Contribution of Americans to medical sciences are - William Morton's use of ether as an anesthetic. Oliver Wendell Holmes's discovery that disease could be transmitted from person to person.
In 1846, American dentist and physician William Thomas Green Morton performed the first open demonstration of the use of inhaled ether as a surgical anesthetic. Holmes promoted the divisive theory that doctors' unwashed hands were to blame for the transmitted puerperal fever from patient to patient.
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a nurse cares for a client with anemia after having a total gastrectomy a year ago. which unique assessment findings will the nurse likely find when assessing this client that may not be present in another client with anemia? select all that apply.
The type of anemia that is associated with gastrectomy that is the problems dealing with the gastric intestinal tract is iron deficiency anemia which deals with the deficiency of vitamin B12.
What is the major cause of anemia ?The major cause of anemia is the diet imbalance along with some serious health issues dealing with the malfunctioning of RBC structures and functions which have an improper mechanism.
The nurse will have to take the assessment for megaloblastic anemia which deals with the deficiency of vitamin B12 that is the concern that when a person undergoes gastrectomy.
In this case the person is prone to face the deficiency of the vitamin B12 leading to anemia thus the assessment for the total blood count (CTC) will help to find the actual patient report and vary from other patients.
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the nurse monitoring a client receiving insulin glulisine notices the client has become confused, diaphoretic, and nauseated; and has a blood glucose of 60 mg/dl. which emergent treatment would the nurse most likely give? select all that apply.
Orange juice or other fruit juice, glucose tablets, or hard candy are the emergency treatments for the client who has been confused, diaphoretic, and nauseous and has a blood glucose level of 60 mg/dl.
The best course of action is to provide an instantaneous source of glucose as the blood glucose level becomes less than 70 mg/dl.
When the amount of blood sugar in the blood is too low, hypoglycemia develops. It is also known as an insulin response or an insulin shock.
Low blood sugar is defined as less than 70 mg/dL. Check your blood sugar levels if you suspect a low. Treat it now if you are unable to inspect it first. Low blood sugar should always be addressed right away since leaving it unattended might be harmful.
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trained professionals that can help you set reasonable physical activity goals based upon your current level of fitness are called multiple choice gym trainers. sports dietitians. health coaches. life coaches.
which condition would the nurse advise a patient with raynaud disease to avoid to prevent vasospastic attacks
Cold exposure and emotional stress condition would the nurse advise a patient with raynaud disease to avoid to prevent vasospastic attacks.
Vasospastic illnesses are conditions where blood flow is constrained as a result of spasms in small blood vessels near to the skin's surface. This can be referred to as vasoconstriction by your doctor. Usually, it's only momentary. A classic vasospastic disorder is Raynaud's syndrome, which affects the hands and feet and makes them feel cold.
When it's chilly outside, the body reduces blood flow to the skin. This acts as a thermoregulatory system to keep the body's core temperature stable and prevent further heat loss. When under stress or in cold weather, Raynaud's phenomenon causes restricted blood flow. In Raynaud syndrome, the cutaneous arterioles and digital arteries in particular experience vasoconstriction.
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the patient in room 206 has an abnormal dilation of the renal pelvis and calyces caused by accumulated urine that cannot flow past the obstruction. this is called?
urine that has built up and is unable to pass the obstruction damages the renal pelvis and calyces. Hydronephrosis is the term for this.
When the Calyces and renal pelvis swell, what ailment results?An restriction to the urine's outflow distal to the renal pelvis is known as hydronephrosis, which causes the renal calyces and pelvis to become engorged with urine. Similar to this, a dilatation of the ureter is what is meant by a hydroureter.
Which phrase best sums up the dilatation of either/or both kidneys?While the term "hydroureter" refers to swelling of the ureter, the term "hydronephrosis" is used to denote dilation and swelling of the kidney. Both pathologic and physiological causes might result in hydronephrosis or hydroureter.
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pinpoint hemorrhages that appear on the lower leg, usually associated with decreased platelets, are called
Pinpoint hemorrhages that appear on the lower leg, usually associated with decreased platelets, are called thrombocytopenia.
Platelets, or thrombocytes, are small, colorless cell fragments in our blood that type clots and stop or forestall hemorrhage. Platelets are created in our bone marrow, the sponge-like tissue within our bones. Bone marrow contains stem cells that turn out to be red blood cells, white blood cells, and platelets.
Thrombocytopenia is a condition within which you have got a coffee platelet count. Platelets (thrombocytes) are colorless blood cells that facilitate blood. Platelets stop hemorrhage by clumping and forming plugs in cardio vascular injuries.
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clsi (clinical and laboratory standards institute) standards are often used to monitor processes during activities for:
CLSI(clinical and laboratory standards institute) standards are often used to monitor processes during activities for clinically and laboratory testing used within the healthcare community.
CLSI ensures assure accuracy, adopt efficient protocols and minimise risk of contamination. CLSI is a procedure for collection of blood specimen. A document remarkably improve quality althrough various steps for collecting blood specimens. tourniquet application time should be verified by all quality laboratory manages. The procedure for collecting blood specimen should be revised to eliminate the source of laboratory variability and quality. Thirty skilled phlebotomist were trained with the CLSI. In the quality improvement and safety of the patients has been the focus of the national and international initiatives.
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the nurse is caring for a client prior to surgery. the surgeon has prescribed a preoperative nasal swab for the client for staphylococcus aureus. in addition to the nasal mucosa, staphylococcus aureus can also be colonized in what other areas of the body? select all that apply.
Other bodily parts, such as the perineum, naval, and hairline, may also harbor Staphylococcus aureus colonies. On human skin, in the nose, armpit, groin, and other places, Staphylococcus aureus, sometimes known as "staph," is a kind of bacteria.
S. aureus has long been acknowledged as one of the most significant bacteria that harm humans. It is the main contributor to cellulitis, abscesses (boils), and other soft tissue diseases. S. aureus can cause serious infections such as bloodstream infections, pneumonia, or infections of the bones and joints, even though the majority of staph infections are not dangerous.
In most cases, an infection can be prevented by the skin and mucous membranes. But if these defenses are broken down, Infection caused by aureus may spread to deeper tissues or the circulation.
So, it is possible for other body parts, like the perineum, naval, and hairline, to harbor Staphylococcus aureus colonies.
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newborn is inconsolable with a high-pitched cry. newborn sucks vigorously on pacifier but breastfeeds poorly. respirations unlabored. lungs sound clear on auscultation. increased muscle tone with moderate to severe tremors when disturbed. hyperactive moro reflex noted. several loose stools today.
A newborn is inconsolable with a high-pitched cry, breastfeeds poorly, has severe tremors when disturbed, has hyperactive reflexes, and has respiration unlabored. The nurse should suspect that this newborn is having: an infant drug withdrawal.
What is infant drug withdrawal?Infant drug withdrawal is a condition where a baby has been exposed to a specific substance before birth. As the newborn’s body adjusts to the environment outside the womb and there are no longer the drugs or medicine the mother took in pregnancy, they can experience an infant's drug withdrawal. Some medicines that can cause serious withdrawal for infants include methadone and opioid.
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the nurse has created a care plan for a client admitted with acute pericarditis and a nursing diagnosis of acute pain related to pericardial inflammation. what is an appropriate nursing intervention for this client?
The appropriate nursing intervention for this client is placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on.
What is acute pericarditis and how this cause a acute pain?Pericarditis is an inflammation of the tissues that surround the heart, called the pericardium, this can result in a spillage of the fluid found in the membrane or in a hardening of the membrane, pressing on the heart, restricting its pumping.
Among the symptoms of acute pericarditis we find a sharp pain in the central part of the thorax that can radiate to the back, for this reason it is advisable to put the patient in high-Fowler's position which will help relax the muscles and will allow the patient to breathe more normally.
Therefore, we can confirm that the correct option is 4. Placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on.
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The nurse has created a care plan for a client admitted with acute pericarditis and a nursing diagnosis of acute pain related to pericardial inflammation. What is an appropriate nursing intervention for this client?
1- Administering around-the-clock opioids as prescribed
2- Promoting progressive relaxation techniques with the use of slow, deep breathing
3- Positioning the patient on the right side with the head of the bed elevated 15 degrees
4- Placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on
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it is important for the nurse to develop a therapeutic relationship with the client. when conducting the admission interview, what actions best facilitate the process? (select all that apply. one, some, or all options may be correct.)
The nursing actions that best facilitate the process include the following:
Clarify info by questioning client to verify infoLet the client do most of the talking & actively listenWhat are nursing actions?
Nursing actions are interventions that a nurse takes to implement their patient care plan, including any treatments, procedures, or teaching moments intended to improve the patient's comfort and health.
During any nursing action, the Patient safety is a top priority for registered nurses, no matter how long the patient is under their direct care.
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when developing the plan of care for a child with early duchenne's muscular dystrophy, which nursing goal is priority?
During developing the plan of care for a child with early duchenne's muscular dystrophy, the priority should be maintaining function of unaffected muscles.
What is duchenne's muscular dystrophyDuchenne muscular dystrophy is a severe, progressive, muscle-wasting condition that causes movement problems, the need for assisted breathing, and ultimately, early death. The dystrophin gene (which codes for the condition) is mutated, which stops the muscle's ability to produce dystrophin. Without dystrophin, muscles are more vulnerable to injury, leading to cardiomyopathy as well as a progressive loss of muscular mass and function. Our comprehension of the basic and secondary pathogenetic pathways has substantially increased as a result of recent investigations. The management of the many components of the disease as well as guidelines for interdisciplinary treatment of Duchenne muscular dystrophy have been established.Maintaining muscle function in unaffected areas for as long as feasible is the key nursing goal. Currently, there is no cure for childhood muscular dystrophy. Children who remain active can avoid becoming wheelchair-bound. The likelihood of social isolation is reduced by being active. An important nursing goal is to prevent rather than promote wheelchair use by preserving function for as long as possible. As their disease worsens, and they can no longer keep up with friends, children with muscular dystrophy become socially isolated. Social isolation can be prevented by maintaining function. Muscular dystrophy is not linked to circulatory dysfunction.
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brent is obese and has tried multiple times to implement lifestyle changes to lose weight. he has had some success, but the behaviors never last for very long and he returns to his original weight, which is a serious health risk. he is a good candidate for
Brent is obese and has tried multiple times to implement lifestyle changes to lose weight but the behaviors never last for very long and he returns to his original weight, which is a serious health risk so he is a good candidate for obesity.
Obesity is a advanced illness involving associate excessive quantity of body fat. fatness is not only a cosmetic concern. It is a serious health risk that will increase the chance of alternative diseases and health issues, like cardiovascular disease, diabetes, high vital sign and bound cancers.
The best way treat obesity is to eat a healthy, reduced-calorie diet and exercise often. to try to to this you should: eat a balanced, calorie-controlled diet as counseled by your physician or weight loss management professional person (such as a dietitian) be part of a weight loss cluster.
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a nurse is requesting to receive the change-of-shift report at the bedside of each client. the nurse giving the report asks about the purpose of giving it at the bedside. which response by the nurse receiving the report is most appropriate?
It will allow for us to see the client and possibly increase client participation in care that response by the nurse receiving the report .
What is report?A report is a document that presents information in an organized form for a specific audience and purpose. Although summaries of reports may be presented orally, full reports are almost always written documents.
Types of External Reports
External Reports. Information reports. long reports. Official reports.Reports are prepared to present and discuss research results. They provide the reader with the rationale for the study, description of the method used, findings, results, logical discussion and conclusions recommendations.
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intravenous (iv) fluids have been infusing at 100 ml/hour via a central line catheter in the right internal jugular for approximately 24 hours to increase urine output and maintain the client's blood pressure. upon entering the client's room, the nurse notes that the client is breathing rapidly and coughing. for which additional signs of a complication should the nurse assess based on the previously known data?
The additional signs of complication which the nurse should assess based on the previously known data is crackles in the lungs and is denoted as option 2.
What is Lungs?This is referred to as a pair of organs which are present in the chest region and function in terms of respiratory activities in the body system.
In this scenario, we were told that the nurse notes that the client is breathing rapidly and coughing which means that respiration isn't at an optimal rate. This may be most likely caused by a problem with the lungs which may be presence of crackles.
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The options are;
1. Excessive bleeding
2. Crackles in the lungs
3. Incompatibility of the infusion
4. Chest pain radiating to the left arm
which of the following is a difference between heroin and morphine? 1. heroin is more readily absorbed from the stomach than morphine. 2. heroin is a more effective antipyretic medicine than morphine. 3. heroin is believed to be more potent and acts faster than morphine. 4. heroin reduces the inflammation in an injured area more effectively than morphine.
Heroin is thought to be stronger than morphine and to work more quickly.
3 is the right answer.
How is morphine produced?Opium or concentrated poppy straw are used to make morphine for commercial use. Concentrated poppy straw is collected from the pods after the plants have been harvested, whereas opium is a sticky brown resin that can be made by gathering and drying the latex that comes out of lanced poppy pods.
What distinguishes oxycodone from oxycodone in OxyContin?Oxycodone is sold under the brand name OxyContin. The main distinction between OxyContin and oxycodone is that OxyContin is a drug that contains oxycodone with a controlled release. Unlike oxycodone, which releases its painkilling effects all at once, morphine's painkilling effects are released gradually over several hours.
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a nurse sees a pregnant client at the clinic. the client is close to her due date. during the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of which possibility?
During the visit the nurse would emphasize that the client get evaluated quickly should her membranes rupture spontaneously based on the understanding of the possibility of contractions.
Who is a Nurse?This is referred to as a healthcare professional who is specially trained in the care of sick and infirmed individuals and also ensures that adequate recovery is achieved to prevent various types of complications.
A pregnant woman has to be evaluated quickly when her membranes rupture spontaneously and it is based on the understanding of the possibility of contractions which is an important occurrence during the birth of a child.
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the home health nurse is planning teaching for a client with copd and a history of noncompliance to the medication regimen. which factor does the nurse recognize as having the most influence on enabling complete adherence to a health regimen?
The nurse believes that motivation has the most impact on facilitating full commitment to a health program.
Motivation increases the patient's motivation and lowers stress levels, both of which result in favorable outcomes. It is therefore the finest regimen the nurse can provide the patient.
A person's ability to breathe becomes more and more challenging as a result of chronic obstructive pulmonary disease.
The inaccuracy of several methods used to gauge compliance is a significant issue when trying to detect patients who are not following instructions.
You may manage your COPD by using relaxation strategies like yoga, journaling, and breathing exercises.
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the nurse is discussing the possible side effects of chemotherapy with a client. what information obtained during the client's admission assessment and interview will have a direct influence on the management of nausea and vomiting
The client has been prescribed phenothiazine for anxiety.
What is meant by chemotherapy ?
Chemotherapy is a medicinal therapy that employs strong chemicals to kill your body's rapidly proliferating cells.Chemotherapy is most frequently used to treat cancer because cancer cells reproduce and develop considerably more quickly than the majority of body cells.Chemotherapy medications come in a wide variety. A number of malignancies can be treated with chemotherapy medications either alone or in combination.Although chemotherapy is a successful treatment for many cancer types, there is a chance that it will have adverse effects. While some side effects of chemotherapy are minor and manageable, others might have negative consequences.For stage 4 malignancies, systemic pharmacological therapies including chemotherapy or targeted therapy are frequently used. A clinical trial that offers novel therapies to aid in the treatment of stage 4 cancer is frequently a possibility.Learn more about Chemotherapy refer :
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a nurse is preparing a presentation for a local community group of older adults about colon cancer. what would the nurse include as the primary characteristic associated with this disorder?
A nurse is preparing a presentation for a local community group of older adults about colon cancer. Abdominal pain.
Cancer of the colon is a fairly treatable and often curable disorder whilst localized to the bowel. surgical treatment is the number one shape of remedy and effects in remedy in approximately 50% of the sufferers. Recurrence following surgical treatment is a chief trouble and is often the last motive of demise.
Colon most cancers is considered a silent disease. maximum of the time there aren't any signs. The signs and symptoms that people may also experience encompass a exchange in bowel conduct, stomach pain, blood inside the stool, and weight loss. If individuals have those signs, the disease may already have advanced.
Colorectal most cancers can occur in teenagers and teens, but the majority of colorectal cancers occur in humans older than 50. For colon cancer, the average age on the time of prognosis for men is 68 and for women is 72. For rectal cancer, it is age 63 for each men and women.
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which immunization protocol would the nurse follow when administering a hepatitis b vaccine to an infant whose mother is diagnosed hbsag postitive during pregnancy
Once they are physiologically stable, ideally within 12 hours of birth, infants born to HBsAg-positive mothers should receive HBIG (0.5 mL) intramuscularly (IM).
How is HBsAg positivity treated during pregnancy?Reducing the rates of vertical transmission is the major objective of antiviral therapy in pregnant patients. In the case of HBsAg-positive mothers, immunoprophylaxis with HBIG and HBV immunisation shortly following birth has been employed, followed by the completion of the vaccination series.
Can a pregnant woman receive the hepatitis B vaccine?There are no known side effects for the growing foetus from the vaccine. For women who are expecting, the hepatitis B vaccine is advised.
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a client who has undergone a surgical biopsy of a suspected breast lesion is being prepared for discharge from the ambulatory surgical center. the client is alert and oriented. which criterion would be of least importance in determining her readiness for discharge?
Having a bowel movement is a least importance criteria to determining her readiness for discharge
Breast Biopsy
If breast signs and symptoms or the outcomes of an imaging check (consisting of a mammogram) advise you may have breast cancer, you can want a breast biopsy. All through a biopsy, a doctor eliminates small portions of breast tissue from the suspicious location so they may be checked out in the lab to see if they comprise most cancer cells.
needing a breast biopsy doesn’t always mean you have cancer. most biopsy effects aren't cancer, however a biopsy is the simplest way to discover for positive
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if a woman athlete is not menstruating regularly, she should multiple choice decrease her calcium intake as a high calcium intake can trigger irregular menses. decrease calorie intake to lower body fat. increase fluid intake. consult her primary care provider to determine the cause.
If a woman athlete is not menstruating regularly, she needs to consult her primary care provider to determine the cause. Thus, the correct option for this question is D.
What is the Menstrual cycle?The Menstrual cycle may be defined as the rhythmic series of changes that significantly occur in the reproductive organ of female primates like monkeys, human beings, and apes. It is repeated at an average interval of about 28/29 days.
According to the context of this question, if any woman is suffering from any kind of irregularities in their menstrual cycle, she must definitely needs to consult this process with her primary care provider in order to determine the cause.
Therefore, if a woman athlete is not menstruating regularly, she needs to consult her primary care provider to determine the cause. Thus, the correct option for this question is D.
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a client admitted with hypertensive crisis has an intravenous (iv) infusion of 1000 ml of normal saline with 20 meq of potassium chloride added. a prescription is written to administer sodium nitroprusside by continuous iv infusion. the nurse should plan to do which to administer this medication?
Protect the sodium nitroprusside from light with an opaque material.
After beta blocking, a vasodilator like intravenous nitroglycerin or nitroprusside may be used if the blood pressure still remains high. In a hypertensive emergency with acute pulmonary edema, intravenous nitroglycerin, clevidipine, or nitroprusside are the preferred medications (1,2,5).
For patients going through a hypertensive crisis, an IV drip of combined alpha- and beta-blockers is administered. If the patient is at danger for heart failure, they might be prescribed for outpatient high blood pressure use.
Due to the fact that there are two patients involved, preeclampsia is a hypertensive emergency that is extremely unpleasant and challenging to manage. Magnesium sulfate is the first-line treatment, which is given as a 4–6 g loading dose followed by a 1–2 g/hour infusion.
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a pediatric nurse is discharging a 1-month-old infant. the infant was diagnosed with congenital hypothyroidism on this admission and will be treated with levothyroxine. the nurse knows it is important to teach the parent about medication administration. which process will the nurse include in the teaching?
The nurse knows it is important to teach the parent about medication administration, which process will the nurse include in the teaching is to give the beaten medicine in a syringe blended with a small quantity of formula.
Only levothyroxine is suggested for remedy. It has been mounted as safe, effective, inexpensive, without problems administered, and without problems monitored.
Congenital hypothyroidism is handled with the aid of using giving thyroid hormone medicine in a tablet shape referred to as levothyroxine. Many youngsters would require remedy for life. Levothyroxine need to be beaten and given as soon as daily, blended with a small quantity of water, formula, or breast milk the use of a dropper or syringe.
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you are assessing a man who has a head injury and note that cerebrospinal fluid is leaking from his ear. you should recognize that this patient is at risk for
When examining a man with a head injury, you notice that his ear is dripping with cerebrospinal fluid. You should be aware that bacterial meningitis is a concern for this patient.
Where can you find cerebrospinal fluid?In the cerebral ventricles, the majority of CSF is produced. The retinal plexus, the ependyma, as well as the parenchyma are potential origin sites[2]. According to anatomy, the medial, third, and fourth ventricles' cerebrospinal fluid contains floating choroid plexus tissue.
What results in a leak of cerebrospinal fluid?A tear or hole with in dura, the meninges' top layer, causes a CSF leak. The hole or rip may have been caused by a head injury, brain surgery, or sinus surgery. After lumbar puncture, often known as a spinal tap, CSF leaks can also happen.
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the nurse is preparing to care for a client with a diagnosis of metastatic cancer. the nurse notes documentation in the client's chart that the client is experiencing cachexia. which should the nurse expect to note on assessment of the client?
The nurse will note sunken eyes and a hollow cheek appearance while assessing client with a diagnosis of metastatic cancer and experiencing cachexia.
Cachexia is a general state of health problem involving marked weight loss and muscle loss. Wasting syndrome is usually a signal of unwellness, like cancer, AIDS, heart failure or advanced chronic preventative pulmonic disease (COPD).
Symptoms embody weight loss, muscle loss, sunken eyes, a scarcity of appetence, fatigue, a hollow cheek appearance, and shrivelled strength. Treatment includes nutritional counselling, medication to stimulate appetence and weight gain and treating the underlying unwellness.
Cancer that spreads from wherever it began to a foreign a part of the body is termed as metastatic cancer.
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when reviewing a newly admitted client's previous medication record, the nurse notes that the client has previously been treated with aprepitant. the nurse is justified in suspecting that this client's medical history includes which therapy/treatment?
When used with other medications, aprepitant capsules and oral suspension work to reduce the possibility of nausea and vomiting during cancer treatment (chemotherapy). Additionally, aprepitant capsules are used to stop post-operative nausea and vomiting.
What is treated with aprepitant in medication?Only preventing nausea and vomiting is how aprepitant functions. If you already experience these symptoms, don't start taking aprepitant; instead, call your doctor.
Therefore, Aprepitant is typically only taken for the first three days of the chemotherapy treatment cycles when used to reduce nausea and vomiting brought on by cancer chemotherapy.
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a client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. which finding would the nurse anticipate when auscultating the client's breath sounds?
The nurse would anticipate crackles when auscultating the client's breath sounds.
Extreme breathlessness, dyspnea, air hunger, and the production of foamy, pink-tinged sputum are all symptoms of pulmonary edema.
A disease known as pulmonary edema is brought on by an excess of fluid in the lungs. Breathing becomes challenging because of the fluid buildup in the lungs' many air sacs.
Heart issues are typically the root cause of pulmonary edema. But there are other causes for fluid to build up in the lungs. These include pneumonia, exposure to specific chemicals and drugs, chest wall injuries, and visiting or exercising at high altitudes.
Acute pulmonary edema, which occurs rapidly, is a medical emergency that requires prompt attention. Sometimes, pulmonary edema can result in death. Treatment should start right away. Depending on the cause, pulmonary edema is usually treated with medication and additional oxygen.
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jessica is 16, single, and a mother of a 3-month-old baby girl. she has been provided weekly visits by a nurse who comes to her place of residence. the nurse gives advice to jessica about the care of her child, infant development, and the importance of proper nutrition. what type of delinquency prevention is home visitation within this scenario? group of answer choices secondary prevention primary prevention risk prevention tertiary prevention
In this case, home visits are a primary prevention method of preventing delinquency.
Can nurses become doctors?Can a nurse practice medicine? Without a doubt, an RN can become a physician. By obtaining a Bachelor's degree and going to medical school like any other student, they can obtain a MD or DO. Or, a registered nurse (RN) could get a doctor in pharmacy (DNP), which is a degree in education and does not provide clinical authority.
Is nursing difficult to study?There is a great deal of material to study, the exams are difficult, the schedules are convoluted, and the projects keep coming in. As a student, all of these things may make life challenging for you. From the minute you start the application form until you get hired, the field of nursing is extremely competitive.
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