By N. Stan. University of South Dakota.
There is a heightened feeling of physical or pain characterized by burning cheap 250 mg ponstel mastercard spasms right side of back, stinging ponstel 250 mg line spasms pregnant belly, pleasure followed by overwhelming release irritation, or rawness of the female genitalia and involuntary contraction of the genitals. Continuous abstinence depends on and intensiﬁes; the woman’s clitoris retracts charting a woman’s fertility pattern. Pregnancy cannot occur with coitus interruptus because sperm is kept out of the vagina. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. One who experiences sexual fulﬁllment exhibits and experiences maleness or femaleness with a person of the opposite gender physically, emotionally, and mentally. Diabetes: contraceptive consisting of six capsules placed under the skin of the woman’s upper arm. Cardiovascular disease: daily circulating levels of ethinyl estradiol and norelgestromin to prevent conception. Person of a certain biologic gender with the feelings of the opposite sex Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. List three general categories of patients who in the following phases of the sexual response should have a sexual history recorded by the cycle. List three interview questions a nurse may use during a sexual history when assessing a male b. Complete the following table, listing the advantages and disadvantages associated with Male: contraceptive methods. Sterilization Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Write down the interview questions you would use to obtain a sexual history from the following patients. An 18-year-old female victim of date rape who is brought to the emergency room for testing and treatment 2. What intellectual, technical, interpersonal, practices and/or ethical/legal competencies are most d. A 5-year-old girl who presents with soreness likely to bring about the desired outcome? A sexually active teenager complains of a Read the following patient care study and use burning sensation during urination. He has a history really insistent that each of her sons should of diabetes and hypertension and is receiving respect women and that intercourse was some- numerous medications as treatment. During a thing you saved until you were ready to get routine visit to his primary care physician, Mr. If she told us once, she told us a hun- Smith conﬁdes that he has been having prob- dred times, that we’d save ourselves, the girls lems “in the bedroom. He if we could just learn to control ourselves sexu- asks, “What about all those new drugs they ally.
Angina pectoris is acute cardiac pain caused by inadequate blood flow as a result of plaque occlusion in the coronary arteries of the myocardium or spasms of the coronary arteries ponstel 250mg generic spasms spanish. The decreased blood flow causes a decrease in oxygen to the myocardium buy generic ponstel 500mg on-line spasms youtube, which is the cause of the pain. Anginal attacks may last for a few minutes and can lead to myocaradial infarction (heart attack). Classic angina occurs with stress and exertion and is caused by the narrowing or partial occlusion of coronary arteries. Unstable angina occurs over the course of a day with progressive severity and is caused by the narrowing or partial occlu- sion of coronary arteries. Stress tests, cardiac profile laboratory tests, and cardiac catherization may be needed to determine the degree or blockage in the coronary arteries. A combina- tion of pharmacologic and nonpharmacologic measures (avoiding heavy meals, smoking, extremes in weather changes, strenuous exercise, and emotional stress) is necessary to control and prevent anginal attacks. Proper nutrition, moderate exercise, adequate rest, and relaxation techniques may be used to prevent attacks. Antianginals Nitrates Nitrates reduce venous tone resulting in decreased workload of the heart and increased vasodilation. Isosorbide mononitrate (Monoket, Imdur) can be given orally by immediate-release or sustained-release tablets. Beta-Blockers Beta-blockers (see Chapter 15) decrease the workload of the heart and decrease the heart’s oxygen demands. Drug Group Variant (Vasospastic) Angina Classic (Stable) Angina Nitrates Relaxation of coronary arteries, Dilation of veins, which decreases which decreases vasospasms preload and decreases oxygen demands and increases oxygen supply Beta blockers Not effective Decreases heart rate and contractility, which decreases oxygen demand Calcium Relaxation of coronary arteries, Dilation of arterioles, which decreases channel which decreases vasospasms after load and decreases oxygen blockers and increases oxygen supply demand. Antidysrhythmics Antidysrhythmics are drugs that restore normal cardiac rhythm and are used to treat cardiac dysrhythmias. A disturbed heart rhythm is any deviation from the normal heart rate or heart pattern including slow rates (bradycardia) and fast rates (tachycardia). Table 19-2 lists the actions of antidysrhythmics and Table 19-3 describes classes of antidysrhythmic drugs. Beta blockers were discussed previously in this chapter and discussed in Chapter 15. Prolonged repolarization is the time when the elec- trical impulse returns to normal and is ready to fire again. Slow (calcium) channel blockers were discussed previously in this chapter and include verapamil (Calan, Isoptin) and diltiazem (Cardizem). Essential hypertension affects 90% of patients who are hypertensive and is caused by conditions other than those related to renal and endocrine disorders. Secondary hypertension affects 10% of patients who are hypertensive and is caused by secondary disorders of the renal and endocrine systems. The renin-angiotensin system increases blood pressure by retaining sodium and water. Once baroreceptors in the aorta and carotid sinus detect adequate blood pressure, the baroreceptors signal the vasomotor center in the medulla to signal the renin-angiotensin system to excrete sodium and water, thereby lowering the blood pressure. Each step uses a differ- ent group of antihypertensive drugs to control hypertension. Diuretics Diuretics promote sodium depletion, which decreases extracellular fluid volume. Loop diuret- ics, such as furosemide (Lasix), are usually recommended for these patients because they do not depress renal flow. Diuretics are not used if hypertension is the result of renal-angiotensin- aldosterone involvement because these drugs tend to elevate the serum renin level.
The absence of all stress is not desirable order ponstel 500mg with visa spasms cell cancer, but achieving eustress without distress can be difficult cheap ponstel 250 mg with visa spasms causes. Stress is a complex individual reaction to stressors, with both physiological and psychological manifestations. When stressors exceed individual coping abilities, whether through prolonged exposure to, or intensity of, stressors, distressed begins; unresolved distress may progress to burn-out. Therefore, recognising the signs of stress in ourselves and Intensive care nursing 438 others is a necessary foundation for managing distress. Coping mechanisms may be negative (attempting to alter oneself, which is usually harmful) or positive (attempting to alter stressors). Farrington (1997) provides constructive ways to recognise and manage stress from a wider nursing perspective. Of the many popular books on assertion, Harris (1970) provides a simple self-help text while Dickson (1982) is especially thought provoking. Specify: (a) behaviours (adaptive/maladaptive), emotions (positive/negative) and thoughts (b) verbal comments (c) typical coping mechanisms (effective/ineffective, beneficial/ harmful). Chapter 47 Complementary therapies Introduction The recent growth of interest in complementary therapies is reflected in their increasing use in nursing and healthcare. The literature varies between introductory and anecdotal texts to substantive studies. The placebo effect is also discussed, before concluding with practical application and professional perspectives. Although discussed under separate headings, the use of various complementary therapies may be mixed, just as orthodox medicine may use combination therapy; thus essential oils may be used for massage, with benefits potentially being gained from both the massage and the oil itself. While research studies need to specify causal relationships, for clinical practice the end results to patients is (from utilitarian perspectives) more important than precisely how results are achieved. Concepts and terminology The term ‘complementary therapy’ is increasingly replacing ‘alternative therapy’. Both supporters and opponents of complementary therapies have used ‘alternative’, usually to try and devalue the other approach. This text follows Rankin-Box (1988) in using the term ‘complementary’ rather than ‘alternative’. Many complementary therapies are derived from traditional Chinese medicine, and conflicts can occur from the differing cultural contexts and translation. Yin and Yang, which are popularly and often over-simplistically assimilated into Western culture, involve balances between the various kinds of energy necessary for health (Downey 1995)—this carries similar connotations to orthodox medicine’s concept of ‘homeostasis’. In Chinese medicine, Ki (Qi or Chi), the universal energy which links people to their environment, is dispersed through twelve main channels (meridians) that connect the internal organs to the skin (Downey 1995). Intensive care nursing 440 Orthodox medicine Many complementary therapies are very old; reflexology is depicted in pyramids of c. Since knowledge of the therapies has been mainly transmitted through oral traditions and folklore, the lack of regulation led some practices into disrepute, while the Cartesian focus on atoms largely replaced European folklore medicine with an ‘orthodox’ (and increasingly regulated) medical profession. Orthodox medicine has adopted some of the tried and tested remedies, such as foxglove (digitalis— digoxin) for dropsy (oedema) and willow bark (aspirin) for analgesia, so that, refined and analysed, ‘orthodox medicine’ has preserved elements of herbal medicine. Orthodox medicine’s pursuit of diagnosing anatomically specific problems led to targeting specific problems with specific drugs (e.
For example order 250 mg ponstel with mastercard spasms vs seizures, although garlic does lower blood pressure purchase ponstel 250 mg online muscle relaxant sciatica, taking garlic as an herbal cure might be dangerous if the patient is also taking antihypertensive medication because the patient’s blood pressure could be lowered too much. Herbal reme- dies are preferred by some cultures over traditional Western medicine and some patients continue herbal treatment even when a mild illness progresses to a crit- ical level. A patient may refuse any treatment because of the sole belief in the healing power of prayer. Healthcare providers must be nonjudgmental and tolerate alternative beliefs in healthcare even if those beliefs are harmful to the patient. When con- fronted with cultural differences that can result in an adverse effect to the patient, healthcare providers can educate the patient about the benefits of medications and treatment and the risk that the patient is exposed to by not following rec- ommended treatment. This information is sometimes best given while the health- care provider is assessing the patient. The nurse should be careful to remain nonjudgmental about the patient’s decisions. Cultural beliefs can also influence who makes healthcare decisions for the family. However, in some cultures, although the female is responsible for providing and obtaining care, the oldest male is seen as the head of the family and the authority figure for making overall decisions such as when to access healthcare. The way the patient communicates with healthcare providers is greatly influ- enced by individual culture. Here are factors to consider when communicating with a patient: • Eye contact might not be appropriate. Always address the patient formally until the patient gives permission to be addressed informally. Other- wise, the patient may be unable to comply with the appropriate medication schedule. In some cultures, patients don’t want anyone standing or sitting too close and they feel uncomfortable if someone touches them. The elderly are revered in some cultures and the family goes to great lengths to care for them. In other cultures, the family leaves the elderly to die peacefully without interference. As you’ll recall from Chapter 2, pharmaco- genetics is the study of the influence genetics have on a drug response. For example children with Reyes Syndrome, which is a liver disease, cannot metab- olize aspirin because of a genetic defect. Likewise, a genetic factor in African-Americans makes them less responsive to beta-blocking agents used in cardiac and antihypertensive medications. Asians have a genetic factor that causes undesirable side effects when given the typical dose of benzodiazepines (diazepam [Valium]) alprazolam [Xanax], tricyclic anti- depressants, atropine, and propranol [Inderal]. Waste products are excreted into the amniotic fluid and then absorbed by the mother or swallowed by the fetus. Alcohol, barbiturates, and narcotics—such as diphenhydramine (Benadryl), amobarbital (Amytal), diazepam (Valium), codeine, heroin, methadone, morphine, propoxyphene (Darvon)—that are used during pregnancy can lead to harmful effects on the newborn. This can result in hyperactivity, crying, irritability, seizures and even sudden death. When taken by the mother during the first trimester, some drugs have a ter- atogenic effect on the fetus resulting in fetal defects. This includes mutagenic (genetic mutation) or carcinogenic (causing cancer) effects.
8 of 10 - Review by N. Stan
Votes: 177 votes
Total customer reviews: 177