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I was watching cnbc while donald trump said this (below), and I think its true!

The harder you work the luckier you get.

Evaluating tyhe patient at the bedside with the following criteria in mind will help you assess the patients’ symptoms.

Dyspnea Evaluation
*Patient reports shortness of breath at rest
*patient cannot count to fifteen without more thatn 3 breaths
*patient cannot walk to the bathroom and back without becoming short of breath

Signs of Volume Overload
*patient has had no weight loss since arrival in the hospital
*patient cannot lie flat; requires extra pillows or inclined bed to rest.
*patient has evidence of peripheralk edema

Additional Consideration
*Patient requires supplemental oxygen
*Improve symptoms, especially congestion and low-output symptoms
*Identify etiology
*Identify precipitatign factors
*Optimize chonic oral therapy
*Minimize Side-effects
*Identify patients who might benefit from revascularization
*educate patients concerning medications and self assessment of Heart Failure
*Consider and where possible initiate a disease management program.

If the patient or individual meets any of these criteria, consult your prescribing clinician about need for additional therapy.

from AAHFN(American Association of Heart Failure Nurses)

We have a previous discussion on the regulation of the business of lending (Part 1 and Part 2 ). On 22 May 2007, Republic Act No. 9474, also known as the “Lending Company Regulation Act of 2007,” was approved. The law is consistent with the declared policy of the State to regulate the establishment of lending companies and to place their operation on a sound, efficient and stable condition to derive the optimum advantages from them as an additional source of credit; to prevent and mitigate, as far as practicable, practices prejudicial to public interest; and to lay down the minimum requirements and standards under which they may be established and do business. Here’s a basic discussion of the law:

What is a Lending Company?

It refers to a corporation engaged in granting loans from its own capital funds or from funds sourced from not more than nineteen (19) persons. It shall not be deemed to include banking institutions, investment houses, savings and loan associations, financing companies, pawnshops, insurance companies, cooperatives and other credit institutions already regulated by law. The term shall be synonymous with lending investors.

What is the form of organization for a lending company?

A lending company shall be established ONLY as a corporation. Existing lending investors organized as single proprietorships or partnerships shall be disallowed from engaging in the business of granting loans to the public one year after the date of effectivity of the law. No lending company shall conduct business unless granted an authority to operate by the SEC.

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What is the capital required for lending companies?

The minimum paid in capital of any lending company established under the law is One Million Pesos (P1,000,000.00). Existing lending companies established and in operation prior to the effecetivity of this law shall comply with the required minimum capitalization within such time as may be prescribed by the SEC which time shall, in no case, be less than three years from the date of effectivity. The SEC may also prescribe a higher minimum capitalization if warranted by circumstances.

What is the citizenship requirement?

Upon the effectivity of the law, at least a majority of the voting capital stock shall be owned by citizens of the Philippines. The percentage of foreign-owned voting stock in any lending company existing prior to the effectivity of the law, if such percentage is in excess of forty-nine percent (49%) of the voting stock, shall not be increased but may be reduced and, once reduced, shall not be increased thereafter beyond forty-nine percent (49%) of the voting stock of the lending company. The percentage of foreign-owned voting stocks in any lending company shall be determined by the citizenship of the individual stockholders. In the case of corporations owning shares in a lending company, the citizenship of the individual owners of voting stock in such corporations shall be the basis in the computation of the percentage. No foreign national may be allowed to own stock unless the country of which he is a national accords reciprocal rights to Filipinos.

What are the prescribed amount and charges on loans?

A lending company may grant loans in such amounts and reasonable interest rates and charges as may be agreed upon between the lending company and the debtor. However, the agreement shall be in compliance with the provisions of Republic Act No. 3765, otherwise known as the “Truth in Lending Act” and Republic Act 7394, otherwise known as the “Consumer Act of the Philippines”. The Monetary Board of the Bangko Sentral ng Pilipinas, in consultation with the SEC and the industry, may prescribe such interest rate as may be warranted by prevailing economic and social conditions.

from: http://jlp-law.com/blog/basics-of-lending-company-regulation-act-of-2007-ra-9474/

Exergen Infrared Thermometer was introduced to my unit at Baylor University Medical Center, 10R like 5months ago…

This new device can take temperature in less than 5 seconds and its very quick and it is run by battery. One time all of those Exergen Temporal Scanner Thermometer run out of battery. So we have to call Engineering to replace batteries. Anyway these new device is great especially for big medical center where time is limited and it takes temerature fast!

for those who do not know how to use this all you have to do is press and hold the scan button and pass the infrared probe to their temporal artery and Subclavian arterym, then release the button and check your monitor for temperature reading. Thats how quickly done.

While if you use your traditional oral digital thermoter it takes some time to take the temperature. But we still use it for verifying Exergen’s Temporal Thermometer.

CHF is usually caused by cardiomyopathy. Cardio means “heart” and Myopathy is “muscle related desease”. there are several types of cardiomyopathy they are listed below:

Alcohol cardiomyopathy is a cardiomyopathy that is caused by excessive and habitual use of alcohol which causes the heart muscle to weaken and causes it not to pump properly.

Hypertrophic Cardiomyopathy is a cardiomyopathy wherein the heart muscles becomes thick and makes the heart harder to pump blood out.

Dilated Cardiomyopathy is the most common cardiomyopathy wherein the heart becomes dilated or becomes big that it makes for the heart hard to pump.

Ischemic Cardiomyopathy is what happens to patients who has Congestive Heart Failure secondary to Coronary Artery Disease, Angina, MI, or Atherosclerosis or arteriosclerosis. Ischemic means decreased oxygen.

Restrictive Cardiomyopathy refers to a group of disorders in which the heart chambers are unable to fill with blood properly because of stiffness of the heart. In restrictive cardiomyopathy, the heart is normal in size or only slightly enlarged, but it cannot relax normally during diastole (that is, the time between heartbeats in which the blood returns from the body to the heart). Later in the disease, the heart may not pump blood efficiently. The abnormal heart function can affect the lungs, liver, and other body systems. Restrictive cardiomyopathy may affect either or both ventricles and may or may not be associated with a disease of the heart

Usually when at work, we, nurses, bring food from home might be a leftover or a whole turkey depends at least in every floor or unit they usually have something to eat of have on table for fellowship.

So its still like a normal thanksgiving the only difference is that we are in a facility caring for patients who never had a chance to go home like us.

I work in a CHF telemetry floor at Baylor University Medical Center. Aside from getting all those heart and llung transplant patients, and S/P cardiac sugeries. We also specialize in Congestive Heart Failure(CHF) patients, my colleagues and I are doing an excellent care for these kinds of patients. We have all the resources you need from reading materials to videos, and education classess. Education classes are done at 10Roberts and thats where I work. And if you are admitted where I work you will get a special treatment we have all the materials you need for survival. We also have a Nurse Practitioner who is working with the CHF doctors, who specialize in these kind illness.

All of the staff have undergone education classes to be able to understand this kind of illness.

You might be asking why Im posting this kind of info its because I am glad I am part of this team who takes care of CHF patients.