Si può desiderare di provare un trattamento naturale disfunzione erettile come un diverso per i problemi di costruzione. Al giorno d oggi ci sono diverse terapie sul mercato, ma un trattamento naturale disfunzione erettile è stato confermato qualche ora e ora di nuovo per dare risultati efficienti e permanenti. Cos è la disfunzione sessuale? L incapacità di sviluppare o sostenere una costruzione abbastanza lungo per fare l amore è chiamato disfunzione erettile, ED https://farmacia-senzaricetta.it/ o (maschio) problemi di erezione. Tutti gli uomini possono avere problemi di costruzione di volta in volta e gli scienziati considerano ED essere presenti se si verificano problemi di costruzione almeno il 25% del tempo. Alcuni fatti duri: ED Può essere dovuto a problemi emotivi. Stress, pressione, giltiness, depressione, bassa autostima e ansia prestazioni può essere la causa dei vostri problemi di costruzione. La ricerca ha confermato che il 90 per cento della disfunzione erettile è fisica in origine, non emotiva. L impotenza colpisce la maggior parte degli uomini durante la loro vita e può essere dovuto a troppo colesterolo, problemi cardiaci, diabete, ipertensione, fumo o alcol. Alcuni rimedi possono essere la ragione. Le questioni legate al movimento sono collegate. Se ti occupi dei tuoi problemi di movimento, hai piu possibilita di risolvere questo problema. Qui ci sono 5 consigli facili su come aumentare la circolazione: 1. Mangia i pasti giusti. Questo ti rendera il flusso sanguigno ovvio. Una grande parte di rimanere sani e anche mantenere il flusso sanguigno ovvio è legato al vostro piano di alimentazione quotidiana e quello che si mangia. Una buona cura per la disfunzione erettile è mangiare un piano a basso contenuto di grassi e grande alimentazione di fibre. Mangiare fibre tutti i giorni e questo viene scoperto in prodotti cerealicoli cereali integrali, frutta e verdura. Evitare il più possibile pasti pronti o pasti non sani. 2. Wonder herbal rimedi. Molti rimedi vegetali per ED eseguire bene come possono migliorare il movimento. Hanno molto meno reazioni avverse rispetto ai farmaci convenzionali e si svolgono in modo efficiente per migliorare hardons e la forza, troppo. Erbe naturali come Ginkgo Biloba sono utilizzati come una strategia per ED. Gli specialisti di erboristeria credono anche che le spezie o le erbe come noce moscata, portano al movimento intorno al corpo, tra cui il pene. 3. Vitamine naturali vitali. Gli scienziati sanitari hanno scoperto che una mancanza di supplemento è tipico tra gli uomini con ED in particolare vitamina A. Se si ha una mancanza del nutriente ossido di zinco, Questo è stato confermato per portare alla disfunzione erettile. Queste inadeguatezze derivano dal fatto che molti valori nutrizionali in quello che mangiamo piano non sono sufficienti. Aggiungere al vostro fabbisogno di nutrienti aumenterà la circolazione del sistema e migliorare questa condizione. Gli integratori alimentari sono completamente naturali, quindi non dovrete preoccuparvi dei rischi di reazioni avverse. Inoltre, queste vitamine naturali sono utili per il vostro benessere over-all. Oltre a questi vantaggi benessere, disfunzione erettile vitamine naturali e integratori costano molto meno di farmaci rimedi. 4. Esercitare. Fai una mossa e non un tablet vibrante. Camminare farà di più per migliorare e sostenere hardons di qualsiasi altra compressa chimica nel lungo periodo. Il fitness fisico manterrà bassi livelli di pressione e mantenere grandi stadi di movimento. Andando per un 20-30 minuti di movimento rapido ogni giorno, può affrontare questo problema e può sostenere la vostra libido senza l uso di qualsiasi farmaco. 5. Sottolineare. Questo è il peggior attaccante per problemi di erezione. Scopri diversi metodi per riposare. Alcuni metodi tipici per riposare includono la lettura di un libro, la meditazione, un bagno rilassante o allenamenti di respirazione. Sto solo imparando alcuni semplici allenamenti di respirazione che possono migliorare significativamente il movimento nel reparto pantaloni. Una naturale disfunzione erettile soluzioni di trattamento stanno diventando sempre più popolare con gli uomini. Questi rimedi a base di erbe sono preferiti perché non hanno reazioni avverse e sono confermati essere efficiente come il farmaco. La maggior parte degli uomini combattere parlano dei loro problemi, in particolare la disfunzione erettile come c è poca discussione sui problemi di erezione. La verita e che ED ha un impatto su piu di dieci milioni di uomini solo negli Stati Uniti. Non siete soli e l aiuto è disponibile.
Doi:10.1016/j.jen.2004.08.00
Section Editor: Gail Pisarcik Lenehan, RN, EdD, FAAN
I have been an emergency nurse for more than 20
years and have spent much time precepting newnurses. I have noticed that many novice nurses
Reprints not available from the author. J Emerg Nurs 2004;30:467-9.
make the same medication errors that I myself made when
Copyright n 2004 by the Emergency Nurses Association.
I clearly remember how ashamed and inadequate it
made me feel to make medication errors, and early inmy career, I became a big fan of nursing journals withmedication error sections where nurses could reportmedication errors anonymously. I always believed that ifsomeone else could make a mistake, then so could I. AsI frequently scanned medication error sections to jotdown errors that were pertinent to ED nursing, I beganto notice a pattern. Often the serious errors that had ahigh potential to harm patients involved the same drugs. A good example was Epi 1:1,000. For most allergic re-actions, this concentration should only be given subcuta-neously, but often it was mistakenly given by intravenouspush (IVP). This concentration given IVP can causesudden increases in blood pressure, tachycardia, ventric-ular fibrillation, shock, or cerebral hemorrhage. Anothererror that appeared repeatedly in the journals was thatlidocaine IVP was given to a patient in third-degree/complete heart block or a ventricular escape rhythm. Thiscan cause suppression of all ventricular activity resultingin cardiovascular collapse.
Every time I became aware of a warning about a
medicaton error, I would add it to a small handwrittenpocket guide that I was assembling for the new nurses Iwas orienting. In 1996, our emergency department’seducation committee decided to publish the guide, andit evolved into our current ED Orientation Survival
C L I N I C A L N O T E B O O K /A n o n y m o u s
Guide. The pocket-sized guide includes many high-risk
Recently, I had an experience that was a perfect
drugs such as insulin, heparin, labetalol, 1:1,000 Epi and
example of the benefits of a culture of sharing information
t-PA and what the common errors are. It is still very popular,
about medication errors. After returning to work following
even with many of our experienced nurses.
a lengthy absence, I discovered that the pharmacy could no
Several years later, our ED nurse representative to the
longer obtain Solu-Medrol. There was a note on our
hospital-wide committee that discusses medication errors
automated medication dispenser, Pyxis, to substitute
and how we can prevent them (our hospital is proactive
20 mg of Decadron for 125 mg of Solu-Medrol. Although
about errors in this and many other ways) left, and I
I should certainly have known better, I asked one of our
volunteered to take her place. I was introduced to the
nurses if it was okay to give it the same way—that is, IVP.
Institute for Safe Medicine Practice’s (ISMP) bnon-
She answered yes, so I proceeded to give the Decadron
punitive system-based approach to error reduction.Q They
IVP. My first patient had no problem. The second patient
advocate providing incentives for reporting errors without
I gave the drug to complained of severe burning in the
genital area. I immediately researched the drug and dis-covered the maximum amount of Decadron that can be
given IVP is 10 mg. Thankfully, my patient suffered no
permanent harm. Perhaps emboldened by the fact that Iwas on the Medication Error Quality Improvement
Committee, I told other nurses how badly I felt about
t-PA and what the common errors are.
the discomfort and worry that I caused my patient. Themore nurses I talked with, the more I realized that many of
This concept was totally new to me. A new medication
my colleagues were doing the same thing. Some of their
error reporting form was developed by our hospital that
patients had also complained of burning in the genital
did not require a signature so errors could be reported
area. I decided to post a flyer on the Pyxis to alert staff that
anonymously. In addition, at each monthly meeting, we
20 mg of Decadron should be diluted and given intra-
began reviewing the errors published in the ISMP’s
venous piggyback. After the flyer went up, I had several
Medication Safety Alert bulletin.* With each error, we
more nurses tell me that they had had the same thing
asked, bCould this error happen in our hospital?Q We
found that many of those tips were invaluable.
I began to encourage other ED nurses to take the
time to document medication errors. I put up flyers with
messages like, bThank you for taking the time to reportyour med errors. The safest hospitals are the ones with
the highest reporting rates.Q I must admit that at first the
f lyer got a few laughs, until I explained what it meant. It
took a while, but our nursing staff slowly became morecomfortable and less fearful about reporting mistakes. Our
reporting rates began to increase. Our nurse manager, unit
educator, and I began to meet to discuss and analyze errors
colleagues were doing the same thing.
to find contributing factors. We talked about what changeswe could make to prevent more errors.
Several months later, I was surprised when one of our
best and most experienced nurses said to me, bI havelearned something valuable from you. Now, when I make a
*The ISMP Medication Safety Alert bulletin can be obtained at
med error, I tell everyone.Q It was as though a light bulb
[email protected] or telephone 215-947-7797 for $140 per year(25 issues). It comes by E-mail and can be distributed within the hospital.
went off in my head!! We had used the same principal as
C L I N I C A L N O T E B O O K /A n o n y m o u s
ISMP, just on a smaller scale. This was real progress!!
also should leave the settings on the pump just as they
When I talked with my sister (also a registered nurse on the
were so that Bio-med could actually trace what had
night shift in our emergency department) about this
malfunctioned. Leaving the settings the same was new
concept, she said that whenever she hears anyone talking
information for every nurse in the meeting, and there were
about a medication error, she always perks up and listens.
many very experienced nurses there. So, once again, the
I now add errors that are reported in the ISMP to
All in all, the nurses at the meeting were very receptive
my Orientation Survival Guide on a regular basis. For
to the idea, and even a non-nursing staff member came up
example, the ISMP bulletin reported that after Lovenox is
to me after the meeting and said, bI really like your idea of
given subcutaneously, you need to wait 12 hours before
sharing errors.Q While I would like to think that nurses
starting heparin. In several other hospitals, neglecting to
have been doing this for years and I just have not noticed, I
do this had caused intracranial bleeds. I included the fact
do not think that is true. Often, it seems, the simplest
that you need to give the new rapid-acting insulins,
concepts may improve the care of patients the most.
Humalog and Novalog, right with the meal. For yearswe had given insulin 30 minutes prior to the meal, so thiswas a big change.
Send descriptions of procedures in emergency care and/or quick-
I do not believe the concept of sharing errors has to
reference charts suitable for placing in a reference file or notebook to:
be limited to medication errors. Our emergency depart-
ment recently purchased a new pediatric crash cart. I
c/o Managing Editor, 77 Rolling Ridge Rd, Amherst, MA 01002
was in triage one morning and a mother walked in
800 900-9659, ext 4044 . [email protected]
with a 2-week-old baby who was having difficultybreathing. After one look at the baby, I immediatelytook the mother and baby back to the main emergencydepartment. Although there had been an orientation tothe new cart in a Skill Update several months before, Icould not find the handle to the laryngoscope. It turnsout it was now in the bottom drawer, rather than the topdrawer, where it had always been. In the end, we justventilated the baby with the ambu bag a little longer andthe baby was fine. However, I made a point of tellingeveryone. I believed that if I could not find it, then othernurses might not be able to find it either.
At the last ED staff meeting, when I gave my monthly
report on medication errors, I decided to share this ideawith our nurses. The feedback was great. Another ex-perienced nurse began to share her own recent medicationerror. She had set the rate on the infusion pump at 20 mLper hour and went back in to discover the rate was 200 mLper hour. Being on the medication error committee, Imentioned that it was entirely possible she had set the ratecorrectly and the pump had malfunctioned. Our nursemanager advised us that if this occurred, besides taking thepump out of service, labeling it, and calling Bio-med, we
Evidence for Chlamydia pneumoniae infection in steroid-dependent asthma David L Hahn, MD*; Don Bukstein, MD*; Allan Luskin, MD*; and Howard Zeitz, MD† Background: Chlamydia pneumoniae is an obligate intracellular respiratory strong association of C. pneumoniae pathogen capable of persistent infection. Seroepidemiologic studies and the resultsof open-label antimicrobial treatment o