This One

In: Other Topics

Submitted By jsterner876
Words 420
Pages 2
Chapter 21: Critical Thinking Exercise # 3

* What specific assessment findings indicate that an older patient being treated for congestive heart failure (CHF) is not responding to Digoxin, Furosemide (Lasix), or Vasodilator therapy?

A patient should have increased urine output from diuretic therapy; hypertension/BP should decrease as a result of the diuretic and vasodilator. Heart rate will lower in a patient taking digoxin. The patient should begin to see an improvement/return to baseline in their activity tolerance and ability to preform activities of daily living. Signs and symptoms of CHF (peripheral edema, dyspnea, fatigue, jugular venous distension, crackles, etc.) should begin to resolve. Daily intake and output should be monitored, any weight gain should be reported (greater than 3lbs in 48 hours), as the goal is to reduce fluid volume to improve cardiac output and tissue perfusion. Any increase in blood pressure, heart rate, edema, difficulty breathing, mentation changes, and weight gain indicate that therapy is not effective and that CHF is not resolving.

* How would you differentiate between expected, adverse, and toxic side effects? Digoxin is used to increase contractility, which would be decreased in a patient with CHF. Digoxin may cause; visual disturbances, headaches bradycardia, nausea, anorexia, muscle weakness, and dizziness. The therapeutic range with digoxin is very narrow (0.5-2.0 ng/mL), and is toxic in excess (assess for blind spot and irregular heartbeats/pulse). Potassium levels must be monitored for patients on digoxin because hypokalemia may result from use. Never give digoxin if the heart rate is below 60 BPM, digoxin may further reduce the rate leading to cardiac arrest. Furosemide (Lasix)/diuretic therapy is initiated with CHF to reduce preload (blood volume that returns to the heart) to increase cardiac…...

Similar Documents

Dont Read This One Lol

...diketahui faktor produk (X1) berpengaruh dominan dibandingkan dengan faktor harga (X2) dan distribusi (X3). Hal ini dapat dilihat dari nilai thitung , dimana nilai thitung untuk faktor produk adalah 5,893 lebih besar daripada nilai thitung untuk faktor harga (X2) dan distribusi (X3) berturut-turut adalah 3,719 dan 3,459. Kata kunci: Faktor Produk, Harga ,dan distribusi 1 Abstract Hamdani, influence factor product, pricing, and distribution to the retail trader's decision to buy chips chicken intestine on its Bintang Bersinar in Samarinda, under the guidance of Mrs. Hj.Rusmilawati as supervisor I and Mr. J.Kuleh as supervisor II. The research sample is the customers (retailers) in the company of Bintang Bersinar by 70 people. The purpose of this study was to find out whether the factor of the product, price and distribution have a significant impact on purchasing decisions and retailers to determine which factors were dominant influence a retailer's decision to buy the product on the company's chips intestinal Bintang Bersinar in Samarinda. The analysis tool used is multiple regression. Based on the F test is known that the value of 90.582 F count> F table 2.744 indicating that the product factor (X1), price (X2) and distribution (X3) significantly influence the retailer's decision to buy chips chicken intestine Bintang Bersinar in the company so that the hypothesis is accepted. Of these three factors, the unknown factor of the product (X1) dominant effect compared to......

Words: 3036 - Pages: 13

Outline One Contemporary Issue from the Social Approach and Discuss This Issue Using at Least 3 Concepts or Theories from This Approach

...reflect the search of high levels of emotional arousal after enduring long periods of boredom. The importance of this issue is demonstrated by the large number of incidents where several deaths have been the result of violence. One explanation for the occurrence of football hooliganism is the Frustration-Aggression theory (Freud and Dollard et al). Freud believed that when people get frustrated they displace it onto a scapegoat and not onto the source of the frustration. Dollard developed this by suggesting that frustration leads to aggression, which is what people displace onto another target. With relevance to football hooliganism, fans may become frustrated after either losing a game or watching poor play from players. Moreover, the fans are unable to relieve their aggression on the players themselves because they have legitimate power which prevents most people from expressing violence towards them. Therefore, they displace their aggression onto a scapegoat, which in this instance is the opposing team’s fans. A weakness of this theory is that Berkowitz showed that frustration does lead to aggression, but not specifically to prejudice. Thus there may be other factors involved such as pre-existing prejudice which is expressed more when frustration occurs. More importantly, the Frustration-Aggression theory does not explain why hooliganism occurs before matches because this is usually before supporters become frustrated. However, it could be that the football supporters......

Words: 806 - Pages: 4

Why This Raise Ia a Bad One

...Why this Salary Raise is a Bad Thing Introduction: Economics has been based on multiple theories throughout history, and one of the most popular has been the free market or laissez- faire theories. This theory is based on letting the economy grow on its own without government intervention. The laissez-faire theory is logical for several reasons including, supply and demand and competition. Traditionally, consumers will only pay the amount of value they perceive the product is worth. In the same vein, an employee will only work for a wage that he deems appropriate. If the employer lowers the wage, fewer workers will desire the job. These are a few of the reasons why the free market principle has many benefits. However, in a free market there can also be market failures. Market failures can arise from a multitude of situations such as pollution, or extreme low wages in areas of poverty. In a free market, a company could cause massive amounts of pollution and not have to bear the market cost of that pollution. The society as a whole, including people who do not benefit from the cheaper product, are the ones dealing with the polluted environment. Currently our government has been discussing a raise in the minimum wage. President Barack Obama is pushing for this bill and has many supporters. A rise in the minimum wage will be a major business issue for the next year and presidential election. Pros: Raising the minimum wage some enticing benefits to the American people......

Words: 1237 - Pages: 5

This One

...PESTLE Assessment PESTLE Assessment Political * Ability to get food to all regions, OCG sells to developing countries which may experience unstable government * Must follow guidelines to keep status as a charitable organization for ability to issue donation receipts, tax reductions, etc. | Economic * Gleaners rely on generous donations and surplus foods, which will be greatly affected by economic state * OCG provides food to countries that don’t have enough due to economic conditions * The Gleaners require agencies to have infrastructure to distribute the soup effectively | Social-Cultural * Volunteers are growing in numbers * Companies are more likely to try and improve corporate social responsibility * People feeling more responsible to help those in need | Technological * OCG has an innovative team that looks to improve operations with technological improvements * Different technologies available such as conveyer belts to avoid heavy lifting * Rely on technology for dehydrating the food and could benefit from more efficient/advanced methods | Legal * Laws are requiring that OCG become more accurate and thorough with their financial records | Environmental-Physical * The Gleaners need produce to be harvested in excess so they can receive surplus foods | SWOT Analysis SWOT Analysis Strengths Weaknesses * OCG has grown to be a recognized......

Words: 272 - Pages: 2

This One

...II. Description of Set-Up and Equipment to be used Figure II. The table top Setup The materials/equipment needed in this experiment are as follows: TABLE Table must has a flat surface because it will be the one who will serve as a ground in pitching, flicking or shooting the coins to its target area. YARDSTICK Yardstick will be fastened to the top of the table 24 inches from one edge. Refer to the figure above for the required measurement. It will be used also in measuring the coins that have been pitched, flicked or shooted by the specific workers. PENCIL Pencil will be used to draw the required lines on the top of the table such as 3 inches and 21 inches from the yardstick as shown in the figure above. TAPE The tape is used to attach the yardstick in the top of the table conside- ring the the required measurement in this experiment. TWENTY-FIVE CENTAVO COIN Each group must have atleast 10 pieces of twenty-five centavo coins per workers. The coins are the one who will be pitched, flicked or shooted from shot zone to the target area by the specific workers. STOPWATCH/TIMER The timer can be a stopwatch, cellphones or any devices that can measure time. It will be used to evaluate the overall time of the workers as he finished pitching, flicking or shooting the coins to its traget area. MICROSOFT EXCEL Microsoft Excel will be used to consolidate and compute all the data......

Words: 266 - Pages: 2

This Is the One

...temperature differences * Hot magma nearer the core rises and as it rises it begins to cool and sink. This causes tectonic plates to move * Volcanoes and earthquakes occur most where plate boundaries meet Why are some places more hazardous? Lithosphere * Study of outer layer of earths rigid surface – lithosphere * Lithosphere consists of large irregularly shaped plates that move relative to each other * Lithosphere rests on the asthenosphere which is hot a semi plastic * Convection currents in asthenosphere cause plates to move and this causes earthquakes where plates meet * Volcanoes occur at junction of plates or occasionally in middle. * 3 types of plate boundary. Constructive, Destructive and Conservative * Constructive Plate Boundaries – Earthquakes and Volcanoes * Constructive boundary – two plates move apart * Mantle is under pressure from plates above. They move apart and the pressure is released at the boundary * Release of pressure, causes mantle to melt – producing magma * Magma is less dense than the plate – rises and can erupt to form a volcano * E.g. Eurasian and North American Plate are moving apart at the mid-Atlantic ridge. Iceland has been formed where magma has risen through the gap to form volcanoes * Plates don’t move apart in a uniform way – some parts move faster than others – this causes pressure to build up and too much pressure means the plate cracks making a fault line and......

Words: 10391 - Pages: 42

This One

...Lorem ipsum dolor sit amet, consectetur adipiscing elit. Fusce et urna turpis. Nunc non sagittis lacus. Sed at ipsum nec nisi ornare consectetur. Aliquam sed sapien eros. In iaculis mi a risus maximus, ut ullamcorper risus posuere. Nulla a aliquet velit, lobortis volutpat enim. Pellentesque ultrices ipsum et tellus posuere, id rutrum neque vulputate. Cras nec sem nibh. Quisque mattis rutrum nulla, placerat elementum turpis. Suspendisse rhoncus condimentum sodales. Curabitur at eleifend mauris, non accumsan purus. Duis scelerisque pulvinar gravida. Cras at consectetur nisl. Nullam consequat sollicitudin dui et scelerisque. Pellentesque eleifend eget justo et imperdiet. Sed vel lacus at lorem malesuada laoreet eget id diam. In luctus mauris a velit eleifend tristique id ac tellus. Sed tempor tristique imperdiet. Morbi venenatis id turpis vel feugiat. Sed non lobortis risus, et volutpat augue. Nullam in tincidunt quam. Aliquam rhoncus, tortor ac congue posuere, turpis nunc consequat metus, sodales condimentum eros quam eget quam. Morbi ac neque semper, pellentesque turpis id, aliquet est. Vestibulum in fringilla libero. Praesent sed ornare mi. Aliquam at risus velit. Vestibulum vel eros a mi sagittis tristique. Nunc at consequat augue, maximus feugiat velit. Vestibulum elit urna, imperdiet sit amet aliquam sodales, vehicula in nisl. Duis luctus tortor vitae ante commodo, sit amet fringilla tortor convallis. Vivamus egestas augue purus, et dictum leo fermentum bibendum.......

Words: 1620 - Pages: 7

This One

...enthusiastic employees. It is interesting to note a recent trend whereby big corporates are trying to buy into this higher ideal, as seen in McDonald’s acquisition of socially responsible ice cream makers Ben and Jerry’s, and L’Oreal’s purchase of the Bodyshop. Early evidence suggests, however, that the social responsibility halo may already be slipping. At Ben & Jerry’s, for instance, a post-acquisition social audit revealed that only 45% of employees thought that senior management was taking the company’s social mission seriously. [2] 2. Strategy Strategy is the commercial logic for the company, and links purpose to behaviour in a rational way. If an organisation believes its purpose is to be an international leader in its field, it must have a strategy in place to: ‘define the business that the company is going to compete in, the position that the company plans to hold in that business, and the distinctive competence or competitive advantage that the company has or plans to create.’ [3] Campbell and Yeung give Marks and Spencer as an example of how an organisation’s strategy should link with its purpose. Marks and Spencer’s aim was to be the high street’s best value clothes retailer. At the time of the study, the company achieved this by demanding the highest quality merchandise from its suppliers, by providing very high levels of customer service, and combining this with low overheads as a result of high sales per square foot on the shop floor. 3. Behaviour......

Words: 1182 - Pages: 5

This Should Be One of the Last

...De La Torre, Pamela Z. 2015 – 46044 BA Behavioral Sciences This should be one of the Last Posts by females on social media platforms such as Facebook and Twitter which recount their experiences of men catcalling or inappropriately touching them and news articles on women exposing how they were physically abused and/or raped by colleagues or even high-profile men circulate and can be seen on our timelines and news feeds almost every day. Amidst these haunting cases are comments made by both men and women on how it was the female’s fault why she got raped or harassed in the first place and other posts about how women should dress and act so as not to get harassed or seen as “asking for it”. You have men thinking that it’s okay to say “hi ganda” or “miss beautiful, pahingi naman ng number mo” to ladies passing by because they don’t really get condemned for it as much as the girl who was wearing a short skirt when it happened. Such thinking exists that it’s okay to catcall women but it’s not okay for females to wear shorts on a hot day. Our own culture tolerates and even encourages sexual harassment by joking about it (Expanding the Anti-Sexual Harassment Law, n.d.) and society normalizes sexual violence committed by men (What is Rape Culture?, n.d.). This is rape culture, and it exists and prevails in the Philippines. Emilie Buchwald, co-author of the book Transforming a Rape Culture, defines the culture of rape as “a complex set of beliefs that encourages male sexual......

Words: 732 - Pages: 3

I Don't Have One at This Time.

...Nurse Education in Practice 13 (2013) e11 Contents lists available at SciVerse ScienceDirect Nurse Education in Practice journal homepage: Book review Healing Presence: the Essence of Nursing, JoEllen Koerner, sec- ond ed. Springer Publishing Company, New York (2011). The major premise in this thought provoking book is that nurs- ing is sacred work dedicated to the service of others, and requires a nurse’s deliberate commitment to inner spiritual growth to achieve a healing presence with patients. Healing presence de- scribes the feminine energy and receptivity part of nursing’s heri- tage, which offers limitless possibilities for a nurse’s self enhancement through an inward spiritual journey, the results of which, in turn, contribute to and facilitate a patient’s self healing. This book invites deep personal/professional reflection on the nurse, the nurse–patient relationship, and the profession’s future direction. Its step-by-step approach guides such reflection from a multi-cultural global perspective. An audience of experienced nurse clinicians and educators will discover practical application of healing presence’s evolutionary link to nursing science and art evident in the practical values guide, the professional development analysis and the leadership develop- ment analysis. In science, the nurse employs the ‘evaluator’ aspect of analytic thought; in art, the nurse ‘interprets’ abstract percep- tions and pattern recognition; and in......

Words: 589 - Pages: 3

Organizational Behavior - What Is Kaizen I Low Is This Different from a One-Step Leap Forward

...Answer Sheet of this Question paper, contact ARAVIND – 09901366442 – 09902787224 Organizational Behavior   Q1. Do you believe people are really getting smarter? Why or why not? Q2. Which of the factors explaining the Flynn Effect do you buy? Q3. Are there any societal advantages of disadvantages to the Flynn Effect? Q4. What performance problems is the captain trying to correct? Q5. Use the MARS model of individual behavior and performance to diagnose the possible causes of the unacceptable behavior. Q6. Has the captain considered all possible solutions to the problem? If not, what else might be done? Q7. Identify the stressors in John Breckenridge’s life. Which ones could he have prevented? Q8. What were the results of the stress? Would you consider these to be typical to stress situations and lifestyle choices John made, or was John Breckenridge unlucky? Q9. Assume you are a career coach retained by John Breckenridge to guide him through his next decisions. How would you recommend that John modify his lifestyle and behavior to reduce stress? Should he change jobs? Do you believe he is capable of reducing his stress alone? If not, where should he seek help? Q10. What type of team was formed here? Was it necessary, in your opinion? Q11. Use the team effectiveness model in Chapter 9 and related information in this chapter to identify the strengths and weaknesses of this team’s......

Words: 737 - Pages: 3

This One

...Crystal Hines Soc 11 Dr. Wright May 7, 2012 The Fire Next Time I am so happy that Dr.Wright assigned this book to read because it did (as she promised) changed my outlook on the society around me. Although it wasn’t the easiest read through all of Baldwin’s unconventional writing styles, I still managed to learn a great deal about myself and the world around me. I am sure there are many reasons for Baldwin to write an enlightening book such as this, but I believe that James Baldwin’s main purpose for writing The Fire Next Time was to make all people aware to true position and role of the black American in America. I believe his motives also included making his own racial community aware of how white America feels about them, and motivating blacks to spring into action to evoke change. James Baldwin also makes aware that blacks’ place and situation in America is by no means a mistake, and in fact crafted strategic mechanism to hold African Americans back productively as well as evolutionarily in the American world. Through Baldwin’s accounts with different races throughout his life Baldwin also gives a first hand account of the experiences blacks typically go through living in America. Reading Baldwin’s book The Fire Next Time was definitely a pleasure to read. Throughout the book as Baldwin discussed his life and time as a black man to have gone into the church as a minister, and later become a writer and activists, it was needless to say that I learned a number of......

Words: 1776 - Pages: 8

What Does This Contract Reveal to You About the Nature of Sharecropping? Was This System a Good One for Both the Sharecropper and the Landowner?

...What does this contract reveal to you about the nature of sharecropping? Was this system a good one for both the sharecropper and the landowner?  Explain.  I believe what the contract reveals about the nature of sharecropping is that it was set up to set the “freed” African American for failure and to put them in such debit that they basically became slaves to the landowner once again. The landowner has left a lot of responsibility to the sharecropper obviously I think a good example of this in this contract is that the landowner has agreed to provide the team but the sharecropper has to feed the team Saturday nights, and every other day morning night a day and if he fails to provide the meal he will then owe the landowner 5 cents, which was a lot of money at the time especially for a poor sharecropper. He also has to pay for his half of the manure which the landowner designates as enough of the crops. This system is so beneficial to the landowner but only allows the sharecropper enough to thrive to live. I don’t believe this system was good for both the sharecropper and the landowner. I believe as earlier stated it was one sided to the landowner. The sharecropper had a lot of responsibility while all the landowner did was provided the land and horses for the sharecropper and then reaped all the benefit finically. He got a low cost of labor and once the debit piled up from the landowners harsh expectations basically free labor out of this. This landowner even went as......

Words: 385 - Pages: 2

This Is the Math One

...v XACC/280Week-Seven CheckPoint Ratio, Vertical, and Horizontal Analyses Financial statement analysis is the process of examining relationships among financialstatement elements and making comparisons with relevant information. There are a variety of toolsused to evaluate the significance of financial statement data. Three of the commonly used tools are the ratio analysis, horizontal analysis, andvertical analysis. Ratio analysis is a method of analyzing data to determine the overall financial strength of a business. These ratios are most useful when compared to other ratios such as the comparable ratios of similar businesses or the historical trend of a single business over several business cycles.Horizontal analysis is a type of fundamental analysis in which certain financial data is used toasses a company's performance over a period of time. Horizontal analysis can be assessed on a singlecompany over a period of time, comparing the same items or ratios, or it can be performed on multiplecompanies in the same industry to assess a company's performance relative to competitors.Vertical analysis is a method of analyzing financial statements in which each item in thestatement is represented as a percentage of a single larger item. Vertical analysis makes comparisons between two or more companies in the same industry easier. It also allows a company to weigh......

Words: 317 - Pages: 2

This Is One of My Quizzes in Philhistory Subject.: )

...elections, we choose to vote the kind of people who are well known and very popular even though we are not aware if they are really ready to serve and make a change in our government system. Instead of selecting persons who are very much deserving of leading the people and persons who are capable of making or implementing bills that we opt for, public offices are now being the monopoly of action stars, super stars, pop idols or generally celebrities. Second idea of the author upon answering the question of about why Filipinos keep on electing unworthy leaders is “those who know better and should be criticizing the system, often become its cynical operators.” I also agree with the PDI about his second idea. It is that these persons who can be one of the best leaders we could have if ever they had been straight in their ways and right with their decisions; but worse comes worst, they went with the flow and made themselves naive with the things other politics do. They become hired as assistants of dim-witted officers. I am quite sure until now that they are still fighting over their own guilt feeling, trying to ease their conscience by believing that at least they could serve as positive influences to these officials. Last thought that I would like to expand from the article is “we remained fixated on the redemptive power of charismatic leaders to secure our future. In contrast, we have so little faith in ordinary people’s capacity to create the nation by their sustained......

Words: 554 - Pages: 3