By Q. Reto. Rust College. 2019.
Provide information regarding healthful strate- gies for activities of daily living as well as about harmful effects of substance abuse on the body discount accutane 5 mg free shipping acne body wash. Include suggestions for community resources to assist client when adaptability is impaired order accutane 5mg amex acne treatments that work. Input from individuals who are directly involved in the potential change increases the likelihood of a positive outcome cheap accutane online acne inversa images. Implement teaching plan at a time that facilitates, and in a place that is conducive to, optimal learning (e. Provide activities for client and signiﬁcant others in which to actively participate during the learning exercise. Ask client and signiﬁcant others to demonstrate knowledge gained by verbalizing information regarding positive self- care practices. Verbalization of knowledge gained is a mea- surable method of evaluating the teaching experience. Provide positive feedback for participation, as well as for accurate demonstration of knowledge gained. Positive feed- back enhances self-esteem and encourages repetition of desirable behaviors. Client is able to verbalize available community resources for obtaining knowledge about and help with deﬁcits related to health care. Incest is the occurrence of sexual contacts or interaction between, or sexual exploitation of, close relatives, or between participants who are related to each other by a kinship bond that is regarded as a pro- hibition to sexual relations (e. Neglect of a Child Physical neglect of a child includes refusal of or delay in seeking health care, abandonment, expulsion from the home or refusal to allow a runaway to return home, and inadequate supervision. Emotional neglect refers to a chronic failure by the parent or care- taker to provide the child with the hope, love, and support nec- essary for the development of a sound, healthy personality. Physical Abuse of an Adult Physical abuse of an adult may be deﬁned as behavior used with the intent to cause harm and to establish power and con- trol over another person. It may include slaps, punches, biting, hair-pulling, choking, kicking, stabbing or shooting, or forcible restraint. Sexual Abuse of an Adult Sexual abuse of an adult may be deﬁned as the expression of power and dominance by means of sexual violence, most com- monly by men over women, although men may also be victims of sexual assault. Sexual assault is identiﬁed by the use of force and executed against the person’s will. Various components of the neurological system in both humans and animals have been implicated in both the facilitation and inhibition of aggressive impulses. Areas of the brain that may be in- volved include the temporal lobe, the limbic system, and the amygdaloid nucleus (Tardiff, 2003). Studies show that various neurotransmitters—in particular norepinephrine, dopa- mine, and serotonin—may play a role in the facilitation and inhibition of aggressive impulses (Hollander, Berlin, & Stein, 2008). Some studies have implicated heredity as a component in the predisposition to aggressive behav- ior. The psychodynamic theorists imply that unmet needs for satisfaction and security re- sult in an underdeveloped ego and a weak superego. It is thought that when frustration occurs, aggression and vio- lence supply this individual with a dose of power and pres- tige that boosts the self-image and validates a signiﬁcance to his or her life that is lacking. The immature ego cannot prevent dominant id behaviors from occurring, and the weak superego is unable to produce feelings of guilt. This theory postulates that aggressive and violent behaviors are learned from prestigious and inﬂuential role models. Individuals who were abused as children or whose parents disciplined with physical pun- ishment are more likely to behave in a violent manner as adults (Tardiff, 2003). Social scientists believe that aggres- sive behavior is primarily a product of one’s culture and social structure. Societal inﬂuences may contribute to violence when individuals believe that their needs and desires cannot be met through conventional means, and they resort to delinquent behaviors in an effort to obtain desired ends. They may present with different colors of bluish-purple to yellowish-green (indicating various stages of healing). Rashes or itching in the genital area; scratching the area a great deal or ﬁdgeting when seated. Common Nursing Diagnoses and Interventions (Interventions are applicable to various health-care settings, such as inpatient and partial hospitalization, community outpatient clinic, home health, and private practice. Long-term Goal The client will begin a healthy grief resolution, initiating the process of physical and psychological healing (time to be indi- vidually determined). The woman who has been sexually assaulted fears for her life and must be reassured of her safety. She may also be overwhelmed with self-doubt and self-blame, and these statements instill trust and validate self-worth. Ensure that data collection is conducted in a car- ing, nonjudgmental manner to decrease fear and anxiety and increase trust. Ensure that the client has adequate privacy for all immediate post-crisis interventions. Try to have as few people as pos- sible providing the immediate care or collecting immediate Problems Related to Abuse or Neglect ● 315 evidence. Additional people in the environment increase this feeling of vulnerability and may escalate anxiety. Nonjudgmental listening provides an avenue for catharsis that the client needs to begin healing. A detailed account may be required for legal follow-up, and a caring nurse, as client advocate, may help to lessen the trauma of evidence collection. Because of severe anxiety and fear, client may need assistance from oth- ers during this immediate postcrisis period. Long-term Goal Client will exhibit control over life situation by making deci- sion about what to do regarding living with cycle of abuse (time dimension to be individually determined). In collaboration with physician, ensure that all physical wounds, fractures, and burns receive immediate attention. If the cli- ent is accompanied by the person who did the battering, she or he is not likely to be truthful about the injuries. Ask questions about whether this has happened before, whether the abuser takes drugs, whether the woman has a safe place to go, and whether she is interested in pressing charges. Some women will attempt to keep secret how their injuries occurred in an effort to protect the partner or because they are fearful that the partner will kill them if they tell. Making her own decision will give the client a sense of control over her life situation. These may include crisis hotlines, community groups for women who have been abused, shelters, counseling services, and information regarding the victim’s rights in the civil and criminal justice system. Following a discussion of these available resources, the woman may choose for herself. If her Problems Related to Abuse or Neglect ● 317 decision is to return to the marriage and home, this choice also must be respected. Knowledge of available choices can serve to decrease the victim’s sense of powerlessness, but true empowerment comes only when she chooses to use that knowledge for her own beneﬁt. Client is able to verbalize choices available to her from which she may receive assistance.
Depres- sion and suicidal behaviors are sometimes viewed as anger turned inward on the self order 30 mg accutane otc acne jensen. If this anger can be verbalized in a nonthreatening environment order accutane master card acne on chest, the client may be able to resolve these feelings cheap 40 mg accutane with visa acne 8o, regardless of the discomfort involved. Encourage client to discharge pent-up anger through par- ticipation in large motor activities (e. Physical exercise provides a safe and effective method for discharging pent-up tension. Help client identify stressors that precipitate anxiety and irritability and develop new methods of coping with these situations (e. Knowing stress factors and ways of handling them reduces anxiety and allows client to feel a greater measure of control over the situation. Assist with problem-solving to identify behaviors for protection of self and others (e. Recognition of potential for harm to self or others and development of a plan enables client to take effective actions to meet safety needs. Encourage client to reduce or shift workload and social activities during the premenstrual period as part of a total stress management program. Discuss those that may be most troublesome and continue to persist well after initiation of therapy. If traditional measures are inadequate, phar- macological intervention may be required to enhance cop- ing abilities. For example, antidepressants may be admin- istered for depression that remains unresolved after other symptoms have been relieved. Encourage participation in support group, psychotherapy, marital counseling, or other type of therapy as deemed nec- essary. Professional assistance may be required to help the client and family members learn effective coping strategies and support lifestyle changes that may be needed. Client participates willingly in treatment regimen and initi- ates necessary lifestyle changes. Client demonstrates adaptive coping strategies to deal with episodes of depression and anxiety. In the normal im- mune response, they work to destroy an invasive organism and initiate and facilitate repair to damaged tissue. If these cells are not effective in accomplishing a satisfactory healing response, speciﬁc immune mechanisms take over. When the body is invaded by a foreign antigen, these T4 cells divide many times, producing antigen-speciﬁc T4 cells with other functions. An individual with a healthy im- mune system may present with a T4 count between 600/mm3 and 1200/mm3. The symptoms have an abrupt onset, are somewhat vague, and are similar to those sometimes seen in mono- nucleosis. Most symptoms resolve in 1 to 3 weeks, with the exception of fever, myalgia, lymphadenopathy, and malaise, which may continue for several months. The progression of the illness is faster in infants and children than it is in adults. Fever, night sweats, chronic diar- rhea, fatigue, minor oral infections, headaches. Opportunistic infections are those that occur because of the altered immune state of the host. Because the virus is found in greater concentration in semen than in vaginal secretions, it is more readily transmitted from men to women than from women to men. The lining of the anal canal is delicate and prone to tear- ing and bleeding, making anal intercourse an easy way for infections to be passed from one person to another. Modes of transmission include transplacental, through exposure to maternal blood and vaginal secretions dur- ing delivery, and through breast milk. However, only blood, semen, vaginal secretions, and breast milk have been epidemiologically linked to transmission of the virus. Common Nursing Diagnoses and Interventions* (Interventions are applicable to various health-care settings, such as inpatient and partial hospitalization, community outpatient clinic, home health, and private practice. Maintain meticulous sterile technique for dressing changes and any invasive procedure. If client is unable to tolerate oral intake or tube feedings, consult physician regarding possibility of parenteral hy- peralimentation. Have the client eat small, frequent meals with high-calorie snacks rather than three large meals per day. Cleanse skin exposed to diarrhea thoroughly and protect rectal area with ointment. Assess respiratory status frequently: (1) Monitor depth, rate, and rhythm of respirations. Ensure that client does not take aspirin or other medica- tions that increase the potential for bleeding. Clean up areas contaminated by client’s blood with house- hold bleach diluted 1:10 with water. Long-term Goal Family will verbalize areas of dysfunction and demonstrate ability to cope more effectively. Create an environment that is comfortable, supportive, and private and promotes trust. Encourage each individual member to express feelings re- garding loved one’s diagnosis and prognosis. If the client is homosexual, and this is the family’s ﬁrst awareness, help them deal with guilt and shame they may experience. Help parents to understand they are not re- sponsible and their child is still the same individual they have always loved. Resolving guilt and shame enables fam- ily members to respond adaptively to the crisis. Their re- sponse can affect the client’s remaining future as well as the family’s future. The family may have difﬁculty accepting the part- ner as a person who is as signiﬁcant as a spouse. Do this by bringing both parties together to deﬁne and distribute the tasks involved in the client’s care. By minimizing the lack of legally deﬁned roles and by focusing on the need for making realistic decisions about the client’s care, communication and resolution of conﬂict are enhanced. Reduction of stress and support from others who share simi- lar experiences enable individuals to begin to think more clearly and develop new behaviors to cope with this situ- ational crisis.
The “Five Rights” of Drug Administration There are five traditional right actions that should be followed when giving med- ication order accutane 10mg online acne 2015 heels. Five additional rights include the right assessment buy cheap accutane 40 mg skin care quiz products, docu- mentation order accutane with a visa acne 4 hour, education, evaluation, and the right to refuse. Each time a drug is administered, the healthcare provider must verify who the patient is by the patient’s identification bracelet. This is the preferred method as opposed to identifying a patient by asking his or her name. Some patients will answer “yes” to any name and two patients can have similar- sounding names or the same name. Providers check the expiration date and return the medication to the phar- macy if it has expired. If the medication is used past the expiration date, the effect on the patient can be unpredictable. Healthcare providers check the medication label three times before adminis- tering the drug. Next, the label should be checked before pouring the drug, and third it is checked after pouring the drug before throwing away the drug packaging. The healthcare provider should have a general idea of the dose before performing any drug calculations. If the calculated dose varies too much from this estimated dose, check with a pharmacist or another appropriate healthcare provider. Some drug calculations should always be checked by two individuals if the calculation is complicated or the drug has the potential to be harmful if the dose is too large or too small. Medications that are wrapped and labeled or pre-filled for the exact dose are preferred and can reduce errors. The time is specified in the drug order and may be given a half hour before or after the stated time depending on the policy of the hospital or healthcare facility. A drug’s half life is the amount of time for 1⁄2 of the drug to be eliminated from the body. A drug with a short half life must be administered more frequently than a drug with a long half-life in order to maintain a therapeutic level of the drug in plasma. Check if the patient is scheduled for diagnostic or other procedures that might interfere with administration of medications. Healthcare providers should also make sure that medication is given in coor- dination with meals. Some drugs must be given with meals while other drugs are given a specific period before or after a meal. Where possible, the medication schedule is adjusted to conform to the patient’s lifestyle, which may differ from the normal schedule. This becomes important once the patient is discharged and takes medication at home. Caution should be used when administering intravenous medications because the body quickly absorbs these drugs. Therefore, healthcare providers need to know expected side effects, effects that occur when the drug is first given, effects the drug has dur- ing its therapeutic peak, and duration of the drug’s action. This method is also used in some acute and long- term care institutional settings. In these settings the nurse gives the patient a packet of medications with instructions that are kept at the bedside. The patient takes the medication according to the instructions and advises the nurse when he or she has done so. This practice help patients learn how to manage the medications and prepares them for discharge and use of these medications in the home. Patients should be advised of the consequences of the refusal to take the medication such as a worsening of the condition. As a general rule, every effort is made to encourage the patient to take the medica- tion. Healthcare providers should avoid speaking in medical terminology and, instead, use common words and expressions that are familiar to the patient—and always in the language that the patient speaks. The patient provides feedback that he or she understands everything about the medication. It is common for the healthcare provider to ask the patient to tell in his or her own words what was told to them about the medication. The list should have the name of the medication, dose, time the medication is to be taken and the name and phone number of the prescriber who ordered the medication. Summary Pharmacology is the study of drug effects on living tissue and how drugs cure, prevent, or manage diseases. Drugs are derived from plants, animals, miner- als, and are synthesized in the laboratory. These are the chemical name, the generic name that is considered the official name for the drug, and the brand name, which is used by the manufacturer to market the drug. There are two general classifications of drugs: prescription and over-the- counter drugs. Prescription drugs are also known as legend drugs and must be prescribed by an authorized healthcare provider. Drugs have three effects: these are the therapeutic effect to fight or prevent a disease; a side effect that isn’t harmful; and an adverse effect that is harmful to a varying degree. Healthcare providers must know about these effects before administering the med- ication to the patient. Clinical studies determine the therapeutic effect, adverse effect, and side effects the drug has on humans. A drug is prescribed to a patient by writing a drug order or medical prescrip- tion. A drug order specifies, among other things, the name of the drug, the dose, route of administration, and frequency. These are to give the right patient the right drug, in the right dose, at the right time, by the right route. Patients also have the right to refuse medication and the right to education about the medication. With this overview of pharmacology under your belt, let’s take a closer look at how drugs work by exploring the principles of drug action and drug inter- actions in the next chapter. A brand name of a drug is (a) the non-trademarked name given by the original drug manufacturer. A drug order that requires the drug to be given immediately is called a (a) one-time order. The number of times a drug is given to a patient can be determined by the half-life of the drug.