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频道帖子
| 2 | +8 Module 12-How to Facilitate Laboratory Skills PM.ppt | 832 |
| 3 | +9 Module 2-Microscopy Parts, care and handling.ppt | 823 |
| 4 | +9 Result Reporting Form Malaria.docx | 579 |
| 5 | Mosby’s Pocket Guide to Nursing Skills & Procedures.pdf | 706 |
| 6 |  没有文字... | 694 |
| 7 | cardiac nursing.pdf | 646 |
| 8 | 没有文字... | 642 |
| 9 | +2 没有文字... | 592 |
| 10 | ⭕️ENDOCRINE DISORDER⭕️
⭕️HYPOTHYROIDISM⭕️
⭕️DEFINITION:-
Subnormal secretion of thyroid hormone by thyroid gland is known as hypothyroidism
⭕️TYPES:-
●Primary: Insufficient amount of thyroid hormone secreted by thyroid gland.
●Secondary: It is due to pituatary gland failure (which causes Inadequate secretion of TSH)
●Tertiary: It is due to hypothalmus failure (Which causes Subnormal TRH secretion)
⭕️CAUSES:-
●Use of radioactive Iodine
●Over treated with antithyroid drugs
●Thyroidectomy
●Mal-development
●Malignancy of neck or forehead
●Pituatary Dysfunction
●Goitrogenic food e.g., cauliflower, turnip.
⭕️CLINICAL MANIFESTATION:-
■CVS:
●Hypotension
●Bradycardia
●↓es Heart Rate
●Hyperlipidemia
●Hypercholestrolemia
●Anaemia
Tendency to develop:
●CHF (Congestive Heart Failure)
●AP (Agina Pectoris)
●MI (Myocardial Infraction)
■Respiratory system:
●Dyspnoea
■G.I.T:
●Loss of Appetite
●Increase Weight
●Abdomianal distension
●Constipation
●Nausea and Vomiting
●Enlargement of tongue
■Skin:
●Dry skin, thick and elasticity increase.
●Brittle nails
●Dry hair
●Puffy face
●Excessive sweating
●Pallorness
●Cold Intolerance.
■Musculo-Skeletal:
●Fatigue
●Muscle weakness.
●Muscular Pain
●Slow movement.
■Reproductive:
●Decrease lipido
●Menstrual irregularities.
■Others
●Myxoedema (A dry firm waxy swelling of skin)
●Goitre
●Sleeplessness.
⭕️COMPLICATIONS:-
●Myxoedema
●Hypoventilation
●Convulsion
●Cerebral hypoxia.
⭕️DIAGNOSTIC EVALUATION:-
●Subnormal T3 and T4 level
●ECG
●Elevate serum cholestrol level.
⭕️MEDICAL MANAGEMENT:-
●Synthetic levothyroxine (levothyroid or synthroid) is preferred.
●Concentrated glucose may be given if hypoglycemia is evident.
●If myxedema coma is present, thyroid hormone is given IV until consciousness is restored.
⭕️DIETARY MANAGEMENT:-
●If patient having hypothyroidism due to iodine deficiency then provide high iodine diet.
●Avoid soyabean
●Avoid green leafy vegetables.
⭕️NURSING DIAGNOSIS:-
●Altered cardiac output related to elevated cholestrol and decreases metabolic rate.
●Activity intolerance due to decrease fatigue and lethargy. | 743 |
| 11 | ⭕️ Endocrine Disorders ⭕️
Soon...🔥🔥 | 631 |
| 12 | 没有文字... | 545 |
| 13 | 🦴MUSCLOSKELETAL DISORDER🦴
🦴AMPUTATION🦴
🦴DEFINITION:-
The removal of a limb, part of a limb, or any other portion of the body (such as breast or rectum) is called Amputation. It is a surgical reconstructive procedure.
🦴INDICATIONS:-
●Peripheral vascular disease in D.M.
●Severe trauma
●Congenital deformity
●Malignant tumour
●Osteomyelitis/infection
●To relieve symptoms, improve function and save or improve patients quality of life
🦴TYPES OF AMPUTATION:-
●Open (Guillotine)
Used with infection and for patients who are poor surgical risks.
Wounds heals by granulation over time or secondary closure 1 week later.
●Closed (Myoblastic or Flap)
Residual limb is covered by a flap of skin
Flap of skin is sutured posteriorly.
🦴TYPES OF DRESSING:-
●Soft Dressing: Secure with elastic bandage.
●Closed Rigid Plaster Dressing: Secure with plaster.
🦴PREOPERATIVE MANAGEMENT:-
●To relieve anxiety.
●To reduce pain.
●To increase mobility.
●To maintain good nutrition.
●Provide Preoperative teaching.
●To give general preoperative care.
●Evaluation of cardiovascular, respiratory, renal systems.
🦴POSTOPERATIVE MANAGEMENT:-
●Complications are monitored: haemorrhage, infections, non healing wound.
●Acceptance of body image change should be promoted.
●To monitor fluid balance.
●Maintaining adequate tissue perfusion.
●Give psychological support.
●To control pain.
●To promote physical activities.
●To give general post-operative care.
🦴LEVEL OF AMPUTATION:-
Amputation is performed at the most distal point that will heal successfully.
■ The site of amputation is determined by two factors:
●Circulation in the part.
●Functional usefulness, i.e., meet the requirement for the use of the prosthesis.
■There are two levels of Amputation:
●Level of amputation of upper extremity.
●Levels of amputation of lower extremity.
🦴COMPLICATIONS:-
●Haemorrhage.
●Infection.
●Skin breakdown.
●Phantom limb pain (a sensable pain in arm or leg).
●Joint contracture.
🦴NURSING DIAGNOSIS:-
■Acute pain related to Amputation
Nursing Intervention
●Provide opioid analgesics (morphine) to relieve pain.
●Change the patients position or placing a light sand bag on residual limb to counteract the muscle spasm may improve patient's level of comfort.
■Risk for Disturbed sensory perception (phantom limb pain) related to amputation
Nursing Intervention
●Early intensive rehabilitation and stump desensitisation with kneading massage brings relief.
●Transcutaneous electrical nerve stimulation and local anesthetics may provide relief to some patients.
●Beta-blockers may relieve dull, burning discomfort.
●Antiseizure medications control stabbing and cramping pain.
●Also antidepressants are used to improve mood and coping ability.
■Disturbedrbed Body Image related to Amputation
Nursing Intervention
●Nurse has to establish a trust relationship with the patient to communicate acceptance of patient who has experienced an amputation.
●The nurse encourages the patient to look at, feel, and then care for residual limb.
●Provide psychological support to patient.
■Ineffective coping related to failure to accept loss of body part
Nursing Intervention
●Nurse creates an accepting and support atmosphere in which the patient and family are encouraged to express and share their feelings and work through the grief process.
●Provide psychological support also.
■Self care deficit feeding, bathing, hygiene, dressing, grooming, or toileting related to loss of extremity
Nursing Intervention
●Patient is encouraged to be an active participant in self care.
●Nurse should do works with the physical therapist an occupational therapist to teach and supervise the patient in these self-care activities. | 662 |
| 14 | 没有文字... | 469 |
| 15 | 🦴MUSCLOSKELETAL DISORDER🦴
🦴BONE TUMOURS🦴
🦴DEFINITION:-
Formation of tumour inside the bone is known as bone tumour.
🦴TYPES:-
■It is of three types:
●Benign bone tumour, e.g., osteoma, chondroma.
●Malignant bone tumour, e.g., Multiple Myeloma, Osteosarcoma, Chondrosarcoma.
●Metastatic bone tumors: It is most frequently associated with cancers of the breast, the prostate and lungs
🦴SIGNS AND SYMPTOMS:-
●Pain at the tumour site is severe or persistent
●Swelling
●Immobility
●Anaemia
●Tenderness
●Inability to hold heavy objects and things.
●Pathogenic or spontaneous fractures etc.
🦴DIAGNOSTIC FINDING:-
●By X-ray
●Biopsy-Bone marrow aspiration
●FNAC (fine needle aspiration cytology)
🦴MEDICAL MANAGEMENT:-
●Chemotherapy
●Radiotherapy
🦴NURSING MANAGEMENT:-
●To relieve pain by administer analgesics.
●To prevent pathologic fractures by maintaining hazard free environment and to help in movement of patient.
●To reduce patients anxiety by providing psychological support and provide supportive environment.
●To promote self care activities.
●If surgery is done (amputation) then should give pre and post operative care. | 571 |
| 16 | +2 没有文字... | 455 |
| 17 | 🦴MUSCLOSKELETAL DISORDES🦴
🦴ARTHRITIS🦴
🦴DEFINITION:-
It is an inflammation of one or more joints.
🦴CAUSES:-
■Rheumatoid Arthritis
■Rheumatoid Spondiolytis
■Osteoarthritis
1. RHEUMATOID ARTHRITIS
🦴DEFINITION:-
Most severe form of inflammation of joints of fingers, wrists, feet, and ankles with later involvement of hips, knees, shoulders and neck. It is a disease of synovial lining of joints.
🦴CAUSES:-
●Unknown
🦴PREDISPOSING FACTORS:-
●Autoimmune disorder
●Infection
●Endocrine imbalance
●Metabolic disturbances
●Genetic
●Environmental
●DM, obesity, lack of exercise.
🦴PATHOPHYSIOLOGY:-
Immunologic processes
↓
Inflammation of synovium
↓
Antigens and Inflammatory reactions
↓
Destruction of articular cartilage
↓
Oedema, production of grannular tissue (Pannus)
↓
Granular tissue forms adhesions
↓
Decreased joint mobility
🦴SIGNS AND SYMPTOMS:-
●Fever
●Inability in weight bearing
●Swelling over the joints
●Deformity of joint
●joint stiffness in morning time
●Reduced ROM (Range of motion)
●Warmth feeling
●Joint pain
●Muscleache.
🦴DIAGNOSTIC FINDING:-
●MRI and bone scan
●X-ray shows deformed joints
●E.S.R increases
●Synovial fluid assessment it appears turbit yellow.
●W.B.C 2000-80000
●Low viscosity
●CBC (Complete blood count)
🦴MANAGEMENT:-
●To give NSAIDs (Non-steroids Anti-inflammatory drugs), e.g., Voveran-SR, Diclofenac sodium, Ibuprofen.
●Antirheumatic drugs, e.g.,
D-Penicillamine 250mg.
Chloroquine 100mg
Methotrexate (2.5 mg tab)
Sulfasalazine (500 mg tab)
●Heat apply for vasodilation
●Exercises and corticosteroid therapy.
⭕️⭕️⭕️⭕️⭕️⭕️⭕️⭕️
2. ANKYLOSIS SPONDIOLITIS
🦴DEFINITION:-
Rheumatoid spondiolysis is an inflammation of joint between the vertebrae and sacroiliac joints.
🦴CAUSES:-
●Ankylosis
🦴SIGN/SYMPTOMS:-
●Backache
●Inability in weight bearing
●Kyphosis: abnormal increase in curvature of thoracic vertebra stiffness of cervical region.
🦴MANAGEMENT:-
●To give NSAIDs (Non-steroids Anti-inflammatory drugs), e.g., Voveran-SR, Diclofenac sodium, Ibuprofen.
●Antirheumatic drugs, e.g.,
D-Penicillamine 250mg.
Chloroquine 100mg
Methotrexate (2.5 mg tab)
Sulfasalazine (500 mg tab)
●Heat apply for vasodilation
●Exercises and corticosteroid therapy.
⭕️⭕️⭕️⭕️⭕️⭕️⭕️⭕️
3. OSTEOARTHRITIS
🦴DEFINITION:-
It is a non-inflammatory disorders due to cartilages degeneration.
🦴RISK FACTORS:-
●Aging process
●Obesity
●Poor posture
●Excessive strain
●Strain of joint muscles.
🦴PREDISPOSING FACTORS:-
●Autoimmune disorder
●Infection
●Endocrine imbalance
●Metabolic disturbances
●Genetic
●Environmental
●DM, obesity, lack of exercise.
🦴PATHOPHYSIOLOGY:-
Due to degeneration of articular cartilages and calcification of ligaments
↓
Weight bearing joints become immobile
↓
Overgrowth of cartilage
↓
Joint immobility
↓
Pertonsilar abscess (Pus formation)
🦴SIGNS AND SYMPTOMS:-
●Swelling
●Joint pain
●Stiffness of joint
●Reduced range of motion
●Heberden's nodule (a bony thickening arising at the terminal joint of a figure)
●Pain increases during movement
🦴COMPLICATIONS:-
●Limited Mobility
●Neurologic deficits associated with spinal involvement.
🦴MANAGEMENT:-
●Management focuses on slowing and treating symptoms because there is no treatment available that stops the degenerative joint disease process.
🦴PREVENTION:-
●Weight reduction
●Prevention of injuries
●Perinatal screening for congenial hip disease.
🦴PHARMACOLOGICAL THERAPY:-
●Cox-2 enzyme blockers (NSAIDs), e.g., Nimuslide, Celecoxib.
●Corticosteroids therapy.
●Anti Rheumatoid drugs should not be given.
🦴SURGICAL MANAGEMENT:-
●Arthrotomy: Surgical opening of joint.
●Arthroplasty: Replacement, e.g.,
○Knee replacement
○Tendon replacement
○Complete hip replacement.
🦴NURSING MANAGEMENT
●To reduce pain related to local tissue trauma due to surgical incision trauma by administering narcotics analgesics.
●To promote physical mobility.
●To reduce risk of infection.
●To promotes self care activities.
●Provide psychological support to the patient.
●Provide proper nutrition to the patient. | 756 |
| 18 | +2 没有文字... | 400 |
| 19 | 🦴 MUSCLOSKELETAL DISORDER🦴
🦴CONTUSIONS /SPRAIN /STRAIN🦴
■CONTUSIONS:-
- A contusion is a soft tissue injury produced by blunt force, such as a blow, kick, or fall, causing small blood vessels to rupture and bleed into soft tissues (ecchymosis or bruising).
🦴CAUSES:-
●By falls
●Direct blows
●Crust injury
●Motor vehicle collisions
●Sport injuries.
🦴MANAGEMENT:-
P- Protection
R- Rest
I- Ice
C- Compression
E- Elevation.
■STRAIN:-
Injury to a muscle or tendon from overuse, overstretching, or excessive stress may cause strain.
🦴TYPES:-
●Acute:- Acute strains can result from a single injurious incident.
●Chronic:- Chronic strains result from repetitive injuries. Chronic strains can result from improper management of acute strains.
🦴DEGREES:-
■A first-degree strain is mild stretching of the muscle or tendon with no loss of range of motion (ROM).
Signs/symptoms:
●Gradual onset of ●palpation-induced tenderness
●Mild muscle spasm.
■A second-degree strain involves moderate stretching and/or partial tearing of the muscle or tendon.
Signs/symptoms:
●Acute pain during the precipitating event
●Tenderness at the site
●Edema
●Significant muscle spasm
●Ecchymosis.
■A third-degree strain is severe muscle or tendon stretching with rupturing and tearing of the involved tissue.
Signs/symptoms:
●Immediate pain described as tearing
Snapping, or burning,
●Edema
●Loss of function.
●Significant muscle spasm
●Bone injury
●Ecchymosis.
■Sprain:-
A sprain is an injury to the ligaments the tough bands of fibrous tissue that connect two bones together in your joints. It is caused by a twisting motion or hyperextension (forcible) of a joint.
■A first-degree/mild grade sprain results from tears in some fibers of the ligament and mild, localized hematoma formation.
Sign/Symptoms:-
●Mild pain
●Edema
●Local tenderness.
■A second-degree/moderate grade sprain involves partial tearing of the ligaments.
Sign/Symptoms:-
●Increased edema
●Tenderness
●Pain with motion
●Joint instability
●Partial loss of normal joint function.
■A third-degree/severe grade sprain occurs when a ligament is completely torn or ruptured. A third-degree sprain may also cause an avulsion of the bone.
Sign/Symptoms
●Severe pain
●Increased edema
●Abnormal joint motion.
🦴DIAGNOSTIC FINDING:-
●By X-ray
●Sign and Symptoms
🦴MEDICAL MANAGEMENT:-
●Apply ice while swelling is present.
●NSAIDs drug (Analgesics), e.g., Ibuprofen, Diclofenac sodium.
●Provide rest and comfort to patient.
●Elevation of extremity to reduce edema.
●Administer tetanus toxoid if skin integrity is broken.
●Do warmup and stretching to patient to reduce strain or sprain
🦴NURSING MANAGEMENT:-
●Apply cold compresses for the first several days (15-20 minutes at a time every few hours).
●Assess neurovascular status of contused extremity every 1 to 4 hours as patients condition indicates
●Instruct patient on use of pain medication as prescribed.
●Educate patient that rest is must for injured part.
●Teach the patient to avoid excessive exercise of injured part.
●Teach the patient to resume activities gradually. | 609 |
| 20 | 没有文字... | 347 |
