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Apgar scores were designed to monitor neonatal transition and the viagra made in canada effectiveness of resuscitation, and their utility remains essentially limited to this important role. The american academy of pediatrics is currently recommending an expanded apgar score reporting form, which details both the nwneric score as well as concurrent resuscitative interventions. 62 i resuscitation in the delivery room vi. Evolving practices. The practice of neonatal resuscitation continues to evolve with the availability of new devices and enhanced understanding of the best approach to resuscitation. A. End-tidal or expiratory c02 detectors are already widely used to aid in confirming appropriate et tube placement in the trachea. These devices may also have utility during bag-and-mask ventilation in helping to identify airway obstruction. Whether they may help ensure that appropriate ventilation is being offered has not yet been determined. B.

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Gecse kb, bemelman w, kamm ma, et al. A global consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising crohn’s disease. Gut. 2014;63:1381–1392. 15. Ford ac, sandborn wj, khan kj, et al. Efficacy of biological therapies in inflammatory bowel disease. Systematic review and meta-analysis. Am j gastroenterol. 2011;106:644–659. 16. American gastroenterological association. Aga technical review on osteoporosis in gastrointestinal diseases. Gastroenterology. 2003;124:795–841. 17. Ng sc, kamm ma. Review article. New drug formulations, chemical entities and therapeutic approaches for the management of ulcerative colitis. Aliment pharmacol ther. 2008;28:815–829. 18. Sandborn wj, hanauer sb. Systematic review. The pharmacokinetic profiles of oral mesalamine formulations and mesalazine pro-drugs used in the management of ulcerative colitis. Aliment pharmacol ther. 2003;17:29–42. 19.

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1997;81:611–639. 23. Halperin ml. Potassium. Lancet. 1998;352:135–140. 24. Body jj, bouillon r. Emergencies of calcium homeostasis. Rev endocr metab disord. 2003;4:167–175. 25. Gennari fj. Hypokalemia. N engl j med. 1998;339:451–458. 26. Hamil rj, robinson lm, wexler hr, moote c. Efficacy and safety of potassium infusion therapy in hypokalemic critically ill patients. Crit care med. 1991;19:694–699. 27. Kruge ja, carlson rw.

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Infections. Antibiotic therapy as appropriate. Pulmonary emboli. Anticoagulants for prevention and treatment or vena cava filter placement (rarely used in hospice but might have a larger role in palliative care). Rales due to volume overload. Reduction of fluid intake or diuretic therapy as appropriate. Nausea and vomiting a comprehensive review of nausea and vomiting may be found in chapter 20. »» palliative care considerations up to 71% of palliative care patients will develop nausea and vomiting with approximately 40% experiencing these symptoms chapter 4  |  palliative care  37 chemoreceptor trigger zone (ctz) dopamine, 5-ht3, neurokinin-1 treatment. Butyrophenone, phenothiazine, metoclopramide cerebral cortex dopamine, 5-ht3, neurokinin-1, elevated intracranial pressure treatment. Corticosteroid, benzodiazepine gastrointestinal tract dopamine, 5-ht3 treatment. Butyrophenone, phenothiazine, metoclopramide vestibular nerve histamine and acetylocholine treatment. Antihistamine, anticholinergic vomiting center. Activation of salivation center, abdominal muscles, respiratory center figure 4–2. Mechanisms and associated neurotransmitters involved in nausea and vomiting. In the last 6 weeks of life. Chronic nausea can be defined as lasting longer than a week and without a well-identified or self-limiting cause such as chemotherapy, radiation, or infection. 30 four major mechanisms are correlated with the stimulation of the vomiting center (figure 4–2). Potentially reversible causes of nausea and vomiting should not be overlooked. Causes of chronic nausea in end-of-life patients may include autonomic dysfunction, constipation, antibiotics, nonsteroidal anti-inflammatory drugs (nsaids), other drugs, infection, bowel obstruction, metabolic abnormalities (eg, renal or hepatic failure, hypercalcemia), increased intracranial pressure, anxiety, radiation therapy, chemotherapy, or untreated pain.