patient history is as follows. patient1( my 1st day don't forget to mention that I familiarize...

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patient history is as follows. patient1( my 1st day don't forget to mention that I familiarize myself with the unit). a 69 year old Caucasian male with a history of coronary artery disease, type 2 diabetes millitus and chronic kidney disease, now admitted to ICU with acute onset of congestive heart failure and pneumonia,clinically improved with BIPAP. able to place folley cather with my preceptor guidance to monitor his input and out put. hypertension is stable with medicine. he has mild anemia which may be due to chronic kidney disease. has mild metabolic acidosis most likely related to chronic kidney disease as well. familiarize myself with I stat machine to find out his lactic acid level, adminsterd IV lasix 80 mg bid to decrease his blood pressure and reduce swelling,draw lab to check his BUN and creatinene , urine sodium and protein.
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71 year old female with admitting diagnoses of hypotention.has history of end stage renal disease, hemodialisis for past 13 years,chronic hypotension, history of left upper extermity AV assess whichis not currently able to use. she is acutely and chronically ill-appearing eldery women, complaining of being cold under multipe blanket and etc. all in all, I familiarize myself with dialysis procedure with the dialysis nurse brought the motion to ICU, currently dialyzing via a left femoral tunnel dialysis catheter, familiarize myself with how to hung iv fluids and set iv pump.

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Daily Hours: 0700-1730 Cumulative Hours: 12 hours Date: February 11, 2008 Daily Learning Objectives: To demonstrate professional behaviors including punctuality and appropriate dress according to institution policy. To establish a professional relationship with my preceptor and the rest of the staff. To become familiar with the layout of the unit, where all equipment can be located, and with the day to day operation of the unit. Learning Strategies:Preceptor instruction Clinical agency documentation: XXXX 6010/26 (Rev 05/06). Emergency Department Registration Form XXXX 6400/2 (Rev 04/06). Emergency Department Nursing Record XXXX 6400/5 (Rev 02/06). Emergency Medicine Department Triage Note Literature review obtained from: Abbott Point of Care, Inc. (1997-2008). Product Info: i-Stat 1. Retrieved February 23, 2008, from HYPERLINK "http://www.abbottpointofcare.com/istat/www/products/analyzers.htm" http://www.abbottpointofcare.com/istat/www/products/analyzers.htm The information that I utilized from this reference was to gain a better understanding of the i-STAT 1 handheld blood gas analyzer used in the ED. This handheld analyzer provides reliable test results in a little as two minutes with only a few drops of blood. It can test for blood gases, electrolytes, chemistries, coagulation, hematology, glucose, and cardiac markers allowing for faster interventions for serious compromises in client status. I also was able to review the directions on how to use the handheld analyzer. Dreskin, S. C., & Palmer, G. W. (2005, October 7). eMedicine: Anaphylaxis. Retrieved February 23, 2008, from HYPERLINK "http://www.emedicine.com/med/topic128.htm" http://www.emedicine.com/med/topic128.htm The information that I utilized from this reference was to better understand the acute systemic reaction that occurs during anaphylaxis. Anaphylactic reaction is usually a type I IgE-mediated hypersensitivity reaction of more than one organ...

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patient history is as follows.  
patient1( my 1st day don't forget to mention that I familiarize myself with the unit). 
a 69 year old Caucasian male with a history of coronary artery disease, type 2 
diabetes millitus and chronic kidney disease, now admitted to ICU with acute onset 
of congestive heart failure and pneumonia,clinically improved with BIPAP. able to 
place folley cather with my preceptor guidance to monitor his input and out put. 
hypertension is stable with medicine. he has mild anemia which may be due to 
chronic kidney disease. has mild metabolic acidosis most likely related to chronic 
kidney disease as well. familiarize myself with I stat machine to find out his lactic 
acid level, adminsterd IV lasix 80 mg bid to decrease his blood pressure and reduce 
swelling,draw lab to check his BUN and creatinene , urine sodium and protein. 
Type 2 diabetes carries an unequivocal risk for cardiovascular disease. Patients 
with diabetes have the same risk for future cardiovascular events as survivors of 
myocardial infarction. Morbidity and mortality in diabetes is largelydriven by 
atherosclerotic complications. Just the presence of diabetes has a fundamental, 
pervasive effect on the vasculature;for example, erasing the gender benefit seen in 
women in terms of cardiovascular disease and making all patients with diabetes 
less likely to benefit from advances in cardiovascular therapeutics. Adding diabetes 
to CKD only amplifies cardiovascular risk. Many of the metabolic abnormalities 
thought to promote atherosclerosis in type 2 diabetes (e.g., elevated triglycerides, 
low HDL, visceral adiposity, hypertension, hypercoagulability, inflammation) are 
also common in CKD. Indeed, microalbuminuria may well be a missing 
component in the definition of metabolic syndrome. CKD promotes atherosclerosis 
by worsening these metabolic abnormalities. Impaired kidney function has been 
linked to proatherosclerotic mechanisms such as oxidative stress, inflammation, 
endothelial dysfunction, and activation of the renin-angiotensin system. 
Hypertriglyceridemia, 
common in CKD, may foster lipid accumulation in renal cells, instigating 
pathological responses.

patient history is as follows. patient1( my 1st day don't forget to mention that I familiarize myself with the unit). a 69 year old Caucasian male with a history of coronary artery disease, type 2...

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