• Title/Summary/Keyword: Medication administration

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Analysis of Decision-Making Situations and Alternatives for Clinical Nurses in a University Hospital (일 대학 병원 임상간호사의 의사결정상황과 대안에 관한 분석)

  • Kim, Myung-Hee;Choi, Won-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.4
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    • pp.449-457
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    • 2004
  • Purpose: This study seeks to identify situations where nurses are required to consider alternatives, for the delivery of nursing care, appropriate to the needs of a medical care unit, surgical care unit, and intensive care unit in a university hospital. Method: Data was collected from 100 nurses using an open questionnaire, during a one week period in May, 2003. These nurses all had at least two years of experience within a medical care unit, surgical care unit, or intensive care unit at a university hospital. Results: The situations that nurses typically faced were categorized into 21 problems for nurses including : respiratory problems(26.8%), pain(23.6%), problems in relation to bowel habit(23.2%). In cases where nurses were faced with making decisions in relation to solving respiratory problems, the alternatives included ; applying oxygen(29.3%), physical assessment and monitoring(14.7%), refining and modifying order and suggestion order(9.3%). Ventilator care(9.3%), was chosen to solve pain problems ; doing pm orders(30.3%), placebo medication(27.3%), and to refine and modify orders and suggestions(18.2%). To solve problems in relation to bowel habits ; enemas accounted for 32.3%, and laxative medication 30.8%. Conclusion: To improve the quality of nursing, the outcome of nursing care associated with 21 problems for nurses including : respiratory problems, pain, and problems in relation to bowel habit, should be identified and the best alternative nursing care should be developed.

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Clinical trial of oral administration of Bifidobacterium longum in dogs with atopic dermatitis

  • Lee, Kang-Il;Yun, Taesik;Ham, Junsang;Lee, Wan-Kyu;Kang, Ji-Houn;Yang, Mhan-Pyo;Kang, Byeong-Teck
    • Korean Journal of Veterinary Research
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    • v.60 no.1
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    • pp.19-24
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    • 2020
  • This study assessed the effects of probiotics in canine atopic dermatitis (AD). We enrolled 11 client-owned dogs with AD and randomly allocated them to two groups. The probiotics group (n = 7) was prescribed with Bifidobacterium longum while the control group (n = 4) received a placebo powder once a day for 12 weeks. In both groups, the degree of skin lesions was evaluated based on the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-4. We also measured the transepidermal water loss (TEWL). We assessed pruritus severity using the pruritus visual analog scale (PVAS). Alteration of consumed drug doses was converted into medication scores. All the evaluation indices were surveyed every 4 weeks. In the probiotics group, there was a significant decrease in the CADESI-4 score at 4, 8, and 12 weeks compared to that of the baseline score (p < 0.05). There was no significant difference in TEWL, PVAS, and medication score at each time point and between groups. Although these results showed that Bifidobacterium longum did not reduce pruritus, TEWL, and the dosage of drugs for canine AD, it was effective in improving skin lesions, therefore, probiotics could be considered in canine AD with severe skin symptoms.

Effect of Korean Red Ginseng on Sexual Dysfunction and Serum Lipid Level In Old Aged Men (남성 갱년기 성기능 장애에서 홍삼이 성기능과 혈중 지질농도에 미치는 효과)

  • 김영찬;홍영권
    • Journal of Ginseng Research
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    • v.20 no.2
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    • pp.125-132
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    • 1996
  • To investigate the effect of Korean red ginseng (KRG) on male sexual function and serum lipid level, the results of KRG treatments were compared to placebo group. A total of 35 patients with psychogenic impotence were assigned to medication group with KRG (n=28) and placebo (n=7). KRG and placebo were given to each group for 2 months. Changes in symptoms such as frequency of coitus, morning erection, penile rigidity and tumescence were significantly higher in the group receiving KRG than placebo group. The overall therapeutic efficacies on erectile function were 67% for KRG group and 28% for placebo group (p <0.05). In the group treated with 9 tablets of KRG, there was tendency of better efficacy as compared to the group treated with 6 tablets of KRG. The level of serum high density lipid- cholesterol (HDL-cholesterol) was significantly elevated (p < 0.05) while the other serum lipid such as total cholesterol, tiglyceride and low density lipid-cholesterol (LDL-cholesterol) , were not changed after administration of KRG. This effect was observed significantly in the group in which KRG exerted its effect on sexual function(p < 0.05). From the above results, the administration of Korean red ginseng has shown to have superior of facts as compared to the placebo. The tendency of good effect was increased when a large amount of KRG was administered. The mechanism of KRG in improving sexual function would be the result of elevating the level of geum HDL-cholesterol in impotent patients. The effect of KRG was produced when the level of cholesterol was high before starting KRG medication. Therefore, the effect of KRG could be observed more intensively when the patients have high serum cholesterol level.

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Psychiatric Symptoms after Taking Oseltamivir in a Child and Its Causality Assessment (Oseltamivir 복용 이후 소아에서 발생한 이상행동 및 그 인과성 평가)

  • Son, Pyoungwoo;Choi, Joonghyuk;Lee, Seungmin;Park, Seon Soon;Choi, Eunkyung;Yoo, Bong-Kyu;Ji, Eunhee
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.1
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    • pp.56-60
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    • 2019
  • Oseltamivir is an antiviral medication prescribed to prevent and treat influenza A and B. A case from a community pharmacy in Korea was reported for an adverse event associated with oseltamivir administration. A 20-month-old boy had psychiatric symptoms after receiving 2 doses of oseltamivir. Therefore, an evaluation of whether the psychiatric symptoms were caused by oseltamivir was required. To determine whether the adverse event resulted from the administrated medication or other factors, three tools were used: the Naranjo scale, the Korean causality assessment algorithm (Ver.2), and the World Health Organization-Uppsala Monitoring Center (WHO-UMC) criteria. The psychiatric symptoms occurred after oseltamivir administration, and were attenuated after oseltamivir termination. A possible cause of the psychiatric symptoms is high fever, but information on the body temperature of the patient was not sufficient. Therefore, it was unclear whether there were other nonpharmacological causes of adverse drug reaction. For these reasons, in terms of causality, the results evaluated by the three tools represented, "possible", "probable", and "probable/likely", respectively.

Radiological Follow-up of a Cerebral Tuberculoma with a Paradoxical Response Mimicking a Brain Tumor

  • Kim, Jeong-Kwon;Jung, Tae-Young;Lee, Kyung-Hwa;Kim, Seul-Kee
    • Journal of Korean Neurosurgical Society
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    • v.57 no.4
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    • pp.307-310
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    • 2015
  • We report a case of a paradoxical response of a tuberculoma in the brain mimicking a brain tumor. A 76-year-old woman presented with a 2 week history of headache, dysarthia, and orthopnea. Brain magnetic resonance images (MRI) revealed two rim-enhancing lesions on the pons and occipital lobe, and chest computed tomography showed randomly distributed miliary nodules. The tentative diagnosis was tuberculosis (TB) of the brain and lung. She complained of right hemiparesis and worsening general weakness after taking the anti-TB medication. On the monthly follow-up images, the enhanced lesions were enlarged with increased perfusion and choline/creatinine ratio, suggesting a high grade glioma. A surgical resection was completed to diagnose the occipital lesion, and the tuberculoma was pathologically confirmed by a positive TB-polymerase chain reaction. The anti-TB medication was continued for 13 months. A follow-up MRI showed decreased size of the brain lesions associated with perilesional edema, and the clinical symptoms had improved. Brain tuberculoma could be aggravated mimicking brain malignancy during administration of anti-TB medication. This paradoxical response can be effectively managed by continuing the anti-TB drugs.

Reducing Medical Errors : Patients' Self Protect Behaviors and Involvement in Decision Making (의료과오 감소를 위한 환자의 자기보호행동 및 의사결정 참여)

  • An Kyung-Eh;Kim Jeong-Eun;Kang Kim Min-Ah;Jung Yoen-Yi
    • Health Policy and Management
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    • v.16 no.3
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    • pp.70-85
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    • 2006
  • The purposes of this study were (1) to describe patients' behaviors to protect themselves from medical errors and their involvement in decision making on the diagnostic and treatment procedures (2) to examine whether patients' characteristics, such as age, sex, education, experience of hospitalization and/or surgery influence their self protect behaviors and involvement in decision making on the diagnostic and treatment procedures. A survey was conducted with 99 patients visited one university hospital in Seoul, Korea. A 20-item questionnaire, a 4-point Likert scale, was used to measure the degree of patients' active involvement in decision making; patients' self protect behaviors regarding medication, hospitalization, and surgery; and communication (Cronbach's alpha=0.801). SPSS 12.0 was used for the descriptive and correlation analysis. Only 6.1% of the participants were involved in the decision making process for the diagnostic tests and treatment. More patients did self-protect behaviors associated with the medication than other areas but widely varied from 18.2 to 94.3 % among various items. More people with age of 60 or older compared to people in younger age groups reported more protect behaviors particularly associated with medication. Patient education is needed to improve their active role in preventing medical errors and to promote patients' safety.

EXPERIMENTAL STUDY ON THE EFFECT OF CALCITONIN IN THE OSTEOPOROSIS INDUCED BY THE IMMOBILIZATION AND LONG-TERM GLUCOCORTICOID (Glucocorticoid의 장기간 투여 및 운동 억제에 의한 골손실시 calcitonin의 예방효과에 관한 실험적 연구)

  • Park Dong Jin;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.19 no.1
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    • pp.69-87
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    • 1989
  • It is well known that the glucocorticoid induces osteoporosis by suppression of the osteoblast, but its effect on the osteoclast hRS some controversy whether it activates or suppresses the osteoclast. If the calcitonin, which is known to suppress the osteoclast, prevents the osteoporosis by glucocorticoid, then the suppression of the osteoclast by the glucocorticoid is not so significant. And if the calcitonin increases the osteoblastic activity, Tc-99m MDP uptake will be increased in spite of the glucocorticoid effect on the osteoblast. The immobilization operation was performed to the right leg of male Wistar rats weighing about 200gm. each. For 16 weeks after operation, rats were injected glucocorticoid alone or glucocorticoid anci calcitonin. The bone density was measured by means of photodensitometry under reference aluminum step wedge and Tc-99m MDP uptake was available to the index of the osteoblastic activity. 1. The bone density of femora! head was markedly reduced than that of femoral shaft following ration of cancellous and cortical components in both site. 2. Glucocorticoid caused decrease in bone density of spine and femur, md there is significantly increase of it when medication of glucocorticoid and calcitonin injection simultaneously than that of glucocorticoid. 3. Tc-99m MDP uptake was revealed significant reduction in medication of glucocorticoid but increase in gi;.:cocorticoid and calcitonin injection simultaneously in later experimental period. 4. There wail, a slight reduction in plasma osteocalcin in medication of glucocorticoid through experimental periods and an increase in its value in case of giving glucocorticoid and calcitonin simultaneously in later experimental period. From these results, we suggest that osteoporosis by immobilization is more pronounced by glucocorticoid hormone and osteoporosis induced by immobilization and glucocorticoid use is prevented by calcitonin administration with increasing osteoblastic activity.

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Intramural Dissection and Mucosal Laceration of the Esophagus in a Patient Who Was on Antiplatelets Medication - A case report - (항혈소판 제재 복용 중 발생한 식도 벽 박리 및 점막 열상 - 1예 보고 -)

  • Kim, Kyung-Hwa;Kuh, Ja-Hong;Lee, Jung-Moon
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.657-661
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    • 2009
  • Intramural esophageal dissection is a rare disorder that's characterized by a lengthy laceration between the mucosal and submucosal layers of the esophageal wall, and the esophageal wall is without perforation. The three different types of acute esophageal injury are a mucosal tear (Mallory-Weiss syndrome), full-thickness rupture (Boerhaave's syndrome) and intramural esophageal dissection. Most intramural esophageal dissections respond to conservative management with a very good prognosis. This rare condition should be considered in patients who present with acute chest pain, dysphagia or odynophagia, and particularly in the presence of a bleeding disorder or where there has been recent administration of antiplatelet medication, anticoagulantsorthrombolyticsto avoid inappropriate treatment with surgery. We present here a rare case of intramural dissection of the esophagus that occurred when the patient was taking anti platelet medication.

Medication-related osteonecrosis of the jaw: a preliminary retrospective study of 130 patients with multiple myeloma

  • Choi, Woo-Sung;Lee, Jae-Il;Yoon, Hyun-Joong;Min, Chang-Ki;Lee, Sang-Hwa
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.1.1-1.7
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    • 2017
  • Background: Multiple myeloma (MM) is characterized by a neoplastic proliferation of plasma cells primarily in the bone marrow. Bisphosphonates (BP) are used as supportive therapy in the management of MM. This study aimed to analyze the incidence, risk factors, and clinical outcomes of medication-related necrosis of the jaw (MRONJ) in MM patients. Methods: One hundred thirty MM patients who had previous dental evaluations were retrospectively reviewed. Based on several findings, we applied the staging and treatment strategies on MRONJ. We analyzed gender, age, type of BP, incidence, and local etiological factors and assessed the relationship between these factors and the clinical findings at the first oral examination. Results: MRONJ was found in nine male patients (6.9%). The mean patient age was 62.2 years. The median BP administration time was 19 months. Seven patients were treated with a combination of IV zoledronate and pamidronate, and two patients received single-agent therapy. The lesions were predominantly located in the mandible (n = 8), and the most common predisposing dental factor was a history of prior extraction (n = 6). Half of the MRONJ were related to diseases found on the initial dental screen. Patients with MRONJ were treated with infection control and antibiotic therapy. When comparing between the MRONJ stage and each factor (sign, location, etiologic factor, BP type, treatment, and outcome), there were no significant differences between stages, except for between the stage and sign (with or without purulence). Conclusions: For prevention of MRONJ, we recommend routine dental examinations and treatment prior to starting BP therapy.

Analyses of Security Issues for Internet of Things in Healthcare Application (헬스캐어 시스템에서의 사물 인터넷 통신을 위한 보안 문제 분석)

  • Shin, Yoon-gu;Kim, Hankyu;Kim, Sujin;Kim, Jung Tae
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2014.10a
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    • pp.699-700
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    • 2014
  • The use of Radio Frequency Identification technology (RFID) in medical context enables not only drug identification, but also a rapid and precise identification of patients, physicians, nurses or any other healthcare giver. The combination of RFID tag identification with structured and secured Internet of Things (IoT) solutions enables ubiquitous and easy access to medical related records, while providing control and security to all interactions. This paper defines a basic security architecture, easily deployable on mobile platforms, which would allow to establish and manage a medication prescription service in mobility context making use of electronic Personal Health Records. This security architecture is aimed to be used with a mobile e-health application (m-health) through a simple and intuitive interface, supported by RFID technology. This architecture, able to support secured and authenticated interactions, will enable an easy deployment of m-health applications. The special case of drug administration and ubiquitous medication control system, along with the corresponding Internet of Things context, is presented.

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