nurse's notes

Hem0rrhoid is a varicose veins in the lower rectum or anal canal. Asymptomatic hemorrhoids does not require any treatment but when a patient manifest signs and symptoms of hemorrhoids, he/she must see a doctor. A patient advised to adhere to a lower roughage, high fiber diet to keep the stool soft. Frequent hot sitz bath to relieve pain and prevents swelling.
Surgeon advised Hemorrhoidectomy if symptoms are severe.
Hemorrhoidectomy is a removal of hemorrhoid
Indication for Hemorrhoidectomy:
> indicated when patient have prolonged bleeding
>unbearable pain and itchiness
>when a patient complained of unrelieved discomforts.
Pre- operative nursing care:
>be sure the patient or immediate relative signed the consent for operation
>shave the perineum
>lower bowel should be evacuated thoroughly, totally clean to prevent defecation during the operation
>prepare patient physically, must had full bath
>bring to Operating Room with proper identification .
>carry out pre -op medication as ordered by the surgeon

Gas gangrene is a severe soft tissue infection with muscle necrosis that may complicate compound fractures or contused or lacerated wounds or surgical incision. There are different species of Clostridia may produces gas gangrene.

Sign and Symptoms:
>severe pain at the site of injury
>tenderness and discoloration of the surrounding skin
>affected muscles are reddish purple and black
>watery fluid with foul odor from the affected site
>fever
>apprehension and increase cardiac rate of the patient
>anorexic

Nursing Care:
> extreme care to prevent further spread of the infection to other wounds
>strict compliance of aseptic technique
>use only single dressing for the patient alone
>isolate the patient
>encourage fluid intake and nutritiuos foods
>high caloric diet

Tetanus is a disease caused by Bacillus Tetani ( Clostridium Tetani ). This bacteria is anaerobe meaning can not survive in the presence of oxygen. They usually found in a deep wound with small external opening injured by a contaminated with soil, dust and feces of animals or human.

Signs ans Symptoms:
>restlessness, headache
>hyper irritability due to hypersensitive of motor and sensory nerves
>Lockjaw ( trismus )due to spasm of the muscles as first affected muscles in the jaws resulting patient can not open his mouth
>generalized convulsion- a stimuli to a loud voice or loud banging of doors. The patient manifest head retraction, fully extended feet , arched of the trunk (opisthutonus). Sardonic grin due to spasm of the facial muscles.

Death may cause by :
> spasm of respiratory muscles
> lack of nourishment
>excessive fatigue due to muscles spasm

Prevention:
>Routine immunization with tetanus toxoid in all children or in an industrial or in an environment with a history of increase incidence of the disease.
>Effective wound care