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The Other End of the Stethoscope, Interventions and Rationales and Medicatons

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The Other End of the Stethoscope:
When my time should come to be the “bearer of bad news” I like to think I would be able to be strong and as honest as possible with my patient and their family. I know this would be very difficult for me, being that I am a very emotional person, especially when I know of a terminal diagnosis or a tragic life changing events. I like to put myself in other people’s shoes and think. Ok, if that was me, how would I react or take what you are about to say? I know I would be able to follow through and complete it, but it would be very difficult and I believe that’s where you rely on your faith and what you have learned in school or from other experienced nurses.
Establishing Rapport:
When establishing rapport with you patients, I believe it’s essential to be as honest and straight forward with them. Tell them the truth but take into consideration what you are about to tell them. (This is where the brain and mouth filter comes into place). Hold their hand, rub their back. (If you sense them being an emotional type of person). Most importantly be there for them, even if it’s just to listen to what they have to say, you will never know what it means to them.

Interventions and Rationales:

Perfusion:
1.I: Inspect lower extremities for skin texture. (Atrophic, shinny appearance, dry/scaly, reddened areas)
R: Often accompany diminished peripheral circulation.
2.I: Measure capillary refill.
R: Determine adequacy of systemic circulation.
Infection:
3.I: Assess skin color, texture, turgor and moisture.
R: Preventative for skin breakdown.
4.I: Assess for any open wounds and appearances at insertion sites.
R: Break in the body’s first line of defense.
5.I: Change surgical or other wound dressings, as indicated, using proper technique for changing/cleaning.
R: Reduce/ correct existing factors.
Immunity:
6.I: Stress the importance of proper hand hygiene to patient and all caregivers between therapies with patient.
R: First-line defense against healthcare associated infection and reducing risk for compromise.
7.I: Encourage to obtain/update immunizations.
R: Promote wellness.

Medication Classifications that could possibly cause Hyperglycemia:
1.HMG CoA reductase inhibitors, ("statins"): Lipitor (atorvastatin)
2.Beta Blockers: Coreg (carvedilol)
3.Antipsychotic: Zyprexa (olanzapine)

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