This document discusses the pathophysiology and medical management of acute hemorrhagic stroke. It notes that spontaneous intracerebral hemorrhage accounts for 10-20% of strokes and has a high mortality rate. Chronic hypertension is the leading cause, responsible for about 60% of cases. Other common causes include cerebral amyloid angiopathy and anticoagulant use. The location and expansion of the hematoma, development of hydrocephalus and cerebral edema are consequences that impact outcomes. Early management focuses on blood pressure control and reversal of anticoagulation to prevent hematoma expansion.
This document summarizes a study examining the role of the nuclear factor erythroid 2-related factor 2 (Nrf2) in protecting against brain injury caused by intracerebral hemorrhage (ICH) in mice. The study found that Nrf2 knockout mice exhibited larger brain injury volumes and greater neurological deficits 24 hours after ICH induction compared to wild-type mice. Additionally, Nrf2 knockout mice showed increased leukocyte infiltration, reactive oxygen species production, DNA damage, and cytochrome c release during the early post-ICH period. These results suggest that Nrf2 provides protection against ICH-induced early brain injury, likely by reducing leukocyte-mediated free radical oxidative damage.
The document discusses hematologic disorders, focusing on lymphomas. It defines lymphomas as neoplasms of lymphoid cells that usually start in lymph nodes but can spread to other lymphatic tissues. Lymphomas are broadly classified into Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). Hodgkin lymphoma is described in more detail, including its epidemiology, pathophysiology involving Reed-Sternberg cells, clinical manifestations, diagnostic criteria, medical management using chemotherapy and radiation, and nursing considerations around screening and education. NHL is discussed as a heterogeneous group of cancers involving malignant B or T lymphocytes that can infiltrate multiple lymph node sites and extranodal tissues.
This document provides an overview of mechanical ventilation. It defines mechanical ventilation as artificial ventilation of the lungs using a ventilator. Ventilators deliver gas to the lungs with either negative or positive pressure. The main purposes of mechanical ventilation are to maintain ventilation and tissue oxygenation, and decrease the work of breathing. Indications for mechanical ventilation include respiratory failure from various causes. The document describes different types of ventilators including negative pressure ventilators and various positive pressure ventilators. It also covers ventilator modes, settings, and how to optimize ventilation based on a patient's condition.
This document discusses mechanical ventilation, including its purposes, types, modes, settings, complications, weaning process, and nursing care of patients on ventilators. The main types are negative pressure ventilators like iron lungs and positive pressure ventilators. Common modes include assist-control, SIMV, PSV and APRV. Key settings include tidal volume, rate, sensitivity and PEEP. Weaning involves gradually reducing support in stages. Nursing care focuses on airway management, ventilation, safety, communication and weaning progress.
This document discusses polycythemia, which refers to an increased volume of red blood cells. There are two types: primary polycythemia vera, which is a stem cell disorder causing elevated red blood cell, white blood cell, and platelet counts; and secondary polycythemia caused by excessive erythropoietin production in response to factors like smoking or lung disease. Symptoms include headaches and fatigue from increased blood volume and risks of clotting or bleeding. Medical management focuses on phlebotomy to reduce blood thickness while nursing management educates on risk reduction and symptom management.
This document describes respiratory care modalities including chest physiotherapy techniques like postural drainage, percussion, and breathing exercises. Postural drainage uses specific positions and gravity to drain secretions from the lungs into the trachea where they can be coughed or suctioned out. Percussion helps loosen thick secretions for removal. Breathing retraining teaches pursed-lip breathing and diaphragmatic breathing to make breathing more efficient. The nurse's role is to instruct patients and families on these techniques and ensure they are performed correctly and safely to clear the lungs and improve ventilation.
This document discusses ethical issues in nursing research. It outlines the objectives of summarizing the development of ethical codes and guidelines, describing the role of institutional review boards, citing examples of informed consent elements, discussing how integrity in research is promoted, and analyzing issues that threaten integrity among nurse researchers. It also explains the role of nurse researchers as patient advocates.
This document discusses the pathophysiology and medical management of acute hemorrhagic stroke. It notes that spontaneous intracerebral hemorrhage accounts for 10-20% of strokes and has a high mortality rate. Chronic hypertension is the leading cause, responsible for about 60% of cases. Other common causes include cerebral amyloid angiopathy and anticoagulant use. The location and expansion of the hematoma, development of hydrocephalus and cerebral edema are consequences that impact outcomes. Early management focuses on blood pressure control and reversal of anticoagulation to prevent hematoma expansion.
This document summarizes a study examining the role of the nuclear factor erythroid 2-related factor 2 (Nrf2) in protecting against brain injury caused by intracerebral hemorrhage (ICH) in mice. The study found that Nrf2 knockout mice exhibited larger brain injury volumes and greater neurological deficits 24 hours after ICH induction compared to wild-type mice. Additionally, Nrf2 knockout mice showed increased leukocyte infiltration, reactive oxygen species production, DNA damage, and cytochrome c release during the early post-ICH period. These results suggest that Nrf2 provides protection against ICH-induced early brain injury, likely by reducing leukocyte-mediated free radical oxidative damage.
The document discusses hematologic disorders, focusing on lymphomas. It defines lymphomas as neoplasms of lymphoid cells that usually start in lymph nodes but can spread to other lymphatic tissues. Lymphomas are broadly classified into Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). Hodgkin lymphoma is described in more detail, including its epidemiology, pathophysiology involving Reed-Sternberg cells, clinical manifestations, diagnostic criteria, medical management using chemotherapy and radiation, and nursing considerations around screening and education. NHL is discussed as a heterogeneous group of cancers involving malignant B or T lymphocytes that can infiltrate multiple lymph node sites and extranodal tissues.
This document provides an overview of mechanical ventilation. It defines mechanical ventilation as artificial ventilation of the lungs using a ventilator. Ventilators deliver gas to the lungs with either negative or positive pressure. The main purposes of mechanical ventilation are to maintain ventilation and tissue oxygenation, and decrease the work of breathing. Indications for mechanical ventilation include respiratory failure from various causes. The document describes different types of ventilators including negative pressure ventilators and various positive pressure ventilators. It also covers ventilator modes, settings, and how to optimize ventilation based on a patient's condition.
This document discusses mechanical ventilation, including its purposes, types, modes, settings, complications, weaning process, and nursing care of patients on ventilators. The main types are negative pressure ventilators like iron lungs and positive pressure ventilators. Common modes include assist-control, SIMV, PSV and APRV. Key settings include tidal volume, rate, sensitivity and PEEP. Weaning involves gradually reducing support in stages. Nursing care focuses on airway management, ventilation, safety, communication and weaning progress.
This document discusses polycythemia, which refers to an increased volume of red blood cells. There are two types: primary polycythemia vera, which is a stem cell disorder causing elevated red blood cell, white blood cell, and platelet counts; and secondary polycythemia caused by excessive erythropoietin production in response to factors like smoking or lung disease. Symptoms include headaches and fatigue from increased blood volume and risks of clotting or bleeding. Medical management focuses on phlebotomy to reduce blood thickness while nursing management educates on risk reduction and symptom management.
This document describes respiratory care modalities including chest physiotherapy techniques like postural drainage, percussion, and breathing exercises. Postural drainage uses specific positions and gravity to drain secretions from the lungs into the trachea where they can be coughed or suctioned out. Percussion helps loosen thick secretions for removal. Breathing retraining teaches pursed-lip breathing and diaphragmatic breathing to make breathing more efficient. The nurse's role is to instruct patients and families on these techniques and ensure they are performed correctly and safely to clear the lungs and improve ventilation.
This document discusses ethical issues in nursing research. It outlines the objectives of summarizing the development of ethical codes and guidelines, describing the role of institutional review boards, citing examples of informed consent elements, discussing how integrity in research is promoted, and analyzing issues that threaten integrity among nurse researchers. It also explains the role of nurse researchers as patient advocates.
This document outlines the objectives and content for a student presentation on developing nursing knowledge. It will:
1. Define knowing and knowledge and discuss three key phases in the philosophy of knowledge - rationalism, empiricism, and historicism.
2. Discuss the differences between three types of knowledge - "know how", "know that", and "know why" - giving nursing examples.
3. Examine Carper's (1978) "ways of knowing" in nursing and Kerlinger's (1986) "categories of knowledge", providing practice examples.
4. Identify two main strategies to develop nursing knowledge: inductive and deductive reasoning.
The document discusses nursing theory, including its definition, purpose, and construction. It begins by asking what nursing theories are and why they are important. Nursing theories are then defined as conceptual frameworks that describe, explain, or predict phenomena in nursing. Theories are made up of concepts linked by propositions. Several influential nursing theorists such as Florence Nightingale and Hildegard Peplau developed theories by directly observing phenomena in clinical practice. The construction of theory involves identifying concepts and linking them with propositions to form a framework for understanding nursing phenomena.
This document discusses nursing research and its importance. Nursing research is a scientific process that generates new knowledge to directly influence nursing practice. It aims to develop an evidence-based practice that improves outcomes for patients, nurses, and the healthcare system. The document defines different types of nursing research, including quantitative, qualitative, descriptive, correlational, experimental, and historical research. It also outlines the steps of the nursing research process and discusses the importance of ethics and avoiding scientific misconduct in nursing research.
This document outlines the steps in quantitative and qualitative research. It begins by differentiating between the two methods, noting that quantitative research uses numeric and measurable data while qualitative focuses on personal perceptions.
For quantitative research, the steps include identifying a problem, developing a hypothesis, collecting numeric data, analyzing results, and interpreting findings. For qualitative research, the process involves identifying a problem, selecting a design, collecting subjective data through interviews or observations, analyzing themes in the data, and interpreting results.
Finally, the document discusses using both methods together in a single study to gain a more comprehensive understanding of a problem. It provides examples of nursing issues that could be addressed through these research approaches.
The document outlines the key steps in the scientific research process, including identifying a research question, forming a hypothesis, conducting research, analyzing results, and drawing conclusions. It discusses 12 specific steps that guide research, including identifying the research question, reviewing literature, formulating a hypothesis, collecting and analyzing data. The research question is the foundation, and can be descriptive, examine relationships, or test for differences. Variables, including independent, dependent, and extraneous variables, are also defined.
This document discusses hypotheses in research studies. It defines a hypothesis and explains their purposes, including guiding research design and statistical analysis. Hypotheses can be classified in various ways, such as simple vs complex, directional vs nondirectional, and causal vs associative. The null hypothesis predicts no relationship while the research hypothesis states an expected relationship. Guidelines are provided for developing testable hypotheses and critiquing them in research reports.
This document discusses the evaluation and management of comatose patients. It emphasizes performing ABCs (airway, breathing, circulation) initially and evaluating for life-threatening issues. It describes assessing pupils, blood pressure, glucose, and using the Glasgow Coma Scale to evaluate level of consciousness. Causes of coma like head injuries, liver failure, diabetes, and renal failure are reviewed. Treatment focuses on addressing the underlying cause and supporting vital functions.
This document discusses the neural basis of consciousness and provides definitions for different levels of altered mental status including coma. It describes the anatomy related to mental status including the ascending reticular activating system, cerebral hemispheres, and their interaction. Coma is defined as a state of unconsciousness with absent sleep-wake cycles. The Glasgow Coma Scale is used to assess the severity of impaired consciousness. Various approaches for differential diagnosis of an unresponsive patient are outlined. Causes of coma including cerebrovascular disease, subarachnoid hemorrhage, brain tumors, hypotension, and raised intracranial pressure are described. A detailed neurological examination of a comatose patient is also discussed.
This document discusses the approach to patients presenting in a coma. It defines coma as a state of unresponsiveness where patients cannot be aroused even with vigorous stimulation. It describes various stages between alertness and coma. Coma is caused by dysfunction of the brainstem or both hemispheres of the brain. A thorough assessment is needed to determine the cause and guide management, including a neurological exam to identify any focal signs. Key aspects of the exam include vital signs, pupil response, eye movements, motor response and reflexes. Different patterns on exam can localize the lesion causing the coma. Immediate life-saving interventions are also often needed.
This document provides information on approaching and assessing patients in a coma state. It defines coma and outlines systems involved in consciousness. Assessment involves examining level of arousal, brainstem reflexes like pupils and eye movements, motor function, and abnormal breathing patterns. Differential diagnosis considers diseases with and without focal signs. Treatment focuses on stabilizing vital functions, diagnostic testing like imaging and lumbar puncture, and managing elevated intracranial pressure if present. Prognosis depends on the underlying cause, with structural brain injuries generally having a worse prognosis than metabolic causes.
This document provides information about coma, including its neuroanatomical basis, causes, definitions of related states, assessment, and differential diagnosis. Coma results from dysfunction of the brainstem reticular activating system or bilateral damage to the thalamus or both cerebral hemispheres. Immediate management of coma involves assessing ABCs and administering glucose/thiamine/naloxone/flumazenil as needed. A thorough neurological exam assesses level of consciousness, brainstem reflexes, motor function, and helps differentiate structural from toxic/metabolic causes. Pseudocoma conditions like locked-in syndrome or catatonia can mimic true coma and require different management.
The document defines traumatic brain injury (TBI) as an acquired injury to the brain caused by an external force that results in functional or psychosocial impairment. It then discusses the leading causes of TBI which include falls, motor vehicle accidents, and assaults. Common symptoms of TBI are discussed which affect thinking, sensation, language, and emotion. The document also provides statistics on the incidence and prevalence of TBI in different age groups.
This document provides guidance on assessing the head and neck region during a physical examination. It begins by outlining the session objectives, which are to learn anatomy and physiology of the head and neck, components of the health history, specific examination techniques, normal findings, and documentation of significant findings.
It then details the assessment of various head and neck structures including the skull, face, eyes, ears, nose, mouth, oropharynx and neck. For each area, it describes inspection, palpation and any specialized examination techniques, as well as normal findings and potential deviations. Standard protocols for the head and neck exam involving patient preparation, examination steps and possible history questions are also provided.
This document outlines the objectives and content for a student presentation on developing nursing knowledge. It will:
1. Define knowing and knowledge and discuss three key phases in the philosophy of knowledge - rationalism, empiricism, and historicism.
2. Discuss the differences between three types of knowledge - "know how", "know that", and "know why" - giving nursing examples.
3. Examine Carper's (1978) "ways of knowing" in nursing and Kerlinger's (1986) "categories of knowledge", providing practice examples.
4. Identify two main strategies to develop nursing knowledge: inductive and deductive reasoning.
The document discusses nursing theory, including its definition, purpose, and construction. It begins by asking what nursing theories are and why they are important. Nursing theories are then defined as conceptual frameworks that describe, explain, or predict phenomena in nursing. Theories are made up of concepts linked by propositions. Several influential nursing theorists such as Florence Nightingale and Hildegard Peplau developed theories by directly observing phenomena in clinical practice. The construction of theory involves identifying concepts and linking them with propositions to form a framework for understanding nursing phenomena.
This document discusses nursing research and its importance. Nursing research is a scientific process that generates new knowledge to directly influence nursing practice. It aims to develop an evidence-based practice that improves outcomes for patients, nurses, and the healthcare system. The document defines different types of nursing research, including quantitative, qualitative, descriptive, correlational, experimental, and historical research. It also outlines the steps of the nursing research process and discusses the importance of ethics and avoiding scientific misconduct in nursing research.
This document outlines the steps in quantitative and qualitative research. It begins by differentiating between the two methods, noting that quantitative research uses numeric and measurable data while qualitative focuses on personal perceptions.
For quantitative research, the steps include identifying a problem, developing a hypothesis, collecting numeric data, analyzing results, and interpreting findings. For qualitative research, the process involves identifying a problem, selecting a design, collecting subjective data through interviews or observations, analyzing themes in the data, and interpreting results.
Finally, the document discusses using both methods together in a single study to gain a more comprehensive understanding of a problem. It provides examples of nursing issues that could be addressed through these research approaches.
The document outlines the key steps in the scientific research process, including identifying a research question, forming a hypothesis, conducting research, analyzing results, and drawing conclusions. It discusses 12 specific steps that guide research, including identifying the research question, reviewing literature, formulating a hypothesis, collecting and analyzing data. The research question is the foundation, and can be descriptive, examine relationships, or test for differences. Variables, including independent, dependent, and extraneous variables, are also defined.
This document discusses hypotheses in research studies. It defines a hypothesis and explains their purposes, including guiding research design and statistical analysis. Hypotheses can be classified in various ways, such as simple vs complex, directional vs nondirectional, and causal vs associative. The null hypothesis predicts no relationship while the research hypothesis states an expected relationship. Guidelines are provided for developing testable hypotheses and critiquing them in research reports.
This document discusses the evaluation and management of comatose patients. It emphasizes performing ABCs (airway, breathing, circulation) initially and evaluating for life-threatening issues. It describes assessing pupils, blood pressure, glucose, and using the Glasgow Coma Scale to evaluate level of consciousness. Causes of coma like head injuries, liver failure, diabetes, and renal failure are reviewed. Treatment focuses on addressing the underlying cause and supporting vital functions.
This document discusses the neural basis of consciousness and provides definitions for different levels of altered mental status including coma. It describes the anatomy related to mental status including the ascending reticular activating system, cerebral hemispheres, and their interaction. Coma is defined as a state of unconsciousness with absent sleep-wake cycles. The Glasgow Coma Scale is used to assess the severity of impaired consciousness. Various approaches for differential diagnosis of an unresponsive patient are outlined. Causes of coma including cerebrovascular disease, subarachnoid hemorrhage, brain tumors, hypotension, and raised intracranial pressure are described. A detailed neurological examination of a comatose patient is also discussed.
This document discusses the approach to patients presenting in a coma. It defines coma as a state of unresponsiveness where patients cannot be aroused even with vigorous stimulation. It describes various stages between alertness and coma. Coma is caused by dysfunction of the brainstem or both hemispheres of the brain. A thorough assessment is needed to determine the cause and guide management, including a neurological exam to identify any focal signs. Key aspects of the exam include vital signs, pupil response, eye movements, motor response and reflexes. Different patterns on exam can localize the lesion causing the coma. Immediate life-saving interventions are also often needed.
This document provides information on approaching and assessing patients in a coma state. It defines coma and outlines systems involved in consciousness. Assessment involves examining level of arousal, brainstem reflexes like pupils and eye movements, motor function, and abnormal breathing patterns. Differential diagnosis considers diseases with and without focal signs. Treatment focuses on stabilizing vital functions, diagnostic testing like imaging and lumbar puncture, and managing elevated intracranial pressure if present. Prognosis depends on the underlying cause, with structural brain injuries generally having a worse prognosis than metabolic causes.
This document provides information about coma, including its neuroanatomical basis, causes, definitions of related states, assessment, and differential diagnosis. Coma results from dysfunction of the brainstem reticular activating system or bilateral damage to the thalamus or both cerebral hemispheres. Immediate management of coma involves assessing ABCs and administering glucose/thiamine/naloxone/flumazenil as needed. A thorough neurological exam assesses level of consciousness, brainstem reflexes, motor function, and helps differentiate structural from toxic/metabolic causes. Pseudocoma conditions like locked-in syndrome or catatonia can mimic true coma and require different management.
The document defines traumatic brain injury (TBI) as an acquired injury to the brain caused by an external force that results in functional or psychosocial impairment. It then discusses the leading causes of TBI which include falls, motor vehicle accidents, and assaults. Common symptoms of TBI are discussed which affect thinking, sensation, language, and emotion. The document also provides statistics on the incidence and prevalence of TBI in different age groups.
This document provides guidance on assessing the head and neck region during a physical examination. It begins by outlining the session objectives, which are to learn anatomy and physiology of the head and neck, components of the health history, specific examination techniques, normal findings, and documentation of significant findings.
It then details the assessment of various head and neck structures including the skull, face, eyes, ears, nose, mouth, oropharynx and neck. For each area, it describes inspection, palpation and any specialized examination techniques, as well as normal findings and potential deviations. Standard protocols for the head and neck exam involving patient preparation, examination steps and possible history questions are also provided.