Allegra
By Y. Gunock. Lee University.
This results in a lack of standards for the manufacture and sale of herbal therapies generic allegra 120 mg with amex allergy watch. These are oils cheap 120 mg allegra fast delivery allergy testing denver, balms, creams, ointments, teas, tinctures, capsules, tablets, and syrups. Although herbs are available in these forms, some herbs should only be administered externally and not used internally. While herbal therapies provide patients with a therapeutic effect, they can also leave the patient exposed to hazards. When combined with conventional therapies, herbal therapies can produce a toxic effect or an adverse reaction. The nurse should ask if the patient is taking herbal therapies and, if so, for what condition. The patient should be taught about herbal therapies, the risks and benefits, and then given clear instructions on how to continue herbal thera- pies while undergoing conventional treatment—if approved by the patient’s healthcare provider. The patient should not take an herb unless which of the following infor- mation in on the package? A patient who complains about palpitations and who is undergoing herbal therapy may be taking (a) comfrey. The nurse should instruct the patient on how to monitor for adverse side effects of herbal therapies. Comfrey is an ointment used to relieve swelling associated with abra- sions and sprains. We developed a respect for those words because vitamins and minerals are necessary to remain healthy. Therefore, it is critical that you assess the patient for vitamin and mineral deficiencies and administer the prescribed therapy to restore the patient’s nutritional balance. In this chapter you’ll learn about vitamins and minerals and how to assess patients for deficiencies. You’ll also learn about vitamin therapy and mineral therapy and how to educate your patient about proper nutrition. Vitamins Vitamins are organic chemicals that are required for metabolic activities neces- sary for tissue growth and healing. Under normal conditions, only a small amount of vitamins—which are provided by eating a well balanced diet—are necessary. Likewise, patients who do not have a well-balanced diet (such as the elderly, alcoholics, children, and those who go on fad diets) might also develop a vita- min deficiency. That would require the patient to take vitamin supplements to assure there are sufficient vitamins to support his or her metabolism. Expect to provide vitamin supplements for patients who have: • Conditions that inhibit absorption of food. The pre- vious food pyramid placed everyone in the same group, which is not realistic. The revised food pyramid is organized into five color-coded groups, each with a general recommendation. Three ounces of whole grain bread, rice, cereal, crackers, or pasta every day (orange). Fat-soluble vitamins Fat-soluble vitamins are absorbed by the intestinal tract following the same metabolism as used with fat. Any condition that interferes with the absorption of fats will also interfere with the absorption of fat-soluble vitamins. Fat-soluble vitamins are stored in the liver, fatty tissues and muscle and remain in the body longer than water-soluble vitamins. Vitamin A Vitamin A (Acon, Aquasol) helps to maintain epithelial tissue, eyes, hair and bone growth. It is important to keep in mind that Vitamin A is stored in the liver for up to two years, which can result in inadvertent toxicity if the patient is administered large doses of Vitamin A. Vitamin D Vitamin D, absorbed in the small intestine with the assistance of bile salts, is necessary for the intestines to absorb calcium. Contraindications Mineral oil, cholestyramine, alcohol, and antilipemic drugs decrease the absorption of vitamin A. Contraindications Hypercalcemia, hypervitaminosis D, or renal osteodys- trophy with hyperphosphatemia. Use with caution in patients with arteriosclerosis, hyperphosphatemia, hypersensitivity to vitamin D, and renal or cardiac impairment.
Schizophrenia is a chronic psychotic disorder where patients exhibit either positive or negative symptoms order allegra 180mg with mastercard allergy symptoms phlegm. Positive symptoms are exaggeration of normal function such as agitation buy cheap allegra 120 mg allergy forecast ragweed, incoherent speech, hallucination, delusion, and paranoia. Negative symptoms are characterized by a decrease or loss of motiva- tion or function such as social withdrawal, poor selfcare, and a decrease in the content of speech. Psychosis is caused by an imbalance in the neurotransmitter dopamine in the brain. Antipsychotic medication, also known as dopamine antagonists, block the D2 dopamine receptors in the brain thereby reducing the psychotic symptoms. A number of antipsychotic medications block the chemoreceptor trigger zone and vomiting (emetic) center of the brain. Although blocking dopamine improves the patient’s thought processes and behavior, it can cause side effects. These include symptoms of Parkinsonism (see Parkinsonism previously dis- cussed in this chapter). Patients who undergo long-term treatment for psychosis using antipsychotic medications also might be prescribed drugs to treat the symptoms of Parkinsonism. The typical category of antipsychotic med- ication is further subdivided into phenothiazines and nonphenothiazines. Phenothiazines block norepinephrine causing sedative and hypotensive effects early in treatment. Nonphenothiazines include butyrophenone haloperidol (Haldol) whose phar- macologics are similar to phenothiazines as it alters the effects of dopamine by blocking the dopamine receptor sites. Included in this group are prochlorperazine (Compazine), fluphenazine (Prolixin), perphenazine (Trilafon), and trifluoperazine (Stelazine). These have replaced sedatives that were traditionally used because they have fewer and less potent side effects, especially if an overdose of the medication is given to the patient. Anxiolytics are prescribed when the patient’s anxiety reaches a level where the patient becomes disabled and is unable to perform normal activities. Anxiolytics have a sedative-hypnotic effect on the patient, but not an antipsychotic effect. Primary anxiety is not caused by a medical condition or drug use but may be sit- uational. Anxiolytics are usually not administered for secondary anxiety unless the sec- ondary cause is severe or untreatable. Benzodizepines include chlordiazepoxide (Librium), diazepam (Valium), chlorazepatge dipotassium (Tranxene), oxazepam (Serax), lorazepam (Ativan), and alprazolam (Xanax). Depression About 20% of Americans are depressed; however, one-third receives medical or psychiatric help for their depression. Depression is characterized by mood changes and loss of interest in normal activities. Patients who are depressed might have insomnia, fatigue, a feeling of despair, and an inability to concen- trate. Depression is caused by a number of factors including genetic predisposition, social and environmental factors, and biologic conditions such as insufficient monoamine neurotransmitter (norepinephrine and serotonin). Causes of major depression can include genetic predisposition, social and environmental factors, and biologic conditions. Antidepressants are used to treat depressions, however they also can mask sui- cidal tendencies (Table 15-3). They do not cause hypotension, sedation, anticholinergic effects, or cardiotoxi- city. A n t i c h o l i n e r g i c I n s o m n i a / C a t e g o r y e f f e c t S e d a t i o n H y p o t e n s i o n G I d i s t r e s s C a r d i o t o x i c i t y S e i z u r e s A g i t a t i o n T r i c y c l i c A n t i d e p r e s s a n t s A m i t r i p t y l i n e ( E l a v i l ) + + + + + + + + + + + – + + + + + + + – C l o m i p r a m i n e ( A n a f r a n i l ) + + + + + + + + + + – + + + + + + – D e s p r a m i n e ( N o r p r a m i n ) + + + + + – + + + + + D o x e p i n ( S i n e q u a n ) + + + + + + + + + – + + + + – I m i p r a m i n e ( T o f r a n i l ) + + + + + + + + + + + + + + + + + N o r t r i p t y l i n e ( A v e n t y l ) + + + + + – + + + + + – P r o t r i p t y l i n e ( V i v a c t i l ) + + + + + + – + + + + + T r i m i p r a m i n e ( S u r m o n t i l ) + + + + + + + + + + – + + + + + + – S e l e c t i v e S e r o t o n i n R e u p t a k e I n h i b i t o r s F l u o x e t i n e ( P r o z a c ) – + – + + + – 0 / + + + F l u v o x a m i n e ( L u v o x ) – + + – + + + – – + + P a r o x e t i n e ( P a x i l ) – + – + + + – – + + S e r t r a l i n e ( Z o l o f t ) – + – + + + – – + + T a b l e 1 5 - 3. The enzyme monoamine oxidase inactivates norepinephrine, dopamine, epinephrine, and serotonin. Examples of these drugs includes isocarboxazid (Marplan), phenelzine sulfate (Nardil), and tranycypromine sulfate (Parnate). A list of drugs utilized in the treatment of depression is provided in the Appendix. Summary There are many medications that either interfere with impulses transmitted over the neural pathways or stimulate those impulses.
Although intensive care nursing is younger than most healthcare specialities allegra 180 mg low cost allergy relief quick, it already possesses a wealth of nursing knowledge and experience order allegra 180mg line allergy migraine. I hope this book contributes to further growth of intensive care nursing, and enables readers to develop their own specialist practice. I would also like to thank all the reviewers who read and assisted with comments on the developing typescript: John Albarran, University of the West of England; Kate Brown and Maureen Fallon, Nightingale Institute, King’s College University; Kay Currie, Glasgow Caledonian University; Lynne Harrison and Mandy Odell, University of Central Lancashire. All reasonable efforts have been made to contact the copyright holders of material reproduced in this book. Any omissions brought to the attention of the publishers will be remedied in future editions. I am grateful to everyone at Middlesex University for the support given towards this book, and for the sabbatical leave which enabled me to complete it. I would especially like to thank Sheila Quinn (Senior Lecturer, Middlesex University), who has helped me at so many stages of my career, and who first suggested I should write a textbook. I would also like to thank everyone who has helped develop my ideas, especially past and present staff of the Whittington Hospital and all my past students and colleagues and clinical staff at Chase Farm and North Middlesex Hospital. And of course this book would not have been possible without the encouragement and support of Routledge, in particular Alison Poyner and Moira Taylor. It develops issues that may have been introduced during pre-registration courses, but which can too easily be lost in the technical demands of intensive care. The first chapter therefore explores the values underlying intensive care nursing; the second chapter develops these through outlining two influential moments in psychology. The third chapter examines issues about the environment in which intensive care patients are nursed. The human needs and problems of nursing rituals are explored in the chapters on pain management, pyrexia, nutrition, mouthcare, eyecare and skincare. The next two chapters then explore the extremes of age: paediatrics and older adults. Chapter 1 Nursing perspectives Introduction This book explores issues for intensive care nursing practice, and this first section establishes its core fundamental aspects. To help readers to do this, this first chapter explores what nursing means in the context of intensive care and the following chapter outlines two schools of psychology (behaviourism and humanism) that have influenced healthcare and society. Acknowledging and continuously re-evaluating our individual values and beliefs is part of human growth, so that examining nursing’s values and beliefs within the context of our own area of practice is part of our professional growth. This is something that each nurse can usefully explore and there are a number of published exercises available in this respect (e. Manley 1994), but essentially it means working out a nursing philosophy for oneself. What is meant by this is not some esoteric message hung neatly on a wall and seldom read or practised—such as ‘man is a bio-psycho-social being’—but, rather, simple values which may be more meaningful—such as ‘remember our patients are human’. Care can (and should) be therapeutic, but therapy (cure) without care is almost a contradiction in terms. These units offered potentially life-saving intervention during acute physiological crises, with the emphasis on medical need and availability of technology. As the technology and medical skills of the speciality developed, so technicians were needed to maintain and operate machines. However, the fact that technology provides a valuable means of monitoring and treatment should not allow it to become a substitute for care. For nursing to retain a patient-centred focus, it is the patients themselves and not the machines that must remain central to the nurse’s role. Healthcare assistants (and, potentially, robots) can be trained to perform technological tasks—and are cheaper to employ. Doctor-nurse relationships Ford and Walsh (1994) observed that nurses working in high dependency areas often have good relationships with medical staff. But Ford and Walsh suggest this good relationship is on the terms of the medical staff. For example, nursing’s focus on the emotional costs to intensive care patients may limit the wider recognition of nursing as a profession (Phillips 1996). However, while recognising and respecting the valuable and unique role of doctors, this collaboration by nurses should not mean subservience (i. Intensive care nursing 4 Psychology The increasing emphasis by the nursing profession on psychology and the psychological needs of patients, whether conscious or unconscious, makes psychological care an essential part of holistic care—a focus noticeably absent in the medical and technological perspectives above. However, psychology and physiology are not two separate and distinct pigeon-holes that some nursing (and other) course timetables might suggest, and the subject of homeostatic imbalances from psychological distress is explored in Chapter 3.
Individual human beings are structure of processes to do so order allegra 180mg without a prescription allergy vs adverse drug reaction, but also the powers viewed as embodied persons with inherent and capabilities of persons who are the agents or rights that become sustained public rights who actors buy allegra 180mg without a prescription allergy zone map. The internal structure, the constitution, and live in coexistence with other persons. A mature the nature of the powers of nursing agency and self- human being “is at once a self and a person with care agency are content elements of nursing sci- a distinctive I and me... The structure of the processes of designing viable rights and able to possess changes and and producing nursing and self-care is also nursing pluralities without endangering his [or her] science content. Individual human beings are tial in understanding the nature of interpersonal viewed as persons who can bring about condi- systems of interaction and communication be- tions that do not presently exist in humans or in tween nurses and persons who seek and receive their environmental situations by deliberately nursing. The age and developmental state, culture, acting using valid means or technologies to and experiences of persons receiving nursing care bring about foreseen and desired results. The beings are viewed as persons who use symbols ability of nurses to be with and communicate effec- to stand for things and attach meaning to them, tively with persons receiving care and with their to formulate and express ideas, and to com- families incorporates the use of meaningful lan- municate ideas and information to others guage and other forms of communication, knowl- through language and other means of commu- edge of appropriate social-cultural practices, nication. Individuals are viewed as uni- what persons receiving care are endeavoring to tary living beings who grow and develop ex- communicate. Nurses also has been a handicap in nurses’ communications may need to help individuals under nursing care to about nursing to the public as well as to persons take these views about themselves. They know that they have rights as persons and as They are embodied persons, and nurses must be nurses and that they must defend and safeguard knowing about their biological and psychobiologi- these personal and professional rights; their powers cal features. Viewing human beings as organisms of nursing agency must be adequate to fulfill re- brings into focus the internal structure, the consti- sponsibilities to meet nursing requirements of per- tution and nature of those human features that are sons under their care; they must know their the foci of the life sciences. Knowing human beings deficiencies, act to overcome them, or secure help as agents or users of symbols has foundations in bi- to make up for them; they must be protective of ology and psychology. Understanding human or- their own biological well-being and act to safeguard ganic functioning, including its aberrations, themselves from harmful environmental forces. Taking the object view carries with it a re- quirement for protective care of persons subject to The previously described nursing-specific views of such forces. The features of protective care are un- individual human beings are necessary for under- derstood in terms of impending or existent envi- standing and identifying (1) when and why indi- ronmental forces and known incapacities of viduals need and can be helped through nursing; individuals to manage and defend themselves in and (2) the structure of the processes through their environments, as well as in the nursing- which the help needed is determined and pro- specific views of individuals that nurses take in duced. These broad views point to the sciences Such knowing is foundational to model making and disciplines of knowledge that nurses must be and theory development in nursing. For example, knowing in, and have some mastery of, in order to Louise Hartnett-Rauckhorst (1968) developed be effective practitioners of nursing. Establishing models to make explicit what is involved physiolog- the linkages of nursing-specific views of human be- ically and psychologically in voluntary, deliberate ings to the named broader views is a task of nurs- human action, including motor behaviors. Orem’s Self-Care Deficit Nursing Theory 147 • A basic psychological model of action with three of self-care agency, a process with a specified submodels: structure. The first model, self-care operations, is The personal frame of reference of the basic modeled on deliberate action. The study of these and other general theoretical Models of categories of constituent care requisites models of deliberate action stimulated some mem- within the demand (universal, developmental, and bers of the Nursing Development Conference health deviation types) were developed as well as a Group to investigate and formalize the conceptual model to show the constituent content elements of structure of self-care agency, conceptualizing it as a therapeutic self-care demand and their derivation the developed power to engage in a specific kind of (Orem, 1995). The goal of these efforts was the ements of an action system to meet a specific self- construction of models to identify types of relevant care requisite particularized for an individual was information and to aid in the development of tech- developed as an example of what actions must be niques for collection and analysis of data about performed to meet each of the self-care requisites self-care agency. A model of self-care operations, and estimative, the conceptual entity therapeutic self-care demand. The therapeutic self- volved with and enabling for performance of care demand models represent what is to be known self-care operations. A model of human capabilities and dispositions self-care agency or met for them when required by foundational for: reason of self-care agency limitations. The models are offered as a means toward un- The adequacy of the theories should be ex- derstanding the reality of the named entities in plored. Despite the di- to be general models of nursing can be versity of these models, they are all directed toward adequate or deficient in their scope as related knowing the structure of the processes that are op- to expressing why people need and can be erational or become operational in the production helped through nursing or in describing of nursing systems, systems of care for individuals and explaining the structure of nursing or for dependent-care units or multiperson units processes. In any practice field, a general model or For information about models and scientific theory incorporates not only the what and growth involving development of knowledge in in- the why, but also the who and the how. The dividual scientists, see Wallace (1983) and Harré adequacy of a general theory comes into (1970).
She loved her adopted parents and older brother and even wrote an article titled ―Why I Don‘t Want to Find My Birth Mother cheap allegra 180 mg fast delivery allergy shots not refrigerated. In 2003 120 mg allegra allergy symptoms 0f, 35 years after she was adopted, Elyse, acting on a whim, inquired about her biological family at the adoption agency. Elyse dialed Paula‘s phone number: ―It‘s almost like I‘m hearing my own voice in a recorder back at me,‖ she said. The two women met for the first time at a café for lunch and talked until the late evening. Looking at this person, you are able to gaze into your own eyes and see yourself from the outside. Elyse and Paula You can learn more about the experiences of Paula Bernstein and Elyse Schein by viewing this video. One of the most fundamental tendencies of human beings is to size up other people. When we make these statements, we mean that we believe that these people have stable individual characteristics— their personalities. Personalityis defined as an individual’s consistent patterns of feeling, [2] thinking, and behaving (John, Robins, & Pervin, 2008). The tendency to perceive personality is a fundamental part of human nature, and a most adaptive one. If we can draw accurate generalizations about what other people are normally like, we can predict how they will behave in the future, and this can help us determine how they are likely to respond in different situations. Understanding personality can also help us better understand psychological disorders and the negative behavioral outcomes they may produce. We‘ll consider how and when personality influences our behavior, and how well we perceive the personalities of others. We will also consider how psychologists measure personality, and the extent to which personality is caused by nature versus nurture. The fundamental goal of personality psychologists is to understand what makes people different from each other (the study of individual differences), but they also find that people who share genes (as do Paula Bernstein and Elyse Schein) have a remarkable similarity in personality. Define and review the strengths and limitations of the trait approach to personality. Early theories assumed that personality was expressed in people‘s physical appearance. One early approach, developed by the German physician Franz Joseph Gall (1758–1828) and known as phrenology, was based on the idea that we could measure personality by assessing the patterns of bumps on people‘s skulls (Figure 11. In the Victorian age, phrenology was taken seriously and many people promoted its use as a source of psychological insight and self- knowledge. Machines were even developed for helping people analyze skulls (Simpson, [1] 2005). However, because careful scientific research did not validate the predictions of the theory, phrenology has now been discredited in contemporary psychology. Sheldon (1940) argued that people with more body fat and a rounder physique (“endomorphs‖) were more likely to be assertive and bold, whereas thinner people (“ectomorphs‖) were more likely to be introverted and intellectual. As with phrenology, scientific research did not validate the predictions of the theory, and somatology has now been discredited in contemporary psychology. Another approach to detecting personality is known as physiognomy, or the idea that it is possible to assess personality from facial characteristics. In contrast to phrenology and somatology, for which no research support has been found, contemporary research has found that Attributed to Charles Stangor Saylor. Despite these results, the ability to detect personality from faces is not guaranteed. Olivola and [4] Todorov (2010) recently studied the ability of thousands of people to guess the personality characteristics of hundreds of thousands of faces on the website What‘s My Image? In contrast to the predictions of physiognomy, the researchers found that these people would have made more accurate judgments about the strangers if they had just guessed, using their expectations about what people in general are like, rather than trying to use the particular facial features of individuals to help them. It seems then that the predictions of physiognomy may also, in the end, find little empirical support. Personality as Traits Personalities are characterized in terms of traits, which are relatively enduring characteristics that influence our behavior across many situations.
In psychologists to pay more attention to the child’s intel- the early years of life they include motor skills discount 120mg allegra otc allergy shots edmonton, percep- lectual and cognitive development allegra 120mg low price allergy treatment for babies. Child psychologists are working on a series of problems that cover all of the important areas of growth. It is hoped that as these facts are gathered, brilliant theorists sometime in the future will be able to synthesize this information into a coherent theory that clarifies the child’s growth. While Chomsky argued that linguistics should be under- stood as a part of cognitive psychology,in his first book, Noam Chomsky Syntactic Structures (1957), he opposed the traditional 1928- learning theory basis of language acquisition. In doing American linguist whose theory of transformational so, his expressed a view that differed from the behaviorist or generative grammar has had a profound influence view of the mind as a tabula rasa; his theories were also on the fields of both linguistics and psychology. In Noam Chomsky was born in Philadelphia and edu- Chomsky’s view, certain aspects of linguistic knowledge cated at the University of Pennsylvania, where he re- and ability are the product of a universal innate ability, or ceived his B. This theory claims to account for the fact served as professor of foreign languages and linguistics. As evidence that an inherent ability ex- Besides his work in the field of psycholinguistics, ists to recognize underlying syntactical relationships Chomsky is also well-known as a leftist activist and so- within a sentence, Chomsky cites the fact that children cial critic. He was an outspoken opponent of the Vietnam readily understand transformations of a given sentence War and has remained critical of media coverage of poli- into different forms—such as declarative and interroga- tics. Although Chomsky’s work is primarily of interest to tive—and can easily transform sentences of their own. Chomsky has devised the now-famous nonsense sen- Chomsky was a pioneer in the field of psycholinguis- tence, “Colorless green ideas sleep furiously. Chomsky argues that the from the West Indies and worked as a cargo superinten- underlying logic, or deep structure, of all languages is the dent for the United Fruit Company, a major employer in same and that human mastery of it is genetically deter- Central America at that time. Those aspects of language that hu- Hanson Clark, was from Jamaica, and she and his father mans have to study are termed surface structures. Miriam want- Chomsky’s work has been highly controversial, ed to move the family to the United States, where Ken- rekindling the age-old debate over whether language ex- neth and his younger sister Beulah would have greater ists in the mind before experience. His theories also dis- educational and career opportunities than they would in tinguish between language competence (knowledge of Panama. He had rules and structure) and performance (how an individual a good position at United Fruit, and under the harsh uses language in practice). Besides Syntactic Structures, racism and segregation that prevailed even in the north- Chomsky’s books include Current Issues in Linguistics ern United States at that time, he did not believe he could Theory (1964), Aspects of the Theory of Syntax (1965), obtain a similar job in America. Therefore Miriam and Topics in the Theory of Generative Grammar (1966), her two children boarded a boat for New York harbor, Cartesian Linguistics (1966), Language and Mind leaving the children’s father behind. At that time Harlem was a mixed community, and besides other black families, the Clarks found them- Further Reading selves living alongside Irish and Jewish neighbors. Oxford: Oxford experience undoubtedly had an effect on Clark’s later University Press, 1986. In school, he told the New Yorker magazine in 1982, all students were ex- pected to excel, regardless of skin color: “When I went to the board in Mr. Ruprecht’s algebra class,” he re- called, “…I had to do those equations, and if I wasn’t Kenneth Bancroft Clark able to do them he wanted to find out why. In spite of this positive educational environment, the rest of the world was filled with people who had low expectations for black students. Hence when Clark fin- Many psychologists have made history within their ished junior high and had to choose a high school, coun- profession; few, however, have had an impact on the selors urged him to enroll in a vocational school. Such was the case with Kenneth Ban- of his strong academic record, he was black, and there- croft Clark, whose work the Supreme Court cited in its fore he could only hope to gain employment in a limited historic Brown v. In the 1954 range of jobs, all of which involved working with one’s case, which overturned racial segregation in public hands. That, at least, was the logic, and to many people it schools, the Court referred to a 1950 paper by Clark, and would have made sense—but not to Miriam Clark. When described him as a “modern authority” on the psycholog- her son told her what the school counselor had suggest- ical effects of segregation. His recognition by the highest ed, she went to the counselor’s office and informed him court in the land made Clark an instant celebrity, and on that she had not struggled to bring her family from Pana- the heels of this success, he set out to develop a proto- ma so that her son could become a factory worker.
