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http://cs.gmu.edu/~xzhou10/semester/abstract-thesis-paper-example.html abstract thesis paper example What action should you take based on the week 12 hcv rna level?. What other information should you counsel the patient about in addition to the side effects associated with the hepatitis c therapy?. The patient’s husband was recently tested for viral hepatitis and found to be positive for hepatitis b. His only past medical history is mild depression and diabetes. He has not had any surgeries. He is taking metformin and no other over-thecounter drugs, or dietary supplements. All laboratory test results are normal except for the following. Ast 93 iu/l (1. 55 μkat/l) hbeag (−) alt 102 iu/l (1. 70 μkat/l) anti-hb cigg (+) anti-hav igm (−) anti-hbc igm (−) anti-hav igg (+) anti-hbe (−), anti-hbs (−) anti-hcv (−) hbsag (+) hbv dna 3,108,514 iu/ml   (3,108,514 kiu/l) based on the information presented. (a) what additional information do you need before creating a treatment plan for this patient?. (b) create a detailed therapeutic care plan for the patient. (c) discuss adverse effects to monitor. (d) discuss a follow-up plan to determine whether the treatment goals have been achieved. •• end of treatment response (etr or eot) is defined as having undetectable hcv rna levels at the end of treatment. •• biochemical response is defined as normalization of alt. Monitor alt levels every 4 weeks. •• histologic response is defined as improving inflammation and fibrosis as documented by liver biopsy scores. •• check the hcv rna level per hcv guideline recommendations to determine the effectiveness of the hcv therapy and discontinue treatment if the hcv rna has not decreased or become undetectable at certain time points. 24,38 patient care process patient assessment. •• evaluate patient social history and risk factors for acquiring viral hepatitis (see table 24–1). •• obtain past medical history focusing on psychiatric, cardiac, endocrine, and renal disorders. Is any disease present that may worsen the liver condition or be a contraindication to treatment?. •• conduct a medication (prescription, over-the-counter drugs, dietary supplements) to identify drug-interactions or druginduced liver toxicity.

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holt rinehart and winston homework help online Are the primary pathogens if a patient aspirates their oral contents and develops pneumonia. Antibiotics active against these organisms include penicillin g, ampicillin/sulbactam, and clindamycin. If the patient aspirates oral and gastric contents, then anaerobes and gram-negative bacilli are the primary pathogens. The preferred treatment regimen is a β-lactam/β-lactamase inhibitor combination (ampicillin/sulbactam, amoxicillin/clavulanate, piperacillin/tazobactam, or ticarcillin/clavulanate). 27 »» pediatric outpatient guidelines have been published for treating cap in children. The most predominant pathogens in preschool children in the outpatient setting are viruses, and often supportive therapy (maintaining hydration, antipyretics) is all that is needed. 29 for appropriately immunized infants, children, and adolescents with mild-to-moderate pneumonia in an area lacking high-level penicillin-resistant pneumococcus, high-dose amoxicillin is the recommended first-line therapy. If atypical organisms are considered likely, then a macrolide is recommended. If moderate to severe cap is diagnosed and it is during influenza season, then treatment with oseltamivir, zanamivir (relenza), amantadine, or rimantadine is recommended. 29 fluoroquinolones and tetracyclines should not be used in children younger than 5 years. Dosing of antibiotics for pediatric patients is presented in table 71–3. »» pediatric inpatient if the infant or child is fully immunized, then the guidelines recommend the use of iv penicillin g or ampicillin. Alternative β-lactams include iv cefotaxime or ceftriaxone. If the infant or child is not fully immunized, then the third-generation cephalosporins (cefotaxime or ceftriaxone) should be administered. 29 if atypical organisms are suspected, add azithromycin to the β-lactam. If community-acquired mrsa is suspected, then vancomycin or clindamycin should be added to the regimen.

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thesis service Ejaculation disorders educate the patient that this may occur but it is not harmful. May be reversible despite continued use of the 5α-reductase inhibitor. Dry mouth educate the patient that this is a common adverse effect. If drinking fluids and sucking on sugarless hard candy are not effective, the physician may switch to another agent in the same class or possibly reduce the daily dose. Constipation this is a common adverse effect. Educate the patient to drink plenty of fluids and eat a high fiber diet. Confusion, drowsiness if this occurs, the physician may switch to another agent in the same class with less potential to cross the blood brain barrier, eg, trospium. Acute urinary do not use anticholinergic agents in patients with a pvr > 250 ml as they are high risk of retention developing this adverse effect, which is a urologic emergency. Increased risk of heat by decreasing perspiration, patients who are in hot climates and who do not have access to air stroke conditioning, are at risk of heat stroke. Use of anticholinergic agents in elderly who are exposed to these conditions should be avoided. Headache educate the patient that this is a common adverse effect. It is usually mild, temporary, and does not require treatment. If necessary, a low dose of acetaminophen is usually effective. Dizziness educate the patient that this is a common adverse effect and does not require treatment. If the patient is taking other blood pressure lowering medications, stabilize blood pressure on these medications before starting tadalafil. Dyspepsia heartburn-like symptoms may occur. Usually, it is mild and does not require treatment. Back pain or myalgia this occurs more often with tadalafil than with the other phosphodiesterase inhibitors. It usually resolves once the drug is stopped. If not severe, tadalafil may be continued as the adverse effect may resolve with continued tadalafil use. Dysfunction, or those patients with luts that is not responsive to α-adrenergic agonists. The usual recommended dose is 5 mg by mouth daily. The dose should be reduced to 2. 5 mg daily if the creatinine clearance is 30 to 50 ml/min (0. 50–0. 83 ml/s). Tadalafil should be avoided if the creatinine clearance is less than 30 ml/min (0.

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