Acute Medicine: A Handbook for Nurse Practitioners by Lisa Carroll

By Lisa Carroll

This booklet offers Nurse Practitioners operating within the box of Acute drugs with an up-to-the-minute, useful, and complete advisor to the administration of acute scientific sufferers. It serves as a textual content from which the busy hugely expert nurse can receive details on overview, prognosis, and administration of acute health conditions. It identifies priorities for therapy and courses the reader throughout the administration of the sufferer. anyplace attainable the newest released guidance were incorporated. the ultimate bankruptcy of the booklet considers the criminal, specialist and moral matters confronted via nurses operating at a complicated point. the problems of function improvement, the improvement of protocols and prescribing are thought of.

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R Immediately resume chest compressions (30:2) without reassessing rhythm or checking for a pulse. r Continue CPR for two minutes then pause briefly to check the monitor. r If VF/VT persists, give a further shock (150–360 J biphasic, 360 J monophasic). r Resume CPR immediately and continue for two minutes. r Pause briefly to check the monitor. r If VF/VT persists give adrenaline 1 mg IV followed immediately by a third shock (150–360 J biphasic, 360 J monophasic). r Resume CPR immediately and continue for two minutes.

10. Abdominal examination. GASTROINTESTINAL EXAMINATION The approach is slightly different for this system. Auscultation comes after inspection followed by percussion and finally palpation. INSPECTION r Look for scars, striae, hernias, vascular changes, spider naevi, lesions, or rashes. r Look for movement associated with peristalsis or pulsations. AUSCULTATION r Place the diaphragm of your stethoscope lightly on the abdomen. r Listen for bowel sounds. Are they normal, increased, decreased, or absent?

Check gaze in the six cardinal directions using a cross or ‘H’ pattern. Pause during upward and lateral gaze to check for nystagmus. Check convergence by moving your finger towards the bridge of the patient’s nose. r Test pupillary reactions to light. IV Trochlear r Test extraocular movements (inward and down movement). V Trigeminal r Test temporal and masseter muscle strength: ➢ ask patient to open their mouth and clench their teeth; ➢ palpate the temporal and massetter muscles as they do this.

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