Upper Gastrointestinal Bleeding : Diagnostic Studies
Diagnostic Studies Endoscopy Primary tool for diagnosing source of upper GI bleeding Before performing Lavage may be needed for clearer view NG or orogastric tube placed, and room-temperature water or saline used Do not advance tube against resistance Stomach contents aspirated through a large-bore (Ewald) tube to remove clots Angiography Used to diagnose only when […]
Upper Gastrointestinal Bleeding
Upper Gastrointestinal Bleeding Each year, 300,000 hospital admissions for UGI bleeding Approximately 60% of patients are older than 65 years Mortality rate has been 6% to 13% for past 45 years Etiology and Pathophysiology Most serious loss of blood from UGI characterized by sudden onset Insidious occult bleeding can be a major problem Severity depends […]
Nursing planning : Obesity
Nursing planning Overall Goals Modify eating patterns Participate in a regular physical activity program Achieve and maintain weight loss to a specified level Minimize or prevent health problems Nursing implementation Obesity is one of most challenging health problems Successful weight management can be both difficult and lifelong Treatment begins with patients understanding their weight history […]
Nursing and Interprofessional management: Obesity
Nursing and Interprofessional management: Obesity Nursing Assessment Subjective Data Important Health information First rule out physical conditions that may be causing or contributing to obesity Be sensitive and nonjudgmental Clarify rationale for inquiries about weight, dietary habits, and exercise Address patient concerns Past health history Time of obesity onset Diseases related to metabolism and obesity […]
Dallas ER Doctor: ‘We’re Getting About 30% Positivity’ Rate In COVID-19 Testing; Sees No Relief Until Spring 2021
https://cbsloc.al/3nNcrOY DALLAS (CBSDFW.COM) – Those who run coronavirus testing locations say they are being overwhelmed as people prepare to gather for the holidays. Doctors said they’re not only seeing the need for tests going up, but also the amount of positive cases. “I think we’re getting about 30 percent positive, in the summer it was 11 […]
Chronic heart failure
Chronic heart failure Clinical manifestation Dependent on age, underlying type and extent of heart disease, and which ventricle is affected FACES Fatigue Limitation of Activities Chest congestion/cough Edema Shortness of breath Fatigue Dyspnea Orthopnea Paroxysmal nocturnal dyspnea Tachycardia Edema Dependent, liver, abdominal cavity, lungs Edema may be pitting in nature Sudden weight gain of >3 […]
Acute Decompensated Heart Failure
Acute Decompensated Heart Failure Clinical manifestation ADHF Sudden onset of signs and symptoms of HF Requires urgent medical care Pulmonary and systemic congestion due to increased left-sided and right-sided filling pressures Early → increased pulmonary venous pressure Increase in the respiratory rate Decrease in PaO2 Later → interstitial edema Tachypnea Further progression → alveolar edema […]
Compensatory mechanism – Counterregulatory mechanism
Compensatory mechanism Renin-Angiotensin-Aldosterone-System (RAAS) Neurohormonal response – RAAS Endothelin release (contractility) Cytokine release (Hypertrophy) Inadequate stroke volume and CO – (Epi and NoreEpi) Ventricular remodeling Continuous activation of neuro-hormonal responses (RAAS and SNS) Hypertrophy of ventricular myocytes Ventricles larger but less effective in pumping Can cause life-threatening dysrhythmias and sudden cardiac death Dilation Enlargement of […]
Pathophysiology : Systolic heart failure
Pathophysiology Systolic heart failure HFrEF – HF with reduced EF Inability to pump blood forward Caused by Impaired contractile function Increased afterload Cardiomyopathy Mechanical abnormalities Decreased LV ejection fraction (EF) Diastolic heart failure HFpEF – HF with preserved EF Impaired ability of the ventricles to relax and fill during diastole, resulting in decreased stroke volume […]
Heart Disease : Gender differences
Gender differences Men Men experience systolic failure more frequently than women. Men with asymptomatic systolic failure experience greater mortality benefit from ACE inhibitor therapy than women. Women Women experience diastolic failure more frequently than men. Women have a higher risk of ACE inhibitor–related cough than men. Women experience more digitalis-related death than men. Women with […]