Mystery Diagnosis: Recognizing Serotonin Syndrome

Wendy Blatchley

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a guide to recognizing signs and symptoms of serotonin syndrome in patients Mystery Diagnosis: Recognizing Serotonin Syndrome Wendy Blatchley The University of Tampa Abstract Serotonin syndrome (SS) is a rare condition that is believed to be induced by ingestion of serotonergic medications, leading to an increased serotonin level. Although many medications are thought to be responsible, some of the more common are antidepressants and opioids. There are no definitive tests to confirm SS, therefore diagnosis is based on clinical findings and can be somewhat difficult. A triad of symptoms, neuromuscular hyperactivity, altered mental status, and autonomic hyperactivity, are considered the hallmark signs, but are not present in all cases. Symptoms can vary from mild and almost undetectable to severe and life threatening. Three diagnostic systems are currently utilized to assist with diagnosis if SS is suspected: the Hunter, Sternbach, and Radomski criteria. A diagnosis of SS should prompt ... Cont'd

What Can We Do to Promote Professional Socialization in Nursing?

Author 1: Nancy Bellucci, PhD, MSN, RN, CNOR Author 2: Shakeeka Misher, DNP, RN, RNC-MNN, NE-BC

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Abstract Transitioning to a new work setting is challenging for many nurses, regardless of the time spent in practice. Promoting professional socialization, through mentoring and precepting, helps to facilitate a smooth transition. Effective mentoring, using role-play, reflective exercises, and debriefing, provides the transitioning nurse the opportunity to self-actualize his or her potential in the new work environment. The use of Benner's Novice to Expert Theory and Duchscher's Stages of Transition Theory as a basis for mentorship enhances safety and quality in the provision of care.   Introduction to Professional Socialization Professional socialization is a process that entails many stages of development for the nursing student. Professional socialization is defined as the knowledge and skill that characteristics of a profession (Becker-Hentz, 2005). Becker-Hentz (2005) indicated that Florence Nightingale's process for training included professional socialization and emphasized character ... Cont'd

Case Study: A Systematic Approach to Early Recognition and Treatment of Sepsis

Madeleine Augier RN BSN

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Sepsis is a serious medical condition that affects 30 million people annually, with a mortality rate of approximately 16 percent worldwide (Reinhart, 2017). The severity of this disease process is not well known to the public or health care workers. Often, health care providers find sepsis difficult to diagnose with certainty. Deaths related to sepsis can be prevented with accurate assessments and timely treatment. Sepsis must be considered an immediate life-threatening condition and needs to be treated as a true emergency. Relevance and Significance Sepsis is defined as “the life-threatening organ dysfunction resulting from a dysregulated host response to infection” (Kleinpell, Schorr, & Balk, 2016, p. 459). Jones (2017) study of managing sepsis affirms that the presence of sepsis requires a suspected source of infection plus two or more of the following: hyperthermia (>38.1 degrees Celsius) or hypothermia (<36 degrees Celsius), tachycardia (>91 beats per minute), leukocytosis ... Cont'd

Evidenced Based Guidelines: Ischemic Heart Disease

Madeleine Augier RN BSN

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Evidence-Based Guidelines: Ischemic Heart Disease Madeleine Augier The University of Tampa NUR 680 Ischemic heart disease is the leading cause of death worldwide. In fact, this disease has remained the leading cause of death globally in the past fifteen years (World Health Organization, 2018). With this statistic, it is imperative to educate the public on how to reduce risk factors, but also necessary for nurse practitioners to provide primary prevention and improve correct diagnosis and treatment. Definition Ischemic heart disease (IHD), most commonly known as coronary artery disease, is defined as “the presence of atherosclerotic plaques in one or more of the major coronary arteries that supply blood to the heart or the muscle (Lewis & Davis, 2013).” Ischemia occurs when there is an imbalance between myocardial oxygen supply and a demand that is commonly caused by plaques that impede blood flow to tissue distal to the stenosis. There are two different types of IHD: ... Cont'd

Ethical considerations for the mentally unwell in a global pandemic

Anthony Ragnauth

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A recent ethical situation which came up in the past year was that of a public safety issue in a mentally unwell patient in the setting of a global pandemic. The ethical challenges in the care of this patient revolved around preserving patient autonomy, protecting the health and safety of the general public, all while trying to provide very good medical care to this person. The background of the situation is as follows. The patient was a 33 year old gentleman with a history of paranoid schizophrenia and personality disorder. He had been living on the street for more than 10 years and was otherwise physiologically healthy at baseline. For the past month this patient had been checking in to the ED almost daily for assorted medical complaints. One day it would be for abdominal pain, the next day or day after would be for chest pain or back pain etc. The patient would typically be put in a room, and immediately start demanding food. After being seen by an ED provider and a workup ordered, ... Cont'd