informationfornurses

Here is a small management plan for constipation. Though some of us consider it as frivolous matter, it could have result in lot of repercussions in patient’s health.  Nursing management of patient with constipation:-  

-         asses the general condition of patient -         provide privacy -         provide squatting position -         Provide fiber rich food including fruits vegetables etc. -         provide adequate food -         maintain a habit of  expulsion in a fixed time -         provide a relaxed environment -         give him small exercise -         avoid certain drugs like sedatives -         give him plenty of fluids-         give laxatives or suppository/enema as per order of doctor  

Thanks nurses, don’t ever ignore a patient complaining of constipation. Do what you can do best in a conventional way. If you can’t manage it, report it to doctor.  

All the hot nursing procedures down your way in coming days …….

HELLO
Florence Nurses. Here is an article related to GBS.Read more and enlightens yourself ………

Guillain Barre Syndrome is an autoimmune peripheral neuropathy or we call it as acute inflammatory polyneuropathy, in which we can see an ascending paralysis from the lower limps to face and there was obvious loss of deep tendon reflexes.

When there is any infection, the immune system directs the attacks to foreign antigens (but here it was gangliosides in the nervous tissue (nodes of ranvier)), and that results in inflammation of the myelin and conduction block. Loss of deep tendon reflexes, muscle paralysis of the legs, face, diaphragm, etc happens in this case. There may be loss of proprioception (position sense), rubbery legs etc as result of GBS.Electromyogram will show the demyelination changes and there should be no fever, csf showing increased protein count without any pleocytosis (increased cell count), al these help you to pinpoint it as a GBS.

RX – high dose immunoglobins or plasmapheresis will do the job.

Nursing care-

-         take care of the ADL of the patient

-         check the vitals and monitor

NURSES, just like us there has been other life savers like NSG commandos, all defence personal, who sacrificed their precious lives for rescuing innocent lives in various terror sites of Mumbai.

Finally it was end for all the terror havoc. SIGH …………

For a minute let us pray for all the innocent souls and the unsung heroes who fought to save the lives.

Studious nurses – oh we don’t seem to have a problem in diagnosing a patient with shuffling gait or a festination. Do we??

I hope every Nurse’s answer must be “NO”.

Parkinsonism is degenerative disorder of CNS, was a movement disorder, happens because of lack of the dopamine which was produced in the dopaminergic neurons of brain.Genetic, environmental toxins, head trauma, cerebral anoxia are the reasons for the development of the Parkinsonism. The dopaminergic pathway of brain was in right in the case of Parkinsonism (left in normal).There was ostensible loss of dopamine secreting cells from the substantia nigra. While doing the positron emission topography will give a clear picture of lack of dopamine activity in the substantia nigra.

Possible signs and symptoms:-

1. tremor
2. rigidity
3. bradykinesia/ akinesia
4. postural instability
5. shuffling gait
6. decreased arm swing
7. stooped forward flexed posture
8. festination(stooped posture, imbalance, short steps)
9. hypophonia
10. drooling
11. dysphagia
12. mask like face (hypomimia)
13. akathesia(inability to sit)
14. micrographia (small cramped writing)
15. depression
16. dementia

Rx- using combination of levodopa and carbidopa (sinemet or duodopa)

-         Using the deep brain stimulation and pallidotomy.

-         Number of drugs is limited in use for its side effects.

Nursing care-

-         we should take care of the safety of the patient

-         always get one relative with patient while walking as there is more chance to fall

-         give health education about the exercise to be done for the right rehabilitation

-         psychological support

Multiple sclerosis is the autoimmune disorder in which there was immune system attacks the CNS and there was demyelination of the white matter of the brain and spinal cord, making the conduction of the nerve impulses impossible. When we check the signs and symptoms of the patient may present with any of the following – nystagmus, diplopia. Double vision, dysarthria, ataxia, dysphagia, optic neuritis, hypoesthesia, parasthesia, depression.

We can easily diagnose through the MRI of the brain( see active lesions), lumbar puncture (CSF shows the oligoclonal bands) , less response to the optic and sensory perception ( due to demyelination of the neural pathway).

In MS actually the Oligodendrocytes are destroyed which are responsible for formation of white matter.

And T-cells gain entry into the blood brain barrier ( this happens when there is any viral infections) and the T-cells see the myelin as foreign and start to destroy the myelin and thus we gets the MS.

The genetic, environmental, infection, viral are causative factors of the MS. It was proved that low vitamin D causes the MS.

RX—-intravenous corticosteroids like methylprednisolone are given even if there lot of side effects like osteoporosis, impaired memory.

Disease modifying drugs —- 1. 2 formulation of interferon beta 1-a

2. Interferon beta 1-b

3. Glatiramer acetate

4. Mitoxantrone (immunosuppressant)

5. Natalizumab

Hello friends, what will we do if our nerve signal is not passing to the motor end plate of the muscle fibres? Certainly, we would be in trouble, friends that are the same case with mYAtheNIa GraViS patients. We can see one condition here …….enjoy the NEURO RIDE$$$$

Myasthenia gravis is the neuromuscular autonomous disorder in which there is severe muscle weakness and fatigability, and it was an autoimmune disorder in which autoantibody block the acetylcholine receptors at the post synaptic neuromuscular junctions. As we go through the clinic side, we can see most of the patient often complaints of the extreme fatigue and the would be weakness of muscles of either eyes (ophthalmic myasthenia) , face ,swallowing , limps etc. there may be complaints of dysphagia, dysarthria , diplopia. In sever cases like myasthenia crisis we can see the respiratory muscle weakness may lead to death of patient unless you give them immediate ventilation. Actually the auto antibodies are self dangerous and directed towards the receptors at the motor end plate and they are produced by the plasma cells which are developed from the T-cells (thymus gland). So there is no wonder to suspect any MG for a patient who is having the thymus problems like thrymoma, infections etc. in some cases, the auto antibodies produced may be directed towards muscle specific kinase which is essential to produce the neuromuscular junctions. We can also expect the symptoms of myasthenia gravis in the patients treating with penicillamine since they are having the same antibodies. When we were baffled to put a diagnosis, we could reach a decision only after a through physical examination. We can see improvement in the fatigue for the patient who got some rest and it may worsen after some time. We can see the same after applying the ice for some time. We should do some physical examination like testing the muscle strength, we can test through making them to looking upwards and sideward for sometime( to figure out the diplopia and double vision) , looking at the feet, arm stretching, knee bending, sit ups etc. we can figure out through the repeated nerve test. And endorphonium test is helpful tool to diagnose the MG, in which we can give intravenous administration of endorphonium chloride or neostigmine and that will improve the block at the acetylcholine receptors and there would be improvement in the muscle weakness if it is a case of MG.

Rx- medicine like actylcholinestrase inhibitors like neostigmine or pyridostigmine, that will reduce the action of cholinesterase at the junction and they were given at low doses and slowly improving the dose.

Other medicine like immunosuppressive drugs –azathioprine, prednisone, cyclosporine, to improve the autoimmune dysfunction.

Plasmapheresis and intravenousimunoglobins (IVIG) are given to flush out the antibodies from the blood, as last resort.

Thymectomy is the surgical option in the case of any thymus abnormalities.

As nurse we must give the best care to them and they we should monitor the vital signs as there is good chance to get them myasthenia crisis. When we are giving the medicines

Don’t wonder when your patient screaming around like a pain stricken kid , as you are efficient nurse you can easily diagnose it as TRIGEMINAL NEURALGIA if the pain is confined to the face. Study the med surg and read the article below to enrich you more.

TRIGEMINAL NEURALGIA is a neurological disease (trigeminal nerve, Vth mixed cranial) in which patient experiences severe intractable, shock like, stabbing pain in the different areas of the face. Other names are tic doloureux or prosopalgia. Compression from the blood vessel damage the myelin sheath lead to hyperactivity of the nerve and pain signal is rarely shut down. Even the slightest touch or air current may trigger the TN.

Medication used to RX the TN are 1. Oxacarbazepine, 2.Phenytoin3. Topiramate4. Gabapentin 5 Clonanzepam 6. Baclofen 7. Methadone (opiod) 8. Oxocodone9. antidepressants10. Butox injection directly to the nerve 11. Glycerol injections

Surgical options available 1. Micro vascular decompression 2. Balloon compression 3. Radiofrequency rhizotomies 5. Gamma knife radiation surgery

Hello nurses we must take care of the patient at the fullest; for that we can make use of the following methods to relive the shock like pain that patient is experiencing.
a. apply icepacks
b. give adequate rest
c. make him calm
d. provide healthy nutritious diet
e. avoid all the nerve stimulants like tea ,coffee, alcohol
f. give lot of fluid to drink
g. give psychological support
h. provide health education to patient and relatives
i. start to plan the rehabilitative efforts

Soon catch you all ….. march to the ward

Hello nurses, did u ever get a chance to work in Neuro ICU? , oh it’s really fun.we discuss some interesting diseases related to neurology.

Bells palsy is the unilateral facial paralysis in which, facial nerve got compressed in the narrow bone canal below the ear as result of the inflammation and swelling of the facial nerve(cranial nerve V11.Herpex simplex virus is one of the reason for the bells palsy. in some cases paralysis occurs as result of the demyelination of the facial nerve. Eye in the affected side are unable to close and cornea must be protected from drying and otherwise lead to blindness. Other disease like stroke, tumor, and Lyme disease may cause the facial paralysis, so we should able to figure out the exact reason of paralysis. Usually RX with anti-inflammatory (prednisone) or anti viral drugs (acyclovir).

Complications we see most often are loss of taste (ageusia), chronic facial paralysis, and corneal infections.

As nurses we should take care of the psychological aspect of the patient and we should protect the patient’s eye from drying. We should cover the eye with eye pad. We can give ointment, eye drops as per ophthalmologist or neurologist order.

Hello nurses, try every best to enrich your medical knowledge and nursing skills.Here is an article related to epilepsy. Read and enlighten yourself.

We do have a time, when epilepsy or seizures are considered as disease in which associated with lot of social stigma and the resulting frustrations. Epilepsy occurs when there is abnormal electrical activity of brain. Unfortunately we can only control the disease not cure the disease and it is considered as group of syndromes rather than single disorder. Some of the them is life long and others confined to childhood only.

Primary reading epilepsy is the one in which epilepsy originates when patient reads something. While, Photosensitivity epilepsy occurs when there is flash of light. Interestingly, Catamenial epilepsy is the one in which associated with menstruation.

In Emergency we can make into a safe position, prevent self injury, keep away all the sharp objects and place soft thing under the head if you can, and don’t use more physical force and if it continues more time, then we should prevent him going to status epilepticus and some may go into sleep after a epilepsy or become confused, so we should reassure him and give comfortable position and observe him until he returns to normal.

Bromide is the first anticonvulsant used in the history and today there were 19 medication used to treat the epilepsy: they are
1. carbamazepine(tegretol)
2. clorezepate(transxene)
3. clonanzepam(klonopin)
4. ethozuximide(zarontin)
5. felbamate(felbatol)
6. fosphenytoin(cerebyx)
7. gabapentin(neurontin)
8. lamotrigine(lamictal)
9. levetiracetam(leppra)
10. oxacarbazepine(trileptal)
11. Phenobarbital(luminal)
12. topiramate(topamax)
13. phenytoin(dilantin)
14. valproate semi sodium(depakote)
15. tiagabine(gabitril)
16. pregabalin(lyrica)
17. primidone(mysoline)
18. valproic acid (depakene)
19. zonisamide(zonigran)

Other dugs which used are 1. Phenobarbital (Nembutal), 2. Diazepam (valium)3. Lorazepam (ativan)
Drugs used to RX the Status epilepticus are
1. Paraldehyde 2. Midazolam

Palliative surgeries are used to prevent the frequency and severity of the disease. They are 1. Callosotomy 2. Commisurotomy

One of the intractable epilepsy is temporal lobe epilepsy in which we do anterior temporal lobectomy or we do the remove the front portion of temporal lobe including the amygdale or hippocampus in which we call as Amygdalahippocampectomy.
Other methods use are deep brain stimulation, vagus nerve stimulation and avoidance therapy.

As nurses we could gain experience only if we were able to work in neurosurgery department. There we can see lot of these patients; we can learn how we could give holistic care to patients, supporting all our scientific principles.

See you guys with more interesting stuffs

Hello friends, did u ever scrambled around to find IELTS writing topics, here are few original questions which I collected from a coaching institute….. So are u ready to take the IELTS writing essays. Grabbbb good band score.

June 1 2002
Soon people who cannot work with computers will be disadvantaged. To what extent do you agree or disagree with this idea?
Sep 12 2002
Task 1: Write a letter to a bus company saying you have left something valuable on the bus and tell them what to do if they find it.
Task 2: Nowadays, radio is being replaced by TV and the Internet. To what extent do you agree or disagree with this idea?
?
These days, schools introduce behaviour of what is ‘right’ or ‘wrong’. This responsibility is not only parents’. To what extent do you agree or disagree?
13 Feb 2003
Education is a lifelong task. Do you agree or disagree?
14 Feb 2003
Young people are encouraged to travel or work for one year after high school and before university studies. Write the advantages and disadvantages of this matter.
OR
Young people are encouraged to travel or work for one year after high school and before university studies. Do you think it is a good idea to do so?
March 3 2003
Task 1: You have recently moved to a new house. There has been damage after you have moved into the house. Write a letter to your landlord explaining what has happened and ask him what you can do.
Task 2: Nowadays, people care about their appearance more than before. Do you agree or disagree?
7 March 2003
Governments should spend more money on education than on recreation and sports. Do you agree or disagree?
9 March 2003
Technology has facilitated our lives so much and given us a lot of freedom. Some people, however, believe that it has caused more problems for us. What is your opinion?

Hello.,, catch these terminology which I am sure will rejuvenate u ,,,, 

Bolus: A mass of food or medication which isadministered as a single dose.Blood-brain barrier: that tissue which preventsdamaging substances from reaching the cerebrospinalfluid and brain tissue via the circulation..Central venous BP: Blood pressure within agreat vein or a heart chamber. 

Blepharotomy: A surgical incision of the eyelid(s). 

Bituminosis: A form of pneumoconiosis — theetiology of which is exposure to bituminous coaldust.Bitot’s spots: Shiny, triangular, gray marks —seen on the conjunctivae of patients withVitamin A deficiency.Benedikt’s syndrome: Neurological lesions whichproduce hemiplegia with oculomotor paralysisand clonic tremor/spasm on the involved side.Best’s disease: A rare, inherited macular degeneration,for which there is no hope of cure.

Babcock’s operation: The eradication of varicosities.