Case Study: The Efficacy Of Day Surgery

Homeostasis is what allows our internal system to maintain at a constant condition. In order to maintain equilibrium the body must communicate using the control system. It is essential that the body monitors its conditions whether that be blood pressure, thirst sensation or body temperature (this is either gained or lost). Negative feedback is most important and comes first, this allows for the body to correct itself and get back to a set point when it is off track. There are three components that link with this feedback. A sensor (receptor) sends signals to the control center that something is unusual, the control center compares the many values of our normal body range and decides

The work of Burke, et al (2011) reports that a study with the objective of comparing the "efficacy of intradermal bacteriostatic normal saline with that of intradermal buffered lidocaine in providing local anesthesia to adult patients prior to IV catheterization." (p.1) The study concluded that intradermal buffered lidocaine was superior to intradermal bacteriostatic normal saline in providing local anesthesia prior to IV catheterization in this group of predominately white adults and should be the solution of choice for venipuncture pretreatment." (Burke, et al, 2011, p.1) Burke et al reports that surgery is something that most people fear with the fear of the unknown is combined with "apprehension about such anticipated procedures as insertion of an IV line." (2011, p.1) Burke additionally reports that patients admitted for same-day surgery "require IV access. Any venipuncture, including peripheral IV catheterization with a medium-to-large-gauge catheter, can cause some degree of pain. Using local anesthesia prior to IV catheterization has

As Jim’s muscles are at maximum demand, his mitochondria are unable to produce the needed ATP through aerobic respiration because oxygen is unable to diffuse fast enough into his muscle fibers. At this time anaerobic

There are several body systems, for example the digestive system, the respiratory system and cardiovascular system. I am going to look at the respiratory and cardiovascular systems. They are important because they help people grow, reproduce and maintain life. The body system needs energy for it to function. Our body gets energy from digesting food and using it in the respiration process.

The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety

There are two different types of anesthesia; which are local and general. Preoperative services, administration, post-op and monitoring is included in the anesthesia package. Codes for anesthesia codes are simpler that codes for surgery. Qualifying circumstances recognizes four conditions. (99100) which indicates younger than a one year old or older than a 70-year-old, (99116) entire body hyperthermia, (99135) hypotension under control, (99140) situations that are emergency. Anesthesia payment formula is base + time +modifying units x conversion.

According to surveys, up to 80% of patients reported moderate to severe post-surgical pain, which can sometimes be left undertreated (Sinatra et al., 2005). Postoperative pain is generally managed with opioids, which carry numerous side effects. Side effects can be bothersome and possibly cause a delay in the postoperative healing process (Beard, Leslie, & Nemeth, 2011). IV acetaminophen can possibly decrease opioid consumption, minimize side effects, increase patient satisfaction, and decrease costs (Wininger et al., 2010). The purpose of this paper is to dive further into the research to present data on the effectiveness of IV acetaminophen in decreasing opioid usage and whether it produces an additive effect causing more effective pain management in the postop patient.

I have written to you today to express my sincere interest in joining the Veteran Affairs San Diego accredited Postgraduate Year 1 (PGY1) residency program. I recently had the distinct pleasure of getting to learn more about your program at California Society of Health- System Pharmacists (CSHP). I came away impressed with the opportunities offered at VA San Diego pharmacy residency program.

The Nerve tissue is a group of cells which react to, many different types of stimuli. They transmit messages throughout the body which can include things such as temperature, pain, and pressure.

Postoperative surgical pain can often be moderate to severe leaving the client in a state of discomfort that requires the administration of opioid analgesic medications. Morphine intravenous (IV) patient-controlled analgesia (PCA) is commonly provided through a pump to treat postoperative surgical pain, but with advances in the medication administration field, a fentanyl iontophoretic transdermal system (ITS) has become another popular method (Lindley, Pestano, & Gargiulo, 2009). Morphine and fentanyl are similar medications in that they are both opioid analgesics and are both equally effective to reduce pain, but they offer differences through their administration techniques, comfort for the client, and providing care in a timely manner by the nurse. The nurse must take into consideration these differences to choose the proper medication for their specific client.

The main ar-gument of the article is that neuropathic pain is challenging to manage and is a signifi-cant burden on society. The authors highlight how intrathecal drug delivery can be an alternate intervention for neuropathic pain when other methods of treatment fail to re-lieve symptoms. The topics covered in the article are the various medications used to manage neuropathic pain such as opioids, alpha-2 adrenergic agonists, calcium channel blockers, gamma-aminobutyric acid agonists, local anaesthetics, and corticosteroids. Ev-idence shows that intrathecal opioids may provide long term benefits for neuropathic pain, with other medications such as baclofen, ziconotide, bupivacaine, clonidine also showing moderate evidence of effective management of neuropathic

Psychosis is a mental illness that may be related to other mental health issues. This condition is triggered by drugs of abuse, alcoholism and several disease conditions. This suggest that numerous pathological devices within the brain are shared by individuals affected by these conditions. One of the pathological features of psychosis is hallucination which may involve seeing, hearing, smelling or tasting something that is not present. Another pathological feature is delusional thinking or believing something that is not real or true. Delusions may manifest and display in two forms, paranoid delusions or delusions of grandeur.

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).

This feature also enables the use of this technique into the postoperative period for analgesia, using lower concentrations of local anaesthetic drugs or in combination with different agents.

Therefore, the prudent approach for the anesthetist would be to plan for a rapid sequence induction, using a short-acting muscle relaxant such as succinylcholine. The patient’s clinical picture indicates that there is still some occult bleeding and she remains hypotensive despite resuscitation. Therefore, versed, propofol, and large amounts of inhalational agent should be avoided. Small doses of versed can worsen hypotension. Inhalational agent such as Desflurane or Sevoflurane should be kept to less than 1 MAC. Opioids, ketamine and etomidate in decreased doses are better choices when attempting to optimize intubating conditions. According to Barash (2013), metabolic disturbances in the acute trauma patient cannot reliably prevent recall. However, scopolamine, (0.6 mg), and midazolam, if the patient can tolerate it, given before airway management may decrease the likelihood of this complication. Intraoperative use of the bispectral index (BIS) monitor and, whenever possible, titrating anesthetics to bispectral bispectral index levels < 60 may prevent recall in trauma