Hypovolemia Experiment

A patient is admitted to Nightingale Community Hospital to the surgical unit following an infection to a post-op wound. There were several deficiencies found on the patient’s tracer audit once the patient was admitted to the hospital. One deficiency that was found was that the patient was given medication related to pain and the patient was not reassessed properly per Joint Commission Standards (JC). The deficiency found is within the pain assessment policy of the hospital.

I.V. fluids such as normal saline are utilized to increase volume and aid in the prevention of acute kidney injury. These I.V. fluids are initiated as soon as possible and are continued until the creatinine kinase level drops below 1,000 U/L. Diuretics such as Lasix are sometimes administered to promote the excretion of fluid. Bed rest is typically ordered for patients with rhabdomyolysis. In some cases, if compartment pressure exceeds 25 mm Hg, a fasciotomy and debridement may be

I would also perform a urine test to test for any high levels of proteins lost from the kidney. Part 5 A V/Q scan would show blood flow obstruction (embolism) and the use of the radioactive material would be used to examine the airflow in images. The airflow will be normal but the blood flow will be blocked, this is the V/Q mismatch.

Reason for Visit: Puncture Wound to the Right FA S: TM works in GA Chassis when he injured his right FA. According to TM he was putting in nuts on the exhaust muffler and a piece of metal was sticking out of the muffler and stuck him in his right FA. TM denies previous injury to right arm. TM rates his pain at 2/10. O:

The patient follows the doctor’s recommendation for completing blood work to ensure the medication is consistently within the therapeutic level. Therefore, the International Normalized Ratio (INR), prothrombin time

Principles for safe medication administration: • All medications must be administered according to a physician’s orders. • The medication orders must be clear, legible and not open. • The same person should select, prepare, administer and record the administration. • Doses must be prepared for only one patient at a time, immediately before the intended use • Medications should be prepared for immediate administration to a single patient and not retained for later use due to the risks of contamination, potential instability, potential mix-up with other medications and to maintain security of the medication • All medications must be stored in patient care areas in the same container as received from pharmacy. • All RNs and ENs without notation must successfully complete the Medication Assessment Paper prior to administering medications.

On January 31, 2000, Dr. Harold Shipman was convicted of murdering 15 of his patients, as well as, forging a will of 1 of them. The evidence against him was that he had killed them by administering lethal doses of either morphine or diamorphine, more commonly known as heroin. Shipman had been convicted for fraudulently obtaining drugs in order to support an addiction when he was 29. As a result of his past addiction, the police considered that he had obtained heroin illicitly for his killings just as he had obtained the drugs 1975 to feed his addiction. Another way that Shipman may have obtained the drugs is that, he would issue prescriptions for patients, those who required the drug and those who did not, retaining some or all

This drug should not be stopped suddenly. A diuretic should only be used if there is an increase in fluid intake. Furosemide is a loop diuretic that prevents the body from absorbing excess salt. This medication should initially be taken every six to eight hours for 20 to 80 mg per dose. (Burcham

1) In mitral stenosis a diastolic murmur is present due to stenosis, or narrowing of the valve. The murmur is heard when the mitral valve fails to open appropriately in diastole. The leaflets of the valve are usually thicker, stiffer, and become misshapen from the effects of rheumatic fever or a congenital defect (Porth, 2011). The crackles in her lungs are likely due to left sided heart failure leading to pulmonary hypertension.

Dioxins are primarily by-products or residues from thermal industrial processes (combustion) that involve chlorine, but they can also occur during natural phenomena such as volcanic eruptions or forest fires. They are undesirable byproducts in a large number of manufacturing processes, such as melting, chlorine bleaching of pulp, and the production of certain herbicides and pesticides. In terms of emissions, it is considered that most of the dioxin released into the environment comes from uncontrolled waste incinerators (solid waste and hospital waste), which are the biggest culprits, with incomplete combustion. There are also large stocks of used industrial oils throughout the world whose longterm preservation and elimination of these materials

In my facility, the safety of our patients is our top priority. We use a set of interventions using clinical indications to ensure the safety of patients with indwelling catheters. These indications are strict intake and output (I&O), patients monitored for acute renal insufficiency or failure, sedated patients with critical illness, and neurological patients monitored for syndrome of inappropriate antidiuretic hormone (SIADH) or diabetes insipidus. Patients suffering from acute urinary retention, or bladder outlet obstruction with the inability to void, as well as select surgical patients, are also indicated.

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.

Glucosuria Ans: A Feedback: The primary presenting feature of acute glomerulonephritis is hematuria (blood in the urine), which may be microscopic (identifiable through microscopic examination) or macroscopic or gross (visible to the eye). Proteinuria, primarily albumin, which is present, is due to increased permeability of the glomerular membrane. Blood urea nitrogen (BUN) and serum creatinine levels may rise as urine output drops.

Cold as Ice: Principles Behind the Dachau Experiments The main operating principles behind the Dachau hypothermia experiments hail back to the Nazi worldview. Due to how the Germans viewed Jewish citizens, there was no ethical issue concerning using these citizens in medical endeavors.

Therapeutic drug monitoring (TDM) is the clinical practice of measuring specific drugs at timed intervals in order to maintain a relatively constant concentration in a patient's bloodstream, thereby optimizing individual dosage regimens. It is not necessary to use therapeutic drug monitoring for all the of medications, and it is used mainly for monitoring drugs with some narrow therapeutic ranges, drugs with marked variability in pharmacokinetic, medications with target concentrations which are difficult to monitor, and drugs that are known to cause therapeutic and adverse effects. The process of therapeutic drug monitoring is based on the assumption that there is a specific relationship between dose and plasma or blood drug concentration, and between concentration and therapeutic effects. Therapeutic drug