nurse's notes

Human Immunodeficiency virus that causes AIDS- Acquired Immunodeficiency Syndrome

• is when infected partner have sexual contact unprotected,

• when HIV positive blood transfused to other person

• the use of HIV infected needles especially among drug addicts.

• A pregnant woman may also transmit the virus to the new offpring, but not in all cases
• when using an infected needles for injectable medication
  
• accidental needle prick injuries
  

Virus outside a human body is easy to kill like when an infected blood spill to the floor, can be killed by cleaning with water and few drops of clorox. Shake hands, hugging a person with HIV, drinking glasses are not possible way that virus can be transmitted. Mosquito bites cannot transmit HiV.

Sexual Contact is mostly the mode of transmission for HIV positive here in the Philippines. More than half of HIV cases are due to heteresexual contact, followed by homosexual contact and bisexual contact.
Other modes of transmission were prenatal transmission, blood transfusion, drug use through injection and needle prick injuries. Almost half of the HIV positive were OFW and more on males .
Source: Phil Daily Inquirer

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Headache is symptom and arise from different sources through different process. It may cause inside or outside the skull. In One main symptom of Brain Tumor is headache occurs at the site of the affected area or in the site of the tumor. It may be localized but deeply in the frontal area or occipital region or depends on the location of the tumor. There is no such known cause yet of headache . This headache is intermittent but only last for several minutes or hour. Pain may be increased or changed during coughing or straining maybe due to the irritation or pressure of the affected site that triggers the pain nerve endings.

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KERATITIS is the inflammation of the cornea and if loss of substance it will result to CORNEAL ULCER. The inflammation usually spread to the iris resulting pus formation and yellowish discharge and ulceration might result to a serious complication . Cornea has an important role to vision. If there is ulceration resulting scarring and perforation will cause blindness.

Symptoms:
pain at the affected site
photophobia (fear of light)
increased lacrimation
pus and yellowish discharges - if ulceration progresses resulting inflammation of the iris(iritis)

"Prevention is better than Cure"is the best management .
Foreign bodies should be removed quickly and be sure avoid further trauma.
Seek medical treatment for corneal abrasions
Apply warm compress if advised by the physician to relieved pain and comfort.
Carry out all medications at right dose , right time and frequency as ordered by the physician

Wellness is the absence of disease. Advanced wellness is a positive approach to well being free from diseases . Now adays, there are many factors in our environment that cause illness. We are exposed to air pollution, contaminated foods and foods kept with preservatives and sometimes foods prepared with undesirable ingredients that instead of promoting wellness but the more indanger the consumers. Sometimes we don't really know how safe the food we are buying now. Producers of hogs and poultries are managed with some vaccinations , antibiotics and steroids . Plants and vegetables sprayed with pesticides. So these are environmental factors that hard to control and avoid at these time.

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Optician- is not a physician , specialized in grinding , mounting and despense lenses

Oculist, ophthalmologist or the ophthalmic physician are the medical doctor who have the skills in the treatment of all condition and diseases of the eyes. They make more thorough examination of the eye for refractive errors and other changes

Optometrist who is not a physician but licensed to examine for refractive errors in the eye and provide appropriate corrective lenses

Ocularist- a technician who makes artificial eyes or prostheses used in ophthalmology

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JAUNDICE -

• is the yellowish discoloration of the skin and sclerae
  

HEMOLYTIC JAUNDICE- an abnormally high concentration of bilirubin in the blood,


HEPATOCELLULAR JAUNDICE- due to cell damage or functional impairment

SIGNS AND SYMPTOMS:

• mildly to severely ill patient
• lack of appetite
• nausea
• body weakness
• loss of weight
• chill, fever and headache if cause by infection
• SGPT SGOT - rise moderately
• Bilirubin and BSP are increase
• cholesterol is elevated
  

CHOLESTATIC JAUNDICE- post hepatic or obstructive jaundice
SIGNS AND SYMPTOMS:

• jaundice of the sclerae and skin
• deep orange colored urine
• white or clay colored stool
• itchy skin
• dyspepsia

my nursing notes

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PORTAL HYPERTENSION -

• result to the obstruction to the flow of the portal venous blood through the liver resulting the increase of blood pressure.
• accounts for the premature of esophageal, gastric and hemorrhoidal varicosities which are prone to rupture resulting hemorrhage in upper gastrointestinal tract and rectum
• accounts for ascitis -accumulation of fluid in the abdominal cavity

Every human being loves sex but being a well discipline person of course at the right person and place. Good sex makes you feel good. To attain good and beautiful sex should perform if both partner are in the state of wellness physically and emotionally and no feeling of guilt, fear or just only by doing as an obligation. Both partner should feel like wanting it inorder to be able to perform the highest peak of climax. Furthermore they have a good relationship and the feeling should be mutual. Physically fit because need a lot of strength when the whole body will works vigorously.

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Peyronie's disease is an abnormal curvature of the penis. Unfortunately there is no cure of this disease and a male afflicted to this cannot perform sexual intercourse because cause painful sensation to both partners. It causes trauma and scar during penetration. But good enough that still nutritional supplements available in the market for penis good health and provides a psychological effect to the male who used to be depressed because of the condition of his penis.

ACUTE LEUKEMIA -

• occur at any age but most frquently in children and young adult
• onset is sudden manifested by tonsilitis , furunculosis or the appearance of abscess in the mouth or skin
• high fever after few weeks
• hemorrhagic feature appear as bleeding from the gums, the nose, the stomach and rectum
• hemorrhages (bleeding) into the skin and into the fundus of the eyes
• swelling and gangrenous ulceration of the gums, the checks, the jaw and the tonsils
• bone pain
• enlargement of lymph nodes, liver or spleen

.
NURSING INTERVENTION:
1.Prevent Infection-

• have knowledge to common types of infection associated with leukemia such as pneumonia, pharyngitis, esophagitis, peri anal cellulitis, urinary tract infection, sinusitis
• monitor temperature and aware of febrile symptoms like chills, warm to touch, redness , flushed appearance
• avoid mucosal or epithelial damage by avoiding venipuncture, subcutaneous and intramuscular injection unless absolutely necessary
• maintain normal bowel function and avoiding diarrhea or constipation that possibly irritate the mucosa
• avoid foods increase bacterial colonization of gastrointestinal tract like fresh fruits and vegetables, rare meat buttermilk
• keep perianal area always clean
• prevent cross contamination by proper handwashing before and after patient contact
• avoid close contact with visitors or relatives unnecessarily
• employ meticulous personal hygiene measures by bath daily and oral care

2Preventing and managing bleeding episodes

• monitor platelet daily
• observe and be alert on minor bleeding-petechiae, ecchymoses, conjunctival hemorrhage, epistaxis, bleeding gums, heme-emesis and stools, heme positive urine, bleeding at puncture sites, vaginal spotting
• observe and be alert on serious bleeding- headache, change in responsiveness, blurred vision, hemoptysis, hematemesis, melena, hypotension with tachycardia and dizzeness
• teach patient to remain during active bleeding episodes
• control bleeding-keep injection to a minimum

3Monitoring for toxic manifestations of chemotheraphy

• take vital signs and record and inform the doctor for any abnormal result
• make blood examination results
• weight of the patient
• watch for local irritation in the veins
• watch for any nausea and vomitting
• mouth ulcers
• expect the patient to experience hair loss during anti leukemic treatment
• assess for constipation and abdominal pain
• check deep tendon reflexes
• check for other drug side effects
• encourage patient to endure discomfort associated with the treatment
• promote oral comfort and healing

4. Control pain and discomfort
5. Promotes of coping mechanisms to deal with physiologic and emotional distress
6. Encourage participation in support group to help to diffuse anger and defendency

Most of the people now adays have poor vision at early before adulthood. Normally at age of forty, an individual usually starts vision become poorer especially if you are a working mom like me and a breadwinner of the family . Luckily i read an article about Zenni Optical in the New York Times. This is an eye opener to those who sometimes lack or no extra finances for their eyeglasses. Zenni optical.com is offering low cost frames in large selection and styles to choose from . Being a working mom I am choosy of frames . I am looking for a frame that suits to my uniform at the same time suits also in any of my casual dress if i attend church service on Sundays. I am thankful that i found one from the prescription eyeglasses for only $8. My problem solved and now seeing straight without breaking bank.

HEPATIC COMA -

• one of the most serious complication of liver disease
• manifestation of liver failure due to failure of liver cells to detoxify ammonia

Early Signs and Symptoms:

• slightly confused
• far away look in his eyes
• drowsy during the day
• wander at night
• disoriented with time and date
• if progresses - lapses with frank coma

Complication:

• gastrointestinal bleeding
• enteric infection
• fluid and electrolyte imbalance
• hyponatremia - sodium deficit
• hypokalemia- potassium deficit

NURSING CARE:

• close observation of neurologic status and record
  
• accurate record of fluid intake and output
• monitor and record vital signs and blood pressure
• symptoms of pulmonary infection to be reported

Treatment as per doctor's order:

• protein intake reduced or eliminated
• antibiotic
  
• sedatives
• analgesics

Reference: medal nursing book and my nursing notes

Last year , the downfall of America's economy, i thought i am not affected because i am only in a small business not like the other companies with huge capitals needed but they were closed due to economy crises . So many are there became unemployed and some just accepts other job even just only a contractual basis and or getting a lower pay than nothing. Despite of cutting cost for everyday expenses and monthly bills we can't say that our finances is allright. I could really feel that finances is very complicated now adays especially a mother like me who get up at night and to balance the family's budget. At times expect the unexpected expenses that you don't have someone relative or someone to owe you a cash because they are in need too.

Anyway, there are unsecured personal loans offered by americaoneunsecured.com Can offer a loan up to one hundred thousand dollars without collateral . Actually, there are 3 personal loan option to choose from depending how much you need in any purpose you want. Personal loan includes your daily expenses purposes , home improvements, vacation or business loans. Well for me, in my case , i need small business loan because i am planning to open another small store. This loan is process the same way like the other loan. There is no collateral needed and One thing for sure is, cash available anytime you need after approval of your loan application. No need to pick up the money in the office but the company deposit the amount you have loan in your account. So why not start a business now? I am personally encouraging you to start now and don't waste time . Think of how much you supposed to earned in a wasted days. If you have your own business , all the profit is yours. Is it?

Amebic Dysentery is a disease caused by a protozoa Entaemoba Histolytica. It is acquired by ingestion of E. Histolytica in food or water contaminated with human feces. A patient complained of colicky abdominal pain and passage of frequent bloody stools. The patient become feverish and s if not treated at once the patient losses weight . If the infection is acute, there is a tendency that metastasize to the other organ like liver through the way of the portal vein causing liver abscesses. Due to the ulceration of the muscle wall of the bowel caused by the ameba , tendency to get infected called peritonities.
Patient is confined in the hospital for treatment of anti amebiasis and intravenous fluid to replaced fluid loss during the diarrhea. The patient keep bed rest to gain resistance.

INFECTIOUS HEPATITIS -

• disease is acquired through ingestion of food or liquid infected with virus. It is transmitted by direct or indirect contact
• an infected person working in a restaurant can spread the disease
• those people who drink sewage- contaminated water or eat shellfish from sewage polluted shoreland
  
• incubation period 2 - 7 weeks

SIGNS AND SYMPTOMS:

• symptoms of mild upper respiratory infention
• fever
• jaundice
• anorexia
  
• nausea
• heartburn
• flatulence
• liver and spleen are moderately enlarged

Nursing Care and Medical Management

• Bed rest
• diet should be nutritious -optimal foods and fluid levels to counter act weight loss
  
• anorexia- small but frequent feeding and be supplemented as ordered by the physician