Match the following drugs to their actions, use and description.
b. Angiotensin- convertin enzyme(ACE) inhibitors
c. Lisinopirl, capropril, enalpril
—— Coreg; beta blocker; locks alpha and beta – adrenergic receptors, causing decreased heart rate, decrease blood pressure and vasolidation; used selectively in children; improves symptoms and left ventricular function
—— Aldactone; blocks action of adlostrone to produce dieresis; allows retention of potassium
—— Diuril; Acts directly on distal tubules and possibly proximal tubules to decrease sodium, water, potassium, chloride, bicarbonate absorption, decreases urinary diluting capacity; may need to supplement potassium
—– Causes vasodilation that decreases pulmonary and systemic vascular resistance; decreased blood pressure, reduce afterload, and decrease right and left atrial pressures
—– Lasix; blocks reabsorption of sodium and water to produce diuresis
—— Lanoxin: used because of its rapid onset and decreased risk for toxicity; increases the force of contraction (positive intropic effect); decreases the heart rate (negative chronotropic effect), slows the conduction of impluses through the AV node (negative dromotropic effect), and indirectly enhances diuresis
—— ACE inhibitor that are frequently used in pediatrics
—– A drug administered to the newborn with a congenital heart defect to keep the ductus arteriosus open
From your reading, add medications used to treat hypertension and high cholesterol in the pediatric population. What pertinent patient teaching information would you share with the child and family?
What are signs and symptoms of digoxin toxicity? How could they manifest in a young infant or child?
What labs would the nurse monitor and for what specific reason? In other words, state the rationale for this nursing intervention.
What developmental consideration might there be for the older child and adolescent with a cardiac anomaly?
The infant and the young child who is taking digoxin, at what pulse range would the nurse withhold the dose and notify the practitioner?
What is the relationship between potassium level and the success of digoxin therapy?
What nutritional issues would the nurse anticipate when caring for a young infant born with a heart defect?
Complete the table below:
And pathophysiology Medications Nursing management Patient teaching
1. PDA, ASD, and VSD
2. Tetralogy of Fallot
3. Coarctation of the aorta
4. Transposition of the great vessels
5. Aortic and pulmonic stenosis
6. Hypoplastic left heart.
It’s 0700 and you are assigned to care for a 2 year old female was admitted overnight after being seen in the ED. Her parents said she has had a runny nose and cough for four (4) days. Child exhibited rapid and noisy breathing so the parents brought her to the ED. She has refused her food and drinks. She is only taking sips of her parents’ drinks. She was admitted to the unit at 3:00AM.
You assess her status and notes: temperature of 102.6 F, RR. 38, O2 Sat 91%, HR 72, BP is 118/76 and she weighs 28lbs.Upon auscultation of her lungs, coarse breath sounds in the left field and wheezes heard bilaterally. During the initial nursing assessment she is observed sitting on her parents lap, appears listless and frightful of you. Her parents state she talks but she does not answer your questions and looks away from you.
She has a 6 year old brother who is in the 1st grade. She attends daycare. Her brother attends their local public elementary school. Both parents work outside of the home. There are no immunizations included in patient’s medical record. She has NKDA.
She has a PIV on her left forearm running D5 1/3 NS @ 65 ml/hr. Her mother says she has voided but she cannot remember her last “pullup” change nor has she been changed since admission to the unit. She has an order for Tylenol 160 mg PO, PRN q 4h for temperature greater than 101.6 F. She can have a regular diet for age.
1. What additional assessment data would the nurse need?
2. Are the medication and fluid orders safe for this child?
3. List and prioritize 3 Nursing Diagnosis/problems.
4. What pertinent information would be included in a teaching plan for this child and family?
5. Pick one of the top 2 and create a concept map.
6. Discuss the medical and nursing management for the child with a respiratory alteration.
7. Analyze implication for the use of corticosteroids in the care of the child with asthma.
8. Apply family- centered care and atraumatic care concepts and explain the rationale for application to the care of the pediatric patient.
A 10– month – old female infant is the pediatric outpatient clinic for a well child visit. The infant weighed 7 lbs at birth. Today the baby weighs 32 lbs. The baby’s parents often refers to her as “fat beautiful girl” and comments on her as a “good baby and a good eater”.
The nurse notes the infant is sitting unsupported on her father’s laps. The infant has been healthy from birth and appears appropriately development. As a part of the visit a routine lab including a CBC was drawn. On assessment, the infant’s vital signs and height were within normal limits, except her weight and hemoglobin level which is 7.5 g/dl.
The baby is quietly watching the nurse, does not reach for a toy when offered. The nurse notes that when the baby placed seated on a mat on the floor the infant remains seated. When placed in a prone position on the mat, she lays down and looks; does not move or make any attempts to reach several brightly colored toys in her line of sight on the mat.
Her parent’s states” she is too lazy and therefore is a good baby”. She likes to be held. They can count on her remaining where ever she is left and therefore are not worried about her falling or getting injured.
a. Discuss expected normal development of a 10 month old infant.
b. What medical diagnosis should the nurse suspect?
c. What contributing factors are noted in the scenario that supports the expected diagnosis?
d. Based on the Nursing assessment, list 3 prioritized nursing problems.
e. Create a Nursing care and teaching plan for the parents. Include:
1. Treatment/ management
2. Prevention strategies and anticipatory guidance
4. Watch the hemophilia video in the content folder, review the hematological presentation and complete the reading assignment in your text and ATI. Take notes. Use your notes to complete the following learning application activity
2. From the information learned, answer the following:
a. What is hemophilia?
b. How is it diagnosed?
c. How is it treated?
d. What are potential complications?
e. Design a Nursing teaching plan for the child with hemophilia and their family.
5. A 14-year-old male diagnosed with Sickle Cell Anemia at age 2 years is admitted to the pediatric unit. The adolescent reported to the emergency department 6 hours prior to admission with complains of abdominal and joint pain, fever and 1 day history of vomiting. He also reports 4 loose stools at home and one in the ED. His vital signs are on admission to the floor are T. 39.2, P. 98, R. 38 had a B/P 134/91. He weighs 72 lbs and height 68 inches.
Preliminary lab report reveals a serum WBC 19,000 and Hgb. 8. Admitting Diagnoses include R/O gastroenteritis and sickle cell vasoocclusive crisis. The child recently travelled to Denver Colorado from his home in Prince George’s County MD to attend a NFL football game with his father.
He is alert, lying in bed with his cell phone, watching TV. He rates his pain a 9/10 on the numeric pain scale. He requests access to a computer with internet to play his video games. He refuses to drink for fear of more vomiting.
a. What is Sickle Cell Anemia (SCA)?
b. How is it transmitted?
c. What is vasoocclusive crisis?
d. What are the implications of newborn screening? Why is it the law?
e. Discuss the medical management of SCA.
f. Discuss the patient risk for strokes, splenic sequestration and chest syndrome. Are these complications of Sickle Cell Anemia? Why?
g. Create a Nursing plan of care for this child and family
7 . What are the complications Aplastic Anemia and how is treated ?
8. Design a Nursing teaching plan for the child with Aplastic Anemia and their family.
9. What are the complications of Idiopathic Thrombocytopenia Purpura (ITP) and how is treated?
e. Design a Nursing teaching plan for the child with ITP and their family.
Investigation of strategies and issues Distributed: 23rd March, 2015 Disclaimer: This article has been put together by an understudy. This isn't a case of the work composed by our expert exposition scholars. You can see tests of our expert work here. Any suppositions, discoveries, conclusions or suggestions communicated in this material are those of the writers and don't really mirror the perspectives of UK Essays. Presentation Expanded upper hand and the quickly changing worldwide condition (Bach, 2005) are the two most essential purposes behind putting weight on firms for their survival. It is these measures which influence the association to understand the requirement for vital human asset arranging. Vital human asset arranging joins human asset arranging towards the key heading of the organization (De Cenzo and Robbins, 1996) guaranteeing that the association's proceeded with development is kept up by drawing in and holding individuals with high-bore (Cooper, Robertson, and Tinline, 2003). This brings into the requirement for the correct enrollment and determination arrangement and methodology to be set up. In any case, amusingly, it is still observed that numerous associations still embrace inefficient methodologies towards choices and more often than not opportunities get filled in an impromptu way without an efficient activity examination remembering whether particular employments would be required or not (Marchington and Wilkinson, 2008). As poor determination choices can have ruinous impacts for the association running from cost components to efficiency, it is fundamental to enroll and select the perfect individuals. These actualities frame the premise of my thesis think about investigating the enrollment and choice techniques and issues inside an association. This proposition gives a short framework about my expected research process. I start by featuring the essentialness of my examination alongside the destinations I have a tendency to accomplish. Also, I clarify quickly about the writing survey accessible on the enrollment and choice process. The procedure area will tell about the systems I will embrace for the information accumulation and investigation. What's more, the constraints that might be experienced amid my investigation are shrouded in the last area. Reason behind my examination and its Significance This exploration is educational and critical from the perspective that conduct characteristics ought to be checked amid the enlistment and determination process for the adequacy of value administration ensuring that both the specialized and social frameworks in order to end up hard to mirror by contenders because of easygoing uncertainty and way reliance prompting maintaining hierarchical execution for quite a while (Ahmad and Schroeder, 2002). Likewise, a compelling enlistment and choice procedure not just ensures that the organization makes upper hand and progress yet it is additionally vital in light of the fact that newcomers are a medium for altering hierarchical societies and thought about an open door for getting new aptitudes by directors (Marchington and Wilkinson, 2008). What's more, a wrong choice can be costly in connection to retrain poor entertainers and to enlist new representatives in substitution of ones who quit and the ones who were wrongly chosen. Likewise, this can prompt loss of potential customers alongside excess bundles. Along these lines, in conclusion through this examination the negative impacts that wrong choice choices can have will be brought into take note. Research Objectives The examination will be led in a multinational association whose "key objectives are persuaded by the longing to build up a proficient and coordinated business on a universal scale along and the gathering's rationality being to construct very much characterized, esteem included organizations centering serving the requirements of select market specialties where it can contend adequately (About Us: Investec)". All these point towards having a workforce which can successfully contribute in helping the organization accomplish its objectives. Along these lines, the reason for ponder is to investigate the enrollment and determinations techniques received by the association to see the nature and the nature of individuals working in it and the effectiveness of the present strategies. The exploration fundamentally addresses the accompanying inquiries: Are the different enlistment and choice techniques polished by the associations today as recommended by the writing extremely adept? Do the enrollment approaches and systems really help in accomplishing the results which are normal by the association? What are the components (occupation and part determinations, enrollment media, choice methods and so forth.) that influence the outlining and usage of the staffing procedure? Does cost, hierarchical protection from change and national culture affect the enrolling endeavors? Would recommendations be able to be proposed to enhance the enrollment and determination process inside an association? Writing Review 1. Presentation Figured it might appear that enrollment and choice are comparative terms because of their capacities being reciprocal, this audit talks about them independently alongside the capacity of employment investigation in the general enlistment and determination process. Right off the bat, a diagram of the procedure will be given thinking about its different stages, and talking about each stage independently with the upsides and downsides. At last particular issues identified with national culture and costs influencing enlisting endeavors will be examined. 2. Outline of the Recruitment and Selection Process An enrollment and determination process is a technique by which an organization expects to fulfill its labor needs at the base cost conceivable to guarantee the successful proceeding of the association's activity. The fundamental reason for an enlistment and choice process is to consider identity contrasts amongst people and the way it influences their capacity to execution the resulting work (Searle, 2003). Characterizing prerequisites, fascination and enlistment, shortlisting and appraisal or determination are the four phases of an enrollment and choice process (Armstrong, 2006). Necessities mean readiness including investigation of employment to distinguish the requirements alongside what is included as of now which brings about occupation synopsis and individual particulars as the yields. Fascination is a medium to distinguish and assess wellsprings of candidates remembering that it is a two - path association with the firm choosing who to draw in and in addition the candidates basic leadership control whether to join the association (Taylor, 2005). At last, the determination organize includes choosing the most reasonable person(s) to fill the activity from a pool of enlisted great candidates (Cook, 2004). 2.1 Job Analysis Occupation Analysis or Role examination is the most critical stage in enlistment and determination as it gives the data identified with the activity (work-arranged) alongside the aptitudes and characteristics a man (specialist situated) ought to need to play out the activity (Searle, 2003). As indicated by Pearn and Kandola (1993), Job examination is essentially characterized as "...a methodical technique for getting point by point and target data about a vocation, undertaking or part." to give sets of expectations and information to enrollment, preparing needs, execution assessment and administration. Employment investigation should be possible utilizing various procedures going from concentrating on the components of work to being touchy towards specialists and their qualities. Nonetheless, the principle strategies that are utilized are perception techniques, meetings, and surveys and agendas. On account of disadvantages related with every strategy, it is contended that methods be joined for a reasonable and appropriate individual determination depiction (Cooper, Robertson, and Tinline, 2003). Additionally, there are issues of dependability and exactness worried about occupation examination, because of which there must refresh consistently. Likewise, work examination depends on the presumption of one right approach to play out the activity rather than others, bringing up issues in respect of interrelationship between the laborer and the association (Searle, 2003). Sets of responsibilities Sets of responsibilities are the yield of the activity investigation worried about a short portrayal about the job(s) to be taken up. In spite of the fact that they change between associations, by and large similar classifications are incorporated: work title, area, dependable to whom and for what, principle reason for the activity, central employment obligations and some other obligations. A point significant is that, regardless of, these utilized broadly, they are reprimanded for being immaterial to present day times as they are need adaptability and are simply in view of standards. The feedback being that laborers see their undertaking as being characterized influencing them to comply with the principles as opposed to urging them to perform and include an incentive past those. Therefore, sets of expectations are believed to be supplanted by responsibility profiles which center around yields as opposed to the segments of the procedure. Likewise, another system includes the utilization of part definitions and 'key outcome territory' proclamations (KRAs) that allude to the measures for execution for the activity (Armstrong and Marchington). Determination Criteria/Person Specifications This is the second documentation got from work investigation. Individual determinations are fundamentally the human properties required for topping off the part. Essentially these determinations depend on certain heading following customary seven point and five-point designs of Rodger (1952) and Fraser (1996) separately. This structures the premise of choice criteria to decrease the quantity of candidates and at last just have all around qualified competitors with the correct necessities. In any case, in this day and age competency systems depending on conduct of candidates have supplanted the before structures depending on individual judgment. This is a direct result of the reality of diminishing subjectivity in the enlistment and choice process and the inclination to judge individual characteristics (Suff and Newell, 2006). Additionally, they can be identified with execution result and avoid criteria that however might be anything but difficult to quantify>GET ANSWER