Kuwentong Nurse Atbp

ADVANCED CLINICAL SKILLS FOR GENITO URINARY NURSE

2009-05-03T07:44:00.000-07:00

Poor sexual health is now a major public health issue in the UK, with all four
countries having a sexual health strategy, strategic framework or action plan
in place. The Government in England wishes to improve sexual health services,
with a focus on improving access.
All over the country nurses are working in new and innovative ways in
sexual and reproductive health. Many are working in advanced and specialist
clinical roles as independent practitioners and more creative posts are being
developed in the National Health Service to maximise optimum use of nurses’
skills. Several Nurse Consultant posts have now been developed in the speciality
of Genito Urinary Medicine (GUM).
With this important public health agenda in mind, this book provides a valuable
resource for nurses working towards, and at, advanced level in GUM, but the content is also transferable and relevant to nurses working in non-acute
settings.

This book also provides a skill base for more junior nurses in GUM to aspire to. Using a competency-based approach, many GUM nurses could develop their practice to an advanced level, using nurse prescribing and/or patient group directions to complement the level of service they provide. I welcome the publication of this book, as I firmly believe, that historically
there has never been a better time for nurses to develop their roles in GUM
and sexual health, to drive forward improvements and to lead service delivery
in this challenging, changing and dynamic area of health in the twenty-first century.

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KEY NURSING SKILLS

2009-05-02T07:17:00.000-07:00

The ‘nursing process’ is a planned, problem-solving approach to meeting a patient’s health care and nursing needs (Lippincott 2000).
It is a systematic sequence of events in which the first stage is to assess a patient’s needs by the collection of objective and subjective information.
The next stage is interpretation of this information, which results in the identification of actual or potential problems that the patient is experiencing. This can be called making a nursing diagnosis (Lippincott 2000). Nursing goals to alleviate or prevent these problems can then be determined and problems prioritized so that the patient’s immediate nursing care needs are met. These goals are used
to plan the direction and type of nursing interventions required. They should be patient-focused, and SMART:

S pecific
M easurable
A chievable
R ealistic
T imebound

For example, a patient may state his problem as being extreme breathlessness at rest. A short-term goal may be that his respiration rate will be 25–28 breaths per minute within four hours. This would allow time for medication and nursing measures to take effect. This goal statement fulfils the SMART requirements, and would be followed by specific nursing interventions that would contribute to achieving the goal. There are examples of problems and goals throughout this book, together with nursing interventions to meet the goals.

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THE CASE OF UNFAITHFUL WIFE

2009-05-01T07:52:00.000-07:00

This is a case of a 22 year of female patient who sought consult due to abdominal pain. Patient is married to an OFW who is currently working abroad for the past two years. She just underwent a self-induced abortion. The said pregnancy was not fathered by her OFW husband.
It was late afternoon when a woman in office attire accompanied by her female co-worker arrived at the ER. The patient, a deadringer for Diana Zubiri, looked pale and drowsy. Her face was in noticeable pain as she was holding on to her stomach.

I over heard the communication,
"Doc, kanina pa ho kasi sumasakit ang tiyan, namumutla na nga. Muntik pang mahimatay nung pauwi kami," the co-worker initially remarked.

I took the Vital Sign BP was 80/50. Pale palpebral conjunctiva, cold clammy skin and tender hypogastric area were evident. She was quickly hooked to IV fluids.

"Grabe lang ho siguro buhos ng mens ko. Kung maari po pagkatapos ko masweruhan, resetahan nyo na lang ako't uuwi na ho ko," the patient reiterated.

"Teka, di ganun kadali yun, kelangan muna natin ng mga tests at i-IE pa kita," sabi ni Doc.

Upon hearing the word "IE" (internal exam), the patient suspiciously looked like a troubled kid whose tooth is to be extracted by a dentist.

Upon IE, passage of blood and meaty tissue were noted. Cervix is conspicuously soft and dilated.

On a physician's clinical eye, the patient exhibited the classic picture of someone who just underwent an abortion----the bleeding, the acute abdomen, the cervical ripening and the patient in denial of her ordeal.

"Siguradong di ka buntis at nagpalaglag, misis? Kelangan kasi magsabi ka nang totoo para magamot ka nang tama," paniniguro ni Doc.

Yet still, the patient denied, insisting persistently she was just having a menorrhagia (abnormal heavy and long menstrual flow.)

As per protocol, patient was subjected to pregnancy test. The attending inserted a catheter to extract urine for the said test, for the patient was too weak to voluntarily void her urine.

The test was positive.

"Misis, umamin ka na kasing nagpalaglag ka!" vehemently interjected by our feisty ER nurse who happens to have a type A personality and is notorious for her Matutina-like demeanor.

Faced with such overwhelming physical evidence, the patient remained steadfastly quiet and just exhibited a poker face.

At that point, We felt like Jack Bauer of 24 confronting a captive terrorist who is stubbornly hesitant in divulging a pertinent information.

The patient's mother finally arrived. She frantically asked, "Anong nangyari sa anak ko?"

The attending talk to the mother, "Mukhang nagpalaglag ho anak nyo pero ayaw umamin. Baka puwede nyo hong kausapin. Mahirap ho kasi sa pasyente pag di nagko-cooperate."

Upon getting the info, the mother suddenly looked dumbfoundedly astonished, as if a gun was held up against her at point blank.

Seeing "single' at the patient' chart, the doctor curiously asked, "May boyfriend o kinakasama po ba ang pasyente?"

The mother replied in her rattled voice, "Dalawang taon na hong nasa abroad yung mister ng anak ko."

I almost succumbed to an Ang TV moment and nearly uttered the catchphrase "Niyeeh!"

The dust was starting to settle. With the husband out of the country, it was either divine intervention or some other guy pulled a bantay salakay stunt and knocked the patient up. Obviously, it was the latter.

The mother angrily confronted her daughter. I could not help but overhear their conversation (ok...ok..I eavesdropped.)

"Ano bang ginagawa mo sa buhay mo, anak?!" the sobbing mother uttered as she stomped her foot in disgust.

"Buntis ka daw at nagpalaglag sabi ng doktor. Sabihin mo nang totoo, nanay mo ko," the mother continued.

The patient broke down into tears and finally admitted her deed.

"Sinong ama? Si ________ (some guy's name that the mom probably knew)?" the lamenting mother interrogated.

The patient nodded in affirmation as she wiped her tears with a hanky.

"Sabi ko na nga ba. Ilang beses na kitang pinagsasasbihan!" the mother sorrowfully scorned her daughter.

"Diyus ku pu, Lord!!!" yelled by the mother who highly reminded me of the panicking troublesome "Pris di Lurd" antics of Aling Dionisia (Manny Pacquiao's mom) as seen on a tv news coverage whenever there were a Pacquiao fight.

Apparently, the patient was a G2P1 who terminated her pregnancy by taking Misoprostol (Cytotec-an abortifacient) orally and vaginally. She then experienced a crampy abdominal pain and continuous vaginal bleeding thereafter. The pregnancy was a result of an extra-marital affair.

Upon referral of the attending to a OB-Gyn consultant, patient was admitted. D & C (dilatation and curettage-in Filipino, raspa) was done. Blood transfusion was administered. She was discharged four days after.

As the Soul Asylum song goes, "they say misery loves company." During her OFW husband's absence, the patient was lured into infidelity. And that infidelity resulted into a stoic casualty--the killing of an unborn child. True love was what the mother claimed her daughter has for the father of her aborted child for he was a kababata. Whatever it may be, people should be responsible for every action they take. In this case, the patient was not. I cannot help but aimlessly wonder what would be in store for her relationship with the OFW husband once he knows.

Doctors and Nurse can read charts but we cannot read minds. It's a bummer that clinicians and nurses do encounter patients that are elusive despite having a threat to their well-being. Covering up for an infamous and shameful act is indeed human nature, even in the face of a life and death situation.

During the time when the patient was packing her things up as she was up for discharge, the doctor cracks a joke and satirically confronted her.

"Misis next time magsasabi ka na nang totoo kung buhay na ang nakasalalay. Sabi mo nireregla ka lang. Parang ako ang niregla sa yo eh." ahehehe.. muntik na kami napa bulahaw sa tawa..

NUTRITION - A Handbook For Community Nurse

2009-05-01T06:44:00.000-07:00

Nutritional Issues Highlighted in Saving Lives:
Our Healthier Nation

The following are all areas highlighted by the Government in their recent strategy document.

Salt
The Government has begun a series of meetings with the food industry to explore ways of reducing the salt content of processed foods. A number of major retailers have already taken action to reduce the salt content of their own-brand products. Around 90% of the salt we eat is derived from processed foods. Looking for lower salt options in the supermarket, avoidance of adding salt during cooking and use of alternative seasonings at the table can help to reduce salt intake. It is important, however, to ensure that nutritional messages are placed in context. It is recognised in the report that salt is not the only factor that affects blood pressure. Reducing
excess alcohol intake and increasing physical activity are also highlighted as being important.
Practical advice for those with high blood pressure should focus on diet and lifestyle. Maintenance of a body weight within the desirable range should be promoted, along with regular physical activity and adherence to sensible drinking guidelines (no more than two to three drinks a day for women and no more than three or four drinks a day for men). In dietary terms, excess salt intake should be avoided and consumption of fruit and vegetables encouraged to provide
potassium. Low-fat dairy products should also be promoted as a useful source of calcium, which may also beneficially affect blood pressure.

Obesity
There is no specific target given for tackling obesity in Saving Lives: Our Healthier Nation. The targets set in the previous health strategy, The Health of the Nation, to reduce obesity incidence to 6% of men and 8% of women, were very ambitious. The latest figures on obesity (BMI > 30) show that it has now risen to 17% in men and 20% in women in England (Department of Health, 1999). Altogether, 62% of men and 53% of women can now be classed as overweight (BMI
> 25). The Government states in Saving Lives: Our Healthier Nation that the provision of information on healthy eating and the importance of physical activity will help prevent obesity. It may be, however, that a more clearly defined strategy is needed to begin to tackle this problem. A major review of obesity, published by the British Nutrition Foundation (1999a), suggested key action for policy-makers. This might include fundamental changes in legislation, e.g. new legislation to clamp down on miracle weight-loss cures that undermine the efforts of reputable healthcare professionals and new transport policies that promote increased levels of physical activity. The relationship between obesity and health is discussed more fully in Q4.4–4.12. Specific issues relating to obesity are discussed throughout the book and a Government framework for tackling obesity at local level can be found in the National Service Framework
for CHD (Department of Health 2000c).

Breast-feeding
The benefits of breast-feeding are recognised by the Government, which is aiming to increase the prevalence of breast-feeding, especially in areas of the country where breast-feeding rates are lowest. For more information see Q3.21–3.34. There are numerous benefits associated
with breast-feeding (see Q3.24). As well as being a complete nutrient source, breast milk has anti-infective properties and contains a variety of enzymes, growth factors, hormones, nutrient-binding proteins and non-absorbable carbohydrates. Breast-feeding may also help in the development of a warm mother/child relationship.

Importance of good nutrition for schoolchildren
High on the Government’s agenda is the need to focus on the health of Britain’s schoolchildren. The implementation of good habits in childhood is important for the future health of the population. Over the last 50 years, there has been a change in emphasis in relation to
concerns about schoolchildren’s diets. Historically, the focus was on the adequate provision of nutrients, but providing adequate dietary balance is now viewed as the main priority. The National Diet and Nutrition Survey of young people (aged 4–18 years) is the most
detailed survey yet to be undertaken in this age group in Britain (Gregory et al., 2000). This survey demonstrates that, although vitamin intakes are generally adequate, a sizeable proportion of children, particularly older girls, may have inadequate intakes of some minerals. Also, there is a high intake of saturated fatty acids, non-milk extrinsic sugars and salt among many children. Moreover, with the exception of the youngest children (4–6 years), young people In Britain are largely inactive. Clearly, these findings are worthy of our attention because poor eating and physical activity habits in childhood can store up problems for later life, particularly in relation to obesity, heart disease, diabetes, osteoporosis and cancer. There is clear evidence from the survey to justify the Government’s concern about the diets of children living in households
where there is relative poverty. In particular, boys in households in receipt of benefits seem to have lower energy intakes and poorer-quality diets (Gregory et al., 2000). The independent report to the Government on health inequalities from Professor Acheson indicated that one in three of Britain’s children lives in poverty and, in 1996, 2.2 million children in Britain were in families receiving income support (Acheson, 1998). This report highlighted the important
role of education in influencing health inequalities and providing children with practical and social skills, including budgeting and cooking. The Government’s Healthy Schools programme is aimed at creating a healthy ethos in schools. This remit includes promoting good nutrition and the acquisition of cooking skills, as well as increased levels of physical activity. There are also plans to re-establish national nutritional standards for school meals, which came into force in
April 2001. A number of initiatives are under way to improve the nutrition of schoolchildren and their awareness of healthy eating, including school breakfast schemes, ‘healthy’ tuck shops and the development of ‘Wired for Health’ – a website for teachers providing health information
to support the National Curriculum. Pilots for a scheme to provide 4–6 year olds with free fruit at school, are underway with a view to implementation by 2004 (Department of Health 2000b). For further information, see Q3.59–3.76. The government has also published a sports strategy which aims to encourage physical activity among children by providing after school activities for all pupils and establishing school sport co-ordinators in communities of greatest need (for further details see Sports England website).

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Psych Notes A Clinical Pocket Guide

2009-04-26T15:22:00.000-07:00

PsychNotes, a reliable quick reference for key psychiatric clinical information, provides
• common interventions and psychotropics
• how to communicate with a client
• quick at-your-fingertips info on key disorders
• how to form a therapeutic alliance
• cultural considerations
• techniques for handling crisis situations
• client/family teaching tools

Mental Health and Mental Illness: Basics

Mental Illness/Disorder 2
Mental Health 2
Legal Definition of Mental Illness 2
Positive Mental Health: Jahoda’s Six Major Categories 2
Maslow’s Hierarchy of Needs 3
General Adaptation Syndrome 4
Fight-or-Flight Response 4
Theories of Personality Development 5
Psychoanalytic Theory 5
Topographic Model of the Mind 5
Key Defense Mechanisms 6
Stages of Personality Development 7
Freud’s Psychosexual Development 7
Sullivan’s Interpersonal Theory 7
Erikson’s Psychosocial Theory 8
Mahler’s Theory of Object Relations 8
Peplau’s Interpersonal Theory 9
Biological Aspects of Mental Illness 10
Central and Peripheral Nervous System 10
The Brain 11
Limbic System 12
Autonomic Nervous System 13
Sympathetic and Parasympathetic Effects 13
Synapse Transmission 15
Neurotransmitters 16
Neurotransmitter Functions and Effects 16
Legal-Ethical Issues 16
Confidentiality 16
Dos and Don’ts of Confidentiality 16
When Confidentiality Must Be Breached 17
The Health Insurance Portability and Accountability
(HIPAA) Act (1996) 17
Types of Commitment 18
Restraints and Seclusion – Behavioral Healthcare 18
A Patient’s Bill of Rights 19
Informed Consent 20
Right to Refuse Treatment/Medication 20

Mental Illness/Disorder 2
Mental Health 2
Legal Definition of Mental Illness 2
Positive Mental Health: Jahoda’s Six Major Categories 2
Maslow’s Hierarchy of Needs 3
General Adaptation Syndrome 4
Fight-or-Flight Response 4
Theories of Personality Development 5
Psychoanalytic Theory 5
Topographic Model of the Mind 5
Key Defense Mechanisms 6
Stages of Personality Development 7
Freud’s Psychosexual Development 7
Sullivan’s Interpersonal Theory 7
Erikson’s Psychosocial Theory 8
Mahler’s Theory of Object Relations 8
Peplau’s Interpersonal Theory 9
Biological Aspects of Mental Illness 10
Central and Peripheral Nervous System 10
The Brain 11
Limbic System 12
Autonomic Nervous System 13
Sympathetic and Parasympathetic Effects 13
Synapse Transmission 15
Neurotransmitters 16
Neurotransmitter Functions and Effects 16
Legal-Ethical Issues 16
Confidentiality 16
Dos and Don’ts of Confidentiality 16
When Confidentiality Must Be Breached 17
The Health Insurance Portability and Accountability
(HIPAA) Act (1996) 17
Types of Commitment 18
Restraints and Seclusion – Behavioral Healthcare 18
A Patient’s Bill of Rights 19
Informed Consent 20
Right to Refuse Treatment/Medication 20

Mental health is defined as: a state of successful performance of mental
function, resulting in productive activities, fulfilling relationships with other
people, and the ability to adapt to change and cope with adversity. (US
Surgeon General Report, Dec 1999)

Wellness-illness continuum – Dunn’s 1961 text, High Level Wellness, altered
our concept of health and illness, viewing both as on a continuum that was
dynamic and changing, focusing on levels of wellness. Concepts include:
totality, uniqueness,

The legal definition of insanity/mental illness applies the M’Naghten Rule,
formulated in 1843 and derived from English law. It says that: a person is
innocent by reason of insanity if at the time of committing the act, [the
person] was laboring under a defect of reason from disease of the mind as
not to know the nature and quality of the act being done, or if he did know
it, he did not know that what he was doing was wrong.There are variations
of this legal definition

Maslow’s Hierarchy of Needs

Maslow developed a hierarchy of needs based on attainment of
self-actualization, where one becomes highly evolved and attains
his or her full potential.
The basic belief is that lower-level needs must be met first in order
to advance to the next level of needs. Therefore, physiologic and
safety needs must be met before issues related to love and
belonging can be addressed, through to self actualization.

SELFACTUALIZATION

(The individual
possesses a
feeling of selffulfillment
and
the realization
of his or her
highest potential.)

SELF-ESTEEM
ESTEEM-OF-OTHERS

(The individual seeks self-respect
and respect from others, works to
achieve success and recognition in
work, and desires prestige from
accomplishments.)

LOVE AND BELONGING

(Needs are for giving and receiving of
affection, companionship, satisfactory
interpersonal relationships, and
identification with a group.)

SAFETY AND SECURITY

(Needs at this level are for avoiding harm, maintaining
comfort, order, structure, physical safety, freedom from
fear, and protection.)

PHYSIOLOGICAL NEEDS

(Basic fundamental needs include food, water, air, sleep, exercise,
elimination, shelter, and sexual expression.)

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Look for our other Davis’s Notes titles
RNotes® • MedSurg Notes • NutriNotes • MedNotes • LPN Notes
NEW for 2005! IV Therapy Notes: Nurse’s Clinical Pocket Guide
NEW for 2005! LabNotes: Guide to Lab & Diagnostic Tests
NEW for 2005! ECGNotes: Interpretation and Management Pocket Guide

RNotes®: Nurse’s Clinical Pocket Guide
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LPN Notes: Nurse’s Clinical Pocket Guide
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MedNotes: Nurse’s Pharmacology Pocket Guide
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MedSurg Notes: Nurse’s Clinical Pocket Guide
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NutriNotes: Nutrition & Diet Therapy Pocket Guide
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IV Therapy Notes: Nurse’s Clinical Pocket Guide
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Coming Soon!
LabNotes: Pocket Guide to Lab & Diagnostic Tests
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ECG Notes: Interpretation and Management

FUNDAMENTAL NURSING SKILLS

2009-04-21T05:31:00.001-07:00

Its always been inculcated in our mind during our freshman year that fundamentals are very important, and i prove that its true when i graduated and took the board exam, there are so many question in the local board exam that pertains to basic and fundamentals of nursing thats is why i would like to share to you this ebook.

In 1859 Florence Nightingale suggested that ‘The elements of nursing are all but unknown’. It could be argued that this statement remains true today: some groups maintain that nursing is about keeping clients clean and well nourished; others that it is about making clients feel safe; others focus purely on the psychological needs of clients; and yet others think that it is about carrying out physical tasks delegated by, but remaining under the auspices of, doctors (Hilton 1997).

In looking back down the well-trodden path it can be seen that over the past 150 years or so nursing has slowly evolved from something that was considered essentially women’s work, which could be undertaken by any ‘good woman’, was largely concerned with caring for the sick, and with providing the best environment for nature to take its course, to being something that is very complex, skilled and sometimes highly technical, involving health education and promotion as well as meeting a wide variety of illness-related needs of clients. It is now an occupation that attracts both men and women whose pay constitutes more than a bottle of gin(Hilton 1997).

Indeed, many now contend that nursing has reached the epitome, that long-strived-for goal of professional recognition (Clay 1987), as it now has an academic, secular training programme, a Code of Professional Conduct (see Appendix I) and its own regulating body, the Nurses and Midwives Council. It is a profession that is clearly distinct from medicine, where registered
nurses are considered autonomous, accountable practitioners who work from a soundly researched knowledge base and whose practice is for the benefit of others.

The majority of changes that have occurred in nursing and other emergent professions allied to medicine, such as physiotherapy and occupational therapy, have occurred as a result of changing health care needs, technological advances and a plethora of new knowledge as well as changes in societal attitudes, values and beliefs and an increasing cultural milieu. We now live in times of continuing change and advancement.

Consequently health care, and therefore nursing, cannot remain a static entity. It must move, develop and evolve in the light of societal changes along with its other related disciplines.

In order to enable effective response, to provide direction to influence health care policy and legislation, to assist in determining further workforce needs, and to inform resource management the Royal College of Nursing (RCN) has recently undertaken a scoping exercise. It defined nursing as ‘the use of clinical judgement and the provision of care to enable people to promote, improve, maintain or recover health or, when death is inevitable, to die peacefully’ (RCN 2003:1). This has come at a time when the current government is seeking to contain costs, destabilize the professions and merge professional boundaries with the ultimate aim of promoting better interprofessional working and, thus, higher standards and more cost-effective but better-quality health care.

As such, a much greater emphasis is being placed on the promotion and maintenance of health and well-being. However, a word of caution: this definition advanced by the RCN, and the assumptions on which it is based, should not be viewed in isolation. As with many of the previous
definitions of nursing offered and indeed the sometimes radical changes in nursing and health care that have taken place in recent years, to date there has been no client involvement in its conception or development.

However, despite presenting a little background to nursing and health care today, it is not the purpose of this text to dwell on definitions of health and illness or to debate the politics of health care, but to provide practical direction in day-to-day clinical experiences. It would therefore
seem prudent to reflect on current practice, part of which is about assessing client care needs.

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NATURAL HAIR LOSS TREATMENT

2009-04-21T05:24:00.000-07:00

Everyone starts to lose their hair at some point in their lives. It is just a matter of when. The only exceptions are if you are lucky, or if you take action early enough with natural hair loss treatments, before it takes hold and leaves your head looking like a shiny plate.

The main cause of baldness is genetic, but contrary to what all the hair transplant companies will have you believe it is possible to tackle that, as well as the other causes of baldness.

If you suffer from stress, eat a bad diet, or lack in important vitamins and proteins then you are heading for a shiny head. Unless you take the right approach. If you do then you can stop any further loss dead and even reverse what you have lost.

There are many natural hair loss treatments available. Some are little more than herbs used to minor conditions and do nothing for you at all. While there are others that do work. It is important that you know what works and what is just a waste of time and money.

If you do not have the time to read up and find out what each of these natural treatments are then the best thing for you is to take a recognised hair supplement that will prevent hair loss.

Taking supplements along with a healthy diet that includes plenty of vegetables and fruit will go a long way to fighting off the onset of baldness.

If you take action early enough you may not even see any loss at all. Take action now and keep your head looking the way you want it.

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ADVANCED PRACTISE NURSING SECOND EDITION - EMPHASIZING COMMON ROLES

2009-04-19T06:31:00.000-07:00

With information overload a challenge in all of our lives, why should anyone read this book? The answer is simple—this book is not only informative, covering the major issues facing advanced practices nurses (APNs), but it is also vitalto understanding the past, present, and future of advanced practice. This effortweaves together historical views of APNs with present-day issues and trends. The contributors have masterfully analyzed the issues so that the reader will come to know both the larger policy issues facing APNs and how these issues translate into day-to-day care of patients.

The critical examination of financing, values, politics, and intraprofessional education and practice as well as interprofessional relationships combines to bringAPNs into sharp focus. The evolution of APNs has been a major event in the history of nursing. While each of the four APN disciplines—clinical nurse specialist, nurse practitioner, certified nurse midwife, and nurse anesthetist—has a unique history and place within nursing, the commonalities have established a force within health care that has changed the way care is delivered and will continue to change the system. In fact, the commonalities provide a critical basis for forging an even more powerful coalition of APNs to tackle common challenges related to ensuring patients get the best care possible. The social contract that nurses have with the public is unique, and APNs have extended that contract to higher levels of service, decision-making, and accountability.

This book captures the vitality of advanced practice nursing as an aggregated entity. The label of APN is now widely used and recognized by policy makers and patients alike. This represents unprecedented progress in nursing, when few knew what a clinical specialist or nurse practitioner was. We are largely past the days of having to prove the viability, utility, and safety of APNs. We are now constructively examining practice issues in order to advance patient care, not defend the practice.

Each chapter presents perspectives that are useful resources unto themselves. A valuable part of each chapter is the suggested exercises. Readers will appreciate the challenge that these exercises afford them. Taking the time to think through the questions will give APNs and others a chance to explore issues they may not have thought to explore. Even though each chapter is a resource itself, the collection of chapters is so well orchestrated that the full picture is definitely greater than the parts.

Whether this book is used by students, practicing APNs, policy makers, or other health professionals, it will be an extraordinary resource.

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CIGARETTE SMOKING IS DANGEROUS TO YOUR HEALTH

2009-04-19T06:24:00.000-07:00

Many people might wonder after they quit smoking if there is a way that they can heal their lungs. You need to understand that the lines are the most important organ in the body. It controls the function of breathing in moving oxygen in and out of your body so it is important that you keep your lungs clear. There are tiny follicles called cilia that helped to keep the lungs clear so that the red blood cells and get the oxygen they need. If you are a light smoker than the cilia will naturally clean out the lungs told that oxygen flows well. If you're a heavy smoker you can ingest a lot of toxins that can damage the lungs.

understand that if the cilia becomes damaged it makes it harder for them to do their job properly. Usually what happens is a smoker will get what is called a smokers cough. Usually what happens is this cough helps to clean out the lungs because the follicles are not doing their job properly. If you smoke a lot remember that it can cause permanent damage to your lungs and make it more difficult for your body's natural defense system to keep them clean. You can get certain supplements that will help you to naturally clean out your lungs system.

Remember the lungs are one of the most important organs that are located in your body. They helped to bring oxygen to the red blood cells so they function properly. There are small follicles called cilia that help to clean out any toxins that are inside the lungs. If you smoke a lot it can cause damage to these and create a situation where your lungs are not clean.You can take supplements that will help to naturally antitoxin residue you have in your lungs.

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MAKE YOUR DREAM COME TRUE - THINK POSITIVE

2009-04-16T22:18:00.000-07:00

I've learned that the way to achieve anything in life is to have the right attitude. Having the right attitude means thinking positive about everything. You need to wake up and believe that you will have a great day and positive things will happen to you. Believe that you will find a job today, believe that you will get a raise, believe that you will get that parking, believe that there will be no traffic, believe that you can complete that 2 mile run, and believe that you can accomplish anything and everything that life throws at you. Having a positive attitude about work, home, relationships, business, and just life will not only make you feel better but can also have a positive effect on the people around you.

You can turn anything around with a positive spin. For example, what about that person who cut you off on the freeway. You can yell and drive with such rage and follow that person just to give him or her a piece of your mind. Of course it will make you feel better for a second but can you imagine if you changed yourself and spun it in a different way. When that driver cut you off you could just say in your mind, that the driver must either be late for something or just had a bad day. I'll just keep driving and hope that everything is OK with that person. Positive thinking is not only for yourself and thinking about what you can and can't do in life but in reality it is a way of life. If you're positive about yourself and positive about the people and situations around you, you will have a better look on life.

When it comes to starting a business, I know it can be hard for a lot of people. Even for myself I still have trouble trying to stay positive about my goals of starting an Internet business. I've learned through life that being negative and thinking for the worse all the time can actually be a bad thing. I try to always stay positive and have a better look on life. I've learned to see the best in people and hope that they can see the best in me. I remember I went to a seminar and Tony Robbins, motivational speaker, was talking and he gave me a simple way of turning myself around, when I start having negative feelings, is to SNAP MY FINGERS. It may sound a little far fetched but it really works. Every one has the ability to change their mindset by just the snap of your fingers. You can do that with your personal life and your business life. I've almost reached my goals and I'm staying on track. Whatever comes my way!

I hope you have found the article helpful.
Try to visit this site:
http://www.MoneyJammin.com

ANXIETY MANAGEMENT IN ADULT DAY SURGERY

2009-04-16T22:01:00.000-07:00

This book is centrally concerned with the formal management of preoperative anxiety. The vast majority of patients experience varying degrees of anxiety when entering hospital for surgery and yet little formal intervention is commonly provided. This is the first book of its kind to bewritten for nurses exclusively concerning the complete formal pre- and postoperative management of anxiety in relation to modern, elective, adult day surgery. During the early 1970s classic nursing studies suggested information provision to be crucial for effective inpatient preoperative anxiety management.

However, following such early recommendations no other formal aspects of psychoeducational care have impacted on mainstream surgical nursing intervention. Physical aspects of care have dominated proceedings for the last three decades or more, whereas psychoeducational aspects have largely remained informal, marginal issues. Both surgery and anaesthesia have changed dramatically during this period and nursing intervention must now do likewise.

The domination of physical nursing intervention is, however, slowly changing as the continuous global rise in elective ambulatory surgery has highlighted the need for more structured psychoeducational approaches to patient care. The psychological theories to aid preoperative anxiety management have been available for many years. However, they have not succeeded in making an impact within the clinical surgical setting, because they have not previously been constructed into a coherent, clinically realistic plan of care. The purpose of this book is therefore (1) toconsider the relevant psychological concepts that can inform and guide modern surgical nursing practices, (2) to provide a comprehensive map of the wider evidence available and (3) to introduce clinically realistic nursing interventions necessary for the complete psychoeducational
management of adult patients undergoing elective, ambulatory surgery.

On a philosophical level, I hope to communicate with a wide audience of nurses working in the field of adult ambulatory surgery or studying modern surgical nursing practices. We need to re-evaluate nursing knowledge for this new surgical era so that compelling nursing evidence can help to guide practice and not remain in the shadows of medical advances. This book is intended to provoke debate within the profession, present the case for change and, above all, demonstrate the ability of nursing knowledge to make a significant contribution to the care required by patients experiencing modern ambulatory surgery. Much evidence, within the nursing domain, is widely available to help guide important global nursing issues in ambulatory surgery.

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30,000 jobs available in DoLE job fair

2009-04-15T23:48:00.000-07:00

MANILA, Philippines -- The 2008 Labor Day Celebration Job Fair has 30,000 available jobs from 110 employers, but only 3,000 registered for the vacancies as of 2:30 p.m. Thursday.

The job fair, sponsored by the Department of Labor and Employment at the World Trade Center, attracted all kinds of applicants -- new graduates, the unemployed, and even those seeking better jobs.

Raymundo Agravante, DoLE regional director for Metro Manila who gave the registration rate, said the job vacancies were from 72 employers seeking people for work in the country and 38 companies seeking applicants for work abroad.

DoLE spokesman Jay Julian said the department held similar job fairs in other regions which may account for the low registration rate. But he said the rate is fairly average compared to previous job fairs.

Local employers said most of the applicants wanted to work overseas because the job seekers think the local companies are "not that big."Joy Jose is one such job seeker. A computer programming graduate, she instead applied for a job as a room attendant abroad. She said working overseas will give her the opportunity to help her family.Job applicants agreed that the job fair is a big help for them because it provides easy access to available jobs; they don't need to go to individual companies.

HERE ARE SITE I RECOMMEND:

http://www.jobsdb.com.ph/PH/EN/V6/JS/JobSearch/JobSearch.asp?PN=JobListing&JA=47%7C5

http://www.workabroad.ph/list_specific_jobs.php?by_what=specialization&id=57

WHAT IS THE CONDITION THAT AFFECT YOUR BLOOD PRESSURE

2009-04-15T23:34:00.000-07:00

There are some startling statistics related to high blood pressure (hypertension). According to the American Heart Association, it affects about 73.6 million people age 20 and over in the United States alone. One in three adults suffers from this condition and 78.7% of them are aware that they have it. 69.1% were receiving treatment, 45.4% had it under control, leaving 54.6% who did not have it controlled.

You might be very surprised to learn that the cause of 90 - 95% of the cases of hypertension is UNKNOWN. However, regardless of that fact, it is easy to diagnose and there are numerous treatments to help control it.

There are a number of conditions that can adversely affect the blood pressure. Eight of them are as follows:-

STRESS
An argument, financial problems, fear and other emotional factors will temporarily raise your blood pressure. This actually is a defense mechanism to enable you to function more efficiently by increasing the amount of oxygen and nutrients available to the cells. Unless you already have high blood pressure, such a temporary increase should not be harmful, but it could bring about a stroke if you are already a sufferer. This is why people who are chronically hypertensive, are told to stay calm and not get too excited.

SMOKING
Literally within seconds of lighting a cigarette, your blood pressure increases as much as 15-20 points. This happens because of the stimulating effect nicotine has on the adrenal glands. They send out a hormone to help defend the body against the poison and the blood vessels constrict and the pressure goes up.

SALT
Common table salt can affect your blood pressure tremendously. It should be noted that not everyone who has HBP reacts adversely to table salt. You should be able to determine very easily for yourself whether you are affected by it or not. Monitor your blood pressure a few times during the day and then when you have a highly salted meal (for instance Chinese food) check your blood pressure a few times over the next 24 hours. People that are sensitive to salt have to be extremely careful with their diet, and make sure they read the labels on cans and boxes. Canned soups are notoriously high in sodium.

KIDNEY DISEASE
With kidney disease, the kidneys are unable to eliminate the liquid wastes from the body and they accumulate, producing edema and toxicity. ("This is the most important factor")

LIVER CONGESTION
All the blood in the body flows through the liver, both to pick up nutrients that the liver stores and for detoxification. If the liver is congested with toxins or chemicals, and has lost its ability to function properly for a number of reasons, a back pressure builds up in the portal circulation. This can be reflected in the whole body circulation as high blood pressure.

ATHEROSCLEROSIS - ARTERIOSCLEROSIS
Many feel that the major cause of hypertension is the narrowing of the arterial system by deposits of calcium, cholesterol, fibrin and other blood constituents resulting in either atherosclerosis or arteriosclerosis. As plaque builds up, the internal diameter of the blood vessel is decreased significantly. This results in increased pressure because the same amount of fluid is being forced through a narrower tube.

TUMORS
In a very small percentage of patients suffering with HPB, other factors, such as tumors, are involved.

NUTRIENT DEFICIENCIES A deficiency in calcium, magnesium, potassium and other nutrients have a definite effect on creating the condition of hypertension.

NURSING PRACTISE IN MULTIPLE SCLEROSIS

2009-04-15T23:30:00.000-07:00

Multiple sclerosis is a lifelong, potentially disabling disease of the central nervous system that affects the white matter tracts of the central nervous system in a sporadic and unpredictable manner. The disease produces inflammation and demyelination of the white matter, as well as varying amounts of damage and destruction to the underlying axon. The onset of disease is most often in early adulthood. Individuals experience a myriad of symptoms with likely progression of disability over time.

Symptoms may include fatigue, visual disturbances, sensory changes, incoordination, pain, tremor, elimination dysfunction, and cognitive impairment. Symptoms usually occur as relapses early in the disease, or as symptoms that appear over 24–48 hours and recede to some extent
over weeks to months. After a decade or so, many individuals experience fewer relapses, but in their place is a slow progression of MS symptoms that often leads to increased functional disability over time. A small percentageof patients will experience progression from the onset of the disease and experience progressive mobility impairment over time.

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CHILDHOOD OBESITY - WHY ARE SO CHILDREN OBESE?

2009-04-15T23:27:00.000-07:00

How do we let the weight of our children get out of hand? As adults we have a responsibility to teach them. Obesity in children is creating such an overwhelming alarm of despair that it's time to stop and say, what has gone so wrong? Have we lost that gift we were all given to nurture and take care of our young? Have we lost the most important reason for being on earth, the one to procreate and continue our species? Letting our children eat themselves to the point that they cannot help themselves is shame full, to say the least.

The greatest gift given to us from above is surely the one to take care of the ones we love the most, our children! Are we so worried that our children will be in danger when we let them play alone outside? Do we need them to be supervised at all times? When I was young we would play outside until it was either time to eat or time to come in before it got dark. What happened, do we not have enough faith to let our kids play outside anymore? With all the kidnappings and such things being told on the news everyday, we should be fearful of where they go and who they play with, but, so worried as to prevent them from playing outside completely?

People complain about schools getting too involved in telling us how to raise our children. If we are so concerned, why are many of our kids obese? We are so worried about leaving them alone and playing outside that we are feeding them to the point of making them all sick. Were is the common sense in that? Let them play outside and get killed or keep them in the house and slowly kill them ourselves. Does that make more sense to you?

Parents used the backyard and parks to get children out of their hair before supper when we were young. Now days we keep them inside and tell them to eat all the time to get them out of our hair. Who wins playing a game like this, parents or children?

Let us ask ourselves serious questions about how important our children really are to us. Is it time for "Big Brother" to intervene and take the responsibility away from us in order to protect the children "from" us? Who needs the help, the parents or the children. Food for thought.
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Nursing Care of the Pediatric Neurosurgery Patient

2009-04-15T23:18:00.000-07:00

Nursing care of the pediatric neurosurgery patient and family can be extremely challenging and extraordinarily rewarding.

The more complex the illness or injury, the greater the potential contribution of the skilled and empathetic nurse to patient and family recovery.
To paraphrase a parent quoted in this book, each child with a neurosurgical problem will have a unique life story. Although the child’s life story will be affected by the neurosurgical problem, it will be shaped by the child’s family and the valuable contributions of nurses such as those who have authored this book and those who will read it.

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COLON CLEANSING - ROLE OF ANTI-OXIDANTS

2009-04-15T23:12:00.000-07:00

No detox or health treatment is complete without anti-oxidants. They are the agents that combat oxidants and free radicals within the body. These cause a lot of damage to cells. Produced during the normal metabolism of nutrients, they also penetrate the cells and disrupt the DNA contained in them.

Cell membranes which normally protect the cell interior from such foreign substances are unable to stop certain enzymes and bacteria because they can be so small that they pass right through. By disrupting DNA structure, free radicals result in the production of mutant cells.
Some of these mutant cells multiply without restraint, resulting in the formation of a tumor. This is the premise of cancer and are also said to be the root cause of premature aging, hair loss, tooth decay, and skin problems.
Antioxidant enzymes such as superoxide dismutase, catalase and glutathione, bind to free radicals and convert them into harmless substances. Colon cleansing involves the removal of toxins which are analogous to toxins and oxidants. Thus, it is essential that any proposed colon cleansing treatment contains a fair dose of anti-oxidants to help wipe out toxins.
Vitamins such as vitamin C and Vitamin B-complex are very good for your health. Most diets are deficient in these vitamins. It is therefore important to supplement your diet with them if the colon cleansing treatment you are following is not providing you with a source of them. At any rate, no detox treatment will be complete without a good dose of vitamins.
If you want to cleanse your colon, it's best to choose a colon cleansing supplement that works well such as NATRA PURE.
It's a great way to cleanse out toxins and get healthy.

THE INTENSIVE CARE MANUAL

2009-04-10T06:18:00.000-07:00

This is one of the most difficult assignment for a Nurse, handling a very ill patient and it takes all of the time of a nurse... for my fellow nurse hope this book will help you..

THE INTENSIVE CARE MANUAL

Care of critically ill patients requires vascular access for either therapeutic delivery of fluids and pharmaceutical agents or for diagnostic hemodynamic monitoring.

By definition, critically ill patients are physiologically unstable and, therefore, may need medical interventions aimed at supporting one or more functionally compromised organ systems and gauging the response to therapy.
Vascular access is the therapeutic cornerstone that facilitates these measures. All patients who meet admission criteria to critical care units (CCUs) should have asecure vascular access site, even if they are not currently receiving intravenoustherapy, because of the potential need for unanticipated emergent interventions.
The need for and choice of vascular access lines must be continuously weighed
against the costs and risks of complications.

CLICK HERE to download this book.

WHAT IS KIDNEY?

2009-04-10T06:07:00.000-07:00

What are the kidneys?

The kidneys play key roles in body function, not only by filtering the blood and getting rid of waste products, but also by balancing levels of electrolytes in the body, controlling blood pressure, and stimulating the production of red blood cells.

The kidneys are located in the abdomen toward the back, normally one of each side of the spine. They get their blood supply through the renal arteries directly from the aorta and send blood back to the heart via the renal veins to the vena cava. (The term "renal" is derived from the Latin name for kidney.)
The kidneys have the ability to monitor the amount of body fluid, the concentrations of electrolytes like sodium and potassium, and the acid-base balance of the body. They filter waste products of body metabolism, like urea from protein metabolism and uric acid from DNA breakdown. Two waste products in the blood can be measured: blood urea nitrogen (BUN) and creatinine (Cr).
When blood flows to the kidney, sensors within the kidney decide how much water to excrete as urine, along with what concentration of electrolytes. For example, if a person is dehydrated from exercise or from an illness, the kidneys will hold onto as much water as possible and the urine becomes very concentrated. When adequate water is present in the body, the urine is much more dilute, and the urine becomes clear. This system is controlled by renin, a hormone produced in the kidney that is part of the fluid and blood pressure regulation systems of the body.
Kidneys are also the source of erythropoietin in the body, a hormone that stimulates the bone marrow to make red blood cells. Special cells in the kidney monitor the oxygen concentration in blood. If oxygen levels fall, erythropoietin levels rise and the body starts to manufacture more red blood cells.
After the kidneys filter blood, the urine is excreted through the ureter, a thin tube that connects it to the bladder. It is then stored in the bladder awaiting urination, when the bladder sends the urine out of the body through the urethra.

click to download the complete information regarding this topic.

NEUROLOGIC DISORDER

2009-04-10T05:58:00.000-07:00

NEUROLOGIC DISORDERS

Headache, dizziness, insomnia, back pain, weakness, and fatigue occur often in medical practice, and the trivial must be separated from the potentially serious. Some neurologic problems require emergency action before a neurologist can be consulted.

Regardless of the problem's magnitude, the following principles may help during the neurologic evaluation: the anatomy of the lesion should be defined (to limit diagnostic possibilities); its pathophysiology, determined; and the examiner, prepared to provide immediate lifesaving treatment for neurologic emergencies.

click here to download more about this topic.

Long Journey

2009-04-10T05:41:00.000-07:00

Its been a long month and i wasn't able to update my blog... Well as you know im a NURSE so i been too much busy... that i have no time to sit and face my loptop to update this blog... so i decided to make ample time to post now and then..
i remove some of the previous post coz its not that eye catching and ill improve the next post... and also i remove some ads that are not so much relevant and it makes the loading time more faster..so here it goes... check out the latest post...

Always be remembered

2009-01-13T00:05:00.000-08:00

Yesterday, One of our patient is suffering from CVA , one of my colleagues is endorsing to the incoming nurse while they are doing this routine i check on this patient He Mr. X is attach to a manual resuscitators (Ambu bag/ BVM - bag valve musk) connected to a oxygen tank while a student nurse inflating air from air chamber another student is monitoring the vital sign i ask the student what is their latest reading, and replied bp 40/30 mmhg cr 102.. i said are you sure?
the student nod in response.. so i then double check the vitals.. i used my personal steth so i can hear more clear and have a better reading.. and start taking bp.. i dont beleive what i heared the systolic it pump on 30 and the diastolic is none.. then i just look at the student and the relatives i check the CR and i coudnt hear such lub dub.. then i use my personal pulse oxymeter it reads nothing.. i just then instruct the student to continue monitoring.. i just then knew that Mr. X is clinically dead that this ambu bag keeping him alive. before i leave the room i look to the relatives of the patient one them crying while the others are in silent with tears falling from their cheek.. when i got to the nurse station i ask to my fellow nurse how old is our patient my colleagues replied 52, hes still young.. i said this must be difficult time for them, that how i wish we could prolong more his life so that they could be together a longer time, spend more quality time.
After a minute the residence came and talk privately one of the relative, after talking she went back to the room. then i heard one in subbing inside the room asking for their forgiveness to whatever have they done wrong and sinned.

my colleagues said 'they already knew'..

i just then said to my self 'THAT'S LIFE' we live and we die.. it's not how long we live in this world, it is how we manage our life while living in this world, and that we always be remembered.

Paunang Salita

2009-01-12T17:36:00.000-08:00

Habang nag babasa aq ng mga saloobin ng ng nasa frienster... naisip bakit di ako gumawa ng blog ng sarili ko... para sa mga kapwa ko nurse or mga nag aaral palng na nurse... naisip ko bakit di ko ishare mga gingamit ko sa pag rereview o mga libro tungkol sa nursing o sa lahat ng larangan ng medical... upang makatulong din kahit paano... ika nga ang karunungan ay nararapat lang na ibahagi sa ibang taon...
dahil hindi lahat ay may kaya na bumuli ng libro na kanilang gagamitin sa pag aaral..
kaya ang karamihan nanghihiram ng libro sa library...panu kung ang hihiramin mong libro ay 3 lng kanilang kopya? at sa dinami dami ng estudyante at guro na nanganga ilangan ng ng librong iyong nais hiramin... tsk tsk tsk.... maghihintay ka ng ilang oras para isauli ng humiram na nauna bago mo pa mahiram.. malas mo pa kung itoy nakareserve sa iba pang hihiram... kaya karamihan.. pinapaxerox ang buong libro para di na hiramin ulit... pangit nga lang ang kopya..
kaya gingawa ko nun kahit dedline na dapat ay isauli ay hindi ko pa sinasauli.. magbabayad nalang ako ng late fee... pero sayang din ang pambayad diba.. welll diskarte nalang kaylangan.. kung ayaw mo ng pila sa library mag internet ka...
kilalang kilala na ako sa libraray namin ng mga student assistant.. dahil palagi sa library ng rereseach...kaya nga pati birthday ko nakapost na sa birthday chart nila...
kung kaya eto ginawa kong diskarte pina scan ko ang buong libro at binurn s cd upang kung kaylangan ko ay sa cd ko nalang hahanapin ang kaylangan ko... sana makatulong sa inyo ito...