China
Africa
Explore chapters and articles related to this topic
Body fluids and electrolytes
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Elevated blood pressure and a bounding pulse may be present in hypervolaemia as stroke volume increases. The pulse should be palpated manually, and an ECG may show conduction disturbances, e.g., a long or short QT interval, dysarrhythmias or ectopics. Tachycardia or arrhythmias are usually the earliest sign of hypovolaemia but may also be associated with electrolyte disturbances such as hypokalaemia. Bradyarrhythmias may be present with hypercalcaemia. A bounding pulse may be felt in hypervolaemia, as the strength of the contraction of the left ventricle and the amount of blood it ejects increases, whereas a thready, weak pulse may indicate fluid volume deficit because of a reduced circulating blood volume. At the same time, the patient’s skin temperature should be assessed, e.g., is it cold and clammy, or hot and sweaty? The more dehydrated the patient is, the further up the limb the coolness will extend owing to compensatory vasoconstriction.
Diagnosis
Published in Anita Sharma, David Pitchforth, Gail Richards, Joyce Barclay, COPD in Primary Care, 2018
Anita Sharma, David Pitchforth, Gail Richards, Joyce Barclay
Bounding pulse (a sign of hypercapnia).Heart sounds often quiet.Loud second heart sound in pulmonary hypertension.
Approaches to acute care in the community
Published in Sue Chilton, Heather Bain, A Textbook of Community Nursing, 2017
While measuring the peripheral pulses it is important to assess the rate, rhythm and volume of the pulse. A bounding pulse could be indicative of sepsis while a faint pulse could be due to reduced cardiac output (Resuscitation Council, 2015).
The spectrum of missed lower limb clinical findings at a diabetes clinic in KwaZulu-Natal: red flags for costly complications
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2022
AT Thompson, S Pillay, C Aldous
Accurate, thorough testing and documentation are vital for the identification of risk. For example, as completed by the doctors on duty, some clinical records in this study indicated that pedal pulses were ‘weak’ or ‘strong’, based on manual palpation. Doppler ultrasonography of the same patients on the same day and within minutes of each examination showed that these recorded outcomes of manual palpation of pedal pulses showed little relationship to the actual Doppler ultrasonography. For example, a recorded ‘strong’ (palpated) pulse was frequently a stenotic ‘bounding’ pulse as indicated by the doppler waveforms. The 2017 SEMDSA guidelines6 state that: ‘At diagnosis and annually thereafter, a trained healthcare worker (podiatrist, nurse, doctor, community health worker) must examine patient’s feet without socks or bandages to determine risk status: Inspect for foot deformities, skin and nail abnormalities; Inspect footwear; Test sensation (monofilament, 128 Hz tuning fork or “touch the toe” and “Palpate dorsalis pedis and posterior tibial pulses”.’It may be suggested that these guidelines are inadequate in scope, as it has been shown that palpation is an unreliable method to inform on arterial flow or waveforms that require intervention in PLWD.7–16
Association between severe retinopathy of prematurity and postnatal weight gain in very low-birthweight infants at Chiang Mai University Hospital, Thailand
Published in Paediatrics and International Child Health, 2020
Ananya Wongnophirun, Varangthip Khuwuthyakorn, Watcharee Tantiprabha, Atchareeya Wiwatwongwana
SGA was diagnosed when birthweight was <10th percentile on Fenton’s growth chart [22]. Surfactant replacement was considered when a preterm infant had respiratory distress and required an oxygen concentration of >40% to maintain SpO2 at 90–94%. PDA was diagnosed by the presence of all the following: (i) respiratory distress; (ii) clinical signs of PDA: systolic ejection murmur at the left upper sternal border with wide pulse pressure or active precordium or bounding pulse; (iii) typical radiographic appearances including increased cardiothoracic ratio >0.6, increased perihilar vascular marking or haziness of both lungs’ parenchyma; (iv) with or without echocardiographic results. NEC was diagnosed on the basis of modified Bell’s staging criteria [23]. BPD was defined as persistent oxygen dependency up to 28 days of life, IVH and PVL were screened and recorded on the basis of the most extensive cranial ultrasonographic results and classified by Papile’s classification [24], sepsis was defined as a positive blood culture, and hypotension was defined as any systolic blood pressure <3rd percentile for age [25].
Oral indomethacin versus oral ibuprofen for treatment of patent ductus arteriosus: a randomised controlled study in very low-birthweight infants
Published in Paediatrics and International Child Health, 2018
Varangthip Khuwuthyakorn, Chuleeporn Jatuwattana, Suchaya Silvilairat, Watcharee Tantiprapha
After obtaining informed consent from parents, infants were enrolled who satisfied the inclusion criteria: (i) birthweight 500–1500 g, (ii) gestational age 24–32 weeks, (iii) postnatal age 1–30 days, and (iv) hsPDA confirmed by echocardiography. Echocardiography was undertaken in patients clinically suspected to have PDA which included two or more of the following: (i) heart murmur, (ii) active precordium, (iii) persistent tachycardia (>160 bpm), (iv) bounding pulse, (v) wide pulse pressure (systolic–diastolic BP ≥ 25 mm Hg) or (vi) inability to be weaned from mechanical ventilation or respiratory deterioration (conventional ventilation: peak inspiratory pressure [PIP]≥18 mm Hg and FiO2 ≥ 50%; high-frequency oscillation ventilation: mean arterial pressure [MAP]≥12 mm Hg and FiO2 ≥ 0.5 to maintain pH 7.25–7.35, PaCO2 45–55 mm Hg, SpO2 90–95%). If PDA was identified and its diameter was > 1.5 mm (or > 1.4 mm/kg) and/or left atrium to aorta (LA/AO) ratio was > 1.4, with left-to-right shunting [2,20], PDA closure with either IDC or IB was randomly initiated. Exclusion criteria were major congenital anomalies, life-threatening infection, hydrops fetalis, severe IVH, severe bleeding, urine output < 1.0 ml/kg/hr in the previous 8 h, impaired renal function with serum creatinine ≥ 159 μmol/L, BUN > 40 mg/dL, platelet count < 80,000/mm3 or a previous course of treatment with IDC or IB for PDA. Criteria for discontinuation of the treatment included GI perforation, severe GI bleeding and urine output < 0.5 ml/kg/hr over a 24-h period and serum creatinine > 159 μmol/L after receiving medication for 24 h.