Secundum Atrial Septal Defect: Surgical Closure

Secundum Atrial Septal Defect: Surgical Closure Surgical closure of secundum atrial septal defect in a patient with atrial situs solitus and interrupted inferior vena cava: report of 2 cases Key Words: Interrupted inferior vena cava, Situs solitus, Atrium septal defects, limited skin incision Abstract The occurrence of an interrupted inferior vena cava (IVC) in setting of atrial situs solitus is relatively rare. Here, we reported two cases of the surgical closure of secundum atrium septal defects (ASDs) in patients with atrial situs solitus and an interrupted IVC. The first case was a 7-year-old boy with a secundum ASD without the posterior rim whose interrupted IVC and azygos continuation had been preoperatively diagnosed by the echocardiography and cardiac catheterization. The operation was safely performed using a large-sized venous drainage cannula from the superior vena cava (SVC). The second case was a 2-year-old boy with a secundum ASD without the superior rim whose interrupted IVC was not diagnosed at the preoperative examination. The operation was performed through a median partial sternotomy via a 5.0cm limited skin incision, so direct inspection of the SVC was not clearly obtained. A cardiopulmonary bypass was established using the recommended size of venous drainage ca nnulae; however, the SVC could not be removed without elevating the SVC pressure. As a result, the ASD was closed directly under sucking the venous return from the SVC without snaring it. Post-operative computed tomography detected an interrupted IVC with azygos continuation and a persistence of both supracardinal veins, known as a double IVC. Introduction Whereas an interrupted inferior vena cava (IVC) because of the absence of its hepatic segment is mainly noted in patients with heterotaxy syndrome, the occurrence of an interrupted IVC within the atrial situs solitus is reported as ranging from 0.08 to 0.1% [1,2,3]. In these patients, cardiac malformations are frequently associated, and the main types of abnormalities include atrial septal defects (ASDs, 10.5 %) and ventricular septal defects (7.5 %) [1]. Although this systemic venous anomaly provides no symptoms by itself, it seems to be relevant in cardiac surgery, especially in procedures that require approaches through the right atrium. Here, we reported two cases of the surgical closure of secundum ASD in patients with atrial situs solitus and interrupted IVC, focusing on perioperative findings and associated issues. Case Case 1 A clinically asymptomatic 7-year-old boy (body weight, 22 kg; height, 125 cm) with an ASD secundum, which was detected at the age of 10 months, was admitted for surgical closure of the lesion. Device ASD closure by catheter intervention was contraindicated because of the absence of the posterior rim. Preoperative echocardiography revealed an atrial sinus solitus with an 18 by 21-mm ASD secundum without the posterior rim and relative valvular pulmonary stenosis. Also, interrupted IVC was suspected because drainage of the IVC into the right atrium was not detected. Cardiac catheterization to assess the indication for surgical pulmonary valvotomy showed a systemic and pulmonary blood flow ratio of 3.14 and pull-buck pressure gradient of 10 mmHg from the right ventricle to the main pulmonary artery. Furthermore, no hepatic segment of the IVC was detected; thus, an interrupted IVC with azygos continuation was confirmed (Fig. 1). Through the median full sternotomy, a cardiopulmonary bypass was established using arterial cannulation through ascending aorta perfusion with a 16-Fr cannula and venous drainage from the superior vena cava (SVC) and the hepatic vein using 28 and 20 Fr cannulae, whereas recommended cannulae sizes were 20 and 24 Fr, respectively. The ASD secundum was closed directly through the right atriotomy under moderate hypothermia and cardioplegic arrest. The operation was completed without any issues. Case 2 A clinically asymptomatic 2-year-old boy (body weight, 10 kg; height, 81 cm) had recently been diagnosed with a large ASD secundum without the superior rim. Further examination revealed an atrial sinus solitus, an 18 by 18-mm ASD secundum without the superior rim, and a bicuspid aortic valve. However, an interrupted IVC was not diagnosed. Through a median partial sternotomy via a limited skin incision (50mm in length), a cardiopulmonary bypass was established using arterial cannulation through ascending aorta perfusion with a 12-Fr cannula and venous drainage from the SVC and hepatic vein, although it was thought to be an IVC at that time, using the recommended sizes of 16 and 18 Fr cannulae. During the surgery, the SVC was attempted to be snared, but it could not be because of the elevating SVC pressure. The depth of cannula and the location of snaring were repeatedly changed without resolving this issue; therefore, the SVC was left without being snared. The ASD secundum was closed directly under moderate hypothermia and cardioplegic arrest with sucking the venous return from the SVC. Weaning off from cardiopulmonary bypass was uneventful, and the operation was completed without any issues. Post-operative computed tomography showed an interrupted IVC with azygos continuation and a persistence of both supracardinal ve ins, known as double IVC (Fig. 2). On medical check-up at the outpatient clinic one year after discharge, advanced sick sinus syndrome was detected by electrocardiography. 24-Hour Holter electrocardiography monitoring showed that the total number of heartbeats was 142,036 per day, 8 beats of isolated premature atrial contractions, and had no evidence of premature ventricular contractions or more than 2.5 seconds of sinus pose. Discussion Like the first presented case, an interrupted IVC with azygos continuation can usually be diagnosed by preoperative echocardiography [1], which can be easily treated at the establishment of a cardiopulmonary bypass by selecting adequately-sized venous cannulae. If it is not preoperatively diagnosed, direct intra-operative inspection usually makes the diagnosis possible. However, the cosmetic outcome must be taken into consideration during surgical ASD repair as well as secure defect closure after the popularization of percutaneous device closure, like in the second case. Therefore, a limited skin incision with partial sternotomy was selected for this patient, which unfortunately interrupted clear observation of the SVC. Selection of large sized SVC drainage cannula should have been considered first during inadequate venous drainage, however, which was deferred because the total cardiopulmonary bypass was easily established as long as the SVC was not snared. As is our policy, the IVC is not snared during the closing of the ASD secundum in order to obtain a certain identification of the posterior rim. Therefore, the tip of the IVC drainage cannula was positioned at the IVC around the right atrial junction for sufficient drainage of both the IVC and hepatic venous blood flow. As a result, such a maneuver enabled the establishment of a total cardiopulmonary bypass with small-sized SVC drainage cannula and eventually large â€Å"hepatic vein† cannula. As shown in Case 2, an anomalous IVC is known to accompany various rhythm disorders, though only a few cases have been reported [4,5]. One of the causes of rhythm disorders is the degeneration of the atrial muscle around the sinus node, which might occur as a result of a local volume overload on the sinus node by the presence of azygos continuation. Although the total number of heart beats was well maintained and more than 2.5 seconds of a sinus pose was not observed until now, a scheduled follow-up was mandatory for early detection of further advancement of the sinus node dysfunction. In summary, two surgical experiences of secundum ASD associated with an interrupted IVC with azygos continuation were reported. Under partial sternotomy via limited skin incision, precautions should be taken to detect the presence of this venous anomaly if venous drainage from the SVC is not adequately obtained using cannula of the recommended size.

Kobe Bean Bryant Essay

Kobe Bean Bryant nicknamed the â€Å"Black Mamba† is a professional basketball play who plays in the National Basketball Association (NBA). He was born on August 23, 1978. He was drafted right out of high school to play for the Charlotte Hornets, but soon was traded to the Los Angeles Lakers, never playing in Charlotte. Bryant is a five-time champion with the Lakers and a two-time Olympic gold medalist with the USA national team. Bryant was born on August 23 in Philadelphia. Bryant was named after a Japanese steakhouse. He is son of a former NBA player Joe â€Å"Jellybean† Bryant. After the elder Bryant finished his NBA career he took his family overseas where he played in an Italian league. Growing up in Italy where soccer was the most popular sport Bryant grew up loving two sports. He would stay all day playing soccer on the pavement fields all day, then after all the kids went home he worked on perfecting his mid-range jumper. Kobe later returned to Philadelphia where he played in high school with Lower Merion High School. Eyeing the NBA he workout with the nearby NBA team the Philadelphia 76ers. Kobe decided to skip college and head straight to the NBA. He was drafted by the Charlotte Hornets and subsequently traded to the Los Angeles where his career ignited. (Biography.com/Kobe Bryant). Kobe Bryant career did not take long to start in a good manner. In his second year in the NBA as a shooting guard, at the age of 19, he was voted to play in the NBA’s all-star game, becoming the youngest player to appear in the game. Later with the help of Shaquille O’neal the Lakers won three consecutive championships in 2000, 2001, 2002. As he reached the prime of his career without Shaq he had some lackluster season as his team didn’t even nearly compete at the level Kobe was. He was outstanding on January 22, 2006 he scored 81 points and achieving the second highest scoring game in NBA history, only second to Wilt Chamberlain’s 100 point game. Although his race for a title was not yet over in 2008 he linked up with seven footer Pau  Gasol reaching to the NBA finals. They did not win that year but the following year they did in 2009. In 2010 their season was just as great reaching to the NBA finals for a third straight time as Kobe was leading the way . They met their arch rivals again in the games most important stage. They beat the Boston Celtics in a thrilling seven game series. Kobe was named Finals MVP for both of the seasons that they had won the NBA championship. He is now a five-time NBA champion and is still seeking more titles. In the 2013 season he became the youngest player to reach 30000 points at the age of 34. Kobe Bryant is one of the greatest basketball player to ever play the game and will one day be a Hall of Famer. Kobe Bryant has a foundation, â€Å"The Kobe and Vanessa Bryant Family Foundation†, that is dedicated to improving the lives of youth and families in need, both domestically and globally. By providing financial resources and developing unique programs, the foundation strives to strengthen communities through educational and cultural enrichment opportunities. Kobe Bryant is admired by the NBA fans all over the world. They love the excitement he brings to game with his incredible clutch shots and amazing plays. Kobe is also admired for the help he brings to the less fortunate. By helping the financially or educationally. Overall Kobe Bean Bryant is someone you could look up to on and off the court.

Russian Days of the Week Usage and Examples

The week in Russian follows the same order as the English week, beginning with Monday. Russian days of the week are never capitalized and, just like all other Russian nouns, each has either feminine, masculine, or neutral gender. They also decline based on the case they are in. Russian Word Translation Pronunciation Example Ð ¿Ã ¾Ã ½Ã µÃ ´Ã µÃ »Ã'Å'Ð ½Ã ¸Ã º masculine Monday puhnyDYEL'nik Ðâ€"Ð °Ã ²Ã'‚Ã'€Ð ° Ð ¿Ã ¾Ã ½Ã µÃ ´Ã µÃ »Ã'Å'Ð ½Ã ¸Ã º - Tomorrow is Monday. Ð ²Ã'‚Ð ¾Ã'€Ð ½Ã ¸Ã ºmasculine Tuesday FTORnik ÐÅ"Ã'‹ Ð ¿Ã'€Ð ¸Ã µÃ ´Ã µÃ ¼ Ð ²Ã ¾ Ð ²Ã'‚Ð ¾Ã'€Ð ½Ã ¸Ã º - We will arrive on Tuesday. Ã' Ã'€Ð µÃ ´Ã °feminine Wednesday sryDAH Ð ¡Ã'€Ð µÃ ´Ã ° - Ã' Ã µÃ'€Ð µÃ ´Ã ¸Ã ½Ã ° Ð ½Ã µÃ ´Ã µÃ »Ã ¸ - Wednesday is the middle of the week. Ã'‡Ð µÃ'‚Ð ²Ã µÃ'€Ð ³masculine Thursday chitVYERK/chtVYERK Ð £ Ð ²Ã'€Ð °Ã'‡Ð ° Ð ¿Ã'€Ð ¸Ã µÃ ¼ Ð ¿Ã ¾ Ã'‡Ð µÃ'‚Ð ²Ã µÃ'€Ð ³Ã °Ã ¼ - The doctor sees patients on Thursdays. Ð ¿Ã' Ã'‚Ð ½Ã ¸Ã'†Ð °feminine Friday PYATnitsuh Ð ¯ Ð ¸Ã'… Ð ²Ã ¸Ã ´Ã µÃ »Ã ° Ð ² Ð ¿Ã ¾Ã ·Ã °Ã ¿Ã'€Ð ¾Ã'ˆÐ »Ã'Æ'Ã'Ž Ð ¿Ã' Ã'‚Ð ½Ã ¸Ã'†Ã'Æ' - I saw them on Friday before last. Ã' Ã'Æ'Ð ±Ã ±Ã ¾Ã'‚Ð °feminine Saturday suBOHtuh Ð Ã °Ã ·Ã ½Ã °Ã'‡Ð µÃ ½Ã ¾ Ð ½Ã ° Ã' Ã'Æ'Ð ±Ã ±Ã ¾Ã'‚Ã'Æ' - It is arranged for Saturday. Ð ²Ã ¾Ã' Ã ºÃ'€Ð µÃ' Ã µÃ ½Ã'Å'Ð µneuter Sunday vuhskrySYEN'ye Ð’ Ð ²Ã ¾Ã' Ã ºÃ'€Ð µÃ' Ã µÃ ½Ã'Å'Ð µ Ã'  Ð ²Ã'‹Ã' Ã ¿Ã »Ã'ŽÃ' Ã'Å' - I'll catch up on my sleep on Sunday. Using Prepositions With Russian Days of the Week Ð ²/Ð ²o and Ð ½Ã ° - on (Accusative Case) The preposition Ð ²/Ð ²o means on and is used to indicate that something happens on a certain day. The preposition Ð ½Ã ° also means on but is used in situations where an appointment or an event is planned for a particular day. Ð’/Ð ½Ã ° Ð ¿Ã ¾Ã ½Ã µÃ ´Ã µÃ »Ã'Å'Ð ½Ã ¸Ã º - on/for MondayÐ’Ð ¾/Ð ½Ã ° Ð ²Ã'‚Ð ¾Ã'€Ð ½Ã ¸Ã º - on/for TuesdayÐ’/Ð ½Ã ° Ã' Ã'€Ð µÃ ´Ã'Æ' - on/for WednesdayÐ’/Ð ½Ã ° Ã'‡Ð µÃ'‚Ð ²Ã µÃ'€Ð ³ - on/for ThursdayÐ’/Ð ½Ã ° Ð ¿Ã' Ã'‚Ð ½Ã ¸Ã'†Ã'Æ' - on/for FridayÐ’/Ð ½Ã ° Ã' Ã'Æ'Ð ±Ã ±Ã ¾Ã'‚Ã'Æ' - on/for SaturdayÐ’/Ð ½Ã ° Ð ²Ã ¾Ã' Ã ºÃ'€Ð µÃ' Ã µÃ ½Ã'Å'Ð µ - on/for Sunday Examples: Ð’Ã' Ã'‚Ã'€Ð µÃ'‡Ð ° Ã' Ã ¾Ã' Ã'‚Ð ¾Ã ¸Ã'‚Ã' Ã'  Ð ² Ã' Ã'€Ð µÃ ´Ã'Æ'.Pronunciation: VSTREcha sastaEETsa f suBBOtu.Translation: The meeting will take place on Wednesday. Ð’Ã' Ã'‚Ã'€Ð µÃ'‡Ð ° Ð ½Ã °Ã ·Ã ½Ã °Ã'‡Ð µÃ ½Ã ° Ð ½Ã ° Ã' Ã'€Ð µÃ ´Ã'Æ'.Pronunciation: VSTREcha nazNAchyna na SRYEdu.Translation: The meeting is arranged for Wednesday. Ã' /Ã' Ã ¾ - From, Since (Genitive Case) and Ð ´Ã ¾ - Until (Genitive Case) Ð ¡/Ð ´Ã ¾ Ð ¿Ã ¾Ã ½Ã µÃ ´Ã µÃ »Ã'Å'Ð ½Ã ¸Ã ºÃ ° - from / since / until MondayÐ ¡/Ð ´Ã ¾ Ð ²Ã'‚Ð ¾Ã'€Ð ½Ã ¸Ã ºÃ ° - from/since/until TuesdayÐ ¡/Ð ´Ã ¾ Ã' Ã'€Ð µÃ ´Ã'‹ - from/since/until WednesdayÐ ¡/Ð ´Ã ¾ Ã'‡Ð µÃ'‚Ð ²Ã µÃ'€Ð ³Ã ° - from/since/until ThursdayÐ ¡/Ð ´Ã ¾ Ð ¿Ã' Ã'‚Ð ½Ã ¸Ã'†Ã'‹ - from/since/until FridayÐ ¡/Ð ´Ã ¾ Ã' Ã'Æ'Ð ±Ã ±Ã ¾Ã'‚Ã'‹ - from/since/until SaturdayÐ ¡/Ð ´Ã ¾ Ð ²Ã ¾Ã' Ã ºÃ'€Ð µÃ' Ã µÃ ½Ã'Å'Ã'  - from/since/until Sunday Example: ДÐ ¾ Ð ²Ã ¾Ã' Ã ºÃ'€Ð µÃ' Ã µÃ ½Ã'Å'Ã'  Ð ¿Ã' Ã'‚Ã'Å' Ð ´Ã ½Ã µÃ ¹.Pronunciation: da vaskrySYENya PYAT DNYEY.Translation: It is five days until Sunday. Ð ¿Ã ¾ - Until, Including (Accusative Case) ПÐ ¾ Ð ¿Ã ¾Ã ½Ã µÃ ´Ã µÃ »Ã'Å'Ð ½Ã ¸Ã º - until/including/to MondayПÐ ¾ Ð ²Ã'‚Ð ¾Ã'€Ð ½Ã ¸Ã º - until/including TuesdayПÐ ¾ Ã' Ã'€Ð µÃ ´Ã'Æ' - until/including WednesdayПÐ ¾ Ã'‡Ð µÃ'‚Ð ²Ã µÃ'€Ð ³ - until/including ThursdayПÐ ¾ Ð ¿Ã' Ã'‚Ð ½Ã ¸Ã'†Ã'Æ' - until/including FridayПÐ ¾ Ã' Ã'Æ'Ð ±Ã ±Ã ¾Ã'‚Ã'Æ' - until/including SaturdayПÐ ¾ Ð ²Ã ¾Ã' Ã ºÃ'€Ð µÃ' Ã µÃ ½Ã'Å'Ð µ - until/including Sunday Example: Ð ¡ Ð ¿Ã ¾Ã ½Ã µÃ ´Ã µÃ »Ã'Å'Ð ½Ã ¸Ã ºÃ ° Ð ¿Ã ¾ Ð ¿Ã' Ã'‚Ð ½Ã ¸Ã'†Ã'Æ' Ã'  Ã'…Ð ¾Ã ¶Ã'Æ' Ð ½Ã ° Ã'€Ð °Ã ±Ã ¾Ã'‚Ã'Æ'.Pronunciation: s panyDYELnika pa PYATnicu ya haZHOO na raBOtuTranslation: From Monday to Friday I go to work. Ð ¿Ã ¾ - on (Plural, Dative Case) ПÐ ¾ Ð ¿Ã ¾Ã ½Ã µÃ ´Ã µÃ »Ã'Å'Ð ½Ã ¸Ã ºÃ °Ã ¼ - on MondaysПÐ ¾ Ð ²Ã'‚Ð ¾Ã'€Ð ½Ã ¸Ã ºÃ °Ã ¼ - on TuesdaysПÐ ¾ Ã' Ã'€Ð µÃ ´Ã °Ã ¼ - on WednesdaysПÐ ¾ Ã'‡Ð µÃ'‚Ð ²Ã µÃ'€Ð ³Ã °Ã ¼ - on ThursdaysПÐ ¾ Ð ¿Ã' Ã'‚Ð ½Ã ¸Ã'†Ð °Ã ¼ - on FridaysПÐ ¾ Ã' Ã'Æ'Ð ±Ã ±Ã ¾Ã'‚Ð °Ã ¼ - on SaturdaysПÐ ¾ Ð ²Ã ¾Ã' Ã ºÃ'€Ð µÃ' Ã µÃ ½Ã'Å'Ã' Ã ¼ - on Sundays Example: ПÐ ¾ Ã' Ã'Æ'Ð ±Ã ±Ã ¾Ã'‚Ð °Ã ¼ Ð ¾Ã ½Ã ¸ Ð »Ã'ŽÐ ±Ã ¸Ã »Ã ¸ Ð ³Ã'Æ'Ð »Ã' Ã'‚Ã'Å' Ð ¿Ã ¾ Ð ³Ã ¾Ã'€Ð ¾Ã ´Ã'Æ'.Pronunciation: pa suBBOtam aNEE lyuBEEli gooLYAT pa GOradu.Translation: On Saturdays, they liked to go walking around the city. Abbreviations Russian days of the week are often shortened in writing (such as calendars or diaries) using the following abbreviations: ПÐ ½ - MondayÐ’Ã'‚ - TuesdayÐ ¡Ã'€ - WednesdayÐ §Ã'‚ - ThursdayПÃ'‚  - FridayÐ ¡Ã ± - SaturdayÐ’Ã'  - Sunday Russian Vocabulary for Scheduling and Planning Russian Word Translation Pronunciation Example Ð ¡Ã µÃ ³Ã ¾Ã ´Ã ½Ã'  Today syVODnya Ð ¡Ã µÃ ³Ã ¾Ã ´Ã ½Ã'  Ð ²Ã'‚Ð ¾Ã'€Ð ½Ã ¸Ã º - Today is Tuesday. Ðâ€"Ð °Ã ²Ã'‚Ã'€Ð ° Tomorrow ZAVTruh ДÐ ¾ Ð ·Ã °Ã ²Ã'‚Ã'€Ð ° - Until tomorrow./See you tomorrow. Ð’Ã'‡Ð µÃ'€Ð ° Yesterday fchyeRAH Ð’Ã'‡Ð µÃ'€Ð ° Ã'ˆÐ µÃ » Ã' Ã ½Ã µÃ ³ - Yesterday it snowed. Ð Ã °(Ã' Ã'‚Ð ¾Ã ¹) Ð ½Ã µÃ ´Ã µÃ »Ã µ During the week na (Etay) nyDYEly Ðâ€"Ð °Ã ¹Ã ´Ã ¸Ã'‚Ð µ Ð ½Ã ° (Ã' Ã'‚Ð ¾Ã ¹) Ð ½Ã µÃ ´Ã µÃ »Ã µ - Pop in this week. Ð Ã ° Ã' Ã »Ã µÃ ´Ã'Æ'Ã'ŽÃ'‰Ð µÃ ¹ Ð ½Ã µÃ ´Ã µÃ »Ã µ Next week na SLYEdushey nyDYEly Ð ¯ Ã'Æ'Ð µÃ ·Ã ¶Ã °Ã'Ž Ð ½Ã ° Ã' Ã »Ã µÃ ´Ã'Æ'Ã'ŽÃ'‰Ð µÃ ¹ Ð ½Ã µÃ ´Ã µÃ »Ã µ (ya ooyezZHAyu na SLYEdushey nyDYEly) - I am leaving next week. Ð Ã ° Ð ¿Ã'€Ð ¾Ã'ˆÐ »Ã ¾Ã ¹ Ð ½Ã µÃ ´Ã µÃ »Ã µ Last week na PROSHlay nyDYEly Ð’Ã' Ã µ Ð ¿Ã'€Ð ¾Ã ¸Ã ·Ã ¾Ã'ˆÐ »Ã ¾ Ð ½Ã ° Ð ¿Ã'€Ð ¾Ã'ˆÐ »Ã ¾Ã ¹ Ð ½Ã µÃ ´Ã µÃ »Ã µ - It all happened last week. ПÐ ¾Ã ·Ã °Ã ²Ã'‡Ð µÃ'€Ð ° Day before yesterday puhzafchyRAH ПÐ ¾Ã ·Ã °Ã ²Ã'‡Ð µÃ'€Ð ° Ð ¿Ã ¾Ã »Ã'Æ'Ã'‡Ð ¸Ã »Ã ¸ Ã' Ã ¾Ã ¾Ã ±Ã'‰Ð µÃ ½Ã ¸Ã µ - We received a message the day before yesterday. ПÐ ¾Ã' Ã »Ã µÃ ·Ã °Ã ²Ã'‚Ã'€Ð ° The day after tomorrow POSlyZAVTruh ПÐ ¾Ã' Ã »Ã µÃ ·Ã °Ã ²Ã'‚Ã'€Ð ° Ð ½Ã °Ã'‡Ð ¸Ã ½Ã °Ã'ŽÃ'‚Ã' Ã'  Ð ºÃ °Ã ½Ã ¸Ã ºÃ'Æ'Ð »Ã'‹ - School holidays begin the day after tomorrow. Ð §Ã µÃ'€Ð µÃ · Ð ½Ã µÃ ´Ã µÃ »Ã'Ž After a week/a week from CHYEryz nyDYElyu Ð £Ã ²Ã ¸Ã ´Ã µÃ ¼Ã' Ã'  Ã'‡Ð µÃ'€Ð µÃ · Ð ½Ã µÃ ´Ã µÃ »Ã'Ž - We'll see each other next week/see you next week. Ð §Ã µÃ'€Ð µÃ · Ð ´Ã µÃ ½Ã'Å' Every other day CHYEryz DYEN' ПÃ'€Ð ¸Ã ½Ã ¸Ã ¼Ã °Ã'‚Ã'Å' Ð »Ã µÃ ºÃ °Ã'€Ã' Ã'‚Ð ²Ã ¾ Ã'‡Ð µÃ'€Ð µÃ · Ð ´Ã µÃ ½Ã'Å' - Take the medicine every other day. Ð §Ã µÃ'€Ð µÃ · Ð ¼Ã µÃ' Ã' Ã'† In a month's time CHYEryz MYEsyts Ð §Ã µÃ'€Ð µÃ · Ð ¼Ã µÃ' Ã' Ã'† Ð ½Ã °Ã'‡Ð °Ã »Ã' Ã'  Ã'€Ð µÃ ¼Ã ¾Ã ½Ã'‚ - The renovations began a month later.

Accelerated BSN Program Forensic Geriatric Nurses Investigate Cases of Elder Abuse 2019

The profession of nursing is expected to grow over 27% through the year 2018. Along with the predicted rise in nursing jobs is the expectation that the number of people over the age of 65 will make up 19% of the total U.S. population by the year 2030. Some professionals are choosing to complete accelerated BSN program (bachelor of science in nursing) degrees in order to specialize as forensic geriatric nurses in the growing elderly population. What is a Forensic Geriatric Nurse? A Forensic Geriatric Nurse investigates and cares for victims of elder abuse, neglect, and exploitation, most often a graduate of an accelerated BSN program. Forensic Geriatric Nurses are often employed by long-term care facilities, and other times establish their own practices. Sample duties of a forensic geriatric nurse with a BSN degree include: Taking photos of injuries to a newly admitted elderly patient. Conducting patient and family interviews. Analyzing evidence to determine the presence or absence of ill treatment. .u6c76c72a3b5d0b3ba4bf0822fe54467f { padding:0px; margin: 0; padding-top:1em!important; padding-bottom:1em!important; width:100%; display: block; font-weight:bold; background-color:#eaeaea; border:0!important; border-left:4px solid #34495E!important; box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -moz-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -o-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -webkit-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); text-decoration:none; } .u6c76c72a3b5d0b3ba4bf0822fe54467f:active, .u6c76c72a3b5d0b3ba4bf0822fe54467f:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; text-decoration:none; } .u6c76c72a3b5d0b3ba4bf0822fe54467f { transition: background-color 250ms; webkit-transition: background-color 250ms; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; } .u6c76c72a3b5d0b3ba4bf0822fe54467f .ctaText { font-weight:bold; color:inherit; text-decoration:none; font-size: 16px; } .u6c76c72a3b5d0b3ba4bf0822fe54467f .post Title { color:#000000; text-decoration: underline!important; font-size: 16px; } .u6c76c72a3b5d0b3ba4bf0822fe54467f:hover .postTitle { text-decoration: underline!important; } READ A Nursing ShortageRequired Education to Become a Forensic Geriatric Nurse Forensic Geriatric Nurses must be licensed as Registered Nurses in the U.S. Registration may be obtained through completing a hospital diploma, associate degree, or BSN nursing degree. Training in forensic science subjects, such as photography, wound identification, and evidence preservation and collection are extremely helpful in addition to completing an accelerated BSN program. Nurses interested in becoming a Forensic Geriatric Nurse have many options to choose from. BSN nursing schools, such as Kaplan University, offer educational programs that lead to an accelerated BSN program diploma or a Forensic Nursing Certificate. Many hospitals also have internship opportunities for students wishing to gain practical work experience in the field of forensic nursing. Prospective students interested in learning more information about becoming a Forensic Geriatric Nurse may visit the International Association of Forensic Nurses website or College-Pages.com, a leading education and career resource website. .u41cbb9f32ee8b84cdd0ffea5f686651b { padding:0px; margin: 0; padding-top:1em!important; padding-bottom:1em!important; width:100%; display: block; font-weight:bold; background-color:#eaeaea; border:0!important; border-left:4px solid #34495E!important; box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -moz-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -o-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -webkit-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); text-decoration:none; } .u41cbb9f32ee8b84cdd0ffea5f686651b:active, .u41cbb9f32ee8b84cdd0ffea5f686651b:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; text-decoration:none; } .u41cbb9f32ee8b84cdd0ffea5f686651b { transition: background-color 250ms; webkit-transition: background-color 250ms; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; } .u41cbb9f32ee8b84cdd0ffea5f686651b .ctaText { font-weight:bold; color:inherit; text-decoration:none; font-size: 16px; } .u41cbb9f32ee8b84cdd0ffea5f686651b .post Title { color:#000000; text-decoration: underline!important; font-size: 16px; } .u41cbb9f32ee8b84cdd0ffea5f686651b:hover .postTitle { text-decoration: underline!important; } READ Criminal Justice Degree College Online College Proves to be a Smart Choice for Maryland Working ProfessionalsRelated ArticlesAccelerated BSN Option Take a Leadership Position in the Field of Nursing as a Case ManagerBSN Top 5 Reasons to Earn a Bachelor of Science in NursingRN to BSN Degree Labor and Delivery Nurses Care for Women, Families, and NewbornsHow to Answer Common Interview QuestionsOnline BSN Degree Forensic Pediatric Nurses Protect Human Rights of ChildrenOnline RN to BSN Degree Become Qualified to Work as an Operating Room Nurse