By Thomas T. Yoshikawa, Dean C. Norman

ISBN-10: 0585377359

ISBN-13: 9780585377353

ISBN-10: 0824703456

ISBN-13: 9780824703455

This incisive reference systematically studies the analysis and remedy of universal surgical and clinical emergencies in aged patients-thoroughly interpreting surgical interventions, drug remedies and drug prescribing protocols, life-threatening drug reactions, moral matters, and strategies of profiling sufferers for nursing care. Evaluates disorder states and gauges optimum responses to every, helping techniques with worthy case experiences. Written via over forty extraordinary medical examiners, Acute Emergencies and demanding Care of the Geriatric sufferer ·describes excellent patient-physician relationships in severe care settings ·highlights emergency administration of myocardial infarction and cardiogenic pulmonary edema ·illuminates moral questions surrounding confidentiality, proficient consent, surrogate determination making, and sufferer convenience ·assesses precise pharmacokinetic and pharmacodynamic stipulations in geriatric sufferers ·provides very important details on stroke, seizures, and spinal twine compression ·investigates serious issues as a result of pneumonia, meningitis, and endocarditis ·explores acute lung issues equivalent to emphysema, persistent bronchitis, pneumonia, vital fearful procedure disorder, and irregular regulate of air flow ·clarifies preoperative approaches for emergency surgical procedure ·reviews anesthesia options for pulmonary, cardiovascular, renal, hepatic, and neurological stipulations within the aged ·and extra! together with over a thousand references, tables, and illustrations, Acute Emergencies and important Care of the Geriatric sufferer is an necessary source for geriatricians, basic care physicians, internists, emergency drugs physicians, intensivists, hosptialists, surgeons, anesthesiologists, orthopedists, cardiologists, psychiatrists, neurologists, and internists/residents in those disciplines, in addition to nurses, pharmacists, and clinical scholars.

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Example text

Opioids should be used if needed. To begin, small doses of morphine can be used, and the dose and frequency can be increased as needed to achieve comfort. Opioid drugs that are titrated to effect are rarely a contributing cause of death. If anything, they are likely to extend life by preserving energy and allowing more movement. Even when they might accelerate dying, they still should be used. Patients near death deserve relief from suffering, and slight risks on survival are considered justified.

Opioid drugs that are titrated to effect are rarely a contributing cause of death. If anything, they are likely to extend life by preserving energy and allowing more movement. Even when they might accelerate dying, they still should be used. Patients near death deserve relief from suffering, and slight risks on survival are considered justified. Sometimes, law and ethics rely on a justification known as the principle of double effect. In short, this requires that the physi- 24 Cobbs and Lynn cian must be prudently balancing risks and benefits and cannot ever aim to cause death (16).

Whenever possible, the patient should be positioned comfortably and safely, which may require extra pillows, side rails, and frequent observation. Precautions must be taken to prevent injury, such as a fall or a pressure ulcer. Keeping the patient warm, clean, and dry is often of great importance to overall comfort. Extra blankets and attentive nursing care may achieve the better part of the foundation of symptom management for the seriously ill older person. Conversely, a pressure ulcer from a hard stretcher or a fracture while in the emergency department are very troubling calamities.

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Acute Emergencies and Critical Care of the Geriatric Patient by Thomas T. Yoshikawa, Dean C. Norman


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