N-Trivia |
- Phases of Burn Therapy
- Estimates in Pregnancy
- Neonatal Immune System Adaptation Processes
- Cleft Palate Repair
- How I Passed the Nursing Board Examination – Part 2/2
| Posted: 16 Nov 2010 09:11 PM PST
Phases of Burn Therapy Burn is the destruction of the layers of the skin that could possibly result to the depletion of fluids and electrolytes in the body. It could either be small (body's response is localized to the injured area only) or large (consist of 25% or more of total body surface area and the body's response is systemic). Burn interventions include maintaining airway, fluid resuscitation, and relieving pain, preventing infection, providing optimum nutrition, preventing ulcerations, providing psychological support and preventing contractures. Prompt and timely management of burns would prevent threatening complications particularly in large or extensive burns. Management of Burn Injury The phases in the management of a burn injury are the following:
This phase begins immediately at the time of injury and ends with the restoration of capillary permeability. The main goal of this phase is to prevent hypovolemic shock and preserve vital organ functioning. Methods used during this time are prehospital care and emergency room care.
The management involving resuscitation begins when the fluid replacement are initiated or started and ends when the capillary integrity returns to the near normal levels and when the large fluid shifts have decreased. The amount of fluid administered to the patient is based on the client's weight and extent of injury. Usually, fluid replacement formulas are calculated from the time of injury not on the arrival on the hospital. The main goal of the resuscitative phase is to prevent shock through the initiation of fluids to maintain adequate circulating blood volume and maintain vital organ perfusion.
When the client is hemodynamically stable, has restored capillary permeability and has been showing signs of dieresis, acute phase took place. During this time, the emphasis is palced on restoration of the patient's capillary permeability and the phase continues until the wound is totally closed. Main goal of the acute phase is focused on prevention of infection, wound care, optimum nutrition and physical therapy.
Rehabilitative phase is the final phase of managing a burn injury. Most frequently, it overlaps the acute phase and it goes on after hospitalization. Main goals during this phase are helping the client gain independence and achieve maximal function. Related posts:
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| Posted: 16 Nov 2010 09:07 PM PST
Estimates in Pregnancy A good preparation for the upcoming labor and delivery prevents life threatening risks to the mother and the baby. To have an idea when the estimated date of delivery (EDD) is, the nurse should have knowledge on the different estimates used for pregnant women. These techniques may or may not exactly point out the EDD or age of gestation, but it tries to estimate the age of pregnancy and possible date of delivery for the mother to be prepared. Nagele's Rule Nagele's rule is used to determine the EDD on the basis of the first day of the last menstrual period or LMP. To calculate the date of birth in this rule, subtract 3 months from the first day of LMP then add 7 days and change the year. For example the last menstrual period (LMP) began July 30, 2010. To determine the EDD follow the following steps:
Modified McDonald's Rule
 measuring the fundic height in mcdonald's rule McDonald's Rule or method is used to determine the age of gestation by measuring from the fundus (obtaining the fundal height) to the symphysis pubis. The distance in centimeters will determine the age of gestation from 16-38 weeks. (From Benson and Pernoll's handbook of obstetrics and gynecology) Johnson's Rule Johnson's rule is used to estimate the weight of the fetus in grams. To determine this, a standard formula is used. Formula: fundic height in cm – n x k k is constant, it is always 155 n is 12 if the fetus is engaged. It is 11 if the fetus is not yet engaged. Example: A fundic height of 28 cm, and the fetus is not engaged. 28 cm – 11 x 155 = 17 x 155 = 2635 grams Bartholomew's Rule of fourths
This method estimates the age of gestation relative to the height of the fundus of the uterus above the symphysis pubis. By 3rd lunar month (12 weeks), the fundus is slightly palpated above the above the symphysis pubis. By the 5th lunar month (20 weeks), the fundus is palpable at the level of the umbilicus. On the 9th lunar month, the fundus is at the level of the umbilicus. image from womenshealthapta.org
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| Neonatal Immune System Adaptation Processes Posted: 16 Nov 2010 08:19 PM PST
Neonatal Immune System Adaptation Processes Neonates' WBC responds slowly and inefficiently when the body is invaded with microorganisms. This is due to the immaturity of the hypothalamus and inflammatory responses. Because of the immaturity of the immune system, neonates are susceptible to pathogens which do not generally affect older children. Full-term neonates receive antibodies from the mother during the last trimester of pregnancy. When an infant is breastfed, the mother continues to give antibodies to the infant. This is called passive immunity. These immunoglobulin help protect the newborn from infection. At birth there are about 55-80% of antibodies present in the newborn's body. Immunoglobulin G (IgG) There is only one immunoglobulin that passes or crosses that placenta, the IgG. IgG starts to cross the placenta at the first trimester of pregnancy. However, the largest amount of IgG transfer is noted during the third trimester of pregnancy. Thus, a preterm neonate is more susceptible to infection that a full-term infant. This type of immunoglobulin provides the fetus a passive immunity to possible bacterial and viral infections. However, the passive immunity it provides is only temporary. The immunity gradually disappears at about 6 to 8 months of life. The gradual disappearance of passive immunity, leads to the gradual production of larger quantities of immunoglobulin to replace the IgG from the mother. Immunoglobulin M (IgM) IgM is the first immunoglobulin produced by the body when the neonate is distressed, has acquired an infection or is challenged. When a newborn is exposed to environmental antigens, production of IgM rapidly increases. This type of immunoglobulin provides protection from gram-negative bacteria. IgM cannot cross the placental barrier. In cases where large amount of IgM is found in the placenta, possible exposure to infection in the utero is probable. Immunoglobulin A (IgA) Another immunoglobulin produced by the infant's body is called the Immunoglobulin A (IgA). Neonates are susceptible to infections in the gastrointestinal (GI) and respiratory systems. IgA is vital in providing protecting of those systems. Another important function of IgA is limiting the absorption of antigenic protein the diet of an infant. A particular form of IgA is present in the colostrum and breast milk. This is the main reason why breastfed infants have more immune protection than the formula fed babies. Related posts:
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| Posted: 16 Nov 2010 04:31 PM PST
Cleft palate repair – is surgical repair of congentinal defects in the palate Causes of defects Complications:
Time of surgery preferred: Before the 2 years old Procedure:
Nursing Considerations in preparing the patient
Nursing Considerations after the procedure:
Photo credits: www.healthguide.howstuffworks.com Related posts: |
| How I Passed the Nursing Board Examination – Part 2/2 Posted: 16 Nov 2010 03:10 PM PST
How I Passed the Nursing Board Examination – Part 1/2 Aside from praying, exerting effort, nourishing the body with proper foods, engaging in group studies and aiming high, books, and review centers can also help a person pass the Nursing Local Board Examination. I would like to share the books that I used before. The following are:
Regarding the review center, I would say that all review centers nationwide are good. However, you have to choose which review center suits you the best. There are some who provides extensive lectures and Q/A practice test whilst others are not conducting a thorough lecture but integrates the concept in a daily basis structured practice exams. With me, I like integrating the structured lecture in a daily basis practice exam because I like to enhance my test-taking skills rather than going through those extensive lectures. But I am not saying that extensive lectures are bad, in my case I just understand a concept more when I am first questioned about it. However, some of my friends like a thorough lecture first before answering a practice test. What works best for you? If my style or my other friend's case works best for you then start looking for a review center that fits your needs and not because of the freebies that they are offering. Study a lot and practice answering NLE patterned questions. Practicing more often helps enhance your test-taking strategy. You need to develop this strategy to correctly choose the right option even though you only have the slightest idea on the topic asked. However, don't overwork yourself. You know yourself well, and allot time for rest, relaxation and enjoyment once in a while (but not too much of enjoyment). And before I end this article, let me share you this verse that helped strengthening and uplifting a positive spirit within me when I was about to take the board exam (I'm not talking about religion here). It is taken from James 1:5 and here it goes, "If any of you lacks wisdom, he should ask God, who gives generously to all without finding fault, and it will be given to him." Whoever you are, wherever you are, Nursingcrib’s prayers are with you guys. God bless you all! Related posts:
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