Oxytrol

By T. Vatras. Pickering University.

If there is standing of the conceptual constructs of Self-Care nursing buy oxytrol 2.5mg cheap, nursing agency is developed and opera- Deficit Nursing Theory and for understanding the tional buy generic oxytrol 5 mg on line. If there is self-care on the part of individu- interpersonal and societal aspects of nursing sys- als, self-care agency is developed and operational. The five views are summarized as follows: The agent view incorporates not only discrete de- liberate actions to achieve foreseen results and the The view of person. Individual human beings are structure of processes to do so, but also the powers viewed as embodied persons with inherent and capabilities of persons who are the agents or rights that become sustained public rights who actors. The internal structure, the constitution, and live in coexistence with other persons. A mature the nature of the powers of nursing agency and self- human being “is at once a self and a person with care agency are content elements of nursing sci- a distinctive I and me... The structure of the processes of designing viable rights and able to possess changes and and producing nursing and self-care is also nursing pluralities without endangering his [or her] science content. Individual human beings are tial in understanding the nature of interpersonal viewed as persons who can bring about condi- systems of interaction and communication be- tions that do not presently exist in humans or in tween nurses and persons who seek and receive their environmental situations by deliberately nursing. The age and developmental state, culture, acting using valid means or technologies to and experiences of persons receiving nursing care bring about foreseen and desired results. The beings are viewed as persons who use symbols ability of nurses to be with and communicate effec- to stand for things and attach meaning to them, tively with persons receiving care and with their to formulate and express ideas, and to com- families incorporates the use of meaningful lan- municate ideas and information to others guage and other forms of communication, knowl- through language and other means of commu- edge of appropriate social-cultural practices, nication. Individuals are viewed as uni- what persons receiving care are endeavoring to tary living beings who grow and develop ex- communicate. Nurses also has been a handicap in nurses’ communications may need to help individuals under nursing care to about nursing to the public as well as to persons take these views about themselves. They know that they have rights as persons and as They are embodied persons, and nurses must be nurses and that they must defend and safeguard knowing about their biological and psychobiologi- these personal and professional rights; their powers cal features. Viewing human beings as organisms of nursing agency must be adequate to fulfill re- brings into focus the internal structure, the consti- sponsibilities to meet nursing requirements of per- tution and nature of those human features that are sons under their care; they must know their the foci of the life sciences. Knowing human beings deficiencies, act to overcome them, or secure help as agents or users of symbols has foundations in bi- to make up for them; they must be protective of ology and psychology. Understanding human or- their own biological well-being and act to safeguard ganic functioning, including its aberrations, themselves from harmful environmental forces. Taking the object view carries with it a re- quirement for protective care of persons subject to The previously described nursing-specific views of such forces. The features of protective care are un- individual human beings are necessary for under- derstood in terms of impending or existent envi- standing and identifying (1) when and why indi- ronmental forces and known incapacities of viduals need and can be helped through nursing; individuals to manage and defend themselves in and (2) the structure of the processes through their environments, as well as in the nursing- which the help needed is determined and pro- specific views of individuals that nurses take in duced. These broad views point to the sciences Such knowing is foundational to model making and disciplines of knowledge that nurses must be and theory development in nursing. For example, knowing in, and have some mastery of, in order to Louise Hartnett-Rauckhorst (1968) developed be effective practitioners of nursing. Establishing models to make explicit what is involved physiolog- the linkages of nursing-specific views of human be- ically and psychologically in voluntary, deliberate ings to the named broader views is a task of nurs- human action, including motor behaviors. Orem’s Self-Care Deficit Nursing Theory 147 • A basic psychological model of action with three of self-care agency, a process with a specified submodels: structure. The first model, self-care operations, is The personal frame of reference of the basic modeled on deliberate action. The study of these and other general theoretical Models of categories of constituent care requisites models of deliberate action stimulated some mem- within the demand (universal, developmental, and bers of the Nursing Development Conference health deviation types) were developed as well as a Group to investigate and formalize the conceptual model to show the constituent content elements of structure of self-care agency, conceptualizing it as a therapeutic self-care demand and their derivation the developed power to engage in a specific kind of (Orem, 1995). The goal of these efforts was the ements of an action system to meet a specific self- construction of models to identify types of relevant care requisite particularized for an individual was information and to aid in the development of tech- developed as an example of what actions must be niques for collection and analysis of data about performed to meet each of the self-care requisites self-care agency. A model of self-care operations, and estimative, the conceptual entity therapeutic self-care demand. The therapeutic self- volved with and enabling for performance of care demand models represent what is to be known self-care operations. A model of human capabilities and dispositions self-care agency or met for them when required by foundational for: reason of self-care agency limitations. The models are offered as a means toward un- The adequacy of the theories should be ex- derstanding the reality of the named entities in plored. Despite the di- to be general models of nursing can be versity of these models, they are all directed toward adequate or deficient in their scope as related knowing the structure of the processes that are op- to expressing why people need and can be erational or become operational in the production helped through nursing or in describing of nursing systems, systems of care for individuals and explaining the structure of nursing or for dependent-care units or multiperson units processes. In any practice field, a general model or For information about models and scientific theory incorporates not only the what and growth involving development of knowledge in in- the why, but also the who and the how. The dividual scientists, see Wallace (1983) and Harré adequacy of a general theory comes into (1970). Black’s Models and Metaphors (1962) was question when there is omission of any one the source first used by the writer.

A stimulus changes the specific permeability of the fiber membrane and causes a depolarization due to a reshuffling of the cations and anions buy generic oxytrol 5mg line. It’s called an all-or-none response because each neuron has a specific threshold of excitation purchase oxytrol 2.5 mg online. After depolarization, repolarization occurs followed by a refractory period, during which no further impulses occur, even if the stimuli’s intensity increases. Intensity of sensation, however, depends on the frequency with which one nerve impulse follows another and the rate at which the impulse travels. That rate is deter- mined by the diameter of the impacted fiber and tends to be more rapid in large nerve fibers. The cyto- plasm of the axon or nerve fiber is electrically conductive and the myelin decreases the capacitance to prevent charge leakage through the membrane. Depolarization at one node of Ranvier is sufficient to trigger regeneration of the voltage at the next node. Therefore, in myelinated nerve fibers the action potential does not move as a wave but recurs at successive nodes, traveling faster than in nonmyelinated fibers. This is referred to as saltatory conduction (from the Latin word saltare, which means “to hop or leap”). Chapter 15: Feeling Jumpy: The Nervous System 241 Synapses Neurons don’t touch, which means that when a nerve impulse reaches the end of a neuron, it needs to cross a gap to the next neuron or to the gland or muscle cell for which the message is intended. An electric synapse — generally found in organs and glial cells — uses channels known as gap junc- tions to permit direct transmission of signals between neurons. But in other parts of the body, chemical changes occur to let the impulse make the leap. The end branches of an axon each form a terminal knob or bulb called a bouton terminal (that first word’s pro- nounced boo-taw), beyond which there is a space between it and the next nerve path- way. Synaptic vesicles in the knob release a transmitter called acetylcholine that flows across the gap and increases the permeability of the next cell mem- brane in the chain. An enzyme called cholinesterase breaks the transmitter down into acetyl and choline, which then diffuse back across the gap. An enzyme called choline acetylase in the synaptic vesicles reunites the acetyl and choline, prepping the bouton terminal to do its job again when the next impulse rolls through. Capacity to record, store, and relate information to be used to determine future action 6. The terminal structure of the cytoplasmic projection of the neuron cannot be a(n) a. Contains storage vesicles for excitatory chemical Minding the Central Nervous System and the Brain Together, the brain and spinal cord make up the central nervous system. The spinal cord, which forms very early in the embryonic spinal canal, extends down into the tail portion of the vertebral column. But because bone grows much faster than nerve tissue, the end of the cord soon is too short to extend into the lowest reaches of the spinal canal. In an adult, the 18-inch spinal cord ends between the first and second lumbar vertebrae, roughly where the last ribs attach. The cord continues as separate strands below that point and is referred to as the cauda equina (horse tail). A thread of fibrous tissue called the filum terminale extends to the base of the coccyx (tailbone) and is attached by the coccygeal ligament. Part V: Mission Control: All Systems Go 244 Spinal cord An oval-shaped cylinder with two deep grooves running its length at the back and the front, the spinal cord doesn’t fill the spinal cavity by itself. Also packed inside are the meninges, cerebrospinal fluid, a cushion of fat, and various blood vessels. Three membranes called meninges envelop the central nervous system, separating it from the bony cavities. The dura mater, the outer layer, is the hardest, toughest, and most fibrous layer and is composed of white collagenous and yellow elastic fibers. The arachnoid, or middle membrane, forms a web-like layer just inside the dura mater. The pia mater, a thin inner membrane, lies close along the surface of the central nerv- ous system. The pia mater and arachnoid may adhere to each other and are considered as one, called pia-arachnoid. There are spaces or cavities between the pia mater and the arachnoid where major regions join, for instance where the medulla oblongata and the cerebellum join. Spaces or cavities between the arachnoid layer and the dura mater layer are referred to as subdural. Two types of solid material make up the inside of the cord, which you can see in Figure 15-2: gray matter (which is indeed grayish in color) containing unmyelinated neurons, dendrites, cell bodies, and neuroglia; and white matter, so-called because of the whitish tint of its myelinated nerve fibers. At the cord’s midsection is a small central canal surrounded first by gray matter in the shape of the letter H and then by white matter, which fills in the areas around the H pattern. The legs of the H are called anterior, posterior, and lateral horns of gray matter, or gray columns. Posterior (dorsal) Lateral white column root of spinal nerve Posterior (dorsal) Posterior gray horn root ganglion Posterior median sulcus Spinal nerve Posterior white column Anterior (ventral) root of spinal nerve Gray commissure Central canal Axon of sensory neuron Figure 15-2: A cross- Anterior gray horn Cell body of sensory neuron section of Anterior white column Lateral gray horn the spinal Anterior white cord, show- commissure Dendrite of sensory neuron ing spinal Cell body of motor neuron nerve con- nections.

Patients who are taking antidiabetic medication may see an increase in the level of that medication when taken with chloramphenicol resulting in hypo- glycemia 5 mg oxytrol with visa. Therefore buy oxytrol 2.5 mg on line, diabetics who take chloramphenicol must closely monitor their blood glucose level. Chloramphenicol also causes a decrease in the therapeutic effect of clin- damycin, erythromycin, or lincomycin. Chloramphenicol increases the drug serum levels of phenobarbital (Luminal), phenytoin (Dilantin), or warfarin (Coumadin) which can lead to toxicity. Chloramphenicol, Nursing Diagnosis, and Collaborative Problems Patients who take chloramphenicol may also experience rash, fever, and dysp- nea. Here are the common nursing diagnoses that are related to a patient who is taking chloramphenicol. Make sure that the patient doesn’t have an allergic reaction to any fluoro- quinolone. If they are allergic to one drug within the fluoroquinolone family, then they are highly likely to be allergic to other fluoroquinolone medications. Patients who take fluoroquinolones can, in rare cases, experience dizziness, drowsiness, restlessness, stomach distress, diarrhea, nausea and vomiting, psy- chosis, confusion, hallucinations, tremors, hypersensitivity, and interstitial nephritis (kidney). The dose of fluoroquinolones should be lowered in patients with hepatic (liver) or renal (kidney) problems. Administer fluoroquinolones with a full glass of water to minimize the pos- sibility of crystalluria. Ofloxacin, a member of the fluoroquinolones family, must be infused into a large vein over 60 minutes to minimize discomfort and venous irritation. The patient should be provided with the same instructions as those given to a patient who is receiving penicillin (see Penicillin and Patient Education). Tell the patient to report blurry or double vision, sensitivity to light, dizziness, light- headedness, or depression. If fluoroquinolones are self administered, tell the patient to avoid taking the drug within two hours of taking an antacid. Patients who are taking theophylline or other xanthines with fluoro- quinolones should be aware that the theophylline plasma levels can rise lead- ing to toxicity. If the patient takes fluoroquinolones while also taking warfarin, the anticoag- ulant effect of warfarin increases and could result in bleeding. Fluoroquinolones, Nursing Diagnosis, and Collaborative Problems Patients who receive fluoroquinolones may also experience rash, fever, dyspnea, nephritis, blood in the urine, lower back pain, rash, edema, and photosensitivity (increased sensitivity of skin to sunlight). Here are the common nursing diagnoses that are the related to a patient who is receiving fluoroquinolones. Time: q8h Protein-Binding: 20% Half-Life: 1 h Pregnancy Category: C Side Effects: pseudomembranous colitis, hypersensitivity, diarrhea, nausea, vomiting, headache, and rash Drug interaction: None Contraindications: Use with caution with clients with allergy to imipenem, cilastin or other beta-lactams. They also should abstain from cola, alcohol, choco- late, and spices which irritate the bladder. Sulfonamides may adversely affect the level of some medications causing a toxic effect. Avoid using sulfonamides with anticoagulants such as coumarin or indanedione derivatives and anticonvulsants (hydantoin) as well as oral anti- diabetic agents and methotrexate. Patients need at least 3000 mL of fluid each day in order to flush the urinary tract and follow good hygiene to reduce the likelihood of acquiring the infec- tion again. Patients should avoid the use of antacids while taking sulfonamides because antacids decrease the absorption of sulfonamides. Tuberculosis Tuberculosis is caused by acid-fast bacillus Mycobacterium tuberculosis. The incidence had decreased in the United States but increased again in the 1980s. The conditions may be mild such as tinea pedis (ahtlete’s foot), or severe as in pulmonary conditions or meningitis. Candidiasis might be an opportunistic infection when the defense mechanisms are impaired. Antibiotics, oral contraceptives, and immuno- suppressives may alter the body’s defense mechanisms. Infections can be mild (vaginal yeast infection) or severe (systemic fungal infection). Polyenes such as amphotericin B are the drug of choice for treating severe systemic infections. It is effective against numerous diseases including histo- plasmosis, cryptococcosis, coccidioidomycosis, aspergillosis, blastomycosis, and candidiasis (system infection), however, it is very toxic. Side effects and adverse reactions include flushing, fever, chills, nausea, vomiting, hypotension, paresthesias, and thrombophlebitis. It is highly toxic, causes nephrotoxicity and electrolyte imbalance, especially hypokalemia (low potassium) and hypomagnesemia (low serum magnesium).

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