How can AKI be prevented? According to the National Confidential Enquiry into Patient Outcome and Death 2009‚ up to 30% of cases of acute kidney injury may be preventable and the best ’treatment of AKI is prevention.’ [3]This can mainly be done by identifying patients most at risk as early as possible. This would involve constant monitoring of urinary output and serum creatinine levels for the high risk patients. However in general‚ all hospitalized patients with acute illness should be monitored
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14. CHOLINERGIC AGONISTS AND CHOLINESTERASE INHIBITORS CHOLINERGIC AGONISTS Overview “muscarinic receptor agonists” cholinergic agonists are drugs that act on acetylcholine receptors‚ thus causing excitation of the parasympathetic autonomic nervous system there are 2 types of acetylcholine receptors 1) NICOTINIC RECEPTORS - are receptor-mediated ion channels - 3 types RECEPTOR TYPE MUSCLE TYPE GANGLION TYPE LOCATION - neuromuscular junction - sympathetic autonomic ganglia - parasympathetic autonomic
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A patient with a C7 spinal cord injury states he must hve the flu because he has a bad headache and nausea. The initial action of the nurse is to check the patient’s temperature. take the patient’s blood pressure. elevate the head of the bed to 90 degrees. call the physician. The priority nursing intervention for a patient with facial trauma is Administration of IV fluids at a rapid rate. Application of a dressing to control facial bleeding. Clearing the airway of blood and debris
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Postpartum Hemorrhage Jorge Garcia‚ MD December‚ 2001 Outline Case History Definition Rapid diagnosis Treatment Review risks Case History. Healthy 32 yo G2P1+0. Previous C/S 2 years back Augmented vaginal delivery with vacuum extraction‚ with episiotomy On admission uterus will contracted. Lochia normal Second day Patient complaining of continues sever pain prescribed as pressure on the rectum side which was not relieved by analgesia. Lochia was minimal‚ episiotomy
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Drugs Anticholinesterases- reversal agents for blocking agents (NBMR) Drugs Dose mg/ Kg Onset Duration Facts Edrophonium. Give glycol b/f otherwise you see bradyacardia- don’t mix! 7 micro grams/ Kg atropine. May need more (10-15 microg/ Kg) if given with opioid- based anesthetic. 0.5-1.5 (usual dose 40-70 mg) Approx equivalent dose- 35 mg 1-2 min 60 min Less effective than neo for deep block Neostigmine 20 mcg/kg atropine (more rapid than neo). 10 microg/ Kg glycopyrrolate (parallels
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Angiotensin-II Receptor Blockers (ARBs): ARBs are a class of drugs that halt the action of Angiotensin-II by blocking the binding between Angiotensin-II and Angiotensin-II receptors. This leads to reduced blood pressure as the blood vessels get dilated. This reduced blood pressure helps to ease heart failure as it now becomes easier for the heart to pump this blood. Commonly used ARBs are Irbesartan‚ candesartan‚ Losartan‚ Olmesartan‚ Telmisartan‚ valsartan‚ and azilsartan. Mechanism Angiotensin-II
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Vomit-tilt head to side‚ lower head of bed‚ suction‚ basin Yonkers-suctioning equipment specific to mouth suctioning Interventions- Assessment-continuous Position- semi fowler‚ rolled towel under neck or pillow under shoulders to keep airway clear Hypotension-caused by drugs (paralytics dilate)‚ can contribute to nausea Shock- is all about perfusion. Need adequate perfusion to kidneys‚ brain‚ lungs‚ and heart. Shock is related to hypovolemia. Give blood and fluid based on what they are losing. If
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contrast medium is injected into the femoral artery and spreads to other arteries in the lower limb‚ and then a series of radiographs are taken of one or more sites. It is used to diagnose narrowing or blockage of arteries in the lower limbs. Hypotension (hī-pō-TEN-shun) Low blood pressure; most commonly used to describe an acute drop in blood pressure‚ as occurs during
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In the beginning Chucks DX were hypercholesterolemia‚ stage I hypertension and his risk for heart disease was significant. At that time I would have recommended the following medications: 1) Red Yeast Rice capsules (1 po qd to help decrease his cholesterol level‚ 2) Omega 3 Fish Oil 3 gms/day to help lower his blood pressure‚ reduce triglyceride level‚ slow the development of plaque in the arteries & reduce the likelihood of heart attack or stroke. My rationale behind this is these herbs are way
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LOC‚ euphoria‚ pupil reaction Respiratory dysfunction Safety measures: •night-light; •call bell within reach Teach: •Report any CNS Cx or allergic reactions. •If drowsiness occurs call for assistance; •Make position Cx slowly d/t orthostatic hypotension Nursing Considerations/Teachings/Interventions: Nursing Consideration: pt should remain recumbent for 1hr after IM/SUBCUT route‚ inject into large muscle mass May cause fatal reaction: MAOI’s‚ carbazine Tx for Overdose: Naloxone (Narcan) 0
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