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effects of poverty essay Identify treatment goals for the patient based on the nla guidelines. Assess her risk for statin-induced side effects. Design a treatment plan for the patient. 226  section 1  |  cardiovascular disorders patient care process patient assessment.

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http://projects.csail.mit.edu/courseware/?term=in-detention-poem-essay in detention poem essay However, in some instances, agitation may require treatment with an antipsychotic (eg, haloperidol 5–10 mg by mouth every 2–4 hours or olanzapine 10 mg given im with repeated doses at least 2 hours apart). Sedation with benzodiazepines has been used, but in the presence of alcohol, respiratory depression can be dangerous or even fatal. There are no medications that can fully reverse the effects of alcohol intoxication. Caffeine and other stimulants are neither indicated nor considered a viable option to make driving safe. Opioid intoxication the word opioid refers to the class of medications and substances that exert their action through the opioid system. Opioids encompass a wide range of substances, including naturally occurring (eg, morphine) and synthetic (eg, oxycodone) substances. Patients who are acutely intoxicated with an opioid usually present with miosis, euphoria, slow breathing, slow heart rate, low blood pressure, and constipation. Seizures may occur with certain agents, such as meperidine (demerol). It is critically important to monitor patients carefully to avoid cardiac and respiratory depression and death from opioid overdose. One strategy is to reverse intoxication using naloxone (narcan) 0. 4 to 2 mg iv every 2 to 3 minutes up to 10 mg. The im or subcutaneous (sc) route may be used if iv access is not available. Because naloxone is shorter acting than most abused opioids, it may need to be readministered at periodic intervals. Otherwise, patients could lapse into cardiopulmonary arrest after a symptom-free interval of reversed intoxication. In addition, naloxone can induce withdrawal symptoms in opioid-dependent patients, so patients may awaken feeling distressed and agitated. It should be noted that buprenorphine intoxication may be more difficult to reverse. 19 it is critically important to secure the airway and ensure breathing in cases of opioid overdose. In some cases, intubation and manual or mechanical ventilation might be required to avoid oxygen desaturation leading to brain hypoxia or anoxia and brain damage or death. Recently, new opportunities for “take-home” naloxone have emerged in the united states. For example, naloxone hydrochloride injection (evzio) was food and drug administration (fda)-approved for this purpose. 20 it is too early to determine the public health impact of this approach for treatment of opioid overdoses. Stimulant (cocaine and amphetamines) intoxication desired outcomes of stimulant intoxication treatment are appropriate management of medical and psychiatric problems. Medical problems include hyperthermia, hypertension, cardiac arrhythmias, stroke, and seizures. Some medical problems are related to route of administration, such as nosebleeds with intranasal administration and infections with iv administration.

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http://projects.csail.mit.edu/courseware/?term=mrs-dalloway-essay-topics mrs dalloway essay topics 27 the β-lactams viagra for dogs cost are the same as for inpatient non-icu treatment. If the patient is allergic to β-lactams, then aztreonam plus a respiratory fluoroquinolone are preferred. If p. Aeruginosa is suspected, then the antimicrobial treatment must be broadened to cover pseudomonas as well as the organisms listed previously. Owing to the high resistance rates observed with pseudomonas, the recommended regimens empirically double cover the pseudomonas to ensure at least one of the antibiotics is active against it. The regimens include the use of an antipneumococcal, antipseudomonal β-lactam (cefepime, ceftazidime, piperacillin/tazobactam, imipenem, or meropenem), plus either ciprofloxacin or levofloxacin or an aminoglycoside. If the aminoglycoside is chosen, then either iv azithromycin or a respiratory fluoroquinolone should be added to cover s. Pneumoniae and the atypical bacterial organisms. 27 if ca-mrsa is suspected in the patient, then the addition of vancomycin or linezolid to the preceding regimen should be considered. Daptomycin cannot be used because surfactant in the lung inactivates the drug, thus rendering it ineffective for pneumonia. Ca-mrsa can cause a necrotizing pneumonia, and the cause is believed to be due to its many virulence factors, including the panton-valentine leukocidin toxin. 6 in these patients the use of an agent that decreases toxin production may be beneficial. Linezolid decreases toxin production. The other recommended agents to decrease toxin production and added to vancomycin therapy are clindamycin or a respiratory fluoroquinolone. 27 »» influenza influenza viruses a and b can cause pneumonia in pediatric and adult patients. Amantadine and rimantadine are available oral agents with activity against influenza virus type a. If started within 48 hours of the onset of the first symptoms, they reduce the duration of the illness by about 1. 3 days. Oseltamivir and zanamivir are oral agents active against both type a and b patient encounter 4, part 2. Creating a care plan based on the information presented, create a care plan for this patient’s pneumonia. Your plan should include. (a) a statement of drug-related needs and/or problems (b) a patient-specific detailed therapeutic plan (c) monitoring parameters to assess efficacy and safety influenza that reduce the duration of the illness by about 1. 3 days if initiated within 40 to 48 hours of the first symptoms. 28 for active infection beyond the first 48 hours, none of these agents are effective in treating infection, and supportive care is the best treatment for these patients. »» aspiration anaerobes and streptococcus spp.

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