A surgical site infection (SSI) is an infection that occurs after surgery in the part of the body where the surgery took place. About 300,000 SSIs occur each year. While most surgeries do not result in infection; about 1-3 patients out of every 100 who have surgery currently develop SSIs. Certain preventable surgical site infections (SSI) will no longer be reimbursed according to the Center for Medicare and Medicaid Services (CMS). Effective October 1, 2008, The Centers for Medicare and Medicaid Services (CMS) selected high-cost or high-frequency events from the National Quality Forum's list of “never events” for inclusion in this reimbursement change (Brown, Doloresco, Mylotte, 2009).
Pathophysiology of Acute Renal Failure Hannah Allison Davidson County Community College Pathophysiology of Acute Renal Failure Acute renal failure, or ARF, refers to the sudden loss of kidney function. Over a period of hours to a few days, the GFR falls, accompanied by a rise in serum creatinine and urea nitrogen. A healthy adult eating a normal diet needs a minimum daily urine output of approximately 400 ml to excrete the body’s waste products through the kidneys. An amount lower than this indicates a decreased GFR. ARF affects 1% of patients on admission to the hospital (Nursing, 2011).
Pressure can be minimized by intermittent application of noninvasive ventilation, Scheduling breaks (30-90 min) to minimize effects of mask pressure. This can be prevented by balancing strap tension to minimize mask leaks without excessive mask pressures and covering vulnerable areas (erythematous points of contact) with protective dressings. Gastric distension can occur also. This can be avoided by limiting peak inspiratory pressures to less than 25 cm water, nasogastric tubes can be placed but can worsen leaks from the mask. Nasogastric tube also bypasses the lower esophageal sphincter and permits reflux.
According to Meleis (2007) knowing includes knowledge based on observation, research findings (evidenced based), clinical manifestations and scientific approach. As a stroke nurse empirical knowing it’s very important in taking care of stroke patients. I determine patient’s neurological status by performing neuro checks frequently every 1-2 hrs as the patient’s condition might deteriorate the first 24hrs and perform swallow test to determine if the patient can swallow medications. Patient’s plan of care is based on assessment findings(vital signs, Glasgow coma score).If a patient is confused and very weak fall precaution is observed by activating the bed alarms, request for a PT/OT consult, if the patient does not pass the swallow test, a speech therapist is consulted. Sometimes patient’s neurological deficits get resolved after a few hours or days and that calls for change of treatment plan.
The higher the blood cholesterol level is the greater risk. According to Pflieger, DO, Winslow, MD, and Mills, PharmD (2011) “In one trial, patients given intensive therapy with atorvastatin (Lipitor) in a dosage of 80mg per day had significantly lower mortality 30 days after MI.” Blood pressure is the force of blood against the wall of artery as the heart pumps blood. If the pressure rises and stays high over time, can lead to plaque buildup and can damage the heart. Antihypertensive (reduces blood pressure) medications help by decreasing myocardial demand, which is increased in those with CAD.
The rate of infection did decrease substantially in the shaved patients if the shaving was done at the time of surgery rather than the customary day prior. Each of the article cited years’ worth of data collection in studies around the world with thousands of patient’s total. In all of the articles they noted that the resistance to changing this procedure is due to custom and practice (Prevention of Surgical Site Infections n.d.). 4. Based upon a review of the literature, if the practice of shaving was eliminated in totality or at least substituted with clipping in more hospitals, the incidence of
According to Schull’s drug handbook (2006), Phytonadione acts on the liver to promote the production of active prothrombin, proconvertin, plasma thromboplastin component, and Stuart factor. In other words, it promotes blood clotting. The safe dose for neonate is 0.5 to 1 mg injected intramuscularly within one hour of birth. Adverse reactions include: hyperbilirubinemia, pain, swelling, tenderness at injection site, and anaphylactoid reactions. Because neonates in the first few hours of life usually don’t have adequate vitamin K in their blood stream, physician often prescribes Phytonadione to prevent hemorrhaging of the newborn.
The affect of strokes on the body can range between mild dizziness or slight numbness to impaired speech and loss of motor control. Major strokes can block blood flow to the brain to the point where the brain becomes impaired. Once the brain shuts down, it is no longer sending signals to the parts of the body that require brain operation to function. This can impair heart function, which can lead to death in the matter of a few minutes. According the American Heart Association’s posted statistics in Chapter 12 of this week’s reading, out of more than 6.5 million Americans suffer from strokes each year, roughly 150,000 die as a result from the damage.
Nursing skills carried out whilst working in maternity: • Ward admission for elective LSCS list eg, correct paperwork, consent, next of kin, care preferences where indicated, etc.. • Cannulation for access plus associated work up • Liasing with medical staff, anaesthetics/ O and G • Womans advocate • Staying in PACU with new family, providing direct nursing care for immediate post operative half hour. • Problem solving: initiating care interventions, with timely review and analysis, eg, Problem: low post op BP in PACU with spinal anaesthetic in place Care intervention: take manual BP, and reduce angle of head elevation Review: BP same on manual, => 20% drop systolic. Anaesthetist informed. Pt symptomatic now vomiting: maxalon IV as per PACU standing order Review: BP same, IV fluids increased: pt healthy with no heart/cvs problems. Anaesthetist orders 4mg odansetron IV antinauseant ( 5ht inhib action) To reduce post op nausea and vomiting/due to hypotension?
(Nawa, Kato, Kawamoto, Okada, Yamamoto, Kohno, Endo & Shiratori, 2008) Rectum: ulcerative lesions, obstruction and bleeding, MD able to feel mass during rectal exam, bright red bleeding. (Nawa, Kato, Kawamoto, Okada, Yamamoto, Kohno, Endo & Shiratori,