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Emale= 1, male= 0 war arin or the novel oral anticoagulants (noacs) order viagra legally online are the choice o treatment. For details please re er to the pharmacology chapters in the same volume. Ca se 19 2 (continued) you put the patient on telemetry, q2h vitals, and activity as tolerated. You call a cardiology consult. The nurse asks whether she should add atrial utter to the problem list.

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C. After achieving birth weight, intrauterine growth and nutrient accretion rate data are widdy accepted as reference standards for assessing growth and nutrient requirements. Goals of 10 to 20 g/kglday weight gain (15-20 glkglday for infants < 1,500 g), approximately 1 em/week in length, and 0.5 to 1 em/week in head circumference are used. Although these goals are not initially attainable in most preterm infants, replicating growth of the fetus at the same gestational age remains an appropriate goal as recommended by the american academy of pediatrics (aap). D. Serial measurements of weight, head circumference, and length plotted on growth curves provide valuable information in the nutritional assessment of the preterm infant. Historically, the lubchenco intrauterine growth curves (1966) have been widely used because the chart is based on a reasonable sample size, provides curves 230 fluid electrolytes nutrition, gastrointestinal, and renal issues i 2 31 to monitor weight, length, and head circumference, and is easy to use and interpret. Of late, the fenton (2003) fetal-infant chart has been more frequently utilized. The chart is based on a larger number of infants from a wider geographic location and reflects infants born more recently. With the fenton chart, the premature infant's growth can be monitored for a longer period of time, from 22 to 50 weeks postmenstrual age (pma). Most recently, the olsen (2010) growth curves have become available (figure 21.1a-d). These newer growth charts are drawn from a large, contemporary, racially diverse us sample. Gender-specific weight, length, and head circumference curves are provided. Postnatal growth curves are also available. Postnatal growth curves follow the same infants over time (i.E., longitudinal growth curves), and are available from a number of single-neonatal intensive care unit (nicu) studies and from the national institute for child health and human development (nichd) multicenter study (2000). These curves, however, show actual, not ideal, growth. Although these curves provide interesting information by allowing comparison of the growth of infants in one nicu to those in another, they do not indicate if either group of infants is growing adequately. Intrauterine growth remains the gold standard for comparison. E. When an infant is in full-term corrected gestational age, the centers for disease control and prevention (cdc) recommends the world health organization (who) child growth standards 2006 be used for monitoring of growth. Infants should be plotted by corrected age and followed for catch-up growth. The charts can be downloaded from Cdc.Gov/growthcharts/who_charts.Htm.

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Neurology. 2007;69(9):904-910. Medication overuse headache 31. Evers s, marziniak m. Clinical eatures, pathophysiology, and treatment o medication-overuse headache. Lancet neurol. 2010;9:391-401. Doi. 10.1016/s1474-4422(10) 70008-9. 32. Créac'h c, radat f, mick g, et al. One or several types o triptan overuse headaches?. Headache. 2009;49(4):519-528.

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Disinfectants 1. Minimize the use of isopropyl alcohol and alcohol-based disinfectants in preterm infants. 2. Use povidone-iodine or chlorhexidine, removing with sterile saline following a procedure to avoid the risk of chemical burns. Evidence is currently inconclusive for chlorhexidine use in low birth weight infants. Prolonged or frequent exposure to iodine-containing solutions in premature infants may affect thyroid function. H. Emollients 1. Emollients are used to prevent and treat skin breakdown and dryness. 2. Emollients should not be used routindy in extremdy premature infants because their use may increase the risk of systemic infection. 3. Single use or patient-specific containers should be used to minimize the risk of contamination. 4. Product should not contain perfumes, dyes, or preservatives. Iv. Wound care. Wounds acquired in the immediate newborn period are most commonly rdated to surgical procedures, trauma, contact dermatitis, or excoriation. Skin care protocols and careful attention to positioning can prevent many of the common wounds requiring treatment. Epidermal stripping is common and can be avoided by minimizing adhesive use and utilizing protective barriers. Routine assessment and prompt treatment maximizes healing. A common causes of neonatal wounds 1. Surgical procedures 2. Trauma 3. Pressure necrosis 4. Iv extravasation 5. Prolonged contact with moisture or chemicals 6. Skin excoriation b. Three phases of wound healing 1. Inhammatory phase occurs when the wound is created and is characterized by erythema, swelling, and warmth. 2. Proliferative phase is characterized by granulation and tissue regeneration.