The major elements of the cardiac exam include observation, palpation and, most importantly, auscultation (percussion is omitted). As with all other areas of the physical exam, establishing adequate exposure and a quiet environment are critical. Initially, the patient should rest supine with the upper body elevated 30 to 45 degrees. Most exam tables have an adjustable top. If not, use 2 or 3 pillows. Remember that although assessment of pulse and blood pressure are discussed in the vital signs section they are actually important elements of the cardiac exam.

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Ellis demonstrates how to clean a reusable inner cannula, care for a tracheostomy site, and suction a tracheostomy.

Our Critical Nursing Skills video tutorial series is taught by Ellis Parker MSN, RN-BC, CNE, CHS and intended to help RN and PN nursing students study for your nursing school exams, including the ATI, HESI and NCLEX.

#ClinicalSkills #NCLEX #tracheostomy #patientcare #ATI #Kaplan #LVN #PN #RN #nurseeducator #nurse #nursingstudent #murse #clinicals #clinicalnursingskills

00:00 What to expect Tracheostomy Care and Suctioning
0:33 Explaining the process Tracheostomy Care and Suctioning
1:10 Positioning patient for a Tracheostomy Care and Suctioning
1:33 Opening tray
1:46 Pouring saline
1:58 Removing inner cannula
2:14 Removing clean gloves
2:25 Donning sterile gloves
3:16 Showing tray contents
3:53 Removing previous dressing
4:06 Pouring saline
4:27 Cleaning stoma
5:10 Cleaning faceplate
5:20 Drying site
5:30 Cleaning inner cannula
6:00 Drying inner cannula
6:20 Reinserting inner cannula
6:40 Placing new gauze
7:00 Replacing ties
8:00 Replacing oxygen
8:13 Preparing for suction
8:58 Checking suction
9:30 Opening saline
9:42 Opening kit
9:58 Donning sterile gloves
11:04 Setting up saline container
11:20 Pouring saline
11:52 Connecting catheter to suction
12:46 Inserting catheter
13:10 Removing catheter
13:24 Rinsing catheter
13:40 Reoxyginating
14:05 Reinserting catheter
14:17 Removing catheter
14:29 Rinsing catheter
14:44 Reoxyginating
14:55 Cleaning up
15:09 Chatting about sterility
17:00 Checking a tie

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The goal of breast cancer surgery is to remove the entire tumor from the breast. Some of the lymph nodes in the underarm area (axillary nodes) may also be removed to see if cancer cells are present.

A very interesting video showing how white blood cells (Neutrophil) are chasing bacteria (Diplococci). It also shows how the white blood cell engulf the bacteria. This is a real video.

Dr. Fizan Abdullah is head of the Division of Pediatric Surgery and vice chair of the Department of Surgery at Ann & Robert H. Lurie Children's Hospital of Chicago. His special interests include ​Chest wall deformities, pectus excavatum, abdominal wall defects, neonatal surgery, pulmonary and upper airway malformations, congenital diaphragmatic hernia, esophageal and gastrointestinal anomalies, hernia repair, tissue engineering, extracorporeal membrane oxygenation (ECMO), surgical safety protocols and surgical infections.

Learn more at www.luriechildrens.org

A stye (also called a hordeolum) is a small, red, painful lump that grows from the base of your eyelash or under the eyelid. Most styes are caused by a bacterial infection. There are two kinds of styes: External hordeolum: A stye that begins at the base of your eyelash. Most are caused by an infection in the hair follicle. It might look like a pimple. Internal hordeolum: A stye inside your eyelid. Most are caused by an infection in an oil-producing gland in your eyelid.

systemic inflammatory response syndrome (SIRS). This is most likely secondary to sepsis from an infection of the patient's Hickman catheter given the associated skin findings, although culture results are needed to confirm this diagnosis. The patient's low blood pressure is likely secondary to developing septic shock, and he has already appropriately been treated with intravenous fluids. Catheter removal is indicated given his hemodynamic instability. Catheter removal is also indicated in patients with severe sepsis with organ hypoperfusion, endocarditis, suppurative thrombophlebitis, or persistent bacteremia after 72 hours of appropriate antibiotic therapy. Long term catheters should also be removed if culture results are positive for S. aureus, P. aeruginosa, fungi, or mycobacteria.

DR.JUE IS SUGAR LAND' S PREMIERE LUMINEERS AND SNAP ON SMILE DENTIST. DR. JUE HAS BEEN FEATURED ON FOX NEWS FOR LUMINEERS! Lumineers . The Den-Mat Corporation has patented a type of porcelain veneer called Lumineer, and we are proud to announce our full certification in Lumineer application. Lumineers work great for fixing gapped teeth, teeth that slope inward, or teeth that are to small. Because there is no drilling, Lumineers are nearly painless to apply.

Cholelithiasis involves the presence of gallstones (see the image below), which are concretions that form in the biliary tract, usually in the gallbladder. Choledocholithiasis refers to the presence of 1 or more gallstones in the common bile duct (CBD).

The brain is that part of the CNS contained within the cranial cavity (figure 13.1). It is the control center for many of the body's functions. The brain is much like a complex central computer but with additional functions that no computer can as yet match. Indeed, one goal in computer technology is to make computers that can function more like the human brain. The brain consists of the brainstem, the cerebellum, the diencephalon, and the cerebrum (table 13.1). The brainstem includes the medulla oblongata, pons, midbrain, and reticular formation. The structure of the brain is described in this chapter. Its functions are primarily discussed in chapter 14. Twelve pairs of cranial nerves, which are part of the PNS, arise directly from the brain. Two pairs arise from the cerebrum, nine pairs arise from the brainstem, and one pair arises from the spinal cord.

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Ingrown toenails occur in both men and women. According to the National Health Services (NHS), ingrown toenails may be more common in people with sweaty feet, such as teenagers. Older people may also be at higher risk because toenails thicken with age. Many things can cause an ingrown toenail, including: cutting toenails incorrectly (Cut straight across, since angling the sides of the nail can encourage the nail to grow into the skin.) irregular, curved toenails footwear that places a lot of pressure on the big toes, such as socks and stockings that are too tight or shoes that are too tight, narrow, or flat for your feet toenail injury, including stubbing your toe, dropping something heavy on your foot, or kicking a ball repeatedly poor posture improper foot hygiene, such as not keeping your feet clean or dry genetic predisposition

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Scleroderma (skleer-oh-DUR-muh) is a group of rare diseases that involve the hardening and tightening of the skin and connective tissues — the fibers that provide the framework and support for your body. In some people, scleroderma affects only the skin. But in many people, scleroderma also harms structures beyond the skin — such as blood vessels, internal organs and the digestive tract. Signs and symptoms vary, depending on which structures are affected. Scleroderma affects women more often than men and most commonly occurs between the ages of 30 and 50. While there is no cure for scleroderma, a variety of treatments can ease symptoms and improve quality of life.

Prenatal repair of myelomeningocele (MMC), the most common and severe form of spina bifida, is a delicate surgical procedure where fetal surgeons open the uterus and close the opening in the baby's back while they are still in the womb.

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