The Stroke Risk Calculator Coursework Example | Topics and Well Written Essays - 1250 words

The Stroke Risk Calculator - Coursework Example The user is placed in a particular age group and then their probability to suffer from stroke is determined. The results obtained are also based on the age group a person falls under. The rating results are provided in either lower than average, average or higher than average of a person in a particular age group. To analyze the stroke probability in a person, the tool enquires on several causing factors. Firstly, the gender of the user is required, the user is then placed in an age group. Questions on the health status of a person are requested. For instance, the tool asks on medical history of condition like diabetes, irregular pulse, fibro muscular dysplasia and transient ischemic attack (UCLA Stroke Center, 2015). Social factors like smoking are then analyzed. The elderly population is the most likely age group to be suffer from stroke. In an argument by Birkett (2012) the population is comprised of too many risk factors as influenced by aging thus a great stroke risk. However, t he risk factors in older adults are significantly influenced by the lifestyle at a younger age. For this reason, the younger age groups are a significant target population as older adults. In addition, the risk calculator can be of great importance to younger adults than older adults. This is based on that risk causing factors in older adults are irreversible. In younger adults changes in lifestyle and seeking good health care may reduce the probability of suffering from stroke at an older age (Birkett, 2012). For the older population the tool may also be effective in analyzing their stroke risks status. Similarly to the younger age groups, older adults may also feel the need to change their lifestyle to minimize their stroke risk. For instance, an older adult may be advised to stop smoking or drinking due to a high probability of them having stroke.

Elderly Person :: History

Elderly Person Chang Sing Lok, also know as Uncle Lok is famous for his mouth watering â€Å"Chau Kuey Teows† which is a kind of fried noodles. He is very well known in Taman University, Petaling Jaya for his exquisite dish. He was born on March 23, 1926 at ShenYang, eastern China and he was brought up there until the age of 9. He is the youngest of the six children in the family and that is why his parents named his last name as Lok, which means six in Cantonese. He is from a poor family. His father was a cook and his mother was a maid. Both parents served a rich family in ShenYang. He was brought up in a village and he spent his formative years nurtured by the humble, traditional values of Chinese village life. He lived with his family in a typical wooden house and the crystal clear water of the stream nearby his house was made his playground. As years passed, the World War II occurred. The Japanese army invaded most of the eastern part of China. At that time, most of the citizens of China had migrated to the other countries since they could not suffer the hardness of life in China. Chang Sing Lok had also decided to migrate to ‘Tanah Melayu’. So he came to ‘Tanah Melayu’ with about a hundred of others Chinese who had decided to migrate to ‘Tanah Melayu’ too by a very old style ship. At first, life was not very good and not stable since he had not get any job. It was because there are too many labour sources in ‘Tanah Melayu’ at that time. Furthermore, he was also too young for any heavy job. Finally, he got a job at a Chinese restaurant as a cleaner. He helped the employer to cleanup the entire restaurant as well as washing all the plates. It was there he first started gaining knowledge of cooking. At that time, he had a negative attitude towards the past, as he had went through lots of difficulties and struggled his way through World War II, where he had lost his family, friends and property. But he had a more positive attitude towards the future. According to him, future is the continuity of the present and if he succeeds in his present life, he believed that the future would be better for him as well as his family.

Respiratory Case Study

Respiratory Case Study The following case study is of a 37-year old Hispanic male weighing 145 lbs and 70 inches tall found unconscious by his girlfriend. According to her he was unconscious for about 15 hours and she was concerned because he would not wake or respond and was breathing shallow and slow. She then called 9-1-1. The patient entered the ER by emergency vehicle and on my initial assessment Pt had an altered mental status, was very unresponsive showing symptoms of a possible drug overdose.The girlfriend told the physician the Pt had taken 75 mg of methadone and an unknown amount of Xanex and other amounts of Benzodiazepines. On assessment, the doctor noticed his altered mental status and unconscious status. He had a gag reflex and responded to pain. Pt had a blood pressure of 63/41 and a 02 saturation of 50% on room air and a heart rate of 108. We put the patient on an oxy mask at 14 liters and his saturation improved to 90%. The Physician then administered Narcan which in return raised the respiratory rate. The physician then eventually intubated with Etomidate.He is then diagnosed with Acute Renal Failure, Acute Lung Injury with possible aspiration and CHF with Atrial Fib. The patient has had no prior history of drug overdose. The patient did, however, have a brother that recently committed suicide and was recently released from jail. The patient does drink alcohol and takes multiple street medications and methadone for pain. For this patient with my initial thoughts would be to order an ABG to test for acidosis and see if there is an electrolyte imbalance, then a possible scan of the brain.An EKG test would also be ordered to see how the heart has dealt with the stress. Giving him Narcan would help block the receptor sites to stop the action of the OD. What ended up being ordered is the ABG, a CT of the brain, EKG, NG tube, Catheter, Glasgow Coma Scale, Chest X-ray and the lab drew blood. The ABG showed severe metabolic and respiratory acidosis, g lucose of 72, potassium of 4. 9, calcium of 7. 9 chloride of 105, C02 of 24, creatinine of 2. 6. The EKG showed atrial fibrillation with rapid ventricular response and signs of CHF.The lab results showed an electrolyte imbalance, sepsis, and no alcohol. The CT scan showed a hypoxemic brain injury and the x-ray showed infiltrates which are assumed to be from aspiration pneumonia. From this we know that the patient will stay intubated until further improvement of acidosis, help to reduce possible development of ARDS, Sepsis and until the patient will be able to breath on his own. The settings on the vent I would have chose would have been SIMV, Vt of 550-600, a rate of 15, pressure support of 10, Cpap of 5, at a 100% Fi02 with the ABG reading Ph 7. 1, Pco2 58, P02 56, and sating 76%, Hco3 18. 4. Physician ordered vent setting, SIMV, 100% Fi02, Vt of 550, rate of 12, pressure support of 10, Cpap of 5. The idea behind these settings is to allow the Pt to ventilate and to breathe off the access co2 and to oxygenate the blood. I would like to have seen a rate of 16 to help with the release of co2. 1 hour later the ABG read Ph 7. 13, Pco2 65, P02 66, Hco3 at 15. 6 and sating 85%. The settings for the Pt as far as respiratory seem to be fine for now unless the Pt develops ARDS.It is more of a metabolic concern at this time now that the Pt is ventilated. Blood gases go as follows: in the ER for initial assessment on the vent at 2130 a critical of Ph- 7. 11, Pc02- 58, P02- 56 Hc03- 18. 4 and a saturation of 76% on 100% Fio2 while on SIMV with a rate of 12, Vt of 550, pressure support of 10 and Cpap of 5. The Pt at this time has no spontaneous breathing while on the vent. Due to the drug overdose the Pt is showing both respiratory and metabolic acidosis with Moderate Hypoxemia. A follow up ABG, 20 minutes later, results in a Ph of 7. 3, Pco2- 47, Po2- 66, Hco3-15. 6 and sating 85% on 100% Fio2. The Pt is now breathing 21 BPM and a Vt of 605 in addition of the vent settin gs. The results of the latest ABG have shown small improvement, but still critical Ph and moderate hypoxemia. Another follow up ABG at 0100 shows a small improvement on the Ph to 7. 18, the Pco2 became more acidotic moved to 53, the Po2 improved to 77 which shows he is oxygenating better but still hypoxic, his Hco3 acidosis is improving at a change to 19. 8, and sating 91% now.The Pt is now breathing at a rate has come down to 10 BPM on his own above and beyond the vent. After consulting with the physician we changed the Vt to 600 and the pressure support to 20 and Cpap to 15. The Pt continued on these settings till 0415. The physician then made the change to Bi-level with the settings of a rate of 14 pressure support of 25, and an H/L pressure of 35/15. The Pt at this time is pulling a Vt of 745 and a spontaneous rate of 17 and still at 100% Fio2 and sating 92%. This is the point when the Pt makes the turn.The Bi-level or APRV was the proper setting for this Pt. He continued to imp rove over the next several days with his peek pressure climbing to 40. The Pt continues these settings and slowly improves and eventually weaned from the ventilator till the Pt no longer needs support. Pt received AP diameter X-ray to confirm tube placement and to see if there were any kind of infiltrates because of possible aspiration and to eliminate possible pneumothorax and pleural effusion. Findings included mild patchy infiltrates in the right upper to middle lobes.The left lower lobe also has some similar findings but less concerning. This may either be due to lung infection or pulmonary edema. The placement of the ET tube was confirmed at 2 cm above the carina. The NG tube was also confirmed to correct placement. The heart silhouette was not enlarged and stable. No pleural effusion was ever confirmed. Pt will be treated for minor Pneumonitis. X-rays continued throughout his stay and infiltrated were slowly diminished and tube placement was confirmed and never changed. The La b reported sodium at 142 to be within normal range, potassium 5. also with in normal range. Chloride at 105 also with in normal range, glucose levels at 169 also within normal range, calcium at 7. 9 is low. The Pt received ionized calcium through his central line. The Hematology reported the WBC at 4. 4 is at the lower spectrum of normal, the RBC at 5. 70 is within the normal limits, and HCT is 51 which are also in the normal spectrum. Blood work came back good. Sputum sample was taken and results were negative for any growth. The Pt is urinating well and color is yellow/clear with trace amounts of protein.No PFT’s were performed. Medications the Pt received in the ER: Dextrose 5% delivered intravenous to hydrate Pt, Sodium Bicarbonate was given intravenous because of the severe acidosis, Nor epinephrine given intravenous to raise the BP to a more stable condition, Dopamine also given for a vaso pressers, Etomidate was given to sedate the Pt for intubation, Clindamycin given due to the allergy of Penicillin to help with any anaerobic infection, Doripenem and Vancomycin other antibiotics, Propofol to keep Pt sedated during his intubation.Medications given while in the ICU: Clopidogrel (Plavix) given to prevent clots, Symbicort given to help prevent bronchospasm and improve lung function, Digoxin given for the CHF and slow the heart rate for Atrial Fibrillation, Famotidine to inhibit the production of stomach acid, Lisinopril given in case of hypertension, Sodium Chloride to treat his hyponatremia, Levophed (Nor epinephrine) given when the HR or BP drops, Phenylephrine also a vaso presser or to relive nasal decongestion, Pitressin also another vaso presser, Dobutamine to prevent cardiogenic shock, Dopamine for another presser, Fentanyl given to reduce pain, Haloperidol (Haldol) to help with his mental heath, Lorazepam also given to treat his mental heath or anxiety, Morphine to treat pain, and Reteplase given for anti-clotting factor.

Human Cosmetic Surgery and Prosthetic Device Implants Essay

Human Cosmetic Surgery and Prosthetic Device Implants The human body is a collection of remarkable biological mechanisms that integrates features that can not be duplicated exactly. However, many modern prosthetic devices can add years to an individuals life, improve physical comfort and function, or in the case of aesthetic implants, improve emotional health. There are many types of implants that server a variety of functions that offer risks and benefits. Implants can server many purposes. Cosmetic surgery has variety prosthesis to select from, not only to change the appearance of a feature for aesthetic reasons, but also to correct disfiguring from trauma or disease. Numerous implants are available to enhance physical appearance†¦show more content†¦These valves are designed to control the direction of blood flow through the heart. The opening and closing of these valves produce the heart beat sounds. When the heart beats, the valves close to keep the blood form flowing backwards. The heart beats more than one hundred tho usand times per day. The valves must be able to flex, stretch and hold back pressure hundreds of million times in an average lifetime. The mitral and aortic valves are on the left side of the heart. These are most commonly affected by aging because the pressure is higher on this side. The right heart valves can be damaged by infection or lung disease. Regardless of the valve damage, as they harden or weaken they do not open properly and therefore blood flow may be blocked. Heart valve conditions may also be congenital. Diseases such as rheumatic fever or bacterial infections may also scar or destroy the valves. Heart valve diseases fall into two categories, stenosis and incompetence. The stenotic heart valve prevents full opening of the valve because of the stiffened valve tissue, therefore the heart works harder to push blood throughout the valve. 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