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Check out the Khan Academy YouTube on Moodle in the Cardiac Section

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Check out the Khan Academy YouTube on Moodle in the Cardiac Section

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Hello, please can you clarify more the cold therapy for sudden cardiac arrest. Is it one of the collaborative care for ACS? I also can't seem to connect the sudden cardiac arrest with ACS.

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Hello, please can you clarify more the cold therapy for sudden cardiac arrest. Is it one of the collaborative care for ACS? I also can't seem to connect the sudden cardiac arrest with ACS.

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Thank you.

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Acute coronary syndrome may result in sudden cardiac arrest.    An MD may order therapeutic hypothermia in response to the client's condition.  

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Acute coronary syndrome may result in sudden cardiac arrest.    An MD may order therapeutic hypothermia in response to the client's condition.  

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In acute coronary syndrome, a client may experience sudden cardiac arrest.  An MD may order therapeutic hypothermia as the age and condition of the client suggests.

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In acute coronary syndrome, a client may experience sudden cardiac arrest.  An MD may order therapeutic hypothermia as the age and condition of the client suggests.

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in our power points it mentions how methlyprendisone is the tx for swelling in SCI but in our books on page 1426 it says methlyprendisone is no longer approved by the FDA because there are no signs it improves acute SCI and actually has harmful side effects
?

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Great Question!  High Doses of Methyprednisolone do have harmful effects (blood clots, hyperglycemia, or  PNA). Low does does not report that.  In light of the fact that your text book's report (and Mayo Clinic, and the FDA) of the Methylprednisolone not being used as a means of inflammation reduction, please do not include that in your course of study for the exam.  

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Great Question!  High Doses of Methyprednisolone do have harmful effects (blood clots, hyperglycemia, or  PNA). Low does does not report that.  In light of the fact that your text book's report (and Mayo Clinic, and the FDA) of the Methylprednisolone not being used as a means of inflammation reduction, please do not include that in your course of study for the exam.  

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Please explain

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What needs to be explained

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For patients with AKI what is the recommended diet as far as protein? our textbook i believe says high protein where as ati book says low protein?  I know when receiving dialysis its a high protein diet but what about pre-dialysis ?

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For patients with AKI what is the recommended diet as far as protein? our textbook i believe says high protein where as ati book says low protein?  I know when receiving dialysis its a high protein diet but what about pre-dialysis ?

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Protein Intake and Pre-Dialysis DietAccording to the American Association of Kidney Patients, those who are in the initial stage of renal disease should reduce the intake of protein and should control their blood pressure, so that the progression of chronic kidney disease to end stage renal failure can be slowed effectively. A daily intake of 40 to 50 gram of protein is optimum for most patients, i.e. about 0.6 gram of protein per kilogram of body weight. The objective of a low protein diet is to preserve the existing kidney functioning. Fish, lean meat, egg white etc. are good choices for attaining your desired protein intake, but you will have to limit the consumption. 1 ounce of chicken contains about 7 gram of protein.Sodium and Pre-Dialysis DietA low sodium diet will help preventing high blood pressure and will assist your kidneys in retaining water in our body. This in turn will ease the kidney from some of its burdensome functions. You should choose fresh, frozen fruits and vegetables rather than those treated with preservatives or salt.Fluid Intake and Pre-Dialysis DietThe amount of fluid you take in should be restricted as the kidney will have to work more if you take in more fluid. A fluid intake of 5-7 glasses a day would be ideal in a pre-dialysis meal plan.A Sample Pre-Dialysis Diet PlanAn English muffin with unsalted margarine, grapes, and a cup of tea with sugar substitute will be an ideal breakfast for a pre-dialysis patient.  A sample lunch would be 1 ounce of unsalted tuna packed in water, 1 slice of whole grain wheat bread. An ideal dinner would be 2 ounces of chicken breast, 6 ounces of asparagus, and one medium potato, one slice of angel food cake and fresh strawberries or grapes.  While this is a sample, and it seems limiting, you can follow much more structured diet plans to achieve the best control and improvements in health.Read More About A Renal Diet here: http://www.renaldiethq.com/choosing-a-pre-dialysis-diet-plan/

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Protein Intake and Pre-Dialysis DietAccording to the American Association of Kidney Patients, those who are in the initial stage of renal disease should reduce the intake of protein and should control their blood pressure, so that the progression of chronic kidney disease to end stage renal failure can be slowed effectively. A daily intake of 40 to 50 gram of protein is optimum for most patients, i.e. about 0.6 gram of protein per kilogram of body weight. The objective of a low protein diet is to preserve the existing kidney functioning. Fish, lean meat, egg white etc. are good choices for attaining your desired protein intake, but you will have to limit the consumption. 1 ounce of chicken contains about 7 gram of protein.Sodium and Pre-Dialysis DietA low sodium diet will help preventing high blood pressure and will assist your kidneys in retaining water in our body. This in turn will ease the kidney from some of its burdensome functions. You should choose fresh, frozen fruits and vegetables rather than those treated with preservatives or salt.Fluid Intake and Pre-Dialysis DietThe amount of fluid you take in should be restricted as the kidney will have to work more if you take in more fluid. A fluid intake of 5-7 glasses a day would be ideal in a pre-dialysis meal plan.A Sample Pre-Dialysis Diet PlanAn English muffin with unsalted margarine, grapes, and a cup of tea with sugar substitute will be an ideal breakfast for a pre-dialysis patient.  A sample lunch would be 1 ounce of unsalted tuna packed in water, 1 slice of whole grain wheat bread. An ideal dinner would be 2 ounces of chicken breast, 6 ounces of asparagus, and one medium potato, one slice of angel food cake and fresh strawberries or grapes.  While this is a sample, and it seems limiting, you can follow much more structured diet plans to achieve the best control and improvements in health.Read More About A Renal Diet here: http://www.renaldiethq.com/choosing-a-pre-dialysis-diet-plan/

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I encountered this same issue with protein when taking the quiz on Evolve Elsevier.... A nurse is giving dietary advice to a patient who is on continuous ambulatory peritoneal dialysis for chronic renal failure. Which dietary instructions are appropriate for this patient? Select all that apply.  The two answers were high calorie foods and high protein foods.  The rational for a client on CAPD is as follows:  A chronic renal failure patient on continuous ambulatory peritoneal dialysis is encouraged to have a high-calorie diet to meet the increased demands of the body. A good amount of protein should be consumed to replace that lost during dialysis. Foods containing high amounts of potassium and phosphorus should be avoided in patients with chronic renal failure. High potassium can cause hyperkalemia and related complications, especially cardiac complications. High phosphorus may deteriorate bone health. Usually there is a modest restriction of fluids when the patient is on dialysis.Text Reference - p. 1115

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I encountered this same issue with protein when taking the quiz on Evolve Elsevier.... A nurse is giving dietary advice to a patient who is on continuous ambulatory peritoneal dialysis for chronic renal failure. Which dietary instructions are appropriate for this patient? Select all that apply.  The two answers were high calorie foods and high protein foods.  The rational for a client on CAPD is as follows:  A chronic renal failure patient on continuous ambulatory peritoneal dialysis is encouraged to have a high-calorie diet to meet the increased demands of the body. A good amount of protein should be consumed to replace that lost during dialysis. Foods containing high amounts of potassium and phosphorus should be avoided in patients with chronic renal failure. High potassium can cause hyperkalemia and related complications, especially cardiac complications. High phosphorus may deteriorate bone health. Usually there is a modest restriction of fluids when the patient is on dialysis.Text Reference - p. 1115

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In the powerpoint it says that people who have anemia caused by CKD should not get blood transfusions. Why not?

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In CKD,  Undesirable effects of transfusions include suppression of erythropoiesis as a result of a decrease in the hypoxic stimulus and the possibility of iron overload, because each unit of blood contains about 250 mg of iron. So, in the case of  anemia in CKD, erythropoetin is adminnstered to produce more red blood cells.  

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In CKD,  Undesirable effects of transfusions include suppression of erythropoiesis as a result of a decrease in the hypoxic stimulus and the possibility of iron overload, because each unit of blood contains about 250 mg of iron. So, in the case of  anemia in CKD, erythropoetin is adminnstered to produce more red blood cells.  

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Good question....keep them coming.

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In cases of shock, is cardiac output increased or decreased? Does it depend on the type of shock?

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the slide that says "empiric antibiotics, based on suspected source" does that mean based on the type of organism or the origin (i.e. appendectomy etc.). Also, does this mean we would obtain labs prior to administering broad spectrum antibiotics, or administer first than obtain labs?

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I noticed for radial and carotid pulses, on slide 24 of trauma and slide 12 of shock we were given two different numbers, which one is correct?

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Yes, Cardiac Output [CO] will increase or decrease depending on the type of shock and the duration of shock.  I.e. septic shock CO increases while in cardiogenic shock, the CO decreases.

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Yes, Cardiac Output [CO] will increase or decrease depending on the type of shock and the duration of shock.  I.e. septic shock CO increases while in cardiogenic shock, the CO decreases.

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Yes, blood or urine cultures are obtained before broad spectrum antibiotics are administered.  In the case of Sepsis in particular, survival increases for patient’s treated with the exact antibiotic for the organism causing the infection.  

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Yes, blood or urine cultures are obtained before broad spectrum antibiotics are administered.  In the case of Sepsis in particular, survival increases for patient’s treated with the exact antibiotic for the organism causing the infection.  

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The quick SBP assessment for carotid pulse should be 60 on both ppt slides

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The quick SBP assessment for carotid pulse should be 60 on both ppt slides