MEQ-10 MEQ-10 is a  10 band equaliser  with -12/+12dB on gain performance and 2 octaves bandwidth control, featuring 5 filter modes. This plugin has a frequency

On Studocu you find all the lecture notes, summaries and study guides you need to pass your exams with better grades.

Laboratório de informática usado nas escolas é ultrapassado; veja por que adotar um espaço maker faz sentido tanto pedagógica quanto financeiramente

scienceandfood: From 6 Things About Eating Insects #food #Science

Download this Machine Mechanical Artificial Intelligent, Technology, Modern, Illustration illustration image that can be used as background or wallpaper in form of with size for totally free. Explore more illustrations, vectors, templates and graphics on Pngtree.| 4117080

The architects of DNK ag approached the task of doing a comfort-class housing project as a super-objective. They were ultimately able to break the frame of “inexpensive housing equals standardized blocks of flats” staying, at the same time, within their budget constraints. Their customized and professional approach to mass housing construction allowed the architects to create a comfortable and human-friendly urban territory.

Shooting Star Phone Logo Design designed by Dalius Stuoka | logo designer. Connect with them on Dribbble; the global community for designers and creative professionals.

Брусника строит современное демократичное жильё в крупных городах Урала и Сибири, в Москве и Московский области. Уделяет внимание качеству и инновациям в строительстве.

Simple yet fun hard surface modeling project. I had a lot of fun creating the textures for this. This asset could easily be piped into unreal or unity and work as a game asset.

Hi, A practice painting of a street corner in Italy. Working from photo reference. Basic blockout in 3dsMax. Thanks for viewing!

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Previously operated by Mexicana as XA-MEQ - Photo taken at Monterrey - General Mariano Escobedo International (MTY / MMMY) in Mexico on April 9, 1994.

Time Dancers (2006) is the second book in Steve Cash's sweeping fantasy trilogy called "The Meq" (also the title of the first book in the trilogy). When forced to explain the plot of The Meq in one sentence, my reply is this: the story is like the Highlander TV series/movies but the immortals here are…

Excess free H2O relative to Na → serum Na < 135 mEq/L. Neurologic spectrum 2/2 water shift in cells: Fatigue → lethargy → AMS (altered mental status) (usually starting

Kuassa’s new EVE-MP5 is a reproduction of two classic Pultec hardware EQs, the MEQ-5 Midrange Equalizer and the EQP-1A Program Equalizer. EVE-MP5 brings massive…

When someone has higher than normal potassium in their blood it’s known as hyperkalemia. Normal levels of potassium for adults should be between 3.7 and 5.2 mEq/L (milliequivalents per liter). When levels drop below 3.5 or exceed 6, the affected individual should speak with a doctor immediately. The elderly are often at risk for higher […]

six) use; o Creates a high risk for dig toxicity ▪ (Lasix can cause hypokalemia, which can lead to dig toxicity) • Digoxin toxicity – know normal digoxin level (0.5 – 2 ng/mL); o Serum potassium (K+) level (3.5 to 5.0 mEq/L); • Low potassium or magnesium levels may o  risk for digoxin toxicity; • S/S of dig toxicity include: o anorexia o bradycardia o headache, o dizziness o confusion o nausea o visual disturbances (blurred vision, yellow vision, and/or halo vision); ▪ Hold digoxin if AP less than 60. • Labetalol (beta blocker) for HTN and Severe HTN emergencies: blocks alpha and beta receptors o Notify prescriber for low pulse rate and do not give med; o SE is weight gain (fluid retention) – pulmonary assessment (which is… pulm edema crackles). o Remember monitoring weight is one of the best indicators of fluid gain or loss o 1 kg (2.2 lb) 1,000 mL fluid gain or loss in 24 hrs. • Nitroglycerin transdermal patch Tx chest pain (angina) – o Remove at night to allow 8 hours without patch (can produce tolerance in 24 hours); o May use SL nitro when wearing patch if patient having chest pain • Why wear gloves when applying nitroglycerin paste or patch? ▪ (Severe vasodilation, ↓BP, intense HA [may give acetaminophen for HA]) • Angina – for chest pain o If Vital Sign OK, leave nitro patch on and administer PRN Sublingual nitro • Pt. in CCU/ICU on nitro drip; o Becomes hypotensive, decrease rate of nitro drip • Calcium channel blockers – dipine (like amlopidine) verapamil (Calan) and diltiazem (Cardizem). o – dipine affect vessels only (vasodilation). ▪ SE: dizziness, facial flushing, hypotension, edema. o Verapamil (Calan) and diltiazem (Cardizem) also affect heart. o Monitor BP, HR (↓). ▪ Constipation & HTNis SE. Avoid grapefruit juice. ▪ • Aliskiren (Tekturna) – (direct renin inhibitor for HTN); o Teach don’t take if pregnant (stop drug if become pregnant); o don’t take with high fat meal. o May increase K+, so don’t take with other drugs that ↑ K+. • Furosemide (Lasix) – loop diuretic; rapid acting; o Used for rapid diuresis in emergencies (pulmonary edema); ▪ May produce hypokalemia (assess for muscle cramps, muscle weakness). Hypotension, F/E abnormalities, dehydration. o SE: dizziness, HA, tinnitus, N/V/D, ↓ K+, hyperglycemia, ▪ ototoxicity with aminoglycosides (-mycin drugs). • May need potassium supplement. o Foods containing potassium: dried fruits, fish, leafy veggies, squash, beans, meats, nuts, bananas, potatoes, dairy products. • IV potassium (KCl) – assess overall condition of the veins. Use large vein, like antecubital (AC) vein when administering potassium. o Venous access is important because IV potassium can irritate the vein. o Have patient notify nurse immediately if burning at site. IV K+ extravasation can cause necrosis of tissues. o Calculate and set the rate as ordered, know anticipated duration of therapy, know restrictions imposed by patient’s history. ▪ Don’t give IV push; infuse at a rate no greater than 20 mEq/hr; ▪ Concentration no greater than 40 mEq/L. • Always use infusion pump.

xamples, and to help students begin to “think like a nurse”. This is facilitated through: (a) the development of critical thinking skills, (b) identification of important cues in a clinical situation, (d) identification of multiple and complex health issues or multiple health problems in the older adult, and (e) prioritizing goals. Directions: ● Provide your responses to each of the questions accompanying each clinical situation. ● Students may work individually, in pairs, or small groups of no more than 4 persons. Students who work in teams are strongly encouraged to review responses together, and decide, which response(s) will be the final ones. This activity is different than dividing up tasks, cutting and pasting responses into one document for homework submission. If there is a different perspective or opinion about which response(s) are final ones, during the team review justify the choice and present a rationale to the team. ● If you are working as a pair or on a team of 4, please indicate all of your names on the assignment, your class section, and delegate one team member to upload a single completed assignment for the group. Upload to “Turnitin” on Moodle, by Tuesday, March 15th, 4:00pm. ● Cite resources and references used in completing this assignment in APA format 7 th ed. (see syllabus), including those from library databases such as CINAHL or Up-to-Date 1. Cultural Cues a. Highlight the statements below that nurses recognize as exacerbating health disparities and inequities in this client: Ms. Yazzie is a 78-year-old long-term care resident. She worked most of her life as a bartender. Her mother belonged to the Mescalero Apache Tribe in New Mexico. Her father was Caucasian. Her mother gave her up at birth, hoping she would be adopted, but she spent her childhood in foster care. As a young adult Ms. Yazzie was raped and severely beaten, resulting in PTSD. She is aggressive with personal care and does not allow men to touch her; only female nurses, assistive personnel, and staff work with her. She has a history of hypothyroidism, hypertension, multi-infarct dementia, and osteoarthritis with chronic pain. She has a 66-pack year history of smoking, and typically drank liquor each night while bartending. She is 5′5″ tall and weighs 110 pounds (BMI 18.30 kg/m2). She is no longer ambulatory. However, she wheels herself around the facility and can often be heard crying and repeatedly asking, “do you love me?.” She engages in conversation, and stops crying, when prompted and talks about her childhood when asked. Ms. Yazzie never married and has no children. b. In addition to exacerbating health disparities and inequities in this client, what are other issues that are of concern based on the information provided? List these. I am concerned about her psychosocial and neurological status given her history with PTSD, rape, drinking, aggression towards men, and her behavior in the facility (i.e. the crying and repeated asking: “do you love me?”) c. Are there other questions you would ask of Ms. Yazzie as you begin your shift with her? What are they? How are you feeling today? What kinds of medications do you take? Could you tell me about your drinking and smoking habits? Could you please tell me about your PTSD? What tends to trigger your PTSD? d. How would you approach her aggressive behavior? I would ask her culturally appropriate questions that will elicit a response and understanding about her aggressive behavior. Questions would include: Why do you think you tend to lash out when we are providing personal care? Is there something that we do that is triggering to you, in terms of your PTSD? How can we best support you and always provide personal care? e. Are there other important assessments or diagnostic tests that should be done? Which ones would you recommend? I would recommend assessment by a social worker or psychiatrist following your own psychosocial assessment. I would also follow through with a neurological assessment given her history of dementia. In addition, I would perform a musculoskeletal assessment, determining her functional skills and ADLs given limited mobility due to osteoarthritis and being confined to a wheelchair. Further, a cardiovascular assessment would be relevant given her history with hypertension and hypothyroidism. f. Given the list you have identified as issues of concern, which are immediate priorities? Immediate priorities include: aggressive behavior and history of PTSD, and behavior in the facility. g. Given the list you have identified as issues of concern, which are longer term priorities? Longer term priorities involve understanding her behavior, and her history of drinking and smoking. h. Who are other interprofessionals with whom you would consult in providing effective care for Ms. Yazzie? Social worker, psychiatrist, physical therapist. i. There is only 1 female RN, in the long term care facility, the nurse manager, where Ms.Yazzie stays. The RN is in meetings with long term care accreditation representatives from the State of California, who have made an unannounced visit that morning. The day shift staff on Ms.Yazzie’s include a male LVN (a licensed vocational nurse) who is assisting residents with rehabilitation exercises. Another staff member is a female CNA (certified nursing assistant) who is overseeing and assisting cognitively impaired and dysphagic residents with breakfast in the common dining room. She cannot leave these residents unattended. A newly licensed graduate, a male RN is in day one of his orientation to the facility with the director of staff development. How would you handle this situation given Ms. Yazzie’s information? Who would you assign to take care of Ms. Yazzie? Why? Given the responsibilities of both the CNA and LVN, it would be most appropriate to assign Ms. Yazzie to the female CNA since she has experience with cognitively impaired residents like Ms. Yazzie with multi infarct dementia and a history of aggressive behavior when it comes to personal care which can be attributed to agitation associated with dementias. 2. Patient-centered Care Highlight the statements below that correspond to a patient-centered culture: Mrs. Adams is an 87-year-old widowed female. She is being admitted to a rural long-term care (LTC) facility following hospitalization for uncontrolled hypertension. Prior to hospitalization, she had been living alone and it was determined she had not been taking her medications for hypertension, osteoporosis, depression, and coronary artery disease. The nurse completing her admission interview concludes by asking Mrs. Adams what time she usually eats, stating the facility serves food cafeteria style between 0600 and 0800 hours for breakfast, 1100 and 1300 for lunch, and 1700 and 1900 hours for dinner. Residents are assisted to bed by 2200 hours. Her bath days would be Tuesday, Thursday, and Saturday mornings. The nurse gives Mrs. Adams an activity schedule with the daily offerings and states that if she did not like any of them, they would try to find something else she enjoyed. 3. Assessment of Late Life Changes Which cues correspond to the “C” in the FANCAPES assessment pneumonic? The home health nurse is completing the intake assessment for Mr. Agens, an 85-year-old male. When responding to question, he replies in clear, complete sentences without dyspnea. He lives on his own in a small one story, two-bedroom home. He has been a widower for 10 years. His two adult children live in a neighboring state. They call him once a month and visit twice a year. He has a 60-pack year history of smoking; he has been using portable oxygen for the past 10 years. He states he has shortness of breath with exertion at times. He receives Meals-on-Wheels each weekday. His neighbor’s wife buys his groceries when she goes shopping once a week. He can cook simple meals without difficulty. Mr. Agens ambulates using a walker; he has used it for the past 3 years. He no longer drives. He attends the local senior center Bingo night each month and attends the local church on Sundays. He wears bilateral hearing aids and has no difficulty hearing the questions he is asked. Mr. Agens also wears bifocal glasses. He states he dropped out of school in the 8th grade to go to work. His vital signs include a blood pressure of 132/82 mm Hg, pulse of 80 beats per minute, respiratory rate of 14 breathes per minute, a temperature of 97.6°F, and pulse oximetry reading of 92% on O2 at 2 L per nasal cannula. 4. Safe Medication Use The nurse is performing the first home visit for Mr. Ortiz, an 86-year-old Hispanic male, following his discharge from the hospital for community-acquired pneumonia. Assessment findings include blood pressure of 110/60 mm Hg, heart rate of 75 beats per minute, respirations 14 breaths per minute, temperature 97.3°F, and oxygen 94% on room air. His heart has regular rate and rhythm; lungs with rhonchi left lower lobe; abdomen with normoactive bowel sounds, soft and nontender; no peripheral edema; skin warm and pale. He reports feeling fatigued but unable to sleep. He has pain in his back and ribs with coughing; he denies shortness of breath. Mr. Ortiz states his appetite has not yet returned, but he is trying to eat. States his last bowel movement was yesterday; it was soft. The hospital discharge summary notes these findings : ● HgbA1c of 7.2% (normal 5.7%), Higher A1c increases risk for DM II ● Creatinine 1.8 mg/dL (adults normal: male-0.6-1.2 mg/dl; female 0.5-1.1 mg/dl), High ● BUN 32 mg/dL(normal 8-21 mg/dl), High ● Sodium 134 mEq/L (normal 136-144 mEq/L), WNL ● Potassium 4.2 mEq/L (normal 3.5-5.0 mEq/L) WNL ● Glucose of 150 mg/dL (normal 110 mg/dl), High ● Hemoglobin/Hematocrit of 10.2 mg/dL and 30.0%. (hemoglobin adults normal: male-12.6-17.4 g/dl; female 11.7-16.1 g/dl)/ (hematocrit adults normal: male-36-52%; female 34-46%) Low When asked to show his medications, Mr. Ortiz brings out the following bottles: UTILIZE BEERS LIST ● Levofloxacin 750 mg daily; should be at 500 mg daily ● Lisinopril/hydrochlorothiazide 20/25 mg daily ● High Potency Multivitamin 400 mcg daily ● Calcium carbonate 500 mg daily ● Vitamin D3 400 units daily ● Aspirin 81 mg daily ● Metformin 850 mg twice daily indicated for PCOS, diabetes & prevention, antipsychotic-induced weight gain ● Glipizide 5 mg twice a day indicated for type 2 diabetes ● Gemfibrozil 600 mg daily ● Glucosamine and chondroitin 2 tabs daily ● Melatonin 300 mcg daily ● CoQ10 200 mg daily ● Odorless Garlic 1000 mg daily indicated for hypertension, atherosclerosis; OTC, not enough scientific evidence to support drug interactions ● Probiotics 2 caps daily ● Pantoprazole 20 mg daily indicated for GERD, erosive esophagitis, PUD, Zollinger Ellison disease, acid reflux ● Paroxetine 10 mg every evening antidepressant; indicated for diabetic nephropathy ● Percogesic Extra Strength 2 tabs every 6 hours as needed contains codeine, analgesic ● Tylenol 8-hour arthritis pain 2 tabs every 8 hours as needed a. Which medication should the nurse clarify with the provider? Select all that apply. 1. Levofloxacin 750 mg daily 2. Metformin 850 mg twice daily 3. Glipizide 5 mg twice a day 4. Odorless Garlic 1000 mg daily 5. Pantoprazole 20 mg daily 6. Paroxetine 10 mg every evening b. Are any of Mr. Ortiz’ medications on Beer’s list? (Consult the 2019 expert panel publication from the American Geriatrics Society posted on Moodle). If “yes” which ones? Are there alternative recommendations from the expert panel? If “yes” what is recommended? Yes, avoid paroxetine. c. Are there any discharge lab values that concern you? Which ones? Why? HgbA1c, creatinine, glucose are high; Hematocrit, Hemoglobin are low. High creatinine and glucose could indicate kidney failure. Low hematocrit and hemoglobin could mean you are losing red blood cells typically, through bleeding. d. Which physical assessment findings are of concern to you? Why? Physical assessment findings of concern include: rhonchi in left lung, pale skin, fatigue, pain in lower back, no appetite. These findings could indicate poor recovery from CAP. e. What are potential factors contributing to Mr. Ortiz’ fatigue? No physical activity, little appetite. f. What are potential factors contributing to Mr. Ortiz’ poor sleep? Fatigue, pain in lower back. g. What are potential factors contributing to Mr. Ortiz’ poor appetite? Pain in ribs when coughing. No appetite. 5. Clinical Judgment and Nutritional Health The nurse is completing the monthly nursing assessment of Mr. Dawson. Mr. Dawson is a 92-year old male. He has been at the long-term care facility for the past 5 years. His weight this month is 300 pounds (BMI 26.6 kg/m2). His blood pressure is 145/82 mmHg, heart rate 90 beats per minute, respirations 18 breaths per minute and temperature 97.4 degrees F (orally). He responds to questions appropriately. During the physical examination at 0900 hours, the nurse notes Mr. Dawson is drooling and coughing intermittently. His upper dentures fall when he opens his mouth for evaluation. His lungs are clear on examination and his heart has regular rhythm. Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided. The nurse recognizes that (1) Copious secretions, (2) Difficulty chewing, and (3) Coughing after eating, put Mr. Dawson at increased risk of (4) Dysphagia, and he should be (5) NPO, until the (6) Swallowing evaluation is completed. Options: Overnutrition Swallowing evaluation Depression Coughing after eating NPO

tory rate is 28 breaths per minute. A tube thoracostomy is performed for decreased left chest breath sounds with the return of a small amount of blood and no air leak. After chest tube insertion, the most appropriate next step is: Select one: a. reexamine the chest b. perform an aortogram c. obtain a CT scan of the chest d. obtain arterial blood gas analyses e. perform transesophageal echocardiography correct answer- A) Reexamine the chest A construction worker falls two stories from a building and sustains bilateral calcaneal fractures. In the emergency department, he is alert, vital signs are normal, and he is complaining of severe pain in both heels and his lower back. Lower extremity pulses are strong and there is no other deformity. The suspected diagnosis is most likely to be confirmed by: Select one: a. angiography b. compartment pressures c. retrograde urethrogram d. Doppler ultrasound studies e. complete spine x-ray series correct answer- e) Complete spine x-ray series Which of the following is true regarding the initial resuscitation of a trauma patient? Select one: a. A patient that presents with a torso gunshot wound and is hypotensive should receive crystalloid fluid resuscitation until the blood pressure is normal b. Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow coma scale score on reevaluation c. Massive transfusion is defined as transfusion of more than 10 of packed red blood cells and plasma in 24 hours d. When tranexamic acid is administered by pre-hospital providers a second dose is required within 24 hours e. Fluid resuscitation is far more important than bleeding control in trauma patients correct answer- b. Evidence of improved perfusion after fluid resuscitation could include improvement in Glasgow coma scale score on reevaluation In managing a patient with a severe traumatic brain injury, the most important initial step is to: Select one: a. Secure the airway b. obtain a c-spine film c. support the circulation d. control scalp hemorrhage e. determine the GCS score Feedback Your answer is correct answer- a. Secure the airway A previously healthy, 70-kg (154-pound) man suffers an estimated acute blood loss of 2 liters. Which one of the following statements applies to this patient? Select one: a. His pulse pressure will be widened. b. His urinary output will be at the lower limits of normal. c. He will have tachycardia, but no change in his systolic blood pressure. d. An ABG would demonstrate a base deficit between -6 and -10 mEq/L e. His systolic blood pressure will be maintained with an elevated diastolic pressure. correct answer- d. An ABG would demonstrate a base deficit between -6 and -10 mEq/L The physiologic hypervolemia of pregnancy has clinical significance in the management of the severely injured, gravid woman by: Select one: a. reducing the need for blood transfusion b. resulting in an elevated hematocrit c. complicating the management of closed head injury d. reducing the volume of crystalloid required for resuscitation e. increasing the volume of blood loss to produce maternal hypotension correct answer- e. increasing the volume of blood loss to produce maternal hypotension The best assessment of fluid resuscitation of the adult burn patient is: Select one: a. Urine output of 0.5 mL/kg/hr b. normalization of blood pressure c. normalization of the heart rate d. measuring a normal central venous pressure e. providing 4 mL/kg/percent body burn/24 hours of crystalloid fluid correct answer- a. Urine output of 0.5 mL/kg/hr The diagnosis of shock must include: Select one: a. hypoxemia b. acidosis c. hypotension d. increased vascular resistance e. evidence of inadequate organ perfusion correct answer- e. evidence of inadequate organ perfusion A 7-year-old boy is brought to the emergency department by his parents several minutes after he fell through a window. He is bleeding profusely from a 6-cm wound of his medial right thigh. Immediate management of the wound should consist of: Select one: a. application of a tourniquet b. direct pressure on the wound c. packing the wound with gauze d. direct pressure on the femoral artery at the groin e. debridement of devitalized tissue correct answer- b. direct pressure on the wound For the patient with severe traumatic brain injury, profound hypocarbia should be avoided to prevent: Select one: a. respiratory acidosis b. metabolic acidosis c. cerebral vasoconstriction with diminished perfusion d. neurogenic pulmonary edema e. shift of the oxyhemoglobin dissociation curve correct answer- c. cerebral vasoconstriction with diminished perfusion After being involved in a motor vehicle crash, a 25-year-old man is brought to a hospital that has surgery capabilities available.. Computed tomography of the chest and abdomen shows an aortic injury and splenic laceration with free abdominal fluid. His blood pressure falls to 70 mm Hg after CT. The next step is: Select one: a. obtain contrast angiography b. transfer to a higher level trauma center c. perform an exploratory laparotomy d. infuse additional crystalloid fluids e. Obtain transesophageal echocardiography correct answer- c. perform an exploratory laparotomy Which one of the following statements regarding abdominal trauma in the pregnant patient is TRUE? Select one: a. The fetus is in jeopardy only with major maternal abdominal trauma. b. Leakage of amniotic fluid is an indication for hospital admission. c. Indications for peritoneal lavage are different from those in the nonpregnant patient. d. With penetrating trauma, injury to the mother's abdominal hollow viscus is more common in late than in early pregnancy. e. The secondary survey follows a different pattern from that of the nonpregnant patient. correct answer- b. Leakage of amniotic fluid is an indication for hospital admission. The first maneuver to improve oxygenation after chest injury is to: Select one: a. intubate the patient b. assess arterial blood gases c. administer supplemental oxygen d. ascertain the need for a chest tube e. obtain a chest x-ray correct answer- c. administer supplemental oxygen A 25-year-old man, injured in a motor vehicular crash, is admitted to the emergency department. His pupils react sluggishly and his eyes open to pressure. He does not follow commands, but he does moan periodically. His right arm is deformed and does not respond to pressure; however, his left hand reaches purposefully toward the stimulus. Both legs are stiffly extended. His GCS score is: Select one: a: 2 b: 4 c: 6 d: 9 e: 12 correct answer- d: 9 Which one of the following findings in an adult is most likely to require immediate management during the primary survey? Select one: a. distended abdomen b. Glasgow Coma Scale score of 11 c. temperature of 36.5°C (97.8°F) d. deformity of the right thigh e. respiratory rate of 40 breaths per minute correct answer- e. respiratory rate of 40 breaths per minute This is just a small description,download to view full exam with all the correct answers