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Tutor profile: Rose S.

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Rose S.
RN, Master's in Nursing Education
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Questions

Subject: Health and Medicine

TutorMe
Question:

You're currently taking care of a patient who is status post a CABG procedure. They have been placed on sternal precautions. How do you explain this to your patient and their family members?

Inactive
Rose S.
Answer:

When you're educating your patients, it's best to keep in mind to keep the conversation around a 4th to 5th grade level. This helps to make sure that the patient and whomever is with them will be able to comprehend the information. We're going to discuss some important items regarding post-op care. Sternal precautions, simply put, are to protect your sternum (the area where your chest was cut open to perform your surgery). During your procedure, your chest was opened with a scalpel (sharp cutting tool) and a small saw was used to cut through the bone in the middle of your chest (sternum). Once surgery was completed, the surgeon had to use sternal wires (like sutures but made of thick stainless steel) to stabilize the bone and prevent it from separating or opening under strain or at random. So, when you're moving around, initially, we'll ask that you call someone for help/assistance and that you use a pillow to hug against your chest. A firm/hard pillow gives better support than a soft pillow. Raising your arms overhead-when you're raising your arms over your head, your muscles will pull at the middle of your chest. We ask that you wait at least 6 weeks before doing so or sometimes even longer if your doctor thinks that's best for you to get healthy. There is a limit on the amount of weight you may pick up. This is very important for your family/friends to know. It's usually up to ten pounds at the beginning of your recovery and then it will gradually increase as you have doctors appointments and visits with the cardiac rehabilitation team (professionals that help you build up your strength after surgery). Cardiac Rehab will also help you with adding new milestones (important timeframes) to your recovery. One last important one is riding in the car. Until you've been told it's ok by your doctor, you will have to sit in the back seat of a car. If the airbag were to come out, it could potentially hit you in your chest and case your incision to re-open. Lastly, you should always ask your patient/caregivers if they have any questions regarding what you've discussed. It's a lot of information and sometimes patients are unable to receive and process all of it at one time. It may need broken into smaller sessions.

Subject: Nursing

TutorMe
Question:

Let's discuss 4 tips on how to care for Shock. 1. What is it? 2. Different causes/types? 3. Your assessment of the patient 4. Interventions/Treatments

Inactive
Rose S.
Answer:

1. Reduction of the oxygen supply to the tissues of the body; if the cause is not identified and shock persists, it will ultimately cause end organ damage to the body. 2. 3 causes/types a. Hypovolemic-loss of fluid b. Septic - infection that has spread to the bloodstream (Sepsis, septicemia) causing widespread inflammation in the tissues of the body c. Cardiogenic- "Card" is at the beginning of this word, so we know it pertains to the heart. This type of shock is caused when the patient has heart failure. A simple way to describe heart failure is the inability of the heart to beat effectively. 3. Even though Shock can be a very difficult process to treat and correct, these are simple observations that can help identify an issue before it's too late. a. BP is decreased (Hypotension) b. HR is elevated (Tachycardia) c. Skin is pale in color (Pallor) d. Urinary output is decreased (Oliguria or even Anuria) 4. Each type of shock can be treated in its own way. Unfortunately for some patients, more than issue is the root of the problem. a. Hypovolemic-simply, the provider would write orders to replace the fluid the patient lost. Picking the right type of fluid can be confusing at times because you need to also assess other symptoms your patient may be having. For example, are they diabetic, too much calcium, or maybe they have alcohol use disorder and need additional vitamins replaced. That's a complete lesson on its own. b. Septic-The cause of the infection needs to be treated. The patient will require an antibiotic, sometimes maybe more than one depending on the infectious organism/s c. Cardiogenic-requires medications to help the heart beat/pump more effectively. These are called vasopressors. Vasopressors tighten blood vessels and in turn raise the blood pressure.

Subject: Biology

TutorMe
Question:

Contrary to popular belief, these, were why the Bubonic Plague was able to spread so quickly. Bonus question, name the type of bacteria that caused the Bubonic Plague.

Inactive
Rose S.
Answer:

Fleas Yersinia pestis

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