1.1.4.2. Symptomatic treatment of ADPKD Cases of ADPKD require a symptomatic treatment by prophylactic and supportive measures such as tight blood pressure management; also include adequate pain control, antibiotics for urinary tract infections, sufficient fluid intake, and avoidance caffeine and smoking. Urinary tract infections could be treated by using cyst-penetrating antibiotics, which is lipophilic agents penetrate the cysts consistently such as trimethoprim-sulfamethoxazole and fluoroquinolone (Elzinga et al., 1987 and Elzinga et al., 1988). 11.126,127, Whereas cyst hemorrhages require a careful administration with bed rest, analgesics and water. Also cases of nephrolithiasis require prophylactic measures, which include good water intake, such as potassium citrate was suggested for three causes of stones associated with ADPKD, uric acid lithiasis, hypocitraturic calcium oxalate nephrolithiasis, and distal acidification defects (Torres et al., 2007). 9A. In severe cases, stone can be treated by alternative approaches, which include extracorporeal shock wave lithotripsy and percutaneous nephrostolithotomy (Christian et al., 2010)11. …show more content…
Also use of narcotic analgesics must be retreated for acute episodes to minimize the potential for dependence (Grantham, 1992) 11.130. When conservative measures fail, surgical interventions ranging from cyst aspiration and sclerosing agents to laparoscopic or surgical cyst fenestration can be considered. Laparoscopy can be carried out only on dialysis-dependent patients as it eliminates any remaining renal function, essentially decreasing GFR to zero (Lee et al., 2003)
Justin is the registered nurse that has been given the handover for Kelly Malone’s postoperative care in the surgical unit. Kelly Malone is a 49 female patient who has had a septoplasty and a right ethmoidectomy. Justin is working with Kelly to identify Kelly’s needs in order for Kelly to be discharged from the hospital. Kelly’s postoperative observations were a temperature of 36.2 degrees celsius; heart rate of 68 beats per minute; respiratory rate of 18 breaths per minute, blood pressure of 111 systolic over 73 diastolic millimetres of mercury; oxygen saturation at 93 percent of room air and a self-rated pain score of two out of ten. Kelly has a history of ‘not being able to breathe well through her nose’ and a history of disturbed sleep.
I spoke with Michelle Chilies-Kusiolek, Chief (RMO). Ms. Chilies Kusiolek declined to give age, race, color or gender. She stated that she is aware of the incident and the alleged racial slur. She contacted the Human Resource department to give her guidance on what would be the appropriate course of action.
Discussion Post Week ten NURS 6501, N-21 Urinary tract infections (UTIs) are usually caused by bacteria and are common. Symptoms of both upper and lower infections are similar; therefore, it is important for advanced practice nurses (APNs) to be able to determine the pathophysiology of upper and lower UTIs. The purpose of this discussion is to evaluate the similarities and differences between upper and lower UTIs, clinical manifestations, treatments, and factors affecting all of these things. UTIs are infections that may occur anywhere in the urinary tract such as the urethra, bladder, ureters, and kidneys. Typically UTIs are caused by bacteria from the gut flora and are inflammation of the urinary epithelium.
Thank you Mrs. Stephanie Smeltzer, for providing the team with the recent incident of Aki. To the school and treatment team, as Aki is receiving OPT/TSF services through New Behavioral Network in his school and family session (only provided by his Therapeutic Support for Families (TSF) worker) on Thursday due to his foster mother’s availability. It is noted, Aki has started to display more frequent aggressive behaviors in his classroom which has been observed by his TSF worker along with school officials, to which the Aki’s behaviors has become a concern as it is putting others at risk of his tantrums as his exhibiting behaviors of throwing objects which last for a period of 2 hours.
The Miami Dade Police depart is currently preparing for the Democratic-Republican National Convention. With proper research, training and an open mind individuals the MDPD can properly plan and execute the DRNC. The actions that should be taken to encourage new ideas from the front line officers in the department to improve crowd control tactics is collaborating with other government agencies and real like scenario training. Major Louis Warren should contact different government agencies such as (FBI,CIA ,Sercet Services) to collaborate and help generate new ideas for the front line officers.
Patients evaluated in acute pain will often have narcotics withheld until after the patient has been evaluated by a surgeon and has given informed consent. Concern that the patient would have impaired judgment due to narcotic effects often prevents the administration of timely pain relief. Similarly administration of anxiolytics and benzodiazepines are avoided until the patient has consented to the procedure. As there is a considerable heterogeneity in the metabolism of a particular drug depending on age and patient characteristics, there is no specific timeline of how long should one wait prior to getting consent if these medications are given accidentally.
After the first session of Gua Sha and Fang Xie (bloodletting therapy), this patient felt less pain and is now capable of drinking a small amount of
PKD can expand the kidneys until each one is bigger than a football. As polycystic kidney disease becomes more advanced, the kidneys inability to function properly becomes more pronounced. The cysts on the kidney may begin to rupture and the kidneys tend to be much larger than normal. People affected with this disease have a much higher rate of kidney stones than the rest of the population. Because the kidneys are primarily responsible for cleaning the blood, people affected often have problems involving the circulatory
Nutritional Assessment & Health Promotion for C.D. Most teenagers do not worry about what they eat. Numerous of them participate in sports or extra curricular activities that leave them with limited time to eat. As a result of their busy schedules, teenagers often get food by going to a fast food restaurant. Usually, bad food choices do not cause teenagers to gain weight, especially if they are physically active.
It has been diagnosed that kidney stones are very common in individuals that have a diet that is high in oxalates . Another known cause for formation of kidney stones is high alkalinity or high acidity of urine. However, genetics also can play a role in kidney stones. A person who has had kidney stones often gets them again in the future. Actually, you have a 50% chance of recurrence within 8 years of the first
In order to diagnosis of painful hydronephrosis in hospital, computed tomography (CT) scans is better than more-often-used ultrasound examinations, according to a clinical study conducted in few medical centers. Computed tomography and ultrasound are most usable modalities that commonly able to demonstrate both directly and indirectly of dilated ureter or known as hydronephrosis. (Jeffrey 2014) . Generally, excessive water consuming may cause gradual renal accumulation of fluids, resulting in hydronephrosis. This continuous accumulation may cause a higher degree of hydronephrosis and resulting impairment of renal function.
Reflect upon the clinical problem that you have identified in your area of nursing practice (as identified in Module 1). Critically appraise the research and summarize the knowledge available on the clinical problem. The problem that was identified in my module 1 is Oxygen desaturation in the pacu patient or post-op surgical patient, patient that is still on opiate analgesics after surgery. The clinical problem that was presented in module 1 reflects on the bodies decrease respiratory capacity after receiving opioid analgesics, or IV anesthesia during the operative setting.
Good morning, Thank you for taking the time and meeting with me yesterday. It was a pleasure meeting Mr. Zack and Mr. Perva. I like the variety of work your company does and me being able to work at different projects at once. I really like the culture of KPI Technology and feel as if I would make a great all-around fit. I believe I would be an asset to KPI Technology because I am a hard-worker, quick learner, and have good communication skills.
Objective: the aims of this study to evaluate the efficacy of Tamsulosin 0.2mg in post shock wave lithotripsy of renal pelvic Stone ≤ 2 cm. Patients and methods: Prospective randomized placebo-controlled double-blind clinical study was conducted in shock wave lithotripsy (SWL) outpatient unit on 106 patients .After successful SWL they were divided into, two groups; Placebo group and Tamsulosin 0.2mg group. Then follow up for 2, 4 and 6 weeks all patients completed the follow-up period except 6 patients were excluded from the study. Results Stone criteria of both groups showed no significant difference.
Unlike ESWL; the shock wave is not focused. Therefore, the stone must be placed where the shock wave is generated . 36 The major disadvantage of EHL is its narrow margin of safety owing to the risk of damage to ureteral mucosa and ureteral perforation, the risk of perforation is greater with higher energies, such as in treatment of a hard stone. regarding advantages, EHL successfully fragments 90% of stones and it is the least expensive intracorporeal device .37 3)Ultrasonic Lithotriptors : Ultrasound has a wide margin of safety when used appropriately.