Trendelenburg Position Essay

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Medical involvement included pharmacological intervention. An infusion of Sotalol 40mg was administered intravenously at approx 0930 over thirty minutes with continuous cardiac monitoring. Sotalol, an antiarrhythmic drug, depresses the sinus heart rate, decreases atrioventricular conduction, decreases cardiac output and decreases systolic and diastolic blood pressure (Bryant, Knights, & Salerno, 2003). As the patient was already hemodynamically compromised, a bolus of fluid (Gelofusion 500mls) was administered prior to the Sotalol infusion. The aim was to increase the circulating volume and raise blood pressure. Vital signs remained stable during the infusion, however the heart rate was neither converted to sinus rhythm or reduced to a normal rate.

The start position will consist of moving the arms up to block the face requiring flexion of the elbows at a little less than a 45o angle, the flexion of the elbow takes place with the mediolateral axis along a sagittal plane (2). This will ensure the protection of the

hypertension. Therapeutic hypothermia (THT) has been considered an effective method for reducing ischemic injury of the brain due to cardiac arrest. But there are some opponents in the medical community who believe that broadening the scope of THT could be dangerous to patients. Although opponents do not seem to blame THT for adverse patient outcomes; the disagreement seems to be about the variables involved before hospital arrival, amount of time that it takes to administer THT in the ER, which therapies should be administered with THT and the need for more research that tracks adverse events. A study published by The American Journal of Emergency Medicine supports the widely held view that THT is an effective treatment for cardiac arrest

The use of restraints is seen in the Emergency Department(ED) on a regular bases and has been a new experience to myself as a student nurse. The College of Nurses of Ontario Restraints Practice Standard (2009) explains restraints may be used where patient are at risk to themselves or others, for treatment purposes and controlling behaviours. Restraints may be chemical, physical or environmental. Restraints have limited increase in patient safety and can increase the agitation, confusion and health risks present. In the emergency department majority of bed rails are kept in the up position regardless of the patients’ mental, physical or emotional state. A bed rail is considered an environmental restraint and therefore should be kept in the down

These procedures are not reported alone but as add-on codes used to identify extraordinary conditions of patients and their unusual risk factors. There are four kinds of certain codes used for particular circumstances which are: 1) Anesthesia for the age younger than one year and over the age of seventy (99100), 2) Anesthesia complicated by the utilization of total body hypothermia (99116), 3) Anesthesia complicated by the utilization of controlled hypotension (99135) and 4)Anesthesia complicated by emergency circumstances

Turing and repositioning will avoid pressure from being exerted on one spot for too long (Miles, Nowicki, and Fulbrook, 2013). The nurse will also implement safety measures to prevent falling such as keeping the bed in the lowest position and hourly rounding (Crawford and Harris, 2016). The last priority nursing intervention for this patient is to get a set of vital signs before and after physical activity and prevent orthostatic hypotension. The patient can prevent orthostatic hypotension by adequate fluid intake, slow position changes and dangling the feet off the side of the bed before standing up (L. Schimke, J. Schimke,

Therapeutic hypothermia can save lives, as well as maintain neurological proficiency. The risks however are ever-present. The possibility of developing a cardiac arrhythmia is very possible. The fact is however that the majority of cardiac arrhythmias do not present immediate or life threatening dangers. It is possible, yet uncommon, for the arrhythmia to pose serious effects on the circulatory system, and therefore seeing as this is the most common problem that s caused by the use of therapeutic hypothermia, when weighed against the possibility of preserving neurological function and or saving a life, the benefits can potentially often outweigh the risks. Though there are other, more serious problems that can arise due to the use of this treatment, they are far less common, and or

Early hemodynamic assessment on the basis of physical findings, vital signs, central venous pressure, and urinary output fails to detect persistent global tissue hypoxia. A more definitive resuscitation strategy involves goal-oriented manipulation of cardiac preload, afterload, and contractility to achieve a balance between systemic oxygen delivery and oxygen demand. End points used to confirm the achievement of such a balance (hereafter called resuscitation end points) include normalized values for mixed venous oxygen saturation, arterial lactate concentration, base deficit, and pH. Mixed venous oxygen saturation has been shown to be a surrogate for the cardiac index as a target for hemodynamic therapy. In cases in which the insertion of a pulmonary-artery catheter is impractical, venous oxygen saturation can be measured in the central circulation (p. 1368).

Compensatory Approach: Prevent further deformation of the ulnar drift with swan neck deformities to maintain client’s present ROM in B (UE).

Six standing trials include 1) single dominant leg stance on a firm surface (SDFS), 2) single non-dominant leg stance on a firm surface (SNDFS), 3) double leg stance on a firm surface (DFS), 4) single dominant leg stance on a wobble board (SDWB), 5) single non-dominant leg stance on a wobble board (SNDWB), and 6) double leg stance on a wobble board (DWB). The order of the standing trials will be randomized. A two minute testing period will be recorded for each standing condition. During testing, participants will be instructed to position barefoot with the hands akimbo for as still as possible for both a firm surface and a wobble board conditions. During all one leg stance trials, participants will be instructed to flex the knee of the contralateral

Anticipatory posture Is Win the body starts to fire a postural muscles as a foregrip response to potential and balance. This is an important thing to study so we can understand how it works and to know how it correctly operates to help people who have issues with this. The purpose of this lab is to observe data collected for multiple subjects in order to understand how posture works. Predicted outcomes of this lab include a lower amount of time taken for the anticipatory response to act compare two motor time

The patient should be seated with the feet flat on the floor. The BP is obtained in both arms,

The prevalence of orthostatic hypotension is around 5% - 30% among institutionalized patients. (Tilvis et al., 1996)(Rutan et al., 1992)(Masaki et al., 1998) The differences in these estimates varies due to a number of factors such as definition of orthostatic hypotension, composition of the population, the segment of the

position, then their blood pressure would ne higher than when it was measured from the reclined