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Virtual Eli - Final Coaching
 

Virtual Eli - Final Coaching

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    Virtual Eli - Final Coaching Virtual Eli - Final Coaching Presentation Transcript

    •  
    • UNANG YAKAP CAMPAIGN
      • launched DECEMBER 9, 2009
      • aims to cut down infant mortality in the Philippines by at least half
      • he campaign employs Essential Newborn Care (ENC) Protocol as a strategy
    • UNANG YAKAP CAMPAIGN
      • ENC Protocol involves focusing on the first hours of life of the newborn
      • The guidelines categorize procedures into
        • time-bound,
        • non time-bound and
        • unnecessary procedures
    • UNANG YAKAP CAMPAIGN
      • Time bound procedures   should be routinely performed
        • first - immediate drying,
        • skin-to-skin contact followed by clamping of the cord after one to three minutes,
        • non-separation of the newborn from the mother and breastfeeding initiation .
    • UNANG YAKAP CAMPAIGN
      • Non time-bound intervention s hould only be done after the first full breastfeed. These are
        • immunizations,
        • eye care,
        • Vitamin K administration and weighing.
        • Washing must be postponed by at least 6 hours .
    • UNANG YAKAP CAMPAIGN
      • Unnecessary procedures  include
        • routine suctioning,
        • routine separation of newborns for observations,
        • administration of prelacteals like glucose,
        • water formula and
        • footprinting.
    •  
    • UNANG YAKAP CAMPAIGN
      • Symposium with the theme " Unang   Yakap :  Yakap  ng Ina.  Yakap  ng Buhay " to tackle the New  DOH -WHO ENC Protocol
      • The ENC is currently being practiced by three hospitals in Metro Manila:
        • Quirino Memorial Medical Center in Quezon City, and
        • Fabella Memorial Medical Center and
        • Philippine General Hospital in Manila.
    • MUSCULO-SKELETAL
    • ISOMETRIC ISOTONIC
      • types of strength training characterized by contraction of a muscle without moving the joint. It good for clients with ARTHRITIS.
      • Exercises that strengthen the muscle by moving the joint.
    • Sprain strain
      • Tear in LIGAMENTS
      • Muscle injury
    • ARTHROSCOPY
      • Purpose: To allow direct visualization of the anatomic site, specifically to evaluate the knee for meniscus cartilage or ligaments tears
    • ARTHROSCOPY
      • PREPARATION:
        • NPO after midnight before the test
        • Inform px that hair will be shaved 6 inches above and below the joint before test
        • FOOT of table is lowered so that the client
        • THUMPIN SENSATION  maybe felt upon insertion
    • ARTHROSCOPY
      • POST-PROCEDURE:
        • Elevate knee when sitting and avoid over-bending so that swelling minimized
    • arthrocentesis
      • PURPOSE: To diagnose infection, crystals-induced arthritis, synovitis or neoplasm
      • PREPARATION:
        • NPO after midnight
    • electromyography
      • PURPOSE: To monitor the electrical activity of the MUCLES.
      • PREPARATION:
        • avoid stimulants and sedatives before the procedure
        • inform the client that a needle will be inserted into the muscles
    • tractions
      • SKELETAL TRACTIONS
        • USE: to immobilize bones
        • EX:
          • Gardner wells
          • Crutchfield tongs
          • Halo-vest
          • Kirschner wire
          • Steinmann pin
      • SKIN TRACTIONS
        • to decrease muscle spasm
        • EX:
          • Buck’s traction
          • Russel’s traction
          • Bryant’s traction
          • Cotrel’s traction
    • SKELETAL SKIN
      • Observe the PIN sites for signs of infection
      • teach how to use a TRAPEZE
      • Clean the pin site with NORMAL SALINE or HYDROGEN PEROXIDE
      • Check to ensure that the ropes are in the wheel groves and that knots do not interfere with the traction
    • Mastery drill
          • Buck’s traction
          • Crutchfield tongs
          • Russel’s traction
          • Kirschner wire
          • Bryant’s traction
          • Cotrel’s traction
          • Steinmann pin
    • Mastery drill
      • Pelvic belt traction
      • Ans: SKIN TRACTION
      • Balanced suspension traction
      • Ans: SKELETAL TRACTION
      • Buck’s traction
      • Ans: SKIN TRACTION
      • Overhead 90-90 traction
      • Ans: SKELETAL TRACTION
    • MASTERY DRILL
      • Rusell’s traction
      • Ans: SKIN TRACTION
      • Cervical tongs
      • Ans: SKELETAL TRACTION
      • Cervical halter
      • Ans: SKIN
    • CARPAL TUNNEL SYNDROME
      • Compression of the MEDIAN NERVE due to handheld type of jobs (typist)
      • s/sx:
        • PARESTHESIA, numbness, pain radiating to forearm
      • Laboratory data  TINEL’s sign and PHALEN’s sign are (+)
    • CARPAL TUNNEL SYNDROME
      • WHAT TO DO:
        • Splint the wrist
        • Administer steroids
        • Surgery: DECOMPRESSION
          • POST-OP: Elevate the hand and arm for 24 hr
          • resume ADL 2-3 days after
    • FRACTURE (Hip leg)
      • Initial s/sx: SADER
      • WHAT TO DO:
        • surgery
        • Post-op care: maintain ABDUCTION by placing a trochanter roll and wedge pressure
        • NO FLADIR
        • YES to SADER
        • FAT/PULMONARY embolism  _______
    • FRACTURE (Hip leg)
      • Crutches
        • GOOD LEG GOES UP, BAD LEG GOES DOWN
      • ORIF
        • PRE-OP:
          • immobilize
          • cover open fractures with gauze
        • POST-OP:
          • monitor 6 P’s
          • monitor neuromuscular status
    • Care of a client with cast
      • CAST  to maintain proper alignment and immobilization
      • Support a plaster cast with pillow  to promote drying
      • PLASTER of PARIS  72 hours drying time
      • FIBERGLASS  24 hours drying time
    • Care of a client with cast
      • Check for nerovascular status
      • report PAIN, PRESSURE, FEVER  means infection
      • 2 and 4 point gaits  weight bearing are allowed on BOTH legs
      • 3 point gait  weight bearing is permitted on ONE extremity
      • swing to and swing through  use if BOTH legs are paralize
    • Sling splints
      • Made of SOFT FABRIC
      • ex: TRIANGULAR, SYNDER SLING
      • MGT:
        • Perform passive ROM
        • Check for signs of nerve impairment
      • Made of LEATHER, metal and hard plastic
      • Ex: DENIS BROWNE SPLINT, THOMAS SPLINT
      • MGt:
        • Clean it DAILY
        • check areas for skin breakdown
    • Restraints (types)
      • For infants and small children during tx and exam involving the HEAD
      • Ans: MUMMY RESTRAINT
      • To keep a child in a wheelchair or crib and to ensure safety of a suicidal client
      • Ans: JACKET RESTRAINT
    • Restraints (types)
      • To keep a child in a wheelchair
      • Ans: BELT RESTRAINT
      • For infants and children receiving IV infusion in the SCALP, post CLEFT LIP and CLEFT PALATE repair EYE SURGERY
      • Ans: ELBOW RESTRAINT
    • Restraints (types)
      • Restraining an extremity by using gauze strips
      • Ans: CLOVE-HITCH DEVICE
      • For children with skin conditions like ECZEMA and BURNS to prevent scratching
      • Ans: MITTS
    • Restraints (types)
      • For children undergoing surgery on head, chest and abdomen. STRAPS are applied in the forehead, lower arms and thighs and attached to a board
      • Ans: PAPOOSE BOARD
      • for CONFUSED ELDERLY
      • Ans: VEST
      • to secure the client’s ankle and wrists to the bed side  POSEY
    • RHEUMATOID ARTHRITIS
      • Inflammation of the SYNOVIAL LINING of the joints  UPPER EXTREMITY  common in WOMEN
      • s/sx: MORNING STIFFNESS
      • What to do: WARM bath
      • other s/sx:
        • SWAN-neck deformity
        • Ankylosis
        • Ulnar deviation
    • RHEUMATOID ARTHRITIS
      • Laboratory  Elevated ESR
      • What to do:
        • ASPIRIN regularly even in the absence of s/sx
        • ICE PACK  acute (first 24 hours)
        • HOT COMPRESS  beyond 24 hours Apply moist heat 15-30 mins
    • GOUTY ARTHRITIS
      • Metabolic d/o of URIC ACID FORMATION and EXCRETION
      • Common in MEN
      • S/sx:
        • DUSKY RED-HOT SWOLLEN JOINTS  BIG TOE
        • TOPHI  accumulation of urate crystals
    • GOUTY ARTHRITIS
      • What to do:
        • avoid PURINE DIET
        • Increase fluid intake
        • use bed cradle  to prevent linen touching the inflamed joints
        • AVOID or ENCOURAGE ASPIRIN?
          • AVOID
    • osteoarthritis
      • DEGENERATIVE  AGING
      • affects BOTH MEN and WOMEN
      • S/sx:
        • PAIN and SWELLING in a weight bearing joints
        • HEBERDEN’s NODES
        • BOUCHARD’s NODES
        • Increase pain in a cold weather
    • osteoarthritis
      • Priority: minimize discomfort
      • Implement:
      • W  weight control
      • H  hot compress or ice packs
      • A  aspirin use
      • T  trunk assistive devices (cane)
    • NOTES
      • DOC for RA  ASPIRIN
      • Avoid ASPIRIN intake in GOUTY
      • Synovium  affected part in RA
      • TINNITUS  aspirin toxicity
      • JOINT SWELLING  RA
      • Obesity  increase risk for OSTEOARTHRITIS
      • Ibuprofen  take it with meals or immediately after a meal
    • notes
      • GRATING SOUND  occur in OSTEO
      • highest priority in the mgt of osteo  DIET for weight control
    • amputation
      • Keep TORNIQUET at bedside  in case of bleeding
      • PHANTOM PAIN type of pain in amputation
      • NOTE  It is best to keep the stump elevated  in 24 hours
      • NOTE  keep PRONE for 20 minutes several times a day after 24 hours