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However order 25mg toprol xl otc blood pressure chart during pregnancy, research also suggests that the relationship between social class and weight concern is not straightforward discount toprol xl 100mg line pulse pressure 120. Similar results were reported by Eisler and Szmukler (1985), who examined abnormal eating attitudes. Fur- thermore, additional studies report that social class is unrelated to factors such as body dissatisfaction, the desire for thinness, the desire for weight loss and symptoms indicative of eating disorders (Cole and Edelmann 1988; Whitaker et al. Therefore, although social class is believed to be a cause of body dissatisfaction, the results remain unclear. The family Research has also focused on the impact of the family on predicting body dissatis- faction. In particular, it has highlighted a role for the mother and suggested that mothers who are dissatisfied with their own bodies communicate this to their daughters which results in the daughters’ own body dissatisfaction. For example, Hall and Brown (1982) reported that mothers of girls with anorexia show greater body dissatisfaction than mothers of non-disordered girls. However, research examining concordance between mothers and daughters has not always produced consistent results. For example, Attie and Brooks-Gunn (1989) reported that mothers’ levels of compulsive eating and body image could not predict these factors in their daughters. Likewise, Ogden and Elder (1998) reported discordance between mothers’ and daughters’ weight concern in both Asian and white families. Therefore, research exploring the role of social factors has highlighted a role for the media, ethnicity, social class and the mother’s own body dissatisfaction. First, much of the evidence is contradictory and therefore straightforward conclusions are problematic. Secondly, even if there was a relationship between social factors and body dissatisfaction, simply looking for group differences (i. Perhaps, simply looking for group differences hides the effect of other psychological causes. From this perspective, ethnicity may relate to body dissatisfaction, but only when ethnicity is also accompanied by a particular set of beliefs. Similarly, it may not be class per se that is important but whether class reflects the way an individual thinks. Research has explored the role of beliefs, the mother–daughter relationship and the central role of control. Beliefs Some research has examined the beliefs held by the individuals themselves and their family members. For example, when attempting to understand ethnicity, studies have highlighted a role for beliefs about competitiveness, the value of achievement, material success and a parental belief that the child is their future (Ogden and Chanana 1998). In addition, the literature has also emphasized beliefs about a woman’s role within society. In a similar vein, when attempting to explain the role of social class research has highlighted a role for beliefs about achievement and it has been suggested that eating disorders may be a response to such pressures (Bruch 1974; Kalucy et al. Lower class individuals, in contrast, may aspire more in terms of family life and having children, which may be protective against weight concern. Cole and Edelmann (1988) empirically tested this possibility and assessed the relationship between the need to achieve and eating behaviour. However, although the need to achieve was associated with class, it was not predictive of weight concern. It has also been suggested that class may be associated with a greater value placed on physical appearance and attitudes towards obesity (Wardle et al. Therefore, beliefs about competitiveness, achievement, material success, the role of women, stereotypes of beauty and the child–parent relationship have been high- lighted as the kinds of beliefs that may predict body dissatisfaction. Ogden and Chanana (1998) explored the role of these beliefs in Asian and white teenage girls and Ogden and Thomas (1999) focused on lower and higher class individuals; both studies con- cluding that, although social factors such as class and ethnicity may be related to body dissatisfaction, it is likely that their influence is mediated through the role of such beliefs held by both the individual who is dissatisfied with their body and their family members. Mother–daughter relationship Some research has also explored the nature of the mother–daughter relationship. Further, Bruch (1974) argued that anorexia may be a result of a child’s struggle to develop her own self-identity within a mother– daughter dynamic that limits the daughter’s autonomy. Some authors have also exam- ined the relationship between autonomy, enmeshment and intimacy.
Check the name of the medication three times: 1) when you remove it from the drawer; 2) when you prepare the medication; and 3) before returning the medication to the drawer or disposing of the wrapper or container buy toprol xl 25 mg on-line arrhythmia guidelines 2011. In doing so order 25 mg toprol xl with visa mutemath blood pressure, the nurse must follow precautions to assure that the medication is administered safely. The patient may be aware of food allergies such as shellfish, but unaware of allergies to medication. However, patients who are allergic to shellfish are also allergic to some medications. Ask the patient if he/she knows about the medication and why the med- ication is being administered. The patient’s response provides insight into knowledge the patient has about his/her condition and treatment. This gives the nurse a perfect opportunity to educate the patient about his/her condition, treatment and medication. Stop immediately if the patient doesn’t recognize the medication as the drug the patient received previously. The dose may have changed, a different medication was substituted, or there is an error in the medication. Make sure you have baseline vital signs, labs, and other patient data before administering the medication. To determine the patient’s reaction to the drug, the baseline can be compared to vital signs, labs, and other patient data taken after the patient receives the medication. Instruct the patient about side effects of the medication and take pre- cautions to assure the patient’s safety such as raising the side rails and instructing the patient to remain in bed until the side effects subside. Properly dispose of the medication and supplies used to administer the medication. Don’t leave the medication at the patient’s bedside unless required by the medication order. You can minimize this adverse effect by giving the patient ice chips prior to administering the medication. The patient is left with the taste of the pleasant tasting medication in his/her mouth. Use the liquid form of the medication where possible because patients find it easier to ingest a liq- uid. Administer medication to a patient who needs extra assistance taking the medication after you give medication to your other patients. In this way, you can devote the necessary time to assist this patient without being pressured to admin- ister medication to your other patients. It is therefore critical that the nurse avoid situations that frequently result in med- ication errors. If an error occurs, assess the patient and notify the nurse in charge and the physician. For example, the patient can use specially marked containers for each day of the week. Evaluating the Patient After Administering Medication The nurse must assess the patient after the patient is given medication to determine if the medication has had the desired therapeutic effect. To do this, the nurse compares the patient’s current vital signs, labs, and other pertinent patient data with baseline information. The patient should also be assessed after the medication has reached its onset and peak time. The nurse must suspend administering further doses of the medication if the patient shows the signs and symptoms indicating an adverse reaction to the medi- cation. The nurse must also note any side effect of the medication experienced by the patient and how well the patient tolerates the side effect. If the patient has a low tolerance to the side effect, then the nurse needs to notify the prescriber. The pre- scriber might substitute a different medication or prescribe other medication to alleviate the side effect. The nurse must determine if the patient is receiving the therapeutic effect from the medication. Patients who are very thin or obese may be receiving too much or too little medication.
Finally generic 25 mg toprol xl fast delivery heart attack jack heart attack, the episiotomy (if one has during the second stage of labor to speed delivery in been performed) is sutured with absorbable stitches buy discount toprol xl 50 mg hypertension hypotension. The order to ease either maternal exhaustion or infant dis- total duration of labor averages about 13 hours for first tress. Other medical techniques utilized include the epi- deliveries and about eight hours for subsequent deliver- siotomy, a surgical incision along the back of the vagina ies, although there are large individual variances from to enlarge the opening. The infant’s physical condi- used with special care—in the case of twins or prema- tion is then assessed by the Apgar score, which evalu- ture infants. Moderate doses of narcotic analgesics may ates the overall level of health based on heart rate, skin be given to the mother, which are metabolized quickly color, muscular activity and respiratory effort, and re- and nearly absent by the time of delivery. Premature labor, which occurs in about one more localized relief with fewer side effects than nar- pregnancy out of 20, is the primary danger to mother and cotics. Methods of childbirth have been developed in child during the last trimester of pregnancy and the major which the use of drugs is kept to a minimum. About 40 to 50 percent of moth- ers—especially first-time mothers—experience mild post- The natural childbirth movement begun by Fernand partum depression,thought to be caused by a combina- Lamaze, which advocates birth without drugs or medical tion of biochemical factors and adjustment to the pres- intervention, departed from the practices of the 1940s sures and demands of parenthood. A smaller percentage— and 1950s, when the administration of drugs and med- between 5 and 10 percent—become severely depressed. Natural childbirth methods use non- medical relaxation techniques for pain control and allow Abnormalities present at the time of birth, known as for more active participation in labor by the mother and a birth defects or congenital defects, occur in one of every lay coach, usually the husband. Women who birth defects have been identified, ranging from minor use the Lamaze method are taught to perform three ac- dark sports or a birthmarks to serious disfigurements or tivities simultaneously during contractions: breathing in limited lifespans. Congenital heart defects occur to one of a special pattern, chanting a nonsense or meaningless every 125 to 150 infants born in the U. Down syn- drome is the most frequently occurring chromosomal ab- The home delivery movement, which became popu- normality, occurring to one of every 800 to 1,000 infants lar in the United States during the 1970s, gave way to the born in the United States. Annually, care of children with establishment of birthing centers (in or affiliated with birth defects in the U. Environment includes maternal illness, such as the absence of medical professionals. Other environmental factors include: al- birth movement has also focused on easing the birth ex- cohol and drugs, consumed during the pregnancy, and ex- perience for the infant. Heavy alcohol physician Frederick Leboyer described modern hospital consumption during pregnancy can trigger fetal alcohol birth as “torture of the innocent” and proposed measures syndrome in newborns, characterized by underweight, to make the transition to life outside the womb a more small eyes, a short upturned nose with a broad bridge, gentle one for the newborn. Thalidomide, lights and a quiet atmosphere in the delivery room, post- prescribed in the 1950s as a mild sedative, led to the birth poning cutting of the umbilical cord, and bathing the in- of 7,000 severely deformed babies, suffering from a con- fant in lukewarm water. Psychologists Otto Rank and dition called phocomelia, characterized by extremely R. Laing have elaborated on the idea of birth trauma short limbs that were often without fingers or toes. Spina bifida, a neural tube defect, is liefs that influence an adult’s behavior and attitudes. These factors include, for example, poor health, close properly during the first month of pregnancy. In anatomical abnormalities, prematurity, and unusual orien- worst cases, the spinal cord protrudes through the back. In some women, the “shunting” to relieve the fluid build up and redirect it pelvic space is too small for spontaneous birth of a baby, into the abdominal area. Sophisticated medical tech- and the delivery of the child is accomplished through a niques allow most children with spina bifida to live well surgical opening made in the mother’s abdominal wall and into adulthood. For a Health Service recommends that women of childbearing healthy mother and child, the risks of childbirth are ex- age in the U. Fritz Klein, a noted psychiatrist, has expanded the other two neural two defects: anencephaly or en- on Kinsey’s work, creating the Klein Sexual Orientation cephalocele. Amniocentesis or ultrasound testing can di- Grid, which takes into account seven different variables agnose spina bifida before birth. Klein’s variables provide a more detailed look at Sickle-cell anemia, Tay-Sachs, color blindness, one’s sexuality, examining preferences in attraction, be- deafness, and extra digits on the hand or feet are heredi- havior, fantasies, emotional involvement, social involve- tary birth defects passed on through generations by ab- ment, lifestyle, and self-identification. Birth defects may not impact each genera- for sexual development over time, an important element tion, but the abnormal gene is passed on. The Illustrated Book of Pregnancy and Klein’s grid, exploring only three, rather than seven, Childbirth.
