N-Trivia
| Billroth Surgery Posted: 26 Dec 2010 06:45 PM PST 
Billroth Surgery is a partial resection of the stomach with anastomosis to the duodenum (Billroth I) or to the jejunum (Billroth II). It is a standard treatment for ulcer disease, stomach cancer, injury and other diseases of the stomach. This was first described by Theodor Billroth, the pioneer in modern surgery. Billroth I & Billroth II Billroth I is also called gastroduodenostomy. It involves the partial gastrectomy or removal of the antrum and pylorus of stomach) with anastomosis of the gastric stump to the duodenum.
Billroth II is also called gastrojejunostomy. It involves the partial gastrectomy or removal of the antrum and pylorus of stomach) with anastomosis of the gastric stump to the jejunum. Procedure - After removing a piece of the stomach, the surgeon reattaches the remainder to the rest of the bowel
- Billroth I gastroduodenostomy specifically joins the upper stomach back to the duodenum while Billroth II joins it to the jejunum
Preparation - Thorough Medical History Taking and assessment
- Intravenous or intramuscular administration of antibiotics
- Insertion of intravenous lines for administration of electrolytes and supply of compatible blood
Nursing Consideration (Postoperative) - Monitor Vital Signs Accurately
- Monitor Operative Site and assess for any signs of infection
- Administer pain Medication as indicated or as ordered
Possible Side Effects - Duodenogastric reflux, resulting in persistent vomiting
- Dumping syndrome, occurring after a meal and characterized by sweating, abdominal pain, vomiting, lightheadedness, and diarrhea
- Low blood sugar levels (hypoglycemia) after a meal
- Malabsorption of necessary nutrients, especially iron, in patients who have had all or part of the stomach removed
Photo credits: www.medical-dictionary.thefreedictionary.com Related posts: - Peptic Ulcer
- Pancreaticoduodenectomy (Whipple Procedure)
- Stomach Cancer (Gastric Cancer)
  |
| Bipolar Versus Unipolar Posted: 26 Dec 2010 05:58 PM PST 
Bipolar - Results from disturbances in the areas of the brain that regulate mood
- It involves periods of excitability (mania) alternating with periods of depression
- This may affects men and women equally
- Usually appears between ages 15 – 25
Cause - Unknown
- It occurs more often in relatives of people with bipolar disorder
Symptoms Manic Phase - Agitation or irritation
- Elevated mood (hyperactivity, increased energy, lack of self-control, racing thoughts)
- Inflated self-esteem (delusions of grandeur, false beliefs in special abilities)
- Little need for sleep
- Over-involvement in activities
- Poor temper control
- Reckless behavior (binge eating, drinking, and/or drug use, impaired judgment, sexual promiscuity, spending sprees)
- Tendency to be easily distracted
Depressed Phase - Difficulty concentrating, remembering, or making decisions
- Eating disturbances
- Fatigue or listlessness
- Feelings of worthlessness, hopelessness and/or guilt
- Loss of self-esteem
- Persistent sadness and thoughts of death
- Sleep disturbances
- Suicidal thoughts
- Withdrawal from activities that were once enjoyed
Medical Intervention - Proper History Taking and Observation
- Antipsychotic medications (such as lithium and mood stabilizers or antidepressant for depressive phase)
- Electroconvulsive therapy (ECT)
Nursing Interventions - Provide a calm environment
- Giving health teachings about regular exercise, and proper diet
- Explain to patient that getting enough sleep helps keep a stable mood
Unipolar - Another name for major depressive disorder
- Occurs when a person experiences the symptoms for longer than a two-week period
Causes - The biopsychosocial model proposes that biological, psychological, and social factors all play a role in causing depression
- The diathesis–stress model specifies that depression results when a preexisting vulnerability, or diathesis, is activated by stressful life events
Symptoms - Depressed mood
- A lack of interest in activities normally enjoyed
- Changes in weight and sleep
- Fatigue
- Feelings of worthlessness and guilt
- Difficulty concentrating
- Has thoughts of death and suicide
Medical Interventions - Antidepressants
- Tricyclic antidepressants
- Monoamine oxidase inhibitors
- Selective serotonin re-uptake inhibitors
- Electroconvulsive therapy
Nursing Interventions - Interpersonal Therapy
- Psychotherapy
- Encourage client to have a regular exercise
- Cognitive behavioral therapy
- Behavioral modification therapy
Difference between Bipolar and Unipolar Disorder | UNIPOLAR | BIPOLAR | | Gender and Age of Onset | Affects women more often than men, appears later in life | Affects men and woman equally, average age of onset suspected to be 18 years | | Sleep | Generally insomnia, difficulty falling asleep or waking repeatedly during the night | Generally hypersomnia, excessive tiredness and difficulty waking in the morning | | Appetite | Often has a loss of appetite and diminished interest in eating | Often binge-eating and cravings for carbohydrates, may alternate with loss of appetite | | Activity Level | Agitated, pacing and restlessness are more common | Inactivity, somnolence, a slowing down of movements (psychomotor retardation) more common | | Mood | Sadness, hopelessness, feelings of worthlessness | Same as for unipolar, although guilt is often much more prominent | | Other | Episodes often last longer, sometimes more responsive to treatment | Risk of drug abuse and suicide higher than in unipolar depression | Photo credits: www.nlm.nih.gov Related posts: - Bipolar Disorder Signs and Symptoms
- Major Depressive Disorder Symptoms and Therapeutic Management
- Obsessive Compulsive Disorder (OCD)
  |
