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Key Points to Start: *Remember, you can access Epic through the Ether website (ether.stanford.edu) whether on or off campus*. See also treatment. Among the services that may be offered at an adult day care center are nursing services (e. See also bed rest. See also hazards of immobility. Cleansing protocols continue until the site is completely healed. Examples include assessment, performing procedures, teaching, and implementation of a care plan. See also dying. ear care in the nursing interventions classification, a nursing intervention defined as prevention or minimization of threats to ear or hearing. See also embolus. See also embolus. See also emergency. Health and Welfare Canada. It is characterized by a great deal of flexibility and parental choice, and health care professionals are encouraged to individualize care. Breast feeding and rooming in are encouraged and grandparent and sibling visits are permitted. Examples include charting and scheduling. See labor. intrapartal care: high- risk delivery in the nursing interventions classification, a nursing intervention defined as assisting vaginal birth of multiple or malpositioned fetuses. There is an emphasis on efficacy and timeliness of interventions to prevent unnecessary delays in discharge from the hospital or agency. See also ostomy. ostomy care (omaha) in the omaha system, management of elimination through artificial openings, including colostomy and ileostomy. See also prosthesis. It currently includes observation during periods of acute or unstable illness; administration of intravenous fluids, enteral feedings, and intravenous or intramuscular medications; short- term bowel and bladder retraining; and changing of sterile dressings. Called also palliative care or treatment. See also ventriculostomy and drain. See also urinary incontinence. The preoperative period may be extremely short, as with an emergency operation, or it may encompass several weeks during which diagnostic tests, specific medications and treatments, and measures to improve the patient's general well- being are employed in preparation for surgery. Although patients react in their own unique ways to the news that they are going to have surgery, all patients experience some degree of anxiety and fear—fear of the unknown, worry over disability or death, and apprehension about the insecurity of their own and their family's future. Much of this anxiety can be relieved if the various aspects of preoperative and postoperative care and the type of surgery planned are explained to the patient. The surgeon usually explains the surgical procedure and assists the patient in planning rehabilitation. The anesthesiologist usually reviews the type of anesthesia to be used and the general effects it will have on the patient. The nursing staff explains the hospital routine, specific nursing procedures necessary, the purpose of diagnostic tests required, and the types of equipment that will be used during the preoperative and postoperative periods. The nurse can demonstrate interest in the patient and family by answering questions (or referring them to the surgeon), and giving them a general idea of how long the patient will be away from his or her room during surgery and recovery from anesthesia. It is reassuring for patients to know, for example, that oxygen administration, blood transfusions, and the use of a nasogastric tube or catheter do not necessarily indicate a critical situation. The use of various pieces of equipment that seem “routine” to the hospital staff may be extremely upsetting to patients and their families if they do not understand why the equipment is necessary. Spiritual reinforcement during this period may be very important to some patients, and without giving the impression of prying into the patient's private affairs, the nurse must also show a willingness to assist patient and family in obtaining a spiritual advisor if they indicate such a desire. The nurse must always respect the individual patient's beliefs and convictions whether sharing them or not, and must support patients in their search for spiritual reassurance and guidance. Legal Aspects. Any patient undergoing surgery, whether it is expected to be major or minor surgery, must sign an operative permit. Patients have the right to know the type of surgery intended and its expected outcome, aftereffects, and possible complications. If an individual is underage, mentally incompetent, or unconscious, the permit is signed by a relative or guardian. The permit protects the patient against unwanted surgery and operative procedures the patient does not understand. It protects the hospital staff and surgeon from legal claims that the surgery was done without the patient's permission or knowledge of what was to be done. The signed operative permit is placed in the patient's chart and is sent to the operating room with the patient. Preventive Aspects. During the preoperative period the patient is instructed in coughing, turning, deep breathing, and exercises of the extremities. These techniques can be most effective in preventing many of the complications of surgery. Exercises to strengthen specific muscles in preparation for rehabilitation, as following amputation, for example, are begun well in advance so that the patient is in optimal condition to begin a program of rehabilitation as soon after surgery as possible. Other topics of instruction will depend on the anticipated needs of the patient during recovery from surgery. Physiologic Aspects. Except in emergency situations every effort is made to have the patient in a state of optimal health before surgery is performed. Specific diets, protein and vitamin supplements, and other measures to improve the nutritional status may be employed. Intravenous infusions and transfusions of whole blood or plasma may be necessary to improve the fluid and electrolyte status and blood volume. Infections should be brought under control before surgery if they cannot be eliminated completely. Accurate records of the patient's vital signs, blood pressure, and urinary output will assist the surgeon in diagnosing and correcting conditions that may adversely affect the patient's physiologic response to an operative procedure. Physical Preparation. Hospital protocol and the preference of the surgeon dictate the procedures for physical preparation prior to surgery. Although studies have repeatedly shown that the removal of hair is not effective in preventing infection and actually may contribute to it by damaging the skin, some surgeons still order removal of hair from the operative site. Restriction of food and fluids varies. Usually the patient is allowed a light evening meal and then given nothing by mouth after midnight the night before surgery. Other procedures for preparation of the gastrointestinal tract may include enemas and insertion of a nasogastric tube. Preoperative Medications. Generally there are three types of drugs used prior to surgery: sedatives, such as one of the barbiturates, to promote relaxation and rest and to stabilize the blood pressure and pulse; drying agents, such as atropine and scopolamine, which decrease secretion of mucus in the mouth and throat; and narcotics, such as morphine and meperidine hydrochloride (Demerol), which promote relaxation and enhance the effects of the anesthetic. Preoperative medications must be given at the exact time ordered because their strength, action, and duration are planned according to the type of anesthesia used. Immediate Preoperative Care. Most institutions use a check list or clearance record for surgical procedures. This eliminates the danger of overlooking some aspect of the immediate preoperative preparation. Such an omission might delay surgery or result in legal problems. The operative permit must be signed by the patient or guardian or legal representative. This permit is necessary to protect the surgeon against claims of unauthorized surgery, and to protect the patient against surgery he would not willingly endorse. The preoperative check list includes such items as laboratory tests and their findings, history and physical examination records, disposal of valuables, removal of dentures and their disposition, vital signs and blood pressure of the patient immediately before going to the operating room, and other specific information such as consultation for sterilization. Unless a urinary catheter has been inserted, the patient is offered the bedpan just before being taken to the operating room. Hairpins, bobby pins, and combs are removed from the hair and the head is covered with a cap or scarf. Medical Therapy, Surgical Therapy, Preoperative Details. Several surgical options for repair of CSF leaks arising from the anterior skull base exist. There has been a paradigm shift over the last 3. Intracranial repair. Intracranial repair was frequently used (and is still used in select cases) for the routine repair of anterior cranial fossa CSF leaks. These leaks were typically approached via a frontal craniotomy. In rare situations, a middle fossa or posterior fossa craniotomy was required. Different repair techniques have been used, including the use of free or pedicled periosteal or dural flaps, muscle plugs, mobilized portions of the falx cerebri, fascia grafts, and flaps in conjunction with fibrin glue. Leaks arising from the sphenoid sinus are difficult to reach by means of an intracranial approach. Advantages of the intracranial approach include the ability to inspect the adjacent cerebral cortex, directly visualize the dural defect and seal a leak in the presence of increased ICP with a larger graft. When preoperative localization attempts fail to reveal the site of a leak, intracranial approach with blind repair has been successful. In these situations, the cribriform and the sphenoid area, if necessary, are covered with the repair material. Disadvantages of the intracranial approach include increased morbidity, increased risk of permanent anosmia, and trauma related to brain retraction, including hematoma, cognitive dysfunction, seizures, edema, and hemorrhage. In addition, the postoperative hospital stay is longer, adding to the overall cost of the procedure. Failure rates for this approach are 4. External approaches. Defects in the posterior table of the frontal sinus may be approached externally via a coronal incision and osteoplastic flap. The osteoplastic flap provides the surgeon with a view of the entire posterior table of the frontal sinus and is especially useful for defects more than 2 cm above the floor and lateral to the lamina papyracea. In select cases, these defects may also be approached with a simpler eyebrow incision and an extended trephination of the frontal sinus in combination with an extended endoscopic frontal sinusotomy. Care must be taken to avoid unnecessary trauma to the surrounding mucosa and the frontal recess entirely. External approaches to the skull base can also be obtained through various incisions or through nasal approaches for access to the ethmoid sinuses and sphenoid sinus. These include external ethmoidectomy, transethmoidal sphenoidotomy, transseptal sphenoidotomy, and the transantral approach to the skull base. These procedures are infrequently chosen in current practice, given the high success rates and low morbidity associated with the endoscopic approach. However, they should be part of every skull base surgeon. The incision is made halfway between the medial canthus and the midline of the nose down to bone. Lateral elevation of the periosteum exposes the anterior lacrimal ridge and the lacrimal fossa. The lacrimal sac is elevated and retracted out of the fossa. As the periosteum is elevated posteriorly along the lamina papyracea, the anterior ethmoidal artery will be encountered 2- 2. This artery needs to be ligated to increase exposure. The frontoethmoid suture line marks the level of the fovea ethmoidalis, thus dissection should never be superior to this line. The posterior ethmoidal artery is found approximately 1. The optic nerve lies 5 mm posterior to the posterior ethmoidal artery. The ethmoidal cells are then entered in the area of the lacrimal fossa, and the anterior two thirds of the lamina are removed. A complete dissection of the ethmoid labyrinth is performed. The skull base is then identified in the posterior ethmoids, and the anterior wall of the sphenoid is exposed. Transethmoidal sphenoidotomy. To perform a transethmoidal sphenoidotomy, an external ethmoidectomy is carried out first as described above. The sphenoid sinus ostium is identified and opened first with a small curette or a beaded probe. A Kerrison punch can then be used to enlarge the opening. The anterior wall of the sphenoid is removed in a meticulous fashion to gain access to the sellar region. Transseptal sphenoidotomy. The transseptal approach to the sphenoid can be carried out using a sublabial or transnasal incision. An external rhinoplasty incision is preferred by the authors. The sublabial approach requires the use of a gingivobuccal sulcus incision to expose the pyriform aperture and free the nasal spine. The caudal septal cartilage is then identified, and a left (or right) septal mucoperichondrial flap is elevated. This mucoperichondrial flap is elevated laterally and inferiorly along the nasal floor in the subperiosteal plane. The cartilaginous septum is dislocated from the maxillary crest, and the contralateral nasal floor mucoperiosteal flap is elevated. The contralateral nasal septum is, therefore, not elevated off the cartilage. Once the bony- cartilaginous junction is reached, it is disarticulated and the contralateral posterior flap is elevated. The bony septum is removed to expose the sphenoid rostrum, which is widely removed via osteotomies or a drill to expose the entire sphenoid sinus. Transantral approach. A transantral approach to the skull base offers wider access to the anterior sphenoid, ethmoids, pterygopalatine fossa, and maxilla. An open anterior maxillary sinus antrostomy is known as the Caldwell- Luc procedure. A gingivobuccal sulcus incision is made, and the anterior wall of the maxilla is exposed. The periosteum is elevated superiorly as far as the infraorbital nerve, exercising extreme care to avoid injuring the nerve as it exits via the infraorbital foramen. A canine fossa osteotomy is performed to enter the maxillary sinus. Kerrison rongeurs are then used to extend the opening into the maxillary sinus. The ethmoidal bone can then be approached medially and superiorly through the maxilloethmoidal angle. A more posterior route is taken to expose the sphenoid sinus. When needed, exposure of the pterygopalatine fossa is achieved by creating an opening into the posterior wall of the maxillary sinus. Endoscopic approaches. Compared with external techniques, endoscopic techniques have several advantages, including better field visualization with enhanced illumination and magnified as well as angled visualization. Another advantage is the ability to more accurately position the underlay or overlay grafts. Multiple studies demonstrate a 9. However, the authors believe that given the previously published rates of ascending meningitis in untreated CSF leaks, the administration of perioperative intravenous antibiotics is warranted. Decongestion of the nasal cavity with topical 1: 1. Injection of 1% lidocaine with 1: 1. The use of intravenous anesthesia with propofol and remifentanil has also been demonstrated to reduce intraoperative blood loss when compared with inhalational anesthesia. This is related to a decreased heart rate, which translates into decreased cardiac output, thus reducing the amount of peripheral circulatory volume. Placement of a lumbar drain has not been demonstrated to decrease recurrence rates of CSF rhinorrhea after endoscopic repair. In theory, lumbar drain placement decreases the pressure exerted by the CSF at the site of the repair, thus allowing the tissues to heal. However, this theory has not been validated. In fact, a recent study found no difference in leak recurrence when patients who had a lumbar drain were compared to those who did not. This finding remained true when the patients were subdivided according to the etiology of the leak. In general, lumbar drain placement remains institution and surgeon dependant. One must take into account that a lumbar drain can lead to headaches related to overzealous CSF drainage and limits patient mobility postoperatively. One of the benefits of lumbar drain placement is the ability to administer fluorescein to guide in the localization of the leak. When a lumbar drain is used, fluorescein mixed with autologous CSF is injected slowly over several minutes. As previously discussed, fluorescein is not approved by the FDA for the diagnosis and treatment of CSF leaks. Precisely 0. 1 m. L of 1. 0% fluorescein is mixed with 1. L of CSF or bacteriostatic saline. The authors have found that injecting this mixture over 1. A study by Elmorsy and Khafagy of 3. CSF rhinorrhea indicated that skull base defects can be successfully closed endoscopically using a septal graft and a middle turbinate rotational flap. In a retrospective chart review, the investigators found that defect closure was obtained in 2. Closure was unsuccessful in two of the 3. The surgery was successful in seven out of nine patients in the study, although one of the seven patients required a revision procedure. Each is designed to gain access to the area of interest in the most efficient fashion. The transfrontal, transcribriform, transplanum, transsellar, transclival, and transpterygoid have all been well described. Transfrontal approach. The transfrontal approach allows access to the floor and posterior wall of the frontal sinus. Leaks originating from this area can be successfully repaired using this approach in the majority of the cases. The frontal sinus outflow tract must be carefully preserved in order to prevent mucocele formation in the long term. The main advantage of the transfrontal approach is that it avoids obliteration of the frontal sinus with an osteoplastic flap. This approach, however, may not effectively manage defects originating in the most lateral or superior aspects of the frontal sinus, since these regions may exceed the limitations of current instrumentation when the technique is performed endoscopically. The approach begins by performing a complete ethmoidectomy. This is followed identification and dissection of the frontal recess. This area is then widened via a modified endoscopic Lothrop or Draf III procedure, which provides a panoramic exposure of the posterior table of the frontal sinus. Broward College Central Campus Nursing Program. I admit after hearing the horror stories I got discouraged and looked into other schools as well, but I found out some horror stories do have their special circumstances as in not preparing well, working, working with kids, etc. After I looked into other schools you have to have five or more pre- reqs in order to get in and they have waiting lists and deadlines. BC took away all that and really I just want to get this done and will continue with them. I will do what Ive always done, which is study hard and pray and leave it in the hands of the All Mighty. Nothing worth having, is going to be easy no matter what school I guess, so good luck ou there and dont get too freaked out by everyone elses suggestions and stories, do what you feel is right for you, based on your own experiences. Broward College RN Program. Nursing School Admissions Requirements; RN. Nursing Schools in Florida with Degree Program Options; Nursing Schools in Florida with Degree Program Options. Associate of Science in Nursing. The mission of the Broward College Nursing Program is to. Associate of Science in Nursing. Program Code 2127 (RN). Broward College & Broward Health have partnered to offer an upper-level $. Students enrolled in an RN-BSN program are NOT eligible. Orientation Requirements. RN Program Broward College. Angela Russell teaches in the RN-BSN program at Broward College and uses simulations. We discuss the requirements for getting. Broward College RN Program. School Admissions Requirements; RN Schools. Info about Broward College RN to BSN program. Broward College has a. FAU Receives $2 Million Grant for Advanced Nursing Program. FAU's College of Nursing will use the grant. Lynn College of Nursing. Broward College 2012-2013 www.broward.edu NURSING Bachelor of Science in. Science in Nursing Program. It covers testing and calibration performed using standard methods, non- standard methods, and laboratory- developed methods. It is applicable to all organizations performing tests and/or calibrations. These include, for example, first- , second- and third- party laboratories, and laboratories where testing and/or calibration forms part of inspection and product certification. ISO/IEC 1. When a laboratory does not undertake one or more of the activities covered by ISO/IEC 1. 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I created a form that was for my Welsh to English flash cards. I wanted the translation to be hidden until I clicked a button to make it visible so first I had to make the text box called . I want the text box to be invisible when the form opens so I select . I will see these words at the top above the line. Private Sub Form. But I need a way to turn it back on. To do that, I'll create a button. Again I selected the button and clicked on the code icon to put in the code to tell it what to do. I just closed the wizard when it popped up since there is no built in command for this. Now I want the text box to be visible when I click the button. The drop down boxes at the top should be set to . The code will be. Private Sub check. The vmstat output looks like. This generally involves dismounting the file system. Use vmstat to Monitor System Performance. Updated Friday, July 8th, 2. Amanda Folson. Use promo code DOCS1. Credit on a new account. It can be used to determine the root cause of performance and issues related to memory use. Using vmstat. Vmstat Operation. Use the vmstat command to run the program. Using DTrace to understand mpstat and vmstat output. To locate the executables that are blocking on a reader/write lock. Indicates the write service time per write over the monitoring. Generates the XML output. The default file name is iostat. Vmstat - Unix, Linux Command Manual Pages. Utilities, File System, Directories, Memory Management, Special Variables. Linux vmstat does not count itself as a running process. Capturing and sending of vmstat output. Consider the following output: 1. This data provides an average view of virtual memory and system usage since the last reboot. Often, the following form of the command is used: 1vmstat . Subsequent reports, until . The following example illustrates an interval of one (1) second twenty (2. You may run vmstat without a . In these cases, intervals of 3. You may choose to direct this output to a file for logging instead of leaving it running endlessly in a background terminal session. To stop the vmstat process, send the break character (^C or Control+C) as above. In the default operation, vmstat displays memory statistics in kilobytes. To generate vmstat reports where 1 kilobyte is equal to 1. S k 1 1. 0. procs - -- -- -- -- -- memory- -- -- -- -- - - -- swap- - - -- -- io- -- - - system- - - -- -cpu- -- -. Consider the following example: 1. S M 1 1. 0. procs - -- -- -- -- -- memory- -- -- -- -- - - -- swap- - - -- -- io- -- - - system- - - -- -cpu- -- -. Interpreting Vmstat Outputvmstat reports describe the current state of a Linux system. Information regarding the running state of a system is useful when diagnosing performance related issues. Often Linode Support will request vmstat reports in order to more conclusively diagnose some issues; however, with a little background in what all of the data represents, you can interpret this data yourself. The output of vmstat is displayed in a number of columns. The following sections provide brief overviews of the data reported in each column. Procs. The procs data reports the number of processing jobs waiting to run and allows you to determine if there are processes . The b column displays the total number of processes in a . The free column reports the amount of unallocated memory. The cache column reports the amount of allocated memory that could be swapped to disk or unallocated if the resources are needed for another task. Swap. The swap section reports the rate that memory is sent to or retrieved from the swap system. The so column reports the amount of memory that is moved to swap from . The bo column reports the number of blocks sent, or . The cs column reports the number of context switches that the system makes in order to process all tasks. CPUThe cpu section reports on the use of the system. The columns in this section always add to 1. The sy column reports the amount of time that the processor spends on kernel related tasks. The id column reports the amount of time that the processor spends idle. The wa column reports the amount of time that the processor spends waiting for IO operations to complete before being able to continue processing tasks. More Information. You may wish to consult the following resources for additional information on this topic. While these are provided in the hope that they will be useful, please note that we cannot vouch for the accuracy or timeliness of externally hosted materials. This guide is published under a CC BY- ND 4. Production, Market and Forecast in Russia/CIS. This report is the third edition of the research of the market of synthetic. CIS countries. As information sources, we used data of Rosstat. Federal Customs Service of Russia, official statistics of rail transport of. Also, when working on the report. The data on the requirements for the quality of products, production. The Section presents supply- demand balance. Zeolites structure and types. The porous zeolite is host to water molecules and ions of potassium and calcium. Richard Barrer first produced a synthetic zeolite that did not have a natural counterpart. Welcome to the Database of Zeolite Structures. This database provides structural information on all of the Zeolite Framework Types that have been. Synthetic Zeolites Detergents.—Zeolite usage in detergents increased in some regions and stagnated or declined in others. The world market was estimated to be more than 1 Mt. Europe consumed about 650,000 tons per year. HIGH-SILICA ZEOLITE High-silica zeolite is a general term for zeolites rich in the silica component (with a SiO 2/Al 2O 3 molar ratio of 10 or higher), and the high-silica zeolite provided by our company has an MFI structure. Zeolites and zeolite-like materials W.M. Meier Institute of Crystallography. It should be noted that the FD is not a measure of channel dimensions but of the void volume which is just over. Calcium ion removal by a synthetic zeolite in the manufacture of mechanical grade papers By J.-B.Thibodeau, B. Daneault MECHANICAL PAPERS 42 106:3 (2005) T 71 Pulp & Paper Canada ALCIUM CARBONATE fillers (PCC and. FT-IR studies of zeolite materials: characterization and environmental applications. FT-IR STUDIES OF ZEOLITE MATERIALS: CHARACTERIZATION. FT-IR STUDIES OF ZEOLITE MATERIALS: CHARACTERIZATION AND ENVIRONMENTAL. ZEOLITES -DO THEY HAVE A ROLE IN POULTRY PRODUCTION? Synthetic Zeolite: Production, Market and Forecast in Russia/CIS: Published: April 1, 2013: Content info. Synthetic Zeolite Pdf DownloadRECOMMENDED NOMENCLATURE FOR ZEOLITE MINERALS: REPORT OF THE SUBCOMMITTEE ON ZEOLITES OF THE INTERNATIONAL MINERALOGICAL. In the light of advances in mineralogy, the Hey (1930). Synthetic Zeolite Pdf WriterSchool information, administration, curriculum, news, schools, board of education information, and employment opportunities. It is the mission of USA Powerlifting to provide powerlifting competition of uniform high quality which is drug tested and available to all athletes who meet the. Applicants and their parents say yes—despite reporting increased stress about admission and debt. Explore our featured colleges to find schools that both match your interests and are looking for students like you. Which colleges have the best career prospects? These schools pay you back in a big way.
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