Team Faculty Of Nursing internship 💙

يلا بسم الله 🌚

دعواتكم ل إخواتنا بتوع اولي يشباب 🏌️💙 ربنا يوفقهم ويجبر بخاطرهم ف مبادئ بكره 💙.

ارضي وقول الحمدلله مهما ساءت الاحوال هيجي وقت وتتعدل ،انت في اختبارات وابتلاءات علشان تحمد ربنا في السراء والضراء متبقاش شخص جاحد بيحمد ربنا في الاوقات الكويسة بس ولما يوقع في مشكلة يجحد ارضي وكمل سعي لعل رضاك بكون سبب دخولك الجنة بلاش تقنت محدش هيخسر غيرك والله. ♥️

⭐ Perioperative 1⃣ Preoperative • the aim are find and correct factor and prevent expected complications ▪️evaluation ( history , examination , investigation, risk of anaesthesia ) ➡️ Chest X ray is not routine ➡️ ECG is not routine ecxept with major surgery and the elderly • ASA classification 1 ▶️ health pt 2 ▶️ Mild + no function limitations 3 ▶️ sever + definite function limitations 4 ▶️ sever + constant threat to life 5 ▶️ moribund • most serious surgery ▶️ cardiac, aortic operation Following by thoracic and abdominal operation • less serious skin and subcutaneous tissue • emergency dangerous than elective surgery ▪️ Optimization Fluid , electrolyte and nutritional deficiencies ▪️ Prophylactic anticoagulant Against thromboembolism and pulmonary edema • Indication Major surgery , obesity , DVT , PE راجل سمين هيعمل عملية خطيرة عنده جلطة Use LOW molecular weight heparin ( enoxaparin ) once daily and continue still ambulate for one week ▪️ prophylactic antibiotics • SSI ▶️ Cephalosporins ,Cephazolin Given one hour before surgery • bacteria endocarditis ▶️ Amoxicillin • gastro duodenal ulceration ▶️ PPI , H2 blocker

✔️ Hematoma ➡️ Collection blood clot ✔️Seroma ➡️ Fluid ✔️ Abscess ➡️ Pus ✔️ Pulmonary edema ➡️ Circulatory overload ✔️ Dehiscence ➡️ Disruption of facial layers, skin , Doesn't prolapse المحتوي سليم داخل الجسم ، بيكون تحت الجلد ✔️ Evisceration ➡️ Disruption of all abdominal wall , extrusion contient المحتوي بيخرج لبره

Burn ✔️ Skin ➡️ second largest organ in the body ✔️A burn is one of the most serious injuries ✔️Skin = Formation Of vitamin D ✔️ Most common cause of burn is Flame burn ignition cloths ✔️ Most dangerous is Electrical burn ✔️ Less dangerous is Radiation burn ✔️ Pathology of burn Extend and Depth ✔️ Extend Percent of burnt skin surface area Follow rule of nine ✔️ Depth ✔️ First degree epidermis = only , erythema, sunburn , Heal rapidly ✔️ Superficial partial thickness Heal with epithelization in 10 to 14 days ✔️ Deep partial thickness Slow Deal 25 to 35 days ✔️Third degree = Full thickness Complete destruction is epidermis and dermis . After separation of the eschar by patient should be prepared for skin grafting .the third week ✔️ Partial thickness = blister of erythema, painful, red , 3 week healing , moist ✔️ Full thickness is dark and white, lethargy, no blister, painless , dry , burn Slough , Granulation tissue, echer, after 3 weeks ✔️ immediate direct = cellular injury occurs first ✔️ delayed injury is inflicted as a result of progressive dermal ischemia. ✔️ temperatures greater than 45 °C. protein denaturation exceeds the capacity of cellular repair. 3 Zones 1. Central inner Zone = Zone of coagulation, visible burn Escher , Separate 3weeks ☞⁩ Granulation tissue = full thickness ☞⁩ Re epithelization ➡️ partial thickness 2.Intermittent= Zone of stasis , surrounding coagulation, viable tissue die over 48 hours 3.Outer = hyperaemia inflammatory mediators , edema, recover 7 to 10 , infections Complications ✔️ Systemic complications ‌╭⁠☞⁩Inhalation injury as asphyxia ‌╭⁠☞⁩Neurogenic, Hypovolemic ‌╭⁠☞⁩ Renal failure, Git ‌╭⁠☞⁩ Multiple organ failure ✔️ Local complications ✔️ Early local complications ☞⁩ Infections= sepsis = Primary cause of death , 4 to 7 days postburn ☞⁩ Deep circumferential burn = Chest, limbs = Escharotomy ☞⁩ Face , Neck = Tracheostomy ☞⁩ Compartment syndrome = increase pressure inside muscles , cause pain , restricted blood flow ✔️ Delay local complications Contracture, scar , malignant Management ☞⁩ Patient airway , analgesic ☞⁩ Saline, tape water 15 min ☞⁩ Ice cold is contraindicated ☞⁩ Minor burn is less than 15% adult , 10% children= dressing, chemotherapeutic, analgesic ☞⁩ Half the amount calculated is given over the first 8 hours and the other half over the next 16 hours. وبس كدا بالتوفيق إن شاء الله ‌◉⁠‿⁠◉⁩

🌟 If Drain is moved ➡️ First secured then Notify Team and Doctor 🌟 If drain is Removed or dislodged ➡️ First Sterile dressing then Notify Team and Doctor 🌟 If Drain Is receded in the patient ➡️ First Notify Team then imaging X ray

شباب الجروب بينزل عليه اسئله خشوا حلوها

✔️ Plasma Derivatives 1️⃣. Albumin عندنا منه نوعين واحد 5 %ودا اكتر شيوعا ، وواحد 20% وظيفته الحفاظ ع توازن الماء ف الجسم ف طبيعي نستخدمه ف حالتين الحروق ونقص ترويه الدم للانسجه burn , hypovolemic shock 2️⃣. Immunoglobulin : Concentrate IGg fraction of plasma الاجسام المناعيه بناخديها بطريقتين IM , IV IM ➡️ viral infections, hepatitis A and measles عن طريق العضل لما يكون ف عدوي فيروسيه ناخده عشان يحارب الفيروس IV ➡️ Antibody deficiency syndromes , recurrent infections, thrombocytopenia purpura نستخدمه ف حاله تكرار العدوي ، نقص ف حاجتين الصفائح ، نقص ف الاجسام المضاده 3️⃣. Coagulation factors ➡️ Factors IX , X , VII عوامل التجلط 7.9.10 ونستخدمها ف حاله Hemophilia A , B

✔️ Plasma Derivatives 1️⃣. Albumin عندنا منه نوعين واحد 5 %ودا اكتر شيوعا ، وواحد 20% وظيفته الحفاظ ع توازن الماء ف الجسم ف طبيعي نستخدمه ف حالتين الحروق ونقص ترويه الدم للانسجه burn , hypovolemic shock 2️⃣. Immunoglobulin : Concentrate IGg fraction of plasma الاجسام المناعيه بناخديها بطريقتين IM , IV IM ➡️ viral infections, hepatitis A and measles عن طريق العضل لما يكون ف عدوي فيروسيه ناخده عشان يحارب الفيروس IV ➡️ Antibody deficiency syndromes , recurrent infections, thrombocytopenia purpura نستخدمه ف حاله تكرار العدوي ، نقص ف حاجتين الصفائح ، نقص ف الاجسام المضاده 3️⃣. Coagulation factors ➡️ Factors IX , X , VII عوامل التجلط 7.9.10 ونستخدمها ف حاله Hemophilia A , B

هتكلم ع اول نوع بس 🏌️ 1. Hypovolemic ➡️ Deminished blood volume 🏌️ Causes Loss of : 1️⃣ Blood ⁦◉⁠‿⁠◉⁩ Most common cause is hemorrhage 2️⃣ Plasma ⁦◉⁠‿⁠◉⁩ burn 3️⃣ Fluid ⁦(⁦◉⁠‿⁠◉⁩ sever vomiting, diarrhea 🔷 Less critical tissue ➡️ skin , Git , kidney 🔷 More critical is ➡️ brain, heart ✔️ Local factors C ,C 🌚 ➡️ Immediate Vasoconstriction, Clot formation ✔️ General ف الشريان والوريد 🌚 ➡️ Constriction of vein , ➡️ Constriction arterioles , ➡️ Increased rate cardiac contraction ✔️ Endocrinal factors ➡️ Increase ADH , Aldosrerone, Renin 🔷 Symptom المريض تعبان سقعان عطشان وبيدوخ لما بيقف ، دي الاعراض اللي المريض بيشتكي منها Weak , cold , thrist 🔷 Signs علامات الدكتور ييلاحظها Pulse is rapid , weak . Hypotension, descrease temperature, tachypnea , pale , cold clammy skin , oliguria ✔️ Treatment ✔️ 1️⃣ Stop bleeding 2️⃣ Fluid resuscitation مهمه جداااااا من هنا لبكره 😂 🗨️Located ringer's solution ➡️Loss 15 to 30 of blood volume Class 2 hemorrhage 🗨️ Blood transfusions ➡️ loss > 30 of blood volume class 3, 4 hemorrhage 🗨️ Colloid solution ➡️ plasma , albumin 3️⃣ Pulmonary support ➡️ Face mask 4️⃣ Position ➡️ Elevating both Legs , supine position, Modified trendelenburg position 5️⃣ Patient monitoring ➡️ UOP .5 to 1 ml / kg / hour , CVP is 5 TO 10 6️⃣ Inotropic ➡️ Condition fails. وبس كدا بالتوفيق 🌚💙💙💙

✔️ Shock ➡️ State of hypo perfusion of tissue *5 Types of Shock* 1️⃣ Hypovolemic Shock ➡️ Deminished blood volume 2️⃣ Cardiogenic shock ➡️ Inadequate blood flow to vital organs , Inadequate cardiac output 3️⃣ Neurogenic shock ➡️ Paralysis of the vasomotor fibers , peripheral pooling of blood , Inadequate venous return 4️⃣ Anaphylactic shock ➡️ Follow administration of drugs or blood ( antibiotics as penicillin ) 5️⃣ Septic shock ➡️ Most lethal type of shock , one of the major killers in surgical practice

تجميع الاسئلة اللي زميلنا عملها 🏌️💙 • Perioperative • Postoperative • Surgical drain http://t.me/QuizBot?start=kaPddMQA • Surgical infection • Surgical nutrition • Wound healing • Fluid & electrolyte balance http://t.me/QuizBot?start=RMaWiFyQ •Hemorrhage •Blood transfusion •Shock •Burn http://t.me/QuizBot?start=U65qptqs

الاسئلة نزلت يشباب https://t.me/c/1834567642/25315

اجهزوا يا شباب باذن الله ع ميعادنا الساعه 5 كويز 35 سؤال ع ⤵️ •Hemorrhage •Blood transfusion •Shock •Burn ✨دعواتكم لزميلنا اللي بيتعب فيهم ربنا يجازيه كل خير يا رب💙.

هوِّنوا على نفسكُم يا ولاد هى عُمرها ما كانت بشطارتنا ولا تعبنا دايمًا بتمُرّ بكرم ربنا ورحمتُه و المرَّة دي كمان هتمُرّ بكرمُه ورحمتُه التوتُر والقلق ما لوش أي لازمة لسه معاكُم وقت ذاكروا واستودعوا اللي ذاكرتوه في ودائع الرحمن الذي لا تضيع عنده الودائع وبإذن الله هيراضيكُم في النتيجة. - من آمن بعوض الله أتاهُ 💛.

‏ما يضر أحدكم إذا جلس فارغاً ‏أن يقول للمَلَك: ‏اكتب يرحمك الله ‏ثم يُمليه : ‏سبحان الله، الحمد لله، الله أكبر ! ‏. ‏الحسن البصري

ملخص محاضرة Fluid 🏌️