Slip Inn

By M. Sebastian. Marist College.

Not surprisingly discount 1pack slip inn visa herbals2go, writing often becomes a battleground order slip inn 1pack on line herbs collinsville il, where those who have power give a hard time to those who might wish to wrest power from them in the future. Modern word processing packages allow us to use a wide range of them nowadays, but this does not mean that you have to use all of them at the same time (see typefaces). Pomposity A disease of the over-comfortable, characterized by a tendency to use long words and needless phrases. Pompous initial capitals There is great confusion over the use of capitals. Some people feel that an Initial Capital Letter conveys Dignity, and should therefore be used to describe People and Institutions whom we know and value. Thus we talk about Professors and University and Gynaecology and Resource Management Initiatives. Also, most research on writing shows clearly that capitals are hard to read and slow the reader down. They send a strong message that We are Important (though you, dear reader, are not). And when we start writing Consultants and Doctors but patients and nurses, then it risks becoming offensive – and therefore bad communication. Make an exception to this rule wherever there is likely to be major confusion. Positives Readers find it easier to cope with what is rather than what is not. This has demotivated several otherwise good writers (see macro-editing). Posters A poster is simply a way of communicating informa- tion on a single sheet of paper, cardboard, etc. We are surrounded by them, which suggests that they are an excellent way of putting messages across (see PIANO). The medical and scientific community has adopted them as an important part of their intraprofessional communication. But in this context the posters are usually dull and 97 THE A–Z OF MEDICAL WRITING badly presented, apparently favouring cut-down versions of the scientific paper (see IMRAD), rather than using the medium to its full potential. This makes it particularly important for those who wish to present a poster to work out in advance why they are doing it, and how they will judge their success (see brief setting). You may want to influence your supervisor, who will be at the conference, in which case you should look at his or her posters and follow that style. You may be wanting to impress the prestigious research unit up the road, in which case follow their style. On the other hand, you may wish to make an impact, in which case you should consider doing something fairly dramatic, such as limiting your poster to a photograph, one main sentence in bold type, and a few numbers. Once you have decided what you want to achieve, you can start thinking about the mechanics. Print out individual sheets of text and glue them onto large sheets of card. Print out your text onto sheets of A4, enlarge them onto a clean photocopier to A3 and then get them encapsulated. This makes them tough and transportable – even in a normal- sized briefcase. When you have finished, send the file to a specialist printer who will print it out on a large sheet of paper. In many institutions there are specialist departments who will construct these for you. They will normally have considerable expe- rience of producing posters, and are worth listening to. However, you will be responsible for your poster, so keep the following principles in mind. Many people feel that being creative with a poster involves overloading it with text and different typographical devices. Trim your message to the bare essentials; this is not an examination but the communication of a message to someone whose feet are beginning to hurt. If you use illustrations make sure they are good, and that they are there for a purpose (e.

In one study of 1116 hospi- keted in dosage forms and concentrations suitable for tals cheap 1pack slip inn with amex himalaya herbals india, medication errors (a total of 430 purchase slip inn 1pack free shipping rumi herbals pvt ltd,586) were reported in adults. This often requires dilution, calculation, prepara- approximately 5% of admitted patients. Each dose of a drug must be recorded require additional treatment, or death). Specific drugs often associated with errors include in- ized, locked cabinets for which each nurse on a unit has a sulin, heparin, and warfarin. These automated systems maintain an inventory getting each dose of a medication to the intended client. Each step or person has a potential for contributing to a Controlled drugs, such as opioid analgesics, are usually medication error (Box 3–1). All health care providers in- kept as a stock supply in a locked drawer or automated cabi- volved in drug therapy must be extremely vigilant in all net and replaced as needed. Each nurse must comply with legal regulations and agency policies for dispensing and recording controlled drugs. The unit- MEDICATION ORDERS dose system, in which most drugs are dispensed in single- dose containers for individual clients, is widely used. The main pur- for information about prescription and nonprescription drugs pose of including potential sources of errors here is to increase the when needed. Drugs may have similar names that can lead to erroneous pre- Health Care Providers scribing, dispensing, or administration. As a result, the FDA-proposed labeling function, and disease process when selecting a drug or dosage; fail changes to make the differences more noticeable. The FDA is to consider other medications the client is taking, including pre- also looking at proposed trade names of new drugs prior to mar- scription and over-the-counter drugs; lack sufficient knowledge keting, to see if they are likely to be confused with older drugs, about the drug; fail to monitor for, or instruct others to monitor for, and increasing surveillance of medication errors attributed to effects of administered drugs; and fail to discontinue drugs appro- drug name confusion. This can dispense incorrect medications, mislabel containers, or fail to ask lead to errors if container labels are not read carefully, especially outpatients about other drugs being taken. Nurses may have in- if the products are shelved or stored next to each other. Clients/Consumers People may take drugs from several prescribers; fail to inform one Circumstances physician about drugs prescribed by another; get prescriptions Prescribers, pharmacists, and nurses may have a heavy workload, filled at more than one pharmacy; fail to get prescriptions filled or with resultant rushing of prescribing, dispensing, or administering refilled; underuse or overuse an appropriately prescribed drug; medications. They may also experience distractions by interrup- take drugs left over from a previous illness or prescribed for some- tions, noise, and other events in the work environment that make one else; fail to follow instructions for drug administration or stor- it difficult to pay needed attention to the medication-related task. Occasionally, verbal or telephone orders are accept- DRUG PREPARATIONS AND able. Some drugs are available in only one dosage pharmacy staff prepare a computer-generated MAR for each form; others are available in several forms. For clients in ambulatory care settings, the procedure is es- Dosage forms of systemic drugs include liquids, tablets, sentially the same for drugs to be given immediately. For drugs capsules, suppositories, and transdermal and pump delivery to be taken at home, written prescriptions are given. Systemic liquids are given orally (PO) or by injec- tion to the previous information, a prescription should include tion. Prescriptions for drug plus binders, colorants, preservatives, and other sub- Schedule II controlled drugs cannot be refilled. Capsules contain active drug enclosed in a gelatin cap- To interpret medication orders accurately, the nurse must sule. Most tablets and capsules dissolve in the acidic fluids of know commonly used abbreviations for routes, dosages, and the stomach and are absorbed in the alkaline fluids of the upper times of drug administration (Table 3–1). Tablets for sublingual or buccal ad- ministration must be specifically formulated for such use. TABLE 3–1 Common Abbreviations Several controlled-release dosage forms and drug delivery systems are available and more continue to be developed. Routes of Drug Administration These formulations maintain more consistent serum drug lev- IM intramuscular els and allow less frequent administration, which is more con- IV intravenous venient for clients.

The client will: • Receive or self-administer the drugs as directed Contraindications to Use • Receive prompt and appropriate treatment if adverse ef- fects occur Both tetracyclines and sulfonamides are contraindicated in clients with renal failure purchase 1pack slip inn free shipping herbs used for healing. Tetracyclines are also contraindi- Interventions cated in pregnant women and in children up to 8 years of • During tetracycline therapy for systemic infections 1pack slip inn overnight delivery herbals books, mon- age. In the fetus and young child, tetracyclines are deposited itor laboratory tests of renal function for abnormal values. If given during ac- • During sulfonamide therapy, encourage sufficient fluids tive mineralization of these tissues, tetracyclines can cause to produce a urine output of at least 1200 to 1500 mL permanent brown coloring (mottling) of tooth enamel and daily. A high fluid intake decreases the risk of crystalluria can depress bone growth. With the exception of doxycy- (precipitation of drug crystals in the urine). The urinary Increased photosensitivity is a common side effect, and tract is normally sterile except for the lower third of the clients should be warned to take precautions against sun- urethra. Introduction of any bacteria into the bladder may burn while on these drugs. With in- than 2 months of age (except for treatment of congenital dwelling catheters, bacteria colonize the bladder and toxoplasmosis), and people who have had hypersensitivity produce infection within 2 to 3 weeks, even with metic- reactions to them or to chemically related drugs (eg, thi- ulous care. Sulfasalazine • When indwelling catheters must be used, measures to (Azulfidine) is contraindicated in people who are allergic decrease UTI include using a closed drainage system; to salicylates and people with intestinal or urinary tract keeping the perineal area clean; forcing fluids, if not con- obstruction. CHAPTER 36 TETRACYCLINES, SULFONAMIDES, AND URINARY AGENTS 543 levels (12 to 15 mg/100 mL) more rapidly. The amount traindicated, to maintain a dilute urine; and removing the is usually twice the maintenance dose. Urine pH is important in drug therapy with sulfonamides and irrigate the catheter unless obstruction is suspected. With sulfonamide therapy, alkaline urine increases • Force fluids in anyone with a UTI unless contraindicated. In ad- also increases the rate of sulfonamide excretion and dition, emptying the bladder frequently allows it to refill the concentration of sulfonamide in the urine. This decreases the bacterial popu- urine can be alkalinized by giving sodium bicarbon- lation of the bladder. Alkalinization is not needed with sulfisoxazole • Teach women to cleanse themselves from the urethral area (because the drug is highly soluble) or sulfonamides toward the rectum after voiding or defecating to avoid used to treat intestinal infections or burn wounds contamination of the urethral area with bacteria from the (because there is little systemic absorption). With mandelamine therapy, urine pH must be acidic helps cleanse the lower urethra and prevent UTI. At a higher pH, Evaluation mandelamine does not hydrolyze to formaldehyde, the antibacterial component. Urine can be acidified • Observe for improvement in signs of the infection for by concomitant administration of ascorbic acid. Urine cultures and sensitivity tests are indicated in sus- • Interview and observe for adverse drug effects. The best results are obtained with drug therapy indi- cated by the microorganisms isolated from each client. Culture and susceptibility studies are needed before Tetracyclines should not be used in children younger than tetracycline therapy is started because many strains of 8 years of age because of their effects on teeth and bones. In organisms are either resistant or vary greatly in drug sus- teeth, the drugs interfere with enamel development and may ceptibility. Cross-sensitivity and cross-resistance are cause a permanent yellow, gray, or brown discoloration. The oral route of administration is usually effective and tissue and may interfere with bone growth. Intravenous (IV) therapy is used when oral Systemic sulfonamides are contraindicated during late administration is contraindicated or for initial treat- pregnancy, lactation, and in children younger than 2 months. Tetracyclines decompose with age, exposure to light, tal transfer, in breast milk, or by direct administration, the and extreme heat and humidity. Because the break- drug displaces bilirubin from binding sites on albumin. As a down products may be toxic, it is important to store result, bilirubin may accumulate in the bloodstream (hyper- bilirubinemia) and central nervous system (kernicterus) and these drugs correctly.