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November 27th post

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1 November 27th post on Sun Nov 27, 2011 5:54 pm

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I think the best way to break bad news to anyone is to let them see that you really care. Your behavior and choice of words are critical. I remember when Mrs. Bloomfield told us that when her daughter was dying, the doctor was cold and indifferent. This isn't acceptable no matter how tired he was or how busy he was. When we accept the responsibility of being nurses and doctors, we also accept the responsibilty of treating our patients and their families with love and respect. I have often thought that if we would all just do what we were taught in Sunday School (to treat others the way we want to be treated) the world would be a far better place to live in. However, what I have experienced is that when you are different, you are persecuted. I plan to treat my patients with the respect that I want for myself and my family. Sometimes, that might just mean sitting there quietly with them. Like Marcus said, "I'm here" can mean so much.

Nursing Interventions and Rationales
Perfusion:
Administer oxygen as needed per care giver's order. Rationale: Clinical practice guidelines cite that oxygen should be administered to relieve symptoms r/t hypoxemia.
If chest pain is present, have client lie down, monitor cardiac rhythm, give oxygen, check vital signs, run a monitor strip, medicate for pain, and notify the care giver. Rationale: Prompt assessment of the client with acute coronary symptoms is critical bacause the incidence of ventricular fibrillation is 15 times greater during the first hour after symptoms of acute MI.
Apply graduated compression stockings as ordered. Ensure proper fit and remove at least twice per day. Assess extremity often. Rationale: a study that assessed use of knee-length graduated compression stockings found that they are effective, more comfortable than TED hose, and easier for staff to apply and remove.

Infection
Use proper hand hygiene. Rationale: Meticulous infection prevention precautions are required to prevent healthcare-associated infection. Studies have shown a lower rate of MRSA infections with the use of good hand hygiene.
Assess temperature of all patients suspected to have or be at risk for having an infection. Rationale: Fever is often the first sign of infection.

Immunity
Indentify vulnerable populations and marginalized populations. Rationale: Residents of minority communities bear greater risk for disease; substantial variation in the use of preventive services among different minority populations provide opportunities for health interventions.
Assess for knowledge of risk associated with disease. Rationale: There is a general lack of awareness among parents and adolescents about the risk and severity of infectious diseases and the need for immunizations.

Source: Nursing Diagnosis Handbook by Betty Ackley and Gail Ladwig (Evidence-Based)

Meds that can cause hyperglycemia.
Some anticonvulsants such as Acetazolam
Steriods like Betamethasone
Antispasticity agents like Baclofen

Source: Davis's Drug Guide for Nurses

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