PLEASE POST YOUR COMMENT HERE FOR YOUR TPO'S AND EO'S, AS WELL AS YOUR WEEKLY LEARNING FEEDBACK DIARY IN A PARAGRAPH FORM, AND MAY POST YOUR REPORT SUMMARY. LET'S GO PAPERLESS!
HAVE A BEAUTIFUL DAY AHEAD TO ALL!
Subscribe to:
Post Comments (Atom)
ENRIQUEZ, JOSHUA RUTH I.
ReplyDeleteBSN IV-B
School Nursing
SEPTEMBER 14-16, 2009
8:00-4:00 PM
Vivian C. Laput, RN, MN
Terminal Performance Objective:
Application of kn0wledge skills, and attitude in pr0viding quality nursing care am0ng students, faculty and administrative pers0nnel in the sch0ol setting, utilizing b0th nursing and teaching pr0cess with emphasis on health pr0moti0n, maintenance and disease preventi0n.
Enabling Objectives:
At the end of 24 h0urs I will be able to:
1. Reinforce g0od interpers0nal relati0nship with the Clinical Instruct0r, co-student nurses, school clinic pers0nnel,faculty and administrative personnel and clients harmoniously.
2. Participate during pre and p0st c0nference actively.
3. Familiarize school clinic's set-up, policies and rules and regulati0ns thoroughly.
4. Participate in the school clinic activity actively.
5. Render initial care to clients during emergency cases immediately .
6. Utilize therapeutic c0mmunicati0n when dealing to the clients nicely.
7. Participate during discussions facilitated by the clinical Instructor attentively.
8. Carry out clinical instruct0r's order effectively.
9. Discuss assigned topics correctly and completely.
10. Evaluate perf0rmance objectively.
Plan of Activities
7:30-8:00= Assemble in the area
8:00-8:30= Checking of attendance and objectives.
8:30-9:00= Pre-c0nference
9:00-9:30= Snack time
9:30-12:00= School clinic's activity
12:00-1:00= Lunch time
1:00-3:00= Lecture Discussi0ns
3:00-3:30= Post c0nference
3:30-4:00= Dismissal...
JUNI, GRETCHIN A.
ReplyDeleteBSN IV-D
SCHOOL NURSING
SEPTEMBER 3-5/10-12, 2009
8:00-4:00 PM
Vivian C. Laput, RN, MN
1.Scabies, also known as the itch, is a contagious ectoparasite skin infection characterized by superficial burrows and intense pruritus (itching). It is caused by the mite Sarcoptes scabiei. The word scabies itself is derived from the Latin word for "scratch" (scabere). Other names for the condition include Mite, Itch Mite, Mange, Crusted Scabies, Norwegian Scabies, Sarcoptes scabiei, or The Seven-Year Itch.
ETIOLOGY/CAUSE
The causative factor is the itch mite, Sarcoptes scabiei. The female parasite is easily visible with a magnifying glass and measures 0.33 to 0.45 millimeters in length by .25 to .33 millimeters in height. She burrows beneath the epidermis to lay her eggs, and sets up an intense irritation. The male is smaller and resides on the surface.
PATHOPHYSIOLOGY
Both male and female parasites live upon the skin, but the female burrows into the superficial layer of the skin to deposit their eggs. The female itch mite penetrates the stratum corneum and burrows into the skin. Within several hours after skin penetration, the itch mite lays a large number of eggs and deposits fecal materials. The larvae mature in 10 days and move to the skin surface, where the females are impregnated; then the cycle repeats itself. Delayed hypersensitivity is thought to be a major factor. Transmission of scabies is by direct contact and to limited extent from soiled sheets and undergarments freshly contaminated by infected persons.
SYMPTOMS
1. Severe itch at incubation (immune reaction to feces)
2. Symptoms worse at night
SIGNS
1. Characteristics
1. Initial: Tiny erythematous Papules
2. Next: Vesicles or Pustules may form
3. Pathognomonic: Burrow (variably present but umcommon)
4. Secondary to scratching: Excoriations, crusts
5. Variants in immunocompromised patients
6. Hyperkeratotic crusted scabies
DIAGNOSIS
When a suspected burrow is found, diagnosis may be confirmed by microscopy of surface scrapings, which are placed on a slide in glycerol, mineral oil or immersion in oil and covered with a coverslip. Avoiding potassium hydroxide is necessary because it may dissolve fecal pellets. Positive diagnosis is made when the mite, ova, or fecal pellets are found.
NURSING MANAGEMENT
1. Isolate patient until treatment is completed to prevent contamination
2. Have fingernails cut short to prevent from excoriation of scratching
3. Instruct patient in meticulous hand washing
4. Advice patient that recurrence is common
5. Instruct patient and family in modes of infestation and transmission
6. Stress the importance of the correct use of treatment lotion to avoid neurotoxicity and undue irritation
TREATMENT
Kwell (lindane) (lotion)
Eurax (Crotamition) (lotion or cream)
Elimite (Permethrin 5%) (cream)
Rabies (from Latin: rabies, “madness, rage, fury.” Also known as “hydrophobia”) is a viral zoonotic neuroinvasive disease that causes acute encephalitis (inflammation of the brain) in mammals. It is most commonly caused by a bite from an infected animal, but occasionally by other forms of contact. If left untreated in humans it is almost invariably fatal. In some countries it is a significant killer of livestock.
ReplyDeleteETIOLOGIC AGENT:
Rhabdovirus
1. It is a bullet-shaped filterable virus with strong affinity to the CNS.
2. It is sensitive to sunlight, ultraviolet light, ether, formalin, mercury, and nitric acid. The organism is resistant to phenol, merthiolate, and common antibacterial agents.
PATHOGENESIS:
1. From the site of the bite, the organism proceeds to the CNS through the exoplasm of the peripheral nerves.
2. Experimental studies have shown that the virus stays for sometimes in the inoculation site, and the multiplication of the virus occurs in the myocytes.
3. It has been observe that the period between inoculation and nerve invasion is the only time when prophylactic vaccine is effective.
4. Once the virus infects the individual, the spread is both centripetal and centrifugal.
5. After infection of the CNS, the virus spreads though the peripheral nerves, to the salivary glands, and also to other organs such as the lungs, the adrenals, the kidneys, the bladder, and the testicles (priapism).
PATHOLOGY:
1. Rabies virus causes widespread changes throughout the CNS.
2. This consists of neural necrosis and mononuclear cellular infiltration specially in the thalamus, hypothalamus, pons, and medulla.
3. The cranial nerve nuclei are extensively damaged.
4. Neural changes are present in the spinal cord especially in the posterior horns.
5. Negri bodies are most abundant in the hypocampus, basal ganglia, pons, and medulla, and are found in the degenerating neurons of the salivary glands (pathologic sign for rabies).
CLINICAL MANIFESTATIONS:
1. Prodromal/Invasion phase
a. The phase is characterized by fever, anorexia, malaise, sore throat, copious salivation, lacrimation, perspiration, irritability, hyperexcitability, apprehensiveness, restlessness, sometimes drowsy, mental depression, melancholia, and marked insomia.
b. There is pain at the original site of the bite. Headache and nausea may be present.
c. The patient becomes sensitive to light, sound and temperature.
d. There are pain and aches in different parts of the body.
e. Anesthesia, numbness, tingling, burning, and cold sensation maybe felt along the peripheral nerves involved and the site of the bite.
f. Mild difficulty in swallowing.
2. Excitement or neurological phase
a. This phase is characterized by marked excitation, and apprehension. Terror may even occur.
b. There is delirium associated with nuchal rigidity, involuntary twitching or generalized convulsions.
c. The patient may exhibit maniacal behavior, eyes are fixed and glossy, and the skin is cold and clammy.
d. There is a severe and painful spasm of the muscles of the mouth, pharynx, and larynx, on attempt to swallow water or food or even at the mere sight of them.
e. There is aerophobia or intense fear or dislike of flying.
f. There is profuse drooling of saliva.
g. There is tonic or clonic contraction of the muscles.
h. Death may occur during the episode of spasm or from cardiac/respiratory failure.
i. If patient survives during this phase, patient deteriorates rapidly and enters to the terminal phase.
3. Terminal/paralytic phase
a. The patient becomes quiet and unconscious.
b. There is loss of bowel and urinary control.
c. Spasm ceases with progressive paralysis.
d. There is tachycardia, labored, or irregular respiration.
e. Death occurs due to respiratory paralysis, circulatory collapse, or heart failure.
DIAGNOSTIC PROCEDURES:
ReplyDelete1. Virus isolation from the patient’s saliva or throat.
2. Fluorescent rabies anti-body (FRA) provides the most definite diagnosis.
3. Presence of negri bodies in the dog’s brain.
MODALITIES OF TREATMENT:
1. Thoroughly wash the wounds from the bite and scratches of dog with soap and running water for at least three minutes.
2. Check the patient’s immunization status. Give tetanus toxoid if needed.
3. Give tetanus antiserum infiltrated around the wound-or given intramuscularly after a negative skin test.
4. Give anti-rabies vaccine, both passive and active, depending upon the site and extensiveness of the bite as well as the health condition of the biting animal.
NURSING MANAGEMENT:
1. Isolate the patient.
2. Give emotional and spiritual support.
3. Provide optimum comfort.
4. Darken the room and provide a quiet environment.
5. Patient should not be bathed and there should not be any running water in the room or within the hearing distance of the patient.
6. If IV fluid has to be given it should be wrapped and needle should be securely anchored in the vein to avoid dislodging in times of restlessness.
7. Concurrent and terminal disinfection should be carried out.
3. Cholera is an acute bacterial entric diseases of the GIT characterized by profuse diarrhea, vomiting, massive loss of fluid and electrolytes that could result to hypovolemic shock, acidosis and death. Sometimes known as Asiatic or epidemic cholera. Cholera was originally endemic to the Indian subcontinent, with the Ganges River likely serving as a contamination reservoir. The disease spread by trade routes (land and sea) to Russia, then to Western Europe, and from Europe to North America during the Irish immigration period. Cholera is now no longer considered a pressing health threat in Europe and North America due to filtering and chlorination of water supplies, but still heavily affects populations in developing countries.
ReplyDeleteETIOLOGIC AGENT:
Vibrio Cholerae/Vibrio coma
1. The organisms are slightly curved rods (coma shape), gram negative (-) and motile with a single polar flagellum.
2. The organisms survive well at ordinary temperature and can grow well in temperature ranging from 22-40 degrees centigrade.
3. They can survive well in ordinary temperature and can survive longer in refrigerated foods.
4. An enterotoxin, choleragen, is elaborated by the organism as they grow in the intestinal tract.
PATHOGENESIS AND PATHOLOGY:
1. Fluid loss is attributed to the enterotoxin elaborated by the organism as they lie in opposition with the lining cells of the intestines.
2. The toxin stimulates adenylate cyclase, which results in the conversion of the adenosine truphosphate (ATP) to cyclic adesine monophasphate (CAMP).
3. The mucosal cell is stimulated to increase secretion of chloride, associated with water and bicarbonate loss.
4. The toxin acts upon the intact epithelium on the vasculator of the bowel, thus, resulting in outpouring of intestinal fluids.
5. Fluid loss of 5 to 10 percent of the body weight resulting in dehydration and metabolic acidosis.
6. If treatment is delayed or inadequate, acute renal failure and hypokalemia become secondary problems.
CLINICAL MANIFESTATIONS:
ReplyDelete1. There is an acute, profuse, watery diarrhea with no tenesmus or intestinal cramping.
2. Initially, the stool is brown and contains fecal materials, but soon becomes pale gray, “rice-water” in appearance with an inoffensive, slightly fishy odor.
3. Vomiting often occurs after diarrhea has been established.
4. Diarrhea causes fluid loss amounting to 1 to 30 liters per day owing to subsequent dehydration and electrolyte loss.
5. Tissue turgur is poor and eyes are sunken into the orbit.
6. The skin is cold, the fingers and toes are wrinkled, assuming the characteristic “washer-moman’s hand”.
7. Radial pulse become imperceptible and the blood pressure unobtainable.
8. Cyanosis is present.
9. The voice becomes hoarse and then, is lost, so that the patient speaks in whisper (aphonia).
10. Breathing is rapid and deep.
11. Despite marked diminished peripheral circulation, consciousness is present.
12. Patients develops oliguria and may even develop anuria.
13. Temperature could be normal at the onset of the disease but becomes subnormal in later stage especially if the patient is in shock.
14. When the patient is in deep shock, the passage of diarrhea stops.
15. Death may occur as short as four hours after onset, but usually occurs on the first or second day if not properly treated.
DIAGNOSTIC EXAMS:
• Rectal Swab
• Darkfield or phase microcopy
• Stool Exam
MODALITIES OF TREATMENT:
Treatment of cholera consist in correcting the basic abnormalities without delay – restoring the circulating blood volume and blood electrolytes to normal levels.
1. Intravenous treatment is achieved by rapid intravenous infusion of alkaline saline solution containing sodium, potassium, chloride and bicarbonate ions in proportions comparable to that in water-stool.
2. Oral therapy rehydration can be completed by oral route (Oresol, Hydrites) unless contraindicated or, if the patient is not vomiting.
3. Maintenance of the volume of fluids and electrolytes to ensure rehydration. This is done by careful intake and output measurement.
4. Antibiotics
1. Tetracycline 500mg every 6 hours might be administered to adults, and 125 mg/kg body weight for children every 6 hours to 72 hours.
2. Furazolidone 100 mg for adults and 125mg/kg for children, might be given every 6 hours for 72 hours.
3. Chlorampenicol may also be given 500 mg for adults and 18 mg/kg for children every 6 hours for 72 hours.
4. Cotrimoxazole can also be administered 8mg/kg for 72 hours.
NURSING MANAGEMENT:
1. Medical septic protective care must be provided.
2. Enteric isolation must be observed.
3. Vital signs must be recorded accurately.
4. Intake and output must be be accurately measured.
5. A thorough and careful personal hygiene must be provided.
6. Excreta must be properly disposed of.
7. Concurrent disinfection must be applied.
8. Food must be properly prepared.
9. Environmental sanitation must be observed.
4. MALARIA is an acute and chronic parasitic disease transmitted by the bite of infected mosquitoes and it is confined mainly to tropical and subtropical areas. This disease causes more disability and heavier economic burden than any parasitic disease.
ReplyDeleteETIOLOGIC AGENT:
Protozoa of genus plasmodia
1. The disease is caused by four species of protozoa:
a. Plasmodium falciparum (malignant tertian)
b. Plasmodium vivax (Benign tertian)
c. Plasmodium malariae (Quartan)
d. Plasmodium ovale is the rare type of protozoan species.This is rarely seen in the Philippines.
2. The primary vector of malaria is the female Anopheles mosquito which has the following characteristics:
PATHOGENESIS:
1. The parasite enters the mosquito’s stomach through the infected human blood obtained by biting or during blood meal.
2. The parasite undergoes sexual conjugation.
3. After 10 to 14 days, a number of young parasites are released which work their way into the salivary gland of the mosquito.
4. The organisms are carried in the saliva into the victim when the mosquito bites again.
5. The female alone plays the role of a vector and definitive host in conveying the disease from man to man (sexual propagation).
6. In humans, the organisms invade the RBC where they grow and undergo sexual schizogony.
7. Erythrocytic merozoites are produced leading to the rupture of RBC upon the release of the tiny organisms.
8. Young merozoites invade a new batch of RBC, to start another schizonic cycle.
CLINICAL MANIFESTATIONS:
ReplyDelete1. Paroxysms with shaking chills
2. Rapidly rising fever with severe headache
3. Profuse sweating
4. Myalgia, with feeling of well-being in between
5. Splenomegally, hepatomegally
6. Orthostatic hypotension
7. Paroxysms may last for 12 hours, then, maybe repeated daily or after a day or two.
8. In children:
a. Fever maybe continuous
b. Convulsions and gastrointestinal symptoms are prominent
c. Splenomegally
9. In cerebral malaria
a. Changes in sensorium, severe headache, and vomiting
b. Jacksonian or grand mal seizure may occur
DIAGNOSTIC PROCEDURE:
1. Malarial smear – In this procedure, a film of blood is placed on a slide, stained, and examined microscopically.
2. Rapid diagnostic test (RDT) – This is a blood test for malaria that can be conducted outside the laboratory and in the field. It gives a result within 10 to 15 minutes. This is done to detect malarial parasite antigen in the blood.
NURSING MANAGEMENT:
1. The patient must be closely monitored.
a. Intake and output should be closely monitored to prevent pulmonary edema.
b. Daily monitoring of patient’s serum bilirubin, BUN creatinine, and parasitic count
2. If the patient exhibits respiratory and renal symptoms, determine the arterial blood gas and plasma electrolyte
3. During the febrile stage, tepid sponges, alcohol rubs, and ice cap on the head will help bring the temperature down.
4. Application of external heat and offering hot drinks during chilling stage is helpful.
5. Provide comfort and psychological support.
6. Encourage the patient to take plenty of fluids.
7. As the temperature falls and sweating begins, warm sponge bath maybe given.
8. The bed and clothing should be kept dry.
9. Watch for neurologic toxicity (from quinine infusion) like muscular twitching, delirium, confusion, convulsion, and coma.
10. Evaluate the degree of anemia.
11. Watch for any signs especially abnormal bleeding.
12. Consider severe malaria as medical emergency that requires close monitoring of vital signs.
TREATMENT AND MEDICATIONS:
Anti-Malarial Drugs
• Artemether-lumefantrine (Therapy only, commercial names Coartem and Riamet)
• Artesunate-amodiaquine (Therapy only)
• Artesunate-mefloquine (Therapy only)
• Artesunate-Sulfadoxine/pyrimethamine (Therapy only)
• Atovaquone-proguanil, trade name Malarone (Therapy and prophylaxis)
• Quinine (Therapy only)
• Chloroquine (Therapy and prophylaxis; usefulness now reduced due to resistance)
• Cotrifazid (Therapy and prophylaxis)
• Doxycycline (Therapy and prophylaxis)
• Mefloquine, trade name Lariam (Therapy and prophylaxis)
5. MEASLES An Acute highly communicable infection characterized by fever, rashes and symptoms referable to upper respiratory tract; the eruption is preceded by about 2 days or coryza, during which stage grayish pecks (Koplik spots) may be found on the inner surface of the cheeks. A morbilliform rash appears on the 3rd or 4th day affecting face, body and extremities ending in branny desquamation. Death is due to complication (e.g. secondary pneumonia, usually in children under 2 years old. Measles is severe among malnourished children with fatality of 95-100%.
ReplyDeleteETIOLOGIC AGENT: Filterable virus of Measles
PATHOPHYSIOLOGY
The measles virus initially infects the respiratory epithelium and is transmitted via respiratory droplets. It is highly transmissible with an infectivity rate of 76%, even greater than that of varicella. Prior to the measles vaccine, infection with the measles virus was simply considered a part of life. Instead of replicating in the respiratory epithelium, as was once thought, replication appears to occur in the regional lymph nodes. Replication in regional lymph nodes eventually leads to viremia. Infection of the endothelial cells ensues, causing an enanthem (Koplik spots). Epithelial cells are also infected, leading to the well-known cutaneous eruption of measles.
CLINICAL MANIFESTATIONS:
1. Pre-eruptive Stage
o patient is highly communicable
o fever
o catarrhal symptoms – start in the nasal cavities; then in the conjunctivae, oropharynx, progress to the bronchi resulting successively in rhinitis, conjunctivitis and then bronchitis.
o Respiratory symptoms – which appear first as a common cold, and sneezing nasal discharges, steadily progress into a distressing and annoying cough that persists up to convalescence.
o
2. Eruptive Stage/Stage of Skin Rashes
o exanthem sign – means eruption in the skin
Maculopapular Rashes – appears 2-7 days after onset
With high fever – increases steadily
Anorexia and irritability – are disturbing particularly at the height of the fever
Diarrhea, pruritis, lethargy and occipital lymphadenopathy
3. Stage of Convalescence
o Rashes – fade in the same manner as they appeared, from the face downwards, leaving a dirty brown pigmentation and finely granular which maybe noted for several days.
o Fever – gradually subsides as the eruptions disappear on the hands and feet
PUBLIC HEALTH NURSING RESPONSIBILITIES
1. Emphasize the need for immediate isolation when early catarrhal symptoms appear .
2. If immune serum of globulin is available (gamma Globulin), explain this to the family and refer to physician or clinic giving this service.
3. Observe closely the patient for complications during and after the acute stage.
4. Teach, demonstrate, guide and supervise adequate nursing care indicated.
5. Explain proceedings in proper disposal of nose and throat discharges.
6. Teach concurrent and terminal disinfection.
NURSING CARE
1. Protect eyes of patients from glare of strong light as they are apt to be inflamed.
2. Keep the patient in an adequately ventilated room but free from drafts and chilling to avoid complications of pneumonia.
3. Teach, guide and supervise correct technique of giving sponge bath for comfort of patient.
4. Check for corrections of medication and treatment prescribed by physician.
5 IMMUNOLOGIC DISORDERS
ReplyDeleteMultiple sclerosis
is an autoimmune disease that affects the brain and spinal cord (central nervous system).
Causes, incidence, and risk factors
Multiple sclerosis (MS) affects woman more than men. The disorder most commonly begins between ages 20 and 40, but can be seen at any age.
MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. When this nerve covering is damaged, nerve impulses are slowed down or stopped.
MS is a progressive disease, meaning the nerve damage (neurodegeneration) gets worse over time. How quickly MS gets worse varies from person to person.
The nerve damage is caused by inflammation. Inflammation occurs when the body's own immune cells attack the nervous system. Repeated episodes of inflammation can occur along any area of the brain and spinal cord.
Researchers are not sure what triggers the inflammation. The most common theories point to a virus or genetic defect, or a combination of both.
MS is more likely to occur in northern Europe, the northern United States, southern Australia, and New Zealand than in other areas. Geographic studies indicate there may be an environmental factor involved.
People with a family history of MS and those who live in a geographical area with a higher incidence rate for MS have a higher risk of the disease.
Symptoms
Symptoms vary, because the location and severity of each attack can be different. Episodes can last for days, weeks, or months. These episodes alternate with periods of reduced or no symptoms (remissions).
Fever, hot baths, sun exposure, and stress can trigger or worsen attacks.
It is common for the disease to return (relapse). However, the disease may continue to get worse without periods of remission.
Because nerves in any part of the brain or spinal cord may be damaged, patients with multiple sclerosis can have symptoms in many parts of the body.
Signs and symptoms
Muscle symptoms:
* Loss of balance
* Numbness or abnormal sensation in any area
* Pain because of muscle spasms
* Pain in the arms or legs
* Problems moving arms or legs
* Problems walking
* Problems with coordination and making small movements
* Slurred or difficult-to-understand speech
* Tremor in one or more arms or legs
* Uncontrollable spasm of muscle groups (muscle spasticity)
* Weakness in one or more arms or legs
Eye symptoms:
* Double vision
* Eye discomfort
* Uncontrollable rapid eye movements
* Vision loss (usually affects one eye at a time)
Other brain and nerve symptoms:
* Decreased attention span
* Decreased judgment
* Decreased memory
* Depression or feelings of sadness
* Dizziness and balance problems
* Facial pain
* Hearing loss
* Fatigue
Bowel and bladder symptoms:
* Constipation
* Difficulty beginning urinating
* Frequent need to urinate
* Stool leakage
* Strong urge to urinate
* Urine leakage (incontinence
Treatment
There is no known cure for multiple sclerosis at this time. However, there are therapies that may slow the disease. The goal of treatment is to control symptoms and help you maintain a normal quality of life.
Medications used to slow the progression of multiple sclerosis may include:
* Immune modulators to help control the immune system, including interferons (Avonex, Betaseron, or Rebif), monoclonal antibodies (Tysabri), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), methotrexate, azathioprine (Imuran), cyclophosphamide (Cytoxan), and natalizumab (Tysabri)
* Steroids may be used to decrease the severity of attacks
Medications to control symptoms may include:
* Medicines to reduce muscle spasms such as Lioresal (Baclofen), tizanidine (Zanaflex), or a benzodiazepine
* Cholinergic medications to reduce urinary problems
* Antidepressants for mood or behavior symptoms
* Amantadine for fatigue
MIGRAINE
ReplyDeleteA migraine is a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. In many people, a throbbing pain is felt only on one side of the head.
Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, usually vision disturbances, that serve as a warning sign that a bad headache is coming. Most people, however, do not have such warning signs.
Causes, incidence, and risk factors
A lot of people get migraines -- about 11 out of 100. The headaches tend to first appear between the ages of 10 and 46. Occasionally, migraines may occur later in life in a person with no history of such headaches. Migraines occur more often in women than men, and may run in families. Women may have fewer migraines when they are pregnant. Most women with such headaches have fewer attacks during the last two trimesters of pregnancy.
Symptoms
Vision disturbances, or aura, are considered a "warning sign" that a migraine is coming. The aura occurs in both eyes and may involve any of all of the following:
* A temporary blind spot
* Blurred vision
* Eye pain
* Seeing stars or zigzag lines
Other symptoms that may occur with the headache include:
* Chills
* Increased urination
* Fatigue
* Loss of appetite
* Nausea and vomiting
* Numbness, tingling, or weakness
* Problems concentrating, trouble finding words
* Sensitivity to light or sound
* Sweating
Treatment
There is no specific cure for migraine headaches. The goal is to prevent symptoms by avoiding or changing your triggers.
TO avoid attacks always anticipate:
* When your headaches occur
* How severe they are
* What you've eaten
* How much sleep you had
* Other symptoms
* Other possible factors (women should note where they are in their menstrual cycle)
* Drink water to avoid dehydration, especially if you have vomited
* Rest in a quiet, darkened room
* Place a cool cloth on your head
* Reduce the number of attacks
* Stop the migraine once early symptoms occur
* Treat the pain and other symptoms
REDUCING ATTACKS
If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. Such medicine needs to be taken every day in order to be effective. Such medications may include:
* Antidepressants such as amitriptyline
* Blood pressure medicines such as betablockers (propanolol) or calcium channel blockers (verapamil)
* Seizure medication such as valproic acid and topiramate
* Serotonin reuptake inhibitors (SSRIs) such as venlafaxine
* Learn to relax and reduce stress -- some patients have found that biofeedback and self-hypnosis helps reduce the number of migraine attacks
Parkinson's disease
ReplyDeleteis a disorder of the brain that leads to shaking (tremors) and difficulty with walking,
Causes, incidence, and risk factors
Parkinson's disease was first described in England in 1817 by Dr. James Parkinson. The disease most often develops after age 50. It is one of the most common nervous system disorders of the elderly. Sometimes Parkinson's disease occurs in younger adults, but is rarely seen in children. It affects both men and women.
In some cases, Parkinson's disease occurs in families. When a young person is affected, it is usually because of a form of the disease that runs in families.
The term "parkinsonism" refers to any condition that involves the types of movement changes seen in Parkinson's disease. Parkinsonism may be caused by other disorders (such as secondary parkinsonism) or certain medications.
Symptoms
The disorder may affect one or both sides of the body. How much function is lost can vary.
Symptoms may be mild at first. For instance, the patient may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging.
Symptoms include:
* Automatic movements (such as blinking) slow or stop
* Constipation
* Difficulty starting or continuing movement, such as starting to walk or getting out of a chair
* Drooling
* Impaired balance and walking
* Lack of expression in the face (mask-like appearance)
* Loss of small or fine hand movements (writing may become small and difficult to read, and eating becomes harder)
* Muscle aches and pains (myalgia)
* Problems with movement
* Rigid or stiff muscles (often beginning in the legs)
* Shaking, tremors
o Tremors usually occur in the limbs at rest, or when the arm or leg is held out
o Tremors go away during movement
o Over time, tremor can be seen in the head, lips, tongue, and feet
o May be worse when tired, excited, or stressed
o Finger-thumb rubbing (pill-rolling tremor) may be present
* Shuffling gait
* Slowed movements
* Slowed, quieter speech and monotone voice
Treatment
There is no known cure for Parkinson's disease. The goal of treatment is to control symptoms.
Medications control symptoms, mostly by increasing the levels of dopamine in the brain. As symptoms change, the following may need to be altered:
* Type of medication
* Dose
* Amount of time between doses
* How the medications are taken
Many medications can cause severe side effects, including hallucinations, nausea, vomiting, diarrhea, and delirium. Monitoring and follow-up by the health care provider is important.
Eventually, symptoms such as stooped posture, frozen movements, and speech difficulties may not respond very well to drug treatment.
Medications used to treat symptoms of Parkinson's disease are:
* Levodopa (L-dopa), Sinemet, levodopa and carbidopa (Atamet)
* Pramipexole (Mirapex), ropinirole (Requip), bromocriptine (Parlodel)
* Selegiline (Eldepryl, Deprenyl), rasagiline (Azilect)
* Amantadine or anticholinergic medications -- to reduce early or mild tremors
* Entacapone -- to prevent the breakdown of levodopa
Lifestyle changes that may be helpful for Parkinson's disease:
* Good general nutrition and health
* Exercising, but adjusting the activity level to meet changing energy levels
* Regular rest periods and avoiding stress
* Physical therapy, speech therapy, and occupational therapy
* Railings or banisters placed in commonly used areas of the house
* Special eating utensils
* Social workers or other counseling services to help you cope with the disorder and get assistance (such as Meals-on-Wheels)
Guillain-Barre syndrome
ReplyDeleteis a serious disorder that occurs when the body's defense (immune) system mistakenly attacks part of the nervous system. This leads to nerve inflammation that causes muscle weakness, which continues to get worse.
Alternative Names
Landry-Guillain-Barre syndrome; Acute idiopathic polyneuritis; Infectious polyneuritis; Acute inflammatory polyneuropathy
Causes, incidence, and risk factors
Guillain-Barre syndrome causes inflammation that damages parts of nerves. This nerve damage causes tingling, muscle weakness, and paralysis. The inflammation usually affects the nerve's covering (myelin sheath). Such damage is called demyelination. Demyelination slows nerve signaling. Damage to other parts of the nerve can cause the nerve to stop working.
Signs and symptoms
* Muscle weakness or loss of muscle function (paralysis)
o In mild cases, there may be no weakness or paralysis
o May begin in the arms and legs at the same time
o May get worse over 24 to 72 hours
o May occur in the nerves of the head only
o May start in the arms and move downward
o Weakness begins in the feet and legs and may move up to the arms and head
* Numbness, decreased sensation
* Sensation changes
* Tenderness or muscle pain (may be a cramp-like pain)
* Uncoordinated movement
Treatment
There is no cure for Guillain-Barre syndrome. However, many treatments are available to help reduce symptoms, treat complications, and speed up recovery.
When symptoms are severe, the patient will need to go to the hospital for breathing help, treatment, and physical therapy.
A method called plasmapheresis is used to clean a person's blood of proteins called antibodies. Blood is taken from the body, usually from the arm, pumped into a machine that removes the antibodies, then sent back into the body.
High-dose immunoglobulin therapy (IVIg) is another procedure used to reduce the severity and length of Guillain-Barre symptoms.
Meningitis
ReplyDeleteis swelling and irritation (inflammation) of the membranes covering the brain and spinal cord. This inflammation causes changes in the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord.
Causes, incidence, and risk factors
The most common causes of meningitis are viral infections that usually get better without treatment. However, bacterial meningitis infections are extremely serious, and may result in death or brain damage even if treated.
Meningitis is also caused by:
* Chemical irritation
* Drug allergies
* Fungi
* Tumors
Signs and Symptoms
* Fever and chills
* Mental status changes
* Nausea and vomiting
* Sensitivity to light (photophobia)
* Severe headache
* Stiff neck (meningismus)
Other symptoms that can occur with this disease:
* Agitation
* Bulging fontanelles
* Decreased consciousness
* Opisthotonos
* Poor feeding or irritability in children
* Rapid breathing
Signs and tests
* Blood culture
* Chest x-ray
* Head CT scan
* Gram-stain and culture of CSF (cerebral spinal fluid)
* Lumbar puncture ("spinal tap") with CSF glucose measurement and CSF cell count
Treatment
Doctors prescribe antibiotics for bacterial meningitis. The type will vary depending on the bacteria causing the infection. Antibiotics are not effective in viral meningitis.
Other medications and intravenous fluids will be used to treat symptoms such as brain swelling, shock, and seizures. Some people may need to stay in the hospital, depending on the severity of the illness and the treatment needed.
Expectations (prognosis)
Early diagnosis and treatment of bacterial meningitis is essential to prevent permanent neurological damage. Viral meningitis is usually not serious, and symptoms should disappear within 2 weeks with no lasting complications.
Complications
* Brain damage
* Hearing loss or deafness
* Hydrocephalus
* Loss of vision
Espinol, Lene Lim
ReplyDeleteIV- C
School Nursing
Sept. 14-16, 2009
7:00 am - 3:00 pm
Vivian C. Laput, R.N., M.N.
Terminal Performance Objective:
Application and acquisition of knowledge, skills, and attitude in providing quality nursing care among students, faculty and administrative personnel in the school setting utilizing both nursing and teaching process with emphasis of health promotion, maintenance, and disease prevention.
Enabling Objectives:
At the end of 24 hours duty, I shall be able to:
1. Reinforce good working relationship with the clinical instructor, co-student nurses and school personnel harmoniously.
2. Participate in the pre and post comferences actively.
3. Conducy Group discussion regarding the designated topics effectively.
4. Revise paper works after the clinical instructor checked it correctly.
5. Accept criticism coming from other people and view it constructively.
6. Discuss to the co-student nurses the assigned topic precisely.
7. Evaluate co student nurses understanding objectively.
8. Carry out clinical instructor's order effectively.
9. Document accomplished activity properly.
10. Evaluate performance objectively.
Plan of Activities
7:30-8:00---Call time
8:00-9:00--Checking of attendance and requirements.
9:00-10:00--Pre conference (giving of Instructions).
10:00-12:00--School Clinic Activities
12:00-12:30--Lunch Break
12:30-2:30--Lecture Discussion
2:30-3:00--Post conference (evaluation)
3:00-------Dismissal
COSAIN, NOOR SAMIRAH T.
ReplyDeleteBSN IV -B
SEPTEMBER 14-16, 2009
7:00AM-3:00PM
SCHOOL NURSING
VIVIAN C. LAPUT, R.N, M.N.
Terminal Performance objectives;
Application of knowledge, Skills and Attitude in providing quality nursing care among students,faculty and administrative personnel in the school setting utilizing both nursing and teaching process with emphasis of health promotion, maintenance and disease prevention.
Enabling Objectives:
1. Establish good interpersonal relationship to the clinical instructor and co-student nurses harmoniously.
2. Participate in the pre and post conferences, attentively.
3. Discuss my assigned report to the group , comprehensively.
4. Impart knowledge to my co-student nurses, correctly.
5. Performed task, properly.
6. Carry out clinical instructor's order, correctly.
7. Provide nursing care appropriately.
8. Acquire knowledge from this rotation comprehensively.
9. Verbalize feelings and learning in this rotation honestly.
10. Perform after care before leaving the area properly.
Plan of Activities
7:00-8:00 Arrival time to the designated area.
8:00-8:30 checking of attendance
8:30-9:00 Pre conferences
9:00-9:15 break
9:15-12:00 reporting and discussions
12:00-1:00 lunch break
1:00-2:30 continuity of duty
2:30-3:00 post conferences and dismissal
FAJARDO, JENNY ROSE G.
ReplyDeleteIV - D
School of Nursing
September 17-19,2009
7:00am - 3:00pm
Vivian C. Laput, R.N, M.N
Terminal Performance Objective
Application of knowledge skills, and attitude in providing quality nursing care among students, faculty and administrative personnel in the school setting, utilizing both nursing and teaching process with emphasis on health promotion, maintenance and disease prevention.
Enabling Objectives
At the end of 24 hours I will be able to:
1. Establish good working relationship with the clinical instructor, co-student nurses and school personnel harmoniously.
2. Participate in the pre-and-post conferences actively.
3. Familiarize the school clinic set-up, policies, rules and regulations thoroughly.
4. Participate in the school clinic activities actively.
5. Establish rapport with the students or staffs going to the clinic therapeutically.
6. Render initial nursing care with the clients during emergency cases immediately.
7. Participate in the group discussion actively.
8. Perform the given tasks actively.
9. Discuss the assigned topic in the group clearly.
10. Carry-out clinical instructor's order effectively.
11. Evaluate performance objectively.
PLAN OF ACTIVITIES
TIME ACTIVITY
7:30 - 8:00 Call time
8:00 - 9:00 Pre - conference
9:00 - 9:30 Checking of attendance, nursing kit and objectives
9:30 - 10:00 BREAK
10:00 -12:00 School clinic time
12:00 - 1:00 LUNCH
1:00 - 2:00 Group discussion
2:00 - 2:30 Post - conference
2:30 - 3:00 Dismissal
MEILEEN A. FRANCICO
ReplyDeleteIV - F
SCHOOL NURSING
SEP 17,18,19
7am - 3pm
VIVIAN C. LAPUT, RN, MN
TERMINAL PERFORMANCE OBJECTIVE:
Application of knowledge, skills and attitude in providing quality nursing care among students, faculty and administrative personnel in the school setting utilizing both nursing and teaching process with emphasis of health promotion, maintenance and disease prevention.
ENABLING OBJECTIVES:
At the end of 24 hours duty, i may be able to:
1.Establish good interpersonnal relationship with the CI, co-student nurses, clinic staff and client harmoniously.
2.Participate in the pre and post conferences actively.
3.Observe good attitude at all times keenly.
4.Assist in the school clinic actively.
5.Render initial nursing care by taking-up vital signs accurately.
6.Listen to the discussion attentively.
7.Accomplish given task completely.
8.Carry out CI's order correctly.
9.Research on the assigned topic carefully
10.Evaluate performance objectively.
PLAN OF ACTIVITIES
Time --------------- Activity --------------- Remarks
7:30-8:00 -------- Call time
8:00-8:30 ---- Pre-conference
8:30-9:00 ---- Checking of requirements
9:00-9:15 ------- Break time
9:15-12:00 ---- Assist in clinic
12:00-12:30 --- Lunch break
12:30-3:00 --- Lecture/Discussion
3:00-3:30 ---- Post-conference
3:30-4:00 ---- Dismissal period
DEMECILLO,KENNY L.
ReplyDeleteBSN IV-C
School Nursing
SEPTEMBER 21-23, 2009
8:00-4:00 PM
Vivian C. Laput, RN, MN
Terminal Performance Objective:
Application of kn0wledge skills, and attitude in pr0viding quality nursing care am0ng students, faculty and administrative pers0nnel in the sch0ol setting, utilizing b0th nursing and teaching pr0cess with emphasis on health pr0moti0n, maintenance and disease preventi0n.
Enabling Objectives:
At the end of 24 h0urs I will be able to:
1. Reinforce g0od interpers0nal relati0nship with the Clinical Instruct0r, co-student nurses, school clinic pers0nnel,faculty and administrative personnel and clients harmoniously.
2. Participate during pre and p0st c0nference actively.
3.Cooperate during group discussion attentively.
4.Deliver assigned topics to the group clearly.
5. Learn by heart all the topics that have been discussed by the group completely.
6. Answer all possible questions regarding the topics discussed comprehensively.
7. Utilize therapeutic c0mmunicati0n when dealing to the clients nicely
8. Carry out clinical instruct0r's order effectively.
9. Accompish all given tasks for the week completely.
10. Evaluate perf0rmance objectively.
Plan of Activities
7:30-8:00= Call time
8:00-8:30= pre conference (Checking of attendance )
8:30-9:00= break time
9:00-12:00=reporting/lecture discussion
12:00-1:00= Lunch time
1:00-3:00= Resume lecture Discussi0ns/reporting
3:00-3:30= Post c0nference
3:30-4:00= Dismissal...
LEUKEMIA
ReplyDeleteLeukemia is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation.
Classification
1. Acute leukemia
2. Chronic leukemia
major kinds
1. Acute lymphoblastic leukemia (ALL)
2. Chronic lymphocytic leukemia (CLL)
3. Acute myelogenous leukemia (AML)
4. Chronic myelogenous leukemia (CML)
Pathophysiology
>>Leukemia is malignant neoplasms of the cells derived from either the myeloid or lymphoid line of the hematopoietic stem cells in the bone marrow. Proliferating abnormal and immature cells (blast) spill out into the blood and infiltrate the spleen, lymph nodes, and other tissue. Acute leukemias are characterized by rapid progression of symptoms. High numbers of circulating blast weaken blood vessel walls, with high risk for rupture and bleeding, including intracranial hemorrhage.
Although the cause of leukemias is unknown, predisposing factors include genetic susceptibility, exposure to ionizing radiation or certain chemicals and toxins, some genetic disorder (Down syndromes, Fanconi’s anemia), and human T-cell leukemia-lymphoma virus. Complications include infection, leukostasis leading to hemorrhage, renal failure, tumor lysis syndrome, and disseminating intravascular coagulation.
Here are some general leukemia symptoms:
>Anemia
>Recurrent Infections
>Bone and Joint Pain
>Abdominal Distress
>Swollen Lymph Nodes
>Difficulty Breathing or Dyspnea
Diagnostic Test done:
Blood tests
Cultures
Bone Marrow Biopsy
Spinal Tap
Bone Scan, Gallium Scan, MIBG
Computerized Tomography (CT) Scan
Magnetic Resonance Imaging
Echocardiogram
Ultrasound
Treatment
Chemotherapy
Radiation Therapy
Bone Marrow Transplant
Biological Therapy
DESDIMONA Y. JAWALI
BSN IV-F
1041700
ENRIQUEZ, JOSHUA RUTH I.
ReplyDeleteBSN IV-B
School Nursing
SEPTEMBER 22, 2009
8:00-4:00 PM
Vivian C. Laput, RN, MN
Terminal Performance Objective:
Application of kn0wledge skills, and attitude in pr0viding quality nursing care am0ng students, faculty and administrative pers0nnel in the sch0ol setting, utilizing b0th nursing and teaching pr0cess with emphasis on health pr0moti0n, maintenance and disease preventi0n.
Enabling Objectives:
At the end of 8 h0urs duty,I will be able to:
1. Reinforce g0od interpers0nal relati0nship with the Clinical Instruct0r, co-student nurses, school clinic pers0nnel,faculty and administrative personnel and clients harmoniously.
2. Participate in the school clinic activity actively.
3. Render initial care to clients during emergency cases immediately .
4. Utilize therapeutic c0mmunicati0n when dealing to the clients nicely.
5. Discussed case study about Depression and Schizophrenia to co-student nurses and clinical Instructor thoroughly.
6. Take and answer shifting exam correctly.
17. Evaluate perf0rmance objectively.
Plan of Activities
7:30-8:00= Assemble in the area
8:00-8:30= Checking of attendance and objectives.
8:30-12:00=Report
12:00-1:00= Lunch time
1:00-3:00= Shifting exam
3:00-3:30= Signing of clearance
3:30-4:00= Dismissal...
Depression is a serious medical illness that involves the brain. It's more than just a feeling of being "down in the dumps" or "blue" for a few days
ReplyDeleteDepression is an overwhelming disorder. The clinical symptoms and course of depressive phenomena is complex, dynamic biophyscosocial process involving lifespan and cultural aspects. Unless appropriate treated. Depression persist over time, having a significant negative effect on life and increasing the risk for suicide
Mood disorders are associated with high levels of impairment in occupation, social and physical functioning and cause as much disability and distress to patients as chronic medical disorders.
The primary alteration is in mood, rather than in thought or perception.
Depressive disorder is one of the categories of mood disorders. Major depressive disorders last at least 2 weeks
Four of the following symptoms are present:
Changes in appetite or weight
Sleep or psychomotor activity
Decreased energy
Feelings of worthlessness or guilt
Difficulty thinking
Concentrating or making decisions or recurrent thoughts of death or suicidal ideation plans or attempts.
These symptoms must be present everyday for 2wks and result in significant distress or impairsocial, occupational, or other important areas of functioning.
DEPRESSIVE DISORDER
• seasonal depression
• Postpartum or maternity blues
• Postpartum depression
• Children and adolescence Depressive disorder
• Elderly people depressive disorder
Etiology
Genetics,neurobiologic hypotheses,neuroendocrine and psycho immunology
Psychological theories
Psychodynamic factors, developmental factors, behavioral factors, cognitive factors, family factors and social factors.
Risk factors
• Proir episode of depression
• Family history of depressive disordrr
• Lack of social support
• Lack of coping capabilities
• Presence of life and environmental stressor
• Current substance use and /or abuse
• Medical comorbidity
TREATMENT
Psychopharmacology
Cyclic anti depressant
MAOI’S
SSRI’S
Atypical antidepressant
Psychotherapy
Electroconvulsive therapy
Interpersonal therapy
Behavior therapy
Cognitive therapy
Nursing diagnoses
• Risk for suicide
• Anxiety
• Ineffective Coping
• Hopelessness
• Disturbed sleep pattern
Nursing interventions
• Encourage the client to verbalize and describe emotions
• Begin therapeutic relationship by spending non demanding time with the client
• Provide for safety of the client and others
• Institute suicide precautions if indicated
• Establish adequate nutrition and hydration
• Promote sleep and rest
Schizophrenia is thought of as syndrome or disease process with many different varieties and symptoms
ReplyDeleteSchizophrenia causes distorted and bizarre thought, perceptions, emotions, movements and behavior.
Schizophrenia usually diagnosed in late adolescence or earl adulthood. the peak incidence of onset is 15-25 years of age for men and 25-35 years of age for women
The symptoms of schizophrenia are divided into two major categories the positive or hard symptoms\sign and the negative or soft symptoms\sign
Positive symptoms
• delusion
• hallucination
• grossly disorganized thinking
• speech
• behavior
negative symptoms
• flat affect
• lack of volition
• social withdrawal or discomfort
Types of schizophrenia acc.to DSM-IV
• schizophrenia, paranoid type
• schizophrenia, disorganized type
• schizophrenia catatonic type
• schizophrenia undifferentiated type
• schizophrenia residual type
ETIOLOGY
Nuerologic\neurochemical causes, dysfunctional parenting or family dynamics
Biologic theories
Genetic anatomic, neurochemical factors, immunologic factors
Treatment
Psychopharmacology
Conventional antipsychotics (thorazinel, haloperidol)
Atypical antipsychotic (clozapine)
Psychosocial treatment
Individual and group therapy
Family education and therapy
Nursing diagnoses
Risk for other directed violence
Risk for suicide
Disturbed thought processes
Disturbed personal identity
Nursing interventions
Promoting safety of client and others and right to privacy and dignity
Establishing therapeutic relationship by establishing trust
Establish and maintain reality for the client
Help present and maintain reality by frequent contact and communication with client
Do not judgmental or belittle or joke about the clients beliefs
REWRITE:
ReplyDeleteSHEENA A. GADOR
BSN IV-D
SCHOOL OF NURSING
7:00-3:00 P.M.
SEPTEMBER 17,18-19,2009
VIVIAN C. LAPUT, R.N.,M.N.
TERMINAL PERFORMANCE OBJECTIVE:
APPLICATION OF SKILLS, KNOWLEDGE, ATTITUDE IN PROVIDING QUALITY NURSING CARE AMONG STUDENTS, FACULTY AND ADMINISTRATIVE PERSONNEL IN THE SCHOOL SETTING UTILIZING BOTH NURSING AND TEACHING PROCESS WITH EMPHASIS ON HEALTH PROMOTION, MAINTENANCE AND DISEASE PREVENTION.
ENABLING OBJECTIVES:
At the end of 24 hours RLE duty, I shall be able to:
1. Establish good interpersonal relationship with my clinical instructor, co-student nurses, school clinic personnel and clients enthusiastically.
2. Participate in the pre and post conferences actively.
3. Illustrate the school clinic set-up, rules and regulations appropriately.
4. Participate in the school clinic activity actively.
5. Observe the client needs and problems properly.
6. Conduct therapeutic communication when dealing with clients appropriately.
7. Participate in the class discussion attentively.
8. Listen to the clinical instructors teaching or instructions properly.
9. Perform all assigned task for the week attentively.
10. Evaluate nursing care rendered this week attentively.
PLAN OF ACTIVITIES
6:30-7:00= REPORTING FOR DUTY
7:00-8:00= CHECK ATTENDANCE
8:00-9:00= PRE CONFERENCES
9:00-9:30= B R E A K
9:30-12:00= SCHOOL CLINIC ACTIVITY
12:00-1:00 = L U N C H
1:00-2:30=DISCUSSION
2:30-3:00= POST CONFERENCE
3:00======D I S M I S S A L
SHEENA A. GADOR
ReplyDeleteBSN IV-D
SCHOOL OF NURSING
7:00-3:00 P.M.
SEPTEMBER 24,25-26,2009
VIVIAN C. LAPUT, R.N.,M.N.
TERMINAL PERFORMANCE OBJECTIVE:
APPLICATION OF SKILLS, KNOWLEDGE, ATTITUDE IN PROVIDING QUALITY NURSING CARE AMONG STUDENTS, FACULTY AND ADMINISTRATIVE PERSONNEL IN THE SCHOOL SETTING UTILIZING BOTH NURSING AND TEACHING PROCESS WITH EMPHASIS ON HEALTH PROMOTION, MAINTENANCE AND DISEASE PREVENTION.
ENABLING OBJECTIVES:
At the end of 24 hours RLE duty, I shall be able to:
1. Maintain good interpersonal relationship with my clinical instructor, co-student nurses, school clinic personnel and clients enthusiastically.
2. Participate in the pre and post conferences actively.
3. Participate in the school clinic activity actively.
4. Observe the client needs and problems properly.
5. Conduct therapeutic communication when dealing with clients appropriately.
6. Obtain and Record clients Vital Signs correctly.
7.Conduct Case Presentation on Immunologic diseases properly.
8. Participate in the class discussions attentively.
9. Listen to the clinical instructors teaching or instructions properly.
10. Perform all assigned task for the week attentively.
11. Evaluate nursing care rendered this week attentively
PLAN OF ACTIVITIES
6:30-7:00= REPORTING FOR DUTY
7:00-8:00= CHECK ATTENDANCE
8:00-9:00= PRE CONFERENCES
9:00-9:30= B R E A K
9:30-12:00= SCHOOL CLINIC ACTIVITY & CASE PRESENTATIONS
12:00-1:00 = L U N C H
1:00-2:30=DISCUSSION
2:30-3:00= POST CONFERENCE
3:00======D I S M I S S A L
Name: Noel A. Gajelloma
ReplyDeleteYear & Sec.: BSN 4-D
Area of exposure: School Nursing (Universidad de Zamboanga)
Date of Exposure: September 24, 2009
Time: 7:00 am – 3:00 pm
Clinical Instructor: Vivian C. Laput, RN, MN
TERMINAL PERFORMANCE OBJECTIVE
Application of skills, knowledge and attitude in the care of an individual, family and community focusing on the basic concepts and principles of medical nursing through the utilization of the family nursing process with emphasis on health promotion, maintenance and disease prevention.
ENABLING OBJECTIVES:
At the end of 24 hours duty, I will be able to:
1. Maintain rapport with the clinical instructor, health center personnel, and co-student nurses nicely.
2. Re-familiarize the physical set-up of the School
3. Re-establish good interpersonal relationship with the clients effectively
4. Maintain the cleanliness of the room
5. Record and assess clients vital signs
6. Provide any needed nursing care to clients.
7. Discuss the assigned topic correctly.
8. Maintain the client’s confidentiality at all time when performing nursing care.
9. Assess the client’s condition thoroughly.
10. Participate in the scheduled activity of the clinical instructor
11. Participate in the case presentation of the group
12. Participate in the pre and post conferences actively.
13. Evaluate performance objectively.
PLAN OF ACTIVITIES
6:30 – 7:00 Arrival Time
7:00 – 8:00 Checking of attendance, nsg. Kits, uniform and submission of the requirements & Pre – conference
8:00 – 10:00 Participate in the scheduled activity
10:00 – 10:15 Break
10:15 – 12:00 Discussion
12:00 – 1:00 Lunch Break
1:00 – 2:00 Discussion
2:30 – 3:00 Post conference
3:00 Dismissal
MEILEEN A. FRANCISCO
ReplyDeleteIV - F
SCHOOL NURSING
SEP 24,25,26
7am - 3pm
VIVIAN C. LAPUT, RN, MN
TERMINAL PERFORMANCE OBJECTIVE:
Application of knowledge, skills and attitude in providing quality nursing care among students, faculty and administrative personnel in the school setting utilizing both nursing and teaching process with emphasis of health promotion, maintenance and disease prevention.
ENABLING OBJECTIVES:
At the end of 24 hours duty, i may be able to:
1.Re-enhance good interpersonnal relationship with the CI, co-student nurses, clinic staff and client harmoniously.
2.Participate in the pre and post conferences actively.
3.Observe good attitude at all times keenly.
4.Assist in the school clinic actively.
5.Render initial nursing care by taking-up vital signs accurately during clinic hours.
6.Listen to the discussion attentively.
7.Accomplish given task completely.
8.Carry out CI's order correctly.
9.Research on the assigned topic carefully.
10.Deliver given report approppriately.
11.Evaluate performance objectively.
PLAN OF ACTIVITIES
Time --------------- Activity --------------- Remarks
7:30-8:00 -------- Call time
8:00-8:30 ---- Pre-conference
8:30-9:00 ---- Checking of requirements
9:00-9:15 ------- Break time
9:15-12:00 ---- Assist in clinic
12:00-12:30 --- Lunch break
12:30-3:00 --- Lecture/Discussion
3:00-3:30 ---- Post-conference
3:30 - 4:00 ---- dismissal
hello mam gud evening.
ReplyDeleteGastric Cancer
ReplyDeleteMalignant tumor of the stomach
Pathophysiology and Etiology
1. risk factors include:
a. chronic atrophic gastritis with
intestinal metaplasia.
b. pernicious anemia or having had gastric resections (more than 15 yrs.)
c. Adenomatous polyps.
2. Related factors:
a. More common in men and blacks
b. Incidence increases with age
Clinical manifestation
1. progressive loss of appetite
2. Noticeable change in, or appearance of GI symptoms- gastric fullnest
3. Blood in the stools
4. Vomiting
5. weight loss, loss of strenght, anemia, metastasis (usually to liver), hemorrhage, obstruction
6. Abdominal or epigastric mass.
Diagnostic Evaluation
1. History
2. Upper GI radiography and endoscopy
3. Imaging, such as bone or liver scan
Management
surgery
chemotherapy
Nursing Assessment
Assess for anorexia, weight loss, GI symptoms
Evaluate for pain, location
Check stool for blood occult
Monitor CBC to assessfor anemia
Nursing Intervention
promoting comfort and wound healing
preventing shock and other complication
attaining adeguate nutritional status
Breast Cancer
ReplyDeleteis the most common invasive cancer in women
Pathophysiology and Etiology
1. most breast cancer begins in the lining of the milk ducts, sometimes in the lobule.Eventually it will grows through the wall of the duct and into the fatty tissue.
2. Family history accounts for approximately 7% of all breast cancers.
Risk factor
Major- sex, increased age,, prior of breast or ovarian cancer, and family history.
Clinical manifestation
1.firm lump or thickening of breast, usually painless.
2.nipple discharge
3.breast asymmetry
4.nipple retraction or scaliness
Diagnostic Evaluation
1.Mammography
2.Biopsy or aspiration
3.laboratory test to detect metastasis
Management
surgery
radiation theraphy
chemotheraphy
endocrine theraphy
adrenalectomy
Nursing Assessment
1. assess general health status and underlying chronic illness that may have impact on patients response to treatment.
2. Identify what the patient and family need to know regarding breast cancer and its treatment, and it take to measures to decrese their impact.
3. Determine level of anxiety, fears and concerns.
4. Identify coping ability and availability of support systems.
Nursing Intervention
reducing anxiety
providing information about treatment
strengthening coping.
Multiple Myeloma
ReplyDeleteis a malignant disorder of plasma cells
Pathophysiology and Etiology
1. Etiology unknown; genetic and environmental factors such as chronic exposure to low levels of ionizing radiation, may play a part.
2. Characterized by proliferation of neoplastic plasma cells derived from one B lymphocyte (clone) and producing a homogenous immunoglobin (Mprotien or Bence jones protien) without any apparent antigen stimulation.
3. Plasma cell produce osteoclast-activating factor leading to extensive bone loss, severe pain, and pathologic fractures.
4. Abnormal immunoglobulin affect renal function, platelet function,resistance to infection, and may cause hyperviscosity of the blood.
5. Generally affects older people (median age at diagnosis is 68) and is common in black men and womem.
Clinical manifestations
1. Constant, usually severe bone pain
2. Fatigue and weakness
3. Proteinuria and renal insufficiency
4. Electrolyte disturbances
Diagnostic Evaluation
1. Bone marrow aspiration and biopsy
2. CBC and blood smear
3. Urine and serum analysis
4. Skeletal x-rays
Management
1. chemotherapy
2. thalidomide
3. alpha interferone as maintainance therapy
4. Bortezomib (velcade)
5. Bone marrow or peripheral blood stem cell transplant.
Nursing assessment
1.Obtain health history, focusing on pain and fatigue.
2.Evaluate for evidence of bone deformities and bone tenderness or pain.
3.Assess patient's support system and personal coping skills
Nursing Interventions
1. controlling pain
2. promoting mobility
3. relieving fear
4. monitoring for complication
Lymphoma(Hodgkin and non Hodgkin lymphoma)
ReplyDeleteHodgkin disease, the abnormal cells are called the Reed-Sternberg cells. this type of cancer can spread throughout the lymphatic system, affecting any organ or lymph tissue in the body.Hodgkin disease usually affects people in their late 20s or older than 50. males gets the disease more often than females, and whites are affected more often than people of other races.
Non-Hodgkin Lymphoma
Most lymphoma is non-Hodgkin lymphoma. In adults, non-Hodgkin lymphoma affects males more than females and often occurs between the ages of 60 and 70. whites are affected more often than people of other races.
Risk factors
1. suppressed immune systems
a. people infected with HIV and people who have undergone an organ transplant that requires long term treatment with drugs that altered the immune system.
Several factors may contribute to the development of lymphoma:
. Environmental factors
. Genetic factors
. Viral infection such as the Epstein-Barr virus and HIV.
Clinical Manifestation
.swelling of lymph nodes in the neck,under the arms , groin
. Fever
. night sweats
. Fatigue
. Abdominal pain
. unexplained weight loss
. itchy skin
. Rash
. Difficulty swallowing
Diagnosis
.blood test
.lymph node biopsy
.x-rays
.bone marrow biopsy
.gallium scan or PET scan and CT scan.
Treatment
.Radiation
.Chemotherapy
.immunotherapy