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November 9, 2010

N-Trivia

N-Trivia

Renal Problems – Renal Calculi

Posted: 09 Nov 2010 02:00 PM PST


Renal Calculi also called kidney stones or renal lithiasis are found in the inner surfaces of the kidney, they usually contain mineral and acid salts.
kidneystone 300x240 Renal Problems – Renal Calculi
Pathophysiology:
Renal stones are formed when the urine is not able to dissolve the minerals that comes along with the excretion of the body. Those minerals crystallizes and solidifies until it may block the passageway.

Types of calculi based on composition:
1. Calcium stones – the most common form of renal stone, it is due to accumulation of oxalate that comes from the diet that’s rich in vitamin D.

2. Struvite Stone – this is common in women since they are more prone to have urinary  tract infections. They are described as staghorn shaped because they usually collect themselves on the urine collecting space of the kidney.

3. Uric Acid Stone – this is the result of high-protein diet.

4. Cystine Stones – this is a genetic disorder wherein the kidneys excrete excessively high amounts of amino acids (cystinuria).

Complications:

1. Kidney damage

2. Bleeding

3. Infection

Clinical Manifestations:

  1. acute, sharp, intermittent pain (ureteral colic)
  2. dull, tender ache in the flank
  3. nausea and vomiting accompanying severe pain
  4. fever and chills
  5. hematuria
  6. abdominal distention
  7. pyuria

Diagnostic Evaluation:

  1. Kidneys, ureters and bladder radiography reveals visible calculi.
  2. Stone analysis detects mineral content calculi
  3. Intravenous pyelography determines size and location of the calculi
  4. Renal ultrasonography reveals obstructive changes, such as hydronephrosis.

Medical Management:

  1. For severe infections antibiotic therapy is indicated.
  2. Supportive therapy is given for fever, pain control and hydration.

Surgical Management:

  1. Crucial decision in removing the kidney to relieve the obstruction.
  2. Nephrectomy
  3. Hand-assisted laparoscopic nephrectomy

Nursing Management:

  1. Assess for ability to tolerate oral fluids and food.
  2. Obtain urologic history that could suggest recurrent infections or urinary tract infections
  3. Give prescribed analgesics to relieve pain
  4. Administer oral and intravenous fluids as ordered to reduce concentration of urinary crystalloids and ensure adequate urine output.
  5. Explain preventive measures including good fluid intake, personal hygiene measures and healthy voiding habits.

Photo credits: www.homeopathictreatment4u.com

Related posts:

  1. Nursing Care Plan – Renal Failure
  2. Acute Renal Failure
  3. Nursing Care Plan – Urinary Tract Infection (UTI)

Angioplasty

Posted: 09 Nov 2010 12:00 PM PST


angioplasty 300x228 AngioplastyAngioplasty is a technique used to open an area of arterial blockage with the help of a catheter that has an inflatable small sausage-shaped balloon at its tip.

PTCA or Percutaneous Transluminal Coronary Angioplasty on the other hand involves introducing a balloon catheter through the groin, sometimes of the arm. It is placed within the blood vessel that is why it is medically called transluminal.

Procedure:

  1. The doctor inserts a catheter into the artery usually at the groin area.
  2. The angiography shows the travel of the catheter as it is being inserted, the doctor inserts a smaller double lumen balloon catheter through the guide catheter and directs the balloon through the occlusion.
  3. The doctor inflates the balloon, causing arterial stretching and plaque fracture.

Nursing Management:
Before the Procedure:

  1. Inform the patient that a catheter will pass through the artery and a vein in the groin area.
  2. Reassure the patient that the procedure lasts from one to four hours and he or she will lie flat on the operating table all the time.
  3. Advice deep breathing episodes during the procedure to provide ease with the process.

After the Procedure:

  1. Inform the patient that he or she will spend ample time in the cardiac ICU or a certain facility wherein closer monitoring will be done until he or she is stable.
  2. Monitor the heparin effects and other intravenous medications.
  3. Asses for the peripheral pulses from time to time, there is a tendency that it will be impeded due to prolonged supine position.

Discharge Instructions:

  1. When the patient goes home, emphasize that it he or she experienced complications such as bleeding or lack of sensation on the lower extremity, inform to call the attending physician immediately.
  2. Instruct that if chest pains happen there would be a tendency for the reinsertion of the catheter.

Photo credits: www.revolutionhealth.com

Related posts:

  1. Percutaneous Transluminal Coronary Angioplasty
  2. Balloon Valvuplasty
  3. Pelvic Laparoscopy

TURP (Transurethral Resection of the Prostate)

Posted: 09 Nov 2010 10:00 AM PST


TURP (Transurethral Resection of the Prostate) is the most common procedure used to treat BPH. It can be carried out through endoscopy. The surgical and optical instrument is introduced directly through the urethra toTURP 300x240 TURP (Transurethral Resection of the Prostate) the prostate, which can then be viewed directly. The gland is removed in small chips with an electrical cutting loop.This procedure, which requires no incision, may be used for glands of varying size and is ideal for patients who have small glands and for those who are considered poor surgical risks.Newer technology uses bipolar electrosurgery and reduces the risk of TUR syndrome (hyponatremia, hypovolemia).TURP usually requires an overnight hospital stay. Urethral strictures are more frequent than with (non-trans-urethral procedures, and repeated procedures may be necessary because the residual prostatic tissue grows back.

TURP rarely causes erectile dysfunction, but may trigger retrograde ejaculation because removal of the prostatic tissue at the bladder neck can cause seminal fluid to flow backward into the bladder rather forward through the urethra during ejaculation.

Pre-operative Management:

  1. Inform the patient about the procedure and the expected postoperative care, including catheter drainage, irrigation and monitoring of hematuria.
  2. Discuss the complications of surgery which include:
  3. Incontinence or dribbling of urine up to 1 year after surgery and that Kegel’s exercise will help alleviate this problem
  4. Retrograde ejaculation
  5. Bowel preparation is given.
  6. Optimal cardiac, respiratory and circulatory status should be achieved to decrease risk of complications.
  7. Prophylactic antibiotics are ordered.

Post-operative Management:

  1. Urinary drainage is maintained and observed for signs of hemorrhage.
  2. Maintain patency of urethral catheter.
  3. Avoid overdistention of bladder, which could lead to hemorrhage.
  4. Administer anti-cholinergic medications to reduce bladder spasms.
  5. Maintain bed rest for the first 24 hours.
  6. Encourage early ambulation, thereafter to prevent embolism, thrombosis and pneumonia.
  7. Wound care is provided to prevent infection.
  8. Administer pain medications.
  9. Promote comfort through proper positioning.
  10. Administer stool softeners to prevent straining that can lead to hemorrhage.
  11. Reduce anxiety by providing realistic expectations about postoperative discomfort and overall progress.
  12. Encourage patient to express fears related to sexual dysfunctions and to discuss with partner.
  13. Teach measures to regain urinary control.

Photo credits: www.healthguide.howstuffworks.com

Related posts:

  1. What is Prostate Cancer
  2. Benign Prostatic Hypertrophy
  3. Anastomosis of Small Intestine (Small Bowel Resection)

Anatomy and Physiology Practice Test

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.

1. The cells that fight disease is known as:





2. A patient is complaining of pain in the region at the right side of the hypogastric region. This area of the abdomen is also known as:





3. The substance present in the largest amount in a solution is which of the following?





4. A clinical instructor is discussing about the body planes and sections. When a section is made along a horizontal plane the body is divided into:





5. A frontal section divides the body into:





6. The process by which molecules are moving from an area of higher concentration to an area of lower concentration to become evenly distributed is called:





7. Knowledge on body landmarks is essential to learn about anatomy and physiology. The posterior surface of the lower leg is known as:





8. The genetic material , deoxyribonucleic acid (DNA) is contained in:





9. While on duty, the student nurse notices that the client's crural area has lesions and abrasions. Crural area is also known as the:





10. A correct anatomical position is best exemplified by which of the following?





11. The knee in relation to the thigh is termed as:





12. If the located area is at pointing away from the midline of the body it is termed as:





13. An adolescent has been participating in a competitive sport game. Accidentally, he fell off and complains of pain in his coxal area. The adolescent has pain on:





14. The cellular material outside the nucleus but is located inside the cell membrane is called:





15. The dorsal cavity of the body has two subdivisions. Select all dorsal body cavity. A. Thoracic B. Cranial C. Spinal D. Adbominopelvic





16. To maintain homeostasis the body function interacts. The homeostatic control mechanism that responds to environmental changes is called:





17. When the body is divided into right and left parts the cut is a:





18. Which membrane junction is responsible for preventing the skin cells from pulling apart during a mechanical stress such as someone pulling a person's extremity?





19. To sustain life an individual must be able to function properly. Survival needs include the following apart from:





20. The abdominal region located at the left side of the umbilical area is called:





21. Most school age children are having cuts or wounds at the anterior knee region because of the tendency to fall during extreme activity involvement. The anterior knee region is also known as:





22. The fragile, transparent barrier that contains the cell contents is called:





23. The process by which water and solutes are forced through a membrane or capillary wall by fluid or hydrostatic pressure is called:





24. A homogeneous mixture of two or more components is known as:





25. The plasma membrane in the body allows some substances to pass through it while excluding others. This type of barrier is termed as:







Related posts:

  1. Nursing Board Review: Fundamentals of Nursing Practice Test Part 2
  2. Nursing Board Review: Maternal and Child Health Nursing Practice Test Part 2
  3. Nursing Board Review: Maternal and Child Health Nursing Practice Test Part 1

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 teagreen tea Foods That Improve Grades – Part 2/2

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 attentioncoffee 300x225 Foods That Improve Grades – Part 2/2

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

Related posts:

  1. Foods that Help to Improve Grades – Part 1/2
  2. Nutritional Guidelines for Filipinos
  3. Hypoparathyroidism
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