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Virtual Eli - Final Coaching
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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