Placenta Previa Essay Example for Free

Placenta Previa Essay The topic I have chosen for my journal is placenta previa. My patient, 39-year-old M.C came in to the hospital for her fourth cesarean delivery. She has three healthy children that are twenty, ten and two years old. She is not a good candidate for vaginal birth because she has an android or heart shaped pelvis. The birth of her first child resulted in an emergency cesarean delivery and she has opted to have planned cesarean deliveries since then. During this pregnancy M. C had preeclampsia, which is an increase in blood pressure after 20 weeks gestation, which is also commonly accompanied by protenuria. During this pregnancy M.C also had placenta previa, which is a placental implantation in the lower uterine segment over or near the internal os of the cervix (Buckley Schub, 2013). M.C did not have this complication in her other 3 pregnancies. It is a very rare occasion occurring in only 2 per 1,000 births or 0.3-0.5% of all pregnancies in the United States. Placenta previa occurs during the second or third trimester. There are three types of placenta previa, which are total, partial and marginal. M.C presented with marginal placenta previa also known as low lying, which occurs when the edge of the placenta reaches the internal cervical os (Buckley Schub, 2013). The cause of placenta previa is not known but it may be from abnormal vascularization due to a prior uterine injury (Buckley Schub, 2013). M.C presented with vaginal bleeding during her pregnancy and that is when she found out about her condition. Placenta previa is the most common cause of bleeding in the second half of pregnancy (Buckley Schub, 2013). If a patient presents with sudden, painless vaginal bleeding beyond 20 weeks gestation than placenta previa should be suspected. If placenta previa is suspected the use of a transvaginal ultrasound is the most useful diagnostic tool and has an accuracy of 100% in diagnosing placenta previa. After M.C was diagnosed with placenta previa she was ordered to be on bed rest for the rest of her pregnancy and was monitored very closely by her obstetrician. There are many potential complications that come with placenta previa and a few are premature rupture of membranes, preterm birth, placental abruption, postpartum hemorrhage, anemia, infection disseminated intravascular coagulation, shock, renal failure, thrombophlebitis and maternal or fetal death (Buckley Schub, 2013). According to Buckley Schub, (2013) â€Å" for women who have had multiple cesarean deliveries the risk for placenta previa can reach 10%† and M.C had three previous cesarean sections which could be a reason why she developed this condition. M.C was carrying a boy and placenta previa is also more common in pregnancies with male fetuses (Buckley Schub, 2013). Fortunately M.C was able to carry her baby boy to term but 50% of women with placenta previa have a preterm delivery. The treatment goals for patients with placenta previa is to monitor the mothers vital signs, vaginal bleeding and watch for physiologically signs of hemorrhage, shock and infection. Closely monitor the fetal heart tones for any type of distress such as bradycardia, tachycardia and late and variable decelerations. Closely monitor post-surgical patients for bleeding, infection and other complications. Assess the patient’s anxiety level and any knowledge deficits the patient might have regarding placenta previa. Provide the patient is emotional support, education regarding the condition and reassurance that the prognosis is usually good.

What’s in a Name? :: essays papers

What’s in a Name? I have always been very proud of everything that I have accomplished in my life. I am proud of one thing more than anything else; my heritage. Ever since I was a child I was told all about my grandparents and their trek from Denmark to the United States. I was curious what their homeland was like, but it never seemed to be a topic of discussion. My grandmother boasted the Danish flag in her home, and displayed little trinkets that said â€Å"velkomen† on them. My knowledge was limited to these few things I saw when I was a child. Since both of my grandparents had passed away, I started my research by picking up the phone and calling my father. My father, Larry Jensen, didn’t know very much about Denmark either. He knew a few names from his family and their birth dates, so I started from there. I hit the internet with my newly obtained knowledge and I searched for anything that could link me to my past. I did not find anything about any of my specific relatives, but I learned about how and why I got my last name. Apparently, Danish people did not have last names until the late 19th century when new laws were introduced forcing them to take on a surname. The common people of Denmark didn’t use family names to identify themselves. Before it was required to have a last name, people used patronymics, meaning they took on their father’s first name with an ending to make their last name. It was also common for people in a town that was large to use their occupation or place of residence as a last name. Many of the girls would get the father’s first name with â€Å"datter† or â€Å"dot ter† attached to it (meaning daughter of.) The boys would get their father’s first name with â€Å"sen† or â€Å"son† attached to it (meaning son of.) In Denmark, â€Å"datter† and â€Å"dotter† meant the same thing, just as â€Å"sen,† and â€Å"son† were the same thing (Origins of Danish Names). The name Jensen, meaning â€Å"son of Jens,† has many different spellings. The Dutch forms of Jensen are Jans, Johansen, Janse, Jansen, Janssen, Hoensen and Janzen. The root of all of these names comes from the stem or the variation of a stem, which is Jan.

Kidney Stone Ncp

Kidney Stone Care Plan Admitting Diagnoses: Client not being admitted at this time Current Diagnosis: Ureteral Calculi Other Medical Diagnoses: HTN, Hyperlipidemia, Kidney stones, Smokes Tobacco, Tonsillectomy-child age yrs. Pathophysiology: Urinary calculi are solid particles in the urinary system. They may cause pain, nausea, vomiting, hematuria, and, possibly, chills and fever due to secondary infection. Diagnosis is based on urinalysis and radiologic imaging, usually noncontrast helical CT. Treatment is with analgesics, antibiotics for infection, and, sometimes, shock wave lithotripsy or endoscopic procedures.About 1/1000 adults in the US is hospitalized annually because of urinary calculi, which are also found in about 1% of all autopsies. Up to 12% of men and 5% of women will develop a urinary calculus by age 70. Calculi vary from microscopic crystalline foci to calculi several centimeters in diameter. A large calculus, called a staghorn calculus, can fill an entire renal calyc eal system. About 85% of calculi in the US are composed of Ca, mainly Ca oxalate. Composition of urinary calculi; 10% are uric acid; 2% are cystine; most of the remainder are Mg ammonium phosphate (struvite).General risk factors include disorders that increase urinary salt concentration, either by increased excretion of Ca or uric acid salts, or by decreased excretion of urine or citrate. Urinary calculi may remain within the renal parenchyma or renal pelvis or be passed into the ureter and bladder. During passage, calculi may irritate the ureter and may become lodged, obstructing urine flow and causing hydroureter and sometimes hydronephrosis. (Preminger, MD, 2012) Common areas of lodgment include the ureteropelvic junction, the distal ureter, and the ureterovesical junction.Larger calculi are more likely to become lodged. Typically, a calculus must have a diameter > 5 mm to become lodged. Calculi ? 5 mm are likely to pass spontaneously. Even partial obstruction causes decreased gl omerular filtration, which may persist briefly after the calculus has passed. With hydronephrosis and elevated glomerular pressure, renal blood flow declines, further worsening renal function. Generally, however, in the absence of infection, permanent renal dysfunction occurs only after about 28 days of complete obstruction.Secondary infection can occur with long-standing obstruction, but most patients with Ca-containing calculi do not have infected urine. Preminger, MD, G. M. (n. d. ). Nephrolithiasis; stones; urolithiasis. Retrieved from http://www. merckmanuals. com/professional/genitourinary_disorders/urinary_calculi/urinary_calculi. html Textbook clinical symptoms: The major manifestation of stones is severe pain, commonly called renal colic. Flank pain suggests the stone is located in the kidney or upper ureter. Flank pain that extends toward the abdomen or to the scrotum and testes or the vulva suggests that stones are in the ureters or bladder.Nausea, vomiting, pallor, and d iaphoresis often accompany the pain. Frequency or dysuria occurs when a stone reaches the bladder. (Ignatavicius & Workman, 2010) pg 1571 Actual symptoms: Flank pain extending toward the abdomen, dizziness, sweating, and nausea w/o vomiting. Patient states his pain is an 8/10 on the pain scale. Pain is described as constant and sharp with no alleviating factors. Complications or potential complications: Potential; Hydroureter, hematuria, hydronephrosis, abrasion, oliguria or anuria, and infection. Ignatavicius & Workman, 2010) pg 1571-1572 Safety Issues: Fall risk level – Low, but still a potential complication from patient’s c/o dizziness from pain. Delegation Issues: Assist patient when ambulating. |Client Data | |Age | |38 | |Physical Exam (include all body systems) | (Physical Exam) | |Age | |38 | | | |Male | | | |Height | |69. in | |Weight | |180lb | |Temp | |99F | |Pulse | |90 | |Apical Pulse | |88 | |Resp | |20 | |BP | |169/71 | |BP supine | |( Noted | |O2 Saturation | |100% RA | | | | | |NEURO: nonfocal, AXOX4, c/o pain. |HEENT: Denies headache; PERRLA, Ears unobstructed, symmetrical, no loss of hearing, Nares are clear, w/o drainage or obstruction, Oropharynx is clear w/ | |membranes pink in color and intact, Neck is supple with full range of motion, | |INTEGUMENT: Skin warm, moist-diaphoretic, intact w/saline lock in RU-AC, dressing is clean, intact, non-tender, free of redness. | |CARDIOVASCULAR: No JVD noted, apical pulse regular at 88bpm, S1/S2 auscultated, no c/o chest pain/pressure | |distal pulses palpated in all extremities, capillary refill

Alfred Charles Kinsey s The Reception Of The Kinsey

Alfred Charles Kinsey vs. Historian Dagmar Herzog Alfred Charles Kinsey altered the way in which people of the twentieth century understood homosexuality. Kinsey’s findings created a great deal of discussion and controversy that became an enduring part of American culture. Historian Dagmar Herzog’s work The Reception of the Kinsey Reports in Europe observed European and American reactions to both volumes of Kinsey’s work. Alfred Charles Kinsey’s work supports and challenges Historian Dagmar Herzog’s findings. Alfred Charles Kinsey’s work supports Historian Dagmar Herzog’s findings on European activists’ views over the Kinsey Scale. However, Alfred Charles Kinsey’s work also challenges Historian Dagmar Herzog’s findings on Europeans’†¦show more content†¦The scale ranged from zero, for exclusively heterosexual with no experience with or desire for sexual activity with their same sex, to six, for exclusively homosexual with no experience with or desire for sexual activity with those of the opposite sex, and one through five for varying levels of desire or sexual activity with either sex (â€Å"The Kinsey Institute – Kinsey Sexuality Rating Scale,† n.d.). The Kinsey Scale made homosexual behavior, not only more common, but also less pathological. Alfred Charles Kinsey’s work supports Historian Dagmar Herzog’s findings by comparing Europeans’ reactions to Kinsey’s research on homosexuality. With Americans’ reactions Kinsey’s research had a profound effect on the gay subculture in the United States (â€Å"The Kinsey Institute – Kinsey Sexuality Rating Scale,† n.d.). However, it also impacted homosexuals in other parts of the world. Historian Dagmar Herzog argues that activists for homosexual rights in France and West Germany were thrilled by Kinsey’s research that showed heterosexual and homosexual behaviors as being on a continuum rather than as a dichotomy between gay and straight (Herzog, 2006). This is ultimately due to the fact that in West Germany homosexuality was still illegal and in