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1.우선 순위?

FHR 태아심박수-sinusoidal pattern(부드러운 물결모양)

amniotic fluid volume

A sinusoidal pattern in a Non-Stress Test (NST) is a rare, ominous fetal heart rate (FHR) pattern characterized by a smooth, sine wave-like, undulating pattern with a frequency of 3–5 cycles per minute and amplitude of 5–15 bpm. It signifies severe fetal anemia, hypoxia, or distress, often indicating high risk of morbidity/mortality

2.죽음 앞둔 환자 호흡소리 심하고 가래

scopolamine

antibiotic

atropine

atropine appear equally effective in treating end-of-life noisy breathing

Morphine or Oxycodone: Used for pain management and to alleviate breathing difficulties (dyspnea).

Midazolam: Used to manage terminal restlessness, agitation, or severe breathing distress.

Haloperidol: Used to manage delirium, agitation, or nausea.

Glycopyrrolate: Another antimuscarinic used for reducing airway secretions; it does not cross the blood-brain barrier, making it less likely to cause delirium or sedation compared to scopolamine.

Lorazepam: Often used for anxiety or terminal restlessness

Scopolamine (specifically scopolamine butylbromide or hyoscine butylbromide) is widely used in palliative care to manage the "death rattle"—a noisy breathing sound caused by the buildup of mucus in the upper respiratory tract when a person is near death. It works as an anticholinergic agent, reducing the production of secretions, and is considered effective in reducing this symptom when administered at the end of life

3Scopolamine correct?

apply flat area

remove when shower

use cutting half size at first time then use whole size

new patch apply when once falling

carefully drive because dizziness

hand washing

#Do not drive or do anything else that could be dangerous until you know how this medicine

#half size fold when discard

#Do not drive or do anything else that could be dangerous until you know how this medicine affects you

#The patch should stay in place even during showering, bathing, or swimming. Apply a new patch behind the other ear if the first one becomes too loose or falls off

4 scopolamine patch 적용으로 맞는 것

귀 뒤쪽 편평한 곳에 한다

운전 하지 않는다

소변이잘안나올수도있다

일주일마다 교환한다

변기에 버린다

5.sickle cell 아이 부모교육

stroke 위험 때문에 16세까지 일년에 한번씩 뇌도플러

Children with sickle cell anemia (SCA) face a high risk of stroke (approx. 10-11% by age 20) due to blocked blood vessels. Annual Transcranial Doppler (TCD) ultrasound screening is essential for children ages 2 to 16 to detect high blood flow velocities, identifying those at risk to allow preventative treatments like blood transfusions.

6.sickle cell disease complication

① COPD  ② CVA  ③ MI   ④ spleen..~ ⑤ bone cancer

Sickle cell anemia can lead to a host of complications, including:

Stroke.

Acute chest syndrome.

Pulmonary hypertension.

Organ damage.  including your kidneys, liver and spleen. Organ damage can be fatal.

Blindness.

Skin ulcers.

Gallstones.  A high level of bilirubin in your body can lead to gallstones.

Priapism.

7,NGN Endocarditis

client is admitted with the diagnosis of infective endocarditis (IE). History of which finding is most important for the nurse to report to the registered nurse (RN)?

tiredness and drowsiness

a rash that appeared suddenly

fever for the past 24 hours

clubbing of the nails

infection are arthralgia, fever, and rash; endocarditis occurs as a rare complication

8. 감염성 심내막염으로 입원환자 간호사가 Alert해야 하는 증상

호흡곤란

Heart murmur

hemorrhage

9. endocarditis

murmur

WBC 15000

ESR 상승

substernal chest pain

fever

10. “Endocarditis 병력 있는 환자가 치과치료 예정 시 올바른 간호는?”

“치료 전 prophylactic antibiotics 투여.”

penicillin 투여한다.

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