“Anatomy and Physiology Practice Test” plus 4 more nursing article(s): NursingCrib.com Updates

Anatomy and Physiology Practice Test
Foods That Improve Grades – Part 2/2
Stomach Cancer (Gastric Cancer)
Modalities of Nursing Care
Acute Gastroenteritis (Stomach flu)

Posted: 08 Nov 2010 09:18 PM PST

December 2010 Nursing Board Exam Review Questions on Anatomy and Physiology.

Mark the letter of your choice then click on the next button. Your score will be posted as soon as the you are done with the quiz. We will be posting more of this soon. If you want a simulated Nursing Board Exam, get a copy of our Nursing Board Exam Reviewer v1.0 and v2 now.

Foods That Improve Grades – Part 2/2

Posted: 08 Nov 2010 03:37 PM PST

Foods That Improve Grades – Part 2/2

A previous student of mine who is taking the nursing local board examination mailed me asking about what foods to eat for optimal brain functioning. Food intake is an essential factor in passing the big test. Of course food intake alone won't make you pass; it should be partnered with effective study habits, faith in God and interest in learning. Here is the second list of foods that enhances brain function.

Combat mental fatigue with tea

When freshly prepared, tea helps increase memory and focus of an individual at the same time providing relief from mental fatigue. Stress has been one reason why students get low grades on their examination. Green tea has been known for giving mental relaxation and keeping wits sharpened.

Green, green, green

Green vegetables contain folate which has a direct effect on memory. No wonder, mothers are forcing their kids to eat green vegetables. These foods helps retain memory and boost brain function. Spinach (kangkong) prevents and reverses memory loss. Studies have shown that ½ cup of cooked spinach meets the 2/3 daily folate requirement.

Coffee for memory and attention

Good news for coffeeholics! Research has proved that individuals who are consuming a cup (or two) of coffee per day has slow cognitive decline than those who are not. Coffee gives a person a wake-up buzz that keeps the person alert and focused in lectures and review sessions. Short-term memory, attention and concentration are also increased with coffee intake. It also contains antioxidants that are beneficial to the body. However, for those who have medical problems (e.g. high cholesterol) caffeine allowance should be avoided or limited to drinking plain brewed coffee only.

Blueberries for the brain

Blueberries contain antioxidants that decrease inflammation and free radical damage. It also improves neuron signaling in the brain that improves motor skills and learning capacity.

Don't skip breakfast

Breakfast is essential for improving short-term memory of a person and attention span. An individual who skips breakfast may pose slow concentration due to pangs of hunger and decrease brain energy. A breakfast should contain any or combination of the following:

Carbohydrates

Carbohydrates are converted to glucose in the body. Glucose in return provides fuel for the brain as it functions in daily activities. However, limit carbohydrate intake to whole grains, oatmeal, brown rice, barley, legumes, fruits and vegetable only. These foods are the best brain stimulating foods and increases blood supply in the brain. Refined carbohydrates such as pasta, white bread and pastries can make someone lethargic.

Oatmeal is a low-glycemic carbohydrate that provides faster energy than that of protein. It also promotes serotonin (a neurotransmitter) production that gives a person a sense of calm.

Milk

Milk is rich in calcium that improves the function of the nerves. Intake of milk can increase alertness and memory.

Do not eat too little or too much in breakfast. Eating too little results to poor concentration as pangs of hunger would distract someone from listening to a lecture or taking an examination. Too much food consumed in breakfast would make someone feel uncomfortable that would also disrupt concentration and focus.

Have a balanced diet and follow the food guide pyramid in deciding what foods to eat in a meal. This might sound very simple that most people neglect to follow it. Keep in mind that one of the main factor to top or pass that test is a good functioning brain. Make most of your brain by nourishing it with foods to increase its function and power. A poorly functioning brain can't help you on that big test. Help your brain, and in response it will help you more.

image from tea-brewery.com, renalcarcinoid.com

Stomach Cancer (Gastric Cancer)

Posted: 08 Nov 2010 01:00 PM PST

Stomach Cancer (Gastric Cancer)

Stomach cancer can develop in any part of the stomach and spread to other organs. It usually begins in cells in the inner layer of the stomach. Over time, the cancer may invade more deeply into the stomach wall. A stomach tumor can grow through the stomach’s outer layer into nearby organs, such as the liver, pancreas, esophagus, or intestine. Stomach cancer cells can spread by breaking away from the original tumor. They enter blood vessels or lymph vessels, which branch into all the tissues of the body. The cancer cells may be found in lymph nodes near the stomach. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues.

Risk Factors:

Helicobacter pylori infection

H. pylori is a bacterium that commonly infects the inner lining of the stomach, thereby causing stomach inflammation and peptic ulcers. It also increases the risk of stomach cancer, but only a small number of infected people develop stomach cancer.

Long-term inflammation of the stomach

People who have conditions associated with chronic stomach inflammation, such as those with pernicious anemia are at increased risk of stomach cancer. Also, people who have had part of their stomach removed may have long-term stomach inflammation and increased risk of stomach cancer.

Smoking

Heavy smokers are most at risk.

Family history

Family members and close relatives of a person with a history of stomach cancer are somewhat more likely to develop the disease themselves. If many family members have a history of stomach cancer, the risk is even greater.

Poor diet, lack of physical activity, or obesity

People who highly consume foods that are smoked, salted, or pickled have an increased risk for stomach cancer. On the other hand, people who eat a diet high in fresh fruits and vegetables may have a lower risk of this disease. Lack of exercise and obesity are often linked with most cancers.

Symptoms:

Symptoms of stomach cancer are often vague. Early stomach cancer often does not cause symptoms. As the cancer grows, the most common symptoms are:

Discomfort or pain in the stomach area
Difficulty swallowing
Nausea and vomiting
Weight loss
Feeling full or bloated after a small meal
Vomiting blood or having blood in the stool

Diagnostic Evaluation:

Physical exam

The doctor feels the abdomen for fluid, swelling, or other changes. He will also check for swollen lymph nodes.

Endoscopy

Direct visualization of the stomach through a lighted tube (endoscope). The tube is passed through your mouth and esophagus to the stomach.

Biopsy

An endoscope has a tool for removing tissue. The doctor uses the endoscope to remove tissue from the stomach. A pathologist checks the tissue under a microscope for cancer cells. A biopsy is the only sure way to know if cancer cells are present.

When stomach cancer spreads, cancer cells may be found in nearby lymph nodes, the liver, the pancreas, esophagus, intestine, or other organs. The following tests may be ordered:

Chest x-ray
CT scan
Endoscopic ultrasound
Laparoscopy

Medical Management:

Treatment of stomach cancer depends on the size, location, and extent of the tumor, the stage of the disease, and the health of the patient. It may involve surgery, chemotherapy, or radiation therapy. A combination of these treatments may also be done.

Surgery

The type of surgery for stomach cancer depends mainly on where the cancer is located. The surgeon may remove the whole stomach or only the part that has the cancer.

Partial (subtotal) gastrectomy for tumors at the lower part of the stomach

Removal the lower part of the stomach with the cancer. The surgeon attaches the remaining part of the stomach to the intestine. Nearby lymph nodes and other tissues may also be removed.

Total gastrectomy for tumors at the upper part of the stomach

Removal of the entire stomach, nearby lymph nodes, parts of the esophagus and small intestine, and other tissues near the tumor. Rarely, the spleen also may be removed. The surgeon then connects the esophagus directly to the small intestine.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. It may be given before or after surgery. After surgery, radiation therapy may be given along with chemotherapy. The drugs that treat stomach cancer are usually given intravenously.

The side effects depend mainly on which drugs are given and how much. Chemotherapy kills fast-growing cancer cells, but the drugs can also harm normal cells that divide rapidly.

Radiation therapy

Radiation therapy uses high-energy rays to kill cancer cells. It affects cells only in the part of the body that is treated. Radiation therapy is usually given with chemotherapy to treat stomach cancer. Treatments are usually 5 days a week for several weeks. Side effects depend mainly on the dose and type of radiation.

Nursing Management:

Plan to have smaller, more frequent meals a day.
Drink liquids before or after meals
Cut down on very sweet foods and drinks such as cookies, candy, soda, and juices.

Help the patient and the family cope positively with the disease.
Listen when the patient airs out their concerns regarding the treatments, side effects and hospital stay.
Encourage them to ask for clarifications when they are in doubt or when they need facts regarding the disease process.

Photo credits: www.medkast.libsyn.com

Modalities of Nursing Care

Posted: 08 Nov 2010 11:00 AM PST

Modalities of Nursing Care

This refers to the manner in which nursing care is organized and provided. It depends on the philosophy of the organization, nurse staffing and client population.

Case Method/Total Patient Care

In case method, the nurse cares for one patient whom the nurse cares for exclusively. The Case Method evolved into what we now call private duty nursing. It was the first type of nursing care delivery system.

In Total Patient Care, the nurse is responsible for the total care of the patient during the nurse’s working shift. The RN is responsible for several patients.

Advantages:

Consistency in carrying out the nursing care plan
Patient needs are quickly met as high number of RN hours are spent on the patient
Relationship based on trust is developed between the RN and the patient’s family

Disadvantage:

It can be very costly

Functional Nursing

It is a task-oriented method wherein a particular nursing function is assigned to each staff member. The medication nurse, treatment nurse and bedside nurse are all products of this system. For efficiency, nursing was essentially divided into tasks, a model that proved very beneficial when staffing was poor. The key idea was for nurses to be assigned to tasks, not to patients.

Advantages:

A very efficient way to delivery care.
Could accomplish a lot of tasks in a small amount of time
Staff members do only what they are capable of doing
Least costly as fewer RNs are required

Disadvantages:

Care of patients become fragmented and depersonalized
Patients do not have one identifiable nurse
Very narrow scope of practice for RNs
Leads to patient and nurse dissatisfaction

Team Nursing

This is the most commonly used model and is still in use today. It was developed in the 1950's in order to somewhat ameliorate the fragmentation that was inherent in the functional model. The goal of team nursing is for a team to work democratically. In the ideal team, an RN is assigned as a Team Leader for a group of patients. The Team Leader has a core of staff reporting to her, and together they work to disseminate the care activities. The team member possessing the skill needed by the individual patient is assigned to that patient, but the Team Leader still has accountability for all of the care. Team conferences occur in which the expertise of every staff member is used to plan the care.

Advantages:

Each member's capabilities are maximized so job satisfaction should be high
Patients have one nurse (the Team Leader) with immediate access to other health providers

Disadvantages:

Requires a team spirit and commitment to succeed
RN may be the Team Leader one day and a team member the next, thus continuity of patient care may suffer
Care is still fragmented with only 8 or 12 hour accountability

Primary Nursing

The hallmark of this modality is that one nurse cares for one group of patients with a 24-hour accountability for planning their care. In other words, a Primary Nurse (PN) cares for her primary patients every time she works and for as long as the patient remains on her unit. An Associate Nurse cares for the patient in the PN's absence and follows the PN's individualized plan of care. This is a decentralized delivery model: more responsibility and authority is placed with each staff nurse.

Advantages:

Increased satisfaction for patients and nurses
More professional system: RN plans and communicates with all healthcare members. RNs are seen as more knowledgeable and responsible.
RNs more satisfied because they continue to learn as as part of the in-depth care they are required to deliver to their patient

Disadvantage:

Only confines a nurse’s talents to a limited number of patients, so other patients cannot benefit if the RN is competitive
Can be intimidating for RNs who are less skilled and knowledgeable

Modular Nursing (District Nursing)

This is a modification of team and primary nursing. It is a geographical assignment of patient that encourages continuity of care by organizing a group of staff to work with a group of patients in the same locale.

Advantages:

Useful when there are a few Rns
RNs plan their care

Disadvantage:

Paraprofessionals do technical aspects of nursing care

Photo Credits: www.nursesolutions.com

Modalities of Nursing Care

This refers to the manner in which nursing care is organized and provided. It depends on the philosophy of the organization, nurse staffing and client population.

Case Method/Total Patient Care

? In case method, the nurse cares for one patient whom the nurse cares for exclusively. The Case Method evolved into what we now call private duty nursing. It was the first type of nursing care delivery system.

? In Total Patient Care, the nurse is responsible for the total care of the patient during the nurse’s working shift. The RN is responsible for several patients.

? Advantages:

· Consistency in carrying out the nursing care plan

· Patient needs are quickly met as high number of RN hours are spent on the patient

· Relationship based on trust is developed between the RN and the patient’s family

? Disadvantage:

· It can be very costly

Functional Nursing

? It is a task-oriented method wherein a particular nursing function is assigned to each staff member. The medication nurse, treatment nurse and bedside nurse are all products of this system. For efficiency, nursing was essentially divided into tasks, a model that proved very beneficial when staffing was poor. The key idea was for nurses to be assigned to tasks, not to patients.

? Advantages:

· A very efficient way to delivery care.

· Could accomplish a lot of tasks in a small amount of time

· Staff members do only what they are capable of doing

· Least costly as fewer RNs are required

? Disadvantages:

· Care of patients become fragmented and depersonalized

· Patients do not have one identifiable nurse

· Very narrow scope of practice for RNs

· Leads to patient and nurse dissatisfaction

Team Nursing

? This is the most commonly used model and is still in use today. It was developed in the 1950's in order to somewhat ameliorate the fragmentation that was inherent in the functional model. The goal of team nursing is for a team to work democratically. In the ideal team, an RN is assigned as a Team Leader for a group of patients. The Team Leader has a core of staff reporting to her, and together they work to disseminate the care activities. The team member possessing the skill needed by the individual patient is assigned to that patient, but the Team Leader still has accountability for all of the care. Team conferences occur in which the expertise of every staff member is used to plan the care.

? Advantages:

· Each member's capabilities are maximized so job satisfaction should be high

· Patients have one nurse (the Team Leader) with immediate access to other health providers

? Disadvantages:

· Requires a team spirit and commitment to succeed

· RN may be the Team Leader one day and a team member the next, thus continuity of patient care may suffer

· Care is still fragmented with only 8 or 12 hour accountability

Primary Nursing

? The hallmark of this modality is that one nurse cares for one group of patients with a 24-hour accountability for planning their care. In other words, a Primary Nurse (PN) cares for her primary patients every time she works and for as long as the patient remains on her unit. An Associate Nurse cares for the patient in the PN's absence and follows the PN's individualized plan of care. This is a decentralized delivery model: more responsibility and authority is placed with each staff nurse.

? Advantages:

· Increased satisfaction for patients and nurses

· More professional system: RN plans and communicates with all healthcare members. RNs are seen as more knowledgeable and responsible.

· RNs more satisfied because they continue to learn as as part of the in-depth care they are required to deliver to their patient

? Disadvantage:

· Only confines a nurse’s talents to a limited number of patients, so other patients cannot benefit if the RN is competitive

· Can be intimidating for RNs who are less skilled and knowledgeable

Modular Nursing (District Nursing)

? This is a modification of team and primary nursing. It is a geographical assignment of patient that encourages continuity of care by organizing a group of staff to work with a group of patients in the same locale.

? Advantages:

· Useful when there are a few Rns

· RNs plan their care

? Disadvantage:

· Paraprofessionals do technical aspects of nursing care

Acute Gastroenteritis (Stomach flu)

Posted: 08 Nov 2010 09:00 AM PST

Acute Gastroenteritis (also called Stomach Flu)

Acute gastroenteritis is a sudden condition that causes irritation and inflammation of the stomach and intestines or the gastrointestinal tract.
Viral infection is the most common cause of gastroenteritis but bacteria, parasites, and food-borne illness (such as shellfish) can also cause acute gastroenteritis.
Fifty to seventy percent of cases of gastroenteritis in adults are caused by the noroviruses while rotavirus is the leading cause of infection in children. Staphylococcus aureus can form a toxin that cause food poisoning while the resident Escherichia coli can also cause significant problems.
Many people who experience symptoms of vomiting and diarrhea, which develop from these types of infections or irritations believe they have food poisoning, and they indeed have a food-borne illness.
The severity of gastroenteritis depends on the immune system’s ability to resist and fight the infection. Electrolytes, especially sodium and potassium may be lost if the client continue to vomit and experience diarrhea.
Most people recover easily from a short course of vomiting and diarrhea by drinking lots of fluids and resuming a typical diet. But for some, especially the young and the old, loss of body fluids with gastroenteritis can cause dehydration, which is a life-threatening condition unless it is treated and fluids are replaced.

Pathophysiology:

The mechanisms potentially responsible for viral diarrhea include lysis of enterocytes, interference with the brush border function that leads to malabsorption of electrolytes, stimulation of cyclic adenosine monophosphate (cAMP), and carbohydrate malabsorption. For bacterial gastroenteritis, the pathophysiology involves the elaboration of toxin by enterotoxigenic pathogens and the invasion and inflammation of mucosa by invasive pathogens. Parasitic organisms invade epithelial cells and cause villus atrophy and eventual malabsorption.

Clinical Manifestations:

Low grade fever to 100°F (37.8°C)
Nausea with or without vomiting
Mild to moderate diarrhea
Crampy and painful abdominal bloating

More serious symptoms include:

Blood in vomit or stool
Vomiting more than 48 hours
Fever higher than 101°F (40°C)
Swollen abdomen or abdominal pain
Dehydration that is manifested by weakness, lightheadedness, decreased and concentrated urination, dry skin and poor turgor, and dry lips and mouth

Diagnostic Tests:

Blood test
Analysis of stool samples
Electrolyte tests
Physical examination to rule other existing conditions such as appendicitis

Medical Management:

Home care:

Clear fluids are appropriate for the first 24 hours to maintain adequate hydration.
They should be given oral rehydration solutions such as Pedialyte for pediatric patients or commercially prepared oral rehydration solution. For homemade ORS, mix 2 tablespoons of sugar (or honey) with ¼ teaspoon of table salt in 1 liter (1 qt) of clean or previously boiled water.
After 24 hours without vomiting , begin to offer soft bland foods such as the BRAT diet, which includes bananas, rice, applesauce without sugar, toast, pasta, and potatoes.

Hospitalization: