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By M. Kelvin. University of Arkansas at Monticello.

The medication might have a different effect if the patient’s body weight falls outside this range purchase 400mg maxaquin visa. For example order 400 mg maxaquin fast delivery, the recommended dose might be too strong for a very thin patient resulting in a toxic effect. Likewise, the recommended dose might be too low for an obese patient and never reach the therapeutic level. This is particularly important to assess when administering medications such as antineoplastics (anti-cancer drugs) where a low therapeutic level can have a non-therapeutic effect for the patient—resulting in an undesirable outcome. Pharmacogenetic ° Genetic factors might have a serious influence on the response to a drug. Depending on the medication, a patient might have a genetically based adverse reaction to the drug. Therefore, in assessing the patient, the nurse must determine if parents, siblings, or other close relatives have had an adverse reaction to the medication. Some drugs are effective only if taken with meals while other medication cannot be taken with meals. Food-drug interaction ° Certain types of foods can adversely effect the drug’s therapeutic effect by increasing absorption, delaying absorption, and even preventing absorption of the medication. Nardil cannot be given with foods that use bacteria or molds in their prepa- ration or for preservation of those that contain tyramine, such as cheese, sour cream, beer, wine, figs, raisins, bananas, avocados, etc. The nurse must assess if the drug has a contraindication with food and educate the patient about this food-drug interaction. Drug-drug interaction ° The nurse should be aware that the combination of drugs administered to the patient may have a negative effect. Some drugs when administered together might increase or decrease the therapeutic effectiveness of either or both medications by competing for the same receptor sites in the body. Furthermore, a combination of some medications produce toxicity or a fatal condition such as anaphylaxis. The prescribers should be notified before medica- tions are administered if there is a possibility of a drug-drug interaction. Drug History, Tolerance, and the Cumulative Effect ° Continued use of a medication might lessen the therapeutic effect of the drug because the patient’s body becomes tolerant of the medication. The nurse must assess the patient’s drug history and monitor the patient for signs and symptoms that the drug is having a therapeutic effect. One such example would be the absence of seizures if the patient is taking phenytoin (Dilantin), an antiseizure medication. The patient may be unable to metabolize and excrete the medication as fast as new doses are administered. For example, ataxia (muscular incoordination), nystagmus (rhythmic oscilla- tion of eyes), and double vision are signs of toxic levels of Dilantin. It is crit- ical for the nurse to review all medications and not just those that will be given on the nurse’s shift because previous medications may still be active in the patient’s body. Remember that some drugs have a long half-life making them still a potential conflict with other medication days after it was administered to the patient. Sometimes the patient may not have recalled any allergies when the patient’s history was taken, but will recall an allergy after being questioned again by the nurse. It is best to create a medication administration worksheet that schedules both medication and the patient’s other activities so there is one schedule for the patient. Make sure that all of the patient’s medications that will be administered during the shift are in the patient’s medication drawer.

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The theory has grown in recognition and value for Sixth discount 400mg maxaquin with amex, the theory of culture care is a synthesized several reasons purchase 400mg maxaquin otc. First, the theory is the only nursing concept; integrated with the ethnonursing method, theory that focuses explicitly and in depth on it has already provided a wealth of many new in- discovering the meaning, uses, and patterns of sights, knowledge areas, and valuable ways to work culture care within and between specific cultures. Thus, it has greatly expanded nurses’ are the new knowledge holdings that support the knowledge about care so essential for nurses to new discipline of transcultural nursing. Third, the theory has the “gold nuggets” to change or transform health a “built-in” and tailor-made ethnonursing nursing care to realize therapeutic outcomes for different research method that helps to realize the theory cultures. It is different from ethnography and other been reported in the Journal of Transcultural research methods. The ethnonursing method is a Nursing and other transcultural nursing books and qualitative method and is valuable in discover- journals since 1980. They substantiate the theory ing largely covert, complex, and generally hidden (Leininger, 1991, 1995, 1997a, 1997b). It was Seventh, the theory and its research findings are the first specific research method designed so that stimulating nursing faculty and clinicians to use the theory and method fit together. This has culture specific care appropriate and safe for cul- brought forth a wealth of new data. Thus, transcultural nursing knowledge is to data methods were not helpful to find hidden be used in clinical and community settings. Nursing administrators in service and academia Fourth, the theory of culture care is the only the- need to be active change leaders to use transcultural ory that searches for comprehensive and holistic nursing findings. Nursing faculty members need to care data relying on social structure, worldview, promote and teach ways to be effective with cul- and multiple factors in a culture in order to get a tures (Leininger, 1998). The theory is being used a lot to trism and racial biases and prejudices are being re- do culturalogical–health care assessments. Many nurses transcultural nursing concepts, findings, policies, also like to discover the differences and similarities and standards of care are being developed and used among cultures as it expands their worldviews and from findings (Leininger, 1991). Interdisciplinary deepens their appreciation of human beings of di- health personnel are finding the theory and trans- verse cultures. Learning to become immersed in a cultural nursing concepts and are finding help in culture has been a major benefit. This has been the most rewarding benefit of be used in any culture and at any time and with the theory. The consumer also likes the ethno- the theory slightly to fit their major and unique in- nursing method as they can “tell their story” and terest and goals of their discipline. Several disci- guide health researchers to discover the truths plines, including dentistry, medicine, social work, about their culture. Informants speak of being and pharmacy, are now using the culturally con- more comfortable with researchers. The goal for United States government and several theory encourages the researcher or clinician to dis- states. The concept is growing in use and will be- cover culture from the people and to let them be in come a global force. In general, the theory of culture care is a theory Tenth, nurse researchers who have been pre- of global interest and significance as we continue to pared in transcultural nursing and have used the understand cultures and their care needs and prac- theory and method commonly say things like, “I tices worldwide. It is the only theory that makes principles, theory, and findings must become fully sense to help cultures.

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The problem seems to be that we never seem to have enough money to make us “really‖ happy cheap maxaquin 400mg on line. Csikszentmihalyi [26] (1999) reported that people who earned $30 maxaquin 400mg low price,000 per year felt that they would be happier if they made $50,000 per year, but that people who earned $100,000 per year said that they would need $250,000 per year to make them happy. These findings might lead us to conclude that we don‘t always know what does or what might make us happy, and this seems to be at least partially true. For instance, Jean Twenge and her [27] colleagues (Twenge, Campbell & Foster, 2003) have found in several studies that although people with children frequently claim that having children makes them happy, couples who do not have children actually report being happier than those who do. Psychologists have found that people‘s ability to predict their future emotional states is not very [28] accurate (Wilson & Gilbert, 2005). For one, people overestimate their emotional reactions to Attributed to Charles Stangor Saylor. Although people think that positive and negative events that might occur to them will make a huge difference in their lives, and although these changes do make at least some difference in life satisfaction, they tend to be less influential than we think they are going to be. Positive events tend to make us feel good, but their effects wear off pretty quickly, and the same is true for negative events. For instance, Brickman, Coates, and Janoff-Bulman [29] (1978) interviewed people who had won more than $50,000 in a lottery and found that they were not happier than they had been in the past, and were also not happier than a control group of similar people who had not won the lottery. On the other hand, the researchers found that individuals who were paralyzed as a result of accidents were not as unhappy as might be expected. For one, people are resilient; they bring their coping skills to play when negative events occur, and this makes them feel better. Secondly, most people do not continually experience very positive, or very negative, affect over a long period of time, but rather adapt to their current circumstances. Just as we enjoy the second chocolate bar we eat less than we enjoy the first, as we experience more and more positive outcomes in our daily lives we habituate to them and our life satisfaction returns to a more [30] moderate level (Small, Zatorre, Dagher, Evans, & Jones-Gotman, 2001). Another reason that we may mispredict our happiness is that our social comparisons change when our own status changes as a result of new events. People who are wealthy compare themselves to other wealthy people, people who are poor tend to compare with other poor people, and people who are ill tend to compare with other ill people, When our comparisons change, our happiness levels are correspondingly influenced. And when people are asked to predict their future emotions, they may focus only on the positive or negative event they are asked about, and forget about all the other things that won‘t change. Wilson, Wheatley, Meyers, [31] Gilbert, and Axsom (2000) found that when people were asked to focus on all the more regular things that they will still be doing in the future (working, going to church, socializing with family and friends, and so forth), their predictions about how something really good or bad would influence them were less extreme. We might think we can‘t be happy if something terrible, such as the loss of a partner or child, were to happen to us, but after a period of adjustment most people find that happiness levels return to prior levels [32] (Bonnano et al. Health concerns tend to put a damper on our feeling of well-being, and those with a serious disability or illness show slightly lowered mood levels. But even when health is compromised, levels of misery are lower than most people expect (Lucas, 2007; Riis et [33] al. For instance, although disabled individuals have more concern about health, safety, and acceptance in the community, they still experience overall positive happiness levels [34] (Marinić & Brkljačić, 2008). Taken together, it has been estimated that our wealth, health, and life circumstances account for only 15% to 20% of life satisfaction scores (Argyle, [35] 1999). Clearly the main ingredient in happiness lies beyond, or perhaps beneath, external factors. Do you believe that material wealth is not as important as you might have thought it would be?

9 of 10 - Review by M. Kelvin
Votes: 35 votes
Total customer reviews: 35

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