| Accutane (Isotretinion) on Birth Defects Posted: 21 Oct 2010 05:00 PM PDT 
 Accutane is a form of vitamin A or of Isotrenition. It is marketed since 1982 to reduce the amount of oil released by oil glands in the skin, and helps the skin renew itself more quickly.It is used to treat severe nodular acne. It is usually given after other acne medicines or antibiotics have been tried without successful treatment of symptoms.
However, it is well document on researches that excessive intake of Vitamin A has something to do with miscarriage and congenital anomalies. Women at any time of conception or during pregnancy, regardless of the length of exposure to this substance is in great risk of experiencing fetal abnormal development. Congenital anomalies include: - Crainofacial anomalies – like lacking of ears, abnormally smaller jaw, cleft palate, misshapen skull, small eyes (micropthalmia),
- Cardiac anomalies like congestive heart failure
- Central Nervous System anomalies – like facial and muscle paralysis, hydrocephalus, small head (microcephaly)
 
These are severe, life-threatening birth defects. That is why it is our role as nurses to help doctors in the assessment stage to have a thorough drug history for clients having signs of pregnancy. Accutane is strictly prohibit during pregnancy. Nursing Considerations: - Assess properly during the drug history to enable to know if the client uses Isotrenition or taking vitamin A supplements.
- Teach the client to refrain from using such substances during pregnancy due to harmful severe effects to the fetus and fetal development.
- Apply comforting measures and non-teratogenic measures for mothers experiencing acne as well as relief from oily skin caused by hormonal changes during pregnancy.
- Give more importance to incorporate knowledge about the harmful effects of this chemical to pregnancy and would-be mothers.
Photo credits: http://www.google.com.ph; www.emedicine.medscape.com Related posts: - Oligohydramnios
- MOXIFLOXACIN HYDROCHLORIDE
- How to Treat Acne During Pregnancy
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| LASIK (Laser Eye Surgery) Posted: 21 Oct 2010 04:51 PM PDT 
 LASIK or Lasik is an abbreviation for laser assisted in situ keratomileusis. It is the newest type of refractory surgery which mainly treats my opia (near-sightedness), hyperopia (far-sightedness) and astigmatism (when the cornea curves or flattens unevenly, the result is astigmatism, which disrupts focus of near and distant vision). Only ophthalmologists perform this type of surgical procedure. The purpose of this surgical procedure is to provide a clearer vision.
Procedure: In summary, the procedure involves creating a thin flap on the eye, folding it to enable remodeling of the tissue beneath with a laser. The client is conscious while this operation is going on, medications such as sedative or anesthetic eye drops are given. - Flap is created to the corneal tissue. Corneal suction is applied to the eye, holding the eye in place. Once it is immobilized, a metal blade or IntraLASIK procedure creates a series of tiny closely arranged bubbles within the cornea.
- The laser remodels the corneal stroma by vaporizing tissue in a fine manner without undue damage.
- LASIK flap is carefully repositioned over the treatment area. Routine check for proper placement and absence of bubbles indicates proper placement.
Possible Risks: - Undercorrections – These are common in people who are nearsighted. If little tissue is taken off, little effect on the clarity of the vision will happen.
- Overcorrections – This happens when too much tissue is taken off.
- Astigmatism – This happens when there is too much eye movement during the surgery. It results to uneven tissue and requires another surgery.
- Glare, halos and double vision – There are cases that there is difficulty at seeing at night, or even halos or double visions. Eyedrops with corticosteriod are used to prevent further inflammation and better movement of the eyes after surgery.
- Dry eye – This is due to blockage or trauma on the lachrymal glands.
Nursing Considerations: Preoperative stage: - Encourage verbalization of feelings of the unfamiliar procedure.
- Assess the level of understanding of the client regarding the upcoming surgery, the sedation, procedure as well as the responsibility to take of the eye newly operated.
- Encourage compliance to prophylactic antibiotics to prevent risk of infection.
Intraoperative Stage: - Assist in eye surgery.
- Observe and keep the site sterile while the operation is going on.
- Monitor the vital signs all throughout the procedure.
Postoperative Stage: - Encourage compliance on a course of antibiotic and anti-inflammatory eye drops. These are continued in the weeks following surgery.
- Instruct the client to sleep or lie on the unoperated side to prevent increase of interocular pressure.
- Instruct the client to avoid overexertion such as straining, lifting and pushing objects.
- Frequently reorient the client to the environment and the date and time of the day to prevent sensory deprivation.
- Teach the client regarding the signs of complications such as any sharp pain or feelings of pressure in the eyes which may indicate hemorrhage, increased intraocular pressure or infection. When this happens, consult the surgeon immediately to prevent further complications.
Result depends still on the severity of the refractory errors on the eye. Photo credits: articlediary.com Related posts: - Types of Surgery
- How Coronary Artery Bypass Graft Surgery is Carried Out
- Blepharoplasty Surgery
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| Staphylococcal Food Poisoning Posted: 21 Oct 2010 04:49 PM PDT 
 Food poisoning Staphylococcal food poisoning is caused by staphylococcal enterotoxin produced by some strains of Staphylococcal aureus, a gram positive bacteria.It can cause a wide variety of diseases such as bacteremia, pneumonia, osteomyelitis, skin infections and food poisoning. This discussion is focused on food poisoning only. This is the leading cause of gastroentiritis. The organism is often an inhabitant of the nasal passages from which it contaminates the hands. It is also a frequent cause of skin lesions on the hands. From these sources, it can readily enter food. If the microbes are allowed to incubate in the food, a situation called temperature abuse, or reproduction and release of enterotoxin into the food. The incubation period is 1 to 7 days. Events which may lead to outbreaks of staphylococcal intoxication: - Cooking foods rich in protein
- Food handlers have staphylococcal growth on bare hands which may be transmitted to the food
- Organisms incubate in the food long enough to form and release toxins
*Reheating will eliminate staphylococci but not the toxin.
The toxin is heat stable and can survive up to 30 minutes of boiling. Therefore, once the toxin is formed, it is not destroyed when the food is reheated, although the bacteria will be killed. - Food with the toxin is ingested.
- Intoxication occurs in one to six hours or days
Pathophysiology: Once the toxin has been ingested, it quickly triggers the brain’s vomiting reflex center; abdominal crapms and usually diarrhea then happens. Physical Findings: - diarrhea
- abdominal cramping
- excessive salivation
- nausea
Diagnosis: - Physical examination according to presenting signs ans symptoms. Short incubation time characteristic of intoxication.
- Blood, sputum, vomitus, feces and spinal fluid
- Contaminated food (usually contaminated are custards, pastries, salads, ham and other foods rich in carbohydrates and protein)
Medical Management: - Use of Penicillin G – drug of choice; cephalosporin as substitute drug
- Culture and sensitivity test is done for cases with resistance to Penicillin-resistant strains
Nursing Management: - Administer prescribed medications, which include antipyretics and antibiotics.
- Provide health education as well as encourage compliance to the whole course of antibiotics
- Practice proper hand washing regularly
- Observe good personal hygiene
- Teach clients to refrain from eating left over foods, especially foods rich in carbohydrates and protein
Related posts: - Nutrients: Functions, Deficiencies, Toxicities and Food Sources
- Nutritional Guidelines for Filipinos
- Cholera (El Tor)
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