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Nursing questions 

Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialties with differing levels of prescription authority. Nurses comprise the largest component of most healthcare environments;[1][2] but there is evidence of international shortages of qualified nurses.[3] Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. Nurse practitioners are however permitted by most jurisdictions to practice independently in a variety of settings. Since the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.[4][5]

Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient's family, and other team members that focuses on treating illness to improve quality of life. In the United Kingdom and the United States, advanced practice nurses, such as clinical nurse specialists and nurse practitioners, diagnose health problems and prescribe medications and other therapies, depending on individual state regulations. Nurses may help coordinate the patient care performed by other members of a multidisciplinary health care team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.

 Nursing historians face the challenge of determining whether care provided to the sick or injured in antiquity was nursing care.[6] In the fifth century BC, for example, the Hippocratic Collection in places describes skilled care and observation of patients by male "attendants," who may have been early nurses.[7] Around 600 BC in India, it is recorded in Sushruta Samhita, Book 3, Chapter V about the role of the nurse as "the different parts or members of the body as mentioned before including the skin, cannot be correctly described by one who is not well versed in anatomy. Hence, any one desirous of acquiring a thorough knowledge of anatomy should a dead body and carefully, observe, by dissecting it, and examine its different parts."

Before the foundation of modern nursing, members of religious orders such as nuns and monks often provided nursing-like care.[8] Examples exist in Christian,[9] Islamic[10] and Buddhist[11] traditions amongst others. Phoebe, mentioned in Romans 16 has been described in many sources as "the first visiting nurse".[12][13] These traditions were influential in the development of the ethos of modern nursing. The religious roots of modern nursing remain in evidence today in many countries. One example in the United Kingdom is the use of the historical title "sister" to refer to a senior nurse in the past.[14]

During the Reformation of the 16th century, Protestant reformers shut down the monasteries and convents, allowing a few hundred municipal hospices to remain in operation in northern Europe. Those nuns who had been serving as nurses were given pensions or told to get married and stay home.[15] Nursing care went to the inexperienced as traditional caretakers, rooted in the Roman Catholic Church, were removed from their positions. The nursing profession suffered a major setback for approximately 200 years.[16]

19th century

Question 111

What is the maintenance dose of phenytoin in seizures arising as a

complication of chronic renal failure?

Question 112

I know that the loading dose of phenytoin in status epilepticus is

20 mg/kg with an upper limit of 1000 mg but if the same situation arose

as a complication of chronic renal failure (on regular dialysis), should

this dose remain the same or be reduced? If reduced, what should the

dose be?

Neurological disease 21

233

Question 113

1. What is the most effective antiepileptic for a patient with simple

partial motor status epilepticus who is not responding to a loading

dose of phenytoin?

2. How long does phenytoin, given in a loading dose, take to work?

Question 114

Is valproate effective if given rectally in status epilepticus and, if so, what

dose is recommended?

Question 115

In simple partial motor status epilepticus, if the patient does not respond

to diazepam and phenytoin, is it justifiable to proceed to anaesthetic

medication?

Question 116

What is the recommended upper limit dose of lamotrigine when

combined with both carbamazepine and valproate?

Question 117

Is a valproate-lamotrigine combination more effective than

carbamazepine on its own against partial seizures?

Question 118

Why is the incidence of parkinsonism less common in smokers?

Question 119

Is it recommended to start the treatment of parkinsonism with dopamine

agonists alone in elderly (over 60 years old) patients, and to delay using

L-dopa until the disease has progressed much further? Is there a rationale

for this protocol in younger patients?

Question 120

Does amantadine increase the endogeno

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