diet, as well as what foods may be high in sodium. She also may not have an adequate understanding of what a "fluid" restriction diet entails. CASE STUDY PROGRESS During the admission interview, the nurse makes a list of the medications M.G. took at home. * Chart View Nursing Assessment: Medications Taken at Home Enalapril (Vasotec) 5 mg po bid Pioglitazone (Actos) 45 mg po every morning Furosemide (Lasix) 40mg/day po Potassium Chloride 20meq/day po 2. Which of these medications may have contributed to M.G.’s heart failure? Explain. a. Pioglitazone: Side effects:Severe weight gain and water retention (edema) are both known to contribute to heart probelms. . 3. How do angiotensin-converting enzyme (ACE) inhibitors, such as enalapril (Vasotec), work to reduce heart failure? (Select all that apply.) ACE inhibitors: a. prevent the conversion of angiotensin I to angiotensin II. b. cause systemic vasodilation. c. promote the excretion of sodium and water in the renal tubules. d. reduce...
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...married for 56 years and have three children: two daughters and a son. She worked for McDonalds for 12 years and then retired to be a stay at home mom. My patient was admitted to the hospital based on an abnormal finding from a CAT scan. They CAT scan showed a mass in her right kidney. The patient described that she had no idea of the mass. She went in for a CAT scan because of blood in her urine and experience of her previous diagnosis of kidney cancer, and was informed of the findings. In June of 2013, she had received a total left nephrectomy because of malignant neoplasm in her left renal pelvis. She also informed me that she was born with three kidneys, one left and two rights. However she now only has the two right ones. Malignant neoplasm of the renal pelvis means any new or abnormal growth of tissue found in the renal pelvis associated with cancer. The kidneys are bean shaped, so the renal...
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...surplus of cystine into the body’s system. Recognizing signs and symptoms and properly diagnosing is a key factor in treating this disorder. Individuals with infantile cystinosis experience both tubular dysfunction (renal Fanconi syndrome) and glomeralular deterioration. The renal Fanconi Syndrome usually occurs within the first year of life. Glomeralular deterioration progresses throughout the first decade of life, resulting in end-stage renal failure unless patients are treated with cysteamine (The importance of early diagnosis of nephropathic cystinosis to limit tissue and organ damage by treating it with specific medication, and if left untreated patient can develop renal failure by the age of 10. The prevalence of the infantile form of cystinosis transpires in 1 in 100,000 – 200,000 live births and in the North American population there is a carrier frequency of 1 in every 200. Europeans from the United Kingdom, France, and Germany have a higher prevalence of infantile cystinosis. Cystinosis is prone to but not limited to European descendants with blue eyes, fair skinned and pale blond hair (Rahkeja, Wooten &et al, 2005). Without treatment, infantile cystinosis can lead to advancement of renal failure that requires dialysis or renal transplant by approximately 10 years of age. A kidney...
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...Nursing Practice Review Fluid balance Keywords: Fluid balance/Input/Output/ Dehydration/Overhydration ●This article has been double-blind peer reviewed Measuring and managing fluid balance In this article... What fluid balance is and how fluid moves around the body Causes and signs and symptoms of dehydration and overhydration How to assess fluid balance, including clinical assessment How to keep an accurate fluid balance chart Author Alison Shepherd is tutor in nursing, department of primary care and child health, Florence Nightingale School of Nursing and Midwifery, King’s College London. Abstract Shepherd A (2011) Measuring and managing fluid balance. Nursing Times; 107: 28, 12-16. Ensuring patients are adequately hydrated is an essential part of nursing care, yet a recent report from the Care Quality Commission found “appalling” levels of care in some NHS hospitals, with health professionals failing to manage dehydration. This article discusses the importance of hydration, and the health implications of dehydration and overhydration. It also provides an overview of fluid balance, including how and why it should be measured, and discusses the importance of accurate fluid balance measurements. Assessing hydration status and measuring fluid balance can ensure optimal hydration balance, including what fluid balance is, and how and why it is measured. It also discusses the importance of measuring fluid balance accurately, and the health implications of dehydration...
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...Evidence-Based Nursing Care for Multiple Myeloma Patients Evidence-Based Nursing Care for Multiple Myeloma Patients Comprised of the blood cells, blood, lymph, and other organs involved in the formation or storage of blood, the hematologic system allows the human body to maintain adequate oxygenation and tissue perfusion (Ignatavicius & Workman, 2010, p. 876). Because every cell, tissue, organ, and system is dependent on blood circulation for survival, hematologic problems involving impaired production, impaired function, or abnormal destruction of blood cells are likely to have wide-reaching effects on the patient's health and wellness (Ignatavicius & Workman, 2010, p. 876). This is especially clear when examining cancers of the hematologic system, including multiple myeloma. A cancer of certain white blood cells in the bone marrow known as plasma cells, “myeloma” refers to a tumor of the bone marrow, and “multiple” refers to more than one area of the bone marrow being affected (Mangan, 2006, p. 64hn1). Because the disease is incurable, and because only 30 percent of patients survive longer than five years after diagnosis, living with multiple myeloma can be difficult for patients and their families (Mangan, 2006, p. 64hn1). As health care providers on the front lines of patient care, nurses must be aware of the multi-system manifestations of multiple myeloma, be able to make the assessments needed to identify and prevent complications...
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...Approximately 17 million Americans have diabetes.(Lamb) As many as one-half are unaware they have it. This chronic disease causes serious health complications including renal failure, heart disease, stroke, and blindness. It is a condition in which the pancreas no longer produces enough insulin or cells stop responding to the insulin that is produced. Then glucose in the blood is not able to be absorbed into the cells of the body.(Kishore) The cells in the human body need energy in order to function. Glucose is the body's primary energy source. It is a simple sugar resulting from the digestion of foods containing carbohydrates. It circulates in the blood from the foods that are digested as a ready energy source for any cells that need it. Insulin is a hormone or chemical produced by cells in the pancreas, it is located behind the stomach. It bonds to a receptor site on the outside of cell and goes into the cell through which glucose can enter. Glucose can be saved for later use by converting to concentrated energy sources like glycogen or fatty acids. When there is not enough insulin produced , glucose stays in the blood rather entering the cells. The body will attempt to dilute the high level of glucose in the blood, which called hyperglycemia. Hyperglycemia acts by drawing water out of the cells and into the bloodstream, to dilute the sugar and excrete it in the urine. People with undiagnosed diabetes to be constantly thirsty, drink large quantities of water, and urinate...
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...Course Title | BTEC National Health & Social Care | Unit Title | Anatomy and Physiology for health & social care | Level | 3 | Unit Number | 5 | Unit Credit | 10 | Assignment Title | Anatomy and Physiology for health & social care | Part Unit | | Whole Unit | Yes | Assessor | Shanroy Dehaney | Start Date | 20/05/15 | Submission Date | 10/06/15 | Feedback Date | 17/05/15 | Vocational Context | Task 1 - 3 (P1,P2,P3)You are working in a health clinic and have been asked to produce a poster to explain the functions of the main cell, tissue and body components to display in the clinic. Task 4 (P4,M1,D1)You are an advisor in your local sports centre and you have been asked to design and produce an information booklet to explain to clients how the body requires and utilises energy. This should include:Produce a written report on the body’s response to exercise. The report will be based on primary and secondary research. The report will include:Task 5 (P5,M2,D2) 1. An explanation of the concept of homeostasis and its role in exercise and healthy functioning of the body. 2. Measurements collected from practical work involving physical activity and your interpretation of them together with comments on the validity of the data collected.Task 6 (P6)Complete exercise programme and complete data form and graphs sheets | The Brief | Task 1 (P1)Using a large piece of paper, produce an annotated poster of a cell as it is seen under the microscope. You...
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...period, the urine output was good, extremities were warm, blood gases were normal and the patient remained hemodynamically stable. Despite no sign of low cardiac output, the serum potassium was constantly high around 5.2-5.5 meq/L. Patient was extubated uneventfully after 6 hours of shifting to ICU. Serial serum potassium estimation had a rising trend and was consistently around 5.5 meq/L. In order to lower down the serum potassium level, dextrose insulin solution, intermittent furosemide and potassium binding resins were repeatedly tried. Despite of all the efforts, serum potassium was persistently high and gradually rose to 6.4 meq/L. Finally, trying to find out the cause of this intractable hyperkalemia we reviewed the patient’s drug chart and after thorough discussion, the nicorandil infusion was stopped. After stopping the nicorandil infusion, the serum potassium started decreasing. After 2 hours of stopping nicorandil infusion serum potassium decreased to 5.3 meq/L and after 24 hours it became 4.8 meq/L and remained at a safer level thereafter. Rest of the course was uneventful and patient discharged on 7th post operative day. Discussion: Efficacy and safety of nicorandil in the treatment of angina pectoris have been evaluated extensively [3]. At antianginal doses, nicorandil has a coronary vasodilating effect as well as a balanced peripheral action that leads to decreases in both preload and afterload. Therefore, nicorandil affects two of the main hemodynamic...
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...Dear nutrition student, Thank you for inquiring about my RD/DTR study guide. And yes, there is no catch, the study guide is COMPLETELY FREE! All I ask for is some feedback. So feel free to shoot me any questions/comments! A little background: This study guide is the culmination of years of my own research. And after careful thought, I put into the study guide what I feel are the most important concepts you need to know for the RD/DTR exam. If you notice, I spent much time teaching you in detail the concepts you need to know, not just “spitting” you questions with little or no explanation. I believe this is important. I know you might be thinking “oh, how am I going to absorb and learn all this material?” I say, just read and answer the questions at your own pace. Simply test yourself and of course take some breaks along the way. Just take it one concept at a time. After you have mastered one concept, then move on to the next. I know if you study whole-heartedly what I have outlined in this study guide, you are sure to pass! GOOD LUCK! YOU CAN DO IT! ϑ Your nutrition friend, -Jonathan Brown, B.S, DTR THE “NO FLUFF” RD/DTR STUDY GUIDE *Updated as of July 2011 The “NO FLUFF” RD/DTR STUDY GUIDE Tips for taking the RD/DTR exam 1. PERIODICALLY CHECK THE CLOCK TO MAKE SURE YOU’RE GOOD ON TIME! If you wish, get a basic digital watch with a timer for...
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...NURSING CARE PLAN COURSE: Basic Adult Health CLIENT INITIALS: DATE OF ADMISSION: AGE: GENDER: JL June 13, 2011 85 M HT: WT: ALLERGIES: 140 lbs. NKA CODE STATUS: FULL RACE/ETHNICITY: CULTURAL CONSIDERATIONS: Caucasian None RELIGION/SPIRITUAL CONSIDERATIONS: Unknown OCCUPATION/HOBBIES/RECREATIONAL ACTIVITIES: Retired LIVING SITUATION/WITH WHOM: (home, assisted living, LTC, etc) Lives with daughter. SOCIAL HISTORY: (tobacco, ETOH, illicit drugs, family dynamics) Quit smoking many years ago, no history of ETOH or drug use. NURSING CARE PLAN ADMITTING MEDICAL DIAGNOSIS: Client's principal admitting diagnosis was leukocytosis. Definition: (from Taber’s) “An increase in the number of leukocytes (usually above 10,000/mm3) in the blood. It occurs most commonly in disease processes involving infection, inflammation, trauma, or stress, but it also can result from the use of some medications” (Venes, 2009, p. 1327). Etiology/pathophysiology: ( NOT from Taber’s or Wikipedia) Etiology: Causes of leukocytosis are infection, inflammation, tissue damage, immune reaction, bone marrow problems, medications, and stress (Drug Information Online, 2011). Pathophysiology: “Leukocytosis can be a reaction to various infectious, inflammatory, and, in certain instances, physiologic processes (eg, stress, exercise). This reaction is mediated by several molecules, which are released or regulated in response to stimulatory events that include growth or survival factors (eg, granulocyte...
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...patient needs) Discharge to rehab facility. Nutrition consult. Educational needs Educate on low sodium diabetic diet. Medication teaching. How to accurately check blood sugar. Diagnostic Data: Labs: Lab Test Lab Date Lab Value Rationale for Abnormal/Significant labs Troponin I Admission Monday Tuesday Wednesday 0.34ng/ml Elevation of both Troponin and B Type Natriuretic peptide indicates continued ventricular strain which occurs with heart failure Pro B Type Natriuretic peptide Admission Monday Tuesday Wednesday 2701.0...
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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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...J christine August 17, 2013 Tuesday Clinical Background Information Patient: Betty Boop Sex: Female Married status: Widowed Age: 79 No. of children: 2 Occupation: Disabled Date admitted: 09/03/13 Admitting diagnosis: Hematemesis, melanotic stools, cirrhosis, hepatorenal syndrome. Allergies: Codeine Signs and symptoms on admission: fatigue, lethargic, oriented x 1, vomiting bright red blood, reported recent black stools, jaundice. Summary of History and Physical on admission: Patient has a history of hepatitis C, alcohol abuse, cirrhosis, GI bleed, and pancreatitis. Patient was lethargic, with mental status changes. Patient’s appearance is jaundice, stomach distended and tender to palpation. History of Surgical Procedures with dates: Not Known Patient was brought to Memorial ER by her neighbor who was with patient when she collapsed while checking the mail. She has multiple home medications including lactulose. She has a history of hepatitis C, pancreatitis, cirrhosis, and alcohol abuse. Patient is allergic to codeine. She is suspected to have hepatic portal hypertension. She is on Protonix, multi-vitamins, folic acid, thiamine and lactulose at home. Skin appears to be jaundice. Seems confused and is only oriented to place. Pupil’s dilated, not reactive to light and conjunctivae pallor. Patient is in no respiratory distress. Her abdomen is hard and tender. Blood Pressure 79/46, pulse of 59, respiratory rate of 22, and temp of . Patient possibly...
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...This assignment reflects on one day’s care delivered to a patient during my practice as a healthcare support worker (HSW). It presents anatomy and physiology of the urinary system and focuses on the patient’s catheter use, urinalysis, regular intake of medication and legal issues associated with delivery of care to the patient without mental capacity to make crucial decisions in his life. For the purpose of this care study, I use the pseudonym Chris for the patient in order to protect his identity and maintain confidentiality (NMC, 2008). There is also a legal obligation under Data Protection Act (1998) not to disclose patient’s personal details. Chris is a 73 year old male, who I worked with in a residential home for people with learning disabilities and challenging behaviour, where he was residing. Chris has been diagnosed with a learning disability (LD), which means that he has significantly. reduced ability to understand new or complex information and learn new skills (Department of Health, 2002). He has a reduced ability to cope independently due to recent leg amputation and the LD. Amputation is the surgical removal of a limb or body part (Mosquera, 2010). It was performed on Chris’s right leg above the knee to relieve the recurring pain caused by a severe case of peripheral artery disease (PAD). The PAD is a form of peripheral vascular disease in which there is partial or total blockage of an artery, caused by deposits of fat built up along its walls (Patient UK...
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...[pic] A Project Report On THE PRE – LAUNCH MARKET SURVEY OF CALCIUM SUPPLEMENTS At Shreya Life Sciences Pvt. Ltd Submitted to: Company Guide: Mr.Ranjeet Kadam General Manager Marketing, Akucare Division Submitted by: Darshana D Ghadi MBA (Bioinformatics) Dr. D.Y.Patil University, Department of Business Management . INDEX |SERIAL NO |CONTENTS |PAGE NUMBERS | |1 | PREFACE |3 | |2 |ACKNOWLEDGEMENT |4 | |3 |DECLARATION |5 | |3 |COMPANY PROFILE |6-10 | |4 |INTRODUCTION |11-14 | |5 |PRODUCT INTRODUCTION |15 ...
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