Pre-diabetes, which affects approximately 1 in 6 persons (more than 2 million people) over the age of 25, is a similar disorder. When blood glucose levels are above normal but not high enough to be classified as diabetes, the condition is called pre-diabetes.
What disease is marked by slightly raised blood glucose levels?A higher than usual blood sugar level is referred to as prediabetes. It is not yet regarded to be type 2 diabetes due to its low level. But without a change in lifestyle, prediabetic adults and kids run a serious danger of developing type 2 diabetes.
The term diabetes is most generally used to refer to diabetes mellitus. It occurs when your pancreas doesn't make enough insulin to keep the level of glucose, or sugar, in your blood under control.
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why should pressure not be applied to the injection site after administering an intradermal injection?
Answer:
Massaging the area may spread the solution to the underlying subcutaneous tissue and the medication is not intended to be absorbed into tissues.
Explanation:
when providing cpr to an adult victim, it is vital to remember this philosophical point regarding attempted rescue. t/f
True, it is important to keep this ethical consideration in mind when doing CPR on an adult victim.
Compressions entail applying particular pressure to the person's chest with your hands while pressing down quickly and forcefully. Compressions represent the most crucial CPR procedure.
Place your heel on the person's breastbone in the middle of their chest while squatting down next to them. Interlock your fingers and place the palm of the other hand on top of the palm that is on their chest. Put your hands directly over your shoulders as you stand.
Safety measures that are applied to every client are known as universal precautions. All human bodily fluids must be handled as if they were recognized to be contagious since it is impossible to tell which patients could spread an illness. The single most efficient way to stop the spread of infection is by washing your hands.
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a nursing student has been assigned to care for a client with pancreatic cancer. the student is aware that the risk for pancreatic cancer is most directly proportional to
The student is aware that age has a direct correlation with the probability of developing pancreatic cancer.
Who is most susceptible to getting chronic pancreatitis?The prevalence of chronic pancreatitis is 50/100,000 people, according to information about it. Men are more likely than women to develop chronic pancreatitis, which frequently appears in individuals between the ages of 30 and 40.
Which demographic has the highest incidence of pancreatitis?Black people are more likely than people of other races to experience pancreatic diseases. The risk and etiology of pancreatitis vary with age and sex. The most frequent cause of acute pancreatitis is gallstones, and early cholecystectomy reduces the risk of recurrent attacks.
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the nurse is concerned that an older adult client is at risk for developing type 2 diabetes. what assessment finding caused the nurse to have this concern?
The nurse is concerned that an older adult client is at risk for developing type 2 diabetes,30.3 body mass index .
What causes type 2 diabetes?The main causes of type 2 diabetes are two connected issues:Insulin resistance develops in the liver, muscle, and fat cells.These cells don't absorb enough sugar because insulin doesn't interact with typically them.The pancreas is unable to produce enough insulin to regulate .
What distinguishes type 1 from type 2 diabetes?Type 1 diabetes is a genetic illness that frequently manifests in childhood, but type 2 diabetes is primarily connected to lifestyle choices and develops over time.Your immune system attacks and kills your insulin-producing cells within your pancreas when you have type 1 diabetes.
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the nurse is caring for a child with a diagnosis of meningitis. which clinical findings indicate an increase in intracranial pressure? select all that apply. one, some, orall - responses may be correct.
The nurse is caring for a child with a diagnosis of meningitis. Headache, drowsiness, decreased alertness, vomiting, bulging fontanelle (infants)- these symptoms indicate an increase in intracranial pressure.
What is meningitis?
The meninges, which are the protective membranes that cover the brain and spinal cord, can get infected either acutely or chronically. The most frequent indications and symptoms include fever, headaches, and stiff necks. Unable to manage light or loud noises, altered consciousness or states of confusion, nausea, and vomiting are some other warning signs and symptoms. Frequently, only nonspecific symptoms in young children—such as irritability, drowsiness, or poor feeding—are present. Another possibility is a rash that does not blanch when a glass is rolled over it.
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a client with an emergently placed central venous catheter (cvc) is to have emergent hemodialysis. upon assessment of the cvc the nurse visualizes redness, drainage, and odor to the area around the cvc. palpation of the surrounding skin causes the client pain. which intervention is the priority?
As per the information provided in the question, the nurse visualizes redness, drainage, and odor to the area around the cvc palpation of the surrounding skin which causes the client pain.
Hence, the nurse should notify the health care provider about the assessment findings of the patient.
What is a central venous catheter?A central venous catheter, also referred to as a central line, is a tube that doctors insert into a sizable vein in the neck, chest, groin, or arm to quickly perform medical tests or administer fluids, blood, or medications.
How long can a CVC stay in?
A central venous catheter can be left in place for weeks or months, and many patients are treated through the line multiple times per day. In intensive care units, central venous catheters are crucial for treating a variety of conditions.
What are the risks of CVC?Artery puncture, heart arrhythmias, improper positioning of CVC, and hematomas at the site of catheter insertion are the most frequent complications that can occur during CVC application. By coming into contact with the heart structures if the catheter's top enters the right heart chambers, arrhythmias in the heart can result.
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in assessing the neutropenic patient's understanding of discharge education, which patient statement
Statement that indicates that more education is needed for neutropenic patient for discharge: If I have a fever or chills, I should take acetaminophen and recheck my temperature an hour later.
What is Neutropenic fever ?The Infectious Diseases Society of America defines fever in neutropenic patients as a single oral temperature of ≥38.3°C or temperature ≥38.0°C sustained over a one-hour period.
Neutropenic fever is an oncologic emergency and neutropenic patients who have fever must notify the health care provider immediately and anticipate going to the emergency room for evaluation. If the patient is not able to reach health care provider by phone then the patient should go to the nearest hospital.
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which clients would the medical-surgical nurse identify as appropriate for transfer or discharge to make room for admission of victims of a disaster? select all that apply. one, some, or all responses may be correct.
There are no options provided, but it is most likely that the clients identified by the medical-surgical nurse as appropriate for transfer or discharge to allow for the admission of disaster victims are patients who have progressed sufficiently to no longer require the services provided.
The following are examples of patients in the Department of Surgery for whom it would be appropriate for the medical-surgical nurse to transfer or discharge for the admission of disaster victims:
Patient who is on the third post-operative day after a complete knee replacement.Patient who is taking medicine for transient ischemic seizures.The patient is starting oral anticoagulant medication for a deep vein thrombosis.Etc.
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the client is 24 weeks pregnant. by how many calories have her nutritional needs increased compared to those during the first trimester
The customer gained roughly 300 calories over her first trimester at 24 weeks' gestation.You can start experiencing nausea and sore breasts as pregnancy symptoms.
Which week in the first trimester is most important?
The first 12 weeks are when the fetus is most susceptible. All of the body's major organs and systems are developing during this time, and exposure to drugs, infectious diseases, radiation, some medications, tobacco, and toxic substances can harm the developing fetus.
How should I sleep in the first trimester?
You could find that getting regular exercise throughout pregnancy makes it easier for you to fall asleep. Stop heartburn. Eat little, frequently, and stay away from eating three hours before bed. Heartburn sensations might also be lessened by sleeping with your head elevated on your left side.
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a young child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. what assessment question should the nurse ask to address the etiology of this health problem?
Young child has been brought to the clinic with signs and symptoms that are consistent with otitis externa, then assessment question that nurse should ask is : Has he been swimming a lot in the last little while?
What is otitis externa?Otitis externa in children is often due to to moisture in the ear, as a result of swimming. Poor hygiene, interaction with animals, and lack of immunizations are not relevant factors.
Otitis externa is a condition that causes inflammation of external ear canal, which is a tube between outer ear and eardrum. Otitis externa is often called as "swimmer's ear" because repeated exposure to water makes the ear canal more vulnerable to inflammation.
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when caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. what is the initial appropriate action by the nurse?
One of the telltale signs of a perforation is abrupt, intense upper abdomen discomfort that persists and gets worse over time. The pain may also radiate to the shoulders, particularly the right shoulder.
What types of jobs are there for nurses?Registered nurses (RNs) oversee and perform medical operations, assist patients' families emotionally, and educate the public about a range of health concerns. The majority of registered nurses work in a variety of settings with physicians and other healthcare professionals.
One category of candidates is nurses.Their duties also include several post-operative surgical therapy chores. Heart, pediatric, and obstetric surgery is a typical area of specialization for surgical nurses.
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Therapeutic radiology treatment planning with simulation of a single treatment area and no blocking. Select the proper code.
a. 77261
b. 77262
c. 77263
d. 77299
The correct code for therapeutic radiology treatment planning with a single treatment area simulation and no blocking is 77261. Hence, the correct answer to this question is A.
The American Medical Association's Current Procedural Terminology, or CPT, stated that the code 77261 refers to a medical procedural code in the range of "Clinical Treatment Planning (External and Internal Sources) for Radiation Treatment". Radiation therapy, also known as radiotherapy and radiology therapy, can be defined as a type of cancer treatment in which strong doses of radiation are used to destroy cancer cells and reduce the size of tumors.
Each radiation therapy session lasts around 10 minutes. Radiation therapy is often administered on a regular basis in an attempt to cure cancer.
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dr. smith operated on polly jones, and it was determined three weeks after surgery that dr. smith left a small needle in the patient's abdomen. which doctrine would apply to this negligent act?
Res ipsa loquitur is the theory that would apply to this negligent act. Dr. Smith operated on Polly Jones, and it was discovered three weeks after the procedure that Dr. Smith left a little needle in the patient's abdomen.
What is the abdomen area?The body's largest cavity, or space, is the abdomen. Many of the body's organs are housed in it, which is located between the chest and the pelvis. The liver, stomach, and intestines are a few of these. The region of the body where the lower portion of the abdomen and the upper thighs meet is called the groin. The abdomen, or simply "the belly," refers to the part of the body that is between the thorax (chest) and pelvis. The top layer of the abdomen is made by the diaphragm. The abdomen and pelvis separate at the level of the pelvic bones.
What is the function of the abdomen and what are the causes of it?In the end, the abdomen acts as a cavity to house important organs of the circulatory, endocrine, exocrine, digestive, urinary, and endocrine systems. Nine layers make up the anterior wall of the abdomen.
Menstrual pains, the flu, or even common causes like food poisoning and gas and indigestion may be easily identifiable. Other factors might be more puzzling. And occasionally experiencing stomach pain can indicate a serious or undiagnosed disease. Any discomfort between the chest and the groin is considered abdominal pain. This is frequently referred to as the belly or stomach area.
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this paper describes a novel, long-term, means of controlling blood glucose levels in individuals with type i diabetes. what is this method? diabetes has sometimes been described as a disruption in intestinal absorption of carbohydrates. does this paper support that hypothesis? why do the patients in the clinical study not experience immediate reduction in hba1c levels? would this treatment be appropriate for individuals with type 2 diabetes?
A blood sugar metre must be used for blood sugar testing. The metre detects the level of sugar in a little quantity of blood, often from the tip of your finger, that you apply to a temporary test strip.
What recent techniques are used to identify glucose?With the advent of the glucotyping technique, it is now possible to classify and evaluate the patterns of glucose dysregulation for specific individuals.
By generating and releasing glucagon and insulin, the pancreas plays important functions in preserving appropriate blood glucose levels.
The symptoms of type 2 diabetes, formerly known as adult-onset diabetes, include elevated blood sugar, insulin resistance, and a relative shortage of insulin. Increased thirst, frequent urination, and unexplained weight loss are typical symptoms.
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the nurse is caring for a client diagnosed with a urinary tract infection. the primary care provider orders include an antibiotic, an antipyretic, and a urine culture and sensitivity, and urine specimen for nitrates. which actions should the nurse take? select all that apply.
The nurse should take the following actions:
A. Collect the first void clean urine specimen since the client arrived at the ER at 0500.
B. After collecting the specimen, place it in a biohazard bag with the appropriate label and send it to the lab.
C. Collect urine specimens before beginning the prescribed antibiotic.
D. Before obtaining the urine culture and sensitivity, administer the antipyretic.
E. Inform the client about midstream urine collection.
What is urinary tract infection?
Urinary tract infections (UTIs) are infections of the urinary tract, which include the bladder (cystitis), urethra (urethritis), and kidneys (kidney infection). Antibiotics can be used to treat UTIs, but they are not always necessary.
A urinary tract infection (UTI) can cause the following symptoms:
1. When peeing, you may experience pain or a burning sensation (dysuria).
2. having to pee more frequently than usual during the night (nocturia).
3. needing to pee suddenly or more urgently than usual needing to pee
4. more frequently than usual blood in your pee
5. lower tummy pain or pain in your back, just under the ribs
6. a high temperature, or feeling hot and shivery
7. a very low temperature below 36C
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a patient with high cholesterol is ordered to take atorvastatin. what information will be included in the patient teaching? (select all that apply.)
Patient teaching must include option c ,d and optionf that is : The medicine should be taken with a full glass of water. The patient should watch for body aches or gastrointestinal upset as side effects. The patient should have liver function tests frequently.
What is atorvastatin ?A class of drugs known as HMG-CoA reductase inhibitors includes atorvastatin . It functions by reducing the amount of cholesterol that may accumulate on the artery walls and obstruct blood flow to the heart, brain, and other organs of the body. This is done by delaying the body's creation of cholesterol.
typical adverse consequences :
experiencing nausea or indigestion Eat simple meals only
Headaches. Rest and ingest a lot of drinks, please
Nosebleeds
unwell throat
symptoms of a cold, like a runny or blocked nose or sneezing
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in a study conducted by the centers for disease control and prevention of complementary and alternative medicine (cam), the most common form of cam was found to be
Manipulative therapies yoga and other forms of exercise, and acupuncture were some of the most often utilized CAM treatments (cam).
What is CAM?The term complementary and alternative medicine (CAM) describes a range of therapies that go beyond standard Western medical practices. When treatments are used in addition to normal care, they are referred to as complementary, and when they are used in place of them, they are referred to as alternative.
What is acupuncture?Acupuncture is an alternative medicine that uses wire-thin needles inserted by a trained practitioner into specific points to relieve pain.
What is heathcare?Heathcare consists of means and ways to keep a body in its healthiest state.
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a client who is 14 weeks' pregnant mentions that she has been having difficulty moving her bowels since she became pregnant. which hormone is responsible for this common discomfort during pregnancy?
2. This typical discomfort during pregnancy is caused by grapelike clusters hormone
Which hormone initiates menstruation?Every month an embryo is ready for implantation thanks to the endometrium, the uterus' lining. Estrogen and progesterone from the ovary affect this preparation throughout its action. A menstrual cycle, which typically lasts fourteen days after ovulation, is how the endometrium is shed if a pregnancy does not occur.
what is The purpose of hormones?The chemical messengers of the body, hormones transmit information to the tissues and blood. Hormones regulate a variety of bodily functions, including mood, sexual function, reproduction, and growth and development. They also affect metabolism, which is how your body converts food into energy.
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Viruses that incorporate their genome with that of the host cell have what type of replication?.
Viruses that incorporate their genome with that of the host cell have lytic cycle type of replication where the DNA is injected into the cell.
What is DNA?DNA is a hereditary material which is present in human beings as well as all other living organisms. Every cell which is present in an organism's body has DNA which is the same. Most of the DNA is situated in the cell's nucleus and small amount of it can be found in the cell's mitochondria as well.
Information which is stored in DNA is stored as codes made up of four chemical bases namely, adenine, thymine , cytosine and guanine.Human DNA consists of 3 billion bases .The order of the bases determines information which is required for building and maintaining an organism.
DNA bases are capable of pairing up with each other. Adenine pairs with thymine and guanine pairs up with cytosine .Each base is also attached to a sugar molecule and a phosphate group. A base, phosphate sugar are together called as nucleotides.
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the client comes to the healthcare provider reporting nasal discharge, malaise, headache, and a nonproductive cough. the healthcare provider orders guaifenesin for the client. what interventions should the nurse suggest with this medication? select all that apply.
Humidify the air and increase fluid intake is the interventions the nurse should take.
What is non productive cough?
A dry cough that does not generate sputum, or the mucus that collects in the lower airways of the lungs during an infection or chronic sickness, is referred to as a non-productive cough. This is in contrast to a productive cough, sometimes referred to as a wet cough, when the act of coughing causes sputum to be produced and is typically a symptom of chronic lung disease, congestive heart failure, viral infections, or other disorders.Non-productive coughs can have a variety of causes, such as viral illnesses like the common cold or bronchospasms, which are bronchial tube spasms brought on by irritation. Infections, chilly air, or environmental toxins and pollutants are common bronchospasm inducers. A non-productive cough can also be brought on by allergies and postnasal drip. A non-productive cough can also be caused by an inhaled object, such as food or a tablet, blocking the airway. A persistent dry cough may also be a symptom of cough variant asthma, a kind of asthma in which a dry, ineffective cough is the primary symptom.Humidify the air and increase fluid intake is the interventions the nurse should take.
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a woman who is taking isotretinoin calls the office to say that she thinks she may be pregnant. what will the nurse instruct the patient to do first?
Beginning on the first day of your last menstruation, you can calculate how many weeks you are pregnant. the first two weeks or so after conception, you are not actually pregnant.
Where do bumps during pregnancy appear?Where may one find pregnant acne? Acne that develops during pregnancy can show anywhere. They frequently show up on the face, chin, neck, chest, and back.
What are the initial pregnancy cramps like to feel like?As your body adjusts to your developing kid, it's normal to have some cramping in your lower abdomen from the beginning of your pregnancy, according to Dr. Nalla. Your uterus expands along with your tummy.
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the nurse is discussing pain relief methods for a pregnant first-time mother. the discussion should include which labor support methods? select all that apply.
The preferred pain reliever for usage during pregnancy is paracetamol, which can be taken without a doctor's supervision.Before learning they were pregnant, it's not really uncommon for women for using different forms of painkillers early on.
What techniques are used to aid with labor?Two varieties of assisted vaginal delivery exist,Births aided by forceps, and , births aided by vacuum.The sort of birth that is performed is determined by a number of variables, including your unique circumstances and the expertise of your obstetrician-gynecologist .
What are the four typical delivery methods?Examples of delivery methods include vaginal childbirth, C-section, VBAC, and assisted vaginal delivery.vaginal birth.assistance during vaginal birth (vacuum or forceps).C-section (Cesarean birth) (Cesarean birth).VBAC (vaginal birth after cesarean) (vaginal birth after cesarean).
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when reviewing data collection on a client with a cardiac output of 2.5 liter/minute, the nurse inspects the client for which symptom?
A normal heart beats between 3.5 and 8.0 liters per minute on average. The amount of blood in circulation that can carry oxygen to the tissues decreases with decreased cardiac output.
What is a typical cardiac output and index?The average cardiac output while rest is 5 L/min, and the normal range is 4.0 to 8.0 L/min. Elite athletes can workout at a heart rate of up to 40 L/min. The cardiac index's normal range is 2.5 to 4.0 L/min/m2.
How do you determine the average cardiac output?The stroke volume and heart rate are multiplied to determine the cardiac output. Preload, contractility, or afterload all influence stroke volume. The usual range in cardiac output as roughly 4 to 8 L/min, however it might change based on the body's metabolic requirements.
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the primary healthcare provider has prescribed medication for a patient. while caring for the patient, the nurse finds that the patient is allergic to this medication. the nurse informs the primary healthcare provider, and the provider prescribes a new medication. which principle of the code of ethics has the nurse followed?
After the doctor and provider prescribe a new drug, the nurse complies with the code on care ethics.
What is medication in plain English?Medicines are substances or chemicals that treat, halt, or prevent illness, lessen symptoms, or aid in the disease diagnosis. Cardiology is the practice and study of caring for a patient, regulating the diagnosis, prognosis, avoidance, treatment, therapeutic interventions of their injury or sickness, and improving their health. Advances in medicine have made it possible for surgeons to cure countless diseases and save lives.
What role does medicine play in society?Reduced blood pressure, the treatment of infections, and pain relief are a few examples of how drugs are beneficial. Medication hazards are the likelihood that When you utilize them, something undesired or unexpected can occur to you.
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the nurse suspects that the patient receiving parenteral nutrition (pn) through a central venous catheter (cvc) has an air embolus. what action does the nurse need to take first?
The nurse will move this patient towards the left lateral decubitus position at first.
What is an embolus?The embolus is really a blood clot that forms that begins in a blood vessel in one area of the body, splits, and travels inside blood to another area of the body. An embolus may reside in a blood vessel. This can stop the organ's blood flow.
What is a thrombus and embolus?Any blood clot that develops in a vein is called a thrombus. Anything that travels through the vascular system until it reaches an vessel that is just small to allow it to pass is called an embolus. When blood flow is interrupted as a result .
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the nurse is caring for a client with alcoholism who now presents with gastrointestinal bleeding. what alteration does the nurse anticipate related to the bleeding?
The change the nurse expects to see related to bleeding is an increase in ammonia level.
The nurse is caring for a client with alcoholism.Why?The gradual, constant GI bleeding causes the patient to not even be aware that they are ill until their haemoglobin level is so low that they are unable to breathe normally or get up without assistance.
What is GI bleeding?Gastrointestinal (GI) bleeding is a symptom of some disorder in the digestive tract that causes mild to severe bleeding.
What is haemoglobin?Haemoglobin is a protein inside red blood cells that carries oxygen from the lungs to tissues and organs in the body and carries carbon dioxide back to the lungs.
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a newborn, whose mother is hiv positive, is scheduled for follow-up assessments. the nurse knows that the most likely presenting symptom for a pediatric client with aids is
Infections of the respiratory system are quite prevalent in children. The infant with AIDS, however, commonly exhibits a persistent cold as their first presenting symptom because of their body's limited ability to fight off these infections.
The correct option is C
What transpires if an infant has HIV?
Ears and nasal infections, sepsis, pneumonias, TB, urinary tract infections, gastrointestinal illnesses, skin conditions, and meningitis are common infections among children who are HIV-positive. Children with HIV are frequently diagnosed with TB, diarrhea, and respiratory infections, especially in developing nations.
What longer can a child with HIV survive?
Children with HIV have a death rate of 52.5% by the time they are 2 years old, compared to 7.5% for children without HIV. A kid with HIV is unlikely to survive past age one if antiretroviral therapy is not started as soon as possible, say some HIV experts.
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a pregnant patient took levothyroxine priorto becoming pregnant. what should be doneabout the levothyroxine now that she ispregnant?
According to the given information, the patient is under medication of L-thyroxine, hence she should continue it even after being pregnant and have monthly TSH levels checked.
The thyroid supplement L-thyroxin is used to treat hypothyroidism in patients. It should be kept up as it is safe to use while pregnant. She will need regular monitoring, though, as her need for thyroid hormone rises during pregnancy. If her levels fall to a hypothyroid state, the fetus's growth could be seriously hampered.
What is L thyroxine used for?An underactive thyroid gland is treated with the medication levothyroxine (hypothyroidism). The thyroid gland produces thyroid hormones that aid in regulating growth and energy levels. To make up for the lack of the thyroid hormone thyroxine, people take levothyroxine. Only with a prescription is levothyroxine accessible.
Why is this medication prescribed to patients with hypothyroidism?Levothyroxine belongs to the hormone class of medications. It functions by replacing thyroid hormone, which the body normally produces. Without thyroid hormone, your body can't function properly, which can lead to issues like slow speech, poor growth, low energy, constipation, gain in weight, hair loss, dry and thick skin, increased sensitivity to cold, joint as well as muscle pain, heavy or irregular periods, and depression. Levothyroxine treats these symptoms when taken properly.
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the nurse is reviewing the record of a newborn infant in the nursery and notes that the primary health care provider (phcp) has documented the presence of a cephalohematoma. based on this documentation, what should the nurse expect to note on assessment of the infant?
The nurse expect to note on assessment of the infant Edema caused from bleeding below the brain's periosteum
What is cephalohematoma ?A blood clot under the scalp is referred to as a cephalohematoma. Small blood vessels on the fetus's head are broken during birth as a result of minor trauma.
A soft bulge or bump, usually on the back of the head, develops as a result of blood accumulating under the scalp. This swelling develops shortly after birth and may continue to grow for a few days. It might resemble a bruise. The soft mass gradually begins to harden or calcify with time.
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the nursing instructor is teaching a class on the physiologic prosperities involved with the birthing process. the instructor determines the session is successful when the students correctly match surfactant with which function?
When the students properly connect surfactant to the substance that prevents alveoli from collapsing with breaths, the lesson is effective.
What kinds of work must nurses to perform?In addition to providing patients' families with emotional support and educating the general public about various health issues, registered nurses (RNs) supervise and carry out medical treatments. In a variety of settings, the majority of registered nurses collaborate alongside doctors and other medical professionals.
Would a nurse be qualified to perform the role?They are in charge of a variety of post-operative surgical therapeutic duties. The job of many surgical nursing practitioners is focused on cardiac, pediatric, or obstetric surgery.
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