When a client living in a long-term care home is not allowed to shower and is completely dependent, a complete bed bath should be given as per the care plan. The bed bath should be provided following the necessary hygiene protocol in order to avoid infection.
The complete bed bath should start with washing the face and progress from head to toe. Firstly, gather all the necessary equipment that is needed. The equipment will include basin, warm water, soap, towel, clean linens, and a change of clothes.Once the equipment is collected, make sure to ensure the client's privacy is maintained at all times. Use the water and soap to wet the washcloth. Then start cleaning the client's eyes, ears, nose, and face gently, taking care not to use too much water.
Once the face is washed, clean the neck and chest. Then move down the arms, starting with the upper arms and shoulders, before washing the lower arms and hands. Next, the back and buttocks should be washed, moving down to the legs, with attention to all the folds and crevices, including the genitals. Finally, the feet are washed. To maintain the dignity of the client, the body should be covered with a towel or sheet except for the area being washed. To ensure that the client is comfortable, it is advisable to make sure they are adequately covered after the bath is complete.
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A 72-year-old male patient presents with low back pain. He is pale and tires easily. He states that he just plopped on his favorite chair and got sudden back pain that wraps around his back. His urinalysis reveals negative protein, SSA+2, increased ESR, and rouleaux formation. Which of the following is the most likely differentials? (Pick Two) a. Type II Diabetes b. Vertebral compression fracture c. Prostate cancer d. Large bowel adenocarcinoma e. Acute pancreatitis f. Kidney stone g. Viral hepatitis h. Multiple myeloma
The 72-year-old male patient presents with low back pain. He is pale and tires easily. He states that he just plopped on his favorite chair and got sudden back pain that wraps around his back. His urinalysis reveals negative protein, SSA+2, increased ESR, and rouleaux formation.
The most likely differentials for this case are vertebral compression fracture and multiple myeloma. These two diseases are the most likely ones based on the symptoms and the test results that the patient has provided.
Vertebral compression fracture: Vertebral compression fracture is the most common type of compression fracture, which happens when the front of a vertebra in the spine collapses. Vertebral compression fracture can happen due to sudden pressure on the spine such as from a fall or severe back strain.
The symptoms of vertebral compression fracture are back pain and stiffness, loss of height, kyphosis (humpback), and trouble breathing.
Multiple myeloma: Multiple myeloma is a cancer of the bone marrow cells that produce antibodies, also known as plasma cells. Multiple myeloma is a type of cancer that damages the bones, immune system, kidneys, and red blood cell count. The symptoms of multiple myeloma are bone pain, anemia, fatigue, frequent infections, weight loss, kidney damage, and nerve damage.
Therefore, vertebral compression fracture and multiple myeloma are the most likely differentials for this case.
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Andrew Jamison is a 47-year-old construction worker with a long history of alcohol abuse. Recently he has been experiencing fatigue, weakness, loss of appetite, and weight loss. A visit to his physician and laboratory testing confirmed a diagnosis of cirrhosis. He is 5’10" tall and currently weighs 145 pounds.
What laboratory test would most likely be elevated in Mr. Jamison?
Andrew Jamison, a 47-year-old construction worker, who has been experiencing fatigue, weakness, loss of appetite, and weight loss has a history of alcohol abuse. A diagnosis of cirrhosis has been confirmed after a visit to his physician and laboratory testing. Alanine aminotransferase (ALT) is the most likely laboratory test to be elevated in Mr. Jamison.
Cirrhosis is a chronic disease that occurs when the liver gets scarred and it's damaged. Scar tissues replace healthy tissues in the liver and as the damaged liver tries to heal, the scar tissue continues to form. Liver cirrhosis is the end result of chronic liver damage caused by different conditions. It is a serious condition that, over time, can lead to liver failure, liver cancer, and even death.
The symptoms of cirrhosis include jaundice (yellowing of the skin and eyes), fatigue, weakness, loss of appetite, and weight loss. Itching, bruising, swelling in the legs, and abdomen are some of the other symptoms of cirrhosis. The liver is a vital organ in the body that helps remove toxins, bacteria, and other harmful substances from the body.
Alanine aminotransferase (ALT) is the most likely laboratory test to be elevated in Mr. Jamison. It is a type of liver enzyme that is usually measured along with aspartate aminotransferase (AST) to check if the liver is healthy. When liver cells get damaged, the ALT enzyme leaks into the bloodstream, and the blood levels of ALT get higher than normal levels.
The main function of ALT is to help break down the protein in the liver and release nitrogen. ALT is an essential liver enzyme that helps detect liver injury and inflammation. ALT levels are increased in people who have liver disease, such as cirrhosis and hepatitis.
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When typing directions for pediatric medications, which of the following are examples of how to write the dose?
a)
Give 1 teaspoon (5 mL) three times a day.
b)
Give 1 tablespoon three times a day.
c)
Give 5 mL three times a day.
d)
Give 1 teaspoon three times a day.
When typing directions for pediatric medications, "give 1 teaspoon (5 mL) three times a day" and "give 5 mL three times a day" are two examples of how to write the dose.
The pediatric medication dosage is generally written in terms of milliliters (mL), and it's important to know the exact milliliter amount of the medication being given. Because children come in various shapes and sizes, the dose of medication is generally determined by weight or age.
It is recommended that medication be administered in the precise amounts directed by a doctor or pediatrician. A typical pediatric dosage for many medications is determined based on the child's age and weight. In general, pediatric medications are administered in milliliters (mL). Thus, "Give 1 teaspoon (5 mL) three times a day" and "Give 5 mL three times a day" are two examples of how to write the dose.
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Construct a PICO(T) question (step 1 in the EBP process).
Summarize the PICO(T) components of the health care challenge
presented in the following Vila Health scenario and qualitative
research study,
PICO(T) is a framework used to structure clinical questions and form the basis for research. The acronym stands for Patient/Problem, Intervention, Comparison, Outcome, and Time. PICO(T) questions help clinicians, researchers, and students make clinical decisions and research effectively.
Scenario:
Vila Health, a large healthcare system, has recognized a significant problem with opioid addiction in their community. The hospital system has recognized that most of the patients with addiction are aged between 18-35 and have a history of mental health conditions. Vila Health is seeking the best way to reduce opioid addiction rates while ensuring that patients' pain is adequately managed.
Qualitative research study:
A recent qualitative study analyzed patients' and caregivers' experiences with long-term opioid therapy. The study sought to understand the impact of long-term opioid therapy on patients' lives, how it affects their relationships, and their experiences with care providers. The study participants included patients with chronic pain who have been on opioids for more than a year and their caregivers.
PICO(T) question:
For patients aged 18-35 with a history of mental health conditions, does reducing the dosage of opioids while introducing non-pharmacologic pain management strategies compared to continued use of opioids alone, reduce the risk of opioid addiction and improve patients' quality of life? The research will be conducted over a period of 12 months, focusing on patients' experiences and outcomes with the two treatment strategies.
PICO(T) components of the health care challenge presented in the scenario and qualitative research study are as follows:
Patient/Problem: Patients aged 18-35 with a history of mental health conditions.
Intervention: Reducing the dosage of opioids while introducing non-pharmacologic pain management strategies.
Comparison: Continued use of opioids alone.
Outcome: Reduced risk of opioid addiction and improved patients' quality of life.
Time: The research will be conducted over a period of 12 months, focusing on patients' experiences and outcomes with the two treatment strategies.
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Order: kanamycin 15 mg/kg per day IV in 2 equally divided doses. How many mg will you administer to a patient who weighs 70 kg? 12 Find the BSA of a patient who weighs 80 kg and is 166 cm tall. 13 A patient weighing 100 lb must receive 15 mg/kg PO of a drug. How many 700 mg tablets will you administer? 350 mm
Kanamycin is an antibiotic used to treat severe bacterial infections and tuberculosis. This drug is not the drug of choice. This medication can be taken by mouth, injected into a vein, or injected into a muscle. Kanamycin belongs to the aminoglycoside group which works by inhibiting the production of proteins needed by bacteria to live.
To answer the following questions, you need to use the appropriate mathematical formulas.
Order kanamycin 15 mg/kg per day IV in 2 equally divided doses. How many mg will you administer to a patient who weighs 70 kg?
Answer To calculate the dose of kanamycin to give a patient, you need to multiply the patient's weight by the dose per kilogram. The dose per kilogram is 15 mg/kg per day. So, the total dose given is:
15 mg/kg x 70 kg = 1050 mg per day
Because the dose is divided into two administrations, the dose per administration is:
1050 mg / 2 = 525 mgSo you'd give 525 mg of kanamycin each time.
12 Find the BSA of a patient who weighs 80 kg and is 166 cm tall.
Answer: To calculate the patient's body surface area (BSA), you can use the Du Bois formula. This formula is:
BSA = 0.007184 x (body weight in kg)^0.425 x (height in cm)^0.725
So, the patient's BSA is:
BSA = 0.007184 x (80 kg)^0.425 x (166 cm)^0.725
BSA = 1.86 m^2
13 A patient weighing 100 lb must receive 15 mg/kg PO of a drug. How many 700 mg tablets will you administer?
Answer: To calculate the number of tablets given to a patient, you need to take a few steps:
1) Convert the patient's weight from pounds to kilograms. One pound is equal to 0.4536 kilograms. So, the patient's weight in kilograms is:
100 lb x 0.4536 kg/lb = 45.36 kg
2) Calculate the total dose required by the patient by multiplying the patient's body weight by the dose per kilogram. The dose per kilogram is 15 mg/kg. So, the total dose required is:
15 mg/kg x 45.36 kg = 680.4 mg3) Divide the total dose by the tablet strength to get the number of tablets administered. The strength of the tablets is 700 mg. So, the number of tablets given is:
680.4 mg / 700 mg = 0.97Since it is not possible to give a portion of the tablet, you should round the result up or down according to your doctor's or pharmacist's instructions. For example, if you round up the number of tablets given is:
1 tablet
About DosesDoses is the level of something that can affect an organism biologically; the greater the level, the greater the dose. In medicine, this term is usually reserved for the grades of drugs or other agents administered for therapeutic purposes.
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write a paragraph about each of the 11 body systems explaining
what it is, how it works, and its functions/ capabilities
The body is a complex machine that has 11 different body systems. Each of these body systems works together to keep the body running efficiently. In this essay, I will be explaining each of the 11 body systems, how they work and their functions/capabilities.
1. The digestive system: This system is responsible for breaking down food into nutrients that can be absorbed by the body. It begins in the mouth, where food is chewed and mixed with saliva, and ends in the intestines, where nutrients are absorbed. The digestive system also eliminates waste from the body.
2. The respiratory system: This system is responsible for taking in oxygen and expelling carbon dioxide. Oxygen is taken in through the nose or mouth and travels through the trachea to the lungs. The lungs then exchange oxygen for carbon dioxide and exhale it out.
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a) Identify the meaning of a fragility hip fracture and the impact this can have on an elderly person. b) Describe the specific situation in this case study. c) Using the Framework of Ethical Decision
The recovery process can be challenging, and individuals may experience pain, decreased mobility, loss of independence, and an increased risk of complications such as infections or blood clots. The overall impact can include a reduced quality of life, increased dependency on others, and a higher likelihood of long-term disability or mortality.
a) A fragility hip fracture refers to a broken hip bone that occurs as a result of minimal trauma or a fall from a standing height. It typically affects elderly individuals who have weakened bones due to conditions such as osteoporosis. Fragility hip fractures can have a significant impact on an elderly person's physical, emotional, and social well-being.
b) Specific Case Study: Mr. Johnson is an 80-year-old retired teacher living alone in a two-story house. He has a history of osteoporosis and has experienced several falls in the past due to his weakened bones. Unfortunately, one day while climbing the stairs, he loses his balance and falls, resulting in a fragility hip fracture. He is rushed to the hospital, where he undergoes surgery to repair the fracture.
c) Framework of Ethical Decision: When faced with ethical decisions related to the care of an elderly person with a fragility hip fracture, it is essential to consider several factors:
Autonomy: Respect Mr. Johnson's autonomy by involving him in decision-making regarding his treatment, rehabilitation, and long-term care options.
Beneficence: Ensure that the decisions made prioritize Mr. Johnson's well-being and aim to maximize his overall quality of life.
Non-maleficence: Take steps to prevent further harm to Mr. Johnson, considering the increased vulnerability and potential complications associated with fragility hip fractures.
Justice: Ensure fair and equitable access to healthcare services and resources for Mr. Johnson, taking into account his individual needs, preferences, and available support systems.
Dignity: Treat Mr. Johnson with respect, empathy, and dignity throughout his care journey.
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10. An infant who weighs 22 lb is prescribed Ibuprofen 7.5mg/kg/dose prn for fever q8h. The safe therapeutic range is 5 to 8 mg/kg/dose. a. What are the minimum and maximum recommended dosages for the infant in mg? b. Is the dose safe and therapeutic? . Ans:
The minimum recommended dose for the infant is 49.5 mg/dose, and the maximum recommended dose is 79.2 mg/dose.
a. To calculate the minimum and maximum recommended dosage for the infant in mg:1 lb = 0.45 kgTherefore, the infant’s weight in kg is:22 lb × 0.45 kg/lb = 9.9 kg
To calculate the minimum recommended dose:
Minimum recommended dose = 5 mg/kg/dose × 9.9 kg= 49.5 mg/dose
To calculate the maximum recommended dose:
Maximum recommended dose = 8 mg/kg/dose × 9.9 kg= 79.2 mg/dose
Therefore, the minimum recommended dose for the infant is 49.5 mg/dose, and the maximum recommended dose is 79.2 mg/dose.
b. To determine whether the dose is safe and therapeutic:Infant’s prescribed dose = 7.5 mg/kg/doseTherefore, the infant’s prescribed dose = 7.5 mg/kg/dose × 9.9 kg = 74.25 mg/dose
Since the prescribed dose (74.25 mg/dose) falls within the safe therapeutic range (49.5 mg/dose to 79.2 mg/dose), the dose is both safe and therapeutic. Therefore, the dose prescribed is safe and therapeutic.
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Hypersecretion of human growth hormone after the epiphyseal plates have closed can cause: ______ (list 3)
Hypersecretion of human growth hormone after the epiphyseal plates have closed can cause acromegaly, organ enlargement, and joint pain.
The epiphyseal plates are responsible for bone growth and elongation during childhood and adolescence. Once these plates close, further longitudinal bone growth is no longer possible. If there is hypersecretion of human growth hormone (HGH) after the closure of the epiphyseal plates, it can lead to several effects:
Acromegaly: Excess HGH can cause abnormal growth of bones and tissues in the body, leading to the enlargement of certain body parts. Commonly affected areas include the hands, feet, face (particularly the jaw and nose), and forehead. Acromegaly can result in changes in physical appearance and features.Organ Enlargement: Hypersecretion of HGH can also affect the internal organs, causing them to enlarge. This can result in an increase in the size of organs such as the heart, liver, and kidneys. Organ enlargement can lead to various health complications and impair organ function.Joint Pain: The excessive growth of bones and tissues associated with acromegaly can put pressure on joints, leading to joint pain and discomfort. This can affect mobility and cause difficulties in performing daily activities.It's important to note that hypersecretion of HGH after the closure of the epiphyseal plates is typically caused by a tumor in the pituitary gland, known as a growth hormone-secreting adenoma. If suspected, medical evaluation and treatment are necessary to manage the condition and its associated symptoms.
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CT, is a 19 year old female who lives with her mother. She does not have a dental home (established regular dentist), but reports she has rampant caries (her decay is so severe that she may eventually be a candidate for a partial denture) and plaque biofilm-induced gingivitis. She also reports that her mother had almost all her teeth pulled at age 37. CT wants to keep her teeth. CT has a 1 year old child whom she is breastfeeding and recently learned that she is pregnant again. She reports sipping on a 2-liter bottle of soda throughout the day to help her stay alert at her job and thinks she might be lactose intolerant, so she has avoided dairy. She reports she does not live in a community with fluoridated water and does not use any fluoride supplements besides the fluoride found in her toothpaste. She has no medical conditions requiring treatment, nor is she taking any medications.
1) What additional questions might you ask CT regarding her dietary/nutritional habits in order to better understand her level of caries risk and oral health? Word your questions in the manner you would ask them to CT. And, why are these questions important?
2) What is ONE goal might you suggest for this patient? Make sure your goal includes a WHY. Explain why you chose this goal.
3) Identify 2 or 3 specific changes (strategies) you might develop with this patient to support the one goal you stated in Question 2. Make sure your strategies are specific, measurable, and realistic for CT. Explain why you chose these strategies.
1)Word your questions in the manner you would ask them to CT. And, there are few questions that are important to ask CT regarding her dietary/nutritional habits to understand her level of caries risk and oral health.
They are: It is important to know about the type of food and beverages CT intakes as certain types of food are associated with caries risk and oral health. It is important to know the frequency and timing of meals and snacks CT intakes as it is a risk factor for caries and oral health.
It is important to know the oral health habits CT practices as they help in reducing caries risk and maintaining good oral health.
2) Make sure your goal includes a WHY. Explain why you chose this goal. The goal I suggest for CT is to reduce the frequency of sipping soda throughout the day. This is because sipping soda frequently is a risk factor for caries and poor oral health.
3)Identify 2 or 3 specific changes (strategies) you might develop with this patient to support the one goal you stated in Question 2. Make sure your strategies are specific, measurable, and realistic for CT.
The strategies that can be developed with CT to support the goal of reducing the frequency of sipping soda are: Switch to drinking water instead of soda - This strategy is specific, measurable, and realistic as it suggests switching to a healthier alternative. The goal is measurable as it aims at reducing the frequency of soda sipping.
Drink soda with meals - This strategy is specific, measurable, and realistic as it suggests drinking soda with meals instead of sipping it throughout the day. The goal is measurable as it aims at reducing the frequency of soda sipping.
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"during a shower, the female client you are caring for depends on
the support worker to perform most aspects of the task. how do you
allow the client to help care for herself?
To promote the female client's independence during a shower, the support worker should communicate, provide assistive devices, and give step-by-step instructions while allowing the client to perform tasks she is capable of. This approach includes adapting tools, offering support and encouragement, and gradually increasing her involvement in self-care tasks.
When providing care during a shower, it is important to encourage the female client to participate and empower her to care for herself as much as possible. Here are some ways to allow the client to help care for herself:
1. Communication: Establish open communication with the client to understand her preferences, abilities, and limitations. Respect her autonomy and involve her in decision-making regarding the care process.
2. Assistive devices: Provide appropriate assistive devices such as grab bars, shower chairs, or handheld showerheads to enhance the client's independence. Show her how to use these devices effectively and safely.
3. Step-by-step instructions: Break down the showering process into simple, manageable steps. Clearly explain each step and give the client the opportunity to perform tasks that she is capable of doing, such as washing her face, applying shampoo, or rinsing specific body parts.
4. Adapted tools: Modify tools or equipment to make them more accessible for the client. For example, provide a long-handled sponge or a brush with an extended handle to assist with reaching difficult areas.
5. Support and encouragement: Offer constant support and encouragement throughout the process. Praise the client for her efforts and achievements, fostering a sense of accomplishment and independence.
6. Gradual progression: Over time, gradually increase the client's involvement in self-care tasks as her abilities improve. This helps build confidence and allows for a sense of ownership over her own care.
Remember, the aim is to strike a balance between providing necessary assistance and promoting the client's independence and self-esteem.
Each client is unique, so it is essential to tailor the approach to her specific needs and capabilities.
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What is Kentucky's reporting requirements for reporting
unprofessional or unsafe practices to the board of nurses and when
it would be appropriate to report such behavior.
The requirements for reporting unprofessional or unsafe practices to the board of nurses include risk to patient safety, violation of ethical standards & failure to meet professional standards.
Reporting such behavior to the board may be appropriate in the situations:
When the behavior poses a risk to patient safety:If you witness or become aware of any unprofessional or unsafe practices that could potentially harm patients, it is important to report them to the board. This includes situations where a nurse's actions or behaviors may compromise the quality of care provided.
Violation of ethical standards:If a nurse engages in unethical conduct, such as breaching patient confidentiality, engaging in fraudulent activities, or exhibiting unprofessional behavior, it may be appropriate to report these violations to the board.
Failure to meet professional standards:If a nurse consistently demonstrates a lack of competence or fails to adhere to the established standards of nursing practice, reporting to the board may be necessary to ensure patient safety and maintain the integrity of the profession.
It is important to note that each case may have unique circumstances, and it is crucial to consider the specific details and context of the situation before deciding whether reporting is appropriate. Consulting with a supervisor, legal counsel, or the Kentucky Board of Nursing can provide guidance and clarification on the reporting requirements and process in Kentucky.
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Mrs. Jones IV of 1000mL of R/L was started at 8:00 A.M. to run in 12 hours. It is now 3:00 P.M. and 800mL remains. The drop factor is 15gtt/mL. What is the new rate of flow in gtt/min?
The new rate of flow in gtt/min is 14 gtt/min.
In order to calculate the new rate of flow in gtt/min, we first need to calculate the total volume of fluid that was infused from 8:00 A.M. to 3:00 P.M. We can calculate this by subtracting the volume of fluid remaining from the initial volume.1000 mL - 800 mL = 200 mL
Next, we need to calculate the amount of time that has passed from 8:00 A.M. to 3:00 P.M. We can do this by subtracting 3:00 P.M. from 8:00 A.M.8:00 A.M. to 3:00 P.M. = 7 hours
We can now calculate the rate of flow in mL/min by dividing the volume infused by the time elapsed.
200 mL / 7 hours = 28.57 mL/min
Finally, we can calculate the rate of flow in gtt/min by multiplying the rate of flow in mL/min by the drop factor.
28.57 mL/min x 15 gtt/mL = 428.55 gtt/min ≈ 429 gtt/min
We should always round the answer to the nearest whole number. Therefore, the new rate of flow in gtt/min is 14 gtt/min.
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The client receives cefepime 0.5 g via IV piggyback (IVPB) every 12 hours at 0100 and 1300 along with famotidine 20 mg IVPB every 12 hours at 0900 and 2100. The pharmacy sends cefepime 0.5 g in 100 ml. 0.9% sodium chloride (NaCl) and famotidine 20 mg in 50 ml 0.9% NaCl. Which should the nurse document in the intake and output record as the IVPB intake for the 2300 to 0700 shift?
In the given scenario, the nurse should document 0 ml as the IVPB intake for the 2300 to 0700 shift in the input-output record.
The client receives cefepime 0.5 g via IV piggyback (IVPB) every 12 hours at 0100 and 1300 along with famotidine 20 mg IVPB every 12 hours at 0900 and 2100. The pharmacy sends cefepime 0.5 g in 100 ml. 0.9% sodium chloride (NaCl) and famotidine 20 mg in 50 ml 0.9% NaCl.
To calculate the IVPB intake for the 2300 to 0700 shift, we need to find out the total intake during this time period, which can be done by adding all the IV piggyback (IVPB) infusions given during this time and the volume given as IV push. To find out the IVPB intake for the 2300 to 0700 shift, we need to calculate the total volume of cefepime and famotidine infused between 2100 to 0100 and 0100 to 0700.
Given: 100 mL of 0.9% NaCl containing 0.5 g of cefepime and 50 mL of 0.9% NaCl containing 20 mg of famotidine. So, the calculation will be done as follows:2100-0100 (IVPB infusion):Volume of cefepime = 100 volume of famotidine = 0 ml (not given)0100-0700 (IVPB infusion): Volume of cefepime = 100 volume of famotidine = 0 ml (not given)
So, the total IVPB intake for the 2300 to 0700 shift is 200 ml (100 ml for cefepime and 100 ml for famotidine) which the nurse should document in the intake and output record. However, famotidine is not infused during this period, so the nurse should document 0 ml as the IVPB intake for the 2300 to 0700 shift in the input-output record.
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Develop a grid comparing the various possible transfusion
reactions including cause, manifestations, treatment modalities,
and nursing implications
Possible transfusion reactions, causes, manifestations, treatment modalities, and nursing implications are summarized in the table below. Transfusion Reaction Causes Manifestations Treatment Modalities Nursing Implications Allergic reaction Sensitization to foreign substances that bind to IgE antibodies
Reddish rash, pruritus, urticaria, wheezing, dyspnea, hypotension, tachycardia Epinephrine injection, vasopressors, oxygen, antihistamines, corticosteroids, blood transfusion discontinued Observe the patient for at least 20 minutes after transfusion to evaluate for any allergic reactions Anaphylactic reaction Severe allergic reaction caused by immune system release of chemicals in response to the transfused blood.
Transfusion-related acute lung injury (TRALI)It occurs when anti-human leukocyte antigen or anti-human neutrophil antibodies react with leukocytes in the lungs, causing an inflammatory response that damages lung tissues. Hypoxemia, fever, hypotension, tachypnea, bilateral infiltrates in the chest radiograph, Supplemental oxygen, mechanical ventilation, blood transfusion discontinued, diuretics, corticosteroids. Report to the healthcare provider immediately when the symptoms occur. As a result of the risk of hypoxemia, oxygen saturation is closely monitored after transfusion.
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In which order would the interventions occur according to Maslow's hierarchy of needs? 1. The patient receives meals and snacks that meet the need for a low-fat diet. 2. Newly admitted patients are assigned a unit buddy. Being assured unit rules will be enforced by staff. A patient who enjoys painting is provided with the needed supplies. Being told by a staff member that, "You did a great job cleaning up your room
1. Meeting physiological needs by providing appropriate meals, 2. Addressing the need for safety and security through assigning a unit buddy and enforcing rules, 3. Promoting self-esteem by providing painting supplies, and 4. Enhancing self-worth through positive feedback and recognition.
The patient receives meals and snacks that meet the need for a low-fat diet. This intervention addresses the physiological needs, which are the most fundamental in the hierarchy.
Meeting the patient's basic nutritional requirements ensures their physical well-being and survival. By providing appropriate meals and snacks, the healthcare team addresses the need for sustenance and helps maintain the patient's overall health.
Newly admitted patients are assigned a unit buddy. Being assured unit rules will be enforced by staff. This intervention addresses the need for safety and security, which is the next level in Maslow's hierarchy.
By assigning a unit buddy and assuring the enforcement of unit rules, the healthcare team creates a sense of stability and protection for the patients. This intervention promotes a safe and secure environment, which is essential for their well-being.
A patient who enjoys painting is provided with the needed supplies. This intervention addresses the need for self-esteem, which is the following level in the hierarchy.
By providing the patient with the necessary supplies for painting, the healthcare team supports their creative expression and enhances their sense of competence and accomplishment. Engaging in activities that bring joy and fulfillment contributes to their self-esteem and overall psychological well-being.
Being told by a staff member that, "You did a great job cleaning up your room." This intervention addresses the need for esteem and self-worth, which is the subsequent level in the hierarchy.
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If blood potassium levels are too high 1) aldosterone will prompt potassium secretion and sodium reabsorption 2) ADH will prompt potassium secretion and sodium reabsorption 3) aldosterone will prompt sodium secretion and potassium reabsorption 4) ADH will prompt sodium secretion and potassium reabsorption
If blood potassium levels are too high, aldosterone will prompt potassium secretion and sodium reabsorption (Option 3)
Why is aldosterone important?
Aldosterone is a hormone secreted by the adrenal gland that regulates salt and water balance in the body by increasing the reabsorption of sodium ions and the secretion of potassium ions from the kidneys.
In addition, aldosterone can have effects on the salivary glands, sweat glands, and colon.
Aldosterone regulates the potassium and sodium balance in the body. If blood potassium levels are too high, aldosterone levels increase, promoting potassium secretion and sodium reabsorption in the kidneys.
On the other hand, if blood potassium levels are too low, aldosterone secretion is reduced, allowing potassium to accumulate and be conserved while sodium is excreted in the urine.
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Mr. Orlando is 50 years old man who reports to clinic for follow up office visit. He has been smoker but relatively healthy. Recently he has been complaining of dyspnea upon exertion (DOE) when climbing the stairs. He has started to sleep on two pillows. You gather all pertinent hx and now will perform your PE:
The patient's age, sex, and the reason for his visit should be recorded in your clinical records. You should record all other symptoms and vital signs as well.
In the case of Mr. Orlando, a pulmonary function test (PFT) should be performed. This test will assist in diagnosing the patient's respiratory disease. A chest x-ray will also be performed to determine if there are any abnormal lung images.
Mr. Orlando should be instructed to avoid all triggers that cause dyspnea upon exertion, such as walking long distances, carrying heavy items, or walking uphill. He should be instructed to walk slowly and calmly and to take frequent rest breaks.
When he lies down, he should elevate his head to reduce the pressure on his lungs and improve his breathing. It is necessary to provide him with a well-balanced diet and to encourage him to quit smoking. As a result, he would be able to enhance his breathing by reducing his lung-related issues.
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Define
- Black Box Warning
- Teratogenicity
- Toxic dose
- Lethal Doses
- Carcinogenicity
It's important to note that these definitions provide a general understanding of the terms, but specific details and considerations may vary depending on the context and the specific substances.
1. Black Box Warning: A black box warning is the strongest warning issued by the U.S. Food and Drug Administration (FDA) for prescription drugs. It is used to alert healthcare providers and patients about serious or potentially life-threatening risks associated with the use of a particular medication.
The warning is called a black box warning because it is presented in a black-bordered box at the top of the drug's prescribing information.
2. Teratogenicity: Teratogenicity refers to the ability of a substance, such as a drug or chemical, to cause birth defects or developmental abnormalities in a developing fetus when it is exposed to the substance during pregnancy. Teratogenic substances have the potential to interfere with normal fetal development and can lead to structural or functional abnormalities in the newborn.
3. Toxic dose: The toxic dose of a medication or substance refers to the amount or concentration at which it becomes harmful or toxic to the body. It is the dose at which adverse effects or toxicity can occur. The toxic dose may vary depending on the specific substance and individual factors such as age, weight, and overall health.
4. Lethal Doses: Lethal doses refer to the doses of a substance that are expected to cause death in a certain percentage of individuals or in a specific population. Lethal dose values are often determined through experiments or observations in animal models or, in some cases, from documented human cases. The lethal dose can vary depending on the substance and the route of administration.
5. Carcinogenicity: Carcinogenicity refers to the ability of a substance to cause or promote the development of cancer. Carcinogens are substances that can initiate or contribute to the development of cancerous cells in the body. Exposure to carcinogens, such as certain chemicals, drugs, or environmental factors, increases the risk of developing cancer over time.
It's important to note that these definitions provide a general understanding of the terms, but specific details and considerations may vary depending on the context and the specific substances or medications involved.
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What are the four important characteristics of pressure waveforms? What kind of waveforms dies pressure ventilation create? How is the flow waveform impacted in pressure ventilation by changes in lung characteristics?
The four important characteristics of pressure waveforms in respiratory physiology are amplitude, frequency, shape, and duration.
Amplitude: It refers to the magnitude or intensity of the pressure waveform. It indicates the level of pressure applied during the respiratory cycle.
Frequency: It represents the number of complete pressure cycles occurring in a given time period, typically expressed in breaths per minute (BPM). It reflects the respiratory rate.
Shape: The shape of the pressure waveform provides information about the inspiratory and expiratory phases of the respiratory cycle. It helps in assessing the presence of abnormal respiratory patterns or disorders.
Duration: It refers to the length of time for which the pressure waveform is sustained during the respiratory cycle. It indicates the duration of inspiration and expiration.
Pressure ventilation creates square waveforms. In pressure-controlled ventilation, the inspiratory phase is characterized by a constant and sustained pressure level, while the expiratory phase is defined by a sudden drop to zero pressure.
Changes in lung characteristics, such as changes in compliance (the lung's ability to expand) and airway resistance, significantly impact the flow waveform in pressure ventilation. Increased lung compliance results in faster and higher peak inspiratory flow rates.
Conversely, decreased lung compliance leads to slower and lower peak inspiratory flow rates. Changes in airway resistance affect the shape and magnitude of the flow waveform, causing alterations in the rise and fall of flow rates during inspiration and expiration.
Monitoring and analyzing the flow waveform provides valuable information about lung mechanics and the effectiveness of ventilation strategies.
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Step 1 Read the case to formulate a priority nursing diagnosis
Step 2 Describe why you chose that diagnosis you did and the reason behind it (include cluster data support, method of prioritization, and Maslow hierarchy)
Mrs. K is a 68-year-old woman who presented to the emergency department with shortness of breath. She is unable to walk to her mailbox without becoming very winded.
Her assessment is as follows:
Neuro: A&O x 4, anxious
Cardiac: HR 105 bpm, bounding pulse, jugular venous distention (JVD),
Respiratory: crackles, dry cough, dyspnea on exertion (DOE)
GI: BS normoactive in all 4 quadrants, LBM yesterday
GU: decreased urine output
Peripheral/neurovascular: +3 pitting edema in bilateral lower extremities
Vitals:
T: 98.2 Oral
HR: 105 bpm apically
RR: 24
POX: 87% on RA, 93% on 2LPM nasal cannula
BP: 143/89 left arm
Weight: 185 lb (last visit to PCP in September she was 176 lb)
Labs:
Na: 130 mEq/L
K: 3.6 mEq/L
Mg: 2.2 mEq/L
Cl: 100 mEq/L
Ca: 8.6 mEq/L
She was diagnosed with heart failure and admitted to the med/Surg unit.
One priority nursing diagnosis for Mrs. K would be Ineffective Breathing Pattern.
Mrs. K is 68 years old and presented to the emergency department with shortness of breath. She was diagnosed with heart failure and admitted to the med/Surg unit. From her assessment, her Neuro reveals that she is anxious, cardiac reveals an elevated heart rate, bounding pulse, and jugular venous distention (JVD), Respiratory shows crackles, dry cough, and dyspnea on exertion (DOE), GU reports decreased urine output and peripheral/neurovascular exhibits +3 pitting edema in bilateral lower extremities. Her vital signs also report low oxygen saturation levels.
Ineffective Breathing Pattern is defined as "inspiration and/or expiration that does not provide adequate ventilation." This diagnosis would be appropriate as it describes Mrs. K's shortness of breath and her other respiratory symptoms. Shortness of breath, along with crackles and dry cough, supports this diagnosis. She also has decreased oxygen saturation, which is a priority concern.
The method of prioritization can be based on Maslow's hierarchy of needs, which is a pyramid of physiological, safety, love/belonging, esteem, and self-actualization needs that are needed for humans to progress. Oxygen is necessary for survival, which falls under the physiological needs category of Maslow's hierarchy of needs. Therefore, it is vital to prioritize Mrs. K's breathing pattern as it will address her oxygenation needs and support her respiratory status.
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True or false: extended-release/long-acting (er/la) opioids are more effective and safer than immediate-release/short-acting (ir/sa) opioids
Extended-release/long-acting (ER/LA) opioids and immediate-release/short-acting (IR/SA) opioids have different properties and are used for different purposes. ER/LA opioids are designed to provide pain relief over a longer period of time, often up to 12 hours or more, while IR/SA opioids provide more immediate pain relief but may only last a few hours. ER/LA opioids may be preferred for patients with chronic pain who require around-the-clock pain management, while IR/SA opioids may be used for acute pain episodes.
It is also important to note that ER/LA opioids are not necessarily safer than IR/SA opioids. Both types of opioids carry risks of side effects, including addiction, respiratory depression, and overdose. In fact, some studies have suggested that the risk of overdose may actually be higher with ER/LA opioids, due to their longer duration of action and potential for accidental misuse or overdose.
Ultimately, the decision to use ER/LA opioids versus IR/SA opioids should be based on a careful evaluation of the patient's individual needs, medical history, and other factors, and should always be made in consultation with a healthcare provider.
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A client with acute kidney injury has a urine specific gravity of 1.035, blood urea nitrogen (BUN) of 40 mg/dL, and creatinine of 1.2 mg/dL. Urinalysis reveals no protein. Blood pressure is 89/60, heart rate 120beats per minute, and respiratory rate 30 breaths per minute. Which of the
following is the cause of this acute kidney injury?
a) Glomerulonephritis
b) Muscle injury
c) Nephrotoxic
d) Hypovolemic shock
The cause of acute kidney injury in the client among the options given is hypovolemic shock. Acute kidney injury (AKI) is an episode of complex medical syndrome that results in sudden damage to the kidney, leading to a drop in functional losses, occurring over hours or days. AKI is seen as an abrupt decline in glomerular filtration, evidenced by an increase in BUN and serum creatinine concentration, decreased urine output, or both.
Hypovolemic shock occurs as a result of decreased intravascular volume due to blood or fluid loss causing a sudden decrease in blood pressure, thereby lowering blood flow to the kidneys and the amount of blood and fluid the kidneys receive. It happens when there is a loss of extracellular fluid, the fluid that is present outside the cell. This results in the inability of the kidneys to excrete toxic metabolites from the body, impairing the filtration process. The typical etiology is blood loss, vomiting, diarrhea, or excessive sweating. In the context of the question, the cause of acute kidney injury is hypovolemic shock. The given blood pressure (89/60 mm Hg), heart rate (120 beats per minute) and respiratory rate 30 beats per minute indicates hypovolemia or a decreased volume of circulating blood with jeopardized renal perfusion, leading to a decline in urine output. The urine specific gravity of 1.035 indicates concentrated urine, which is a typical response to reduced fluid intake or volume depletion. Blood urea nitrogen (BUN) of 40 mg/dL and creatinine of 1.2 mg/dL suggests potential AKI causing increased nitrogenous waste accumulation.
(A) Glomerulonephritis which is an inflammation of the glomerulus or the tiny blood vessels in the kidneys is not the cause of AKI due to the absence of protein in the urine analysis.
(B) Muscle injury is irrelevant.
(C) Nephrotoxicity refers to substances that can harm the kidneys, and although it can cause AKI, hypovolemia is a more likely cause in this scenario according to the clinical findings and laboratory values.
Thus, the correct answer is (D) hypovolemic shock.
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How
would you solve a suspension that is difficult to redisperse?
A suspension is a heterogeneous mixture in which the solid particles settle down at the bottom of the container after some time. A suspension that has been stored for an extended period or exposed to temperature and humidity fluctuations may become challenging to redisperse.
The following are some of the methods for solving such a suspension:
1. Redispersion can be accomplished by adding a dispersing agent to the suspension. Dispersing agents may have a variety of chemical structures, and they aid in breaking up the particle aggregates and stabilizing the suspension.
2. The use of ultrasonic energy is also an effective method to redisperse a challenging suspension. Ultrasonic waves cause the particles to disintegrate and become more evenly dispersed.
3. In some situations, it may be necessary to change the suspension's pH to enhance particle stability and prevent sedimentation.
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Choose a clinical situation in your specialty and create a theory from your observations. Report the theory to the class. Use a form that clearly identifies your concepts and proposition such as; "psychosocial development (Concept A) progresses through (Proposition) stages (Concept B)". Identify and define the concepts involved and the proposition between them. For example, a surgical unit nurse may have observed that elevating the head of the bed for an abdominal surgery patient (Concept A) reduces (Proposition) complaints of pain (Concept B). The concepts are the head of the bed and pain. The proposition is that changing one will decrease the other. Raising the head of the bed decreases pain. Use current literature to define your concepts. Each concept should have at least two supporting references.
This is my idea and maybe you can work on this:
Assisting in the early postoperative mobilization of surgical patients (concept A) reduced (Proposition) the likelihood of postoperative complications and promoted early recovery (concept B).
Assisting in early postoperative mobilization (Concept A) - explain
Postoperative complications and promoted early recovery (Concept B) - explain
Assisting in the early postoperative mobilization of surgical patients reduced the likelihood of postoperative complications and promoted early recovery.
The concept of assisting in early postoperative mobilization refers to the aid provided to surgical patients to move, stretch, and engage in activities that aid recovery from surgery. The theory is that early mobilization has a positive impact on patients, including the reduction of postoperative complications and promotion of early recovery. Postoperative complications may include wound infection, thrombosis, pneumonia, among others.
Early mobilization is linked to positive effects on these complications, such as improved pulmonary function, bowel motility, and reduced risk of deep vein thrombosis. In conclusion, assisting in the early postoperative mobilization of surgical patients promotes early recovery, reduces the likelihood of postoperative complications and has a positive impact on patient outcomes.
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Both 5 alpha-reductase inhibitors and alpha 1 adrenergic receptor blockers can be used in the treatment of benign prostatic hypertrophy. How does each one work to reduce the symptoms of BPH? Identify priority nursing care/assessments for patients taking these each of these medications References required
Benign prostatic hypertrophy (BPH) is a common condition in elderly men, characterized by noncancerous prostatic enlargement that obstructs the bladder outlet leading to urinary symptoms. Treatment options for BPH include medical management and surgical intervention.
This question seeks to identify how two categories of drugs, 5 alpha-reductase inhibitors and alpha-1-adrenergic receptor blockers, work to relieve BPH symptoms and priority nursing care/assessments for patients taking each medication.
5 alpha-reductase inhibitors 5 alpha-reductase inhibitors work by blocking the enzyme that converts testosterone to dihydrotestosterone (DHT). DHT is responsible for prostatic growth; thus, blocking its production leads to prostate shrinkage. 5 alpha-reductase inhibitors take a long time to work, up to 6 months, but are useful in managing BPH symptoms over time.
Examples of 5 alpha-reductase inhibitors are Finasteride and Dutasteride. Alpha-1-adrenergic receptor blockers Alpha-1-adrenergic receptor blockers work by relaxing the smooth muscles of the prostate gland, bladder neck, and urethra, leading to better urine flow and decreased symptoms of BPH.
Alpha-1-adrenergic receptor blockers are fast-acting, taking effect in days, but do not reduce prostate size. Examples of alpha-1-adrenergic receptor blockers include Prazosin, Terazosin, and Tamsulosin.
Priority nursing care/assessments for patients taking 5 alpha-reductase inhibitors and alpha-1-adrenergic receptor blockers include; Assess baseline blood pressure, as alpha-1-adrenergic receptor blockers may cause orthostatic hypotension and syncope.
Monitor prostate-specific antigen (PSA) levels to monitor prostate size and screen for prostate cancer.
Monitor liver function tests as 5 alpha-reductase inhibitors are metabolized in the liver and may cause liver damage.
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Which of the following is NOT associated with Guillain-Barre Syndrome?
A. pseudohypertrophy of skeletal muscles
B. ascending flaccid paralysis
C. paresthesias and numbness
D• respiratory failure
The option that is NOT associated with Guillain-Barre Syndrome (GBS) is A. pseudohypertrophy of skeletal muscles.
What is Guillain-Barre Syndrome?Guillain-Barre Syndrome (GBS) is an autoimmune neurological condition that affects the peripheral nervous system. The immune system attacks healthy nerves in the peripheral nervous system, resulting in paralysis, muscle weakness, and other symptoms, in this syndrome. GBS is a rare condition that affects approximately one person per 100,000 people in the population. GBS can occur in anyone, regardless of their age or gender. It affects people of both sexes equally and can occur at any age, but it is more common in men than in women.
Guillain-Barre Syndrome symptoms include:Weakness in the legs, arms, or both Tingling or numbness in the legs and arms (paresthesias)Unsteadiness and incoordination Progressive muscle weakness, often leading to paralysis of the legs, arms, breathing muscles, and faceMuscles that feel tender to the touchMuscle cramping or twitching, particularly in the arms, legs, or tongueDifficulty with eye movements, facial movements, chewing, swallowing, or speaking in severe casesGBS is a medical emergency that can lead to respiratory failure if not treated immediately, which is why it's essential to seek medical attention as soon as symptoms arise. A few symptoms, such as pseudohypertrophy of skeletal muscles, are not associated with Guillain-Barre Syndrome.
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Nursing Care of the Client Being Treated with Chemotherapy
Develop a nursing care plan for clients taking oncological and
hematological medications. Explain the rationale(s) for your
interventions
When a client is being treated with chemotherapy, the nursing care plan should involve the following
Assessment of Vital Signs- Vital signs should be taken before the chemotherapy treatment is administered and monitored for any signs of fever, tachycardia, hypotension, and other changes in the vital signs.
Administration of Chemotherapy- The healthcare practitioner should administer chemotherapy medications as prescribed by the oncologist or hematologist. The nurse should ensure the correct dosage, infusion rate, and route of administration. The nurse should also confirm that the chemotherapy medication is not expired or contaminated.Monitoring for Adverse Reactions- The nurse should observe the client for any adverse reactions such as nausea, vomiting, diarrhea, constipation, mouth sores, fever, chills, and other side effects. The nurse should also monitor the client for signs of an allergic reaction, such as rash, itching, or swelling of the face and throat.Pain Management- Clients undergoing chemotherapy may experience pain in various parts of their body. The nurse should assess the intensity, location, and character of the pain and provide appropriate pain medication. The nurse should also teach the client how to use relaxation techniques and other non-pharmacologic pain management strategies.Infection Control- Clients receiving chemotherapy are at an increased risk of developing an infection. The nurse should practice good hand hygiene, use sterile techniques when necessary, and monitor the client for signs of an infection, such as fever, chills, and increased white blood cell count.Education- The nurse should provide the client with information about the chemotherapy medication, potential side effects, self-care strategies, and when to seek medical attention. The nurse should also educate the client on how to maintain a healthy lifestyle and manage the emotional stress of the cancer diagnosis.Rationale for interventions:
Assessment of Vital Signs- Helps to identify any abnormal vital signs before administering chemotherapy, which may indicate potential risks.Administration of Chemotherapy- Ensures that the client receives the correct dosage, infusion rate, and route of administration, which may prevent complications.Monitoring for Adverse Reactions- Helps to identify any side effects and manage them promptly, which may prevent complications.Pain Management- Helps to relieve pain and improve the client's quality of life, which may improve their overall outcome.Infection Control- Helps to prevent infections and other complications, which may improve the client's overall outcome.Education- Helps to empower the client to take control of their health and manage their treatment effectively, which may improve their overall outcome.To know more about chemotherapy visit:
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Nurses are taught to, "do no harm." Discuss how medical
professionals who were involved in the Tuskegee study did or did
not adhere to this golden rule?
The medical professionals involved in the Tuskegee study did not adhere to the principle of "do no harm."
The Tuskegee study, conducted between 1932 and 1972, involved withholding treatment from African American men with syphilis to observe the natural progression of the disease.
This study violated several ethical principles, including informed consent, respect for autonomy, and beneficence.
The medical professionals involved failed to provide proper medical care and knowingly allowed harm to be inflicted upon the participants by withholding effective treatment.
By intentionally withholding treatment and concealing information from the participants, the medical professionals violated the fundamental principle of "do no harm." They not only failed to provide the necessary medical intervention but also prolonged the suffering of the participants and allowed the progression of a potentially deadly disease.
This disregard for the well-being and dignity of the individuals involved demonstrates a clear violation of the ethical obligations that medical professionals have to prioritize patient welfare and prevent harm.
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The provider ordered aminophylline 250 mg to infuse at 50 mL/hr. The pharmacy stocks aminophylline 1 g in 10 mL. How many milliliters of aminophylline should the nurse add to the IV fluid bag? Round to the nearest tenth. Use Desired-over-Have method to show work.
The nurse should add 2.5 mL of aminophylline to the IV fluid bag.
In this problem, the nurse needs to find the number of milliliters of aminophylline to add to the IV fluid bag. Here are the given data:
Desired dose = 250 mg, Dosage available = 1 g in 10 mL
Therefore, the first step is to convert the desired dose to the same units as the dosage available by using dimensional analysis.1 g = 1000 mg
Then, we have:
Desired dose = 250 mg × 1 g/1000 mg = 0.25 g
The next step is to use the Desired-over-Have method to calculate the quantity to be given:
Desired dose/ Dosage available = Quantity to be given/ Total volume
Quantity to be given = (Desired dose × Total volume) / Dosage available
Quantity to be given = (0.25 g × 1000 mL) / (1 g × 10 mL)
Quantity to be given = 25 mL / 10 = 2.5 mL (rounded to the nearest tenth)
Therefore, the nurse should add 2.5 mL of aminophylline to the IV fluid bag.
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