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By T. Jensgar. The Open University. 2018.

You notice his skin related to age-related degenerative changes is pale and there are several bruises on his and weak pelvic muscles and structural arms and legs elavil 25 mg mastercard pain treatment for lumbar arthritis. On examination, you notice supports his spleen is enlarged and the abdominal area is tender. Nursing Diagnosis: Activity Intolerance weight loss, chronic fatigue, and heavy related to decreased amount of oxygenated sweating at night. He has a productive blood available to tissues cough with yellowish mucus and chest pain. Patient goal: Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Why is the identification of goals in each stage necessary for optimal care and outcomes? If possible, interview nurses or search through the literature to discover how plans can make a difference. Use the following expanded scenario from Chapter 14 in your textbook to answer the questions below. What resources might be helpful for assessment, the nurse notes that she is 25 Ms. During the visit, she verbalizes a strong motivation and desire to become physi- cally fit, lose weight, increase her muscle tone, and improve her cardiorespiratory capacity. She says, “I know it’ll involve some major lifestyle changes, including diet and exercise. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. It is difficult to collect complete data in the Circle the letter that corresponds to the best initial assessment. It enables the nurse to revise the care plan the unique focus of nursing implementation? Your patient, who presented with high care in general blood pressure, is put on a low-salt diet and instructed to quit smoking.

Autistic children lack in- Autism terest and skill in games and other typical kinds of recip- rocal child’s play discount elavil 50 mg unifour pain treatment center hickory, including imitative play. Standard A severe psychological disorder that first appears in nonverbal behaviors that support social interactions— early childhood and is characterized by impaired eye contact, facial expressions, and body language—are social interaction and language development, and other behavioral problems. Leo Kanner in 1943, autism is most often leads parents to seek diagnosis and help for a severe psychological disorder that affects an estimat- autistic children. Autism manifests itself in either delayed or totally absent in children with autism. The autistic child is impaired socially, Those who can speak still have trouble listening to oth- in language development, and exhibits other behavioral ers and initiating or carrying on a conversation. This disorder is also known as infantile or speech of autistic persons often lacks normal grammati- childhood autism and Kanner’s autism. Besides social and language impairments, the other Further Information major symptom of autism is the presence of repetitive, Autism Society of America (formerly National Society for ritualized patterns of behavior. Autistic behavior may also take such forms as arranging objects in specific patterns or quantities, mimicking a particular action, or performing a routine activity exactly the same way every day. Other behavioral characteristics associated with autism are a Autoeroticism preoccupation with a single interest (often one for which Manual stimulation (usually self-stimulation) of the a large number of facts may be collected); resistance to genital organs with the intention, typically, of pro- trivial changes in routine; fascination with a moving ob- ducing sexual arousal and orgasm. Autoeroticism is the scientific term used to describe Persons with autism may exhibit oversensitivity to certain masturbation, the stimulation of the genital organs to stimuli (such as light or touch), unusual pickiness in eat- achieve orgasm. Although masturbation was widely con- ing, inappropriate fear and/or fearlessness, and self-injur- demned in most premodern societies, and has been the ing behavior, such as head banging. As many as 25 per- subject of remarkable and persistent superstitions and ex- cent of autistic children develop epileptic seizures later in treme taboos, there is evidence that contemporary atti- life, often in adolescence, although this particular symp- tudes toward masturbation are becoming increasingly tol- tom appears only in those who are mentally retarded. Howev- adult males and about 80 percent of adolescent and adult er, many demonstrate skill in music, mathematics, long- females have engaged in masturbation. While masturba- term memorization of trivial data, and specialized tasks tion is usually a private, solitary activity, it is often ac- such as assembling jigsaw puzzles.

Pediatricians and emergency medicine specialists are typical of those nonforensic practitioners who may encounter patients with injuries that may be contentious within court proceedings cheap 25 mg elavil free shipping new pain treatment uses ultrasound at home. Such docu- mentation (whether notes, body charts, or computer records) may be reviewed by other doctors, legal advisers, and the courts. Consent for the examination and for subsequent production of a medical report should be sought from the individual being examined. It should also be remembered that vexatious or frivolous accusations of assault can be made, and the examiner should be aware that false allegations and counter allegations do occur, which may only become obvious at a later date. Key Factors Table 1 identifies key factors that may be relevant in the examination of anyone with injuries and that, if relevant, should be determined when the his- tory is taken from the injured person. It is important to document the time at which the injury was said to have occurred. Injuries heal, and thus the appearance of an injury after assault is time dependent. If more than one type of assault has occurred, clear records must be made of which injury was accounted for by which imple- ment. Document the handedness (left, right, or both) of both the victim and Injury Assessment 129 Table 1 Potential Relevant Factors to Determine From History • How was the injury sustained? Table 2 Potential Relevant Information Required When Assessing Injury • Location • Type (e. Witnesses may give different accounts of the incident; it is the forensic physician’s role to assist the court in determining the true account. These accounts may also be influenced by the effect of drugs and/or alcohol, and it is appropriate to assess the influence that these may have in each case. Knowledge of the type of weapon used can be important when assessing injury because particular implements can give identifiable injuries. When examining any individual for injury, all these features should at least be considered to see whether they may have relevance to the case; others may become relevant as the examination progresses or as other accounts of any assault are given. Documentation of injuries can be in several formats, including hand-drawn notes, annotated pro forma diagrams, and photographic.

From both an- the children discount elavil 10 mg amex pain treatment center in franklin tn, she became aware that the children in thropological and nursing perspectives, she held the guidance home were from many different cul- that care and caring were basic and essential human tures. Children were different in their behaviors, needs for human growth, development, and sur- needs, responses, and care expectations. She argued that what home were children who were Anglo-Caucasian, humans need is human caring to survive from birth African American, Jewish American, Appalachian, to old age, when ill or well. The reality was a cultural shock to Leininger nursing concepts derived from anthropology. She as she was not prepared to care for children of di- developed assumptions of culture care in order to verse cultures. Likewise, nurses, physicians, social establish a new knowledge base for the new field of workers, and health professionals in the guidance transcultural nursing. Synthesizing or interfacing home were also not prepared to respond to such culture care into nursing was a real challenge. Because of this cultural shock, new Theory of Culture Care Diversity and Univer- she felt helpless to care for the children and their sality had to be soundly and logically developed parents. It soon became evident that she needed (Leininger, 1976, 1978, 1990a, 1990b, 1991). Findings from the theory could be the ignorance of the clients’ beliefs, values, and ex- knowledge to care for people of different cultures. There were signs of misdiagnosis and mistreat- granted or assumed to be understood by nurses, ment of clients from unknown cultures be- clients, and the public (Leininger, 1981, 1984). Yet cause they did not understatnd the culture of the meaning of “care” from the perspective of dif- the client.