Base on the information of above, the nursing care can be as such: daily weight, intake and output chart to observe any fluid retention, oliguria due to hypotension and diarrhea, decreased intravascular volume, and/or impaired cardiac function. Insert IA line for hemodynamic monitoring keep SBP> 90, insert CVP line for medication, watch temperature for fever, heart rate to keep < 120, spo2 keep > 95 in room air, Oxygen therapy necessary and neurological assessment for mental status, pain score, and fluid restriction to 1.5 liters including IV fluid to minimize the risk of pulmonary edema. Avoid IM injection during therapy. Daily blood test for full blood count, fluid & electrolyte, liver function test, renal panel and PT/PTT. Patients
In both the cases the SAM block was administered for entirely different indications. But the noteworthy observation in both the cases was the striking reduction in pain and total requirement of analgesia over 24 hours. There are sporadic case reports where an epidural catheter has been left in situ for continuous analgesia.3 In the present cases, in patient following MRM, patient was connected to IV PCA but patient did not take any additional top up. In patient in intensive care unit, the block had to be repeated after 24 hours in view of complaints of pain.
Pre-operative Care: o Take a complete health history including any recurrent infections. o Head to toe assessment including cardiovascular, respiratory, and gastrointestinal. o Smoking cessation if the patient smokes. o Blood tests including Blood type and cross matching.
It was reliable due to the fact that it had a large sample size of 1,419 patients and data was gathered in daily clinical practice. Each dry eye symptom as well as the Schirmer test scores and the TBUT improved significantly with P<0.001, suggesting high statistical significance. However, the study is unable to determine causation because it lacked a placebo, did not have a control group, and the treatment period only lasted 12 weeks. Since it was a prospective study, there may also be bias due to loss of follow
80% of patients will have mild attack of pancreatitis, having mortality around 1%. Severe acute pancreatitis is characterized by poancreatic necrosis, a severe systemic inflammatory response and often multi organ failure1. In those who have a severe attack of pancreatitis the mortality varies from 20-50%. About one third of deaths occur in the early phase of the attack, from multiple organ failure,
Premedication and induction of general anaesthesia was done as per institutional protocol. After lubricating the tracheal tube and right nostril with 2% lignocaine jelly, a 6.5 portex cuffed oral/ nasal endotracheal tube was introduced initially but due to resistance to further entry, a 6.0 cuffed endotracheal tube was successfully passed and fixed at 24 cm mark. Considering the cost of preformed nasal tubes and the affordability of our patient, we used an oral/ nasal tracheal tube for nasal intubation. Throat pack was placed in the pharynx under direct vision by larynoscopy. The only significant event in the intra-operative period was readjustment of tube tapes due to loosening of the tapes.
His temperature was 98.8◦F, the blood pressure was 99/68 mm Hg and he had a pulse of 70 bpm. The patient was administered with oxygen at 0.5 mg (1:1000). A dose of Epinephrine was ordered and shortly after he was administrated with the IV infusion of the epinephrine shortly after he started complaining of chest pain and tingling sensation on his left arm radiating to his fingertips. An ECG was ordered and showed an elevated ST,
C a fifty five years old Chinese man was admitted to the ICU post Coronary Artery Bypass Graft (CABG) surgery. He had an uneventful CABG with no complication intra operation. He was ventilated over night. Vital signs, blood pressure: 153/75mmHg, heart rate: 86beats per minutes, sinus rhythm and temperature 35.3C. Post operative, the Cardiac Surgeon had ordered targeted systolic blood pressure of less than 130mmHg. The surgeon had prescribed blood pressure medication, such as Sodium Nitroproside infusion and for pain, Dormicum plus Morphine infusion.
Physiotherapy; started from second post-operative day with assistance of physiotherapist and full weight bearing was allowed for all cases, one patient was allowed for wheel chair only for 8 weeks due to periprosthetic fracture, then progressive weight bearing afterwards, this protocol was modified as per patient tolerance and stability. X ray; was done post-operatively in 2 views (AP and Lateral). Patients were discharge home on seventh post- operative day after ensuring proper wound care, and education for rehabilitation. One patient needed to stay more than 7 days (for 5 days more due to wound leakage) which has improved and continued his routine follow
Of the 79 patients studied, serum Amylase was found to be elevated (> 200 S.U) in 37 patients (46.95%), among them in three patients it was 800 S.U. One of them showed swollen pancreas on ultrasonography which was confirmed by Computerised Tomography. In other two patients, evidence of pancreatitis was not observed. There was no significant correlation between the nature of compounds (OP or carbamates), duration and severity of cholinergic syndrome and increase in serum Amylase. It has been concluded that mild elevation of serum Amylase is common in patients with OP poisoning, however acute pancreatitis is rare
Temperature: 97.20F, Heart rate: 70 beats per minute, BP: 130/76 mmHg, respiration: 18breaths per minute, and Pulse oximetry: 98% on room air. Rudd reports no pain on pain assessment using PQRST pain assessment method. Rudd is looking very happy to go back home. The nurse brings the discharge paperwork, educational booklet and discharge medication reconciliation form.
An initial dose of 300-600 mg clopidogrel should to be given along with the aspirin (NSW Health 2012). Nursing consideration: monitor for internal and external bleeding and allergies. Heparin: heparin prevents conversion of fibrinogen to fibrin and prothrombin to thrombin.
I am comparing and contrasting a peripherally inserted central catheter (PICC) line, tunneled catheter and an implanted port. A PICC line is inserted into a vein in the arm rather than into the neck or chest. It is usually inserted inside of the upper arm then threaded into the larger vein in your chest. A PICC allows medications to be given that would otherwise cause damage if given in the smaller veins.
The Patient Assessment is one of if not the most important skill and tool in the in the career of an Emergency Medical Technician. EMS stands for Emergency Medical Services this is like the genus or the foundation and Paramedic, Advance Emergency Medical Technician (AEMT), and Emergency Medical Technician (EMT) are like the spices. Each of these spices has different ranges of the skills they are allowed to perform but each one has to go through one common step and that is the Patient Assessment. There are five steps to the Patient Assessment those steps are Scene size-up, Primary assessment, History taking, Secondary assessment, and Reassessment. Step One: Scene size-up 1.