Clinical Coach for Nursing Excellence: Accelerate Your by Campbell, Gilbert, Laustsen

By Campbell, Gilbert, Laustsen

Speed up your mastery of the $64000 wisdom, talents, and attitudes you must be successful as an RN. You ll locate insurance that encompasses basic options to the commonest demanding situations confronted within the place of work.

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Pylori • Those at increased risk for developing PUD, H. pylori infection, and S/S of the disorder • Education of the patient in lifestyle changes, medications, and other treatment modalities (surgical options) • When patients should contact their primary health-care provider: patients report continuous abdominal or epigastric pain; patients report crushing pain to chest; pain worsens after exercise; stools have bright red blood or appear black and tarry; patients experience unintentional weight loss Diabetes Mellitus DM is a group of metabolic disorders consisting of impaired carbohydrate, protein, and lipid metabolism resulting from a lack of insulin, the effects Pathophysiology and Pharmacology 49 of the lack of insulin, or both.

It includes several types of cardiac dysfunction resulting in lack of tissue perfusion. The most common cause of heart failure relates to dysfunction of the left ventricle (systolic and diastolic heart failure). Heart failure also may occur in conjunction with pulmonary disease (right heart failure) or in conditions of normal or elevated cardiac output and poor tissue perfusion (high-output failure). Risk factors associated with various types of heart failure include those that are modifiable with lifestyle changes and those that are unavoidable, such as old age: • Untreated hypertension (HTN) • Smoking • Alcohol abuse • Obesity • Coronary artery disease (CAD) • Acute myocardial infarction (AMI) • Heart valve disease • Dysrhythmias • Side effects of chemotherapy drugs • Cocaine abuse • Advancing age An important process related to myocardial dysfunction in systolic, diastolic, and even right heart failure is the pathophysiological remodeling of the left ventricle.

They may also take a baby aspirin or other antiplatelet drug as well as medications to lower their cholesterol, such as HMG CoA reductase inhibitor or statin, fibrates, niacin, bile acid sequestrants, ezetimibe, and plant sterols (Box 2–2). O. O. O. with ↑ O2 demand F I G U R E 2 - 3 : Compensatory mechanisms and sequelae in heart failure. Box 2–1 Heart Failure Signs and Symptoms Know the characteristic signs and symptoms (S/S) for the various types of heart failure. 1. S/S systolic left heart failure: ventricles cannot fully contract; caused by AMI, uncontrolled HTN, cardiomyopathy, or valve abnormalities • Exercise intolerance • Fatigue • Shortness of breath (SOB), dyspnea, paroxysmal nocturnal dyspnea (PND), orthopnea, tachypnea, cough • Tachycardia with increased or decreased BP • Cardiomegaly, S3 gallop, CAD; low ejection fraction (EF <55%) • Pulmonary edema (cyanosis, basilar crackles, pleural effusions) Continued Pathophysiology and Pharmacology 23 Box 2–1 Heart Failure Signs and Symptoms—cont’d • Peripheral edema • Hepatomegaly, swollen abdomen • Distended jugular veins • Weight gain • Decreased urinary output, nocturia 2.

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