RATIONALE by:  RANDEL DALAUTA,RN www.nursendoutfield.blogspot.com
Types of Hygienic Care TIME PROCEDURE MATERIALS PURPOSE Early morning offer urinal/bedpan, wash face & hands, & give oral ...
- transfer of heat between two objects without contact -  60 % of heat in a nude person standing in a room at normal tempe...
CONVECTION EVAPORATION/ APORIZATION - dispersion of heat by air currents -  body has usually a small amount of warm air ad...
RISK FOR SKIN INTEGRITY ON TEENAGER Increase activity of hormone testosterone Produce excess sebum Clogs the skin pores Ba...
ater should be tested (should be tepid not hot) W Foot care for a Diabetic Client A ntibacterial soap should be avoided -s...
lways use cotton socks  -  Avoid nylon socks A <ul><li>cross and straight below the tips of the toes is the direction to c...
W et feet should by dried thoroughly and air out E <ul><li>levate the feet during the day </li></ul><ul><li>keep the feet ...
NURSING PROCESSS
Appropriate Verbs to Use  Cognitive return demo  Affective listening/ observation Psychomotor observation Compare Describe...
 
 
14 Principles of Management:  (by Henry Fayol) <ul><li>  Division of  Labor –  specialization  increases productivity </li...
<ul><li>Subordination of personal interest – patient first before self </li></ul><ul><li>Scalar chain – hierarchy; top to ...
<ul><li>Identify the client by name, hospital or id number </li></ul><ul><li>Give the date, time, and place of the inciden...
<ul><li>Include pertinent facts </li></ul><ul><li>Clients account/story </li></ul><ul><li>MD’s order, time, and patients r...
MANAGER LEADER Are given the position Take the initiative to lead Organize and staff Align people with direction Emphasize...
  Levels of Anxiety Degree of Anxiety Characteristics Reaction Nursing Management Mild (+)  * increased level of perceptio...
Continuing Professional Education
DIET INDICATION PURPOSE LIMIT ENCOURAGE TO: Low Sodium Diet Hypertension Edema due to: - CHF, Liver cirrhosis, Nephrotic S...
DIET PURPOSE LIMIT BLAND DIET promotes healing of the gastric mucosa and is chemically and mechanically nonstimulating  So...
Blood Transfusion  <ul><li>Use gauge 18 </li></ul><ul><li>Normal saline to be used (the only compatible) </li></ul><ul><li...
NEW BORN SCREENING <ul><li>done 48 to 72 hours after birth, usually with. in 24 hours after birth or during hospital stay ...
DISEASES DETECTED BY NEWBORN SCREENING DISEASE SIGNS & SYMPTOMS INTERVENTION PKU (Phenylketonuria) - Is the inability to p...
 
DISEASE  SIGNS & SYMPTOMS  INTERVENTION  Galactosemia - is the inability of the body to use (metabolize) the simple sugar ...
Congenital Adrenal Hyperplasia -not enough cortisol & aldosterone - too much of androgen - lack of an  enzyme needed by th...
Intervention: - cortisol (dexamethasone, fludrocortisones, or hydrocortisone) - chromosomes (karyotyping) - reconstructive...
Congenital Hypothyroidism <ul><li>s/sx: </li></ul><ul><li>Jaundice </li></ul><ul><li>Constipation </li></ul><ul><li>Lethar...
Test Implication Risk <ul><li>Non Stress Test (NST) </li></ul><ul><li>electronic fetal monitoring </li></ul><ul><li>Relati...
Test Implication Risk <ul><li>Contraction Stress Test (CST) </li></ul><ul><li>Associated fetal heart rate response to indu...
<ul><li>1. EPI is a basic health service, that is free for all and nationwide. (Wednesday) </li></ul><ul><li>2. EPI is bas...
ELEMENTS: <ul><li>1. Cold Chain Management:  </li></ul><ul><ul><li>to maintain vaccine potency and right storage </li></ul...
<ul><li>3. Target Setting: </li></ul><ul><ul><li>(the primary element of EPI) to determine eligible population </li></ul><...
Major Cause of Diarrhea Cause Physiologic Effects <ul><li>Psychologic stress (example Anxiety) </li></ul><ul><li>Medicatio...
Average Daily Urine Output By Age Age Amount ( mL) 1-2 days 3- 10 days 10 days – 2 months 2 months to 1 year 1 year to 3 y...
  CONSTIPATION is almost the universal adverse effect of opioid use. All patients should receive prophylactic stimulant la...
<ul><li>Ventro gluteal site – seven months and adult s </li></ul><ul><li>Vastus Lateralis site- seven months and younger <...
OLDCART METHOD O- onset of pain L- location of pain D- duration of pain C- characteristic of pain A- aggravating factors R...
ADVENTITIOUS BREATH SOUNDS NAME CAUSE LOCATION Crackles (rales) Air passing through fluid or mucus in any air passage Most...
 
Care after Cataract Removal <ul><li>Leave the eye patch in place </li></ul><ul><li>For 24 hours, limit your activity to si...
Susbtance Effect on  CNS  Cardinal Sign Withdrawal  S/Sx <ul><li>Stimulants </li></ul><ul><li>Cocaine </li></ul><ul><li>Am...
Approaches to Clients with Eating Disorders DO…. DON’T… <ul><li>Small frequent feedings </li></ul><ul><li>Monitor intake a...
SEXUAL DISRODERS <ul><li>Soixante neuf- 69 </li></ul><ul><li>Fellatio – penis sucking </li></ul><ul><li>Cunnilingus – vagi...
SEXUAL DISORDERS <ul><li>Scartophilia – phone sex </li></ul><ul><li>Pigmaliunism – statue </li></ul><ul><li>Emetophilia – ...
SCHIZOPHRENIA (+) signs (-) signs <ul><li>Hallucination </li></ul><ul><li>Delussion </li></ul><ul><li>Incoherence </li></u...
LITHIUM  DRUGS LITHIUM CARBONATE (Eskalith, Lithane,Lithobid, Lithotab DRUGS THINGS TO CONSIDER Increase fluid intake and ...
…… any question?
THE END www.nursendoutfield.blogspot.com
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Copy Of October 6 Rationale

  1. 1. RATIONALE by: RANDEL DALAUTA,RN www.nursendoutfield.blogspot.com
  2. 2. Types of Hygienic Care TIME PROCEDURE MATERIALS PURPOSE Early morning offer urinal/bedpan, wash face & hands, & give oral care bedpan/ urinal Done in preparation for breakfast and increase appetite Morning Bath/shower, perineal care, & oral, nail & hair care bedpan/ urinal after breakfast, in preparation for diagnostic procedures Afternoon washing hands & face, oral care, & backrub bedpan/ urinal relaxation and refreshing the client Hours of Sleep(HS) Elimination needs, washing face and hands & oral care Back massage Bedpan/ urinal in preparation for sleep As needed (prn) Care as needed
  3. 3. - transfer of heat between two objects without contact - 60 % of heat in a nude person standing in a room at normal temperature RADIATION CONDUCTION HEAT TRANSFER - transfer of heat from one molecule to a molecule of lower temperature or with contact - body is immersed in cold water
  4. 4. CONVECTION EVAPORATION/ APORIZATION - dispersion of heat by air currents - body has usually a small amount of warm air adjacent to it - continuous evaporation of moisture from respiratory tract, mouth and skin. - also insensible water loss/insensible heat loss; 10% basal heat loss 
  5. 5. RISK FOR SKIN INTEGRITY ON TEENAGER Increase activity of hormone testosterone Produce excess sebum Clogs the skin pores Bacteria gets the proper environment to grow and multiply Infection, swelling and inflammation
  6. 6. ater should be tested (should be tepid not hot) W Foot care for a Diabetic Client A ntibacterial soap should be avoided -soap that is gentle on the skin W <ul><li>ear foot coverings at all times </li></ul><ul><li>Sandals that are open toed should be avoided </li></ul><ul><li>Use slippers while in the home </li></ul><ul><li>Choose shoes that are a half size bigger and wide enough to accommodate cotton socks </li></ul><ul><li>Leather shoes are better than vinyl </li></ul><ul><li>Avoid shoes that have high heels w/c causes ingrown/loose of feeling </li></ul>
  7. 7. lways use cotton socks - Avoid nylon socks A <ul><li>cross and straight below the tips of the toes is the direction to cut nails </li></ul><ul><li>Cut the nails according to the shape of the toes so they are even with the skin on the end of the toes </li></ul><ul><li>Avoid cutting down into the corners </li></ul><ul><li>Never cut skin at the end of the toes </li></ul><ul><li>Make sure to trim the toenails in proper light </li></ul><ul><li>Trim toenails only after soaking feet, for example, after a bath or shower </li></ul><ul><li>If the toenails are thickened, they may have to be trimmed by a doctor </li></ul>A
  8. 8. W et feet should by dried thoroughly and air out E <ul><li>levate the feet during the day </li></ul><ul><li>keep the feet higher than the heart for circulation </li></ul><ul><li>avoid standing for long periods of time </li></ul>E liminate use of perfumed lotions on the feet
  9. 9. NURSING PROCESSS
  10. 10. Appropriate Verbs to Use Cognitive return demo Affective listening/ observation Psychomotor observation Compare Describe Evaluate Explain Identify Labels List Names Plans Select States Writes Accept Attends Choose Discusses Displays Initiates Joins Participates Shares Uses Assembles Calculates Changes Demonstrate Measures Moves Organizes Shows
  11. 13. 14 Principles of Management: (by Henry Fayol) <ul><li>  Division of Labor – specialization increases productivity </li></ul><ul><li>Authority and Responsibility / Command Responsibility – must assume responsibility; accountability </li></ul><ul><li>Unity of Command – only one to believe and to follow </li></ul><ul><li>Unity of Direction – same goal, objective for the whole team </li></ul><ul><li>Order – system of deployment of people, materials and right place </li></ul><ul><li>Remuneration – fare wage scheme </li></ul><ul><li>Centralization vs Decentralization – pertains to source of decisions </li></ul>
  12. 14. <ul><li>Subordination of personal interest – patient first before self </li></ul><ul><li>Scalar chain – hierarchy; top to bottom rank </li></ul><ul><li>Stability of Tenure </li></ul><ul><li>Equity </li></ul><ul><li>Discipline </li></ul><ul><li>Initiative – goes with experience </li></ul><ul><li>Esprit the Corps </li></ul>
  13. 15. <ul><li>Identify the client by name, hospital or id number </li></ul><ul><li>Give the date, time, and place of the incident </li></ul><ul><li>Describe the incident as one saw it, avoid blame or conclusion </li></ul><ul><li>Incorporate the client’s account of the accident, use direct quotes </li></ul><ul><li>Identify all witnesses to the incident </li></ul><ul><li>Identify any equipment by number and any meds by name and dosage </li></ul>Incident Report
  14. 16. <ul><li>Include pertinent facts </li></ul><ul><li>Clients account/story </li></ul><ul><li>MD’s order, time, and patients reaction </li></ul><ul><li>Do identify and label equipment defects </li></ul>  Do’s and Don’ts of Incident Report <ul><li>Own perception </li></ul><ul><li>Place on the client’s chart </li></ul>DO DONT’s
  15. 17. MANAGER LEADER Are given the position Take the initiative to lead Organize and staff Align people with direction Emphasize tactics, structure and systems Emphasize philosophy, core value and shared goals Focus on the present Focus on the future Avoid risks Takes risks Motivate people to comply with standards Inspire people to change Operate WITHIN organizational rules, regulations, policies and procedures Operate OUTSIDE of organizational rules, regulations, policies and procedures
  16. 18.   Levels of Anxiety Degree of Anxiety Characteristics Reaction Nursing Management Mild (+) * increased level of perception * well developed and effective problem solving *increase level of intelligence Psychological reaction Encourage to verbalize feelings ( Tell me more) Acknowledge feelings Moderate (++) * Narrowed perception *selective inattention *Pacing Psycho physiological reaction * relaxation technique *assist the patient *give PRN medication(anxiolytics) Severe (+++) *perception is greatly reduced *Doesn’t know what to do and say Neurologic reaction *stay with the patient all the time *give clear directions without touching *instruct the client what to do Panic (++++) *distorted reality *hyperventilating (doom/edge) Psychotic reaction * brown paper bag
  17. 19. Continuing Professional Education
  18. 20. DIET INDICATION PURPOSE LIMIT ENCOURAGE TO: Low Sodium Diet Hypertension Edema due to: - CHF, Liver cirrhosis, Nephrotic Syndrome, PIH To DECREASE sodium/ fluid load canned food, salted food, smoked meat, ham, bacon, sauce Salt Substitute: Potassium Chloride LOW CHOLESTEROL DIET Cardiovascular Disease Diabetes Mellitus To DECREASE risk for CAD FRIED FOODS, EGG YOLK, SHELL FISH, LIVER, PORK BROILED OR STEAMED FOOD, FRUITS, VEGETABLES, CHICKEN MEAT, VEGETABLE OILS
  19. 21. DIET PURPOSE LIMIT BLAND DIET promotes healing of the gastric mucosa and is chemically and mechanically nonstimulating Soft diet without spices
  20. 22. Blood Transfusion <ul><li>Use gauge 18 </li></ul><ul><li>Normal saline to be used (the only compatible) </li></ul><ul><li>Vital signs prior a must (temperature) </li></ul><ul><li>Two nurses to verify client identification </li></ul><ul><li>KVO rate for first fifteen minutes </li></ul><ul><li>(prevent abrupt hypersensitivity reaction) </li></ul><ul><li>Stay with the client for the first 15 minutes (usual onset of reaction) </li></ul><ul><li>STOP if with reaction </li></ul><ul><li>Four hours to infuse (risk of hyperkalemia) </li></ul>
  21. 23. NEW BORN SCREENING <ul><li>done 48 to 72 hours after birth, usually with. in 24 hours after birth or during hospital stay </li></ul><ul><li>Heel prick. </li></ul><ul><li>Result available 7 to 14 working days after sample was taken. </li></ul><ul><li>Note: if positive result and sample was taken 24 hours after birth repeat the test at 14 day of age. </li></ul>
  22. 24. DISEASES DETECTED BY NEWBORN SCREENING DISEASE SIGNS & SYMPTOMS INTERVENTION PKU (Phenylketonuria) - Is the inability to process phenylalanine a component in making protein in the body, high phenyl causes MR -vomiting -seizures -musty odor of the urine -mental retardation -hypertonia -hypopigmentation -hyperactive behavior - Newborn screening - Rescreen the infant by 14 days of age if the NBS was done before 48 hours of age - Restrict pheylananine intake(instead Lofenalac ) - Avoid high protein food
  23. 26. DISEASE SIGNS & SYMPTOMS INTERVENTION Galactosemia - is the inability of the body to use (metabolize) the simple sugar galactose accumulation of galactose 1-phosphate in the body causes damage to the liver, CNS, and other body systems. - autosomal recessive - jaundice - vomiting - poor feeding - poor weight gain - lethargy - irritability - convulsions - galactosemia - strictly avoiding all milk and milk-containing products - soy formula - meat-base formula - nutramigen (a protein hydrolysate formula) - calcium supplements are recommended - read products labels and be an informed consumer
  24. 27. Congenital Adrenal Hyperplasia -not enough cortisol & aldosterone - too much of androgen - lack of an enzyme needed by the adrenal gland to make the hormones - Death in 7-14 days after birth <ul><li>s/sx: </li></ul><ul><li>Girls </li></ul><ul><li>swollen clitoris with the urethral opening at the base(ambiguous genitalia </li></ul><ul><li>normal internal reproductive organs </li></ul><ul><li>depending of the voice </li></ul><ul><li>facial hair </li></ul><ul><li>- failure to menstruate at puberty </li></ul>
  25. 28. Intervention: - cortisol (dexamethasone, fludrocortisones, or hydrocortisone) - chromosomes (karyotyping) - reconstructive surgery for girls with masculine external genitalia(1-3months) Boys - increasingly muscular - penis enlarges - pubic hair appears - voice deepens - appear to enter puberty as early as 2-3 years of age - puberty testes are small
  26. 29. Congenital Hypothyroidism <ul><li>s/sx: </li></ul><ul><li>Jaundice </li></ul><ul><li>Constipation </li></ul><ul><li>Lethargy </li></ul><ul><li>feeding problems </li></ul><ul><li>large tongue </li></ul><ul><li>puffy face </li></ul><ul><li>- distended abdomen </li></ul><ul><li>Intervention: </li></ul><ul><li>thyroid hormone (synthroid, levothroid) </li></ul><ul><li>- monitor T4 & TSH level </li></ul>
  27. 30. Test Implication Risk <ul><li>Non Stress Test (NST) </li></ul><ul><li>electronic fetal monitoring </li></ul><ul><li>Relationship of fetal movement with FHR and intact fetal CNS </li></ul><ul><li>( Gross movements are associated with acceleration of FHR) </li></ul>Reactive Test: Indicates intact CNS Non-Reactive Test: does not meet criteria for creativity May indicate fetal danger Noninvasive procedure. No known contraindications
  28. 31. Test Implication Risk <ul><li>Contraction Stress Test (CST) </li></ul><ul><li>Associated fetal heart rate response to induce uterine contractions </li></ul><ul><li>Indicator of uteroplacental insufficiency. </li></ul><ul><li>Increased doses of oxytocin are administered to stimulate uterine contractions. </li></ul><ul><li>Negative Result: </li></ul><ul><li>(Indicates absence of abnormal decelerations with all condications) </li></ul><ul><li>Guarantee that the fetus is likely to survive if the labor occurs in 1 week. </li></ul><ul><li>Positive result: </li></ul><ul><li>(Indicates abnormal FHR decelerations with contractions) </li></ul><ul><li>May indicate uteroplacental insuffieciency. Fetus is at risk for perinatal morbidity and death. </li></ul>Invasive procedure. May jeopardize the fetus and may cause uterine hyperstimulation.
  29. 32. <ul><li>1. EPI is a basic health service, that is free for all and nationwide. (Wednesday) </li></ul><ul><li>2. EPI is based on Epidemiological status. </li></ul><ul><li>3. EPI is a Mass Approach and not Individual Approach. </li></ul>EPI (Expanded Program on Immunization) Principles:
  30. 33. ELEMENTS: <ul><li>1. Cold Chain Management: </li></ul><ul><ul><li>to maintain vaccine potency and right storage </li></ul></ul><ul><ul><li>RN role: Manager </li></ul></ul><ul><li>Heat sensitive vaccines: AMV, OPV (stored in the freezer) </li></ul><ul><li>Cold sensitive vaccines: BCG, DPT, Hepa B (Body of the Ref) </li></ul><ul><li>  </li></ul><ul><li>2. Epidemiological Situation: </li></ul><ul><ul><li>the basic element of EPI. (herd immunity) </li></ul></ul><ul><li>  </li></ul>
  31. 34. <ul><li>3. Target Setting: </li></ul><ul><ul><li>(the primary element of EPI) to determine eligible population </li></ul></ul><ul><ul><li>RN role: Planner </li></ul></ul><ul><li>0-1year: total population x 3% </li></ul><ul><li>Pregnant: total population x 3.5% </li></ul><ul><li>4. Surveillance: monitoring of EPI (the least element of EPI)  </li></ul>
  32. 35. Major Cause of Diarrhea Cause Physiologic Effects <ul><li>Psychologic stress (example Anxiety) </li></ul><ul><li>Medications </li></ul><ul><li>Antibiotics </li></ul><ul><li>Iron </li></ul><ul><li>Cathartics </li></ul><ul><li>Allergy to foods, fluids,drugs </li></ul><ul><li>Intolerance of food or fluid </li></ul><ul><li>Diseases of the colon </li></ul><ul><li>Increased intestinal motility and mucus secretion </li></ul><ul><li>Inflammation and infection of the mucosa due to overgrowth of pathogenic intestinal microorganism </li></ul><ul><li>Incomplete digestion of food or fluid </li></ul><ul><li>Increased intestinal motility and mucus secretion </li></ul><ul><li>Reduced absorption of fluids, inflammation and ulcer formation </li></ul>
  33. 36. Average Daily Urine Output By Age Age Amount ( mL) 1-2 days 3- 10 days 10 days – 2 months 2 months to 1 year 1 year to 3 years 3 years to 5 years 5 years to 8 years 8 years to 14 years 14 years to adulthood Older Adulthood <ul><li>15- 60 </li></ul><ul><li>100-300 </li></ul><ul><li>250-450 </li></ul><ul><li>400-500 </li></ul><ul><li>500-600 </li></ul><ul><li>600-700 </li></ul><ul><li>700-1000 </li></ul><ul><li>800-1400 </li></ul><ul><li>1500 </li></ul><ul><li>1500 or less </li></ul>
  34. 37.   CONSTIPATION is almost the universal adverse effect of opioid use. All patients should receive prophylactic stimulant laxative therapy, unless contraindicated. <ul><li>Prevent constipation thru: </li></ul><ul><li>Increasing fiber intake </li></ul><ul><li>Using mild laxative regularly </li></ul><ul><li>Taking oral laxatives at bedtime </li></ul><ul><li>Using rectal suppositories in the morning </li></ul>
  35. 38. <ul><li>Ventro gluteal site – seven months and adult s </li></ul><ul><li>Vastus Lateralis site- seven months and younger </li></ul><ul><li>Dorso gluteal- not used under three years old unless the child has been walking for a year </li></ul><ul><li>Deltoid- adults </li></ul><ul><li>Rectus femoris- clients who administer own injections </li></ul>INTRAMUSCULAR INJECTION SITE
  36. 39. OLDCART METHOD O- onset of pain L- location of pain D- duration of pain C- characteristic of pain A- aggravating factors R –radiation of pain T- treatment PQRST mnemonics P- provoked ( what brought about pain) Q- quality of pain R- region or radiation of pain S- severity T- timing MNEMONICS FOR PAIN ASSESSMENT
  37. 40. ADVENTITIOUS BREATH SOUNDS NAME CAUSE LOCATION Crackles (rales) Air passing through fluid or mucus in any air passage Most commonly heard in the base of the lower lung Gurgles (ronchi) Air passing through narrowed air passage as a result of secretions, swelling and tumors Loud sounds can be heard over most lung area but predominate over the trachea and bronchi Friction rub Rubbing together of inflamed pleural surfaces Heard in most areas of greatest thoracic expansion Wheeze Air passing through constricted bronchus as a result of secretions, swelling and tumors Heard all over the lungs
  38. 42. Care after Cataract Removal <ul><li>Leave the eye patch in place </li></ul><ul><li>For 24 hours, limit your activity to sitting in a chair, resting in bed, and walking to the bathroom. </li></ul><ul><li>Do not rub your eye </li></ul><ul><li>You can wear your glasses </li></ul><ul><li>Do not lift more than 5 pounds </li></ul><ul><li>Do not sleep on your side of the body that was operated </li></ul><ul><li>Take your eye drops </li></ul><ul><li>Take acetaminophen as needed for pain and itching. </li></ul><ul><li>DO NOT take Aspirin or drugs containing aspirin. </li></ul><ul><li>Report any pain that is unrelieved, redness around the eyes, nausea, vomitting. </li></ul><ul><li>Wear eye shield to protect your eyes </li></ul>
  39. 43. Susbtance Effect on CNS Cardinal Sign Withdrawal S/Sx <ul><li>Stimulants </li></ul><ul><li>Cocaine </li></ul><ul><li>Amphetamine </li></ul><ul><li>Caffeine </li></ul>Alcohol / Marijuana <ul><li>Narcotics/ </li></ul><ul><li>Opiates </li></ul><ul><li>Morphine </li></ul><ul><li>Heroine </li></ul><ul><li>Codeine </li></ul><ul><li>Opium </li></ul>
  40. 44. Approaches to Clients with Eating Disorders DO…. DON’T… <ul><li>Small frequent feedings </li></ul><ul><li>Monitor intake and output, and bowel functions. </li></ul><ul><li>Monitor weight gain and laboratory results. ( electrolytes, urine, BUN) </li></ul><ul><li>Encourage expression of feelings. </li></ul><ul><li>Set realistic expectation of self </li></ul><ul><li>Encourage participation in activities. </li></ul><ul><li>Stay with the client during meal time, and at least one hour after eating (Bulimia). </li></ul><ul><li>Accompany to the bathroom ( if self induced vomiting is expected) </li></ul><ul><li>Don’t indicate feelings of shock, disbelief or disgust at eating disorder. </li></ul><ul><li>Don’t confront and judge hostility and anger should they occur. </li></ul><ul><li>Don’t discuss and explain food, diet, or body unless these are linked with feelings. </li></ul><ul><li>Don’t compare client’s behavior and appearance with others. </li></ul><ul><li>Don’t allow long meal time ( set 30-40 minutes of mealtime only) </li></ul>
  41. 45. SEXUAL DISRODERS <ul><li>Soixante neuf- 69 </li></ul><ul><li>Fellatio – penis sucking </li></ul><ul><li>Cunnilingus – vagina licking </li></ul><ul><li>Necrophilia – corpse </li></ul><ul><li>Voyeurism – peeping </li></ul>
  42. 46. SEXUAL DISORDERS <ul><li>Scartophilia – phone sex </li></ul><ul><li>Pigmaliunism – statue </li></ul><ul><li>Emetophilia – vomitus </li></ul><ul><li>Urophilia – urine </li></ul><ul><li>Copraphilia – feces </li></ul><ul><li>Phagophilia – food in Genitalia </li></ul>
  43. 47. SCHIZOPHRENIA (+) signs (-) signs <ul><li>Hallucination </li></ul><ul><li>Delussion </li></ul><ul><li>Incoherence </li></ul><ul><li>Pressured speech </li></ul><ul><li>Bizaare </li></ul><ul><li>Anhedonia – lack pleasure </li></ul><ul><li>Avolition – lack motivation </li></ul><ul><li>Akinesia – lack movement </li></ul><ul><li>Apathy – lack feelings </li></ul><ul><li>Alogia – lack in words </li></ul>Typical Anti-Psychotic Atypical Anti-Psychotic <ul><li>treat (+) s/sx </li></ul><ul><li>More EPS </li></ul><ul><li>“ zine”, “xene”, “dol” </li></ul><ul><li>treat (-) s/sx </li></ul><ul><li>Few or without EPS </li></ul><ul><li>“ pine”, “done” </li></ul>
  44. 48. LITHIUM DRUGS LITHIUM CARBONATE (Eskalith, Lithane,Lithobid, Lithotab DRUGS THINGS TO CONSIDER Increase fluid intake and maintain normal level of NA. to prevent toxicity Monitor Lithium Level: 1 st two weeks: 2-3 x a week Therapeutic Level: .5 – 1.5 mEq/L Maintenance Level: .6- 1.6 mEq/L Toxic level: 2 mEq/ L Letahl Level: 3 mEq/l <ul><li>Antidote: Mannitol </li></ul><ul><li>Signs of Toxicity </li></ul><ul><li>Tremors </li></ul><ul><li>Diarrhea and vomiting </li></ul><ul><li>Side Effects: </li></ul><ul><li>Agranulocytosis Leukocytopenia </li></ul>
  45. 49. …… any question?
  46. 50. THE END www.nursendoutfield.blogspot.com

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