Aka icd implantable cardioverter defibrillator

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-aka ICD (implantable cardioverter defibrillator) generator implanted under skin , Nurs. Interventions : hematoma at the site is common, wear a medic alert bracelet, when device fires the patient will feel either tingling or discomfort or won’t even know it went off, avoid strong magnetic fields (MRI), keep cell phones 6 inches from ICD, may fire when tachycardic, avoid driving for 6 months if hx of cardiac arrest, teach family CPR, cont. taking antidysrhythmic meds even aft pacemaker is inserted Pancreatitis -“autodigestion” , occurs with destruction of flow to pancreatic enzymes resulting in inflammation of the pancreas, affects LUQ- associated with alcohol, PUD, NSAIDS, gallstones, s/s- cullens/grey turner’s sign (bluish discoloration) , hypoactive bowel sounds, N/V, guarding, distention, fever, jaundice, epigastric/abdominal pain, labs: dec. ca+, K+, & Mg+, inc. amylase (14 days), & inc. lipase (24-48), hyperglycemia, inc. triglycerides, liver func. Test, & WBC Nurs. Interventions : NPO with NG tube, IV hydration, TPN for prolonged episodes, maintain bedrest
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during acute phase, pt should avoid fats, & alcohol, avoid refined carbs (high fructose, bread etc), pt’s pain can be relieved by leaning forward, meds: meperidine for pain, antiemetics, H2 blockers (-dine’s), electrolyte replenishment, insulin to reg. glucose, antibiotics if infection is present, around the clock analgesics, morphine, fentanyl, hydromorphone (dilaudid), PPI’s- tagemet tx: surgical removal of gallstones, may need long term Chronic pancreatitis-low fat diet, steatorrhea, malabsorption tx of pancrelipase (give right bfr meal), pt should take pancrealipase (creon, & pancretin) with acidic (applesauce) (if pt has grey colored stools, pancrealipase is not working RA-Rheumatoid - autoimmune disease r/t inflammatory disorders Nurs. Interventions: Exercise Daily (do not exercise stiff joints), do not perform ROM exercises, tx: NSAIDS (pain), corticosteroids (dec. inflammation), immobilization, rest joints, & use warm compresses Spinal cord injuries -more prevalent in men, priority : stabilize spine, preserve airway & resp status, & prevent complications assoc. with SCI Nurs. Interventions : asses RR, & neuro is 1 st priority, ET tube may be needed, if in neuro shock cannot reg. body temp, (bradycardia, hypothermia, hypotension), know signs dysreflexia (inj above T6-hypotension, nasal congestion, diaphoretic), use jaw-thrust maneuver to open airway meds: high dose steroids SIADH- condition in which excess ADH is produced- caused by : trauma, stroke, lung, pancreas malignancies, meds or stress tx w. diuretics & NS s/s -HTN, tachycardia, change in LOC, N/V, decreased UO, hyponatremia labs: Na+ below 135, inc. BUN & create., inc. specific gravity, Nurs. Interventions -restrict fluid, elevate HOB no more than 10 degrees, do not give acetaminophen, daily weights meds : hypertonic solution (takes fluids out cell), diuretics (take fluid out of body) SVT -tx with adenosine can be repeated up to 2x’s & cardioversion Sepsis - VAP is common infection that causes sepsis Before antibiotics are started, the source of infection must be identified, C&S (culture & sensitivity).
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