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Physical assessment is taking an educated, systematic look at all aspects of an individual’s health status utilizing knowledge, skills and tools of health history and physical exam. To collect data- information about the client’s health, including physiological, psychological, sociocultural and spiritual aspects To establish actual and potential problems To establish the nurse-client relationship Method: The history is done first, then the physical examination focuses on finding data associated with the history. Health History- obtained through interview and record review. Physical exam- accomplished by tools and techniques ** A complete assessment is not necessarily carried out each time. A comprehensive assessment is part of a health screening examination. On admission, you will do an admission assessment (not necessarily including everything presented here) and document it on the admission form. You will do a daily shift assessment (patient systems review). And, if client has a specific problem, you may assess only that part of the body (focused). Data Collection: Information is organized into objective and subjective data: Subjective: Apparent only to person affected; includes client’s perceptions, feelings, thoughts, and expectations. It cannot be directly observed and can be discovered only asking questions. Objective: Detectable by an observer or can be tested against an acceptable standard; tangible, observable facts; includes observation of client behavior, medical records, lab and diagnostic tests, data collected by physical exam. ** To obtain data for the nursing health history, you must utilize good interview techniques and communications skills. Record accurately. DO NOT ASSUME. D. Frameworks for Health Assessment There are two main frameworks utilized in health assessment: Head to Toe- systematic collection of data starting with the head and working downward. Functional Health Assessment- Gordon’s 11 functional health patterns that address the behaviors a person uses to maintain health. PERSON is the ACC-ADN framework for assessment. It is similar to Gordon's functional health patterns.
Acute kidney injury is common entity in medical practice. The present definition is based on a serum creatinine rise of more 0.3 mg/dl in 48 hours or less, a 50% increase from the baseline over a period of 07 days or a urine output of less than 0.5 ml/kg/hour for more than 06 hours. The main causes of acute kidney injury may be classified into pre renal, intrinsic or post renal causes. Rapid diagnosis and prompt treatment is essential to prevent mortality or morbidity. This presentation discusses in detail the causes of all three mechanisms, pre-renal, post renal and intrinsic.
This video: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women of reproductive age. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can all occur in women with polycystic ovary syndrome. In adolescents, infrequent or absent menstruation may raise suspicion for the condition. The exact cause of polycystic ovary syndrome is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications, such as type 2 diabetes and heart disease.
Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis. There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer. Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact. Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
Things nurses should know about their patients. As a new nurse, it can be hard trying to determine what information you need to know during your shift. In addition, nurses can get extremely busy and strapped for time, so how do you keep up with all of the things you need to know?
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In this video, Nurse Sarah explains some of the most important things nurses need to know about their patients. However, these things can vary depending on your specialty and patient population. These tips are designed to help new nurses begin to think like a nurse.
Some examples of thing nurses should know about their patients include their allergies, code status, diagnosis, medications, vital signs, and much more.
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Ellis demonstrates how to administer an intradermal, subcutaneous, and intramuscular injection.
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.
#NCLEX #ClinicalSkills #injections #HESI #Kaplan #ATI #NursingSchool #NursingStudent #Nurse #RN #PN #Education #LVN #LPN #nurseeducator
00:00 What to expect
00:20 Intradermal injections
00:35 Cleaning site
00:54 Explaining bevel up
1:40 Inserting needle
2:00 Injecting medication
2:16 Withdrawing needle
2:29 Subcutaneous Injections
2:39 Selecting site for subcutaneous injections
3:08 Cleaning subcutaneous injections site
3:18 Pinching subcutaneous injections site
3:30 Inserting needle subcutaneous injections
4:13 Injecting medication subcutaneous injections
4:23 Post injection
4:36 Intramuscular injection
4:54 Locating intramuscular injection site
5:18 Cleaning intramuscular injection site
5:38 Inserting needle intramuscular injection
6:28 Anchoring needle intramuscular injection
6:44 Injecting medication intramuscular injection
6:55 Withdrawing needle intramuscular injection
7:05 Disposing of needle
7:43 Cleaning site
8:00 Displacing with Z-track
8:10 Inserting needle
8:23 Releasing tissue
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Thoracentesis is a procedure used to obtain a sample of fluid from the space around the lungs. Normally, only a thin layer of fluid is present in the area between the lungs and chest wall. However, some conditions can cause a large amount of fluid to accumulate. This collection of fluid is called a pleural effusion.
Warning: This video contains actual surgical footage, which may not be suitable for all viewers.
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Cardiothoracic surgeon Faisal Bakaeen, MD, discusses how he does single and bilateral internal mammary arteries, and the benefits of doing this type of coronary artery bypass.
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Acute respiratory distress syndrome is characterised by rapid onset dyspnea, bilateral infiltrates on chest x-ray and respiratory failure. This may be due to conditions which directly affect the lung such as pneumonia, aspiration and near drowning. It may also be due to indirect lung injury, as in conditions like sepsis, pancreatitis, trauma and poisoning. The diagnostic criteria of ARDS, often described as the Berlin criteria is discussed in this presentation along with various management aspects of ARDS including ventilation strategies and use of antibiotics and diuretics. Finally prognostic features and alternative strategies are also discussed.
Aplastic anemia is a hematopoietic disorder caused due to T lymphocyte mediated destruction of stem cells resulting in pancytopenia with a cellular bone marrow and normal cell cytogenetics. The causes of aplastic anaemia may be inherited or acquired. The causes and the diagnostic approach, along with spectrum of severity of this disorder is discussed in this presentation. A detailed discussion of the management options, along with pharmacological therapy and supportive therapy in these cases is also discussed. The treatment options include, in addition to a stem cell transplant, anti-thymocyte globulin, cyclosporine, methyprednisolone and eltrombopag (for patients who have failed treatment on combined modality therapy with ATG and cyclosporine)
A step wise approach to the pathogenesis, types, disease entities and diagnosis of vasculitis. This discussion also includes the management options of vasculitis and their adverse drug reactions. In essence, vasculitis is a clfinicopathologic process characterised by inflammation and damage of blood vessels. This may be mainly due to three pathological processes which include immune complex deposition, anti-neutrophillic antibody formation and pathological T lymphocyte response and granuloma formation. The disease entities include Wegner's granulomatosis, Churg Strauss and many others. These present with palpable purpura, unexplained renal dysfunction etc which can be diagnosed based on biopsy and angiogram.
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