Angina Pectoris Care Plan Essay Example for Free

Angina Pectoris Care Plan Essay Care Plan For Angina Pectoris Angina Pectoris Chief Complaint: Patient complains of having tightness and pain in his chest that seems to move down the left arm. Patient describes the pain as being sharp and can be sometimes a mild pain or an immobilizing pain. Medical Diagnosis: Coronary Artery Disease Pathophysiology of: Angina Pectoris Angina Pectoris develops when coronary blood flow becomes inadequate to meet myocardial oxygen demand. This causes myocardial cells to switch from aerobic to anaerobic metabolism, with a progressive impairment of metabolic, mechanical, and electrical functions. Angina pectoris is the most common clinical manifestation of myocardial ischemia. It is caused by chemical and mechanical stimulation of sensory afferent nerve endings in the coronary vessels and myocardium. These nerve fibers extend from the first to fourth thoracic spinal nerves, ascending via the spinal cord to the thalamus, and from there to the cerebral cortex. (http:// emedicine. medscape. com/article/15021 5-overview, 6/1 5/10 12:30 pm) Medical Interventions: Diagnostic Tests: 1. Coronary intravascular ultrasonography A coronary intravascular ultasonography is an invasive ultrasound performed rom a transducer within the lumen of the coronary arteries. (Laboratory test and diagnostic procedures, By: Cynthia Chernicky, 5th Edition 2008). Electrocardiography is a noninvasive acoustic imaging procedure that determines the size, shape, position, thickness and movements of the heart valves, walls, and chambers during each cardiac cycle. (Laboratory test and diagnostic procedures, By: Cynthia Chernicky, 5th Edition 2008). Lipid Profile; Blood 3. Lipid profile; blood is a test to check the units of each of the following: Total lipids, A. Triglycerides B. HDL Cholesterol C. LDL Cholesterol D. E. Total HDL Cholesterol ratio. 4. Stress Exercise Test Stress exercise test measures the efficiency of the heart during a period of physical stress on a treadmill or on a stationary bicycle. Medications: 1. Nitroglycerin Tablets: Classification: Vasodilator, antihypertensive. Action: Reduces preload and afterload, decreasing myocardial workload and oxygen demand. Uses: To prevent or treat angina pectoris, hypertension, and heart failure. Contraindications: Acute Myocardial Infarction, angle- closure glaucoma, cerebral hemorrhage, concurrent use of phosphodiesterase inhibitors, constrictive ericarditis. Route and Dosage: Adults: PO 1 mg. tablet every 5 hours while awake. (Buccal) 0. 1 To 0. 8 mg. hr. worn 12 to 14 hours at a time. (Transdermal Patch) Adverse Reactions: Some side effects of this drug that should be reported to a healthcare provider if they become severe are as follows: headaches dizziness flushing lightheadedness reported to a healthcare provider immediately. The adverse effects of nitroglycerin are: Nausea vomiting Weakness blurred vision fainting spell abdominal pain sweating chest pain pale skin rashes ? peeling of the skin blisters on the skin hives itching difficulty breathing Surgery: 1 Transluminal coronary angioplasty Your hearts arteries can become clogged from a buildup of cholesterol, cells or other substances. This can reduce blood flow to your heart and cause chest discomfort. Sometimes a blood clot can suddenly form or get worse and completely block blood flow, leading to a heart attack. Angioplasty opens blocked arteries and restores normal blood flow to your heart muscle. Angioplasty, a type of percutaneous coronary intervention (PCI), is not major surgery. It is done through a small puncture in a leg or arm artery and opens a clogged heart artery by inflating a tiny balloon in it. Assessment: Subjective: Patient is a 68 year old male with a history of coronary artery disease, and hypertension. Vital Signs as follows: -r: 986 R: 25 p: 102 Objective: Patient seemed to be crying and in severe pain. Skin was flushed, and clammy. Right hand was over left shoulder as if he were trying to relieve the pressure of the pain. Nursing Diagnosis: 1 Physical: 1. Acute pain related to decreased oxygen supply to the myocardium. Nursing Intervention: . Patient will remain on oxygen as ordered for the next 12 hours. 2. Give Nitroglycerin Tablets sublingually every 5 minutes for the next 1 5 minutes. . Patient will sleep for at least 30 minutes every 2 hours for the next 8 hour shift. Nursing Evaluation/Outcome: 1. Patient was able to be taken off of oxygen after the first 12 hours. 2. Patients pain had stopped after 1 5 minutes of administration of the nitroglycerin tablets. 3. Patient was able to sleep for 30 minutes every 2 hours with no interruptions in the last 8 hour shift. Nursing Diagnosis: 2 Psychosocial: 1. Anxiety related to change in lifestyle. Nursing Interventions: 1. Patient will be informed of the importance of taking the nitroglycerin at first sign of pain within an 8 hour shift. 2. Patient will learn how to decrease personal activities within 30 days. 3. Patient will Join a stress management course within the next month. 1. Patient was able to better understand the use of the nitroglycerin tablets after an 8 hour shift. 2. Patient was able to decrease physical activities in the last 30 days. 3. Patient was able to Join a stress management course in last month. Potential/ Risk: 1. Deflecient Knowledge related to coronary artery disease. . Patient will learn the causes of angina pectoris within an 8 hour shift. 2. Patient will learn the importance of side effects to medications within 8 hours. 3. Patient will make sure to get all information of medications before leaving the hospital. 1. Patient was better able to understand what caused the angina pectori by the time he left the hospital. References 1. Laboratory test and diagnostic procedures, By: Cynthia Chernicky, 5th Edition 2008. 2. http://emedicine. medscape. com/article/1 5021 5-overview, 6/1 5/10 12:30 pm

Russo Japanese War Essay -- Russian Defeat, Distance

Is distance an insurmountable problem, judging from the Russian Experience in this conflict and the British experience in the War of American Independence? In order to clearly understand the points presented, insurmountable must first be clearly defined and understood in relation to the case. For this essay insurmountable means that Russia and the British were unable to overcome distance. Distance was the single factor that led to their inability to successfully wage war and defeat their opponents baring all other difficult matters were achievable. In the Russo-Japanese War, distance from theater and within theater was not an insurmountable problem for the Russians. In contrast, distance from and within theater proved an insurmountable problem for the British during the War of American Independence. The Russian’s defeat was a combination of a unaffectionate value of the object (government & people), inadequate leadership (government & forces), and a poorly trained and equipped force that could not t unite their land and sea forces (government & forces). However, the British were severely handicapped by vast area of operations; this impacted their ability to receive supplies, guidance, and reinforcements, as well as project its sea power effectively. By the late 1800’s Russia had infiltrated the Far East, with two naval stations, Port Arthur and Vladivostok, forces based in Manchuria as well as the construction of the Trans-Siberian Railroad. Russia military desires in Asia were not of national security importance but that of imperialism and wealth, the former was most important to Nicholas II and the latter of Witte. The Far East expansion would allow Russia to initially capitalize on Manchuria and Korea’s resourc... ... the war (Fuller, pg. 406). The trading capacity of Russia was also in shambles. Domestic trading and trading with Siberia was halted to support the sole use of Trans-Siberian railway for military transport (Warner and Warner, p.317). Revenue was down and the hatred for Nicholas II had increased. Nicholas II was warned that an object so remote and out of touch with the national spirit would only fan the flames of revolution (Koda, p.397). The Revolution was fully blown and the political and economic reform was being demanded. Boycotts and attacks on public officials were common. Nichols II content to lead a nation without the interest of his people, led Russia into war with itself. Russia was losing face value with the world. Matters on the home front needed immediate attention and the war was a distraction that could no longer be afforded or tolerated.

How Businesses in Puerto Rico Are Using Social Networks Essay

Social Media Gives Industrial Companies Competitive Advantage, Says Thomas Industrial Network Report March 29, 2012 New York, NY Industrial companies that hesitate to embrace social media, believing that competitors are not using these platforms, are in danger of losing business opportunities, according to recent research from Thomas Industrial Network. In fact, seven out of 10 small and midsize suppliers (68 percent) are already engaging with prospects through these channels, gaining a competitive advantage over those who have yet to start. More than 3,000 respondents to Thomas surveys say that they routinely use social media to market their products and services, generate leads, answer questions, conduct research, and gain new business. Thomas studied the behaviors of suppliers (i.e., manufacturers and distributors) through its Industrial Marketer survey, and buyers through its Industrial Purchasing Barometer (IPB). The research focused on their use of platforms such as LinkedIn, YouTube, Twitter, Facebook, industry forums, and blogs. The responses paint a picture of an industrial sector that has made social networking a mainstream business practice. Buyers regularly rely on social media to conduct research on companies, and to seek others opinions on particular suppliers. Indeed, 56 percent of buyers now recommend that all suppliers establish a social media presence if they want to do business with them. In response, suppliers are jumping onto the social media bandwagon to provide information on their offerings (41 percent), find new prospects (27 percent), and learn what customers have to say about their companies (20 percent). The industrial sector is awakening to the fact that social media isn t just a passing consumer fancy, but an essential part of any branding and marketing program, said Susan Orr, Senior Director, Strategic Marketing, Thomas Industrial Network. Savvy suppliers also understand that the most effective social media programs need constant care and feeding. To influence prospective buyers, suppliers need to continually update their social media content, and to be actively engaging in and initiating conversations. But for many industrial suppliers, dedicating the resources and having the in-house expertise to manage social media is a challenge. In response, Thomas Industrial Network recently launched a new, cost effective program to help them take advantage of this important new channel. The Social Media Program helps suppliers reach prospects who are seeking information and advice for their businesses through channels such as LinkedIn, Twitter, Blogs, Facebook and Google+. Thomas takes the work off their hands, handling everything from strategy sessions and goal setting, to writing and posting unique content for each company. We re thrilled to offer a turn-key and affordable program that leverages Thomas 115 years of experience bringing buyers and suppliers of industrial products and services together, said Phil Paranicas, Director of Digital Media, Thomas Industrial Network. We have made it easy for any supplier to participate in social networking, and to begin reaching and influencing those prospects who regularly use these platforms. For more information on Thomas Social Media Program, please contact Mr. Paranicas at 212- 629-2134 or pparanicas@thomasnet.com. Thomas has also just published a new, free white paper, Why industrial businesses need to have a social media presence and how to get started, which includes additional results of its surveys, and provides social media best practices. To download a complimentary copy, please visit: http://promoteyourbusiness.thomasnet.com/white-papers/. About Thomas Industrial Network ® Thomas Industrial Network is an innovative information and technology company that helps industrial businesses to connect, collaborate and grow. We help companies to develop a complete web strategy, enabling them to share product data through all of their sales channels. As a result, we help industrial companies to increase sales, improve customer relationships and expand into new markets. One of our key offerings is ThomasNet.com, the premier website for product sourcing and supplier discovery and selection. We also provide strategic website development, tools and technology for industrial businesses to manage and share product and service data internally and externally. They include WebCAD publishing, and syndication of detailed product data to channel partners. Custom SPEC was designed for the unique needs of custom manufacturers. Additionally, we offer social media programs and search engine optimization services to help these businesses build brand awareness and generate leads. Our Navigator Platform is the hub through which we help our customers to manage their information. Our focus on the industrial sector for more than a century gives Thomas Industrial Network a unique perspective to anticipate and deliver new solutions that help industrial businesses grow. Visit us today to learn more. Home Supplier Search Product Search Product News CAD Drawings About Us SiteMaps Categories Featured Companies Featured Categories Featured Products Community Log In to MyThomas Sign Up for MyThomas Contact ThomasNet Provide Feedback Forums Careers Additional Resources Guides | White Papers Resources Press Room Testimonials FAQs Tools & Gadgets Job Board Deal of the Day Promote Your Business Free Listing Advertising Services Log In to Client Center  © 2013 Thomas Publishing Company. All rights reserved. See Terms and Conditions or Privacy Statement. Website Last Modified January 31, 2013. Thomas Register ® and Thomas Regional ® are part of ThomasNet.com. ThomasNet Is A Registered Trademark Of Thomas Publishing Company. http://www.thomasnet.com/print/pressroom/news/social-media-gives-industrial-companies†¦ 1/31/2013

Stress Inoculation Training ( Sit ) Is A Treatment Program

Stress Inoculation Training Camille Maela Anderson Brenau University Donald Meichenbaum and Stress Inoculation Training Over the years, people have gotten themselves into more stressful situations or conditions, which are called stressors, throughout their lives, whether it is their career, family, friends, an event, or other things that tends to stress people out (Meichenbaum, 2007, p. 1). Donald Meichenbaum decided that he wanted to help others solve that problem. Meichenbaum and a few of his colleagues came together to create cognitive behavioral therapy due to this increase (Meichenbaum, 2007, p. 2). After a while, Donald Meichenbaum and a few of his colleagues created Stress Inoculation Training in the mid-1970s. Stress Inoculation Training (SIT) is a treatment program that makes efforts in helping people take control over finding a positive way in dealing with stressful events and also being ready in advance to handle stressful situations (Meichenbaum, 2007, p. 8). This stress intervention is broken up into three phases: the conceptualization or educational phase, the skill acquisition and rehea rsal phase, and the application and follow through phase (Admi, 1997, p. 39). Phase One: The Conceptualization The conceptualization phase of Stress Inoculation Training (SIT) is the initial phase of this intervention program. The therapist begins to get to know their client and building a relationship through an interview process (Meichenbaum, 2007, p. 43).Show MoreRelatedThe Long Term Effectiveness Of Prolonged Exposure Therapy712 Words   |  3 Pagesassault and rape victims from other types of trauma victims may decrease the treatment effectiveness or inadvertently harm participants in this subgroup. Trauma associated from rape or sexual assault differ from other forms of trauma; treatment efficacy should be examined once this matter has been taken into consideration. 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