N-Trivia

Posted: 07 Dec 2010 09:58 PM PST

Obsessive Compulsive Disorder (OCD) is characterized by persistent thought and urges to perform repeated acts or rituals, usually as a means of releasing tension or anxiety. The frequency and intensity of the ritualistic behaviors, such as handwashing, ordering, or checking, are time consuming (taking more than one hour per day) and cause marked distress, significant impairment, or interfere with daily living.

Obsession

The person experiences recurrent and persistent thoughts, impulses, images that are intrusive, disturbing, inappropriate, and usually triggered by anxiety.
The thoughts, images, and impulses are not simply excessive worries about real life problems.
The person recognizes the thoughts, images, and impulses are from within own mind.

Compulsion

Repetitive behaviors or mental acts that a person feels driven to perform, which usually adhere to a rigid and specifically defined routine.
The behaviors and ideations are typically aimed at reducing anxiety or preventing some dreaded situation from occurring.

Specific Biological Factors

There is some evidence that indicates OCD is linked to a deficiency in serotonin.
Clients have also been shown to have abnormalities in frontal lobes and basal ganglia; it is unclear what the implications are for clinical care.

Signs and Symptoms

Obsessions – recurrent, persistent ideas, thoughts or impulses, involuntarily coming to awareness.
Ruminations – forced preoccupation with thoughts about a particular topic, associated with brooding and inconclusive speculation.
Cognitive rituals – elaborate series of mental acts the client feels compelled to complete.
Compulsive motor rituals – elaborate rituals of everyday functioning such as grooming, dressing, eating, washing or checking doors or appliances.
Other symptoms – chronic anxiety, low self-esteem, difficulty expressing positive feelings and depressed mood.

Nursing Diagnoses

Anxiety
Powerlessness
Ineffective verbal communication
Self-esteem disturbance
Impaired social interaction
Risk for injury
Sleep pattern disturbances
Ineffective breathing pattern

Nursing Interventions

Limit, but do not interrupt, the compulsive acts.
Teach the client to use alternate coping methods to decrease anxiety.
Client's behavior maybe frustrating to staff and family. Power struggles often result. Consistency to the approach to care is critical.
Assess the client's needs carefully.
Provide an environment that has structure and predictability as a strategy to decrease anxiety.
Risk associated with the use of alcohol and drug abuse.

Operating Room Team: Sterile Members

Posted: 07 Dec 2010 09:43 PM PST

Operating Room Team

When a patient is about to undergo a surgical procedure direct patient care will be pass on to the operating room personnel. The operating room (OR) team is responsible for the well-being of a patient throughout the operation. This team should not only consider the patient's privacy but will also promote safety measures for the patient. One way of promoting safety of patients inside the OR is by preventing infection from the surgical incision that will be done.

As described, the OR team is similar to that of a symphony orchestra. There are many members in an orchestra but they work together in unison and harmony to create a superb outcome. The operating room (OR) team does the same thing. They coordinate their work with each other to have a successful operation.

Classification of OR team

There are two types of OR team according to the functions of its members.

Sterile team members

Surgeon
Assistants to the surgeon
Scrub person (either a registered nurse or surgical technologist)

Unsterile team members

Anesthesiologist
Circulator
Biomedical technicians, radiology technicians or other staff that might be needed to set up and operate specialized equipment or devices essential in monitoring the patient during a surgical operation

Operating Room Team: Sterile Personnel

The members of the OR sterile team will do the following things:

Perform surgical hand washing (arms are included).
Don sterile gowns and gloves.
Enter the sterile field.
Handles sterile items only.
Functions only within a limited area (sterile field).
Wear mask.

Operating Surgeon

The surgeon is a licensed physician (MD), osteopath (DO), oral surgeon (DDS or DMD), or podiatrist (DPM). This professional is especially trained and is qualified by knowledge and experience for the performance of a surgical operation.

Responsibilities of a surgeon:

Preoperative diagnosis and care of the patient
Performance of the surgical procedure
Postoperative management of care

Assistants to surgeon

During a surgical procedure, the operating surgeon can have one or two assistants to perform specific tasks under his/her (operating surgeon) direction. The responsibilities of a surgeon's assistant:

Help maintain the visibility of the surgical site
Control bleeding
Close wounds
Apply dressings
Handles tissues
Uses instruments

Types of Assistants to Surgeon:

First Assistants could either be:

A qualified surgeon or resident in an accredited surgical education program. The first assistant should be capable of assuming the operating surgeon's responsibility in cases of incapacitation or accidents.
Registered Nurse and surgical technologists that have a written hospital policy permitting the action.

Second Assistant could be a registered nurse or surgical technologist. These staff should be trained and they mar retract tissues and suction body fluids to help provide exposure of the surgical site.

Scrub Person

A scrub person could be the following: