basic nursing knowledge

*Types of insulin "five" types of Insulin are:* 1 Ultrashort-acting analogues 2 short-acting insulin 3intermediate-acting insulin 4 long-acting analogue insulin 5 mixed insulin. *1. Ultra short-acting analogue insulin Rapid onset–fast-acting insulin has a clear appearance.* ★ Its onset 5 to 10 minutes. ★Peak effect is 1 to 3 hours ★ duration is 5 hours. Pt must eat immediately after they inject. *◆NovoRapid (insulin aspart)* *◆Humalog (insulin lispro)* *◆Apidra (insulin glulisine).* *2. Short-acting insulin , look clear.* ★onset is 30 minutes. ★Peak effect is 2.5 to 5 hours ★duration is 8 hours. *◇Actrapid* (insulin neutral, regular) from Novo Nordisk *◇Humulin R* (insulin neutral, regular) from Eli Lilly. *3. Intermediate-acting insulin* appear cloudy. They have either protamine or zinc added to delay their action. These insulins need to be shaken before every use ♧ onset of work is 1.5 hours. ♧Peak action is 4 to 12 hours ♧ duration is 12 to 16 up to 24 hours. *◆Protaphane (isophane)* from Novo Nordisk *◆ Humulin NPH (isophane NPH)* from Eli Lilly. *4. Long-acting analogue insulin* have clear appearance They have no pronounced peak action, which means the insulin is released into the bloodstream at a relatively constant rate. One injection can last 24 hours. *★ Levemir* (insulin determir) from Novo Nosdisk *★ Lanctus* (insulin glargine) from Sanofi-Aventis. .... *5. Mixed insulin*, looks cloudy. It contains a pre-mixed combination of either a rapid onset–fast-acting or a short-acting insulin and intermediate-acting insulin. ■ If the insulin is ‘30/70’, then it contains 30% of quick-acting and 70% of intermediate-acting insulin *■‘50/50’* means 50% of each. Before injecting mixed or other cloudy insulin, the person must gently roll the vial or pen between the palms . *With ultra-short acting insulin:* *★ Humalog Mix 25* (25% insulin lispro, 75% lispro protamine suspension) *★ Humalog Mix 50* (50% insulin lispro, 50% lispro protamine suspension) *★ NovoMix 30* (30% insulin aspart 70% aspart protamine suspension) With rapid acting insulin *■ Humulin 30/70* (30% insulin neutral regular, 70% isophane) *Other mixed insulins* *♧ Mixtard 30/70* (30% insulin neutral regular, 70% isophane) *♧ Mixtard 50/50* (50% insulin neutral regular, 50% isophane)

A congenital diaphragmatic hernia (CDH) is a birth defect where there is an abnormal opening in the diaphragm, the muscle that separates the chest and abdominal cavities.. This opening allows abdominal organs, such as the stomach, intestines, and sometimes the liver, to move into the chest cavity, which can interfere with lung development and function.. Key Features: • Types of CDH: • *Bochdalek* hernia: The *most common* type, typically located on the *left* side, near the back of the diaphragm. • _Morgagni_ hernia: *Less* common, located *near the front of the* diaphragm. • Symptoms: • Respiratory distress shortly after birth, often due to underdeveloped lungs (pulmonary hypoplasia). • Cyanosis (bluish tint to the skin) due to low oxygen levels. • Abdominal distension. • Causes: The exact cause of CDH is *unknown* , but it can be associated with other birth defects, genetic syndromes, or environmental factors. • Diagnosis: *prenatal* *ultrasounds* • Post-birth, chest *X-rays or CT scans* can *confirm* the diagnosis. • Treatment: • Surgical repair is required to close the hole in the diaphragm and reposition the abdominal organs. • Treatment often involves addressing lung issues first, as the underdeveloped lungs (pulmonary hypoplasia) are the most serious complication. • Intensive care, including mechanical ventilation or *ECMO* (Extracorporeal Membrane Oxygenation), may be needed in severe cases

Notes on Neural Control and Coordination Parts of nervous system (1) Nervous system is divided into three parts: (i) Central nervous system (CNS): (a) In all the vertebrates including man, CNS is dorsal, hollow and non-ganglionated while in invertebrates when present, it is ventral, solid and ganglionated. (b) CNS is formed of two parts: Brain – Upper and broader part lying in the head; and Spinal cord – Lower, long and narrow part running from beginning of neck to trunk. (ii) Peripheral nervous system (PNS): (a) It is formed of long, thin, whitish threads called nerves which extend between CNS and body parts (muscles, glands and sense organs). (b) It controls the voluntary functions of the body. (c) It has cranial and spinal nerves. (iii) Autonomic nervous system (ANS): (a) It is formed of nerve fibres extending upto visceral organs and controls the involuntary functions of visceral organs of body like heart beat, peristalsis etc. (b) It is again formed of two systems: sympathetic and para-sympathetic nervous system which has opposing functions. Central nervous system: (1) Central nervous system is made up of brain and spinal cord. CNS is covered by 3 meninges and its wall has two type of matter. (2) Types of matter: CNS of vertebrates is formed of two types of matter – (a) Grey matter: It is formed of cell-bodies and non-medullated nerve fibres. (b) White matter: It is formed of only medullated nerve fibres which appear white due to presence of medullary sheath. Brain (Encephalon): It is soft, whitish, large sized and slightly flattened structure present inside cranial cavity of cranium of the skull. In man, it is about 1200-1400 gm in weight and has about 10,000 million neurons. Brain is made up of 3 parts (1) Fore brain (Prosencephalon) (i) Olfactory lobe – Rhinencephalon (ii) Cerebrum – Telencephalon (iii) Diencephalon – Diencephalon (2) Mid brain (Mesencephalon) (i) Optic lobes – Mesencephalon (3) Hind brain (Rhambencephalon) (i) Cerebellum – Metencephalon (ii) Medulla oblongata – Myelencephalon Reflex action (1) The reflex actions are involuntary actions because these are not under the conscious control of the brain. (2) The spinal cord and brain stem are responsible for most of the reflex movements. (3) A few examples of the reflex actions are withdrawal of hand or leg if pricked by a pin, secretion of saliva as soon as one thinks of delicious food or mere its sight causes salivation, if the body part is touched with acid or hot object it is automatically, without thinking and planning is withdrawn, cycling, motor driving etc. (4) Component of reflex action: The whole of the reflex are includes six parts – (a) Receptor organs: Receptors are windows of the body or guards of the body. These are situated on all, important organs, for example – eyes, nose, ear, tongue, integument etc. These perceive the stimuli from outside the body. (b) Sensory neurons: These are also termed afferent neurons. These carry the stimuli from receptors to spinal cord. These neurons are situated in the ganglion on the dorsal side of spinal cord. (c) Nerve centre: Spinal cord is termed as nerve centre. Synaptic connections are formed in it. (d) Association neurons: These are also called intermediate neurons or interstitial neurons. These are found in spinal cord. They transfer the impulses from sensory neurons to motor neurons. (e) Motor neurons: These are situated in the ventral horn of spinal cord. These carry the impulses to effector organs. (f) Effector organs: These are the organs, which react and behave in response to various stimuli, for example – muscles and glands. (5) Type of reflexes: The reflexes are of following types – (a) Monosynaptic reflex (b) Polysynaptic Spinal Reflex (c) Polysynaptic Spinal/Brain Reflexes (d) Unconditioned or Simple reflex (e) Conditioned or Acquired reflex

Here are some common diseases related to the digestive system: 1. Gastroesophageal Reflux Disease (GERD) 2. Inflammatory Bowel Disease (IBD) - Crohn's disease - Ulcerative colitis 3. Irritable Bowel Syndrome (IBS) 4. Peptic Ulcer Disease 5. Diverticulitis 6. Gastrointestinal Bleeding 7. Celiac Disease 8. Chronic Pancreatitis 9. Gallstones 10. Cholecystitis (inflammation of the gallbladder) 11. Hepatitis (liver inflammation) 12. Cirrhosis (liver scarring) 13. Liver Cancer 14. Gastrointestinal Stromal Tumors (GISTs) 15. Colon Cancer 16. Rectal Cancer 17. Anal Cancer 18. Dysphagia (swallowing difficulty) 19. Achalasia (esophageal motility disorder) 20. Scleroderma (systemic sclerosis) These diseases can be categorized into various groups, such as: - Inflammatory conditions (e.g., IBD, celiac disease) - Functional disorders (e.g., IBS, dyspepsia) - Structural disorders (e.g., peptic ulcer disease, diverticulitis) - Neoplastic disorders (e.g., colon cancer, GISTs) - Infections (e.g., hepatitis, gastroenteritis) - Motility disorders (e.g., achalasia, scleroderma) It's important to note that this is not an exhaustive list, and there are many other diseases and conditions that can affect the digestive system.

There are 4 types of genetic diseases 1⃣  Single Gene - Disorders caused by abnormality or mutation in the sequence of one gene. 2⃣  Multifactorial - Caused by a combination of environmental factors as well as mutations in multiple genes. 3⃣  Chromosomal - Abnormalities in chromosome structure such has missing or extra copies 4⃣  Mitochondrial - Caused by a mutation in non-chromosomal DNA of mitochondria

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Lymph nodes are an integral part of the immune system. They are more prominent in neck regions, groin, chin, behind ears and armpits however they are all over the body. They are more noticable  when they are enlarged or swollen. The Lymph becomes  swollen due to infections like bacteria, viruses and parasites. Some reasons the lymph becomes swollen; Infections in ear. Tooth infections. Suppressed immune system due to HIV paramyxovirus that cause measles. Tuberculosis. Cold or flu Tooth abscess Skin infections Syphilis sexually transmitted disease. Lupus ( body’s immune system start attacking body’s joints and blood cells.) Some medications Cancer And lots more. Various herbs can help to strength the immune system. With the help of proper eating habits and lymph massage therapy one can overcome  swollen lymph node conditions. Ashwagandha. This herbal remedy for the swollen lymph nodes is quite effective to strengthen  the lymphatic system, it is packed with rejuvenating properties. With antimicrobial and anti-inflammatory properties that can help to provide the relief in the cases of swollen lymph nodes. Lymph nodes are part of immune system and the following  herbs help to strength the immune system and are super  effective for the treatment of swollen lymph nodes. Lymphatic system formula This herbal combination is the mixture of various herbs like Emblica officinalis Terminalia chebula Terminalia bellerica Zingiber officinale Piper nigrum Piper longum Crataeva religiosa. Super effective in supporting the lymph and conditions  of swollen lymph nodes.

♨️ *DRUG OF CHOICE*✒️ *CARDIOVASCULAR SYSTEM* 🌊• Myocardial infarction pain - Morphine 🌊• Mild hypertension - diuretics 🌊• hypertensive crisis - nitroprusside 🌊• HTN with ischemic heart disease - Beta blockers 🌊• HTN with Diabetes mellitus - ACE inhibitors 🌊• HTN in younger patients - ACE inhibitors 🌊• HTN with diabetes nephropathy - ACE inhibitors 🌊• HTN with asthma - ACE inhibitors 🌊• Isolated systolic HTN - Calcium channel blockers 🌊Low renin HTN - Calcium channel blockers 🌊• HTN with bronchial asthma - Calcium channel blockers / ACE inhibitors 🌊• HTN with chronic kidney disease - ACE inhibitors 🌊• HTN in older patients - Thiazide 🌊• digoxin overdose - Digifab / Digibind 🌊• Endocarditis - Amoxiclav 🌊• Rapid fast diuresis - Loop diuretics 🌊• digoxin - Potassium

*Healthcare Vocabulary* 1. #Analgesic (Pain relief medicine) 2. #Antibiotic (Bacterial infection treatment) 3. #Antiseptic (Infection prevention) 4. #Cardiac (Heart-related) 5. #Diagnosis (Disease identification) 6. #Dosage (Medicine quantity) 7. #Epidemic (Widespread disease) 8. #Intravenous (IV, direct injection) 9. #Medication (Medicine) 10. #Pharmacy (Medicine store) 11. #Prescription (Doctor's order) 12. #Symptom (Disease sign) 13. #Therapy (Treatment) 14. #Trauma (Injury) 15. #Vaccination (Preventive medicine) *Medical Terms* 1. #Anaphylaxis (Severe allergic reaction) 2. #Bradycardia (Slow heartbeat) 3. #Hypertension (High blood pressure) 4. #Hypoglycemia (Low blood sugar) 5. #Myocardial (Heart-related) 6. #Neurology (Brain/Nerve study) 7. #Oncology (Cancer study) 8. #Pathology (Disease study) 9. #Radiology (X-ray/MRI study) 10. #Surgery (Operation) *Daily Vocabulary* 1. #Communication (Talking/Listening) 2. #Documentation (Record-ke

Urinary System Nephrology is the scientific study of kidney. Orology 1s the scientific study of male and female urinary system and male reproductive system. ne urinary system is one of the major excretory system of body consist ot following structures- o Two kidneys - Urine formation. O Two ureter- Convey urine from kidney to bladder o One bladder-Temporarily collect and store urine. o One urethra - Convey urine from bladder to exterior Other excretory system/organs are GIT (feces), lungs, skin and ihver (heavy nctls, uugS, lOXins etc., through ugh bile). Functions of urinary system or kidney Excretion of waste products Kidney excretes waste products like ammonia & urea (metabolism of protein) uric acid (metabolism of nucleie acid e.g. DNA & RNA), creatinine (metabolism of phosphocreatine of muscles fibers) & bilirubin (destruction of Hb). Production of hormones Hormones produced by kidney are erythropoietin (secreted by renal tubular cells), rennin (secreted by Juxtaglomerular cells into wall of afferent arteriole) & 1, 25 dihydroxy-cholecalciferol. Regulation of blood pH o Blood pH regulated by excretion of H into urine & retention or synthesis of HCO; from renal tubules. Regulation of clectrolyte and blood osmolarity O Kidaey maintains homeostasis of Na, K, CI, HPO4", Catt ete. O It also maintains constant blood osmolarity (total number of dissolved particles per liter of solution) close to 290 milliosmoles/liter Regulation of blood volume and BP O By conserving or elimination of water and sodium in the urine by secreting renin. Kidney Location lt situated on either side of vertebral column from Ti2 to Li. below the diaphragm, behind the peritoneum (so it called retroperitoneal organ) and between the level of 11" and 12" pair of ribs. Right kidney situated slightly lower than left kidney because liver situated into right side. Some grOss features of kidney are- Shape (bean shape), Measurement (12 x6x 3 cm), Weight (135-150gm) and Colour (redaisn) Gross Structure of Kidney Three area of tissue can be seened by naked eye in a longitudinal section of kidney, tiey au () Fibrous Capsule or Renal Capsule OA layer of connective & fatty tissue surrounding the kidney. O proteets the kidney from trauma, maintain shape and anchor from surrounding issuc