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Transitioning the Nutritional Support Patient to Homecare
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Although early forms of HPN were given continuously, most patients today receive HPN as a cycled, overnight infusion. This permits the patient to disconnect from the IV for an extended period of time. This method allows for freedom of movement to perform tasks in the home, return to work or school and participate in leisure activities. This is an important factor in the quality of life (QOL) for an HPN patient. Therefore, cycled infusions should be considered whenever possible in HPN management.
Overview of Therapeutic Biomarkers in Cancer
Published in Sherry X. Yang, Janet E. Dancey, Handbook of Therapeutic Biomarkers in Cancer, 2021
Sherry X. Yang, Janet E. Dancey Treatment
Therapeutic biomarkers in clinical practice or have potential for clinical utility can be classified according to their applications (Table 1.2). They are exploited to identify responders and nonresponders to a treatment and adjust the dosage of drugs to optimize their efficacy and safety. The biomarkers can be classified as (i) clinical benefit or response, (ii) resistance to treatment, (iii) risk for cancer recurrence, and (iv) risk for adverse reactions or dosage and administration guidance. Therapy is categorized into four major ones: (i) molecularly targeted or genotype-directed therapy, (ii) immunotherapy, (iii) chemotherapy or radiotherapy, and (iv) combinations of immunotherapy or targeted therapeutics with chemotherapy. These will be introduced in greater detail in the following sections.
The patient with acute cardiovascular problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Fluids that may be given to patients by intravenous (IV) infusion may be: Isotonic (having the same concentrations as body cells).Hypertonic (having a higher concentration than body cells)Hypotonic (having a lower concentration than body cells).
Prehospital Fluid Administration for Suspected Sepsis in a Large EMS System: Opportunities to Improve Goal Fluid Delivery
Published in Prehospital Emergency Care, 2023
Nathaniel S. Miller, Mehul D. Patel, Jefferson G. Williams, Michael W. Bachman, Julianne M. Cyr, José G. Cabañas, Jane H. Brice
A suspected sepsis protocol was established at Wake County EMS in 2016 to direct prehospital screening and treatment of suspected sepsis patients (see online Appendix, supplementary materials). The adult sepsis protocol uses a sepsis screening tool that is a hybrid of variables from systemic inflammatory response syndrome (SIRS) and quick sequential organ failure assessment (qSOFA) criteria (21), as well as signs of poor perfusion. A patient screens positive if he or she has a suspected source of infection and at least one of the following: systolic blood pressure (SBP) <90 mmHg, heart rate (HR) >90/min, respiratory rate (RR) >20/min, Glasgow Coma Scale (GCS) score <15, or body temperature ≥100.4 °F or <96 °F. If a patient screens positive for sepsis, the treatment protocol recommends a 500 mL normal saline bolus that can be repeated up to a total of 2 L. The protocol allows the paramedic to administer fluids by IV or the intraosseous (IO) route. Fluid administration by IO in this patient population in this EMS system is rare. Therefore, this study focused on IV fluid administration. If the patient has two consecutive end-tidal CO2 (EtCO2) readings of < 26 mmHg at least 5 minutes apart at any point during the patient encounter, then a sepsis alert notification is given to the receiving facility prior to arrival.
Mechanical and Histological Characteristics of Phasix™ ST Mesh in a Porcine Model of Hernia Repair
Published in Journal of Investigative Surgery, 2022
Corey R. Deeken, Darcy H. Gagne, Amit Badhwar
Animals were not offered their daily food ration prior to surgical induction to decrease the chances of perioperative regurgitation. Water was not restricted. Daily food ration was provided upon recovery from anesthesia; thus, no daily food ration was omitted. On the morning of surgery, Carprofen (∼2.2 mg/kg, oral [PO]) was administered. Telazol® (4–6 mg/kg, intramuscular [IM]) was administered as a pre-anesthetic. Isoflurane anesthesia (delivered in 100% oxygen) was administered to effect via mask/nosecone until the animals were in a plane of anesthesia that facilitated endotracheal intubation. Once sufficiently anesthetized, the animals were intubated and maintained with isoflurane inhalant anesthetic to effect for the remainder of the surgical procedure. An intravenous (IV) catheter was placed in a peripheral vein for administration of supportive IV fluids. Preemptive buprenorphine therapy (0.03 mg/kg, IM) was administered; additionally, antibiotic therapy (Ceftiofur [5 mg/kg, IM] and Excede® [5 mg/kg, IM]) was administered at time of anesthesia, prior to surgical incision. An ophthalmic lubricant was applied to the eyes. The animals were prepared for surgery using accepted veterinary care standards. The hair was shaved from the abdominal region, and the animal was placed in dorsal recumbency. Supportive fluids (Lactated Ringer’s Solution) were administered, and the fluid volume was documented in the animal’s record. Warm water heating pads and/or other warming devices were used to maintain adequate body temperature while under anesthesia. The animals were prepared and appropriately draped for aseptic procedures.
The effectiveness of a non-tourniquet procedure on peripheral intravenous catheterization in older patients: A pilot study
Published in Contemporary Nurse, 2020
Funda Büyükyılmaz, Merdiye Şendir, Betül Kuş, Hacer Yaman Güçlü
Medication administration is a basic nursing intervention that involves skillful technique and consideration of the patient’s development, health status, and safety (Taylor et al., 2015). Intravenous (IV) medicines are often used to replace the loss of fluid and electrolytes, give blood or blood elements, give irritant drugs (especially for digestive system), or adjust the acid–base balance. To achieve these application goals, patients are often IV treatment (Potter & Perry, 2009; Taylor et al., 2015). Nurses administer medications intravenously by several methods, including large-volume infusions, IV bolus, and volume-controlled infusions (Potter & Perry, 2009). To perform these tasks, health care professionals especially registered nurses (RN) insert peripheral intravenous catheters (PIVCs) into patients’ veins. A key point in this process is the assessment of the patient (e.g. age, body structure, or skin status) before inserting a PIVC.