Abdominal CT scan was performed but revealed nothing except cholelithiasis. A descion of removing the previously inserted plastic stent in CBD was made. The patient underwent ERCP under general anesthesia to remove the stent. The fever started to decline 24 hours after ERCP and was completely gone after 48 hours. The patient was kept on antibiotics for 4 more days and was discharged with instructions of eating only boiled food and weekly
Abstract Background: Laparoscopic cholecystectomy has become the treatment of choice for symptomatic gallstones. Previous abdominal surgery has been reported as an absolute contraindication to laparoscopic cholecystectomy in early days of this technique but nowadays it considered as a relative contraindication. This study specifically investigate the effect of previous abdominal surgery on the feasibility and safety of laparoscopic cholecystectomy. Methods: This study included 120 well-documented patients with gallstones who underwent laparoscopic cholecystctomy at our surgical department between December 2008 and October 2012. The patients were classified into 2 groups: group A, patients without a history of previous abdominal surgery (n_90);
DISCUSSION The Main anesthetic goal in Intraocular surgery is the maintenance of a stable intraocular pressure, as the sudden raise in Intraocular pressure during open eye surgery can cause prolapse of iris or lens and vitreous loss leading to permanent loss of vision. Conventional laryngoscopy with general anesthesia is usually practised in paediatric patients coming for Intraocular procedure. This causes sympathetic stimulation with resultant increase in IOP, with associated raise in MAP & HR. There are few studies conducted in children to compare the effect of insertion of LMA with endotra-cheal intubation on IOP. But there are a number of studies done on adults, to confirm that LMA serves as an effective alternative to endotracheal intubation.
Before Bill was given medication, food, or fluids he was assessed for ineffective swallow by the nurse. If the screening shows swallow impairment the patient must be referred to SALT within 24hours (NICE,2008). The screen used in this hospital was the “Stroke dysphagia screen” (Lepine,2009 cited in Barnard,2011). This involves giving an alert patient (absent of facial droop and with a gag reflux) a sip of water, if they can swallow without coughing/choking they are allowed more and observed for coughing/choking (Barnard, 2011). If facial droop present, as in this case, the test is not done and the protocol requires immediate referral to SALT.A nursing diagnosis of “ineffective swallowing” was
Perfusion : Perfusion is the process of a body delivering blood to a capillary bed in itsbiological tissue. The word is derived from the French verb "perfuser" meaning to "pour over or through". Tests verifying that adequate perfusion exists are a part of a patient's assessment process that are performed by medical or emergency personnel. The most common methods include evaluating a body's skin color, temperature, condition and capillary refill. Perfusionists employ artificial blood pumps to propel open-heart surgery patients' blood through their body tissue, replacing the function of the heart while the cardiac surgeon operates.
A video recording shows that the patient cannot engage in a lengthy conversation before the lungs flare-up, thereby causing breathing problems. In particular, the patient experiences an acute shortage of breath (SOB) (Holland 2014). A historical investigation of the present complaint alludes to a condition that has continued for the last six years. The present medical history shows that the patient has Type 2 IDDM and mild right knee osteoarthritis, besides the emphysema. Initially, the patient used to smoke, but has since stopped the habit.
PI value has been considered a useful tool for accurately monitoring changes in peripheral perfusion in real time caused by certain anesthetics. An increased PI is an early indicator of the pharmacologic effect of the anesthesia, often occurring before the onset of the anesthetic effect providing the physician an early indicator of successful anesthetic administration. In the neonatal acute care setting, a low PI has been shown to be an objective indicator of severe illness. In conjunction with oxygen saturation and pulse rate, a diminished PI becomes an important indicator of a critical state of neonatal health. As such, the PI may be important to consider as a standardized, objective measure in addition to conventional subjective means of assessing the state of the neonate.
Physical complications are fixed from the mental portion, and medicine has improved tremendously from the efforts brought by music. Sleeping habits are improved making people happier and look forward to days to come. Music is the best use of therapy to heal those hurting in as many forms as one can think of. That’s why music therapy should be used above all other types of therapy because of all the positive characteristics it
The aneurysm will be watched for sign of changes, by closely monitoring your thoracic aortic aneurysm with CT or MRI scans on a regular basis or every 6-12 months. High blood pressure is one of the particular symptoms of thoracic aortic aneurysm, if you have high blood pressure, your physician will prescribe blood pressure medication for you to lower at least your overall blood pressure and in the weakened area of the aneurysm. And there is this thing called a “statin” (or cholesterol lowering medication) to maintain the health of your blood vessels. 2. Surgical Repair If the thoracic aortic aneurysm become larger or you are already causing symptoms, you will need a quick treatment to prevent a rupture from occurring.
If you are stressed with your daily routine, then having 10 minutes of this massage can reduce the stress levels and also the anxiety. It is said that patients who have good through abdominal colorectal surgery feels less pain, tension, and anxiety after going through hot stone massage. Reduce cancer symptoms: There have been studies saying that around 1290 people who are suffering from cancer had experience this massage therapy and it helped them reducing pain, fatigue, stress, and anxiety, depression and also nausea. Having Swedish massage improves cancer symptoms. But make sure to consult your doctor before going for hot stone massage.
The patient has completed physical therapy, time, rest, medications, chiropractic care, and acupuncture with no alleviation of the pain. Significant pathology on the MRI is noted with degenerative disk disease, neural foraminal stenosis and a nerve root impingement in the cervical spine. Treatment plan includes epidural at the bilateral C5-C6 level, continuation with home exercise program and medications and follow up in 2 weeks. She was given a prescription for Lidoderm
If your antidepressant affects the chemical serotonin in the brain, your body will experience physical and emotional symptoms when the medication is discontinued. #*These symptoms are frequently referred to as antidepressant discontinuation syndrome and will affect one in five individuals who are on antidepressants for six weeks or longer.http://www.webmd.com/depression/guide/withdrawal-from-antidepressants #*These symptoms do not indicate addiction to antidepressants as this class of medications is not habit-forming. Rather, they reflect the body 's reaction to suddenly stopping your medication regimen. These symptoms can be prevented or minimized by gradually going off your
My second question relates to an intervention of the VAP bundle. In the mechanically intubated patient, how does the use of chlorhexidine mouthwash, compared to the use of alternative oral care products affect the VAP bundle? There has been a big push towards oral hygiene care in mechanically ventilated patients. Through evidenced-based practice, this single intervention could significantly change the outcome. “Oral hygiene care, using mouthwash, gel toothbrush, or combination, together with the aspiration of secretions may reduce the risk of VAP in these patients” (Shi, 2013, p. 3).
Barcode Scanning Prevents Medication Administration Errors “The six rights of medication administration are: the right drug, the right dose, the right route, the right time, and the right patient” (Burchum & Rosenthal, p. 5). Since the implementation of barcode scanning of medications, it has reduced medication errors tremendously compared to paper-based medication administration. Research after research has shown that medication administration errors have declined, thus reducing harm or adverse effect to the patient. Pilot testing was done on numerous hospitals proving it has not just reducing medication errors, but it also helped on reducing the amount of work nurses have to deal with when it comes to medication administration and documentation.
Application of cold, application of heat, bending forward, medications and rest, relieve the pain. Medication side effects include nausea and vomiting. Patient’s primary care doctor stopped her oral medication due to nausea and vomiting; and her liver function tests were elevated. She does not know names, but the sleep aid and the oral medication for pain during the day were stopped. She tolerates the medications well.