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Sickle cell anemia (sickle cell disease) is a disorder of the blood caused by an inherited abnormal hemoglobin (the oxygen-carrying protein within the red blood cells). The abnormal hemoglobin causes distorted (sickled) red blood cells.
Insulin resistance — also called syndrome X or metabolic syndrome— is so pervasive today that we evaluate nearly every woman who visits our clinic to determine her level of risk. Most are taken aback when they learn they either already have insulin resistance syndrome (or as I call it pre-pre diabetic) or are well on their way to developing it. Experts estimate that 25% of all Americans suffer from insulin resistance. We believe the percentage is much higher among perimenopausal women. Because insulin is one of the “major” hormones, it’s also impossible for your body to balance its “minor” hormones (estrogen, progesterone and testosterone among them) until your insulin metabolism is balanced first. To put it simply, if you have hot flashes and you are insulin resistant, it’s going to be nearly impossible to cure the hot flashes without first healing the insulin resistance. Cortisol is also a “major” hormone – to understand it’s role in hormonal balance, read our related articles on adrenal fatigue. The good news is that you can heal insulin resistance. This has been a primary focus of our practice at Women to Women for over a decade, and our approach has been quite successful. Throughout the website you will find simple solutions on how to begin to heal this problematic syndrome.
Spinal stenosis can put pressure on the spinal cord and the nerves within the spine. It commonly occurs in the neck and lower back. The condition is often caused by age-related wear and tear. Symptoms, if they occur, include pain, numbness, muscle weakness, and impaired bladder or bowel control. Treatment includes medication, physical therapy, and possibly surgery
Vial medication administration nursing skill. Learn techniques to withdraw medication from a vial using a syringe with a needle.
Medications can come in different forms, such as ampules, vials, tablets, capsules, and so forth. When withdrawing medication from a vial, there are a few things you'll want to know as a nursing student or nurse.
First, there are different needles that can be attached to the syringe. You can use a traditional needle with a beveled tip; you can use a blunt-tip needle to reduce the risk of needle sticks; or you can use a filter needle, which is sometimes required or recommended when drawing medication from a vial, particularly in cases of reconstituted medication.
When withdrawing from a vial, you'll want to do these things (assuming they fit with the protocols and manufacturer's instructions):
NOTE: Some medications or vaccines may require a different technique, so always consult with the manufacturer's instructions.
-gather your supplies
-perform hand hygiene
-clean the vial's top with alcohol prep
-attach the appropriate needle
-stick the needle using a technique to prevent coring of the rubber on the vial (start with 45 degree angle, and as you puncture the vial, rotate the needle to a 90 degree angle in one smooth motion).
-push air into the vial equal to the amount of medication you plan to draw
-invert the vial to withdraw medication
-remove air bubbles
-and much more
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The urinary bladder is a hollow muscular organ that collects urine from the kidneys before disposal by urination. A hollow muscular, and distensible (or elastic) organ, the bladder sits on the pelvic floor. Urine enters the bladder via the ureters and exits via the urethra.
Closed Reduction of Distal Radius Fractures - Discussion: (distal radius fracture menu) - closed reduction & immobilization in plaster cast remains accepted method of treatment for majority of stable distal radius frx; - unstable fractures will often lose reduction in the cast and will slip back to the pre-reduction position; - patients should be examined for carpal tunnel symptoms before and after reduction; - carpal tunnel symptoms that do not resolve following reduction will require carpal tunnel release; - cautions: - The efficacy of closed reduction in displaced distal radius fractures. - Technique: - anesthesia: (see: anesthesia menu) - hematoma block w/ lidocaine; - w/ hematoma block surgeon should look for "flash back" of blood from hematoma, prior to injection; - references: - Regional anesthesia preferable for Colles' fracture. Controlled comparison with local anesthesia. - Neurological complications of dynamic reduction of Colles' fractures without anesthesia compared with traditional manipulation after local infiltration anesthesia. - methods of reduction: - Jones method: involves increasing deformity, applying traction, and immobilizing hand & wrist in reduced position; - placing hand & wrist in too much flexion (Cotton-Loder position) leads to median nerve compression & stiff fingers; - Bohler advocated longitudinal traction followed by extension and realignment; - consider hyper-extending the distal fragment, and then translating it distally (while in extended position) until it can be "hooked over" proximal fragment; - subsequently, the distal fragment can be flexed (or hinged) over the proximal shaft fragment; - closed reduction of distal radius fractures is facilitated by having an assistant provide counter traction (above the elbow) while the surgeon controls the distal fragment w/ both hands (both thumbs over the dorsal surface of the distal fragment); - flouroscopy: - it allows a quick, gentle, and complete reduction; - prepare are by prewrapping the arm w/ sheet cotton and have the plaster or fibroglass ready; - if flouroscopy is not available, then do not pre-wrap the extremity w/ cotton; - it will be necessary to palpate the landmarks (outer shaped of radius, radial styloid, and Lister's tubercle, in order to judge success of reduction; - casting: - generally, the surgeon will use a pre-measured double sugar sugar tong splint, which is 6-8 layers in thickness; - more than 8 layers of plaster can cause full thickness burns: - reference: Setting temperatures of synthetic casts. - position of immobilization - follow up: - radiographs: - repeat radiographs are required weekly for 2-3 weeks to ensure that there is maintenance of the reduction; - a fracture reduction that slips should be considered to be unstable and probably require fixation with (pins, or ex fix ect.) - there is some evidence that remanipulation following fracture displacement in cast is not effective for these fractures; - ultimately, whether or not a patient is satisfied with the results of non operative treatment depends heavily on th