The assgnment symptoms -include a 3 paper that is to be typed on the following:
ID: 124881 • Letter: T
Question
The assgnment symptoms -include a 3 paper that is to be typed on the following:
1. Extrapyramidal symptoms - include all symptoms and how the patient presents with each symptom and the interevntions available for each symptom. which meds are most problematic for this side effect?
2. Anticholinergic symptoms - include all symptoms and how the patient presents with each symptom and the interventions available for each symptom. What meds are most problematic for this side effect?
3. Agranulocytosis - include all symptoms and how the patient presents with each symptom and the intervention available for each symptom. Which meds are most problematic for this effect?
Please utilize 3 sources of information and cite them in your paper. you cannot receive a passing grade in clinical unless this assignment is completed on time.
Explanation / Answer
Patient picture
Interventions
Disturbed thought process:
Inaccurate interpretation of stimuli (people thinking his thoughts, trying to take information from his brain).
Cognitive dysfunction, including memory deficits, difficulty in problem solving and abstraction.
Suspiciousness
Hallucinations
Confusion/disorientation
Impulsivity
Inappropriate social behavior
Initiate a nurse-patient relationship by demonstrating an acceptance of patient as a worthwhile human being through the use of nonjudgmental statements and behavior. Approach in a calm, nurturing manner. Be patient (patient’s brain is not processing data normally) and nurturing.
Assist patient in differentiating between his own thoughts and reality. Validate the presence of hallucinations. Identify them as a part of the disorder and explain that they are present because of the metabolic changes that are occurring in his brain. Focus on reality-oriented aspects of the communication.
Teach patient about his disorder. Assure him that the symptoms can be improved and that he can manage the disorder.
Administer Risperdal as prescribed. Teach about the action, side effects, and dosage of medication. Emphasize the importance of taking medication after discharge, even if symptoms go away completely. Ask patient for a commitment to take the medication.
When patient is hallucinating, determine the significance to the patient (what are the voices telling him?), then try to reassure JB that he is not alone and then redirect him to the here-and-now.
When patient is making delusional statements, assess the significance of the delusion to the patient (it is frightening), support patient if necessary, and redirect to the here-and-now. Do not try to convince patient that the delusion is false.
Assist patient in communicating effectively. Encourage patient to attend communication groups.
Assess ability for self-care activities. Identify areas of physical care for which the patient needs assistance. Note level of motivation and interest in appearance.
Assess sleep and rest patterns. If problems with sleep continue after initiation of medication, explore techniques that may promote sleep. Structure times for sleep, rest, and diversional activities.
Recognize changes in thinking and behavior.
Learn coping strategies to deal effectively with hallucinations and delusions.
Express delusional material less frequently.
Take Risperdal as prescribed orally.
5. Participate in unit activities according to tr Use coping strategies to deal with hallucinations and delusions.
7. Communicate clearly with others.
8. Agree to take antipsychotic medication as prescribed.
Maintain reality orientation.
Risk for violence:
Assaultive toward others, self, and environment
Presence of pathophysiologic risk factors: delusional thinking
Avoid hurting self or assaulting other patients or staff, with assistance from staff.
Acknowledge patient’s fear, hallucinations, and delusions. Be genuine and empathetic. Assure patient that you will help him control behavior and keep him safe. Begin to establish a trusting relationship.
Offer patient choices of maintaining safety: staying in the seclusion room, medications to help him relax. Avoid mechanical restraints and a show of force by having several persons approaching him at once.
Altered sleep pattern:
Difficulty falling or remaining asleep
Dozing during the day
Assess patient’s sleep cycle. Report time he goes to bed, ability to fall to sleep, waking up in the middle of the night
Increase activities by attending day treatment program daily. Encourage JB to resist urge to sleep during the day. Establish a daily routine for getting up and going to bed.
Plan with patient how to increase physical exercise
Impaired social interaction:
Inability to establish and maintain stable relationship
Dissatisfied with social network
Avoidance of others
Interpersonal difficulties
Social isolation
Initiate a nurse-patient relationship with JB. Establish a time each day to meet with him to support him as he learns to cope with his disorder.
Provide supportive group therapy to focus on the here-and-now, establish group norms that discourage inappropriate social behavior, and encourage testing of new social behavior.
Role-play certain accepted social behaviors. Foster development of relationships among group members through self-disclosure and genuineness. Encourage members to validate their perception with others.
Monitor adherence to medication regimen. Encourage JB to attend medication group. Ask patient about specific side effects and symptom exacerbations. Encourage JB to attend the evening symptom management group.
Identify the environment in which social interactions are impaired (living, learning, working, leisure).
Role-play aspects of social interactions such as initiating/terminating a conversation, refusing a request, asking for something, interviewing for a job, asking someone to participate in an activity (going to a movie). Give positive feedback. Focus on no more than three behavioral connections at a time.
Assist family and community members in understanding and providing support. With JB’s permission, develop an alliance with the family. Encourage them to attend a support group.
2. Anticholinergic symptoms - include all symptoms and how the patient presents with each symptom and the interventions available for each symptom. What meds are most problematic for this side effect?
Presentation of symptoms
Interventions to treat
3. Agranulocytosis - include all symptoms and how the patient presents with each symptom and the intervention available for each symptom. Which meds are most problematic for this effect?
Presentation of symptoms
Interventions to treat
FEVER & RIGORS
Assess patient temperature– degree and example. Note shaking chills or plentiful diaphoresis.
Assess environmental temperature
Give lukewarm wipe showers. Maintain a strategic distance from utilization of liquor.
Oversee antipyretics, for example, acetylsalicylic corrosive (ASA) (headache medicine) or acetaminophen (Tylenol).
Survey skin shading and temperature.
Screen WBC, Hct and other correlated research facility records.
a. Raised wbc levels demonstrate nearness of disease.
b. Raised Hct demonstrates lack of hydration.
Expel overabundance covers when the customer feels warm; give additional glow when the customer feels chilled.
Give sufficient sustenances and liquids. To give extra calories and to anticipate lack of hydration.
Measure Intake and Output.
Keep up recommended IV liquids as requested by the doctor.
Advance rest. To diminish body warm generation.
Give great oral cleanliness. To anticipate herpetic injuries of the mouth.
Give cool, flowing air utilizing a fan. To disperse warm by convection.
Give dry dress and bed materials. To guarantee comfort.
Give TSB (Temperature of water 80-98°F). To upgrade warm misfortune by dissipation and conduction.
SORE THROAT
Plan to manage recommended anti-infection agents, analgesics, antitussives and decongestants.
Urge the customer to wash with warm saline rinses and utilize throat tablets.
Train the customer that the temperature of saline ought to be adequately high to be compelling and ought to be as hot as the customer can endure.
Teach the customer to apply an ice neckline to serious sore throats.
Educate the customer on appropriate mouth mind.
Educate the customer to have a fluid or delicate eating routine.
Urge the customer to expand liquid admission to 2,000 ml/every day
Dishearten the customer from eating fiery sustenances and drinking juices that are acidic.
In the event that the customer can't drink, liquids might be regulated IV.
Teach the customer to take all anti-infection agents, regardless of the possibility that he is resting easy.
Urge the customer to evade presentation to aggravations, smoking, used smoke, and introduction to frosty and liquor.
Urge the customer to maintain a strategic distance from contact with people with upper respiratory contaminations.
Urge the customer to utilize a dispensable cover when presented to natural and word related poisons.
PNEUMONIA
Evaluate breaths and chest development
Auscultate lung fields, taking note of regions of diminished or truant wind stream and extrinsic breath sounds: crackles, wheezes.
Hoist the quaint little inn the position as often as possible
Instruct and help persistent with legitimate profound breathing activities. Exhibit appropriate bracing of chest and compelling hacking while in upright position. Urge him to do as such regularly.
Suction if showed
Power liquids to no less than 3000 mL/day (unless contraindicated, as in heart disappointment). Offer warm, as opposed to icy, liquids.
Manage nobulization and spirometry as endorsed
Manage meds as demonstrated: mucolytics, expectorants, bronchodilators, analgesics.
IV treatment
Screen serial chest x-beams, ABGs, beat oximetry readings.
Help for bronchoscopy, thoracenthesis if showed
Urge all out of commission and postoperative patients to perform profound breathing and hacking practices as often as possible.
UTI
Survey the patient's example of disposal
Note patient's age and sex
Empower liquid admission and furthermore voiding
Palpate the customer's bladder at regular intervals.
Keep up an acidic situation of the bladder by the utilization of specialists, for example, Vit.C, Mandelamine (a urinary germ-free) when proper.
Urge female customer to wipe the region from front to back and abstain from utilizing baths
SEPTICEMIA
Evaluate customer for a conceivable wellspring of disease (e.g., consuming pee, confined stomach torment, consumes, open injuries or cellulitis, nearness of obtrusive catheters, or lines).
Keep up sterile system while evolving dressings, suctioning, and giving site mind, for example, an obtrusive line or a urinary catheter.
Examine wounds and destinations of intrusive gadgets every day, giving careful consideration to parenteral sustenance lines. Record indications of neighborhood irritation and disease and changes in character wound waste, sputum, or pee.
Breaking point utilization of obtrusive gadgets and methodology when conceivable. Expel lines and gadgets when disease is available and supplant if fundamental.
Give disengagement and screen guests, as demonstrated,
Get examples of pee, blood, sputum, wound, and obtrusive lines or tubes for culture, and affectability, as showed.
Screen research center investigations, for example, WBC check with neutrophils and band tallies
Direct medicines as recommended
High risk for infection:
Patients with a neutrophil check of under 2,000 are at high danger of creating genuine contaminations and those with agranulocytosis (a neutrophil tally under 500) are at a perilous danger of building up a lethal sepsis. The attendant ought to precisely screen the white platelet check to look for descending patterns and the patient ought to be deliberately evaluated for any indications of disease.
Until the mid-1980's, neutropenic patients were set backward confinement. More current conventions prescribed by the Centers of Disease Control (CDC) stress strict handwashing as the most huge methods for shielding a neutropenic persistent from contamination. Presentation to individuals with upper respiratory contaminations or different irresistible sicknesses ought to be killed. It is essential for the patient to have great individual cleanliness and the patient's condition must be controlled to dispose of potential bacterial wellsprings of disease. Potential wellsprings of disease incorporate dormant water and eating methodologies that contain new natural product or crude vegetables. Any system that may cause a break in the skin, for example, intravenous or intramuscular infusions, pharmaceuticals given by suppository, rectal temperatures or purifications, increment the danger of contamination in a neutropenic tolerant.
Reference: Nurse labs – Nursing care plans (Online resource)
http://nursingfile.com/nursing-care-plan/nursing-interventions/nursing-interventions-for-fever.html
Patient picture
Interventions
Disturbed thought process:
Inaccurate interpretation of stimuli (people thinking his thoughts, trying to take information from his brain).
Cognitive dysfunction, including memory deficits, difficulty in problem solving and abstraction.
Suspiciousness
Hallucinations
Confusion/disorientation
Impulsivity
Inappropriate social behavior
Initiate a nurse-patient relationship by demonstrating an acceptance of patient as a worthwhile human being through the use of nonjudgmental statements and behavior. Approach in a calm, nurturing manner. Be patient (patient’s brain is not processing data normally) and nurturing.
Assist patient in differentiating between his own thoughts and reality. Validate the presence of hallucinations. Identify them as a part of the disorder and explain that they are present because of the metabolic changes that are occurring in his brain. Focus on reality-oriented aspects of the communication.
Teach patient about his disorder. Assure him that the symptoms can be improved and that he can manage the disorder.
Administer Risperdal as prescribed. Teach about the action, side effects, and dosage of medication. Emphasize the importance of taking medication after discharge, even if symptoms go away completely. Ask patient for a commitment to take the medication.
When patient is hallucinating, determine the significance to the patient (what are the voices telling him?), then try to reassure JB that he is not alone and then redirect him to the here-and-now.
When patient is making delusional statements, assess the significance of the delusion to the patient (it is frightening), support patient if necessary, and redirect to the here-and-now. Do not try to convince patient that the delusion is false.
Assist patient in communicating effectively. Encourage patient to attend communication groups.
Assess ability for self-care activities. Identify areas of physical care for which the patient needs assistance. Note level of motivation and interest in appearance.
Assess sleep and rest patterns. If problems with sleep continue after initiation of medication, explore techniques that may promote sleep. Structure times for sleep, rest, and diversional activities.
Recognize changes in thinking and behavior.
Learn coping strategies to deal effectively with hallucinations and delusions.
Express delusional material less frequently.
Take Risperdal as prescribed orally.
5. Participate in unit activities according to tr Use coping strategies to deal with hallucinations and delusions.
7. Communicate clearly with others.
8. Agree to take antipsychotic medication as prescribed.
Maintain reality orientation.
Risk for violence:
Assaultive toward others, self, and environment
Presence of pathophysiologic risk factors: delusional thinking
Avoid hurting self or assaulting other patients or staff, with assistance from staff.
- Decrease agitation and aggression.
- Control behavior with the help of staff
Acknowledge patient’s fear, hallucinations, and delusions. Be genuine and empathetic. Assure patient that you will help him control behavior and keep him safe. Begin to establish a trusting relationship.
Offer patient choices of maintaining safety: staying in the seclusion room, medications to help him relax. Avoid mechanical restraints and a show of force by having several persons approaching him at once.
- Administer Ativan 2 mg. Offer oral medication first. If IM necessary, give injections deep into muscle mass; monitor injection sites.
Altered sleep pattern:
Difficulty falling or remaining asleep
Dozing during the day
Assess patient’s sleep cycle. Report time he goes to bed, ability to fall to sleep, waking up in the middle of the night
Increase activities by attending day treatment program daily. Encourage JB to resist urge to sleep during the day. Establish a daily routine for getting up and going to bed.
Plan with patient how to increase physical exercise
Impaired social interaction:
Inability to establish and maintain stable relationship
Dissatisfied with social network
Avoidance of others
Interpersonal difficulties
Social isolation
Initiate a nurse-patient relationship with JB. Establish a time each day to meet with him to support him as he learns to cope with his disorder.
Provide supportive group therapy to focus on the here-and-now, establish group norms that discourage inappropriate social behavior, and encourage testing of new social behavior.
Role-play certain accepted social behaviors. Foster development of relationships among group members through self-disclosure and genuineness. Encourage members to validate their perception with others.
Monitor adherence to medication regimen. Encourage JB to attend medication group. Ask patient about specific side effects and symptom exacerbations. Encourage JB to attend the evening symptom management group.
Identify the environment in which social interactions are impaired (living, learning, working, leisure).
Role-play aspects of social interactions such as initiating/terminating a conversation, refusing a request, asking for something, interviewing for a job, asking someone to participate in an activity (going to a movie). Give positive feedback. Focus on no more than three behavioral connections at a time.
Assist family and community members in understanding and providing support. With JB’s permission, develop an alliance with the family. Encourage them to attend a support group.
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