Nursing Quotes

I promised my doctor only one cup a day

Funny Quotations

دہلی میں 5سٹار ہوٹل بھی محفوظ نہ رہا، عیاشوں کی نرس کے ساتھ درندگی

نیو دہلی (نیوز ڈیسک) بھارتی وزیراعظم کی طرف سے ملک کے یوم آزادی پر خواتین کے خلاف جنسی جرائم کا ماتم کیا گیا اور اسی دن دارالحکومت کے ایک مشہور فائیو سٹار ہوٹل میں ایک نرس کو بدترین جنسی درندگی کا نشانہ بنا دیا گیا۔ ڈپٹی پولیس چیف کرونا کرن کا کہنا ہے کہ دو ملزمان کو گرفتار کرلیا گیا ہے اور نرس کا طبی معائنہ مکمل ہونے کے بعد اس کی نفسیاتی کونسلنگ کی جارہی ہے اطلاعات کے مطابق درندگی کا نشانہ بنائی جانے والی نرس کو دہلی کے عالمی شہرت یافتہ اوبرائے ہوٹل کے مالک کی بیمار بیوی کی دیکھ بھال کیلئے مقرر کیا گیا تھا۔ ایک اور پولیس افسرنے خبر رساں ایجنسی اے ایف پی کو بتایا کہ ابتدائی معلومات کے مطابق ملزمان نرس کو زبردستی اٹھاکر اپنے کمرے میں لے گئے اور اسے اجتماعی زیادتی کا نشانہ بنایا۔ ملزمان نے اس کی عصمت دری کے بعد اسے خطرناک دھمکیاں دے کر چھوڑ دیا لیکن جب جمعہ کے روز انہوں نے دوبارہ اس پر حملہ آور ہونے کی کوش کی تو اس نے سارا معاملہ اپنے خاوند کے سامنے رکھ دیا۔ ہوٹل کی نمائندہ دیپکا شرمانے بتایا کہ ملزمان ہوٹل کے ملازم نہیں ہیں اور ان کے خلاف تحقیقات میں پولیس کے ساتھ مکمل تعاون کیاجارہا ہے۔

مردوں کا علاج، ISISکی جانب سے خاتون ڈاکٹر کو سخت ترین سزا

دمشق (مانیٹرنگ ڈیسک) خبر رساں ویب سائٹ ’’المصور نیوز‘‘ نے انکشاف کیا ہے کہ دولت اسلامی عراق و شام (آئی ایس آئی ایس) نے دیرالزور شہر سے ایک خاتون ڈینٹسٹ کو مرد مریضوں کا علاج کرنے کے جرم میں گرفتار کرکے قتل کردیا ہے۔ ویب سائٹ کے مطابق خاتون ڈاکٹر دوحہ دیاب کو دو دن قبل گرفتار کیا گیا اور بغیر کسی عدالت میں مقدمہ چلائے بغیر انتہائی مختصر وقت میں ہی اس کے قتل کا فیصلہ کردیا گیا۔ شامی حکومت کا کہنا ہے کہ اسی شہر میں پچھلے ایک ہفتہ کے دوران 700 شہریوں کو قتل کیا جاچکا ہے۔ دیرالزور شہر کے قبائل اور آئی ایس آئی ایس کے درمیان مفاہمت پچھلے دو ہفتون کے دوران شدت اختیار کرچکی ہے

وزن کم کرنے کے لئے ’ڈائٹنگ ‘کا سہارا لینے والے افراد خبردار ہو جائیں

ہیلسنکی (نیوزڈیسک) دنیا بھر میں وزن گھٹانے کے لئے ڈائیٹنگ (پرہیزی غذا) پر خصوصی توجہ دی جاتی ہے، کیوں کہ وزن گھٹانے میں غذا اہم کردار ادا کرتی ہے لیکن ایک نئی تحقیق نے اس نظریہ کو غلط قرار دیدیا ہے، جس کی مختلف وجوہات بیان کی گئی ہےں۔ تحقیق کے مطابق وزن گھٹانے کے لئے ایسی غذاﺅں سے پرہیز کیا جاتا ہے، جن میں کاربوہائیڈریٹس کی تعداد زیادہ ہوتی ہے، لیکن اس پرہیز کی وجہ سے جسم کو کاربوہائیڈریٹس کی طلب کا شدت سے احساس ہوتا ہے اور یہ کمی نتیجتاً زیادہ بھوک لگانے کا باعث بنتی ہے، جو بعدازاں وزن بڑھا دیتی ہے۔ دوسرا پرہیزی غذا میٹابولز میں بھی مسائل پیدا کرتی ہے، جو چھوٹے پٹھوں کے ضیاع کا باعث ہے اور بعدازاں یہی چیز دوبارہ وزن بڑھانے کا سبب بن جاتی ہے۔ اس تحقیق کا تیسرا اور دلچسپ پہلو یہ ہے کہ ماہرین کے مطابق وزن بڑھنے اور گھٹنے کا تعلق انسانی جینز پر بھی منحصر ہے۔ بعض اوقات انہیں جینز کی وجہ سے ایسا ہوتا ہے کہ ڈائیٹنگ کرنے پر وزن گھٹنے کے بجائے بڑھ جاتا ہے۔ فن لینڈ کے ماہرین نے اس نظریہ کی تشریح کے لئے 4ہزار 129 جڑواں افراد (1922مرد اور 2207خواتین) کو اپنی تحقیق کا حصہ بنایا۔ ماہرین نے 16،17،18اور 25سال کی عمر رکھنے والے ان جڑواں افراد سے ان کے قد، وزن، عمومی صحت اور سماجی تعلقات کے حوالے سے سوالات کئے، جن کا تجزیہ کرنے کے بعد یہ حقائق سامنے آئے کہ 34 فیصد خواتین اور 24 فیصد مردوں نے زندگی میں وزن کم کرنے کی ایک شعوری کوشش کی، جس سے ان کا 5کلو گرام وزن کم ہوا، جبکہ 15 فیصد خواتین اور 10 فیصد مردوں نے زندگی میں دوبار وزن کم کرنے کی شعوری کوشش کی۔ اس تحقیق میں دلچسپ نتیجہ یہ سامنے آیا کہ وہ لوگ جنہوں نے کبھی بھی وزن کم کرنے کی شعوری کوشش نہیں کی وہ شعوری کوشش کرنے والوںکی نسبت زیادہ وزن گھٹانے میں کامیاب رہے، بلکہ جنہوں نے وزن گھٹانے کی شعوری کوشش کی، وہ اس دوران وزن کم کرنے کے بجائے بڑھا بیٹھے، اور ایسا صرف ان کے جینز کی وجہ سے ہوا۔ تحقیق کے آخر میں ماہرین کا کہنا تھا کہ وزن گھٹانے کے لئے غذا کم نہیں کرنی چاہیے بلکہ اس کا استعمال سمجھداری، احتیاط اور مناسب مقدار میں کریں۔ اس کے علاوہ وزن گھٹانے کے لئے روزانہ 30 منٹ کی ورزش کو ضرور معمول بنائیں۔

معدہ کو طاقتور بنانے کیلئے عرق الائچی کا استعمال کیا جائے،

لاہور(پ ر) ،محمد علی جناح میڈیکل کمپلیکس کے چیئرمین بشیر مہدی نے کہا ہے کہ تلی ہوئی اورچٹ پٹی اشیاء کھانے سے معدہ کمزور ہوجاتا ہے جس سے مختلف بیماریاں پید ا ہوتی ہیں،معدہ کو طاقت ور بنانے کے لئے عرق الائچی کا استعمال کیا جائے ،ایک بیان میں انہوں نے کہاکہ ہماری تقریبات میں پھل اور سبزیوں کااستعمال نہیں ہوتا بلکہ مٹھائیاں اور مرچوں سے بھر پوراشیاء ہوتی ہیں جن کے کھانے سے عوام مختلف بیماریاں پیدا ہوتی ہیں،عوام میں مٹھائیوں کے بجائے پھل کے استعمال کے لئے شعور اجاگر کیا جائے ،عوام کو بتایا جائے کہ مٹھائیوں کے استعمال سے کون کون سی بیماریاں پیدا ہوتی ہیں،ملاوٹ شدہ مصالحہ بہت ہی نقصان پہنچاتے ہیں،بازاری کھانوں میں ناقص مصالحے استعمال کئے جاتے ہیں جن سے انسان بہت جلد بیماریوں میں گھر جاتا ہے اور اس کے لئے بہت سے مشکلات پیدا ہوتی ہیں،بازاری کھانوں سے ہرممکن پرہیزکیا جائے،
گھر میں پکے کھانوں کو ترجیحی دی جائے ،صاف برتنوں میں کھانا کھایاجائے اورکھانے سے قبل ہاتھ ضروردھوئے جائیں 

افریقی ملک میں ڈاکٹروں کو ہڑتال کرنا بہت مہنگا پڑا

ابوجا (نیوز ڈیسک) ہمارے ہاں ینگ ڈاکٹر گاہے گاہے ہڑتال کرتے رہتے ہیں مگر تاحال اس مسئلے کا کوئی پائیدار حل تلاش نہیں کیا جاسکا، نائجیریا میں بھی ڈاکٹروں نے حکومت کے خلاف ہڑتال کر دی لیکن حکومت نے بلا جھجھک اس مسئلے کا مستقل حل کرتے ہوئے 16000 ڈاکٹروں کو ملازمت سے فارغ کردیا۔ صدر گڈ لک جوناتھن نے سارے ملک کے سرکاری ہسپتالوں کے ہڑتالی ڈاکٹروں کو برخاست کرنے کی منظوری دے دی ہے۔ ڈاکٹروں کو حکومت سے شکایت تھی کہ ان کے ساتھ کئے گئے وعدوں پر عمل نہیں کیا گیا تھا جس پر یکم جولائی سے ہڑتال پر چلے گئے تھے۔ حکومت نے اپنے بیان میں کہا ہے کہ صحت کے شعبے کو درپیش مسائل کے حل کیلئے یہ اقدام کیا گیا ہے۔ ریذیڈنٹ ڈاکٹروں کو فارغ کئے جانے سے جو خلا پیدا ہوا ہے اسے پر کرنے کیلئے ہسپتالوں کو ایڈمنسٹریٹرز کو حکم دیا گیا ہے کہ وہ چھ ماہ کے کنٹریکٹ پر جزوقتی ڈاکٹر بھرتی کریں۔ دوسری جانب نیشنل ایسوسی ایشن آف ریذیڈنٹ ڈاکٹرز کے چیئرمین بریل عبدالائی نے صدر کے فیصلے کو خلاف قانون قرار دیا ہے اور خصوصاً ریذیڈنسی ٹریننگ پروگرام کے معطل کئے جانے کو سخت تنقید کا نشانہ بنایا ہے

پر سکون نیند کےلئے مفید غذائیںFood for good sleep

Food for Good Sleep
پیرس (نیوز ڈیسک) دن بھر کی مصروفیت اور تھکاوٹ کے بعد اچھی اور پرسکون نیند بہت ضروری ہوتی
 ہے کیونکہ اس کے بغیر ہم اگلے دن کیلئے تازہ دم نہیں ہوسکتے۔ دور جدید کے مسائل اچھی نیند کے حصول کو بہت مشکل بنا چکے ہیں اور اگر آپ بھی اس مسئلہ کا شکار ہیں تو مندرجہ ذیل تدابیر آپ کی مدد کرسکتی ہیں۔
-1 دودھ کو روزمرہ غذا کا لازمی حصہ بنائیں کیونکہ یہ معدے کی تیزابیت کو ختم کرتا ہے اور جسم کو پرسکون رکھتا ہے۔
-2 اگرچہ چائے اور کافی نیند کیلئے منفرد اثرات کی حامل ہیں لیکن سبز چائے ایک مفید مشروب ہے کیونکہ اس میں پائی جانے والی تھیانین پرسکون میں مدد دیتی ہے

Lady Health Worker injured in Hangu Firing May 31, 2014

Lady Health Worker injured in Hangu Firing by abbtakktv

Bloody reporting of media.
#ExpressNews reporting that Malaria vaccine were given orally to children.
They did not even knew that vacines were of measles and it was administred intramuscularly see in photo

27 students hospitalised after vaccination... by awaztoday101

Measles Vaccine side effets in KPK

Above 100 children effected by measles vaccines in KPK.

SPSS guide free download

Applied Statistics download free

Content

Preface

1. Descriptive Statistics
   1. Introduction
   2. Descriptive Statistics
   3. Frequency Distributions
   4. Graphical Presentation
   5. Summation Notation
   6. Numerical Methods for Summarizing Quantitative Data
   7. Some Properties of the Numeric

Health benifits of walking In Urdu

Lady that coudlnot get sleep since 30 years !

Sarghoda(Web Desk) A female which couldnot get to sleep since 30 years. Resident of Kot Raja Zubaida Bibi suffers from an unknown disease when she was 10. since than she could not sleep even for a minute. family members said that nothing left behind for her treatment, now she is been treated with traditional Hakeems.

Appeal for financial assisstance.

Obs and Gynae NCLEX questions

Topics

• Obstetrical Nursing
• Antepartal Care
• GTPAL Questions
• Preeclampsia

Guidelines

• Read each question carefully and choose the best answer.
• You are given one minute per question. Spend your time wisely!
• Answers and rationales are given below. Be sure to read them.
• If you need more clarifications, please direct them to the comments section.

Questions

1. A nursing instructor is conducting lecture and is reviewing the functions of the female reproductive system. She asks Mark to describe the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH). Mark accurately responds by stating that:

1. FSH and LH are released from the anterior pituitary gland.
2. FSH and LH are secreted by the corpus luteum of the ovary
3. FSH and LH are secreted by the adrenal glands
4. FSH and LH stimulate the formation of milk during pregnancy.

2. A nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse accurately tells the client that fetal circulation consists of:

1. Two umbilical veins and one umbilical artery
2. Two umbilical arteries and one umbilical vein
3. Arteries carrying oxygenated blood to the fetus
4. Veins carrying deoxygenated blood to the fetus

3. During a prenatal visit at 38 weeks, a nurse assesses the fetal heart rate. The nurse determines that the fetal heart rate is normal if which of the following is noted?

1. 80 BPM
2. 100 BPM
3. 150 BPM
4. 180 BPM

Nursing Process NCLEX Questions

Topics

• Nursing Process

Guidelines                                             Answers here

• Read each question carefully and choose the best answer.
• You are given one minute per question. Spend your time wisely!
• Answers and rationales are given below. Be sure to read them.
• If you need more clarifications, please direct them to the comments section.

24 Questions

1. Once a nurse assesses a client’s condition and identifies appropriate nursing diagnoses, a:

1. Plan is developed for nursing care.
2. Physical assessment begins
3. List of priorities is determined.
4. Review of the assessment is conducted with other team members.

2. Planning is a category of nursing behaviors in which:

1. The nurse determines the health care needed for the client.
2. The Physician determines the plan of care for the client.
3. Client-centered goals and expected outcomes are established.
4. The client determines the care needed.

3. Priorities are established to help the nurse anticipate and sequence nursing interventions when a client has multiple problems or alterations. Priorities are determined by the client’s:

1. Physician
2. Non Emergent, non-life threatening needs
3. Future well-being.
4. Urgency of problems

4. A client centered goal is a specific and measurable behavior or response that reflects a client’s:

1. Desire for specific health care interventions
2. Highest possible level of wellness and independence in function.
3. Physician’s goal for the specific client.
4. Response when compared to another client with a like problem.

NCLEX 80 Q & A with rationals

Topics

• Liver Failure
• Liver Disorders
• Ostomy Care

Guidelines

• Read each question carefully and choose the best answer.
• You are given one minute per question. Spend your time wisely!
• Answers and rationales are given below. Be sure to read them.
• If you need more clarifications, please direct them to the comments section.

Questions and Answers

1. A patient with chronic alcohol abuse is admitted with liver failure. You closely monitor the patient’s blood pressure because of which change that is associated with the liver failure?

1. Hypoalbuminemia
2. Increased capillary permeability
3. Abnormal peripheral vasodilation
4. Excess rennin release from the kidneys

2. You’re assessing the stoma of a patient with a healthy, well-healed colostomy. You expect the stoma to appear:

1. Pale, pink and moist
2. Red and moist
3. Dark or purple colored
4. Dry and black

3. You’re caring for a patient with a sigmoid colostomy. The stool from this colostomy is:

1. Formed
2. Semisolid
3. Semiliquid
4. Watery

4. You’re advising a 21 y.o. with a colostomy who reports problems with flatus. What food should you recommend?

1. Peas
2. Cabbage
3. Broccoli
4. Yogurt

5. You have to teach ostomy self care to a patient with a colostomy. You tell the patient to measure and cut the wafer:

1. To the exact size of the stoma.
2. About 1/16” larger than the stoma.
3. About 1/8” larger than the stoma.
4. About 1/4″ larger than the stoma.

6. You’re performing an abdominal assessment on Brent who is 52 y.o. In which order do you proceed?

1. Observation, percussion, palpation, auscultation
2. Observation, auscultation, percussion, palpation
3. Percussion, palpation, auscultation, observation
4. Palpation, percussion, observation, auscultation

7. You’re doing preoperative teaching with Gertrude who has ulcerative colitis who needs surgery to create an ileoanal reservoir. Which information do you include?

1. A reservoir is created that exits through the abdominal wall.
2. A second surgery is required 12 months after the first surgery.
3. A permanent ileostomy is created.
4. The surgery occurs in two stages.

8. You’re caring for Carin who has just had ileostomy surgery. During the first 24 hours post-op, how much drainage can you expect from the ileostomy?

1. 100 ml
2. 500 ml
3. 1500 ml
4. 5000 ml

NCLEX qquestions

Answers and Rationale of Questions

1. Answer: 1. Blood pressure decreases as the body is unable to maintain normal oncotic pressure with liver failure, so patients with liver failure require close blood pressure monitoring. Increased capillary permeability, abnormal peripheral vasodilation, and excess rennin released from the kidney’s aren’t direct ramifications of liver failure.

2. Answer: 2. Good circulation causes tissues to be moist and red, so a healthy, well-healed stoma appears red and moist.

3. Answer: 1. A colostomy in the sigmoid colon produces a solid, formed stool.

4. Answer: 4. High-fiber foods stimulate peristalsis, and a result, flatus. Yogurt reduces gas formation.

5. Answer: 2. A proper fit protects the skin, but doesn’t impair circulation. A 1/16” should be cut.

6. Answer: 2. Observation, auscultation, percussion, palpation

7. Answer: 4. An ileoanal reservoir is created in two stages. The two surgeries are about 2 to 3 months apart. First, diseased intestines are removed and a temporary loop ileostomy is created. Second, the loop ileostomy is closed and stool goes to the reservoir and out through the anus.

8. Answer: 3. The large intestine absorbs large amounts of water so the initial output from the ileostomy may be as much as 1500 to 2000 ml/24 hours. Gradually, the small intestine absorbs more fluid and the output decreases.

9. Answer: 2. To avoid overloading the small intestine, encourage the patient to eat six small, regularly spaced meals.

10. Answer: 2. Making observations about what you see or hear is a useful therapeutic technique. This way, you acknowledge that you are interested in what the patient is saying and feeling.

11. C After a Billroth II procedure, a large amount of hypertonic fluid enters the intestine. This causes extracellular fluid to move rapidly into the bowel, reducing circulating blood volume and producing vasomotor symptoms. Vasomotor symptoms produced by dumping syndrome include dizziness and sweating, tachycardia, syncope, pallor, and palpitations.

12. A Gastric emptying time can be delayed by omitting fluids from your patient’s meal. A diet low in carbs and high in fat & protein is recommended to treat dumping syndrome.

13. B Ascites puts pressure on the diaphragm. Paracentesis is done to remove fluid and reducing pressure on the diaphragm. The goal is to improve the patient’s breathing. The others are signs of cirrhosis that aren’t relieved by paracentesis.

14. A A full bladder can interfere with paracentesis and be punctured inadvertently.

15. B Cover the organs with a sterile, nonadherent dressing moistened with normal saline. Do this to prevent infection and to keep the organs from drying out.

16. A Asterixis is an early neurologic sign of hepatic encephalopathy elicited by asking the patient to hold her arms stretched out. Asterixis is present if the hands rapidly extend and flex.

17. A You may administer the laxative lactulose to reduce ammonia levels in the colon.

18. A Achalasia is characterized by incomplete relaxation of the LES, dilation of the lower esophagus, and a lack of esophageal peristalsis. Because nitrates relax the lower esophageal sphincter, expect to give Isordil orally or sublingually.

19. C Eating in the upright position aids in emptying the esophagus. Doing the opposite of the other three also may be helpful.

20. C Pancreatitis involves activation of pancreatic enzymes, such as amylase and lipase. These levels are elevated in a patient with acute pancreatitis.

21. D The normal range of specific gravity of urine is 1.010 to 1.025; a value of 1.030 may be seen with dehydration.

22. C Teach the pt to avoid activities that increase intra-abdominal pressure such as coughing, sneezing, or straining with a bowel movement.

23. C Because obesity weakens the abdominal muscles, advise weight loss for the patient who has had a hernia repair.

24. B After a liver biopsy, the patient is placed on the right side to compress the liver and to reduce the risk of bleeding or bile leakage.

25. A Signs and Symptoms of pneumothorax include dyspnea and decreased or absent breath sounds over the affected lung (right lung).

26. A An NG tube is inserted into the patients stomach to drain fluid and gas.

27. A Aspirating the stomach contents confirms correct placement. If an X-ray is ordered, it should be done immediately, not in 24 hours.

28. B TPN is given I.V. to provide all the nutrients your patient needs. TPN isn’t a tube feeding nor is it a liquid dietary supplement.

29. A Type A causes changes in parietal cells.

30. B Increasing fluids helps empty the stomach. A high carb diet isn’t restricted and fat intake shouldn’t be increased.

31. A Diarrhea d/t an acute episode of ulcerative colitis leads to fluid & electrolyte losses so fluid replacement takes priority.

32. D Sigmoidoscopy allows direct observation of the colon mucosa for changes, and if needed, biopsy.

33. C She needs a high-fiber diet and a psyllium (bulk laxative) to promote normal soft stools.

34. B Stools from ulcerative colitis are often bloody and contain mucus.

35. D One sign of acute diverticulitis is crampy lower left quadrant pain. A low-grade fever is another common sign.

36. C With acute pancreatitis, you need to rest the GI tract by TPN as nutritional support.

37. A The gallbladder is located in the RUQ and a frequent sign of gallstones is pain radiating to the shoulder.

38. D A Jackson-Pratt drain promotes wound healing by allowing fluid to escape from the wound.

39. D After creation of a colostomy, expect to see a stoma that is pink, slightly edematous, with some oozing. Bright red blood, regardless of amount, indicates bleeding and should be reported to the doctor.

40. A Only a small amount of skin should be exposed and more than 1/16” of skin allows the excretement to irritate the skin.

41. B Measuring abdominal girth provides quantitative information about increases or decreases in the amount of distention.

42. C Because the GI tract is functioning, feeding methods involve the enteral route which bypasses the mouth but allows for a major portion of the GI tract to be used.

43. B The first step in assessing the abdomen is to observe its shape and contour, then auscultate, palpate, and then percuss.

44. B Lowering the height decreases the amount of flow, allowing him to tolerate more fluid.

45. D Pancrelipase provides the exocrine pancreatic enzyme necessary for proper protein, fat, and carb digestion. With increased fat digestion and absorption, stools become less frequent and normal in appearance.

46. B Glucose level increases and diabetes mellitus may result d/t the pancreatic damage to the islets of langerhans.

47. D After surgery, she remains NPO until peristaltic activity returns. This decreases the risk for abdominal distention and obstruction.

48. D A brownish-black color indicates lack of blood flow, and maybe necrosis.

49. A Restricting fluids decrease the amount of body fluid and the accumulation of fluid in the peritoneal space.

50. D Dark green, leafy vegetables are rich in calcium.

51. A For pruritus, care should include tepid sponge baths and use of emollient creams and lotions.

52. D Rest periods and small frequent meals is indicated during the acute phase of hepatitis B.

53. D Hepatitis B can recur. Patients who have had hepatitis are permanently barred from donating blood. Alcohol is metabolized by the liver and should be avoided by those who have or had hepatitis B.

54. A To prevent venous stasis and improve muscle tone, circulation, and respiratory function, encourage her to move after surgery.

55. A Telling her not to worry minimizes her feelings.

56. A Diazepam is absorbed by the plastic I.V. tubing and should be given in the port closest to the vein.

57. A For the first few days to a week, slight bleeding normally occurs when the stoma is touched because the surgical site is still new. She should report profuse bleeding immediately.

58. D To wash away tissue debris and drainage effectively, irrigate the wound until the solution becomes clear or all the solution is used.

59. A Ammonia levels increase d/t improper shunting of blood, causing ammonia to enter systemic circulation, which carries it to the brain.

60. D Saline solution is isotonic, or close to body fluids in content, and is used along with sterile dressings to cover an eviscerated wound and keep it moist.

61. B Crohn’s disease penetrates the mucosa of the colon through all layers and destroys the colon in patches, which creates a cobblestone appearance.

62. A Stomach pain is often a late sign of stomach cancer; outcomes are particularly poor when the cancer reaches that point. Surgery, chemotherapy, and radiation have minimal positive effects. TPN may enhance the growth of the cancer.

63. C Melena is the passage of dark, tarry stools that contain a large amount of digested blood. It occurs with bleeding from the upper GI tract.

64. A A patient with an acute upper GI hemorrhage must be treated for hypovolemia and hemorrhagic shock. You as a nurse can’t diagnose the problem. Controlling the bleeding may require surgery or intensive medical treatment.

65. D To stabilize a patient with acute bleeding, NS or LR solution is given I.V. until BP rises and urine output returns to 30ml/hr.

66. A Initially, you should assess the patient’s knowledge about colostomies and how it will affect his lifestyle.

67. B An inflammatory condition that affects the surface of the colon, ulcerative colitis causes friability and erosions with bleeding. Patients with ulcerative colitis are at increased risk for bowel perforation, toxic megacolon, hemorrhage, cancer, and other anorectal and systemic complications.

68. C Medications to control inflammation such as corticosteroids are used for long-term treatment.

69. A Meats and beans are high-protein foods. In liver failure, the liver is unable to metabolize protein adequately, causing protein by-products to build up in the body rather than be excreted.

70. B A gastric residual greater than 2 hours worth of feeding or 100-150ml is considered too high. The feeding should be stopped; NG tube clamped, and then allow time for the stomach to empty before additional feeding is added.

71. C Frequent mouth care helps relieve dry mouth.

72. C Coffee-ground emesis occurs when there is upper GI bleeding that has undergone gastric digestion. For blood to appear as coffee-ground emesis, it would have to be digested for approximately 2 hours.

73. C Normally, drainage is bloody for the first 24 hours after a partial gastrectomy; then it changes to brown-tinged and then to yellow or clear.

74. D If the vagus nerve is cut as it enters the stomach, gastric acid secretion is decreased, but intestinal motility is also decreased and gastric emptying is delayed. Because gastric acids are decreased, gastric pH increases.

75. A Dosage problem. It’s 80/20 = 240/X. X=60.

76. A The output from an Ileostomy is described.

77. B As healing occurs from the bile duct, bile drains from the tube; the amount of bile should decrease. Teach the patient to expect dark green drainage and to notify the doctor if drainage stops.

78. C Misoprostol restores prostaglandins that protect the stomach from NSAIDS, which diminish the prostaglandins.

79. C

80. D

Read Questions here 

Glycogen storage disease

Sexual appearance of fetus at (second to third month) (third to fourth) and (at time of birth) of pregnancy

Factors Causing Hypokalemia and hyperkalemia

Factors Causing Hyperkalemia 

• Acidosis
• ACEI
• Beta-Blockers (Propanolol)
• Digitalis toxicity 
• Succinylcholine
• Renal Failure
• Mineralocorticoid deficiency (Hypoaldosteronism)
• Potassium-Sparing Diuretics (Spironolactone,Triamterene,Amiloride)
• Rhabdomyolysis 

Factors Causing Hypokalemia 

• Loop and Thiazide Diuretics

Maternity Blues,Postpartum Depression and Postpartum Psychosis

Impacts of Clinical Decision Support Technology on Nursing and Medical Practice in U.S. Critical Care

Abstract

Aims and Objectives: To identify and explore the perceived experiences of nurses and physicians with incorporating an automated clinical decision support system in their critical care practices.

Background: Technological advancement has created ethical practice dilemmas in critical care settings. Information technology and statistical analyses have the potential to both further complicate and to contribute to the resolution of changing practice patterns.

The decision support technology used by participants in this study was the Cerner Acute Physiological, Age and Chronic Health Evaluation (APACHE) III system. The key function of this type of system is to predict the outcomes of decisions made in real life situations. The Cerner APACHE III provides decision support for situations such as: patient transfer and triage, life sustaining treatments, ventilation, hemodialysis, or the discontinuation of certain treatments.

Design: Descriptive interview-based design using qualitative methods.  

Methods: Thirty-three healthcare clinical professionals working in a large U.S. medical center participated in in-depth interviews to describe their experiences integrating a clinical decision support system into their nursing or medical practices.

Results: Participants had strongly positive and negative impressions related to decision support system use in clinical practice. Participants opposed use of the computer as a “final decision maker” for patient care decisions, and had concerns about the issues of resource allocation so that insurers might acquire access to system information and use it to deny services or payments to patients. Some participants felt that it was unethical or unprofessional to withhold system statistical predictions from patients and family members.

Conclusions: The issues underlying critical care clinicians’ support or rejection of decision support technology must be examined more carefully to better define how to use this tool to optimally benefit patients and families and to better understand how use of these systems are influencing nursing or medical decision-making.

Clinicians in this study discussed their desire for transparency regarding use of the CSSD information, and provision of all information available as a way of supporting the autonomy of the family as they participated in end-of-life decisions. The consistent theme through all of the interviews was patient-family advocacy. Reservations about the use of CSSD were based primarily on the principle of non-malfeasance. This demonstrates that patient care remains the central priority of the healthcare team.

Relevance to Clinical Practice: Using clinical decision support systems impacts health care practitioners’ professional sensitivities as nurses or physicians in highly variable and often idiosyncratic ways. Dialogue between the professions of medicine and nursing could facilitate mutual understanding. Whether and how clinical decision support system analytic data are communicated to family members engaged in shared decision making regarding the withdrawal of life sustaining technologies depends on individual family circumstances.

Keywords: Clinical decision-making, clinical guidelines, multiprofessional practice, end-of-life decision-making, information technology, critical care

Full Article here

Basic Nursing: Foundations of Concepts and Skills

Chapter Power Notes (powerpoint)

Chapter 1 -

 Chapter 2 - 

Chapter 3 -

 Chapter 4 

-Chapter 5

Chapter 6 -

 Chapter 7 - 

Chapter 8 - 

Chapter 9 

-Chapter 10

Chapter 11 

- Chapter 12

 - Chapter 13 -

 Chapter 14

 -Chapter 15

Chapter 16

 - Chapter 17

 - Chapter 18 

- Chapter 19 -

Chapter 20

Chapter 21

 - Chapter 22

 - Chapter 23 - 

Chapter 24 

-Chapter 25

Chapter 26

 - Chapter 27

 - Chapter 28 

- Chapter 29 

-Chapter 30

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20 Facts about Kissing

1  Only you: Human lips are different from those of all other animals because they are everted, meaning that they purse outward.

2  But we are not the only species to engage in kissing-like behaviors. Great apes press their lips together to express excitement, affection, or reconciliation.

3  Scientists are not sure why humans kiss, but some think the answer lies in early feeding experiences. Through nursing and (in some cultures) receiving pre-chewed food from a parent's mouth, infants may learn to associate lip pressure with a loving act.

4  Another possibility: Smelling a loved one's cheek has long served as a means of recognition in cultures around the world, from New Zealand to Alaska. Over time, a brush of the lips may have become a traditional accompaniment.

5  And yet kissing is not universal, leading some experts, like anthropologistVaughn Bryant of Texas A&M, to think it might actually be a learned behavior.

Bronchitis: 9 Nursing Care Plans

Bronchitis is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs. Bronchitis can be divided into two categories, acute and chronic, each of which has two distinct etiologies, pathologies, and therapies.

Acute bronchitis is characterized by the development of a cough, with or without the production of sputum, mucus that is expectorated (coughed up) from the respiratory tract. Acute bronchitis often occurs during the course of an acute viral illness such as the common cold or influenza. Viruses cause about 90% of cases of acute bronchitis, whereas bacteria account for fewer than 10%.

Chronic bronchitis, a type of chronic obstructive pulmonary disease, is characterized by the presence of a productive cough that lasts for three months or more per year for at least two years. Chronic bronchitis most often develops due to recurrent injury to the airways caused by inhaled irritants. Cigarette smoking is the most common cause, followed by air pollution and occupational exposure to irritants.

9 Nursing Diagnosis For Bronchitis

1. Ineffective airway clearance
related to: increased production of secretions.

2. Acute pain
related to: the inflammation of the pleura.

3. Impaired gas exchange
related to: airway obstruction by secretions, spasm of the bronchus.

Nursing Diagnosis : Impaired Gas Exchange

Goal: Demonstrate improved ventilation and adequate oxygenation of tissues with blood gas analysis in the normal range and free of symptoms of respiratory distress.

Nursing Interventions - Impaired Gas Exchange related to Bronchitis:

a. Assess the frequency, depth of breathing. Note the use of accessory muscles, mouth breathing, inability to speak / talk.
R / useful in the evaluation of the degree of respiratory distress and / or chronic disease process.

b. Elevate head of bed, help patients to choose a position that is easy to breathe. Encourage deep breath or breathing lips slowly as needed / individual tolerance.
R / oxygen delivery can be improved by a high seating position and breathing exercises to reduce airway collapse, dyspnea, and breath work.

c. Provide appropriate bronchodilator required. Can be administered orally, IV, rectal, or inhaled. Give oral bronchodilators or IV at the time interspersed with the action nebulizer, metered dose inhalers to extend the effectiveness of the drug. Observation of side effects: tachycardia, dysrhythmias, CNS excitation, nausea and vomiting.
R / Bronchodilators dilate the airway and helps fight the bronchial mucosal edema and muscular spasm. Because side effects can occur in this action, carefully adjusted doses for each patient, according to tolerance and clinical response.

d. Evaluate the effectiveness of the actions nebulizer, metered dose inhalers. Assess decrease shortness of breath, wheezing or crackles drop, looseness secretion, decreased anxiety. Make sure that the action is given before meals to prevent nausea and to reduce the fatigue that accompanies feeding activity.
R / Combining medication with a nebulizer aerosolized bronchodilator commonly used to control bronchoconstriction. Providing appropriate actions will reduce its effectiveness. Aerolisation ease bronchial clearance, help control the inflammatory process, and improve the function of ventilation.

e. Instruct and encourage the patient on diaphragmatic breathing and effective coughing.
R / techniques improve ventilation by opening the airway and clearing the airway of sputum. Improvement of gas exchange.

f. Provide supplemental oxygen in accordance with the indications of blood gas analysis results and patient tolerance.
R / can fix / prevent worsening hypoxia.

4. Ineffective breathing pattern
related to: bronchoconstriction, mucus.

5. Imbalanced Nutrition, Less Than Body Requirements
related to: dyspnoea, anorexia, nausea, vomiting.

6. Risk for infection
related to: the settlement of secretions, chronic disease processes.

7. Activity intolerance
related to: insufficiency of ventilation and oxygenation.

8. Anxiety
related to: changes in health status.

9. Knowledge Deficit
related to: the lack of information about the disease process and treatment at home.

Sample Nursing Care Plan