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November 6, 2010

“Hepatitis D – Delta Hepatitis” plus 2 more nursing article(s): NursingCrib.com Updates

“Hepatitis D – Delta Hepatitis” plus 2 more nursing article(s): NursingCrib.com Updates

Link to Nursing Crib

Hepatitis D – Delta Hepatitis

Posted: 06 Nov 2010 03:00 AM PDT


hepa D 300x195 Hepatitis D – Delta Hepatitis

Hepatitis D is a defective RNA that appears to replicate only with the hepatitis B virus. It requires HbsAg to replicate. It occurs along with Hepatitis B or may superinfect a chronic HBV carrier. It cannot outlast a Hepatitis B infection. It may be acute or chronic. Its mode of transmission and incubation period are the same as that of HBV.Its occurrence in the United States is primarily among IV drug users and among recipients of multiple blood transfusions. It causes about 50% of fulminant hepatitis, which has a high mortality.

Clinical Manifestations:

• Similar to Hepatitis B but more severe and chronic active hepatitis and cirrhosis

• With superinfection of chronic HBV carriers, it causes sudden worsening of condition and rapid progression of cirrhosis.

Diagnostic evaluation:

  1. Elevated serum transferase levels – ALT, AST
  2. Anti-delta antibodies in the presence of HBsAg or the detection of IgM in acute disease and IgG in chronic disease.

Prevention:

1. Always screen blood and blood products for blood-borne diseases.

2. Always practice safe sex.

3. Never re-use needles for injections. Always open a new sterile syringe and discard properly after use.

4.Wash hand thoroughly right after direct contact with body fluids of patients with Hepatitis D.

5. Never use the personal belongings of persons with Hepatitis D, such as toothbrush, eating utensils, razor, etc.

Medical Management:

  1. Targeting the causative agent of Hepatitis B may also kill the causative agent of Hepatitis D.
  2. Interferon is under investigation as a specific treatment for Hepatitis D.
  3. Acyclovir, ribavirin, lamivudine and synthetic analogues of thymosin have proved ineffective.

Nursing Management:

  1. Inform the patient and family members about the nature of the disease if the patient is taken care at home.
  2. Assist is paracentesis if indicated.
  3. Patients with cirrhosis could be in deep pain and discomfort, use of analgesics should be administered with great caution since it can worsen the liver damage.
  4. Diversionary therapy and non-pharmacological approach should be applied in managing pain.
  5. Ongoing monitoring of vital signs, abdominal girth and reminding for the routine check-up must be emphasized for effective management.Photo credits: www.google.com.ph

Related posts:

  1. Viral Hepatitis
  2. Hepatitis C
  3. Hepatitis B (Serum Hepatitis)

Fundamentals of Nursing Practice Test Part 2

Posted: 06 Nov 2010 01:24 AM PDT


December 2010 Nursing Board Exam Review Questions on Fundamentals of Nursing.

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.

1.    The sound heard when taking the blood pressure is called:





2.    Hering Breuer reflex, is very useful during respirations. What does this reflex does?





3.    The process of exchanging gases between the cells and the blood is known as:





4.    The center for heat regulation is found in the brain. Specifically, which brain part is responsible for thermoregulation?





5.    During conditions where the body's temperature is increased such as with fever, what do the skin blood vessels do to compensate for the warmer temperature?





6.    During physical assessment the nurse observed an elevated skin layer containing pus. This circumscribed superficial elevation of the skin layer with filled with pus is called:





7.    In describing eye findings during a physical assessment, the doctor wrote the word PERRLA. PERRLA stands for Pupils, Round, Reactive to Light and Accommodation. If light is present what is the normal pupillary response?





8.    A client was diagnosed with glaucoma. The following tests are performed for glaucoma apart from:





9.    A nurse is giving health teaching and discharge instructions to the mother of a 3 year old child. An otic medication is prescribed for the child. The nurse correctly stated the method of administering otic medication for a 3 year old when she states that:





10.    A test is performed by a nurse. She used a tuning fork and compared the air conduction with bone conduction. She told the student nurse that when the bone conduction is greater than air conduction a conductive hearing loss is present. This test is known as:





11.    A patient has an enlarged thyroid gland. During physical assessment a soft rushing sound is heard upon auscultation using the stethoscope's bell. The "soft rushing sound" heard on auscultation of an enlarged thyroid is called:





12.    The student nurse was taking measurements of the patient's chest. She observed that the anteroposterior (AP) diameter is wider than the transverse diameter. This  chest abormality is called:





13.    The next patient that the student nurse assessed has a depressed sternum and a narrowed AP diameter. This is what type of chest abnormality?





14.    Garry's assignment includes the definition of a tactile fremitus. Which of the following correctly describe a tactile fremitus?





15.    What is the correct sequence in conducting an abdominal examination?





16.    Student nurse Linda is auscultating the client's abdomen for bowel sounds. She noticed that the left lower quadrant has diminished bowel sounds. Before deciding that bowel sounds are absent in one quadrant Linda must auscultate the area for how many minute/s?





17.    Moving the bones of the forearm with palms facing upwards is what type of joint movement?





18.    The signs of inflammation are rubor, calor, dolor, tumor and loss of function. The word calor means:





19.    Student Nurse Angie what does the "dolor" sign of inflammation mean. Dolor is also called:





20.    A neurological assessment is performed by the student nurses while on their duty. Student Nurse Angie was assessing her 61-year old patient's level of consciousness (LOC). Her patient is unresponsive and is only aroused by pain stimulation. This LOC is best described as:





21.    The geriatric patient on the same room with Angie's assigned patient has a spontaneous lack of movement and speech but is easily aroused by environmental stimulation. this client's LOC is:





22.    Farsightedness is diagnosed if the snellen's chart test result is:





23.    Nearsightedness is diagnosed if the snellen's chart test result is:





24.    Before an abdominal assessment, which is least likely implemented?





25.    In the assessment of motor function a score of three denotes to which of the following characteristics?







Related posts:

  1. Nursing Board Review: Fundamentals of Nursing Practice Test Part 2
  2. Nursing Board Review: Fundamentals of Nursing Practice Test Part 1
  3. Nursing Board Review: Fundamentals of Nursing Practice Test Part 3

Hepatitis C

Posted: 05 Nov 2010 11:00 PM PDT


Hepatitis C (HCV) was formerly called non-A, non-B hepatitis and is an RNA virus. It is not related to any virus that cause hepatitis.

hepa C1 300x240 Hepatitis C

Usual mode of transmission is through blood and blood products, including:

  1. IV drug users and renal dialysis patients
  2. Sexual intercourse
  3. Theoretically, through contaminated piercing and tattooing tools and ink
  4. Sharing a razor or nail-clipper with the patient that is infected.
  • Incubation period varies from 1 week to several months.
  • About 35,000 new cases of Hepatitis C are reported in the United States each year.
  • HCV is the most common reason for liver transplantation.
  • Approximately 50% of HCV develop to chronic liver disease and at least 20% progress to cirrhosis

Clinical Manifestations:

  1. Similar to Hepatitis B, but usually less severe
  2. Symptoms usually occur 6-7 weeks after transfusion but may be attributed to another viral infection

Diagnostic Evaluation:

  1. Elevated serum transferase levels – ALT, AST
  2. Hepatitis C antibody – may not be detected for 3 to 6 months after onset of HCV illness.

Prevention:

  1. Always screen blood and blood products for blood-borne diseases.
  2. Always practice safe sex.
  3. Never re-use needles for injections. Always open a new sterile syringe and discard properly after u se.
  4. Educate adolescents about the risk of piercing and tattooing in transmission of HCV.

Medical Management:

  1. Combination therapy of interferon (Intron-A) and ribavirin (Rebetol) is effective for treating relapses.
  2. Alcohol and hepatotoxic drugs should be avoided.
  3. Close monitoring is imperative.

Nursing Management:

  1. Encourage verbalization of feelings of anxiety of family members as well as the patient when the disease is diagnosed.
  2. Always observe standard precautions in handling blood and body fluids.
  3. Always instruct patient and care givers to properly dispose used needles in a puncture resistant container.
  4. Emphasize proper nutrition, a high-calorie, low-fat diet is small frequent feedings should be given.
  5. Always monitor the vital signs as well as markers if the disease progresses.

Complication:

  • Hemolytic anemia from combination therapy.

Photo credits: www.nhl.gov

Related posts:

  1. Hepatitis D – Delta Hepatitis
  2. Viral Hepatitis
  3. Hepatitis B (Serum Hepatitis)
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