Exparel bupivacaine liposome Tikosyn dofetilide Cerdelga eliglustat

Exparel bupivacaine liposome tikosyn dofetilide

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Exparel (bupivacaine liposome) Tikosyn (dofetilide) Cerdelga (eliglustat) Antiarrhythmic: Monitor ECG continuously and BP and respiratory status frequently during administration. ● Anesthetic: Assess degree of numbness of affected part. ● Transdermal: Monitor for pain intensity in affected area periodically during therapy. Decreas e in ventricul ar arrhyth mias. ● Local anesthes ia May cause drowsiness and dizziness. Advise patient to call for assistance during ambulation and transfer. (Vallerand, Hazard & Sanoski, 2018)
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ACUTE CARE CLINICAL #3 14 across cell membra nes with little or no effect on heart rate. Two Nursing Care Plans: 1. Impaired skin integrity related to immobility and prolonged bed rest, mechanical forces (pressure, shear, friction), pronounced body prominence, poor circulation, bladder/bowel incontinence, Poor nutritional status, edema, dry skin, abnormal/non-healing wounds Goal date: by discharge Skin remains intact, wounds healed ACTION/INTERVENTION Monitor wound for: healing, bleeding Observe itchiness and scratching, pruritus Keep skin clean and moistened at all times Monitor skin for: redness, irritation, dryness and scaling Nutrition consult if necessary Monitor wound for: healing, bleeding Reinforce/change dressing as ordered Wear loose-fitting clothing when edema is present Perform Active ROM or Passive ROM Turn and reposition every 2 hrs. 2. Ineffective breathing pattern/gas exchange related to pulmonary edema and aspiration pneumonia. Goal date: by discharge ---------------------- Clear lung sounds Remains alert, oriented and calm Decreased dyspnea
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ACUTE CARE CLINICAL #3 15 Adequate ventilation Maintain effective breathing pattern as evidenced by: unlabored breathing, no use of accessory muscles, regular rate, and O2 sat within normal limits ACTION/INTERVENTION Observe vital signs and ABG as ordered Auscultate lung sounds and document changes Administer O2 as ordered Provide rest periods and quiet environment Assist and encourage pt. to increase activity and early ambulation Administer bronchodilators as ordered and evaluate effectiveness Observe and document respiration, noting quality, depth and breathing efforts Monitor cardiac rhythm for dysrhythmias Keep HOB elevated Suction orally or nasotracheal if pt. is unable to clear. Recommendations: It is recommended that Mr. P. be put on comfort care to increase quality of life. Mr. Ps family’s goal is to keep him alive for as long as possible, however, most treatments (such as attempting to ween off ventilation) would be futile at this point. With regard to life saving measures, any CPR performed would be traumatic to the veteran and would cause an unpleasant end-of-life experience.
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ACUTE CARE CLINICAL #3 16 References Doenges, M. E., Murr, A. C., & Moorhouse, M. F. (2016). Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales (Vol. Edition 14). Philadelphia, PA: F.A. Davis. Retrieved from ? direct=true&AuthType=ip,shib&db=nlebk&AN Vallerand, A. H. (2018). Davis's drug guide for nurses . FA Davis.
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