Erikson Development Stages - Admission/Application Essay Example

? Coarsework: Care Plan and Assignments September 20, Two care plans (Erikson development stages) Nursing Care Plan for Empyema Patient: Erikson: At Oral –sensory birth stage, patient learned to trust his human contacts. At musculo-anal stage, patient learns to self sufficient. At locomotor genital stage, patient prefers adult activities over childish ones. At latency age, patient is competent and confident in all his home and school activities. At adolescent age, patient learns who the patient is in relation to other members of society and family. At young adult stage, patient is happily in a relationship and has many beneficial friends. Patient is a productive member of society. The elderly patient continues to make sense of one’s existence in the world. The patient finds he is an important contributor to the community. The patient despairs over some unaccomplished life objectives and goals (Shaffer, 2008). Etiology The causes of empyema (purulent pleural fluid) disease include viridians group of streptococci and diphtheroids associate with possible association to pneumonia. Pasteurella multocida also triggers the disease. Clostridium and Bacteroides trigger the Empyema ailment. Pneumocococcus, staphylococcus and betahemolytic streptococci are common culprits of empyema onset (Fisher, 2004). Nursing Diagnosis: There is occurrence of malfunction in the patient’s exhaling carbon dioxide and inhaling oxygen. There is presence of airway blocking. Likewise there is an increase in the amount of secretions. The patient is in a state of bronchial spasm (http://nursesnanda.blogspot.com/). Objectives: To ascertain the level of breathing of the patient and type of ailment. Ascertain patient’s vital signs. To learn how to alleviate the patient’s current breathing difficulty. To determine if patient needs oxygen tank to relieve breathing problem. To determine urgency of the nurse contacting the doctor for additional medical instructions. Nursing intervention: The nurse must assess the patient’s current breathing situation. The nurse must determine patient’s difficulty in breathing, in terms of number of breaths and depth of the patient’s breath. The patient speaks in a hoarse voice. The patient suffers from brochospasm. The patient should focus on the intensity or difficulty of the neck and shoulder muscles to relieve breathing difficulty (http://nursesnanda.blogspot.com) The nurse must help the patient breath better by placing the patient in a better or more comfortable position. The nurse calms the patient down by reassuring the patient that her relaxation will increase the healing process. The nurse persuades the patient to lie still and persuade the patient that the oxygen tank will increase or improve her breathing condition (http://nursesnanda.blogspot.com) Rationale: The nurse should focus on evaluating the degree of respiratory act of breathing’s difficulty. The nurse must evaluate the presence and degree of chronic disease processes. Reassuring the patient contributes to reducing lung collapse. Likewise, the nurse action contributes to updating the oxygen supply fills the patient’s immediate need for oxygen (http://nursesnanda.blogspot.com) Evaluation/Goals: Nurse action is correct resulting to patient’s responding to nurse intervention. Letting the patient take doctor-prescribed medicine alleviates the ailment. The patient’s breathing is increased with the use of oxygen tank support. Nurse action correctly makes the patient is relaxed as the patient. Consequently, patient relaxes from the nurse’s persuasive instructions to relax and let loose her tense muscles. The nurse’s checking of the vital signs and blood oxygen levels correctly indicates the patient will recover from a few days of hospital room rest and constant nurse monitoring. The nurse correctly allots more time to the patient with empyema to monitor and report changes in the patient’s vital signs and other health conditions. The nurse rightfully continues to calm and reassure the patient in order to prevent sudden moves that will agitate the patient and personally trigger shortness of breath. The nurse correctly checks the oxygen exhaust level in order to adjust to the patient’s changing need for oxygen. Expected outcome. Get patient’s vital statistics. Get patient’s history. Nurse calms and reassures the patient. Evaluate each expected outcome. Nurse effectively gets patient’s vital statistics. Nurse effectively gets patient’s history. Nurse effectively calms and reassures the patient. Patient Nonverbal State: Using the oxygen tank will help increase the patient’s breathing difficulty. The nurse correctly implements the doctor’s medicine schedule, including digitalis and diuretics, including bronchodilators, corticosteroids, and antimicrobials (Basavanthappa, 2003; p. 168). The patient has weight loss and thinness problem (Stump, 2007; p 278). Reassuring and calming the patient alleviates the overexertion of the patient’s neck and shoulders. Calming the patient makes the patient relax and sink into deep calming sleep. Letting the patient sleep hastens the tired patient’s body rehabilitation. Calming the patient reduces patient stress (Tecklin, 2007; p.161). Nursing Care Plan for Eclampsia Patient. Erikson: At Oral –sensory birth stage, patient learned is able to trust humans. At musculo-anal stage, patient learns is able to walk. At locomotor genital stage, patient eagerly participates in adult individuals’ activities. At latency age, patient is confident in accomplishing all his home and school activities. At adolescent age, patient learns to build meaningful relations with everyone in school and in school. At young adult stage, patient has many friends and other responsive relationships. Currently, the patient contributes immensely to society, as worker. The 33 year old patient is pregnant with baby. As a young adult, she is comfortable in the married life stage. Patient has established sexual, ethnic, career identities. Patient is happy with the arrival of the family baby (Shaffer, 2008). Etiology. The causes of eclampsia include childbirth. The placenta, uterus or other female organ releases cytotoxic factors. The factor triggers the eclampsia ailment (Caplan, 2001). Further, autoimmune malfunctioning, blood vessel issues, patients’ jeans, and diet contribute to Eclampsia. Obesity, a woman’s age of 35 and above and diabetes history contribute to Eclampsia (http://nanda-nursing.blogspot.com). Nursing Diagnosis: The patient has high blood pressure. Pregnant patients have possible high seizure risk. There is high risk of fetal distress. The patient’s urine test indicates an oversupply of protein in the patient’s body, indicating a health issue. Patient is uncomfortable due to uterine issues (http://nanda-nursing.blogspot.com). The patient complains of changes in her vision. Likewise, the patient complains of a painful headache. The patient’s complaints include dizziness, nausea. The patient goes on a “vomiting” mode. The patient’s weight indicates the onset of preeclampsia. There is excess protein shown in the patient’s urine test. The patient complains of unwarranted reduced urine activity. The reduction causes pain and discomfort on the patient. Objectives: To determine the patient’s edema condition. Ascertain patient’s vital signs. To determine patient’s urine situation (difficulty in urinating). To determine if the patient’s fetal heart condition indicates fetal health resolution. Nursing intervention (Nursing Actions): Care plans are important nursing interventions. For the eclampsia patient, respiratory dysfunction theories should be implemented. Patient’s vital signs should be taken. An oxygen tank should be placed beside the patient to increase oxygen intake. The nurse should ensure patient takes the prescribed medicine dosage on time. Nurse should help the patient who has difficulty breathing. The nurse reports to the medical doctor any changes or unexpected medical issues for immediate action. The Erikson theory states that the adult patient is currently happy working to feed his family, in his middle age years (Shaffer, 2008). Second, the nurse should wash the burn patients’ affected body part with soap and water. Next, the nurse should wipe the wound with anti-tetanus or other wound applications. The nurse should dress the wound with bandage, not too tight or too loose. The nurse lets the patient drink the prescribed burn medicine on time. The nurse takes the patients’ vital signs to ensure patient’s burn incident is not increased by the patients’ current health conditions (hypertension, asthma, etc.). Erikson theory indicates that the patient is a middle age person, also happy with his current occupation, teacher (Shaffer, 2008). Nursing intervention (nursing action) includes (http://nanda-nursing.blogspot.com: 1. Monitoring blood pressures every 4 hours. 2. Assess patient’s consciousness status. 3. Assess eclampsia conditions (hype active, pulse, respiration, Liguria or epigastric pain). 4. Monitor labor and uterine contractions. 5. Coordinate with medical staff to lower hypertension levels. In addition, other nurse intervention procedures include: 1. Nurse must take extra care of the preeclampsia patient. Complications may crop up if the nurse falters in her duty to help the patient during her preeclampsia predicament. 2. Nurse exerts efforts to prevent death, one of the unfavorable outcomes of faulty nursing care actions. 3. The constant monitoring of the patient’s blood pressure should be implemented to ensure setting into motion the required intervention changes. Bed rest will alleviate the patient’s current condition. 4. The patient should be restricted to only sitting, standing, and other necessary activities. Rationale: Blood pressure may indicate hypertension (110 mmHg diastole and systole 160 or more). Patient pulse and respiration may indicate brain, heart, lung, and kidney issues and seizure attacks. Anti-hypertension intervention lowers hypertension levels. Nursing intervention reduces death possibilities. Blood pressure monitoring ensures the proper oxygen flow relieves, not hinders, the patient’s breathing. Death possibility is reduced. Complications of Eclampsia are lessened. Letting the patient reduce physical activity reduces eclampsia’s debilitating effects (http://nanda-nursing.blogspot.com). Evaluation/Goals: The nursing action was effective. The blood pressure results contributed to the doctor’s high quality job of prescribing the best health rejuvenating prescriptions. The nurse action of restricting the patient to sitting, standing, and necessary activities correctly alleviates the patient’s dizziness and other high blood pressure effects (http://www.helium.com). Expected goals include lowering hypertension levels, and resolving fetal heart rate issues and reducing probability of seizures and death (http://nanda-nursing.blogspot.com). Expected outcome. Get patient’s vital statistics. Get patient’s history. Nurse calms and reassures the patient. Evaluate each expected outcome. Nurse effectively gets patient’s vital statistics. Nurse effectively gets patient’s history. Nurse effectively calms and reassures the patient. Patient Nonverbal State: Constant checking of the patient’s blood pressure ensures implementation of required nursing intervention changes (Galsziou, 2008; p. 306). Letting the patient take doctor-prescribed medicine controls the patients’ high blood pressure condition. Letting the patient take doctor-prescribed medicine, including magnesium sulfate, reduces the patient’s dizziness spells. Restricting the patient’s movement will reduce vomiting and other dizzying incidents (Glasiou, 2008; p.306). WEEK 1. 1. Pathophysiology incorporates female hormonal imbalances. The imbalances include the malfunctioning of the hypothalamic- pituitary ovarian axis, mediated by estrogen generation. The imbalance may cause infertility and ovulation prevention. Infections, neurologic pituitary gland malfunction, and tumor may precipitate to gonadotropin levels (Springhouse, 2005). Clinical manifestations include space-occupying lesion effects and excess pituitary gland hormones (Bryant, 2010). In some instances, a drug, GH somatropin, is injected to replace the patient’s required pituitary and thyroid gland hormone (Aschenbrenner, 2008). 2. The assessment of chronic endocrine problems includes scrutinizing alterations of the early, normal endocrine environment for any adverse effects and endocrine disruption (Longnecker, 2003). Interventions include parenteral nutrition and slight burn injury in intensive care environment (Weekers, 2003). The rationale includes fatigue levels have similar somatic symptom characteristics found in endocrine disorders (Montero, 2001). The expected outcomes include the patients’ expressing positive feelings, gain weight, and participating in social activities (Ricci, 2008). 3. The patients generated favorable responses to therapies and nursing care for endocrine dysfunctions. The patients’ happy faces and improved vital signs paint a thousand words of nursing care success. 4. The appropriate pharmacologic therapies for endocrine disorders include hormonal drugs. The main sources of the hormone drugs are human, animal, and synthetic sources. The synthetic hormone is often described as the most potent hormone therapy alternative. The drug is injected in small doses (Brophy, 2010). WEEK 2 1. Pathophysiology dictates head injury includes localized cerebral contusion or hematoma, precipitating to diffuse axonal injury, edema, or hypoxemic variations. Injuries may include skull and sphenoid bone damage (Kothare, 2010). Rabies victims exhibit nervousness, irritability, excessive salivation, and high fever (Springhouse, Pathophysiology made incredibly Easy, 2008). Brain tumor includes recurrences of delusional disorder related to personality traits. (Sadock, 2008). In hematomas, boxing may cause blood vessels to rupture. Blood internally bleeds and may cause blocking blood from supplying oxygen to the brain (Myers, 2002). 2. The complications of the brain injury may trigger headache, neck stiffness, minor head trauma, and lethargy. Consequently, complications include a secondary brain injury (Fleisher, 2010). 3. There are different stroke types. Ischemic stroke is the most prevalent type. The type’s symptoms include weakness, vision loss, numbness, gait disorder, vertigo, and numbness. The type includes absence of the patients’ actions. Ischemic stroke is divided into large artery thrombosis, small penetrating artery thrombosis, cardiogenic embolic stork, and cryptogenic strokes. The second group of stroke types is the hemorrhagic stroke. The stroke type is divided into intracerebral hemorrhage, subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation (Meltzer, 2009). Nursing management includes identification of stroke etiology, proactive management to generate haemodynamic stability, thrombolysis, and arrest of hemorrhage (Williams, 2010). 4. The diagnostic procedures include CT Scan, areteriography, PEG, and craniotomy for head injuries (Wagner, 1981), CTS scan and CT angiography show the hypodense areas and brain swelling symptoms of stroke, indicating infarction appearances (Mehrholtz, 2012). Cerebral Angiography, better than CT and MRA procedures for aneurism procedures, detects aneurysms and anatomy (Rowland, 2009). The Examination of CSF diagnostic procedure focuses on meningitis case (Elliott, 2012). 5. The nurse should make clinical manifestations to the family and friends. The nurse should confront the family and patients regarding the current and future status of the patient WEEK 3 1. Restless leg syndrome pathophysiology includes some Caucasian individuals’ urge to move the legs without paraesthesia, and reduced iron elements that drop in severity in old age (more than 70 years old). Increasing the patients’ iron alleviates the medical condition (Satija, 2008). The etiology of restless leg syndrome is currently unclear, sometimes occurring in idiopathic form without other triggering medical ailments (Lynn, 2012). Collaborative care and nursing management includes walking exercises, moderate exercise, stretching, and a warm bath (Silventri, 2011). Further, Pathophysiology indicates Bell’s Palsy patients’ symptoms include inflammatory 7th cranial nerve disease precipitating to facial weakness (cannot smile, move eyebrow, etc.) or paralysis. The inflammation prohibits normal neural stimulation of the muscles (Lippincott, 2010). Etiology dictates that herpes simplex, herpes zoster, and other viral infections trigger the Bell’s palsy (Bricker, 2001). Collaborative care and nursing management includes giving the patient moist heat, electrical stimulation, and gentle massage to stimulate the affected areas (Lewis, 2010). In addition, Pathophysiology states that Multiple Sclerosis disables the individual’s central nervous system, generating tremors, spasticity, bladder fatigue, weaknesses, sexual desire dysfunction, and bowel problems (Schapiro, 2010). Collaborative care and nursing management includes. There is no conclusive etiology of multiple sclerosis including accidental injuries (Robinson, 2003). Remedies include injections of drugs, especially sexual drive invigorating drugs. Reducing food intake alleviates bowel symptoms. Amantadine or modafinil drugs alleviate the fatigue symptoms. Anti-epileptic drugs, like carbamazepine, reduce Multiple Sclerosis pain (Holland, 2010). In addition, seizure and epilepsy pathophysiology indicates loss of memory or consciousness during attacks triggered by hyper excitation of brain neurons (Shorvon, 2011). Brain tumor, stroke, and blood vessel malfunction precipitates to epilepsy (Singh, 2006). Etiology of seizure and epilepsy indicates epilepsy triggers seizure (Gordon, 2007). Collaborative care and nursing management of seizure and epilepsy includes not restraining the patient, removing harmful objects near the patient, watch patient during the entire seizure process to prevent harm to the patient (Gordon, 2007). Further, Parkinson’s disease pathophysiology indicates tremor, rigidity, reduced movement and loss of balance. Etiology indicates lack of dopamine triggers Parkinson’s disease. Collaborative care and nursing management includes filling the patients’ dopamine requirements with drugs containing L-DOPA & Levodopa (Ronken, 2002). Furthermore, Alzheimer’s disease pathophysiology (Gogia, 2008) indicates a progressive and degenerating brain malfunction. The symptoms include loss of memory, impaired judgment and faulty reasoning, difficult daily functions. Etiology of the disease indicates age, indicating slow death of the brain cells, contributes to the disease. Collaborative care and nursing management includes antihypertensive drugs that block calcium, lowering the patients’ blood pressure, and antioxidants (Gogia, 2008). 2. There are different types of generalized seizures. Grand mal seizure symptoms include convulsions and unconsciousness. The absence seizure involves short loss of consciousness. The Myoclonic seizure indicates jerking movements. The Clonic seizure indicates repetitive movements. The Tonic seizure includes muscle rigidity. The Atonic seizure involves loss of muscle tone. The partial seizures include simple, complex, and presence of secondary generalization (http://www.webmd.com). 3. The medications described in question 1 above effectively alleviates the neurological diseases described in question 1 above. 4. There are laboratory procedures for patients described in Question 1. Restless. Includes polysomnography, actigraphy wristwatch, and sleepiness scale to measure sleep data (http://health.nytimes.com/health/). Laboratory procedures include HSV reactivation tool for Bell’s palsy (Nath, 2003), neuroimaging &cerebrospinal fluid (CSF) electrophoresis for Multiple Sclerosis, measurement of electrolytes, calcium, and blood sugar for Seizure and Epilepsy (Perkins, 2007), and cerebral ischemia for both Parkinson’s disease and Alzheimer’s disease (Chernekcy, 2007), 5. There are nursing diagnosis and interventions procedures. Intervention includes administering the patients’ medicine while in the hospital and monitoring the patients’ vital signs. The diagnosis of the ailments mentioned in Question 1 includes explaining the patient’s complete medical state to the patient and the patients’ relatives, informing them of the strict does and don’ts of caring for the patients (Smeltzer, 2010). WEEK 4 1. Pathophysiology indicates muscuskeletal system diseases include height reduction and bone softening for osteoporosis, pain in bone cancer, scoliosis, fractures, strains, rotator cuff injuries, rheumatic disease, osteoarthritis, arthritis, erythematosus, gout, Lyme disease and chronic fatigue syndrome. Etiology indicates poor food intake, lack of exercise, overexertion, and refusing to carry heavy objects trigger osteoporosis. Nursing care includes changing the patients’ lifestyle, carrying heavy objects, exercise, taking pain relievers, and eating healthy food (Smeltzer, 2010). 2. Further, there are several fracture types. The types include linear, greenstick, segmented, comminuted, angulated, butterfly, impacted, closed, open, traversed, oblique, spiral, and displaced fractures (Morton, 2012). Management includes wrapping a cast around the broken body part (Birrer, 2004). 3. Proper assessment of musculoskeletal system that include osteoporosis, scoliosis, bone cancer, sprains, strains, fractures, rheumatic disease, rotator cuff injuries, arthritis, gout, chronic fatigue syndrome, and systemic lupus erythematosus is a must. First, ask patient to describe the pain and decline in body part function. Next, the neurological assessment of the affected bone or muscle part should be implemented. The patients’ description will determine whether the patient has Rheumatoid arthritis, osteoporosis, fractures, or other musculoskeletal system cases. Palpation and inspection are important procedures (Cox, 2009). 4 There is a common diagnostic procedure for musculoskeletal system, that include osteoporosis, scoliosis, bone cancer, sprains, strains, fractures, rheumatic disease, rotator cuff injuries, arthritis, gout, chronic fatigue syndrome, and systemic lupus erythematosus. The procedures include: Neutral Zero and ott signtest for Spine injury; Sternum compression test for Chest injuries; soto hall test for Cervical spine injuries; range of motion test for shoulder injuries, impingement, jobe supraspinatus tests for rotator cuff injuries; function test for elbows; range of motion test for hands and wrists; muscle traction test for hip injuries; Kraus Weber tests for posture deficiency; and heel test for osteoporosis (Buckup, 2008) 5. There are possible interventions on the musculoskeletal system, that include osteoporosis, scoliosis, bone cancer, sprains, strains, fractures, rheumatic disease, rotator cuff injuries, arthritis, gout, chronic fatigue syndrome, and systemic lupus erythematosus ailments. Laser treatment, surgery, cast placement for fractures, and drugs generates the patients’ quality adjusted life (Gerber, 2001). WEEK 5 1. Pathophysiology indicates Cancer ailments like breast cancer, cervical cancer, ovarian cancer, vulvar cancer, uterine leiomyomas, vaginal cancer, fallopian tube cancer, prostate cancer, and cancer of the penis are produced by cells that have gone out of control. The cancer cells multiply and spread by destroying the nearby normal cells. Etiology shows that food intake, genes, infection, and lifestyle contribute to cancer occurrences (Panno, 2009). Cancer management includes surgery and chemotherapy (Panno, 2009). Endometriosis is the presence of endometrial like tissue outside the uterus that precipitates to chronic, inflamed reaction causing fatigue, irritable bowel movement, and others. Etiology indicates endometrial cell malfunction triggers endometriosis (Velasco, 2010). Surgery alleviates the patients’ sufferings (Redwine, 2004). Menopause occurs when mense does not occur within one year. Age triggers menopause. Management includes accepting menopause as part of life, including its irritability side effects (Wright, 2004). Toxic shock syndrome is triggered by bacteria precipitating from certain hygiene absent practices. Management includes implementing hygiene (Shmaesfsky, 2003), sexually transmitted disease is infection spread through sexual practices. Management includes drugs and avoiding infected individuals (Yancey, 2002). Erectile dysfunction (inability for penis erection) which increases as a man reaches 55 years old. Management includes drugs (Eardley, 2003). Likewise, age influences the testicular dysfunction (malfunction of testicles). Drugs will cure both dysfunctions (Nieschlag, 2009). 2. There are clinical manifestations of the above discussion. Nurses administer the medicine while in the hospital on time and monitor the patients’ vital signs. All cancer types and leiomyomas’ manifestations include fatigue, sleep disorders, anorexia, cachexia, and pain. The invading cancer cells disrupt or impair the harmonious relationship coordination among the normal cells. Consequently, the imbalance triggers the manifestations (Porth, 2010). In menopause, the change manifestations include hot flashes and night sweats, insomnia, ovulation ceasing, thinning of mucous membranes of the vagina and urethra (Phillips, 2003). In dysfunctions, the doctor can easily observe the testicles and penis acting abnormally. Endometriosis manifestation includes visible accumulation outside the uterus. In sexually transmitted diseases and pelvic inflammatory disease, manifestation includes infection of the affected human anatomy. 3. There are possible complications of disease associated with reproductive system. Complications include death from cancer attacks on normal cells. Other complications include heart disease occurrences, diminished sex drive, loss of balance, and disorientation (Lindh, 2009). 4. There are different sexually transmitted diseases. Niesseria Gonorrhea, Chlamydia, Pelvic Inflammatory disease, Chacroid, Herpes Simplex, Syphilis, HIV/AIDS and Hepatitis are cause by infections. All infections are treated with antibiotics, except HIV/AIDS, which does not currently have a convincing cure (Faro, 2003). WEEK 6 1. Pathophysiology of liver and biliary diseases includes presence jaundice. Jaundice includes yellow coloring of the patients’ eyes, face, hands, or trunk from the retention of biliary ingredients. Fever and chills crop up in liver and bilial disease. Anorexia and nausea are symptoms of liver disease. Etiology indicates obesity, rapid weight loss, hyperlipidemia, parenteral nutrition, and hypothyroidism contribute to liver and bilial disease. Bilial diseases include cirrhosis, esophageal varices, esophageal gastric tamponade, liver trauma, hepatitis, gallstones, acute pancreatitis, chronic pancreatitis, liver cancer, bladder cancer, and pancreatic carcinoma. Nursing management includes teaching the patient and relatives the does and don’ts of patient care, especially within the patient’s home environment (Kelly, 2008). 2. Normally, medicine has favorable effect on liver and bilial diseases. Drug therapy reduces biliary tree inflammation and reduces scar occurrences. Ursodcoxycholic acid drug diffuses the liver and biliary diseases. 3. Clinical manifestations of liver and bilial diseases are significant. The manifestations include fatigue, jaundice, fever, weight loss, and abdominal pain (Basavanthappa, 2003). There are possible interventions for liver and bilial diseases. Surgery for cancer and other bilial diseases are good interventions. Drugs can be introduced to reduce the ailments, including insulin sensitizing PPAR –y agonist, rosiglitzone and pioglitazone, antioxidants Vitamin E and Vitamin C, ant diabetic drugs, metformin (Goldblum, 2009). WEEK7 1. Prerenal failure causes include arrhythmias that triggers lessened cardiac output, cardiac tamponade, cardiogenic shot, hemorrhage, diuretic overuse, hypertension, vasculitis, trauma, and dehydration (Springhouse, 2004). Further, intrarenal failure causes include ATN as a consequence of ischemia or toxic attacks on the renal tubules. Ischemia crops up from untreated prerenal malfunction or severe hypoxemia. Other causes include radiographic contrast dye, aminoglycoside and cephalosporin antibiotics, and nonsteroidal anti-inflammatory drugs, and pigments (White, 2012). Furthermore, Postrenal acute renal failure causes include renal calculi, edema, tumors, blood clots, pregnancy, nerve disorder, and urethral structures (White, 2012). 2. Acute Renal Failure (ARF) follows a clinical course. The course incorporates fast correction of the patients’ debilitating condition with prerenal or postrenal failure (Hughes, 2001). Next, nutrition-based food is given to the patient as well as treatment of infection. Dialysis is often prescribed. Drugs, mannitol, frusemide, and dopamine, can be given to acute renal failure (ARF) patients (Hughes, Clinical Pharmacy, 2001). Further, Peritonial dialysis goes through structural and functional changes, sometimes leading to loss of function as dialysis membrane. The dialysis type uses peritoneal lavage to cure the patients. The alterations include loss of mesothelial cells, thickening of the submesothelial compact zone, and vascularization adjustment. Advantages include helping patients who were rejected by the Hemodialysis alternative and good biochemical control, more liberal fluid intakes than hemodialysis. Disadvantages of peritoneal dialysis include ultrafiltration complications (Gokal, 2000). Nursing responsibilities include ensuring the dialysis is done on time and correctly to ensure maximum recuperative effect of the medical procedure (Ronco, 2009). Furthermore, hemodialysis came out prior to the peritoneal dialysis tool. Hemodialysis uses an artificial kidney, a machine to replace a damaged or nonworking kidney. Advantages include the popularity and tested success of the hemodialysis machine, simple and easy to operate the machine. Disadvantages include complexity (requiring more staff to operate the dialysis machine) and very high cost to retain (Henrich, 2009). 3. Medication for respiratory dysfunction includes bronchodilators. The patient inhales the medicine that opens up the respiratory passageway. Consequently, the patients’ breathing is improved. The drugs include adrenergic drugs and anticholinergic drugs. Corticosteroids are anti-inflammatory glucocoritocoids used by asthma patients (http://www.rtmagazine.com/). WEEK 8 1 & 2, the patient has no arterial blood gas result. Consequently, The patient with ph: 7.68 is classified as alkalosis (ph > 7.45). The patient with ph: 7.17 also is acidosis (ph < 7.35). Metabolic Acidosis occurs because serum PH decreased from 7.68 to 7.17. The patient’s PaCO2: 24 and paCO2: 30 show overventilation. Both patients having HCO3: 18 and HCO3: 14 are classified as metabolic acidosis cases. The patient having PaO2:73 increase to PaO2: 78 indicate patient has metabolic alkalosis. The patient with PaO2: 78 is normally oxygenating. He is a normal patient (http://www.fpnotebook.com/ ) 4. For patients with respiratory problems, an oxygen tank is placed inside the patient’s room to increase oxygen intake. 5. The patient generates a favorable respiratory care outcome after bringing an oxygen tank into the patients’ room for breathing purposes. For patients with no respiratory problems, no oxygen tank is needed to increase the patients’ breathing procedure. 6. There are several ways to stabilize the patients’ airway. Letting the patient use oxygen tank increases the patients’ oxygen intake. Bronchodilator and other drugs will enhance breathing. Antibiotics will cure asthma-causing infection of the respiratory tract. WEEK 9 1. There are different types of shocks. Anaphylactic shock is severe life-threatening reaction to a felt material. Cardiogenic shock is the heart’s failure to pump blood. Electric shock occurs when electricity touches human body. Hypoglycemic shock occurs from insulin overdose. Hypovolemic shock precipitates from hemorrhage. Irreversible shock cannot be remedied, resulting to possible death. Neurogenic shock is enlargement of the person’s blood vessel. Lung shock includes acute respiratory distress. Septic shock is triggered by massive infection. Traumatic shock is triggered by trauma. Infection triggers toxic shock (Bunker, 2007). 2. There is a treatment plan for dysrhythmia. Supraventricular dysrhythmias is not life –endangering. Sinus tachycardia answers best to adequate pain relief. Vagal tone increase reduces acute attacks. Atrial premature depolarization can e helped by quinidine, procainamide, anxiolytic drugs, and propranolol drug. Other drugs like procainamide, lidocaine, disopyramide, calcium channel blockers offer health relief to dysrhythmia (Bricker, 2001). 3. Throat culture to detect occurrence of streptococcal infection is standardized. The procedure includes swabbing the patients’ throat, inoculating a sheep agar dish, and using flamed wire loop (Fisher, 2004). 4. In terms of clinical manifestations, the nurse must educate patients’ family and friends of the intricacies of the patients’ illnesses (does and don’ts) for each shock type. Consequently, the family members can do their small share to accomplish healthcare goals and objectives related to patient healthcare recovery (Bunker, 2007). 5. Nursing interventions are required for cardiac rhythm abnormality. The nurse should inform the patient and the patient’s family and concerned persons of the patients’ current illness. Consequently, the nurse will inform the relatives of the does and don’ts of the patients’ current illness. For example, the patient informs the relatives that: sinus tachycardia includes fever, congestive heart failure, and inflammation (Conover, 2003); sinus Arrhythmia show irregular sinus rate; Sinus Bradycardia shows slow heart rate; (Baltazar, 2009); some Atrial flutter conditions indicate inadequate heart functions (Allen, 2007); Junctional dysrhythmias crop out of abnormal pacemaker cells or junctional tissues (Wyka, 2002); Idioventricular rhythms can crop up during 3rd degree heart block, myocardial ischemia, pacemaker malfunction, and other causes (Springhouse, Cardiovascular Care Made Incredibly Easy, 2008); ventricular tachycardia involves correction of cardia imbalances due to extracardiac influences (Murtaugh, 2002) ; Ventricular fibrillation focuses on coarse wave forms or rhythm where there are no P waves and deflection is in chaos (Huff, 2005); ventricular asystole is also called cardiac arrest and asystole occurs when electric activity is absent (Catalano, 2001). There are several causes of burn injuries. Cigarettes, firecrackers, lighted candles, LPG cooking gas, hot oil, microwave oven, and cooking are popular answer. To prevent burns, the fire-generating products should be stored away in a safe place. Cigarettes, firecrackers, sun, spilling hot liquid or coffee, playing with matches, and lighted candles should be store in fire safety locations. Carelessness contributes to burn injuries. Being careful in one’s acts or avoidance of acts can increase or decrease burn occurrences. 1. Classification of burn injuries include: 1st degree burn injury (sunburn), 2nd degree burn (spilling boiling water burn), 3rd degree burn and 4th degree burns (full thickness burns). Fire causes 4th degree burns (White, Foundations of Nursing, 2001). 2. There are local and systematic major burn injury effects. Burn patients may incur reduced lymphocytes, reduced T cells B cells, and killer cells, infection, and immunity dysfunction symptoms (Narayan, 2009). 3. There are three phases of burn care. The emergent phase contains stopping the burn priority. Stopping includes removing the burning object and running away from the burn site. The Acute phase allows the burn wound to heal from two to eighteen weeks. Lastly, the rehabilitation phase includes cosmetic grafting, long term physical, social, and Psychologic counseling . 4. The nurses’ role in the pain management health care service, pulmonary care, wound care, nutritional support, activity and joint motion, and psychological support focuses on encouraging the patient to fight for recuperation and for relatives to do their share in hastening the patients’ healing process (Basavanthappa, 2003). The nurse teaches the relatives the best way to enhance the patient’s recovery process. REFERENCES: Allen, H. (2007). Moss and Adam's Heart Disease. New York: Lippincott Williams & Wilkins. Arterial Blood Gas Calculation, retrieved September 20, 2012, from Aschenbrenner, D. (2008). 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