The victim should be positioned in a recovery position.
When you determine that a victim is unresponsive but breathing, it is important to position them in a recovery position while waiting for EMS personnel to arrive. The recovery position is the most appropriate and safe position for an unresponsive but breathing victim. This position helps to maintain an open airway, prevents the tongue from obstructing the airway, and allows any fluids, such as vomit, to drain out of the mouth. By positioning the victim on their side with their upper leg bent and their head tilted back, you can ensure that their airway remains clear and open.
Additionally, placing the victim in a recovery position can help prevent aspiration, which is the inhalation of vomit or other fluids into the lungs. This is crucial because aspiration can lead to serious complications, such as pneumonia or respiratory distress. By tilting the victim's head back and placing them on their side, you minimize the risk of aspiration and provide a safer environment for the victim until professional medical help arrives.
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which information would the nurse provide about pneumonia prevention to a group of adults older than age 60
The nurse can provide information on these aspects that can help in the prevention of pneumonia to a group of adults older than age 60 by covering all the relevant information and providing it in a language that is easy to understand.
Pneumonia is a potentially severe respiratory condition that can affect people of any age group. Pneumonia is especially dangerous for older adults and those with weakened immune systems. As a result, the nurse's job in educating individuals on ways to avoid pneumonia is critical. Here's what the nurse can do to educate the group of adults older than 60 years of age about pneumonia prevention:First and foremost, they should stress the importance of vaccines as a preventive measure.
Adults over the age of 65, in particular, should receive the pneumococcal vaccine, which helps prevent pneumococcal pneumonia. The CDC recommends that all adults over the age of 65 receive the vaccine at least once. Second, it is critical to avoid smoking and maintain a healthy lifestyle. Smoking harms the lungs, making them more vulnerable to infection. Third, the nurse should also emphasize the significance of personal hygiene, such as washing hands regularly.
Lastly, the nurse should encourage the group to eat a healthy diet to boost their immune system's function, which can help prevent pneumonia. These measures would help the adults to keep away from the condition.
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Based on your readings and/or other experiences and sources, describe the ways you will foster the spirit of inquiry so that the implementation of evidence-based findings within nursing practice becomes the norm. Support your post with a minimum of two (2) scholarly sources and examples (if warranted).
It is crucial for the implementation of evidence-based findings. Two key strategies for promoting this spirit of inquiry include promoting a culture of curiosity and providing access to research resources. These strategies can help nurses develop a mindset of seeking evidence and using it to inform their practice.
1. To foster the spirit of inquiry and make evidence-based findings the norm in nursing practice, promoting a culture of curiosity is essential. This involves creating an environment that encourages questioning, critical thinking, and curiosity among nurses. Leaders and educators can promote curiosity by encouraging nurses to ask questions, challenging assumptions, and seeking evidence to support their practice. For example, nursing educators can incorporate case studies or real-life scenarios into education programs, encouraging students to analyze the situation, gather relevant evidence, and make informed decisions based on the available research.
2. Additionally, providing access to research resources is vital for fostering the spirit of inquiry. Nurses need access to scholarly sources, research databases, and evidence-based practice guidelines to stay updated with the latest findings. Healthcare organizations can invest in subscriptions to research journals, provide access to online databases, and establish partnerships with academic institutions to ensure nurses have the necessary resources. By making research easily accessible, nurses are more likely to engage in evidence-based practice and incorporate the latest findings into their clinical decision-making process.
3. In conclusion, fostering the spirit of inquiry within nursing practice can be achieved by promoting a culture of curiosity and providing access to research resources. These strategies encourage nurses to question, seek evidence, and use it to inform their practice. By embedding the spirit of inquiry, evidence-based findings can become the norm, leading to improved patient outcomes and advancements in the field of nursing.
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f the patient has a right chest tube that was placed
after thorocotomy. Then the patient statrs that it is very painful when he cough asking for cough medicine. How would you handle this
a lethargic but oriented patient is being admitted for sepsis and the family is at the hospital. the patient has her ring cell phone and wallet and she asked if she can keep them with her
If a patient with a right chest tube placed after thoracotomy experiences pain when coughing and requests cough medicine, the nurse must follow these steps to handle the situation:
Assess the patient's pain level: Ask the patient about their pain level and request that they rate it on a scale of 0 to 10 (0 is no pain, and 10 is the worst pain imaginable)Administer the medication: If the patient's pain level is greater than 5, give them the prescribed cough medicine if it is prescribed and approved by the provider.Monitor the patient: Keep a close eye on the patient's oxygen saturation levels, vital signs, and level of consciousness throughout the process, and document the administration of the medication.
A patient who is being admitted for sepsis and is lethargic but oriented, and whose family is at the hospital, is asking to keep her ring, cell phone, and wallet with her. As a nurse, you must allow her to keep these items with her. It is important to encourage patients to keep their personal belongings with them in the hospital as they provide a sense of security and familiarity. Personal items such as cell phones, wallets, and rings should not interfere with the patient's care, and it is the responsibility of the nurse to ensure that they do not pose a risk to the patient's safety or privacy.
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a nurse assesses a client admitted to the cardiac unit. which statement by the client alerts the nurse to the possibility of right-sided heart failure?
Here's one statement that can alert a nurse to the possibility of right-sided heart failure: "I'm so tired, and I feel like I can't get enough air.
Right-sided heart failure is a cardiovascular problem. It occurs when the right side of your heart can't pump enough blood to meet the body's requirements.
Right-sided heart failure can be suggested by different statements made by a client admitted to the cardiac unit.
'Here's one statement that can alert a nurse to the possibility of right-sided heart failure: "I'm so tired, and I feel like I can't get enough air."
Right-sided heart failure happens when the right ventricle of the heart isn't functioning correctly.
The right ventricle is responsible for pumping blood into the lungs to oxygenate it, but when it can't do this, blood gets trapped in other parts of the body.
One result of this is a feeling of breathlessness and fatigue, as the oxygen is not reaching where it needs to.
Other symptoms of right-sided heart failure include:
Weight gainSwollen ankles, feet, and legsRapid heartbeat or heart palpitationsAbdominal bloatingReduced urination.To know more about heart visit:
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Lee MS, Hsu CC, Wahlqvist ML, Tsai HN, Chang YH, Huang YC. Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals. BMC Cancer 2011;11:20
The study titled "Type 2 diabetes increases and metformin reduces total, colorectal, liver and pancreatic cancer incidences in Taiwanese: a representative population prospective cohort study of 800,000 individuals" by Lee et al. (2011) found that having type 2 diabetes increases the risk of developing total, colorectal, liver, and pancreatic cancers in Taiwanese individuals.
However, the study also showed that the use of metformin, a commonly prescribed medication for diabetes, can reduce the incidence of these cancers. This study provides important insights into the relationship between diabetes, cancer, and the potential benefits of metformin.
In summary, the study suggests that individuals with type 2 diabetes should be aware of the increased cancer risk and discuss with their healthcare provider about the potential benefits of using metformin as a preventive measure.
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glycogen stores are an important source of glucose. athletes that compete in events lasting longer than 90 minutes can maximize their muscle glycogen stores before an event by carbohydrate loading or glycogen supercompensation. this involves consuming a very high-carbohydrate diet while resting for 36-48 hours before the event. how much carbohydrate should the diet provide?
Glycogen stores are an important source of glucose. Athletes that compete in events lasting longer than 90 minutes can maximize their muscle glycogen stores before an event by carbohydrate loading or glycogen supercompensation.
This involves consuming a very high-carbohydrate diet while resting for 36-48 hours before the event. The diet should provide 8-10g of carbohydrate per kg of body weight. Glycogen supercompensation helps to maximize glycogen stores by the consumption of carbohydrates-rich foods that increase glycogen synthesis. An athlete should consume 8-10g of carbohydrate per kg of body weight to optimize their muscle glycogen stores before an event.
Moreover, the athletes should consume a high-carbohydrate diet while resting for 36-48 hours before the event to enhance their performance during the event. A high-carbohydrate diet will help to increase the glycogen stores in the muscle which can be used as an energy source during an event. So, 8-10g of carbohydrate per kg of body weight should the diet provide.
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please explain why is important and link it cultural competence
course to it:
Make sure the interpreter conveys everything the patient says
and doesn't abbreviate or paraphrase.
It is important to ensure that the interpreter conveys everything the patient says without abbreviating or paraphrasing because accurate and complete communication is crucial in healthcare settings. Patients rely on effective communication to express their symptoms, concerns, medical history, and preferences, and healthcare providers need this information to make accurate diagnoses and provide appropriate care.
When an interpreter abbreviates or paraphrases the patient's words, important details can be lost or altered, leading to misunderstandings and potential errors in diagnosis and treatment. This can compromise patient safety and the quality of care they receive.
Linking this to cultural competence, it is essential to consider the cultural and linguistic backgrounds of patients when using interpreters. Different cultures may have unique communication styles, expressions, and idioms that are important for accurate understanding. Cultural competence emphasizes the importance of respecting and valuing diverse cultural practices and beliefs, including language use.
Healthcare providers should ensure that interpreters are trained in cultural competence and understand the need for accurate and complete communication. They should be familiar with both the patient's language and the healthcare terminology to accurately convey the patient's words without distortion. By promoting effective communication through skilled interpreters and cultural competence, healthcare providers can improve patient outcomes and ensure that patients receive equitable and patient-centered care regardless of their language or cultural background.
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cystic fibrosis is associated with group of answer choices asthma. chronic bronchitis. bronchiectasis. emphysema.
Answer and Explanation:
-
Bronchiectasis is common in individuals with cystic fibrosis because of their extremely viscous sputum, which easily grows Pseudomonas aeruginosa.
Identify vulnerable population that you see in your caseload or
that lives in your community.
Describe the impact of disparities of health services to that
population on health promotion outcomes.
Some examples of vulnerable populations that are commonly identified in healthcare settings and communities, along with the impact of health service disparities on their health promotion outcomes.
1. Low-income individuals and families: People with limited financial resources often face barriers to accessing healthcare services, including preventive care and health promotion programs. Disparities in health services can lead to reduced access to quality care, preventive screenings, and health education, resulting in poorer health outcomes for this population.
2. Racial and ethnic minorities: Minority populations may experience disparities in healthcare due to factors such as cultural and language barriers, discrimination, and limited access to healthcare facilities. This can lead to unequal health promotion outcomes, including higher rates of chronic diseases, lower preventive care utilization, and poorer overall health status.
3. Older adults: The aging population often faces unique challenges related to healthcare access and utilization. Disparities in health services can affect health promotion outcomes for older adults, including limited access to geriatric care, preventive screenings, and chronic disease management, potentially leading to higher rates of morbidity and functional decline.
4. Individuals with disabilities: People with physical, intellectual, or developmental disabilities may encounter barriers in accessing healthcare services, including lack of accommodations, inadequate provider training, and limited availability of specialized care. Disparities in health services can result in compromised health promotion outcomes for this population, impacting their overall well-being and quality of life.
The impact of disparities in health services on vulnerable populations can lead to higher rates of preventable illnesses, delayed diagnoses, and overall poorer health outcomes. Health promotion interventions, such as preventive screenings, health education, and access to appropriate care, are essential for reducing health disparities.
By addressing barriers and improving the availability, accessibility, and cultural competency of healthcare services, we can strive for more equitable health promotion outcomes for vulnerable populations.
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on one paragraph state how would you feel if a nurse gave a non-
verbal and verbal non-therapeutic communication towards your family
member in the hospital.
If a nurse gave a non-verbal and verbal non-therapeutic communication towards my family member in the hospital, I would feel concerned and frustrated.
Non-verbal communication, such as negative body language or lack of empathy, can make me feel that the nurse is uninterested or indifferent towards my family member's well-being. It may create a sense of disconnect and distrust, making it difficult to establish a positive therapeutic relationship.
Similarly, if the nurse uses non-therapeutic verbal communication, such as dismissive or condescending remarks, it can be hurtful and undermine the confidence and trust I have in the nurse's ability to provide compassionate care. Such interactions can lead to increased stress and anxiety for both my family member and myself, as we rely on healthcare professionals to provide support and comfort during a vulnerable time. It is important for nurses to be mindful of their communication, both verbal and non-verbal, and to prioritize therapeutic interactions that promote trust, empathy, and effective collaboration.
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What are the means and standard deviations (SDs) for age for the Buzzy intervention and control groups? What statistical analysis is conducted to determine the difference in means for age for the two groups? Was this an appropriate analysis technique? Provide rationale for your answer.
The means and standard deviations (SDs) for age in the Buzzy intervention and control groups were not provided. The statistical analysis conducted to determine the difference in means for age between the two groups was not specified.
Unfortunately, the information regarding the means and standard deviations for age in the Buzzy intervention and control groups is missing. Without these values, it is not possible to determine the specific statistical analysis technique used to compare the means of the two groups. Additionally, the question does not provide any information on the study design or data collection methods.
To determine the difference in means for age between the intervention and control groups, various statistical techniques can be employed, such as t-tests or analysis of variance (ANOVA) if there are multiple groups. The choice of analysis technique depends on the study design, assumptions of the data, and specific research questions being addressed.
Without knowing the specific analysis conducted, it is challenging to assess the appropriateness of the analysis technique. It is important to choose a statistical method that is appropriate for the study design, data distribution, and research objectives. Additionally, other factors such as sample size, independence of observations, and potential confounding variables should be considered to ensure the validity of the analysis.
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which tracheostomy cuff pressure would the nurse maintain to prevent mucosal ischemia or air leakage
The nurse should maintain a tracheostomy cuff pressure between 20 and 30 cmH2O to prevent mucosal ischemia or air leakage.
Maintaining an appropriate tracheostomy cuff pressure is crucial to prevent complications such as mucosal ischemia (lack of blood supply to the tracheal tissue) or air leakage. The recommended cuff pressure range is generally between 20 and 30 cmH2O.
To measure the cuff pressure, a handheld manometer or cuff pressure gauge is used. Here is a step-by-step explanation of how to measure and adjust the tracheostomy cuff pressure:
Prepare the equipment: Ensure that you have a handheld manometer or cuff pressure gauge, an appropriate syringe, and a sterile saline solution.
Aspirate the cuff pressure: Attach the syringe to the pilot balloon port of the tracheostomy tube cuff and gently withdraw air until there is no resistance felt. This step ensures that you start with a cuff pressure close to zero.
Inflate the cuff: Slowly inject sterile saline solution into the cuff using the syringe. Monitor the pressure on the manometer or cuff pressure gauge while inflating.
Measure the cuff pressure: Stop inflating the cuff when the pressure reaches the desired range of 20-30 cmH2O. Read the pressure value displayed on the manometer or cuff pressure gauge.
Remove excess air (if needed): If the cuff pressure exceeds the recommended range, release a small amount of air by gently depressing the syringe plunger to decrease the pressure. Check the pressure again until it falls within the desired range.
To prevent complications such as mucosal ischemia or air leakage, the nurse should maintain a tracheostomy cuff pressure between 20 and 30 cmH2O.
Regular monitoring and adjustment of the cuff pressure using a manometer or cuff pressure gauge are essential to ensure the pressure remains within the optimal range.
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the nurse is documenting the description and amount of wound drainage present in a stage iii pressure ulcer. which term should the nurse use to describe bloody drainage observed when the dressing was removed?
The nurse should use the term "serosanguineous" to describe the bloody drainage observed when the dressing was removed from a Stage III pressure ulcer.
When documenting wound drainage, it is crucial for healthcare professionals to use precise and standardized terminology. In the case of a Stage III pressure ulcer, which involves full-thickness tissue loss with visible subcutaneous fat, the nurse would expect various types of wound drainage, including bloody drainage.
The term "serosanguineous" accurately describes the observed drainage. It is a combination of two components: "sero" meaning serum or the clear portion of blood and "sanguineous" referring to blood. Serosanguineous drainage typically appears as a pinkish-red fluid and indicates the presence of both blood and serous fluid.
By using the term "serosanguineous," the nurse provides important information about the characteristics of the wound drainage. This documentation helps the healthcare team monitor the wound's progress, identify potential complications, and assess the effectiveness of the treatment plan. Additionally, using standardized terminology ensures clear communication among healthcare professionals and enhances patient care.
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Sally is a dedicated vegan. Her diet consists of mainly green leafy vegetables, nuts, and tofu. She is pregnant and gets sufficient folate from her diet. However, she gave birth to a child with a neural tube defect even though she was getting enough folate.Which other micronutrients could she be deficient in? Name at least two micronutrients that she may be deficient in, and for each micronutrient discuss the pathway and at least one enzyme that is being affected
Sally is a dedicated vegan who gets sufficient folate from her diet, mainly consisting of green leafy vegetables, nuts, and tofu. Despite getting enough folate, Sally gives birth to a child with a neural tube defect.
Hence, Sally may be deficient in other micronutrients, such as vitamin B12 and choline.Vitamin B12 is an important micronutrient that plays a crucial role in cell metabolism. In the body, vitamin B12 is mainly absorbed in the stomach and small intestine. Then, the vitamin B12 combines with a protein called intrinsic factor (IF) that is produced by the stomach's parietal cells and is carried to the ileum for absorption through receptor-mediated endocytosis. Vitamin B12 is vital for the proper functioning of the nervous system and is involved in DNA synthesis.
Additionally, the deficiency may affect the activity of the enzyme called methionine synthase, which is involved in the conversion of homocysteine to methionine. Choline is another important micronutrient that is required for the proper functioning of the nervous system, brain development, and DNA synthesis. Choline is absorbed in the small intestine and transported to the liver, where it is metabolized to betaine. Moreover, the deficiency may affect the activity of the enzyme called choline acetyltransferase, which is involved in the production of the neurotransmitter acetylcholine.
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1. D escribe a "critical incident," an experience where you believe the interventl difference in a client outcome. G ive a detailed description of what happened. 2. D iscuss any experience you have had with nursing care plans and concept fter reading further about these methods, which do you prefer and why? working with care plans/concept maps foster critical thinking in nursing? 3. D escribe how critical thinking, the nursing process, and evidence-based p together in caring for clients. What have you observed related to evidence-based practice in your workpla you think it is important to have an evidence-based practice philosophy?
A critical incident refers to a situation that has the potential to affect the patient's outcome. The following is an incident where my intervention had a positive impact on the client.
One of my patients was a middle-aged lady who had been admitted to the hospital with hypertension and diabetes. Despite the administration of various medications, her blood pressure continued to rise. I was assigned to the patient, and I noticed that she was anxious, which contributed to her elevated blood pressure. I started to talk to her and learn more about her medical history and lifestyle. I discovered that she had recently lost her job, which was causing her stress, and she was also going through a divorce.
I talked to her about her stressors and helped her to come up with ways to manage her stress. As a result, her blood pressure stabilized, and she was eventually discharged.
A nursing care plan is a detailed document that outlines the patient's nursing diagnosis, interventions, and expected outcomes. I have had experience with nursing care plans, and I prefer them to concept maps because they are more detailed and comprehensive.
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An antibiotic is to be given to an adult male patient (58 years, 75 kg) by IV infusion. The elimination half-life is 8 hours and the apparent volume of distribution is 1.5 L/kg. The drug is supplied in 60-mL ampules at a drug concentration of 15 mg/mL. The desired steady-state drug concentration is 20 mcg/mL.
c. Why should a loading dose be recommended?
d. According to the manufacturer, the recommended starting infusion rate is 15 mL/h. Do you agree with this recommended infusion rate for your patient? Give a reason for your answer.
e. If you were to monitor the patient’s serum drug concentration, when would you request a blood sample? Give a reason for your answer.
f. The observed serum drug concentration is higher than anticipated. Give two possible reasons based on sound pharmacokinetic principles that would account for this observation.
c. Loading dose: Achieve therapeutic levels quickly.
d. Recommended infusion rate: Close to calculated maintenance rate.
e. Blood sample: Request after 32-40 hours for steady-state concentration.
f. High serum concentration: Excessive dosing or impaired drug elimination.
c. A loading dose is recommended to quickly achieve the desired steady-state drug concentration. It helps rapidly establish therapeutic drug levels in the body, especially when the drug has a long half-life like in this case (8 hours). By administering a loading dose, the drug concentration can be raised to the target level more rapidly than if only maintenance doses were given.
To calculate the loading dose, we can use the following formula:
Loading Dose = Desired Concentration × Volume of Distribution
In this case, the desired concentration is 20 mcg/mL, and the volume of distribution is 1.5 L/kg multiplied by the patient's weight (75 kg):
Loading Dose = 20 mcg/mL × 1.5 L/kg × 75 kg
= 22,500 mcg
d. To determine if the recommended infusion rate of 15 mL/h is appropriate, we can calculate the infusion rate required to achieve the desired steady-state concentration.
Maintenance Infusion Rate = Desired Concentration × Clearance
The clearance can be calculated using the elimination half-life:
Clearance = 0.693 × Volume of Distribution / Half-life
= 0.693 × 1.5 L/kg × 75 kg / 8 hours
= 9.84 L/h
Maintenance Infusion Rate = Desired Concentration × Clearance
= 20 mcg/mL × 9.84 L/h
= 196.8 mcg/h
As the concentration is given in mg/mL, we convert the maintenance infusion rate to mL/h:
Maintenance Infusion Rate = 196.8 mcg/h ÷ 15 mg/mL
= 13.1 mL/h
The calculated maintenance infusion rate is approximately 13.1 mL/h, which is slightly lower than the recommended infusion rate of 15 mL/h.
e. To monitor the patient's serum drug concentration, a blood sample should be requested at a time when the drug has reached steady-state levels. This typically occurs after approximately 4-5 half-lives of the drug.
In this case, the elimination half-life is 8 hours.
Therefore, we need to wait for 4-5 half-lives:
4 × 8 hours = 32 hours
5 × 8 hours = 40 hours
f. There are two possible reasons based on sound pharmacokinetic principles that could account for the observed serum drug concentration being higher than anticipated:
1. Accumulation due to excessive dosing: If the drug has been administered at a higher dose or frequency than recommended, it can lead to drug accumulation in the body. This can result in higher serum drug concentrations than anticipated.
2. Impaired drug elimination: If the patient has impaired renal or hepatic function, the clearance of the drug from the body may be decreased. This can result in slower elimination and higher serum drug concentrations.
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18. Which of the following statements made by a parent of an infant with cerebral palsy would indicate a need for further teaching? a. It is not a genetic condition b. It means my child will have many disabilities c. It is a condition that does not progress d. It can occur because of low levels of oxygen at birth 19. What clinical manifestations would suggest hydrocephalus in a neonate? a. Bulging fontanel, dilated scalp veins b. Closed fontanel, high-pitched cry c. Constant low-pitched cry, restlessness d. Depressed fontanel, decreased blood pressure 20. An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Postoperative nursing care should include which of the following? a. Monitor closely for signs of infection b. Pump the shunt reservoir to maintain patency c. Administer sedation to decrease irritability d. Maintain Trendelenburg position to decrease pressure on the shunt 21. The nurse is caring for a child who has been in an automobile accident. The child continues to fall asleep unless her name is called, or she is gently shaken. Which term could be used to document this state of consciousness? a. Coma b. Delirium c. Obtunded d. Confusion 22. The nurse is caring for a child just admitted with bacterial meningitis. When reviewing the child's plan of care, which of the following orders should the nurse question? a. Maintain isolation until 24 hours after receiving IV antibiotics b. Administer acetaminophen for temperature higher than 38 C c. Assess neurological status every 2 hours d. Administer IV fluids at 1½ times maintenance 3. The nurse is caring for a child with epidural hematoma. The nurse should assess for what gns that can indicate Cushing triad? (SELECT ALL THAT APPLY) a. Fever
18. c. It is a condition that does not progress.
Cerebral palsy is a neurological condition characterized by impaired movement and posture. While the severity and progression of symptoms can vary, it is incorrect to state that cerebral palsy does not progress. The condition can change and have different manifestations as the child grows and develops. Further teaching is needed to address this misconception.
19. The clinical manifestations that would suggest hydrocephalus in a neonate are:
a. Bulging fontanel, dilated scalp veins
Hydrocephalus is characterized by an accumulation of cerebrospinal fluid in the brain, leading to increased intracranial pressure. Bulging fontanel (soft spot on the infant's head) and dilated scalp veins are classic signs of increased intracranial pressure and can indicate hydrocephalus.
20. Postoperative nursing care for an infant with a ventriculoperitoneal shunt includes:
a. Monitor closely for signs of infection
After the surgical placement of a ventriculoperitoneal shunt, monitoring for signs of infection, such as fever, redness, swelling, or drainage at the incision site, is crucial. Prompt detection and treatment of infections are necessary to prevent complications.
21. The term that could be used to document the child's state of consciousness is:
c. Obtunded
Obtunded refers to a state of altered consciousness in which the child is less responsive and has a decreased level of awareness. The child in this scenario can only be awakened with a stimulus such as calling their name or gentle shaking.
22. The order that the nurse should question when caring for a child with bacterial meningitis is:
d. Administer IV fluids at 1½ times maintenance
In bacterial meningitis, increased intracranial pressure is a concern. Administering IV fluids at 1½ times maintenance may worsen cerebral edema and increase intracranial pressure. The nurse should question this order and discuss it with the healthcare team.
23. The signs that can indicate Cushing triad in a child with epidural hematoma are:
- Increased blood pressure (hypertension)
- Bradycardia (slow heart rate)
- Irregular or abnormal respirations
These signs indicate increased intracranial pressure and can be observed in children with epidural hematoma. Prompt recognition and appropriate intervention are essential in managing this condition.
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THE CASE OF HEARTY KAPUSO
Hearty Kapuso, a 10-month old infant was admitted for the second time in the Pediatric ICU Bed 4 at Corazon Memorial Medical Center due to central cyanosis, respiratory distress and oxygen saturation of 90%
Upon seeing the client, she has an IVF of D5LR 500ml at 120cc/hr infusing well at left metacarpals vein and had oxygen therapy via facemask at 6 liters per minute and standby intubation using 3.5mm uncuffed endotracheal tube. She was on on high back rest with difficulty of breathing and a capillary refill time of 3 seconds. Her Foley catheter attached to the urine bag draining to 110 cc level with amber yellow color urine. The Doctor ordered Cefuroxime 180mg TIV ANST q12h (Stock available 500mg diluted to 5ml) Propranolol 1mg PO OD (stock 2mg/tab), Paracetamol 85 mg IV PRN (stock 150mg/2ml for temp more than or equal to 39.5°C, Ancillaries test for CBC, UA was done at ER with pending ABG, serum electrolytes and Chest X-ray
Still on mixed feeding with strict aspiration precaution.
Seen by Dra. Mea Amor her attending Pediatrician with adiagnosis of Congenital heart defect cyanotic type R/O Tetralogy of Fallot
Patient’s profile
Hearty Kapuso is 10-month old female, Catholic and weighs 7.4kg with blood type B+, no allergies noted
Address: 30Pinagpusuan St. Kamahalan City Manila
DOB: August 18, 2020
DOA: June 19, 2021 at 9:20 am
Hospital Number : 2020-183019
Vital Signs:
Temp – 38.9°C PR – 122bpm RR – 38cpm CR – 138bpm BP – 90/60mmHg O2 sat – 90%
Physical examination:
She has a dark skin complexion and evenly distributed hair. Skin is dry and warm to touch. Clubbing finger nails noted with bluish discoloration of nailbeds onboth upper and lower extremities non pallor palmar creases. She has some round scars on both legs. Hair is black and no infestations noted upon inspection. Head is normocephalic with no abnormalities noted. Eyes are symmetrical and are aligned at the upper pinna of the ear. Iris is color brown and pupils are equally rounded and are reactive to light accommodation with a diameter of 2 mm, non-pallor conjunctiva. Ears are symmetrical and are aligned at the outer canthus of the eye. Eardrums are intact with cerumen noted upon inspection. No lesions, discharges or abnormalities noted. Nasal flaring noted, no lesions or discharges noted upon inspection. Client was able to swallow without difficulty. Flex neck from front to back and side without any discomfort. Upon palpation of the neck, no mass was noted. Lips have a bluish discoloration with dry mucous membranes and dry tongue, no lesions or abnormalities. Chest is slightly barrel chest with right side of the chest enlarged with AP diameter of 2:1 with clear breath sounds noted with use of accessory muscles noted. . Heart murmur was heard on auscultation along the left sternal border. The abdomen is flat and brown in skin color. Normo-active bowel sounds were heard upon auscultation. no lesions are noted upon inspection. Client has a Foley catheter attached to urine bag at 110cc level with amber yellow colored urine. no lesions or abnormalities noted.
Familial Health History
History taking it revealed that on the Paternal side, the Grandfather has a heart problem, while her grandmother has no hereditary disease.
(+) hypertension and (+)asthma in the family
Both parent was negative to this disease, Hearty’s mother is non-smoker but alcohol drinker.
Medical Health History
Perinatal (Mother)
Prenatal check-up was started at the 4th month of pregnancy and Tetanus toxoid 1 was given. The mother had a febrile episode during the 3rd month of pregnancy. the mother did not consult a physician and there no medication was taken. She gave birth at a Lying-In clinic, full term via normal spontaneous vaginal deliver assisted by a Midwife. The baby presented poor and delayed crying with cyanosis.
OB score G2P1 (1-0-1-1)
Past Medical Illness
Her mother noted that in 4thmonth of age, the client had an episode of syncope, (-) cold and (+) cough for 2 weeks which led her to admit at a local hospital and then was referred to Corazon Memorial Medical Center where she was diagnosed with CHD ruled out Tetralogy of Fallot. 2D Echo was done revealed the presence of a hole in the client’s heart. Surgical management was advised but they refused due inadequate financial resources. She was then discharged with a home medication of Propranolol once a daybut the client mother did not comply. Due to poor compliance to the medication and refusal to the advised for surgical management, the child’s condition was not alleviated and she experienced on and off dyspnea, orthopnea and occasional congestion.
Present Illness
The client become restless and became cyanotic after defecating,which prompted them to rushher to CMMC
Dra. Mea Amor the attending pediatrician advised admission at Pediatric ICU for further medical management.
TASK:
1. Review of the system sheet and at the back of this form make an expound Familial and Medical history of the client.
The client's father has a heart problem, and there is a history of hypertension and asthma in the family. The client's mother is a non-smoker but an alcohol drinker.
The client's father has a heart problem, which suggests that there may be a genetic predisposition to heart disease in the family. The presence of hypertension and asthma in the family also suggests that there may be a genetic predisposition to these conditions. The client's mother is a non-smoker but an alcohol drinker, which could increase her risk of developing health problems.
The client's medical history is also significant. She was born with a congenital heart defect, which has required her to be hospitalized on two previous occasions. She has also experienced episodes of syncope, cough, and congestion. These symptoms suggest that her heart condition is not well-controlled and that she is at risk for further complications.
The client's familial and medical history are important factors that will need to be considered in her treatment plan. The healthcare team will need to work with the client and her family to develop a plan that will help to manage her heart condition and prevent further complications.
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there is family outbreak of 0157.H7 on a local farm and the family is quite concerned about the source of infection, particularly as the two youngest children are hospitalizes with hemorrhagic colitis. the farm has a private water supply and a fast food chain restaurant. outline the steps that should be taken to investigate the outbreak and identify the extent of any sampling that you would request
To investigate the outbreak of E. coli O157:H7 and identify the source of infection, the following steps should be taken: Epidemiological investigation, Environmental sampling, Laboratory analysis,Traceback investigation, Public health intervention.
When investigating an outbreak of E. coli O157:H7, a comprehensive approach is necessary to identify the source of infection and prevent further cases. The first step involves conducting an epidemiological investigation. This includes obtaining detailed information from the affected family members about their symptoms and exposure history. By identifying common factors among the affected individuals, potential sources of contamination can be identified.
Simultaneously, environmental sampling is crucial to collect samples from potential sources of infection. In this case, the private water supply and the fast food chain restaurant are the main focus. Water samples from different points in the supply system should be collected, as E. coli can contaminate the water source. Additionally, samples should be taken from food preparation surfaces, equipment, and ingredients at the restaurant, as contaminated food can also be a source of infection.
The collected samples should be sent to a certified laboratory for analysis. The laboratory will use specific microbiological techniques to detect the presence of E. coli O157:H7 in the samples. If the pathogen is found in the water supply or food samples, it indicates a potential source of the outbreak.
Simultaneously, a traceback investigation should be conducted to identify the source of contaminated ingredients used in the restaurant. This involves tracing the supply chain from the restaurant's suppliers and distributors and collecting samples from their facilities for testing. Identifying the contaminated ingredient can help pinpoint the source of the outbreak.
While waiting for the laboratory results, immediate public health interventions should be implemented to prevent further spread of the infection. This may include advising affected individuals to seek medical attention, promoting proper hygiene practices such as handwashing, and temporarily suspending the use of the private water supply or certain food ingredients at the restaurant until the source of contamination is identified and resolved.
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a nurse evaluates laboratory results for a client with heart failure. which results would the nurse expect? (select all that apply.)
The expected laboratory result in a client with heart failure would be increased levels of brain natriuretic peptide (BNP). Here option A is the correct answer.
When evaluating a client with heart failure, a nurse would expect to see increased levels of brain natriuretic peptide (BNP). BNP is a hormone released by the heart in response to increased stretching of the ventricular walls, which commonly occurs in heart failure.
Elevated BNP levels indicate the presence of heart failure and can help in confirming the diagnosis, assessing the severity of the condition, and monitoring response to treatment.
Troponin is a cardiac enzyme released into the bloodstream when there is damage to the heart muscle, typically seen in conditions such as myocardial infarction (heart attack).
In heart failure, troponin levels may be normal or slightly elevated due to the strain on the heart, but a significant decrease would not be typical. Therefore option A is the correct answer.
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Complete question:
Which of the following laboratory results would a nurse expect when evaluating a client with heart failure?
A) Increased levels of brain natriuretic peptide (BNP)
B) Decreased levels of troponin
C) Elevated white blood cell count
D) Decreased serum potassium levels
which term is used to describe an objectively identifiable aberration of the disease? group of answer choices syndrome symptom sign stage
The term used to describe an objectively identifiable aberration of the disease is a sign.
In medicine, the term "sign" refers to an objectively identifiable aberration or manifestation of a disease. Unlike symptoms, which are subjective experiences reported by the patient, signs are measurable and observable by healthcare professionals.
They can include physical findings, such as abnormal laboratory results, changes in vital signs (e.g., heart rate, blood pressure), or visible alterations in the body (e.g., rash, swelling). Signs provide crucial diagnostic information and help physicians assess the severity and progression of a disease.
By recognizing and interpreting these objective indications, healthcare professionals can make informed decisions about treatment and management strategies for patients.
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The paramedic dispatched to patient with drug overdose of paracetamol orally. Initial management was provided on site and the patient was retrieved to the nearest hospital. Which of the following test the paramedic is expected to assess for the most common organ damage due to overdose? Select one: a. Pulmonary function test b. Liver function test c. Kidney function test d. Electrocardiography (ECG)
The correct answer is (Option B) Liver function test.
In the case of a drug overdose of paracetamol (acetaminophen), the most common organ damage is seen in the liver. Paracetamol overdose can lead to hepatotoxicity, causing liver damage or failure.
To assess the extent of liver damage, the paramedic is expected to assess the patient's liver function by performing a liver function test. This test typically includes several blood tests, such as:
Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels: Elevated levels of ALT and AST indicate liver cell damage.
Bilirubin levels: Increased bilirubin levels can be a sign of impaired liver function.
Alkaline phosphatase (ALP) levels: Elevated ALP levels may indicate liver or biliary tract dysfunction.
Prothrombin time (PT) or International Normalized Ratio (INR): Prolonged PT or increased INR can suggest impaired liver synthetic function.
Given that the patient in question has experienced a drug overdose of paracetamol, the paramedic should primarily assess the patient's liver function by performing a liver function test.
This is important because paracetamol overdose can cause significant liver damage, and monitoring liver function is crucial for timely intervention and appropriate management.
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Read the case study, then answer the questions that follow.
Peter is 74 and has Parkinson’s disease. He resides in his own home in the community. When the support worker arrives, she finds that Peter has left all his washing in the basket in the laundry. When the worker asks Peter why he hasn’t hung out the washing, he tells her that he can’t lift the sheets and towels onto the clothes line because they are too heavy.
What support strategies or resources need to be implemented to ensure Peter can remain living as independently as possible? Identify at least five strategies or resources that can help Peter remain independent. (Approx. 30 words that you can present in a bullet point list if you wish).
Assistive devices: Provide Peter with tools such as a lightweight laundry basket, a reacher/grabber tool, or a clothesline pulley system to help him with lifting and hanging laundry.
Occupational therapy: Arrange for an occupational therapist to assess Peter's home environment and suggest modifications or adaptations that can make tasks easier, such as installing a lower clothesline or adding handrails.
Home support services: Arrange for a home support worker or cleaner to visit regularly and assist Peter with household chores, including laundry.
Exercise and mobility programs: Encourage Peter to participate in exercises and mobility programs specifically designed for individuals with Parkinson's disease to improve his strength, coordination, and overall physical abilities.
Education and training: Provide Peter and his support worker with education and training on Parkinson's disease management, including energy conservation techniques and strategies for adapting daily activities to conserve energy and reduce fatigue.
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What role do you think you could play in creating a more diverse, equitable, and inclusive nursing presence in your communities?
As a nurse In my community, I will address biases and Stereotypes I can help challenge biases and stereotypes by providing accurate and unbiased information and promoting a more inclusive understanding of nursing and healthcare.
What is meant by the word nursing?In a broad sense, it denotes kindness, tolerance, empathy, and sensitivity. It entails being available for a complete stranger at all times of the day and night. It is the capacity to maintain composure in even the most trying circumstances for a patient's loved ones.
Autonomy, beneficence, justice, and non-maleficence are the four major tenets of ethics.
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Electronic documentation tools offer many features that are designed to increase both the quality and the utility of clinical documentation, enhancing communication between all healthcare providers. What are some of the tools that make this possible
Electronic documentation tools in healthcare enhance clinical documentation quality and utility while improving communication between providers.
Electronic documentation tools, such as electronic health records (EHR) systems, offer features that improve clinical documentation. They capture and store patient data electronically, providing easy access to medical history and test results. These tools facilitate real-time collaboration and information sharing among healthcare providers, ensuring effective communication and better care coordination. Decision support systems, standardization templates, and data analytics capabilities further enhance documentation quality and support informed decision-making. Overall, electronic documentation tools improve patient care, care coordination, and healthcare efficiency.
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32. The sores produced from syphilis in its earliest stage are called a. Blisters b. Warts c Chancres d. Rashes 33. Treatment for gonorrhea indudes a. Antiviral drugs b. Antifungal drugs Antibiotics d. Acyclovir 34. Chlamydia is the most common STD. STD. 34. Chlamydia is the most common a Viral b. Bacterial c. Fungal d. Protozoal 35. The main routes of HIV transmission include all of the following EXCEPT a. Certain types of sexual contact b. Direct exposure to infected blood C. HIV-infected woman to fetus d. Sharing eating utensils 36. Pelvic inflammatory disease (PID) is a common complication of a. Syphilis and herpes b. Herpes and gonorrhea C Genital warts and Chlamydia d. Gonorrhea and Chlamydia
The sores produced from syphilis in its earliest stage are called chancres. Treatment for gonorrhea involves antibiotics. Chlamydia is the most common bacterial STD. The main routes of HIV transmission include certain types of sexual contact.
1. The sores produced from syphilis in its earliest stage are called chancres. Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Chancres typically appear as painless ulcers or sores at the site of infection, often on the genitals, rectum, or mouth.
2. Treatment for gonorrhea involves antibiotics. Gonorrhea is a common bacterial STD caused by the bacterium Neisseria gonorrhoeae. Antibiotics are used to treat the infection and prevent complications. It's important to complete the full course of antibiotics as prescribed by a healthcare professional.
3. Chlamydia is the most common bacterial STD. Chlamydia is caused by the bacterium Chlamydia trachomatis. It is a highly prevalent sexually transmitted infection, and many individuals infected with chlamydia may not experience noticeable symptoms. Regular testing and treatment are important to prevent complications and reduce the spread of the infection.
4. The main routes of HIV transmission include certain types of sexual contact, direct exposure to infected blood, and HIV-infected woman to fetus. HIV (Human Immunodeficiency Virus) is primarily transmitted through sexual intercourse, especially if there are open sores, blood contact, sharing contaminated needles or other drug paraphernalia, and from an HIV-infected mother to her baby during pregnancy, childbirth, or breastfeeding. Sharing eating utensils is not a common route of HIV transmission.
5. Pelvic inflammatory disease (PID) is a common complication of gonorrhea and chlamydia. PID refers to an infection of the female reproductive organs, including the uterus, fallopian tubes, and ovaries. Untreated or inadequately treated gonorrhea and chlamydia infections can ascend into the upper genital tract and lead to PID. PID can cause chronic pelvic pain, infertility, and other serious complications if not promptly treated with antibiotics. Regular screening, early detection, and appropriate treatment of sexually transmitted infections can help prevent PID.
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Measures in Epidemiology Worksheet 2: Practice Problems in Measures of Association (Student Version) Name 1. Describe in your own words what it means for two variables to be associated. 2. Suppose it were true that studying was a risk factor for better grades. To specify these vari- ables, we will offer these values: student could study less or more and could get better or worse grades. Fill in the top row and left column of the table below with variable names that would lead to a calculation of an association between these variables. (Hint: Put the risk factor in the left column, and the outcomes in the top row.) Grades vs. Studying: Round 1 Total Total 3. Suppose that of 80 students who studied more, 50 of them got better grades, and of 60 stu- dents who studied less, 35 got better grades. Fill in the table below and calculate the rate difference and the relative risk. Use your results to assess the risk posed by studying. Is it possible that students who study more are at risk of better grades, based on these data? Grades vs. Studying: Round 2 Total Total Measures in Epidemiology 4. Smoking and duodenal ulcers. The Health Professionals Follow-up Study is a prospective study of heart disease and cancer among more than 50,000 health professionals in the United States who were 40-75 years of age in 1986. Every two years questionnaires are sent to these individuals, and newly diagnosed cases of various diseases are reported. The fol- lowing data are constructed from the surveys returned in the 1992 mailing. The investiga- tors in this study were interested in the relationship between smoking status and duodenal ulcers, a common disorder of the gastrointestinal tract. The incidence of duodenal ulcers for three groups is presented below: Smoking and the Incidence of Duodenal Ulcers Number of Persons Number of Observed New at Start of Study Cases of Duodenal Ulcers Nonsmokers 22,295 60 Past Smokers 20,757 60 Current Smokers 4,754 16 a. Calculate the relative risks of being a past smoker and a current smoker, relative to never having smoked. (Hint: You should make two tables, one for smokers and one for past smokers.) b. It is sometimes said by smokers, "The damage has been done, so I might as well keep smok- ing." Others believe that if they quit "right now their risk will be decreased. Which view is supported by the relative risks you calculated above? c. In your judgment, what values for the relative risks would support the opposite view from the one you believed was supported in part b?
The provided worksheet includes several questions related to measures of association in epidemiology. The first question asks for a description of what it means for two variables to be associated.
1. When two variables are associated, it means that there is a relationship or connection between them. The presence or level of one variable is related to the presence or level of the other variable.
2. The table provided is used to assess the association between grades and studying. In the left column, the variable "Studying" represents the level of studying (less or more), which acts as the risk factor. In the top row, the variable "Grades" represents the outcomes (better or worse grades).
3. Based on the given data, we can fill in the table and calculate the rate difference and relative risk. The table will have four cells representing the number of students who studied less and got better grades, studied less and got worse grades, studied more and got better grades, and studied more and got worse grades. Using these numbers, we can calculate the rate difference, which measures the absolute difference in rates between the two groups, and the relative risk, which compares the risk of better grades between the two groups. By assessing these measures, we can determine if studying is associated with better grades based on the provided data.
4. In this scenario, the relative risks of being a past smoker and a current smoker, relative to never having smoked, need to be calculated. Two tables should be constructed, one for smokers and one for past smokers, indicating the number of persons at the start of the study and the number of observed new cases of duodenal ulcers. The relative risk can be calculated by comparing the incidence of duodenal ulcers between the two groups (smokers and past smokers) and the reference group (nonsmokers). This helps assess the relationship between smoking status and the risk of developing duodenal ulcers.
Based on the relative risks calculated, it can be determined whether the view that quitting smoking reduces the risk is supported. If the relative risks for past smokers and current smokers are lower than those for nonsmokers, it suggests that quitting smoking decreases the risk of developing duodenal ulcers. On the other hand, if the relative risks for past smokers and current smokers are higher than those for nonsmokers, it implies that the damage from smoking persists even after quitting.
In terms of the values for the relative risks, if the relative risks for past smokers and current smokers are closer to 1 (no association), it would support the opposite view from the one supported in part b. This would suggest that quitting smoking does not significantly decrease the risk of developing duodenal ulcers.
It is important to note that the specific calculations and interpretations may vary depending on the actual data and statistical methods used.
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a nurse is caring for a school age child following the application of a cast to a fractured right tibia. which of the following actions should the nurse take first?
A nurse is caring for a school-age child following the application of a cast to a fractured right tibia. Which of the following actions should the nurse take first? When caring for a school-age child who has just received a cast for a fractured right tibia, the nurse must ensure that the child is comfortable and safe.
Cast care is crucial in order to prevent any additional complications or damage. Before undertaking any other activity, the nurse must first evaluate the child's level of pain. Pain is the child's main complaint, and it can be quite debilitating. Therefore, the nurse must evaluate the pain level by conducting a pain assessment. It is important to conduct a pain assessment regularly in order to monitor the child's pain level. The frequency of pain assessment should be determined by the child's age and level of pain and discomfort.
There are many different methods for assessing pain, but using a pain scale is a good starting point. The most widely used pain scale is the numeric rating scale, which asks the patient to rate their pain on a scale of 1 to 10. Another method is the visual analogue scale, which uses a visual scale to rate pain.The nurse can also use a variety of non-pharmacological pain relief techniques, such as distraction, relaxation, deep breathing, and guided imagery. After evaluating the child's level of pain and providing the necessary pain relief, the nurse can begin to address other concerns, such as mobility and skin care.
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Activity Time: 2. Hours, Additional Time for Study, Research, and Reflection: 1 Hour Directions: The elimination patterns of our patients are very important to know as we continue to assess and do our care plans. How can impaired elimination affect the integumentary system?
Impaired elimination can have a few impacts on the integumentary framework, which incorporates the skin, hair, nails, and related organs.
What is the care plans?The few ways impeded elimination can influence the integumentary framework are:
Skin conditions: elimination patterns , such as stoppage or lacking liquid admissions, can lead to poison buildup within the body. These poisons can be dispensed with through the skin, coming about in different skin conditions. Cases incorporate skin break out, rashes, dermatitis, and hives.
Dry skin: Lacking disposal can lead to lack of hydration, which can cause dry skin.
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the nurse provides a client with a dose of the beta-selective adrenergic agonist isoproterenol. which assessment finding indicates the medication is effective?
In the case above, the nurse administers a dose of the beta-selective adrenergic agonist isoproterenol to a client.
What is the assessmentTo survey the viability of the pharmaceutical, the nurture ought to screen the client for change in respiratory work. Isoproterenol is fundamentally utilized to treat bronchospasm and respiratory trouble in conditions such as asthma or incessant obstructive aspiratory infection (COPD).
Hence, an appraisal finding that demonstrates the pharmaceutical is compelling would be an advancement within the client's breathing design, expanded ease of breathing, diminished wheezing, or help from shortness of breath.
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Answer:
increased heart rate
Explanation:
Therapeutic effects of isoproterenol are related to its stimulation of all beta-adrenergic receptors. Desired effects of the drug include increased heart rate, conductivity, and contractility in addition to effects on the respiratory and vascular system. Anticipated effects of the medication include dilated and not constricted pupils. Sweating and not warm, dry skin is an expected effect. An increase and not a decrease in urine output would occur as an effect on the blood vessels to the kidneys.
