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Nov 29th post-conference

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1 Nov 29th post-conference on Mon Nov 28, 2011 8:47 pm

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Perfusion
- I: Discourage smoking
- R: Nicotine increases catecholamine output, which subsequently causes vasoconstriction
- I: Maintain a minimum fluid intake of 2500 mL/day unless contraindicated
- R: Adequate hydration is essential for maintenance of a vascular volume sufficient to maintain adequate tissue perfusion
- I: Discourage positions such as crossing legs, pillows under knees, and use of knee gatch
- R: These positions exert pressure on vessels in the lower extremities, which compromises blood flow.
Infection
- I: Use good hand hygiene and encourage client to do the same
- R: Good hand hygiene removes transient flora, which reduces the risk of transmission of pathogens.
- I: Protect client from others with infections
- R: Protecting the client from others with infections reduces his/her risk of exposure to pathogens.
- I: Implement measures to maintain healthy, intact skin (keep skin clean, dry, and lubricated, keep linens wrinkle free, turn q 2 hours)
- R: Healthy, intact skin reduces the risk for infection by: providing a physical barrier against the introduction of pathogens into the body, removing many of the microorganisms on the surface of the skin by means of the constant shedding of the epidermis, inhibiting the growth of some bacteria on the surface of the skin
Immunity
- I: Instruct client to receive immunizations if appropriate
- R: Immunizations are often recommended to reduce the possibility of ome infections in high-risk clients.

Drug classifications that can cause hyperglycemia:
1. Beta-2 agonists
a. Albuterol
2. Corticosteroids
a. Prednisone
3. Beta Blockers
a. Carvedilol

As Marcus states in the book, the only way to deliver bad news to a patient, or their family is to be honest and direct. Trying to soften the blow may not always be appreciated, and the patient and/or family deserves to know the truth no matter how difficult it may be to handle.
When I am trying to establish a rapport with a patient I try to find out about their interests, and talk with them about whatever that may be. I also try and find something in common with the patient, and if there is nothing just listening to them usually makes them more comfortable.

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