Join me as I prepare for my upcoming NCLEX RN exam on October 2009


Friday, December 26, 2008

What are the Essential Positions to know for the NCLEX-RN Exam?

Reference from: NCLEX RN KAPLAN 2007-08


Positions Therapeutic Function


Flat (supine)
  • Avoids hip flexion, which can compress
Dorsal Recumbent
  • Supine with knees flexed; more comfortable

Side Lateral
  • Allows drainage of oral secretions

Side with leg bent (Sim's)
  • Allows drainage of oral secretions

Side with leg bent (Sim's)

  • Allows drainage of oral secretions; decreases abdominal secretions

Head elevated (Fowler's)
  • Increases venous return; allows maximal lung expansion
  1. High Fowler's: 60 - 90 degrees
  2. Fowler's: 45 - 60 degrees
  3. Semi Fowler's: 30 45 degrees
  4. Low Fowler's: 15 - 30 degrees

Feet and legs elevated
  • Increases blood return to heart; relieves pressure on lumbrosacral area

Feet elevated and head lowered (Trendelenbur's)
  • Used to insert CVP line, or for treatment of umbilical cord compression

Feet elevated 20 degrees, knees straight, trunk flat, and head slightly elevated (modified Trendelenburg's)
  • Increases venous return; used for shock
Elevation of extremity
  • Increases venous return. Increases blood volume to extremity
Flat on back, thighs flexed, legs abducted
  • Increases vaginal opening for examination
Prone
  • Promotes extention of hip joint. Not well tolerated by persons with respiratory or cardiovascular difficulties
Knee-chest
  • Provides maximal visualizatio n of rectal area







Thursday, December 25, 2008

zwani.com myspace graphic comments


MERRY CHRISTMAS TO EVERYONE!

Wishing you happiness throughout the holidays!

-Calvin Kalf Tam

Thursday, November 27, 2008

What is Cognitive Therapy?

- Cognitive therapy frequently is used for clients with depression. This type of therapy is based on exploring the client’s subjective experience. Cognitive therapy includes examining the client’s thoughts and feelings about situations and how these thoughts and feelings contribute to and perpetuate the client’s difficulties and mood.

Wednesday, November 26, 2008

What is FANA?

- The antinuclear antibody test measures the titer of antibodies that destroy the nuclei cells and cause tissue death. When the fluorescent method is used, the test sometimes is referred to as FANA (Fluorescent Anti-nuclear Anti-body). If this test gives a positive result, a value greater than 1.8 will be present.

*This test can help confirm a diagnosis when you have symptoms of an autoimmune disease. It is done to help diagnose systemic lupus erythematosus (SLE, or lupus), as well as lupus that is caused by drugs. Lupus is one of several diseases that may cause arthritis (joint inflammation). This test may also be done to see how well treatment for lupus is working.

PRC Room Assignments for November 2008 Nurse Liscencesure Exam

PRC Room Assignments for the November 2008 Nurse Licensure Examination

Tuesday, November 25, 2008

What are the Complications of Vitamin Deficiency?

Water Soluble Vitamins

Vitamin C (Ascorbic Acid)
  • Prolonged deficiency - Scurvy

Vitamin B Complex

Vitamin B1 (Thiamine)
  • Prolonged deficiency - Beri- beri
Vitamin B2 (Riboflavin)
  • Prolonged deficiency - Skin Lesions
Vitamin B3 (Niacin)
  • Prolonged deficiency - Pellagra
Vitamin B6 ( Pyridoxine)?
  • Prolonged deficiency - Peripheral Neuritis
Vitamin B9 (Folic Acid/Folacin)
  • Prolonged deficiency - Megaloblastic Anemia
Vitamin B12 (Cobalamine/Cyanocobalamine)
  • Prolonged deficiency - Pernicious Anemia
Panthotenic Acid
  • Deficiency - fatigue, sleeplessness, nausea, poor coordination
Biotin
  • Deficiency - fatigue and deppression

Fat Soluble Vitamins

Vitamin A (Retinol)
  • Deficiency - Night Blindness and Opacity of the Lens
Vitamin D (Ergocalciferol)
  • Deficiency to Children - Rickets
  • Deficiency to Adults - Osteomalacia
Vitamin E (Tocoferol)
  • Deficiency - Anemia
Vitamin K (Menadione)
  • Deficiency - Bleeding

What are the common causes of a weak immune system?

- The immune system is the part of the body that fights infection. This may be weakened by radiation, poor nutrition, and certain medicines, such as anti-cancer medicines or steroids.

*Having a weak immune system may delay wound healing.

What are the factors influencing Wound Healing?



Factors influencing Wound Healing:

Age
Nutrition Status
Obesity
Extent of the Wound
Oxygenation
Smoking Behavior
Immunosuppression
Diabetes
Wound Stress
Drug Intake

What is the expected complication of Amputation on Diabetes Patients?

- Clients with diabetes mellitus are more prone to wound infection and delayed wound healing because of the disease.

*Postoperative stump edema and hemorrhage are complications in the immediate postoperative period that apply to any client with an amputation. Slight redness of the incision is considered normal, as long as it is dry and intact.

How long does edrophonium (Tensilon) lasts?

- Edrophonium commonly is given to test for myasthenic crisis. If the client is in myasthenic crisis, muscle strength improves after administration of the medication, and the improvement lasts for about 30 minutes.

What is an NPH?


- NPH is an intermediate-acting insulin with an onset of action in 3 to 4 hours, a peak action in 6 to 12 hours, and a duration of action of 18 to 28 hours.

NPH stands for Neutral Protamine Hagedorn and also known for the "N" bottle.

*A hypoglycemic reaction is most likely to occur at peak time.

How does loop of Henle interacts with furosemide (Lasix)?

- Furosemide works by acting to excrete sodium, potassium, and chloride in the ascending limb of the loop of Henle.

(this portion below is taken straight from the horse's mouth wikipedia)

In the kidney, the loop of Henle or Henle's loop is the portion of the nephron that leads from the proximal convoluted tubule to the distal convoluted tubule. The loop has a hairpin bend in the renal medulla. The main function of this structure is to reabsorb water and ions from the urine. To do this, it uses a countercurrent multiplier mechanism in the medulla. It is named after its discoverer, F. G. J. Henle.

What is sertraline hydrochloride (Zoloft)?

- Sertraline hydrochloride (Zoloft) is classified as an antidepressant.

Sertraline generally is administered once every 24 hours. It may be administered in the morning or evening, but evening administration may be preferable, because drowsiness is a side effect. The medication may be administered without food or with food if gastrointestinal distress occurs. Sertraline is not ordered for use as needed.

When is the best time to give ranitidine (Zantac)?

- Ranitidine is a histamine 2 (H2)-receptor antagonist. A single daily dose of ranitidine is scheduled to be given at bedtime. This allows for a prolonged effect, and the greatest protection of the gastric mucosa.

What diseases are initially Asymptomatic?

There are certain diseases which do not have any symptoms at first. Clients are usually diagnosed when the disease is on its worsening stage.

Perhaps a regular check up would have made some difference.


Lists of Asymptomatic Diseases:

  • Abdominal Aortic Aneurism
  • Amoebiasis
  • Cancer of the Cervix
  • Cancer of the Esophagus
  • Cancer of the Rectum
  • Chlamdia Trachomatis
  • Cholelithiasis
  • Coarctation of the Aorta Disease
  • Diverticulosis
  • Genital Herpes
  • Gonorrhea (female patients)
  • Gout
  • Hemophilia B (Christmas Disease)
  • Hiatal Hernia
  • Hypothyroidism
  • Hypertension
  • Lung Cancer
  • Osteoperosis
  • Patent Ductus Arteriosus
  • Pelvic Inflammatory
  • Phenylketonuria (newborn)
  • Prostatic Cancer
  • Trichomoniasis
  • Tuberculosis

Monday, November 24, 2008

What is the major symptom of Pheochromocytoma?

- Hypertension is the major symptom associated with pheochromocytoma. Glycosuria, weight loss, and diaphoresis also are clinical manifestations of pheochromocytoma.

Sunday, November 23, 2008

What are the precautions on carbamazepine (Tegretol)?

- Carbamazepine acts by depressing synaptic transmission in the central nervous system (CNS). Because of this, the client should avoid driving or doing other activities that require mental alertness until the effect of the medication on the client is known. The client should use protective clothing and sunscreen to avoid photosensitivity reactions. The medication may cause dry mouth, and the client should be instructed to provide good oral hygiene and use sugarless candy or gum as needed. The medication should not be abruptly discontinued, because this could lead to return of seizures or status epilepticus. Fever and sore throat should be reported to the physician (leukopenia).

What is the intial step in resolving Diabetic Ketoacidosis?

- Rehydration is the initial step in resolving diabetic ketoacidosis.

Normal saline is the initial IV rehydration fluid. NPH insulin is never administered by the IV route. Dextrose solutions are added to the treatment when the blood glucose level reaches an acceptable level. Intravenously administered potassium may be required, depending on the potassium level, but would not be part of the initial treatment.

Saturday, November 22, 2008

What is the purpose of Behavioral Therapy?


- The purpose of behavioral therapy is to create effective changes in behavior.

What causes breast changes for pregnant woman?

- During pregnancy, the breasts change in size and appearance. The increase in size is because of the effects of estrogen and progesterone. Estrogen stimulates the growth of mammary ductal tissue and progesterone promotes the growth of lobes, lobules, and alveoli. A delicate network of veins is often visible just beneath the surface of the skin.

What is the expected normal occurence on patient using Chest Tube Drainage System?

- With normal breathing, the water level rises with inspiration and falls with expiration.The opposite—the level falls with inspiration and rises with expiration—occurs when the client is on positive-pressure mechanical ventilation. This is an expected normal occurrence in a chest tube drainage system.

What is the characteristics of Lochia?

- Lochia, the discharge present after birth, is red for the first 1 to 3 days and gradually decreases in amount. Normal lochia has a fleshy odor or an odor similar to menstrual flow. Foul-smelling or purulent lochia usually indicates infection, and these findings are not normal.

What is Hyperuricemia?

- Hyperuricemia increased uric acid level. It is especially common following treatment for leukemias and lymphomas because chemotherapy results in massive cell kill.

Where does Glucose bind irreversably as a result of chronic hyperglycemia?

Bold- With chronic high circulating blood glucose levels, some glucose binds irreversibly onto the red blood cells (RBC) and remains there for the life of the cell. The average life span of an RBC is 120 days. The measurement of glycosylated hemoglobin (HbA1c), which detects glucose binding on the RBC membrane, is expressed as a percent. One of the problems in diabetes is that muscle and adipose cells may be unable to transport glucose across cell membranes. Glucose does not bind onto platelets in diabetes mellitus.

What to prioritize in patiants with COPD?

- COPD, Chronic Obstructive Pulmonary Disease is a term that represents the pathology and symptoms that occur with clients experiencing both emphysema and chronic bronchitis. For the nurse prioritizing this client’s problems, it is important to first maintain airway, breathing, and circulation.

What are the early manifestations of Congestive Heart Failure (CHF)?

- The early signs of congestive heart failure (CHF) include tachycardia, tachypnea, profuse scalp sweating, fatigue and irritability, sudden weight gain, and respiratory distress.

What is Aluminum Intoxication?

- Aluminum intoxication can occur when there is accumulation of aluminum, an ingredient in many phosphate-binding antacids. It results in mental cloudiness, dementia, and bone pain from infiltration of the bone with aluminum. It may be treated with aluminum-chelating agents, which make aluminum available to be dialyzed from the body. It can be prevented by avoiding or limiting the use of phosphate-binding agents that contain aluminum.

*Aluminum Hydroxide as a Phosphate-biding agent is given to patients with chronic renal failure (CRF).

What would you expect as a nurse to a patient with Acute Renal Failure (AFR)?

- Clinical manifestations associated with ARF occur as a result of metabolic acidosis. The nurse would expect to note Kussmaul’s respirations as a result of the metabolic acidosis because the bodily response is to exhale excess carbon dioxide.

What is zidovudine (AZT)?

- Zidovudine is a nucleoside reverse transcriptase inhibitor used to treat human immunodeficiency virus (HIV) infection in combination with other antiretroviral agents.

*Diarrhea is an occasional side effect of the medication.

What is Hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?

- Hyperglycemic hyperosmolar nonketotic syndrome occurs in clients with type 2 diabetes mellitus. The onset of symptoms may be gradual. The symptoms may include polyuria, polydipsia, dehydration, mental status alterations, weight loss, and weakness.

What to instruct a client taking azithromycin (Zithromax)?

- Azithromycin should be taken 1 hour before or 2 hours after meals. It is not administered with meals, and it should not be taken with either aluminum- or magnesium-containing antacids.

*Given to patients with Chlamdial Infection

How do you test a client for accomodation?

- The nurse tests for accommodation by asking the client to focus on a distant object. This process dilates the pupils. The client is then asked to shift the gaze to a near object, such as a finger held about 3 inches from the nose. A normal response includes pupillary constriction and convergence of the axes of the eyes.

Thursday, November 20, 2008

What is the importance of special diets for patients with Kidney Disease?

- A low-protein diet is used in people with abnormal kidney function to prevent worsening of their kidney disease. The diet is often low in sodium and potassium as well. For some people on this diet, fluid restriction is also necessary. And if you have diabetes along with kidney disease, a low-carbohydrate diet may be necessary.

This special diet is very helpful because it decreases the stress on the kidney by having less work load.

  • Protein is restricted to decrease the protein load on the kidney and slow down the progression of kidney disease.
  • Sodium may be restricted to improve blood pressure control and to avoid fluid accumulation.
  • Potassium is restricted if it is not excreted effectively and levels in the blood are high. When you have too much potassium in your blood, dangerous heart rhythms may result.

The controlled amounts of each of these nutrients are based on the blood levels of potassium, sodium, protein (measured as total protein and albumin), and urea (a waste product normally excreted in the urine).

Fluid is only restricted if you accumulate excessive amounts in your body.

Calcium and phosphorus, two other important minerals in the body, are also followed closely. Phosphorous can become too high if you have kidney disease. Calcium can become too low. If the blood levels of these two minerals indicate that you need to adjust your intake of them, then the amounts allowed in your diet are altered. If that alone is not enough, supplements and medications are used.

What is the importance of Low Sodium Diet on patients with Heart Failure?

- It is important to decrease the amount of sodium you eat when you have heart failure, because heart failure causes the body to hold on to extra sodium. The sodium attracts extra fluid to build up in your body. Which means that the heart needs to work extra harder because of water retention. How can heart work if it's not working properly? This may also result to symptoms such as swelling of the ankles, feet or abdomen, shortness of breath, or weight gain.

A low-sodium diet can help you, even if you do not have symptoms of fluid build up, or if you are already taking a diuretic (water pill).

What is Histoplasmosis?

- Histoplasmosis is an opportunistic fungal infection that can occur in the client with acquired immunodeficiency syndrome (AIDS).

The infection begins as a respiratory infection and can progress to disseminated infection.

Typical signs and symptoms include: fever, dyspnea, cough, and weight loss. Enlargement of the client’s lymph nodes, liver, and spleen may occur as well.

When should be the first dental check up for a toddler?

- The first dental visit should be made after the first primary tooth erupts and no later than 30 months of age.

The nurse should instruct the mother that proper dental care for a toddler is important. It is important to instruct the mother to substitute sweets with healthy food items to prevent dental caries.

*It will not hurt the child if some of the toothpaste is swallowed.

How long does a Tuberculosis Drugs to work on clients?

- The client is continued on medication therapy for 6 to 12 months, depending on the situation. The client generally is considered not to be contagious after 2 to 3 weeks of medication therapy.

*The client is instructed to wear a mask if there will be exposure to crowds until the medication is effective in preventing transmission. The client is allowed to return to work when the results of three sputum cultures are negative.

What is the manifestation of Hypoglycemia?

- Signs and symptoms of hypoglycemia include hunger, nervousness, anxiety, dizziness, blurred vision, sweaty palms, confusion, and tingling and numbness around the mouth.

*Polydipsia (thirst) and increased urine output are noted in the client with hyperglycemia.

What is the expected gait of a patient with Parkinsons diease?

- The parkinsonian gait is characterized by short, accelerating, shuffling steps. The client leans forward with the head, hips, and knees flexed, and has difficulty starting and stopping.


*A dystrophic gait is broad-based and waddling. A festinating gait is accelerating with walking on the toes. An ataxic gait is staggering and unsteady.

What is the electrocardiogram reading of Hyperkalemia?

A serum potassium level higher than 5.1 mEq/L indicates hyperkalemia.

Electrocardiographic changes include:
  • flat P waves
  • prolonged PR intervals
  • widened QRS complexes
  • and tall peaked T waves

What is carbamazepine (Tegretol)?

- Carbamazepine is classified as an iminostilbene derivative and is used as an anticonvulsant, as well as an antineuralgic, antimanic, and antipsychotic.

What is clotrimazol (Lotrimin)?

- Clotrimazole is a topical anti-fungal agent used in the treatment of cutaneous fungal infections.

*It is not used for sneezing, fever, or pain.

What is tacrolimus (Prograf)?

- Tacrolimus is an alternative medication to cyclosporine (Sandimmune) for prevention of organ rejection in clients after transplantation. The medication is more effective than cyclosporine but is more toxic.

*Concurrent use of glucocorticoids is recommended during administration of this medication.

Wednesday, November 19, 2008

What is the diagnosis of a patient under Dopamine Therapy?

- The client receiving dopamine therapy should be assessed and diagnosed for ineffective tissue perfusion related to peripheral vasoconstriction.

What is lithium carbonate (Eskalith)?


- Lithium is an anti-manic medication and is used to treat the manic phase of a manic-depressive disorder.

What is the characterizations of Full Thickness Burn?

Full-thickness burns involve the epidermis, the full dermis, and some of the subcutaneous fat layer.

-The burn appears to be a tan or fawn color, with skin that is hard, dry, and inelastic. Edema is severe, and the accumulated fluid compresses tissue underneath from eschar formation. Some nerve endings have been damaged, and the area may be insensitive to touch with little or no pain.

What is Bio-Ethics?

- It is the division of Ethics that relates to HUMAN LIFE.

Study of human conduct in the area of the life sciences and health care using moral values and principles.

BIOETHICAL ISSUES:

  • LIFE: Abortion, genetic screening, sterilization, single parents
  • DEATH: futile treatments, euthanasia, withdrawing treatment, right to refuse treatments.

What is Justice?


- It refers to the obligation to be fair to other people.

What is Stewardship?

- Not to harm our body because it is God's, not ours.

What is Totality?

- The body must function as a whole.

What is Fidelity?

- It refers to the obligation not to divulge any information to anyone who does not have any concern regarding the patient's condition.

What is Veracity?

- It refers to telling the truth or not intentionally decieving or misleading patients.

What is Respect?

- Treat all persons with rights with or with out deformity.

What is Autonomy?

- Autonomy means self-determination.

What is Non Maleficience?

- One ought not to inflict evil or harm.

What is Beneficience?

- It means to do good and not to do harm.

Tuesday, November 18, 2008

What is the adverse effect of bleomycin (Blenoxane)?

- The major form of dose-limiting toxicity with bleomycin is injury to the lungs.

It manifests initially as pneumonitis but can progress to severe pulmonary fibrosis and death. In addition to auscultation of lung sounds, pulmonary function studies should be monitored. Bleomycin is discontinued at the first sign of these adverse changes. Nausea and vomiting usually are mild with the use of this medication, and unlike most other anticancer agents, bleomycin exerts minimal toxicity to bone marrow. It does not directly affect the blood pressure.

What is Allent's Test?

Before drawing a sample for arterial blood gas analysis, the nurse assesses the collateral circulation to the hand with Allen’s test.

- Allen’s test involves compressing the radial and ulnar arteries and asking the client to close and open the fist, which should cause the hand to become pale. The nurse then releases pressure on one artery and observes whether circulation is restored quickly. The nurse repeats the process, releasing the other artery. The blood sample may be taken safely if collateral circulation is adequate.

What is the importance of Vitamin K for infants?

- Vitamin K is necessary for the body to synthesize coagulation factors. Vitamin K is administered to the newborn infant to prevent abnormal bleeding.

Vitamin K promotes liver formation of the clotting factors II, VII, IX, and X. Newborn infants are vitamin K–deficient because the bowel does not have the bacteria necessary for synthesizing fat-soluble vitamin K. The normal flora in the intestinal tract produces vitamin K. The newborn infant’s bowel does not support the normal production of vitamin K until bacteria adequately colonize it. The bowel becomes colonized by bacteria as food is ingested.

*Vitamin K does not promote the development of immunity or prevent the infant from becoming jaundiced.

What is Toxoplasmosis?

- Toxoplasmosis (toxo) is an infection caused by a single-celled parasite called Toxoplasma gondii. The infection is most commonly acquired from contact with cats and their feces or with raw or undercooked meat.

The babies of women who were exposed to toxo within a few months of becoming pregnant or during pregnancy are at an increased risk for developing a severe case of toxo.

Infants are prone to toxoplasmosis since the immune system in infant is not fully matured until after birth.

If the immune system of a mother is normal then symptoms of Toxoplasmosis may not show. However, the baby inside may acquire the disease.

Most infants have no symptoms at birth, but a small percentage may be born with eye or brain damage. Unfortunately, the signs and symptoms of the disease often appear a few months after birth.

All pregnant clients should be advised to do the following to prevent the development of toxoplasmosis:
  • Clients should be instructed to cook meats thoroughly, particularly pork, beef, and lamb;
  • avoid touching mucous membranes of the mouth or eyes while handling raw meat;
  • thoroughly wash all kitchen surfaces that come in contact with uncooked meat;
  • wash the hands thoroughly after handling raw meat; avoid uncooked eggs and unpasteurized milk;
  • wash fruits and vegetables before consumption;
  • and avoid contact with materials that possibly are contaminated with cat feces, such as cat litter boxes, sand boxes, or garden soil.

What is Vegan Diet?



-A special diet indicated for Seven Day Adventists (religion), and vegetarians.

What is Tyramine Free Diet?

- A special diet indicated for patients with hypertensive crisis and patients who are taking MAOI anti depressants.

NO to ABC

-----------------------------------------Avocado
-----------------------------------------B
anana
-----------------------------------------Canned and Processed foods

What is Soft Diet?

- A special diet indicated for patients with ill fitting dentures, chewing problems, gastrointestinal disturbances such as gastric ulcers and cholelithiasis.

What is Sodium Restricted Diet?


- A special diet indicated for patients with heart failure, hypertension, renal diseases, PIH - pregnancy induced hypertension and steroid therapy.

A great way to remember foods that are high in sodium (salt) is the all american HOTDOG. All processed foods are high in salt.

Example: hotdogs, sauerkraut, ketchup, pickle relish, chili, hot sauce, CAN goods, sausages

What is Purine Restricted Diet?

- A special diet indicated to patients with Gouty Arthritis, Renal Calculi, and Hyperuricemia.

Action: To reduce uric acid


WHAT YOU SHOULD DO

Carefully avoid all foods on the high-purine list below. In addition, do not drink alcohol unless your doctor gives the OK. If you are overweight, you should also cut down on calories and eat low-fat foods.

HIGH-PURINE FOODS

(Avoid completely.)
  • Anchovies
  • Beef kidneys
  • Brains
  • Game meats
  • Gravies
  • Herring
  • Liver
  • Mackerel
  • Meat extracts
  • Sardines
  • Scallops
  • Sweetbreads

MEDIUM-PURINE FOODS

(You may eat 2 to 4 choices daily.)
  • Asparagus
  • Beans
  • Bouillon
  • Broth
  • Cauliflower
  • Consommé
  • Dried beans, peas, lentils
  • Eel*
  • Eggs (no more than 4 per week)
  • Fats or oils in small amounts
  • Fish
  • Fresh beans and peas
  • Meat (beef, lamb, pork, veal)*
  • Meat soups, broths, gravies
  • Milk (skim or 1 percent---no more than 24 ounces per day)
  • Mushrooms
  • Oats or oatmeal
  • Poultry (chicken and turkey)*
  • Shellfish (crab and lobster)*
  • Spinach
  • Wheat germ and bran
  • Whole grain breads
  • Yeast (all types)
* Do not eat more than 2 medium servings (the size of a deck of cards), cooked, per day.

LOW-PURINE FOODS

(Eat as much as you like.)
  • Breads and cereals (low-fiber, white flour, or refined grain types)
  • Coffee
  • Cream-style soups made with low-fat milk
  • Fruits and juices
  • Gelatin
  • Low-fat and fat-free cheeses
  • Nuts, peanut butter (limit if trying to lose weight)
  • Soda pop
  • Sugar, syrup, sweets in small amounts
  • Tea
  • Vegetables, except those above
  • Vegetable soups without meat extract or broth

What is Residue Diet?

- A special diet indicated to patients with Chron's disease, Ulcerative Colititis, Diverticulitis and patients who will undergo surgery of the GI tract.

Action: To reduce the bulk of the stools

Grain Products:

  • enriched refined white bread, buns, bagels, english muffins
  • plain cereals e.g. Cheerios, Cornflakes, Cream of Wheat, Rice Krispies, Special K
  • arrowroot cookies, tea biscuits, soda crackers, plain melba toast
  • white rice, refined pasta and noodles
  • avoid whole grains

Fruits:

  • fruit juices except prune juice
  • applesauce, apricots, banana (1/2), cantaloupe, canned fruit cocktail, grapes, honeydew melon, peaches, watermelon
  • avoid raw and dried fruits, raisins and berries.

Vegetables:

  • vegetable juices
  • potatoes (no skin)
  • well-cooked and tender vegetables including alfalfa sprouts, beets, green/yellow beans, carrots, celery, cucumber, eggplant, lettuce, mushrooms, green/red peppers, squash, zucchini
  • avoid vegetables from the cruciferous family such as broccoli, cauliflower, brussels sprouts, cabbage, kale, Swiss chard etc

Meat and Protein Choice:

  • well-cooked, tender meat, fish and eggs
  • avoid beans and lentils

Nuts and Seeds:

  • Avoid all nuts and seeds, as well as foods that may contain seeds (such as yogurt)


*From examples taken from: www.healthcare.com

What is Low Sodium Diet?


- A special diet indicated for patients with heart failure, hypertension, renal diseases, PIH - pregnancy induced hypertension and steroid therapy.

A great way to remember foods that are high in sodium (salt) is the all american HOTDOG. All processed foods are high in salt.

Example: hotdogs, sauerkraut, ketchup, pickle relish, chili, hot sauce, canned goods, sausages

What is Low Carbohydrate Diet?

- A special diet indicated to patients with Dumping Syndrome.

What is Low Fat Diet?

- A special diet indicated for patients with cardiovascular diseases, hypertension, cholecystitis, cholelithiasis and patients who undergo resection of the small intestines.

Action: To reduce hyperlipidemia, high blood pressure and to patients with intolerance to fats

What is Kosher Diet?

- A special diet indicated for Orthodox Jews.

NO Milk and Meat

What is High Protien Diet?

- A special diet indicated for patients with Nephrotic Syndrome.

Example: Lean Meat, cheese, eggs

What is High Fiber Diet?

- A special diet indicated for patients who are constipated, diverticulitis or hyper lipedemia.

Action: It fascilitates the food to digestive tract and softens the stool

Example: Fruits and Vegtables

What is Halal Diet?


- A special diet indicated for Muslim patients >NO PIG

What is Gluten Free Diet?


- A special diet indicated for patients with Celiac's Disease.

No to BROW

iiiB - Barley
R - Rye
IO - Oats
W - Wheat

What is Giordano Diet?

- A special diet indicated for patients who suffer from Chronic Renal Failure.

*spare protien

What is Full Liquid Diet?

- A special diet indicated for patients with stomach upsets, post surgical patients, after progression from clear liquid diet.

Action: To provide nutrition to patients who cannot chew or tolerate solid foods

What is Diabetic Diet?

- A special diet indicated for patients with Diabetes Milletus.

Action: to maintain near to normal blood glucose level

D - iet: 50-60 % CHO, 20-30% Fats, 10-20% CHON
I - nsulin -- Type 1
A - nti Diabetic Agents
B - lood sugar monitoring
E - xercise
T - ransplant of pancreas
E - nsure Adequate Food Intake
S - crupulous Foot Care

*Normal blood glucose level: 60-120 mg/dl

Monday, November 17, 2008

What is Clear Liquid Diet?

- A special diet indicated for pre-operative, post-operative patients, vomiting and gastroenteritis.

Action: To relieve thirst and help maintain fluid balance

What is Butterball Diet?

- A special diet indicated for patients with liver disorder.

*spare protein but high in carbohydrates

What is BRAT Diet?

- A special diet indicated for patients with diarrhea.
  • Banana
  • Rice
  • Apple
  • Diet

What is Bland Diet?

- A special diet indicated for patients with gastritis, diarrhea, biliary, indigestion, and hiatal hernia.

Action: mechanical irritans, chemical stimuli

Example: Low fiber

What is an Alkaline Diet?

- A special diet indicated for patients with renal stones. (acidic stones)

Action: Retards the formation of acid renal stones

Examples: Fruits (except cranberries, plums, prunes)

What is an Acid Diet?

- A special diet indicated for patients with renal calculi. (alkaline stones)

Action: Retards the formation of alkalinic renal stones

Example: cheese, cranberry, eggs, meat, plums, prunes, whole grain

What is Dietary Guidelines?

- qualitative advice on healthy eating

What is Therapeutic Diet?

- A diet modified or adopted from the normal diet to suit specific disease conditions, one designed to treat or cure disease, or to support medical management of a disease.

What is Dietary History?

- A record of the usual day to day food intake of the client.

What is Recommended Diatary Allowance?

- Recommended levels of energy and nutrient intakes for a specific population of group.
  • Based on average requirement
  • It has plus allowance, called margin of safety to cover variations in individual requirements and incomplete utilization of food.

What is Nutrition Therapy?

- Interventions used in the treatment of a disorder or illness and includes diet therapy, nutrition, counseling or the use of specialized nutrition theraphies such as supplementation with nutritional or medical foods and nutrition support through enteral or parenteral methods.

What is a Diet?

- an allowance of food and drink consumed regularly by an individual.

What are the positioning limitations of a client who just had a Vein Ligation?

- The client who has had vein ligation and stripping should avoid standing or sitting for prolonged periods. The client should remain lying down unless performing a specific activity for the first few days following the procedure. Prolonged standing and sitting increase the risk of edema in the legs by decreasing blood return to the heart. The client should avoid crossing the legs at any level for the same reason.

What is the diet for a client with a Dumping Syndrome?

- The client with dumping syndrome should be placed on a high-protein, moderate-fat, and high-calorie diet.

*The client should lie down after eating and should avoid drinking liquids with meals. Frequent small meals are encouraged and the client should avoid concentrated sweets.

What is the diet for a client with a Dumping Syndrome?

- The client with dumping syndrome should be placed on a high-protein, moderate-fat, and high-calorie diet.

*The client should lie down after eating and should avoid drinking liquids with meals. Frequent small meals are encouraged and the client should avoid concentrated sweets.

What is the ussual component of diet for Chinese Clients?

- Vegetarian

The Chinese diet generally is vegetarian, although meat may be consumed in small amounts. Native Chinese generally do not drink milk or eat milk products because of a genetic tendency for lactose intolerance. Most Chinese do not eat desserts high in sugar content.

Sunday, November 16, 2008

PRC Philippines Nursing Board Exam School and Seating Assignments for November 2008

Are you about to take the PRC Nursing Board Exam on November 29-30, 2008?

Want to know your school and seating arrangement?

Would you rather not go to PRC Manila to know your seat arrangement (seat number) and which school you are about to take your exam in Manila?

Would you like to review more or relax at home instead of going to Manila and get stucked in the traffic? (which would definitely suck up your energy)

It's really a hassle for PRC not to post the lists of examinees for their school and seat arrangements on the Internet. This would have saved so much energy and time for the board takers.

If you are about to take the exam and you want to have a quick view on your where abouts on the date of your exam then you have come to the right place...

As soon as PRC releases it, (3-5 days prior to exam date) I will send it directly to your eMail address and Inform YOU your school and seating arrangements.

What are you waiting for SUBSCRIBE NOW to get your FREE Updates!!!!

No more traffic and no more hassles!!!


*You may simply put your eMail address on box form on the side bar of this blog to subscribe and make sure to confirm it on your eMail address
*I will also keep you posted on PRC Nursing Board Exam Results as soon as it comes out.

List of emergency Equipments/Instruments needed for bedside safety of clients

These are the lists of emergency instruments /equipments needed for bedside safety of the client in particular cases only:

Amputation - tourniquet

Autonomic Hyperreflexia- catheter

Chest Tube Drainage - extra bottle, forceps, vaselinized gauze

Cholinergic and Myasthenic crisis - endotracheal tube or tracheostomy set

Epiglotitis - endotracheal tube or tracheostomy set

PIH (Pregnancy Induced Hypertension) - padded mouth gag

Parkinson's Disease - suction apparatus

Radium Implant - lead container, forceps

Sengstaken Blakemore tube - scissors

SCI and Thyroidectomy - tracheostomy set

Tonsillectomy - flashlight

Tracheostomy tube - obturator, hemostat

What is the best position for a patient to undergo a colonscopy procedure?

- The client is placed in the left Sims position for the procedure.

This position takes the best advantage of gastrointestinal (GI) anatomy for ease in introducing the colonoscope.

Nursing is a World of Possibilities!

from: www.discovernursing.com

When you become a nurse there are so many opportunities to take specially when you really want to know which area in nursing best suits you. Nursing is a world of possibilities! With a nursing degree, you can shape your career as you go, taking the opportunities that fit you best. Here are some specialties available in a variety of settings and environments.

What is Midwifery?

Midwives have a unique opportunity to journey with women and their families through the cycle of pregnancy and birth. Midwife means ‘with woman’. This meaning shapes midwifery’s philosophy, work and relationships. Midwifery considers women in pregnancy, during childbirth and early parenting to be undertaking healthy processes that are profound and precious events in each woman’s life. These events are also seen as inherently important to society as a whole.

What Nursing is About?

from: www.nursingworld.org

Florence Nightingale, in her Notes on Nursing: What It Is and What It Is Not, defined nursing as having “charge of the personal health of somebody … and what nursing has to do … is to put the patient in the best condition for nature to act upon him.” The philosophy has been restated and refined since 1859, but the essence is the same. In the words of nursing theorist Virginia Henderson, nurses help people, sick or well, to do those things needed for health or a peaceful death that people would do on their own if they had the strength, will, or knowledge. The most current definition that reflects the evolution of professional nursing is from the 2003 edition of

ANA’s Nursing’s Social Policy Statement:
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.

The human response…

What defines nursing and sets it apart from other health care professions, particularly medicine with which it has long been considered part and parcel? It is nurses’ focus – in theory and practice – on the response of the individual and the family to actual or potential health problems. Nurses are educated to be attuned to the whole person, not just the unique presenting health problem. While a medical diagnosis of an illness may be fairly circumscribed, the human response to a health problem may be much more fluid and variable and may have a great effect on the individual’s ability to overcome the initial medical problem. It is often said that physicians cure, and nurses care. In what some describe as a blend of physiology and psychology, nurses build on their understanding of the disease and illness process to promote the restoration and maintenance of health in their clients.

Nurses’ broad-based education and holistic focus positions them as the logical network of providers on which to build a true health care system for the future. An acknowledged realization that individuals have considerable responsibility for their personal health has driven an increasing recognition that there is a professional group, whose focus is education and practice, that can facilitate individuals efforts to reach their fullest health potential. This profession is that of registered nurses.

8 steps on how to avoid stress before it kills you?

Inspired by: Vijay Eswaran, Anthony Robbins, M. Culligan and Dr. Sedlacek


In our life stress is just inevitable. That is with out a doubt. No matter what degree you have in you stress will come across your way. There are situations that cause you stress, anxiety, deppression, fear or panic. What we must learn to do is to handle these situations in a physically and mentally constructive way. Remember the line from shakespeare: "Cowards die many times before their deaths, the valiant never taste but once." To which I might add that those many deaths are agonizing and that one is mercifully quick.

Problems are only dangerous when they are not dealt with. Not doing anything and tolerating the pain to wich becomes a comfort zone is the worst. Speaking of worst I just remembered what Vijay Eswaran, an asian guru wrote with his amazing book the Sphere of Silence "The worst thing that could ever happen is thinking that you are not incontrol of your self."



You are the one who suppose to be incontrol and not him nor the environment or somebodyelse. Stop blaiming others for what you have became as a man. Another inspiring wisdom from whom I consider one of the biggest mentor in this world is Anthony Robbins. He said that " What you focus on determines how you feel, if you focus on how things myt not work out definitely it will not work and focusing on the good things give you a positive results. "


Sometimes heavy physical exercise and mental diversion (movies, reading, romance, conversation) can be life savers.

Do what you can to solve your problems with out getting your emotions with it and your conscience will be clear. And remember the therapeutic value of activity.

If you reach your breaking point follow these 8 simple steps and I guarantee you it truly helps:

  1. Only the dead, very young, and unborn have no major problems. Life is filled with them, so you must be philosophical. Hope for the best, plan for the worst, and take what comes with humor and style. Remember, it is in troubled times that we grow the most.

  2. Don't whine. Sooner or later we will get pretty much what we deserve. So try to appreciate and enjoy the important things life: FAMILY, LOVE, RESPECT, FRIENDSHIP, RESPONSIBILITY and TRANQUILITY (silence).

  3. Only rarely will anything turn out as badly as you fear it will. So why waste the time it takes to imagine the worst? It will only give you a big head ache. Give yourself a break!

  4. When trouble does come, Don't tolerate it. Get out, get away if you can. Keep very active. See all the friends and acquantances you can. Conform it to your trusted friends or if you don't have one, tell to a priest, a councilor or a doctor. Stress can turn you off very effectively, if you let it.

  5. If your sleep is badly affected, cut down your evening meal, and start doing exercises. The ideal way to eat during stressful times is a large breakfast, a light lunc and a very little dinner.

  6. Don't drink to drown your sorrows. That way out is cowardly and foolish. It will deepen your problems, reduce your fighting ability, and hurt your family and friends.

  7. Help others! This may be the best advice I can give you. There is something uplifting, spiritual in helping others. Try making a difference like we nurses do it. You'll see your own problems in better perspective when you've been exposed those of others. Imagine if you were one of those homeless people or abandond street children, hustling to survive on a day to day basis. Do you think your problem is really a problem compare to millions of people who live in a third world country? Count your blessings instead of complaining!
  8. Never despair, never give up.

There you have it. If these simple steps worked for me then it will also work for you.

What is Transvaginal Ultrasonography?

Transvaginal ultrasonography, in which a lubricated probe is inserted into the vagina, allows evaluation of the pelvic anatomy.

A transvaginal ultrasound exam is well tolerated by most clients because it alleviates the need for a full bladder. The client is placed in a lithotomy position or with her pelvis elevated by towels, cushions, or a folded blanket.

Indications for Transvaginal Ultrasonography:

  • To evaluate obese patients
  • To assist in differentiating gynecologic organs from other organs
  • To more accurately evaluate the character of a lesion
  • To more sensitively detect ascites
  • To serially evaluate growth or regression of a lesion
  • To evaluate noninvasively a nonpalpable ovary in a postmenopausal patient
  • To avoid surgery and facilitate ultrasound-guided biopsy (not as a substitute for second look laparotomy in patients with ovarian cancer)
  • To differentiate an ovarian or uterine mass from normal organs
  • To assess movement of pelvic organs ("sliding-organ" sign)
  • To collect oocytes for in vitro fertilization
*The procedure is not physically painful, although the woman may feel pressure as the probe is moved.

What is against Jehova's Witness?

Cultural and ethnic background influences an individual’s response to health, illness, surgery, and death. Awareness of cultural differences enhances the nurse’s knowledge of how a health care experience may be perceived by the client or family.

- In the Jehovah’s Witness religion, the administration of blood and blood products is forbidden.

What is your priority action when the anterior fontanelleof an infant buldges while sleeping?

- The anterior fontanelle is diamond shaped and located on the top of the head. It should be soft and flat in a normal infant, and it normally closes by 12 to 18 months of age. A larger-than-normal fontanelle may be a sign of increased ICP within the skull. Although the anterior fontanelle may bulge slightly when the infant cries, bulging at rest may indicate increased ICP.

Therefore, the priority action is to report the finding to the physician.

What is Oxytocin?

- Oxytocin stimulates uterine contractions and is used to induce labor.

*If uterine hypertonicity or a nonreassuring FHR pattern occurs while recieving oxytocin, the nurse would intervene to reduce uterine activity and increase fetal oxygenation.
  1. The oxytocin infusion is stopped.
  2. The client is placed in a side-lying position.
  3. Oxygen by face mask at 8 to 10 L/min is administered.
  4. The physician is notified.
  5. The nurse would monitor the client’s blood pressure and monitor intake and output.

*However, the nurse would first stop the infusion.

What are the manifestaions of Magnesium Sulfate Toxicity?

- Magnesium toxicity can occur as a result of magnesium sulfate therapy. It is usually given for the management of preeclampsia.

Signs and Symptoms: Magnesium sulfate toxicity relate to the central nervous system depressant effects of the medication and include;
  • respiratory depression; loss of deep tendon reflexes;
  • sudden decrease in fetal heart rate or maternal heart rate, or both;
  • and sudden drop in blood pressure.

*Hyperreflexia indicates increased cerebral edema.

*An absence of reflexes indicates magnesium excess. The therapeutic serum level of magnesium ranges from 4 to 7 mEq/L.

What is methylergonovine (Methergine)?

- Methylergonovine is an ergot alkaloid used for postpartum hemorrhage. It stimulates contraction of the uterus and causes arterial vasoconstriction.

Contra Indications: Ergot alkaloids are avoided in clients with significant cardiovascular disease, peripheral disease, hypertension, eclampsia, or preeclampsia. These conditions are worsened by the vasoconstrictive effects of the ergot alkaloids.

*The nurse would assess the client’s blood pressure before administering the medication and would follow agency protocols regarding withholding of the medication.

What are the complications of Circumcision?

Complications following circumcision include:
  • bleeding
  • failure to urinate
  • displacement of the Plastibell
  • infection (indicated by a fever and purulent or foul-smelling drainage)

*If signs of infection occur, the physician is notified. The nurse would document the findings, but this is not the priority item. The nurse would change, not reinforce, the dressing. The physician will order a culture if it is necessary.

What is Myelitis?

- inflammation of the spinal cord.

What is Meninges?

- membrane covering the brain and spinal cord

What is Splenectomy?

- excision of the spleen

What is Hydradenitis?

- inflammation of the sweat glands

What is Masochist?

- derives pleasure from inflicting pain

What is Encephalitis?

- inflammation of the brain

What is Myocele?

i- muscle herniation

What is Cerebromalacia?

- softening of the cerebrum

What is Tenalgia?

- It's a tendon pain.

What is Hypochondriasis?

- morbid preoccupation with one's health

What is Pedophilia?

- sexual thoughts activities of adults with children

What is Insomia?

- inability to sleep

What is Hysteroptosis?

- falling uterus

What is Colpocele?

- hernia of the vagina

What is Mammary?

- pertaining to the breast

What is Balanorrhagia?

- bleeding from the glans penis

What is Vasectimy?

- excision of all or part of the vas deferens

What is Diastolic?

- pertaining to the dilation of heart vetricles

What is Hystotoxic?

- poisonous to tissues

What is Septisimia?

- toxic micro-organisms in blood

What is Vasospasm?

- contraction of a vessel

What is Angiorrhaphy?

- suturing of a blood vessel

What is Phlebitis?

- inflammation of a vein

What is Arteriosclerosis?

- hardened arteries

What is Spermatocyte?

- sperm cell

What is Steatorrhea?

- fat in feces

What is Psychosis?

- gross impairment in reality setting

What is Panic Attack?

- intense fear of dying or losing control

What is Manchausen's Disorder?

- intentional feigning of symptoms in order to receive medical treatment

What is Pinealectomy?

- excision of the pineal gland

What is Hypophysis?

- pertaining to pituitary gland

What is Andromegaly?

- enlargement of the adrenal gland

What is Pancreatic?

- pertaining to the pancreas

What is Rhenititis?

- inflammation of nasal mucous membranes

What is Pulmonitis?

- inflammation of the lungs

What is Laryngoplegia?

- paralysis of the larynx

What is Thoracic?

- pertaining to the chest

What is Pneumocentesis?

- surgical puncture of a lung

What is Pharynx?

- the throat

What is Dysuria?

- painful urination

What is Cystoscopy?

- visual examination of the urinary bladder

What is Urethropraxis?

- obstruction of the urethra

What is Gastrectomy?

- excision of the stomach

What is Quickening?

- It is the first recognition of fetal movement.

When does quickening occur for a Multiparous Woman?

- The first recognition of fetal movements, or “feeling life,” by the multiparous woman may occur as early as the 14th to 16th week of gestation.

When does quickening occer for a Nuliparous Woman?

- The nulliparous woman may not notice quickening until the 18th week of gestation or later.

*The first recognition of fetal movements, or “feeling life,” by the multiparous woman may occur as early as the 14th to 16th week of gestation.

What is the nursing action when the umbilical cord protrudes the vagina while in labor?

If the umbilical cord is protruding from the vagina, no attempt should be made to replace it because to do so could traumatize it and further reduce blood flow.
  • The nurse would place a gloved hand into the vagina to the cervix and exert upward pressure against the presenting part to relieve compression of the cord.
  • The nurse also would wrap the cord loosely in a sterile towel saturated with warm, sterile normal saline solution.
  • Oxygen, 8 to 10 L/min by face mask, is administered to the mother to increase fetal oxygenation, and the client is prepared for immediate delivery. However, the immediate action is to relieve pressure on the cord.

*The client should already have an external fetal monitor in place.

What is Abruptio Placenta?

- Abruptio placentae is premature separation of a normally implanted placenta from the uterus during late pregnancy.

Signs and Symptoms: vaginal bleeding, abdominal pain, and uterine tenderness and contractions. Mild to severe uterine hypertonicity is present. Pain is mild to severe and localized over one region of the uterus, or diffuse over the uterus, with a boardlike abdomen.

*Painless vaginal bleeding and a soft, nontender uterus in the second or third trimester of pregnancy are signs of placenta previa.

What is Abruptio Placenta?

- Abruptio placentae is premature separation of a normally implanted placenta from the uterus during late pregnancy.

Signs and Symptoms: vaginal bleeding, abdominal pain, and uterine tenderness and contractions. Mild to severe uterine hypertonicity is present. Pain is mild to severe and localized over one region of the uterus, or diffuse over the uterus, with a boardlike abdomen.

*Painless vaginal bleeding and a soft, nontender uterus in the second or third trimester of pregnancy are signs of placenta previa.

What are the common signs and symptoms of Sepsis?

- Fever, chills, and general malaise.

What are the common Manifestations of Fluid Overload?

Signs and Symptoms: Increased intravascular volume, which increases the blood pressure and the pulse rate as the heart tries to pump the extra fluid volume.

*Fluid overload also causes neck vein distention and the shifting of fluid into the alveoli, resulting in lung crackles.

Storm

Published at friendsters blog by: Ck at February 22' 08

What should I do now? Where would I go? What else is there left for me? Why me? Questions that repeating continuously in mind that somehow had been hunting me while asleep. I woke up at four, five, five thirty, six, seven a.m. I guess I was just waiting for somebody to call me or knock at my door to tell me whether a good story had came out. Not until papers had arrived that morning, those short hours that seemed to last forever…

Then again questions popped up. Was I dreaming yesterday? Is it true that..? But at least some of my friends made it? But I still kept bargaining through it…. Overnight these howling voice seemed to be shattering my goals. In times of crisis, I didn’t doubt HIM, I called upon him, but I asked why have you forsaken me? And so at 8 am I opened a book where it says “Failure is another step forward. Failure is paying your dues. If you fail then you needed to fail.” So I said what does this mean? I figured with all the others this has to mean much to me. I held on to it.

Somebody knocked on my door…. Was it worth all the wait? Those changes and sacrifices that I have done not only for myself but to my family as well, just to meet the demands of this course. At first, I considered this as a bitter pill to swallow but the taste became sweeter as I learned many things from it. All this anxiety that builded up with clinical symptoms occurred at times and up to this particular moment.

And so as the door opened, she told me about the……. I felt so sorry, my disappointment only sunk in till this time…and in few seconds I found myself regressing to her like a candy that is taken away from a baby, like a candle melting gradually, a profound emotions as heavy as a storm and seemed so hard to control as it poured. I didn’t know what to do nor how i should get out from that moment. Abyss of fear was overtaking me. I couldn’t speak nor think.

It was tough to swim against strong current, after some hours, I immediately gathered my thoughts…. Should I put up with this, tolerate it and gain control over me or should I focus on the other way around it? I waited patiently not allowing any insignificant artificial means of enjoyment to bear with me (alcohol). Although the worst thought came to me like what if I’ll take these pills that I know, would it make this pain stop? But how about the long term pain my love ones would suffer? I am not this selfish. For my son, it can never occur. I didn’t know what else to think, but only those people mean to me much made me stop from these foolish thoughts.

My savior called in couple of hours, suddenly a new route is made open.

In short hours he answered me. Through her as made instrument, I knew that I wasn’t left alone and another step forward must be taken in order for me to overcome this difficult time. All this has a purpose, could be trial and error as how she described it. I thank them “my family” for unconditional love and understanding. Must be really difficult with out them. But of course GOD knows best for me and I’m willing to wait patiently for my time.

What are the common manifestations of Infiltrated IV Line?

Symptoms: Burning and a feeling of tightness.

Signs: Pallor, coolness, and swelling at the IV site result when IV fluid is deposited in the subcutaneous tissue.

When the pressure in the tissues exceeds the pressure in the tubing, the flow of IV solution will slow down or stop.

The corrective action is to remove the catheter and start a new IV line at another site.

What is Infiltrated IV Line?

- An infiltrated IV line is one that has dislodged from the vein and is lying in subcutaneous tissue.

What is Insentive Spiromenter?

- An incentive spirometer is used to examine the health of your lungs by measuring inspiratory volume. This means that an incentive spirometer measures how well you are filling your lungs with each breath. Though typically used for people recovering from surgery or with conditions such as chronic obstructive pulmonary disease (COPD) and asthma, an incentive spirometer is used by people who need to exercise their lungs.

*For optimal lung expansion with the incentive spirometer, the client should assume a semi-Fowler’s or high Fowler’s position. The mouthpiece should be covered completely and tightly while the client inhales slowly, with a constant flow through the unit. When maximal inspiration is reached, the client should hold her breath for 2 or 3 seconds and then exhale slowly.

How to monitor Water Seal Chamber?

- The presence of fluctuation of the fluid level in the water-seal chamber indicates a patent drainage system.

With normal breathing, the water level rises with inspiration and falls with expiration.

*Fluctuation stops if the tube is obstructed, if the suction is not working properly, or if the lung has re-expanded.

What if the Chest Drainage System is dislodge from the insertion site?

If the chest drainage system is dislodged from the insertion site;

  • The nurse immediately applies sterile gauze over the site and calls the physician.
  • The nurse would maintain the client in an upright position.
  • A new chest tube system may be attached if the tube requires insertion, but this would not be the next action.

*Pulse oximetry readings would assist in determining the client’s respiratory status, but the priority action would be to call the physician.

What is leflunomide (Arava)?

- It is an immunomodulatory agent and has an anti-inflammatory action.

The medication provides symptomatic relief of rheumatoid arthritis. Diarrhea can occur as a side effect of the medication.

What is Lochia?

- Lochia is the uterine discharge present after birth, initially is bright red and may contain small clots.

During the first 2 hours after birth, the amount of uterine discharge should be approximately that of a heavy menstrual period. After that time, the lochial flow should steadily decrease and the color of the discharge should change to a pinkish red or reddish brown.

*This is a normal as expected occurrence.
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