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lovelylia

lovelylia

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lovelylia's Latest Activity

  1. lovelylia

    In need of help ... STRESSED OUT!!!

    so in regards to nursing interventions how would i establish them if the cause of her symptoms can pretty much be a whole range of things
  2. lovelylia

    In need of help ... STRESSED OUT!!!

    i organized the assessment data but still keep coming to a mental block, everything points to renal insufficencly then i cant explain the high cortisol levels im at a complete loss
  3. lovelylia

    In need of help ... STRESSED OUT!!!

    yes thats what we are supposed to do as well its just the way im trying to get this thing started is all wrong please help.....i havent slept all night just thinking about it
  4. lovelylia

    In need of help ... STRESSED OUT!!!

    no australia
  5. lovelylia

    In need of help ... STRESSED OUT!!!

    Here is a bit if what ive done Catherine was admitted 2 days ago through the emergency for collapse for investigation. Her BP was 75/not detectable, and had incomprehensible speech. Hypotension refers to an inadequate intravascular pressure to blood to maintain the oxygen requirements of the body’s tissues. Catherine’s symptoms of a sudden drop in blood pressure seem to correspond to that of what encompass an adrenal crisis, she has a past history of corticosteroid use due to an inflammatory bowel disorder. If stopped suddenly, or not reduced by appropriate tapering measures, the response may be the pituitary gland not producing enough ACTH. Prolonged use of corticosteroids causes adrenal glands to atrophy and therefore they need time to recover. These drugs have a direct effect on the adrenal glands; they decrease the amount of glucocorticoid and mineralcorticoid hormone that the body so desperately need to maintain blood pressure. A typical blood test result of an adrenal crisis which Catherine is displaying is low sodium levels. Aldosterone belongs to a class of hormones called mineralorticoids, also produced by the adrenal glands, it helps maintain blood pressure and water and Na+ balance in the body by helping the kidney retain sodium and excrete potassium. When Na+ falls too low as in Catherines case the kidneys are not able to regulate Na+ and water balance, causing blood volume and blood pressure to drops. A sudden fall in BP could have contributed to her sudden collapse. This could explain Catherine’s collapsing; the sudden drop in BP suggests there was not a sufficient amount of cerebral blood supply. Catherine’s BP was recorded once again in the emergency department but was till considerably low at 90/60. Catherine complained to the medical officer that she was still feeling dizzy this suggest that her low BP could be causing reduced blood and oxygen supply to the cerebrum which is making her feel dizzy. (Merk) Nursing interventions: Restoring fluid balance, select food high in Na+, administer medications as prescribed, until condition stabilized the nurse takes precautions to avoid unnecessary activity and stress that could precipitate another hypotensive episode. Monitor BP, to increase blood pressure. Tachycardia This is strongly relevant to Catherine’s hypotension as her heart rate suggests an increase in an attempt to deliver more oxygen to the cells of her body. When circulating volume decreases, the heart rate increases in an attempt to supply tissues with oxygen. Low circulatory volume can cause dry mucous membranes and increased thirst.
  6. lovelylia

    In need of help ... STRESSED OUT!!!

    Thats just it ive been working on this thing for weeks and always seem to come to a dead end, ive got to the stage that im just so terribly frustrated and ive just gone blank.... any help would be much appreciated i have already started on it but i dont think its correct its too big to post here (13 - 14 pages).....
  7. hi guys, i was wondering if anybody couldl help me out with an assignment i have been presnted with.. i have no idea where to begin and how to get ot started you see i have all the information but dont know how to get it started if that makes sense... fron the case scenario i am to establish what nursing intervention she needs and what could be causing her to have those symptoms any feedback would be much appreciated thank u so much. catherine wilkes a 22 year old unemployed single mother was admitted 2 days ago through emergency department for collapse for investigation. on arrival at triage it was noted that catherine had her two-year old child at her side and both appeared unkempt. catherine's observations were taken at triage and her blood pressure was report as 75 mmhg / not detectable. her speech was incomprehensible, but all limbs were equal in power and pupils were equal and reacting to light. she was promptly transferred to the cubicle area. whilst in emergency department she underwent a physical examination and blood work up. her speech at this time had improved but was slurred. she was reluctant to discuss her family history. health status: non smoker moderate alcohol intake ulcerative colitis for 6 years ileoanal anastomosis 14 months ago observations: temperature 360c bp now 90/60 respirations 22 breaths per minute pulse 130 beats per minute o2 saturation 100% on room air physical assessment: weight 45kg height 160 cm bruises to lower limbs chest clear abdomen soft, non tender blood results: bgl 7.2 mmol sodium 124 mmol/l hb 116 g/l potassium 5.2 mmol/l hct 0.38l/l chloride 89 mmol/l rcc 4.8 x 1012/l bicarbonate 23 mmol/l mcv 78 fl anion gap 17 wcc 16 x 109/l urea 10.3 mmoml/l esr 34 mm/hr creatinine 0.12 mmol/l crp 31 mg/l catherine reported to the medical officer that she had felt nauseous and dizzy all day and that she had not voided the entire day. while catherine was getting into a hospital gown her medications fell out of her pocket. the nurse asked her if she was taking the medications but catherine did not reply. the nurse took the medications to the medical office and they both noted that the medications were: prednisolone 25mg bd orally medazine 1 gram bd orally part two further blood tests revealed: prolactin 1211mu/l cortisol 1066 nmol/l protein 86 g/l albumin 31.6 g/l ggt 113 u/l alt 36 u/l it was noted by the nurse that catherine was previously on mesalazine 250 mg orally tds for ulcerative colitis. she discussed this with the medical officer who withdrew the order for medazine 1 gram and recommenced her on her previous dose of mesalazine the medical officer reported that catherine to undertake a short synacthen test (sst).
  8. lovelylia

    hi daytonite, please help?

    hi daytonite, i was wondering if u could be so kind as to help me with an assignment i have been presented with any feedback would be wonderful i basically need to explain what nursing interventions this woman needs and what could have possible caused her condition??? thank you in advance for any help :) catherine wilkes a 22 year old unemployed single mother was admitted 2 days ago through emergency department for collapse for investigation. on arrival at triage it was noted that catherine had her two-year old child at her side and both appeared unkempt. catherine’s observations were taken at triage and her blood pressure was report as 75 mmhg / not detectable. her speech was incomprehensible, but all limbs were equal in power and pupils were equal and reacting to light. she was promptly transferred to the cubicle area. whilst in emergency department she underwent a physical examination and blood work up. her speech at this time had improved but was slurred. she was reluctant to discuss her family history. health status: non smoker moderate alcohol intake ulcerative colitis for 6 years ileoanal anastomosis 14 months ago observations: temperature 360c bp now 90/60 respirations 22 breaths per minute pulse 130 beats per minute o2 saturation 100% on room air physical assessment: weight 45kg height 160 cm bruises to lower limbs chest clear abdomen soft, non tender blood results: bgl 7.2 mmol sodium 124 mmol/l hb 116 g/l potassium 5.2 mmol/l hct 0.38l/l chloride 89 mmol/l rcc 4.8 x 1012/l bicarbonate 23 mmol/l mcv 78 fl anion gap 17 wcc 16 x 109/l urea 10.3 mmoml/l esr 34 mm/hr creatinine 0.12 mmol/l crp 31 mg/l catherine reported to the medical officer that she had felt nauseous and dizzy all day and that she had not voided the entire day. while catherine was getting into a hospital gown her medications fell out of her pocket. the nurse asked her if she was taking the medications but catherine did not reply. the nurse took the medications to the medical office and they both noted that the medications were: prednisolone 25mg bd orally medazine 1 gram bd orally part two further blood tests revealed: prolactin 1211mu/l cortisol 1066 nmol/l protein 86 g/l albumin 31.6 g/l ggt 113 u/l alt 36 u/l it was noted by the nurse that catherine was previously on mesalazine 250 mg orally tds for ulcerative colitis. she discussed this with the medical officer who withdrew the order for medazine 1 gram and recommenced her on her previous dose of mesalazine the medical officer reported that catherine to undertake a short synacthen test (sst).
  9. lovelylia

    HELP! powerpoint project...

    What kinda help do u need?? if u like i can send u an example of one of my powerpoint presentations
  10. hello all, im in my first year of nursing school and i have been given my first informatics assignment, the question is * Electronic health records must address consumer concerns, not dismiss them with claims of efficient quality health care. Discuss i have tried so hard to answer this question but my mind has gone blank, please can anybody help me out with this one, it would be much appreciated. Thank you so much rose
  11. lovelylia

    Confidence shot down

    Somtimes in life wre need these kind of poeple to put us down, the reason being because it gives us the extra nudge to work even harder. Last year i had a family memeber telling me there was no way i could pass my exams, i was already doing well but with those words of discouragement i tried even harder and ended up passing with distinctions. Use this negative womans attitude to your advantage never let anyone put u down its not worth it!!!
  12. lovelylia

    I know I failed!

    Emnicans i know exactly how you feel because i have felt the exact same way awaiting all my test results, i was absolutely convinced i had failed all of them. I think we underestimate ourselves sometimes, try not to stress so much hang in there im sure you did well. Good Luck!!!!
  13. lovelylia

    "You put me and my unborn child's life at risk"

    She sounds WEIRD!! if she is so worried about stuff like that she shouldnt be working in a hospital. Its not your job to diagnose people, you did the right thing reporting the rash to her. There must be some sort of head of staff you can report her to.
  14. lovelylia

    In Bed with Dying Patient

    How beautiful to have such warmth and comapassion towards patients. Im constantly being told that kind of attitude in the not a good one to have in the nursing profession, i start school this year and after hearing that i strarted to wonder if nursing was really for me. After hearing there are nurses out there that share my feelings, it makes me confidant that not all nurses look at it as "just a job".
  15. lovelylia

    Nursing Admission Essay

    Id be happy to help, ive done 2 admission essays and they both turned out pretty good i could look at yours if u like or id be happy to send u mine. rose
  16. lovelylia

    Do you have Senior-itis?!?

    I cant wait to get to your stage. ive just enrolled today for my a bachelor of nursing degree and i must say i have that bouncy feeling also on getting started. :)
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