Inpatient Meds: * amiodarone (Cordarone) 200 mg 1 T PO Daily * Digoxin 250 mcg 1 T PO Daily * enoxaparin (Lovenox) 90 mg Subcut every 12 hour * pantoprazole (Protonix) 40 mg 1 T PO Daily before breakfast * NaCl flush IV Push every 8 hours * warfarin (Coumadin) 5 mg 1 T PO Daily PRN meds: Active meds * acetaminophen (Tylenol) 325 mg 1 tablet every 4 hours as needed (received 2/6/12 and 2/7/12) * MOA: inhibits COX-2 and release PG by inhibiting pyrogens in the hypothalamus * AE: nausea and pruritis * diphenhydramine (Benadryl) 25 mg 1 capsule PO QID PRN itching (received 2 doses on 2/7/12, 2/6/12) * antagonizes histamine at the H1 receptor * Fentanyl 25mcg/0.5ml IV push PRN pain (Cath lab) (Received 2/6/12, 3 doses on 2/7/12) * acts with the opioid mu-receptor in the CNS * depresses cough, may lead to N/V * hydromorphone (Dilaudid) 0.5mg/0.25ml IV push PRN pain (received 2/7/12) * opioid agonist * constipation, N/V * metoclopramide (Reglan) 10 mg 2ml Injection IV push every 4 hours PRN N/V (received 2/7/12) * promotes motility in the upper GI tract by sensitizing tissues to the action of
1. Superior hypogastric plexus block: the posteromedian transdiscal approach. www.painphysicianjournal.com E51 Superior Hypogastric Plexus Combined with Ganglion Impar Neurolytic Blocks otic was given 30 minutes before the procedure, which were all performed under sterile conditions with c-arm fluoroscopic guidance. This approach is performed with the patient in the lateral or prone position. The L5-S1 interspace was identified under fluoroscopy, the skin overlying the interspace was sterilized and infiltrated with 2 – 3 mL of local anesthetic (lidocaine 2%), a 20-gauge, 15 cm needle with a 30° short bevel (Chiba needle) was inserted perpendicular to the skin at the center of the L5-S1 intrelaminar space under anteroposterior fluoroscopic vision.
He has a 22-year-old son and an 18-year-old daughter who are in good health. A paternal uncle has hypertension and a maternal uncle has prostate cancer. There is no known family history of diabetes mellitus. On review of systems, he has occasional headaches, experiences shortness of breath when he walks up stairs, and gets up once a night to urinate. Questions: 1.
Mr Varga is a 49 year old male who presents to the emergency department with central chest pain. He has no personal history of coronary artery disease or myocardial infarction, and no known family history of atherosclerotic heart disease. Mr Varga stated that he has associated symptoms of nausea, diaphoresis, and pain radiating to both shoulders and down his left arm, which he rates as a pain score of ten out of ten. When Mr Varga is questioned about his social history, he states that he smokes fifteen cigarettes a day, does very little exercise, works in an office and feels very anxious and guilty about his lifestyle as he considers it to be a contributing factor to his admission. Mr Varga is afebrile, has a blood pressure of 106/62 mm Hg, a regular pulse of 68 beats per minute, a respiratory rate of 18 breaths per minute and an oxygen saturation of 96% on room air.
The 40 minor adverse events including nausea, dizziness, heavy sweating, vomit, headache, tired, minor bleeding increase in pain for a short time. In addition, there are no major adverse events at all. This count as only less than one percent of the accidents occurs during and after acupuncture treatments. Furthermore, according to the interview of Dr. Jaroon Jittiwuttikan, the acupuncturist who have more than 10 years experience there were no fatal side effects before. There were no records of people die from doing acupuncture either.
Pathophysiology: Marvin has been diagnosed with Acute Cystitis. Cystitis is an inflammation of the urinary bladder. Inflammation is caused by bacterial infection. (Lippincott Williams & Wilkins, 2010, p.945) A common cause of Cystitis is Benign Prostatic Hyperplasia. (Lippincott Williams & Wilkins, 2010 p.946) Nursing Physical Assessment: Marvin is A&O x3.
Values, health perception The family does not visit the primary care office for visits other than what is absolute necessary. The family has not had health insurance for over 10 years. The youngest child is covered under the mothers insurance. The youngest child visits the doctor’s office as needed and for annual physicals. The older son is underweight and has difficulty gaining weight, he does not visit the doctor and treats his allergy and sinus problems with over the counter products.
cso@aamaine.org Central Service Office, 78 Portland St., Portland, ME 04101 September, 2008 www.aamaine.org 774-3034 or toll free 1-800-737-6237 Volume 25 Number 9 Office Hours Mon., Wed., Fri. and Sat. 9 AM - 1 PM Tues. and Thurs. 9 AM - 7 PM Excerpts from "Living Sober" “So not drinking at all ---that is staying sober--- “One drink is too many, but twenty are not enough.” Doctors who are experts on alcoholism tell us that there is a sound medical foundation for avoiding the first drink. It is the first drink, which triggers, immediately or some time later, the compulsion to drink more and more until we are in drinking trouble again Remembering that alcoholism is an incurable, progressive, fatal disease We are also convinced, after the countless attempts we made to prove otherwise, that alcoholism is incurable—just like some others illness. It cannot be “cured” in this sense: We cannot change our body chemistry and go back to being the normal, moderate social drinkers lots of us seemed to be in our youth.
Infectious diseases and immunization, February 2004 - Volume 16 - Issue 1 - pp 85-88 8. Elder JS. Urinary tract infections. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BE, editors. Nelson Textbook of Pediatrics.
Inj. Atropine IV 0.05 mg/kg every 10 minutes until signs of atropinism appear; maintain it for 24 hours. 9. The signs of high dose of atropine intake are: • Drying of all