SlideShare a Scribd company logo
[5/12/2024 1:00 PM] Shafnafinu: Elaborate on: (2 x 15 = 30)
1. Mr. X, 65 years old male is admitted with diagnosis of Chronic Obstructive
Pulmonary Disease (COPD).
a) Define Chronic Obstructive Pulmonary Disease.
b) Discuss the pathophysiology and signs and symptoms of Chronic Obstructive
Pulmonary Disease.
c) Explain the Medical and Nursing management of Chronic Obstructive
Pulmonary Disease.
2. Mr. X, 42 years old male is diagnosed with Myocardial Infarction (MI).
a) Define Myocardial Infarction.
b) Discuss the clinical manifestation and diagnostic evaluation of Myocardial
Infarction.
c) Explain the collaborative management of Myocardial Infarction.
II. Write notes on: (5 x 5 = 25)
1. Psoriasis.
2. Blood transfusion.
3. Stages of Wound healing.
4. Iron deficiency anaemia.
5. Hyperthyroidism.
III. Short answers on: (10 x 2 = 20)
1. Dressler’s syndrome.
2. Four types of amputation.
3. Reynaud’s disease.
4. Four complication of General Anaesthesia.
5. List out four complications of Peritoneal Dialysis.
6. Difference between Osteoarthritis and Rheumatoid Arthritis.
7. Personal Protective Equipment.
8. Epispadiasis.
9. Sites of colostomy.
10.Four types of Breath sound.
*
[5/12/2024 1:02 PM] : Certainly! Let's start by elaborating on the first question:
*1. Mr. X, 65 years old male is admitted with a diagnosis of Chronic Obstructive Pulmonary Disease
(COPD).*
a) *Define Chronic Obstructive Pulmonary Disease (COPD):*
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease characterized by chronic
inflammation of the airways and obstruction of airflow, making it difficult to breathe. It primarily
includes two main conditions: chronic bronchitis and emphysema. In chronic bronchitis, the airways are
inflamed and produce excess mucus, leading to coughing and difficulty breathing. Emphysema involves
the destruction of the air sacs (alveoli) in the lungs, reducing their elasticity and surface area for gas
exchange.
b) *Discuss the pathophysiology and signs and symptoms of COPD:*
The pathophysiology of COPD involves damage to the airways and lung tissue, primarily caused by long-
term exposure to irritants such as cigarette smoke, air pollution, and occupational dust and chemicals.
This leads to inflammation, narrowing of the airways, and destruction of lung tissue, resulting in
symptoms such as chronic cough, sputum production, wheezing, shortness of breath, and chest
tightness. Over time, COPD can progress, leading to respiratory failure and significant disability.
c) *Explain the Medical and Nursing management of COPD:*
Medical management of COPD aims to relieve symptoms, improve lung function, and prevent
exacerbations. This may include bronchodilators to help open the airways, corticosteroids to reduce
inflammation, oxygen therapy to improve oxygen levels, and pulmonary rehabilitation to enhance
exercise tolerance and quality of life. Smoking cessation is crucial in slowing disease progression.
Nursing management involves educating patients about their condition, promoting adherence to
medications and treatment plans, assisting with activities of daily living, monitoring for complications,
and providing emotional support. Nursing interventions also focus on promoting effective airway
clearance, optimizing oxygenation, and preventing respiratory infections.
If you need further elaboration on any specific aspect, feel free to ask!
[5/12/2024 1:05 PM] : Sure, let's delve into the second question:
*2. Mr. X, 42 years old male is diagnosed with Myocardial Infarction (MI).*
a) *Define Myocardial Infarction (MI):*
Myocardial infarction, commonly known as a heart attack, occurs when there is a sudden blockage of
blood flow to a part of the heart muscle, leading to tissue damage or death due to lack of oxygen. This
blockage usually results from the rupture of an atherosclerotic plaque in one of the coronary arteries,
which supply oxygen-rich blood to the heart muscle.
b) *Discuss the clinical manifestation and diagnostic evaluation of Myocardial Infarction:*
Clinical manifestations of MI typically include severe chest pain or discomfort, often described as
crushing, squeezing, or pressure-like, that may radiate to the left arm, shoulder, jaw, or back. Other
symptoms may include shortness of breath, nausea, vomiting, sweating, lightheadedness, and anxiety.
However, the presentation can vary, especially in atypical cases or in individuals with diabetes or older
adults.
Diagnostic evaluation of MI involves several tests, including an electrocardiogram (ECG or EKG) to detect
changes in the heart's electrical activity, cardiac biomarker tests (such as troponin) to identify cardiac
muscle damage, and imaging studies such as echocardiography or coronary angiography to assess heart
function and identify the location and extent of blockages in the coronary arteries.
c) *Explain the collaborative management of Myocardial Infarction:*
The management of MI involves a multidisciplinary approach that includes medical interventions,
reperfusion therapy, and lifestyle modifications.
Medical interventions may include administering medications such as aspirin, nitroglycerin, beta-
blockers, ACE inhibitors, and statins to reduce pain, prevent further clot formation, decrease cardiac
workload, and improve outcomes.
Reperfusion therapy aims to restore blood flow to the affected area of the heart as quickly as possible to
minimize tissue damage. This may involve either thrombolytic therapy (administration of clot-busting
drugs) or primary percutaneous coronary intervention (PCI), also known as angioplasty with stenting, to
mechanically open the blocked coronary artery.
Additionally, lifestyle modifications such as smoking cessation, adopting a heart-healthy diet, regular
exercise, weight management, and stress reduction are essential components of long-term
management to prevent recurrent events and improve overall cardiovascular health.
If you need further explanation or have additional questions, feel free to ask!
[5/12/2024 1:09 PM] : Certainly! Let's provide brief notes on each topic:
1. *Psoriasis:*
- Psoriasis is a chronic autoimmune skin condition characterized by red, raised, scaly patches on the
skin.
- It occurs when the immune system mistakenly attacks healthy skin cells, leading to rapid turnover of
skin cells and inflammation.
- Triggers for psoriasis include genetics, environmental factors, stress, infections, and certain
medications.
- Treatment options include topical treatments (such as corticosteroids, vitamin D analogs),
phototherapy, systemic medications (such as methotrexate, cyclosporine), and biologic agents targeting
specific immune pathways.
2. *Blood transfusion:*
- Blood transfusion involves the transfer of blood or blood products from a donor to a recipient to
replace lost blood, improve oxygen delivery, or correct abnormalities in blood composition.
- It is commonly used in medical emergencies, surgeries, and treatments for various medical conditions
such as anemia, bleeding disorders, and cancer.
- Blood transfusions must be carefully matched for blood type (ABO compatibility) and screened for
compatibility to minimize the risk of adverse reactions.
- Potential risks of blood transfusion include transfusion reactions, infections, and transfusion-related
complications such as transfusion-associated circulatory overload (TACO) or transfusion-related acute
lung injury (TRALI).
- Blood donation is crucial for maintaining an adequate blood supply, and donated blood undergoes
rigorous screening and testing for safety.
3. *Stages of Wound healing:*
- Wound healing is a complex process involving several overlapping stages: hemostasis, inflammation,
proliferation, and remodeling.
- Hemostasis: Immediate response to injury involving vasoconstriction and platelet aggregation to stop
bleeding.
- Inflammation: Inflammatory cells (neutrophils, macrophages) remove debris and pathogens, and
cytokines stimulate tissue repair.
- Proliferation: Fibroblasts produce collagen, forming granulation tissue, and new blood vessels
(angiogenesis) develop.
- Remodeling: Collagen matures, scar tissue forms, and wound strength increases.
- Factors such as age, nutrition, infection, and underlying health conditions can affect the wound
healing process.
4. *Iron deficiency anemia:*
- Iron deficiency anemia occurs when the body lacks sufficient iron to produce hemoglobin, resulting in
decreased oxygen-carrying capacity of red blood cells.
- Common causes include inadequate dietary intake of iron, blood loss (such as from menstruation or
gastrointestinal bleeding), malabsorption disorders, and increased iron demands (such as during
pregnancy or rapid growth).
- Clinical manifestations include fatigue, weakness, pale skin, shortness of breath, dizziness, and cold
intolerance.
- Diagnosis is based on blood tests showing low hemoglobin, low serum iron levels, low ferritin levels,
and high total iron-binding capacity (TIBC).
- Treatment involves iron supplementation, dietary modifications to increase iron intake, and
addressing the underlying cause if present.
5. *Hyperthyroidism:*
- Hyperthyroidism is a condition characterized by excess production of thyroid hormones (T3 and T4)
by the thyroid gland.
- Causes include Graves' disease (autoimmune disorder), toxic multinodular goiter, thyroiditis, and
thyroid nodules.
- Clinical manifestations include weight loss, increased appetite, heat intolerance, palpitations,
tremors, nervousness, fatigue, diarrhea, and menstrual irregularities.
- Diagnosis is based on blood tests showing elevated levels of thyroid hormones (T3 and T4), low levels
of thyroid-stimulating hormone (TSH), and thyroid ultrasound or nuclear imaging.
- Treatment options include antithyroid medications (such as methimazole, propylthiouracil),
radioactive iodine therapy, or surgical removal of the thyroid gland (thyroidectomy).
Feel free to ask if you need further clarification on any of these topics!
[5/12/2024 1:12 PM] : Certainly! Here are short answers to each of the questions:
1. *Dressler’s syndrome:*
- Dressler’s syndrome, also known as post-myocardial infarction syndrome, is a type of pericarditis that
occurs weeks to months after a myocardial infarction (heart attack). It is characterized by chest pain,
fever, and pericardial effusion (fluid accumulation around the heart).
2. *Four types of amputation:*
- Transmetatarsal: Removal of the forefoot and toes.
- Syme's: Removal of the foot at the ankle joint.
- Below-knee (transtibial): Removal of the leg below the knee joint.
- Above-knee (transfemoral): Removal of the leg above the knee joint.
3. *Raynaud’s disease:*
- Raynaud’s disease is a condition characterized by vasospasm of small arteries in response to cold or
stress, resulting in reduced blood flow to the fingers and toes.
- Symptoms include color changes in the skin (white, blue, red), numbness, tingling, and pain in the
affected extremities.
4. *Four complications of General Anaesthesia:*
- Nausea and vomiting
- Postoperative confusion or cognitive dysfunction
- Respiratory depression or airway obstruction
- Hypotension or cardiovascular instability
5. *Four complications of Peritoneal Dialysis:*
- Peritonitis (infection of the peritoneal membrane)
- Exit site infection (infection at the catheter exit site)
- Catheter-related complications (e.g., catheter malfunction, migration)
- Fluid and electrolyte imbalances (e.g., hyperglycemia, hyperkalemia)
6. *Difference between Osteoarthritis and Rheumatoid Arthritis:*
- Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage and
overgrowth of bone at the joint margins, leading to joint pain and stiffness, typically affecting weight-
bearing joints.
- Rheumatoid arthritis is an autoimmune disease characterized by inflammation of the synovial
membrane, leading to joint pain, swelling, and deformity, typically affecting small joints symmetrically.
7. *Personal Protective Equipment (PPE):*
- Personal Protective Equipment includes items such as gloves, masks, goggles, face shields, gowns,
and respirators, designed to protect healthcare workers from exposure to infectious agents, chemicals,
and other hazards in the workplace.
8. *Epispadias:*
- Epispadias is a congenital defect where the urethral opening is located on the upper surface of the
penis (in males) or in females, on the clitoris or near the labia.
- It occurs due to abnormal development of the urinary tract during fetal development.
9. *Sites of colostomy:*
- Ascending colostomy (usually on the right side of the abdomen)
- Transverse colostomy (usually in the upper abdomen)
- Descending colostomy (usually on the left side of the abdomen)
- Sigmoid colostomy (usually in the lower left quadrant of the abdomen)
10. *Four types of Breath sound:*
- Vesicular breath sounds (heard over most of the lung fields)
- Bronchial breath sounds (heard over the trachea and large airways)
- Bronchovesicular breath sounds (heard over the mainstem bronchi)
- Adventitious breath sounds (abnormal sounds such as crackles, wheezes, or rhonchi)
Feel free to ask if you need further elaboration on any of these topics!
[5/12/2024 1:17 PM] Shafnafinu: swer ALL questions.
I. Essays: (2x15=30)
1. Mr.Mani 64 yrs old man is admitted with the diagnosis of Benign
Prostatic hypertrophy.
Answer the following:
a) Define Benign prostatic hypertrophy. (2)
b) List out the clinical manifestations of Benign prostatic hypertrophy.(4)
c) Describe the surgical procedures done for Benign prostatic
hypertrophy. (4)
d) Explain the pre and postoperative management of Mr. Mani. (5)
2. Mr. Gopi, 38 years is admitted with the diagnosis of cirrhosis of liver.
Answer the following:
a) Define Cirrhosis of Liver. (2)
b) List out the clinical manifestations of cirrhosis of liver. (4)
c) Mention the complications of cirrhosis of liver. (4)
d) Explain the management of cirrhosis of Liver. (5)
II. Write Short Notes on : (5x5=25)
1. Care of patient with chest drainage.
2. Preparation of patient for crutch walking.
3. Suture materials.
4. Dialysis.
5. Surgical management of peptic ulcer.
III. Short Answer Questions: (10x2=20)
1. Two indications of blood transfusion.
2. Two non-invasive diagnostic procedures done in cardiac diseases.
3. Two reasons to obtain written informed consent.
4. Two principles of applying bandages.
5. Two immediate post-operative complications.
6. Two reasons to follow rotation of site for insulin administration.
7. Two complications of general anaesthesia.
8. Two communicable diseases and its causative organism.
9. Two opportunistic infections of AIDS.
10. Two methods of administering Anaesthesia.
[5/12/2024 1:20 PM] : Sure, let's tackle each question:
*I. Essays:*
1. *Mr. Mani, 64 years old man is admitted with the diagnosis of Benign Prostatic Hypertrophy (BPH).*
a) *Define Benign Prostatic Hypertrophy:*
Benign Prostatic Hypertrophy (BPH) is a non-cancerous enlargement of the prostate gland,
commonly seen in aging men. It occurs due to the proliferation of prostate cells, leading to compression
of the urethra and obstructive urinary symptoms.
b) *List out the clinical manifestations of Benign Prostatic Hypertrophy:*
- Urinary hesitancy
- Weak urine stream
- Increased frequency of urination (especially at night)
- Urgency
- Incomplete emptying of the bladder
- Urinary retention
- Dribbling at the end of urination
- Hematuria (blood in urine)
c) *Describe the surgical procedures done for Benign Prostatic Hypertrophy:*
- Transurethral Resection of the Prostate (TURP): Removal of excess prostate tissue using a
resectoscope inserted through the urethra.
- Open Prostatectomy: Surgical removal of the enlarged part of the prostate gland through an
abdominal or perineal incision.
- Laser Prostatectomy: Using laser energy to vaporize or remove prostate tissue, often performed as
a minimally invasive procedure.
d) *Explain the pre and postoperative management of Mr. Mani:*
- Preoperative: Assessment of Mr. Mani's medical history, physical examination, laboratory tests
(including prostate-specific antigen levels), and imaging studies. Preoperative preparation may include
bowel preparation, discontinuation of anticoagulant medications, and optimization of medical
conditions. Education about the procedure, risks, and postoperative expectations is essential.
- Postoperative: Monitoring for complications such as bleeding, urinary retention, and infection. Pain
management, bladder irrigation if indicated, monitoring of urinary output, and gradual advancement of
diet and activity as tolerated. Patient education on catheter care, pelvic floor exercises, and follow-up
appointments for assessment of urinary function and resolution of symptoms.
2. *Mr. Gopi, 38 years is admitted with the diagnosis of cirrhosis of the liver.*
a) *Define Cirrhosis of Liver:*
Cirrhosis of the liver is a chronic, progressive liver disease characterized by the replacement of
healthy liver tissue with scar tissue (fibrosis), leading to impaired liver function and potential
complications such as portal hypertension and liver failure.
b) *List out the clinical manifestations of cirrhosis of the liver:*
- Jaundice (yellowing of the skin and eyes)
- Ascites (accumulation of fluid in the abdominal cavity)
- Hepatic encephalopathy (confusion, altered mental status)
- Easy bruising and bleeding
- Peripheral edema
- Spider angiomas (spider-like blood vessels on the skin)
- Gynecomastia (enlargement of breast tissue in males)
- Palmar erythema (redness of the palms)
c) *Mention the complications of cirrhosis of the liver:*
- Portal hypertension
- Esophageal varices (risk of bleeding)
- Hepatic encephalopathy
- Hepatorenal syndrome
- Spontaneous bacterial peritonitis
- Hepatocellular carcinoma (risk of liver cancer)
- Coagulopathy and bleeding disorders
d) *Explain the management of cirrhosis of the Liver:*
- Treatment of underlying causes (e.g., alcohol cessation, treatment of viral hepatitis)
- Symptomatic management (e.g., diuretics for ascites, lactulose for hepatic encephalopathy)
- Nutritional support
- Surveillance for complications (e.g., screening for hepatocellular carcinoma)
- Liver transplant evaluation for eligible candidates
*II. Write Short Notes on:*
1. *Care of patient with chest drainage:*
- Monitoring drainage output and character
- Maintaining the integrity of the chest tube system
- Assessing for signs of complications (e.g., air leaks, pneumothorax)
- Providing pain management and respiratory support as needed
2. *Preparation of patient for crutch walking:*
- Proper fitting and adjustment of crutches
- Teaching proper crutch positioning and weight-bearing technique
- Demonstrating how to navigate various surfaces and obstacles
- Emphasizing safety precautions to prevent falls or injuries
3. *Suture materials:*
- Absorbable (e.g., polyglycolic acid, polylactic acid)
- Non-absorbable (e.g., silk, nylon)
- Monofilament vs. multifilament
- Natural vs. synthetic
4. *Dialysis:*
- Hemodialysis: Blood is circulated through a dialyzer to remove waste products and excess fluids, then
returned to the body.
- Peritoneal dialysis: Dialysate fluid is introduced into the peritoneal cavity, where waste products and
excess fluids diffuse across the peritoneal membrane.
- Continuous renal replacement therapy (CRRT): Continuous removal of waste products and fluids in
critically ill patients with acute kidney injury.
5. *Surgical management of peptic ulcer:*
- Partial gastrectomy: Removal of the portion of the stomach containing the ulcer.
- Vagotomy: Cutting of the vagus nerve to reduce gastric acid secretion.
- Pyloroplasty: Surgical widening of the pyloric sphincter to improve gastric emptying.
- Antrectomy: Removal of the lower portion of the stomach (antrum) where gastric acid is produced.
*III. Short Answer Questions:*
1. *Two indications of blood transfusion:*
- Severe anemia
- Acute blood loss
2. *Two non-invasive diagnostic procedures done in cardiac diseases:*
- Electrocardiogram (ECG or EKG)
- Echocardiography
3. *Two reasons to obtain written informed consent:*
- Ensuring patient autonomy and decision-making
- Documenting the patient's understanding of risks and benefits
4. *Two principles of applying bandages:*
- Maintaining proper tension for support without impairing circulation
- Securing the bandage with appropriate knots or fasteners
5. *Two immediate post-operative complications:*
- Hemorrhage
- Respiratory distress
6. *Two reasons to follow rotation of site for insulin administration:*
- Preventing lipodystrophy (localized fat deposits)
- Ensuring consistent insulin absorption
7. *Two complications of general anesthesia:*
- Nausea and vomiting
- Respiratory depression
8. *Two communicable diseases and its causative organism:*
- Tuberculosis (Mycobacterium tuberculosis)
- Influenza (Influenza virus)
9. *Two opportunistic infections of AIDS:*
- Pneumocystis jirovecii pneumonia (PCP)
- Cryptococcal meningitis
10. **Two methods
of administering Anesthesia:**
- Inhalation anesthesia
- Intravenous anesthesia
Feel free to ask if you need further clarification on any of these topics!
[5/12/2024 1:24 PM] : I. Essays: (2x15=30)
1. Mrs. Ananthavalli, 45 years old employed women is admitted with
hyperthyroidism for surgical management.
Answer the following:
a) Define thyrotoxicosis. (1)
b) What are its clinical manifestations? (4)
c) Write down the pre and post operative care. (8)
d) Mention the complications after surgery. (2)
2. Mr. Mahadevan, 25 years old is admitted with acute attack of
Bronchial Asthma:
a) Define Bronchial Asthma. (1)
b) State its clinical manifestations. (2)
c) Explain the medical management for this patient. (4)
d) Applying the nursing process, plan care for Mr. Mahadevan based
on three priority diagnosis. (8)
II. Write Short Notes on : (5x5 =25)
1. Iron deficiency anaemia.
2. Lumbar puncture.
3. Infertility.
4. Duties and responsibilities of operation theatre nurse.
5. Dental caries.
III. Short Answer Questions: (10x 2=20)
1. Two stages of bone healing.
2. Two stages of anesthesia.
3. Two differences between small bowel and large bowel obstruction.
4. Two complications of fracture.
5. Two surgical procedure performed in BPH (Benign Prostatic
Hypertrophy).
6. Two complications of cirrhosis of liver.
7. Two congenital malformations of kidney.
8. Two conditions involved in TOF (Tetrology of Fallot).
9. Two suture materials and its uses.
10. Two differences between Empyema and Emphysema.
******
[5/12/2024 1:26 PM] : Sure, let's address each question:
*I. Essays:*
1. *Mrs. Ananthavalli, 45 years old employed woman is admitted with hyperthyroidism for surgical
management.*
a) *Define thyrotoxicosis:*
Thyrotoxicosis refers to a condition caused by excessive thyroid hormone levels in the bloodstream,
leading to hyperactivity of the thyroid gland. It can result from various causes, including
hyperthyroidism, thyroiditis, or exogenous thyroid hormone intake.
b) *What are its clinical manifestations?*
Clinical manifestations of thyrotoxicosis include:
- Weight loss
- Heat intolerance
- Palpitations
- Tremors
- Fatigue
- Increased appetite
- Sweating
- Anxiety
- Irritability
- Menstrual irregularities
- Exophthalmos (bulging eyes)
c) *Write down the pre and post-operative care:*
- *Preoperative care:* Assessment of Mrs. Ananthavalli's medical history, physical examination, and
laboratory tests (thyroid function tests). Optimization of thyroid function with antithyroid medications
(if necessary). Education about the surgical procedure, risks, benefits, and postoperative expectations.
NPO (nothing by mouth) status before surgery. Preoperative medications (e.g., beta-blockers to control
heart rate and symptoms of thyrotoxicosis).
- *Postoperative care:* Monitoring for complications such as hypocalcemia (due to potential
parathyroid injury), bleeding, and infection. Assessment of airway and breathing status. Pain
management. Monitoring of thyroid function tests postoperatively. Patient education on wound care,
thyroid replacement therapy (if total thyroidectomy), and signs of hypothyroidism.
d) *Mention the complications after surgery:*
Complications after thyroid surgery may include:
- Hypothyroidism (if total thyroidectomy)
- Hypoparathyroidism (due to parathyroid injury)
- Recurrent laryngeal nerve injury (resulting in voice changes or hoarseness)
- Hemorrhage
- Infection
2. *Mr. Mahadevan, 25 years old is admitted with an acute attack of Bronchial Asthma:*
a) *Define Bronchial Asthma:*
Bronchial asthma is a chronic inflammatory disorder of the airways characterized by recurrent
episodes of wheezing, breathlessness, chest tightness, and cough, especially at night or in the early
morning. It involves reversible airflow obstruction and airway hyperresponsiveness.
b) *State its clinical manifestations:*
Clinical manifestations of bronchial asthma include:
- Wheezing (high-pitched whistling sound during expiration)
- Dyspnea (shortness of breath)
- Chest tightness
- Cough, particularly at night or in the early morning
- Increased respiratory rate
- Use of accessory muscles for breathing
- Prolonged expiration
c) *Explain the medical management for this patient:*
Medical management of acute asthma exacerbation may include:
- Short-acting beta-agonists (e.g., albuterol) for bronchodilation
- Systemic corticosteroids (e.g., prednisone) to reduce airway inflammation
- Oxygen therapy to correct hypoxemia
- Anticholinergics (e.g., ipratropium) for additional bronchodilation
- Magnesium sulfate for severe exacerbations
d) *Applying the nursing process, plan care for Mr. Mahadevan based on three priority diagnoses:*
Nursing care priorities for Mr. Mahadevan may include:
- Ineffective airway clearance related to bronchoconstriction and mucus production: Monitor
respiratory status, administer bronchodilators and mucolytics as ordered, encourage deep breathing
and coughing techniques.
- Impaired gas exchange related to ventilation-perfusion imbalance: Monitor oxygen saturation,
administer oxygen therapy as prescribed, assess respiratory effort and auscultate lung ķl regularly.
- Anxiety related to dyspnea and acute exacerbation: Provide reassurance and emotional support,
educate on relaxation techniques, administer anxiolytics as prescribed, encourage effective coping
strategies.
*II. Write Short Notes on:*
1. *Iron deficiency anemia:*
- Iron deficiency anemia is a condition characterized by low levels of hemoglobin and hematocrit due
to insufficient iron in the body.
- Causes include inadequate dietary intake, blood loss (e.g., menstruation, gastrointestinal bleeding),
and malabsorption.
- Clinical manifestations include fatigue, weakness, pallor, shortness of breath, and pica (craving for
non-food items).
- Treatment involves iron supplementation and addressing the underlying cause.
2. *Lumbar puncture:*
- Lumbar puncture, also known as spinal tap, is a procedure to collect cerebrospinal fluid (CSF) for
diagnostic purposes or therapeutic interventions.
- It involves inserting a needle between two lumbar vertebrae into the subarachnoid space to obtain
CSF.
- Indications include suspected meningitis, subarachnoid hemorrhage, and evaluation of demyelinating
diseases.
- Complications may include post-lumbar puncture headache, bleeding, infection, or nerve damage.
3. *Infertility:*
- Infertility is defined as the inability to conceive after one year of regular, unprotected intercourse.
- Causes include ovulatory disorders, tubal obstruction, uterine abnormalities, male factor infertility,
and unexplained factors.
- Diagnostic evaluation may include hormonal tests, imaging studies, semen analysis, and evaluation of
tubal patency.
- Treatment options include fertility medications, surgery, assisted reproductive technologies (e.g., in
vitro fertilization), or donor gametes.
4. *Duties and responsibilities of operation theatre nurse:*
- Preoperative responsibilities: Preparing the operating room, ensuring proper functioning of
equipment, verifying surgical consent, assisting with patient positioning and preoperative preparations.
- Intraoperative responsibilities: Assisting the surgical team, maintaining aseptic technique,
anticipating needs of surgeons and anesthesia providers, monitoring patient vital signs, documenting
intraoperative events.
- Postoperative responsibilities: Monitoring patient recovery, assessing for complications, transferring
the patient to the post-anesthesia care unit (PACU), providing postoperative care instructions to the
patient and family.
5. *Dental caries:*
- Dental caries, commonly known as tooth decay or cavities, is a multifactorial disease caused by
bacterial demineralization of tooth enamel.
- Risk factors include poor oral hygiene, frequent consumption of sugary foods or beverages,
inadequate fluoride exposure, and decreased saliva production.
- Clinical manifestations include toothache, sensitivity to hot or cold, visible pits or holes in the teeth,
and tooth discoloration.
- Prevention strategies include regular dental check-ups, proper oral hygiene practices, fluoridated
water, and a balanced diet.
*III. Short Answer Questions:*
1. *Two stages of bone healing:*
- Inflammatory phase
- Repair (reparative) phase
2. *Two stages of anesthesia:*
- Induction
- Maintenance
3
. *Two differences between small bowel and large bowel obstruction:*
- Small bowel obstruction typically presents with more severe symptoms (e.g., vomiting, colicky
abdominal pain), whereas large bowel obstruction may present with more gradual onset and fewer
symptoms.
- Small bowel obstruction is often caused by adhesions or hernias, while large bowel obstruction may
be due to colorectal cancer or diverticulitis.
4. *Two complications of fracture:*
- Compartment syndrome
- Delayed union or nonunion
5. *Two surgical procedures performed in BPH (Benign Prostatic Hypertrophy):*
- Transurethral resection of the prostate (TURP)
- Open prostatectomy
6. *Two complications of cirrhosis of the liver:*
- Ascites
- Hepatic encephalopathy
7. *Two congenital malformations of the kidney:*
- Polycystic kidney disease
- Renal agenesis
8. *Two conditions involved in TOF (Tetralogy of Fallot):*
- Pulmonary stenosis
- Ventricular septal defect
9. *Two suture materials and its uses:*
- Absorbable sutures (e.g., polyglactin): Used for deep tissue approximation and internal suturing.
- Non-absorbable sutures (e.g., nylon): Used for skin closure and areas requiring long-term tensile
strength.
10. *Two differences between Empyema and Emphysema:*
- Empyema is a collection of pus in the pleural cavity, whereas emphysema is a chronic lung condition
characterized by destruction of alveolar walls.
- Empyema is typically associated with infection and inflammation, whereas emphysema is primarily
caused by smoking or genetic factors.
[5/12/2024 1:27 PM] : Elaborate on: Pages Time Marks
(Max.) (Max.) (Max.)
1. a) Define peritonitis and write the causes for peritonitis. 19 33 20
b) Enumerate the Pathophysiology and complications
of peritonitis.
c) Write the post-operative management of this patient based
on nursing process.
2. a) Define hypertension and write the pathophysiology of
hypertension. 19 33 20
b) Clinical manifestations and complications of
hypertension.
c) Draw a nursing care plan for this patient.
II. Write Notes on:
1. Cardio Pulmonary Resuscitation. 3 8 5
2. Care of patient with anaemia. 3 8 5
3. Aetiology and nursing management for acute renal failure. 3 8 5
4. Write about infertility. 3 8 5
5. Universal precautions. 3 8 5
6. Role of a nurse during counselling. 3 8 5
7. Pathophysiology of pulmonary tuberculosis. 3 8 5
8. Wound healing process. 3 8 5
III. Short Answers on:
1. Fumigation. 1 5 2
2. Stages of illness. 1 5 2
3. Hepatitis B virus. 1 5 2
4. Adverse blood transfusion reaction. 1 5 2
5. Drugs used in intensive care unit. 1 5 2
6. Importance of foot care. 1 5 2
7. Thyroid storm. 1 5 2
8. Alopecia. 1 5 2
9. Meningitis. 1 5 2
10. Nephritis. 1 5 2
*****
[5/12/2024 1:30 PM] : Let's address each question:
*I. Elaborate on:*
1. *a) Define peritonitis and write the causes for peritonitis:*
- Peritonitis is inflammation of the peritoneum, the thin tissue lining the inner wall of the abdomen
and covering the abdominal organs.
- Causes of peritonitis include:
- Perforation of abdominal organs (e.g., perforated peptic ulcer, appendicitis, diverticulitis)
- Abdominal trauma or injury
- Rupture of intra-abdominal abscess
- Complications of abdominal surgery
- Peritoneal dialysis-associated infections
- Pancreatitis
- Pelvic inflammatory disease (PID)
- Foreign body ingestion
*b) Enumerate the Pathophysiology and complications of peritonitis:*
- Pathophysiology: Peritonitis results from the release of bacteria, digestive enzymes, or foreign
material into the peritoneal cavity, leading to inflammation and infection. This triggers an immune
response, causing vasodilation, increased capillary permeability, and the recruitment of inflammatory
cells. The inflamed peritoneum leads to fluid shift, electrolyte imbalance, and systemic inflammatory
response syndrome (SIRS).
- Complications: Complications of peritonitis may include:
- Sepsis and septic shock
- Intra-abdominal abscess formation
- Intestinal obstruction
- Adhesive bowel disease
- Multiple organ dysfunction syndrome (MODS)
- Death if left untreated
*c) Write the post-operative management of this patient based on the nursing process:*
- Assessment: Monitor vital signs, abdominal assessment for signs of infection or complications, fluid
and electrolyte balance, pain assessment.
- Diagnosis: Risk for infection, impaired tissue integrity, altered fluid volume.
- Planning: Prevent infection, promote wound healing, maintain fluid and electrolyte balance, manage
pain.
- Implementation: Administer antibiotics as prescribed, maintain aseptic technique with wound care,
monitor intake and output, provide pain management, educate on signs of complications.
- Evaluation: Monitor patient's response to treatment, assess for resolution of symptoms, evaluate
wound healing, and prevent complications.
2. *a) Define hypertension and write the pathophysiology of hypertension:*
- Hypertension is a condition characterized by elevated blood pressure persistently higher than normal
levels.
- Pathophysiology: Hypertension can result from increased cardiac output, increased systemic vascular
resistance, or both. Contributing factors may include genetics, obesity, sedentary lifestyle, dietary
factors (e.g., high sodium intake), stress, and certain medical conditions (e.g., renal disease, endocrine
disorders). The renin-angiotensin-aldosterone system (RAAS), sympathetic nervous system activation,
and endothelial dysfunction play key roles in regulating blood pressure.
*b) Clinical manifestations and complications of hypertension:*
- Clinical manifestations: Often asymptomatic (silent killer). Symptoms may include headache,
dizziness, blurred vision, and epistaxis. Severe hypertension may present with symptoms of end-organ
damage such as chest pain, dyspnea, or neurological deficits.
- Complications: Complications of hypertension may include:
- Cardiovascular: Coronary artery disease, heart failure, myocardial infarction, stroke, peripheral
arterial disease.
- Renal: Chronic kidney disease, renal failure.
- Neurological: Stroke, transient ischemic attack (TIA), cognitive impairment.
- Ocular: Retinopathy, vision loss.
*c) Draw a nursing care plan for this patient:*
- Assessment: Obtain blood pressure measurements, assess for signs of end-organ damage, review
medication history, assess lifestyle factors (e.g., diet, exercise).
- Diagnosis: Risk for ineffective peripheral tissue perfusion, risk for altered cerebral tissue perfusion,
noncompliance with therapeutic regimen.
- Planning: Lower blood pressure to target levels, promote adherence to treatment regimen, educate
on lifestyle modifications.
- Implementation: Administer antihypertensive medications as prescribed, monitor blood pressure
response to treatment, provide education on diet (low sodium, DASH diet), exercise, stress
management, smoking cessation.
- Evaluation: Monitor blood pressure trends, assess for signs of complications, evaluate patient's
understanding and compliance with treatment plan.
*II. Write Notes on:*
1. *Cardio Pulmonary Resuscitation (CPR):*
- CPR is an emergency procedure performed to manually maintain circulation and breathing in a
person who is in cardiac arrest.
- Steps include checking responsiveness, calling for help, initiating chest compressions, providing
rescue breaths, and using an automated external defibrillator (AED) if available.
- CPR aims to restore blood flow and oxygenation to vital organs until advanced medical support
arrives.
2. *Care of patient with anaemia:*
- Anaemia is a condition characterized by a deficiency of red blood cells or hemoglobin, leading to
decreased oxygen-carrying capacity of the blood.
- Nursing care includes monitoring vital signs, administering prescribed iron supplements or blood
transfusions, promoting a diet rich in iron and other nutrients, educating on energy conservation
techniques, and assessing for signs of complications such as fatigue and dyspnea.
3. *Aetiology and nursing management for acute renal failure:*
- Acute renal failure is a sudden loss of kidney function, often reversible if detected early and managed
promptly.
- Nursing management includes monitoring fluid and electrolyte balance, administering medications to
manage underlying causes (e.g., diuretics, antibiotics), providing renal replacement therapy (e.g.,
hemodialysis, peritoneal dialysis), and preventing complications such as fluid overload and electrolyte
imbalances.
4. **Infertility:
**
- Infertility is the inability to conceive after one year of regular unprotected intercourse.
- Nursing considerations include providing emotional support, educating on fertility treatment options
(e.g., in vitro fertilization, intrauterine insemination), facilitating access to reproductive specialists, and
promoting healthy lifestyle behaviors.
5. *Universal precautions:*
- Universal precautions are infection control guidelines to prevent transmission of bloodborne
pathogens in healthcare settings.
- Measures include hand hygiene, wearing personal protective equipment (e.g., gloves, masks), safe
injection practices, proper handling and disposal of sharps, and environmental cleaning and disinfection.
6. *Role of a nurse during counseling:*
- Nurses play a vital role in providing counseling and support to patients and families facing various
health challenges.
- This includes assessing psychosocial needs, providing information and education about diagnoses and
treatment options, facilitating communication between patients and healthcare providers, and
promoting coping strategies and emotional well-being.
7. *Pathophysiology of pulmonary tuberculosis:*
- Pulmonary tuberculosis is caused by Mycobacterium tuberculosis and primarily affects the lungs.
- After inhalation of infectious droplets, the bacteria invade the alveoli and are engulfed by
macrophages, leading to granuloma formation and latent infection.
- Reactivation of latent infection can occur, leading to active tuberculosis characterized by necrosis,
cavitation, and dissemination of bacteria.
8. *Wound healing process:*
- Wound healing involves four overlapping phases: hemostasis, inflammation, proliferation, and
remodeling.
- Hemostasis: Platelet aggregation and vasoconstriction to stop bleeding.
- Inflammation: Migration of inflammatory cells to the wound site to clear debris and pathogens.
- Proliferation: Granulation tissue formation, epithelialization, and angiogenesis.
- Remodeling: Maturation of scar tissue and restoration of tissue strength.
*III. Short Answer Questions:*
1. *Fumigation:*
- Fumigation is a method of pest control that involves filling an area with gaseous pesticides to
suffocate or poison pests.
- It is commonly used to eliminate insects, rodents, and microorganisms in enclosed spaces such as
buildings, warehouses, and agricultural commodities.
2. *Stages of illness:*
- Prodromal stage
- Acute stage
- Convalescent stage
3. *Hepatitis B virus:*
- Hepatitis B virus (HBV) is a DNA virus transmitted through blood and body fluids.
- It causes inflammation of the liver and can lead to acute or chronic hepatitis, cirrhosis, and
hepatocellular carcinoma.
- Prevention includes vaccination and adherence to universal precautions.
4. *Adverse blood transfusion reaction:*
- Adverse blood transfusion reactions include hemolytic reactions, febrile non-hemolytic reactions,
allergic reactions, transfusion-related acute lung injury (TRALI), and transfusion-associated circulatory
overload (TACO).
5. *Drugs used in the intensive care unit:*
- Drugs commonly used in the ICU include vasopressors (e.g., norepinephrine), sedatives (e.g.,
propofol), analgesics (e.g., opioids), antibiotics, diuretics, and anticoagulants.
6. *Importance of foot care:*
- Foot care is essential for preventing complications such as diabetic foot ulcers, infections, and
amputations in patients with diabetes.
- Measures include daily inspection of feet, proper hygiene, wearing appropriate footwear, and regular
podiatry assessments.
7. *Thyroid storm:*
- Thyroid storm is a life-threatening complication of hyperthyroidism characterized by severe
exacerbation of symptoms such as fever, tachycardia, hypertension, and altered mental status.
- Treatment involves aggressive management of symptoms, including antithyroid medications, beta-
blockers, cooling measures, and supportive care in the ICU.
8. *Alopecia:*
- Alopecia refers to hair loss or baldness, which can be temporary or permanent.
- Causes include genetics, hormonal changes, medical conditions (e.g., thyroid disorders, autoimmune
diseases), medications, and stress.
9. *Meningitis:*
- Meningitis is inflammation of the meninges, the protective membranes covering the brain and spinal
cord, usually caused by infection (bacterial, viral, fungal).
- Symptoms may include headache, fever, neck stiffness, photophobia, altered mental status, and
seizures.
10. *Nephritis:*
- Nephritis refers to inflammation of the kidney, which can be acute or chronic and may result from
various causes such as infection, autoimmune diseases, or drug toxicity.
- Clinical manifestations may include hematuria, proteinuria, hypertension, edema, and impaired
kidney function.
[5/12/2024 1:33 PM] : Let's tackle each question:
*I. Essays:*
1. *Mrs. Kala, 48 years old lady is admitted with foot ulcer and diabetes mellitus:*
a) *Define diabetes:*
Diabetes mellitus is a metabolic disorder characterized by elevated blood glucose levels due to
inadequate insulin production, ineffective insulin action, or both. Insulin, produced by the pancreas,
regulates blood sugar levels by facilitating the uptake of glucose into cells for energy or storage.
b) *Clinical manifestations:*
Clinical manifestations of diabetes mellitus may include polyuria (excessive urination), polydipsia
(excessive thirst), polyphagia (excessive hunger), weight loss, fatigue, blurred vision, slow wound
healing, and recurrent infections.
c) *Etiology and investigations for diabetes:*
- Etiology: Diabetes mellitus may result from genetic predisposition, environmental factors (e.g.,
obesity, sedentary lifestyle), autoimmune destruction of pancreatic beta cells (type 1 diabetes), or
insulin resistance (type 2 diabetes).
- Investigations: Diagnostic tests include fasting blood glucose, oral glucose tolerance test, random
blood glucose, glycated hemoglobin (HbA1c), and urine analysis for glucose and ketones.
d) *Various methods of management:*
Management of diabetes includes lifestyle modifications (diet, exercise), pharmacological therapy
(oral hypoglycemic agents, insulin), regular monitoring of blood glucose levels, and prevention and
management of complications (e.g., foot care, eye exams, renal function tests).
e) *Aspects considered while providing health education:*
Health education for diabetes should focus on diet modification (carbohydrate counting, portion
control), exercise regimen, medication adherence, blood glucose monitoring, foot care practices,
recognition and management of hypo/hyperglycemia, and importance of regular medical follow-ups.
2. *Mr. R. Kannan, 42 years old man is admitted with renal calculi:*
a) *Types of renal calculi:*
Renal calculi, also known as kidney stones, can be classified into calcium stones (calcium oxalate or
calcium phosphate), uric acid stones, struvite stones (magnesium ammonium phosphate), and cystine
stones.
b) *Clinical manifestations and diagnostic procedures:*
Clinical manifestations of renal calculi include severe flank pain radiating to the groin, hematuria,
dysuria, urinary urgency, and nausea/vomiting. Diagnostic procedures include urinalysis, imaging studies
(CT scan, ultrasound), and stone analysis.
c) *Probable surgical interventions:*
Surgical interventions for renal calculi may include extracorporeal shock wave lithotripsy (ESWL),
ureteroscopy with laser lithotripsy, percutaneous nephrolithotomy (PCNL), or open surgical stone
removal (rarely performed).
d) *Pre and post-operative nursing care using nursing process plan for Mr. Kannan:*
- *Pre-operative care:* Assess patient's pain level, provide pain management, maintain hydration,
monitor vital signs, administer prescribed medications, educate on the procedure and post-operative
expectations.
- *Post-operative care:* Monitor urinary output, assess for signs of bleeding or infection, manage
pain, provide wound care, encourage ambulation, monitor for complications (e.g., urinary retention,
infection), educate on discharge instructions and follow-up care.
*II. Write Short Notes on:*
1. *Suture and suture material:*
- Sutures are medical devices used to hold body tissues together after injury or surgery.
- Suture materials include absorbable (e.g., polyglactin, polyglycolic acid) and non-absorbable (e.g.,
nylon, silk) sutures, each with specific indications based on tissue type, location, and desired duration of
wound support.
2. *Colostomy care:*
- Colostomy is a surgical procedure that creates an artificial opening (stoma) in the abdominal wall to
divert feces from the colon to a stoma bag.
- Colostomy care involves monitoring stoma appearance, emptying and changing the stoma bag,
maintaining skin integrity around the stoma, and providing patient education on self-care and
complication prevention.
3. *Renal biopsy:*
- Renal biopsy is a diagnostic procedure to obtain a small sample of kidney tissue for examination
under a microscope.
- It is performed to diagnose renal diseases such as glomerulonephritis, nephrotic syndrome, or
evaluate kidney transplant rejection.
- Complications may include bleeding, infection, or injury to surrounding organs.
4. *Deep vein thrombosis:*
- Deep vein thrombosis (DVT) is the formation of blood clots in deep veins, usually in the legs.
- Risk factors include immobility, surgery, trauma, pregnancy, hormonal therapy, and inherited clotting
disorders.
- Complications may include pulmonary embolism (PE), post-thrombotic syndrome, and chronic
venous insufficiency.
5. *Blood transfusion – safety checks:*
- Safety checks before blood transfusion include verifying patient identity, matching blood type and Rh
compatibility, checking expiration dates, inspecting blood bags for leaks or discoloration, and confirming
consent.
*III. Short Answer Questions:*
1. *Mention the stages of wound healing:*
- Inflammatory phase
- Proliferative phase
- Remodeling phase
2. *Mention two geriatric problems:*
- Falls and fractures
- Polypharmacy and drug interactions
3. *Write two clinical manifestations of left ventricular failure:*
- Dyspnea on exertion or at rest
- Paroxysmal nocturnal dyspnea
4. *List out the types of Leukemia:*
- Acute lymphoblastic leukemia (ALL)
- Acute myeloid leukemia (AML)
- Chronic lymphocytic leukemia (CLL)
- Chronic myeloid leukemia (CML)
5. *Write two clinical manifestations of fracture:*
- Pain at the fracture site
- Swelling, bruising, or deformity
6. *What is the incubation period for poliomyelitis?*
- The incubation period for poliomyelitis is typically 7 to 14 days.
7. *What are all the important components of Glasgow coma scale?*
- Eye opening response
- Verbal response
- Motor response
8. *Mention the causative organism for whooping cough:*
- Bordetella pertussis
9. *How will you assess thyroid gland enlargement?*
- Assess for thyroid gland enlargement by palpating the neck for swelling or nodules, auscultating for
bruits over the thyroid, and performing imaging studies such as ultrasound or thyroid scan.
10. *What is Gene therapy?*
- Gene therapy is a therapeutic approach aimed at treating or preventing disease by modifying or
replacing defective genes with functional ones. It holds promise for treating genetic disorders, cancer,
and certain infectious diseases.
[5/12/2024 1:35 PM] : Sure, let's address each question:
*I. Elaborate on:*
1. *Mrs. Janakiammal, 40 years old lady admitted with diagnosed to have Fracture femur, post-
operative open reduction and internal fixation first day:*
a) *Define fracture:*
A fracture is a medical condition characterized by a break or crack in a bone. Fractures can occur due
to trauma, overuse, or underlying medical conditions such as osteoporosis. They can be classified based
on the type of fracture line, location, and severity.
b) *Explain the complication of fracture:*
Complications of fractures may include:
- Delayed or non-union: Failure of the fractured bone to heal within the expected timeframe.
- Malunion: Healing of the bone in a misaligned position, leading to deformity or functional
impairment.
- Infection: Risk of bacterial contamination during the injury or surgery, leading to osteomyelitis or
septic arthritis.
- Compartment syndrome: Increased pressure within the muscles compartments, leading to tissue
ischemia and nerve damage.
- Deep vein thrombosis (DVT) and pulmonary embolism (PE) due to immobilization and venous stasis.
c) *Write post-operative Nursing care applying Nursing process:*
- *Assessment:* Monitor vital signs, neurovascular status, pain level, surgical site for signs of
infection or complications.
- *Diagnosis:* Risk for infection, impaired mobility, acute pain, risk for impaired skin integrity.
- *Planning:* Prevent infection, promote mobility and wound healing, manage pain, prevent
complications.
- *Implementation:* Administer medications as prescribed (analgesics, antibiotics), assist with early
mobilization and physiotherapy, provide wound care, monitor for signs of complications (e.g., infection,
DVT), educate on self-care and follow-up.
- *Evaluation:* Assess patient's response to treatment, monitor for resolution of symptoms, evaluate
wound healing, and prevent complications.
2. *Mr. Govindarajan is admitted in the Medical ward with Asthma. He is 35 years old:*
a) *Define Asthma:*
Asthma is a chronic inflammatory respiratory condition characterized by reversible airflow
obstruction, bronchial hyperresponsiveness, and recurrent episodes of wheezing, breathlessness, chest
tightness, and coughing, especially at night or in the early morning.
b) *Write the complication of Asthma:*
Complications of asthma may include:
- Severe exacerbations requiring hospitalization or intensive care unit (ICU) admission.
- Status asthmaticus: Life-threatening asthma attack unresponsive to standard treatment.
- Respiratory failure: Severe airflow limitation leading to hypoxemia and hypercapnia.
- Pneumonia: Secondary bacterial infection due to impaired airway clearance.
- Chronic respiratory failure: Long-term impairment of lung function leading to disability and reduced
quality of life.
c) *Write the pharmacologic management:*
Pharmacological management of asthma includes:
- Short-acting beta agonists (e.g., albuterol) for acute symptom relief and rescue therapy.
- Inhaled corticosteroids (e.g., fluticasone) for long-term anti-inflammatory control.
- Long-acting beta agonists (LABAs) or leukotriene modifiers (e.g., montelukast) as adjunctive therapy
for persistent asthma.
- Oral corticosteroids (e.g., prednisone) for severe exacerbations or uncontrolled asthma.
- Controller medications such as mast cell stabilizers (e.g., cromolyn) or anti-IgE monoclonal
antibodies (e.g., omalizumab) for refractory cases.
d) *Discuss Nursing care of Mr. Govindarajan:*
- *Assessment:* Monitor respiratory status, oxygen saturation, lung sounds, vital signs, and response
to medications. Assess for triggers and exacerbating factors.
- *Diagnosis:* Impaired gas exchange, ineffective airway clearance, anxiety, risk for exacerbation.
- *Planning:* Optimize respiratory function, prevent exacerbations, promote self-management,
educate on asthma triggers and medications.
- *Implementation:* Administer medications as prescribed, provide oxygen therapy as needed, assist
with breathing techniques and airway clearance maneuvers, offer emotional support and reassurance.
- *Evaluation:* Assess patient's response to treatment, monitor for signs of improvement or
worsening, evaluate patient's understanding of asthma management and adherence to the treatment
plan.
*II. Write notes on:*
1. *Meningitis:*
- Meningitis is inflammation of the meninges, the protective membranes covering the brain and spinal
cord.
- Causes include viral (e.g., enteroviruses), bacterial (e.g., Neisseria meningitidis), fungal (e.g.,
Cryptococcus neoformans), and parasitic (e.g., Naegleria fowleri) infections.
- Symptoms may include fever, headache, neck stiffness, photophobia, altered mental status, and
seizures.
- Diagnosis is based
on clinical presentation, cerebrospinal fluid analysis, and imaging studies.
- Treatment depends on the underlying cause and may include antimicrobial therapy, supportive care,
and vaccination for preventable forms of meningitis.
2. *Bronchiectasis:*
- Bronchiectasis is a chronic respiratory condition characterized by irreversible dilation and thickening
of the bronchial walls, leading to chronic cough, sputum production, and recurrent respiratory
infections.
- Causes include cystic fibrosis, recurrent respiratory infections, immunodeficiency, and inhalation of
toxic gases or particulate matter.
- Management involves airway clearance techniques (e.g., chest physiotherapy, postural drainage),
bronchodilators, mucolytics, antibiotics, and, in severe cases, surgical resection of affected lung
segments.
3. *Hemorrhoids:*
- Hemorrhoids are swollen and inflamed veins in the rectum and anus, causing pain, itching, bleeding,
and discomfort.
- Risk factors include constipation, straining during bowel movements, pregnancy, obesity, and
prolonged sitting or standing.
- Treatment options include dietary modifications (fiber intake), topical treatments (e.g.,
corticosteroids, witch hazel), sitz baths, and surgical interventions (e.g., hemorrhoidectomy, rubber
band ligation).
4. *Hemodialysis:*
- Hemodialysis is a renal replacement therapy used to remove waste products and excess fluids from
the blood in patients with kidney failure.
- It involves the circulation of blood through a dialyzer (artificial kidney) to filter out toxins and return
cleaned blood to the body.
- Hemodialysis requires vascular access (arteriovenous fistula, graft, or catheter) and is typically
performed thrice weekly in a dialysis center under the supervision of healthcare professionals.
5. *Biomedical waste management:*
- Biomedical waste includes any waste generated during healthcare activities that may pose a threat to
public health or the environment due to its infectious, toxic, or radioactive nature.
- Proper biomedical waste management involves segregation, collection, storage, transportation,
treatment, and disposal according to local regulations and guidelines to minimize risks to healthcare
workers, patients, and the community.
*III. Short Answer:*
1. *Mention four factors that affect wound healing:*
- Nutritional status
- Blood supply and oxygenation
- Infection
- Age and comorbidities
2. *Two complications of Tracheostomy:*
- Tracheal stenosis or scarring
- Infection (tracheitis, pneumonia)
3. *Mention four lifestyle modifications for Hypertension:*
- Dietary changes (e.g., DASH diet, reduced sodium intake)
- Regular exercise
- Weight loss
- Stress management techniques (e.g., meditation, yoga)
4. *Two classical signs of Tetany:*
- Chvostek's sign (facial muscle spasm upon tapping the facial nerve)
- Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff above systolic pressure)
5. *Mention two non-invasive diagnostic tests for Respiratory Problems:*
- Chest X-ray
- Pulmonary function tests (spirometry)
6. *Two disease conditions involved in chronic obstructive pulmonary disease:*
- Chronic bronchitis
- Emphysema
7. *Four clinical manifestations of pulmonary edema:*
- Dyspnea
- Orthopnea
- Pink frothy sputum
- Crackles on lung auscultation
8. *Two complications of Peptic ulcer:*
- Gastrointestinal bleeding
- Perforation leading to peritonitis
9. *Two investigations done to rule out Vascular disease:*
- Duplex ultrasound
- Magnetic resonance angiography (MRA)
10. *Mention two surgical approaches for Benign Prostat:*
- Transurethral resection of the prostate (TURP)
- Open prostatectomy
[5/12/2024 1:41 PM] : Let's address each set of questions:
*I. Elaborate on:*
1. *Mr. Raman, 58 years old, admitted with Chronic Obstructive Pulmonary Disease (COPD):*
a) *Define Chronic Obstructive Pulmonary Disease (COPD):*
COPD is a chronic lung disease characterized by airflow limitation due to chronic bronchitis and/or
emphysema. It is often caused by long-term exposure to irritants such as cigarette smoke and air
pollution.
b) *Discuss the pathophysiology, clinical manifestations of COPD:*
Pathophysiology involves chronic inflammation and narrowing of the airways, leading to airflow
limitation. Clinical manifestations include dyspnea, chronic cough, sputum production, and wheezing.
c) *Draw a nursing care plan for Mr. Raman using the nursing process approach:*
- Assessment: Assess respiratory status, oxygen saturation, and sputum characteristics. Evaluate
activity tolerance and nutritional status.
- Diagnosis: Ineffective airway clearance, impaired gas exchange, activity intolerance related to
dyspnea.
- Planning: Goals include improving airway clearance, optimizing oxygenation, promoting pulmonary
hygiene, and enhancing self-management skills.
- Implementation: Administer bronchodilators, provide oxygen therapy, assist with pulmonary
hygiene techniques (such as chest physiotherapy), and educate on smoking cessation and medication
compliance.
- Evaluation: Assess effectiveness of interventions, monitor respiratory status, and evaluate patient's
ability to manage symptoms at home.
2. *Mrs. Reeta, 47 years old, diagnosed with Acute Renal Failure (ARF):*
a) *Explain the causes of Acute Renal Failure:*
ARF can be caused by various factors including acute kidney injury due to ischemia, nephrotoxic
drugs, sepsis, or urinary obstruction.
b) *Describe the clinical course of Acute Renal Failure:*
Clinical course involves an abrupt decline in kidney function, leading to decreased urine output,
electrolyte imbalances, fluid overload, and accumulation of waste products in the blood.
c) *Discuss the collaborative care of a patient with Acute Renal Failure:*
Collaborative care includes identifying and treating the underlying cause, managing fluid and
electrolyte imbalances, providing renal replacement therapy (such as hemodialysis or continuous renal
replacement therapy), and preventing complications such as uremia and metabolic acidosis.
*II. Write notes on:*
1. *Unconsciousness:*
- Unconsciousness refers to a state of altered consciousness where a person is not aware of their
surroundings or unable to respond to stimuli.
- Causes include head injury, stroke, seizures, drug overdose, or metabolic disturbances.
- Management involves assessing and maintaining airway, breathing, and circulation, and identifying
and treating the underlying cause.
2. *Intestinal obstruction:*
- Intestinal obstruction is a blockage of the intestines that prevents the passage of food, fluids, and
gas.
- Causes include adhesions, hernias, tumors, and volvulus.
- Symptoms include abdominal pain, distension, vomiting, and constipation.
- Treatment depends on the cause and severity and may include bowel rest, nasogastric
decompression, and surgery.
3. *Hypertension:*
- Hypertension, or high blood pressure, is a chronic medical condition characterized by elevated blood
pressure in the arteries.
- Risk factors include obesity, sedentary lifestyle, high salt intake, and family history.
- Complications include heart disease, stroke, kidney disease, and vision loss.
- Management involves lifestyle modifications (diet, exercise), antihypertensive medications, and
regular monitoring.
4. *Hyperthyroidism:*
- Hyperthyroidism is a condition characterized by excessive production of thyroid hormones by the
thyroid gland.
- Symptoms include weight loss, palpitations, heat intolerance, tremors, and fatigue.
- Treatment options include antithyroid medications, radioactive iodine therapy, or thyroid surgery.
- Nursing care involves monitoring thyroid function, managing symptoms, and providing education on
medication adherence and dietary restrictions.
5. *Nursing care of patient with above knee amputation:*
- Nursing care post-amputation involves pain management, wound care, and prevention of
complications such as infection and skin breakdown.
- Rehabilitation includes positioning, exercises, and fitting for prosthetic devices.
- Psychosocial support and education on self-care and mobility are essential for the patient's
adaptation to the limb loss.
*III. Short answers:*
1. *Stages of wound healing:*
- Inflammatory phase
- Proliferative phase
- Remodeling phase
2. *Mention two complications of Cirrhosis of liver:*
- Ascites
- Hepatic encephalopathy
3. *List any four complications of Benign Prostatic Hypertrophy (BPH):*
- Urinary retention
- Urinary tract infections
- Bladder stones
- Acute urinary retention
4. *Mention the two clinical signs of Hypocalcemia:*
- Chvostek's sign
- Trousseau's sign
5. *Write four clinical manifestations of left-sided heart failure:*
- Dyspnea
- Orthopnea
- Paroxysmal nocturnal dyspnea
- Pulmonary crackles
6. *Mention the types of Leukemia:*
- Acute lymphoblastic leukemia (ALL)
- Acute myeloid leukemia (AML)
- Chronic lymphoc
ytic leukemia (CLL)
- Chronic myeloid leukemia (CML)
7. *Classify Anaesthesia:*
- General anesthesia
- Regional anesthesia (spinal, epidural, nerve blocks)
- Local anesthesia
8. *Mention two non-invasive diagnostic tests for cardiovascular disorders:*
- Electrocardiogram (ECG/EKG)
- Echocardiogram
9. *Mention any four chronic complications of Diabetes Mellitus:*
- Diabetic neuropathy
- Diabetic nephropathy
- Diabetic retinopathy
- Peripheral vascular disease
10. *List the types of shock:*
- Hypovolemic shock
- Cardiogenic shock
- Distributive shock (septic, neurogenic, anaphylactic)
- Obstructive shock (pulmonary embolism, cardiac tamponade)
[5/12/2024 1:47 PM] : Sure, let's tackle each question:
1. *Mr. Anand:*
a) *Define bronchial asthma:* Bronchial asthma is a chronic inflammatory condition of the airways
characterized by reversible airflow obstruction, bronchial hyperresponsiveness, and recurrent episodes
of wheezing, breathlessness, coughing, and chest tightness.
b) *Clinical manifestations and medical management:* Mr. Anand may present with wheezing,
dyspnea, coughing, and chest tightness. Medical management involves bronchodilators (e.g., beta-
agonists) to relieve bronchoconstriction and anti-inflammatory agents (e.g., corticosteroids) to reduce
airway inflammation. Additionally, identifying and avoiding triggers, such as allergens or irritants, is
essential.
c) *Nursing process and care plan:* Nursing diagnoses for Mr. Anand may include ineffective breathing
pattern related to bronchial constriction, impaired gas exchange related to decreased airflow, and
anxiety related to dyspnea. Nursing interventions would involve administering medications, monitoring
respiratory status, providing oxygen therapy, teaching relaxation techniques, and educating the patient
on self-management strategies.
2. *Mr. Mani:*
a) *Define Benign prostatic hypertrophy (BPH):* BPH is a non-cancerous enlargement of the prostate
gland commonly occurring in older men. It leads to urinary symptoms due to obstruction of the urethra.
b) *Surgical management:* Surgical interventions for BPH include transurethral resection of the
prostate (TURP), open prostatectomy, and laser therapy. These procedures aim to remove or reduce the
obstructing prostate tissue.
c) *Pre and postoperative nursing management:* Preoperative care involves assessing Mr. Mani's
baseline urinary symptoms, optimizing his medical condition, providing education about the procedure,
and obtaining informed consent. Postoperative care includes monitoring for complications such as
bleeding, urinary retention, or infection, managing pain, promoting early ambulation, providing bladder
training if necessary, and educating the patient on catheter care and pelvic floor exercises.
*II. Write notes on:*
1. *Appendicitis:* Inflammation of the appendix, typically presenting with abdominal pain, nausea,
vomiting, and fever. Requires surgical removal (appendectomy).
2. *Medical management for tuberculosis:* Involves a combination of antibiotics (e.g., isoniazid,
rifampicin) for several months to eradicate the infection.
3. *Collaborative management of diabetes mellitus:* Includes lifestyle modifications (diet, exercise),
pharmacological therapy (insulin, oral hypoglycemic agents), regular monitoring of blood glucose levels,
and patient education.
4. *Dialysis:* Treatment for kidney failure involving the removal of waste products and excess fluid from
the blood, either hemodialysis or peritoneal dialysis.
5. *Emergency management of patient with acute myocardial infarction:* Involves administering
oxygen, aspirin, nitroglycerin, and morphine (if needed), along with reperfusion therapy (thrombolytics
or percutaneous coronary intervention) to restore blood flow to the heart muscle.
*III. Short answer questions:*
1. *Define congestive heart failure:* A condition where the heart's pumping ability is impaired, leading
to fluid buildup in the lungs and other tissues.
2. *State the types of emphysema:* Centriacinar (centrilobular) and panacinar (panlobular) emphysema.
3. *List any four clinical manifestations of nephrotic syndrome:* Proteinuria, hypoalbuminemia, edema,
hyperlipidemia.
4. *List the type of amputation:* Partial foot amputation, below-knee amputation, above-knee
amputation, etc.
5. *List the types of hernia:* Inguinal, femoral, umbilical, incisional, hiatal, etc.
6. *Define psoriasis:* A chronic autoimmune skin condition characterized by red, scaly patches on the
skin.
7. *Define cardio-pulmonary resuscitation:* Emergency procedure to restore cardiac and respiratory
function in individuals experiencing cardiac arrest or respiratory failure.
8. *Define edema:* Abnormal accumulation of fluid in the interstitial spaces of tissues, leading to
swelling.
9. *Mention any four complications of hypothyroidism:* Cardiovascular complications, myxedema
coma, infertility, goiter.
10. *Purposes of traction:* To immobilize and realign fractured bones, reduce muscle spasms, and
promote healing.
Shall we move on to the next set of questions?
[5/12/2024 1:47 PM] : Great! Let's continue:
*Elaborate on:*
1. *Mr. Shanmugam:*
a) *Define Diabetic ketoacidosis (DKA):* DKA is a serious complication of diabetes characterized by
hyperglycemia, ketosis, and metabolic acidosis.
b) *Pathophysiology and clinical manifestations:* DKA occurs due to insulin deficiency, leading to
increased glucose production, lipolysis, and ketogenesis. Clinical manifestations include polyuria,
polydipsia, nausea, vomiting, abdominal pain, fruity breath odor, and altered mental status.
c) *Management of DKA for the first 48 hours:* Involves fluid resuscitation, insulin therapy, correction
of electrolyte imbalances (especially potassium), and identification and treatment of precipitating
factors such as infection or non-adherence to insulin therapy.
2. *Mrs. Geetha:*
a) *Define Thyrotoxicosis:* Thyrotoxicosis refers to the clinical syndrome resulting from excessive
thyroid hormone production.
b) *Clinical manifestations of hyperthyroidism:* Include heat intolerance, weight loss, palpitations,
tremors, hyperactivity, exophthalmos (in Graves' disease), and goiter.
c) *Pre & postoperative management:* Preoperatively, focus on controlling hyperthyroid symptoms,
optimizing thyroid function, and providing education about the procedure. Postoperatively, monitor for
signs of hypothyroidism or complications such as hypocalcemia or recurrent laryngeal nerve injury, and
provide supportive care.
*Write Notes on:*
1. *Colostomy care:* Involves stoma care, skin protection, monitoring output, managing complications
(e.g., obstruction, prolapse), and patient education.
2. *Renal calculi:* Kidney stones formed by the crystallization of minerals in the urine. Management
includes pain management, hydration, dietary modifications, and sometimes surgical intervention.
3. *ECG:* Electrocardiogram, a non-invasive test used to assess the electrical activity of the heart.
4. *Rehabilitation of patient after below-knee amputation:* Focuses on mobility training, prosthetic
fitting, wound care, pain management, psychological support, and education.
5. *Lumbar puncture:* Diagnostic procedure involving the insertion of a needle into the spinal canal to
collect cerebrospinal fluid for analysis.
*Short Answer Questions:*
1. *Four cyanotic heart diseases:* Tetralogy of Fallot, transposition of the great arteries, tricuspid
atresia, total anomalous pulmonary venous connection.
2. *Two disease conditions involved in Chronic obstructive pulmonary disease:* Chronic bronchitis and
emphysema.
3. *Two classical signs of Tetany:* Chvostek's sign (facial muscle spasm upon tapping the facial nerve)
and Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff).
4. *Causative organism of typhoid and cholera:* Salmonella typhi (typhoid) and Vibrio cholerae
(cholera).
5. *Two indications for dialysis:* End-stage renal disease (ESRD) and acute kidney injury (AKI).
6. *Four symptoms of osteoarthritis:* Joint pain, stiffness, swelling, and decreased range of motion.
7. *Four methods of non-pharmacological management of pain:* Heat therapy, cold therapy, massage,
acupuncture.
8. *Four signs and symptoms of fracture:* Pain, swelling, deformity, loss of function.
9. *Four responsibilities of operation theatre nurse:* Preparing the operating room, assisting the
surgical team, ensuring sterile technique, monitoring patient vitals.
10. *Two opportunistic infections in Acquired Immunodeficiency Syndrome (AIDS):* Pneumocystis
pneumonia (PCP) and cytomegalovirus (CMV) infection.
Ready for the next set?
[5/12/2024 1:48 PM] : Let's proceed:
*Elaborate on:*
1. *Mr. Raman:*
a) *Define congestive heart failure (CHF):* CHF is a condition in which the heart is unable to pump
blood effectively, leading to fluid buildup (congestion) in the lungs and other tissues.
b) *Causes and pathophysiology:* Causes include coronary artery disease, hypertension, and
cardiomyopathy. Pathophysiology involves impaired cardiac function, leading to decreased cardiac
output and compensatory mechanisms such as neurohormonal activation and remodeling.
c) *Management:* Involves medications (e.g., diuretics, ACE inhibitors), lifestyle modifications, and
addressing underlying causes. Monitoring fluid intake, weight, and symptoms is crucial.
2. *Fracture of femur:*
a) *Definition:* A fracture of the femur is a break or crack in the thigh bone, which is the longest and
strongest bone in the human body.
b) *Pathophysiology and clinical manifestations:* Fractures occur due to trauma or stress on the bone.
Clinical manifestations include pain, swelling, deformity, and impaired function.
c) *Management:* Treatment may involve immobilization with casting or splinting, surgical fixation
with internal or external devices, pain management, and rehabilitation. Patient education is essential for
proper healing and prevention of complications.
*Write Notes on:*
1. *Bronchial asthma:* A chronic respiratory condition characterized by reversible airflow obstruction,
airway inflammation, and bronchial hyperresponsiveness. Management includes medications (e.g.,
bronchodilators, corticosteroids), avoidance of triggers, and patient education.
2. *Renal failure:* Dysfunction of the kidneys resulting in impaired filtration and regulation of bodily
fluids and electrolytes. Treatment options include dialysis and kidney transplantation.
3. *Bleeding disorder:* Conditions characterized by abnormal bleeding due to impaired clotting
mechanisms. Management depends on the specific disorder and may involve medications, transfusions,
and lifestyle modifications.
4. *Cushing’s syndrome:* A disorder caused by prolonged exposure to high levels of cortisol, leading to
various metabolic abnormalities. Treatment involves addressing the underlying cause, such as pituitary
tumors, and may include surgery, medications, or radiation therapy.
5. *Role of a nurse in blood transfusion:* Includes verifying the transfusion order, obtaining informed
consent, monitoring vital signs during transfusion, and assessing for signs of transfusion reactions.
*Short Answer Questions:*
1. *Define thromboangiitis obliterans:* Also known as Buerger's disease, it is a rare inflammatory
condition affecting the blood vessels of the extremities, leading to ischemia and tissue damage.
2. *Types of shock:* Include hypovolemic, cardiogenic, distributive (e.g., septic shock), and obstructive
shock.
3. *Two clinical manifestations of myocardial infarction:* Chest pain (angina), shortness of breath,
nausea, diaphoresis, and arm or jaw pain.
4. *Define diabetic ketoacidosis:* A life-threatening complication of diabetes characterized by
hyperglycemia, ketosis, metabolic acidosis, and dehydration.
5. *Classify pneumothorax:* Can be classified as spontaneous (primary or secondary), traumatic, or
iatrogenic.
6. *Principles of hemodialysis:* Include diffusion, ultrafiltration, and convection, aimed at removing
waste products and excess fluid from the blood.
7. *Classify anemia:* Can be classified based on morphology (e.g., microcytic, normocytic, macrocytic)
or etiology (e.g., iron deficiency, hemolytic, aplastic).
8. *Types of renal calculi:* Include calcium oxalate, calcium phosphate, uric acid, and struvite stones.
9. *List any two immediate postoperative complications:* Include hemorrhage, infection, thrombosis,
atelectasis, and ileus.
10. *Define compartment syndrome:* A serious condition characterized by increased pressure within a
muscle compartment, leading to reduced blood flow and tissue ischemia.
Would you like to continue with another set of questions?
[5/12/2024 1:49 PM] : Great! Let's proceed:
*Elaborate on:*
1. *Mr. Shanmugam:*
a) *Define Diabetic ketoacidosis (DKA):* DKA is a severe complication of diabetes characterized by
hyperglycemia, ketosis, metabolic acidosis, and dehydration.
b) *Pathophysiology and clinical manifestations:* DKA occurs due to insulin deficiency, leading to
increased lipolysis, ketogenesis, and acidosis. Clinical manifestations include polyuria, polydipsia,
nausea, vomiting, abdominal pain, altered mental status, and Kussmaul breathing.
c) *Management:* Initial management involves fluid resuscitation, insulin therapy, electrolyte
replacement, and correction of acidosis. Close monitoring of glucose, electrolytes, and fluid balance is
essential.
2. *Mrs. Geetha:*
a) *Define Thyrotoxicosis:* Thyrotoxicosis refers to a state of excess thyroid hormone in the body,
often caused by conditions such as hyperthyroidism or thyroiditis.
b) *Clinical manifestations:* Include weight loss, heat intolerance, palpitations, tremors, anxiety, and
exophthalmos (in Graves' disease).
c) *Pre & postoperative management:* Preoperative management may involve anti-thyroid
medications (e.g., methimazole), beta-blockers, and iodine preparations to prepare the patient for
surgery. Postoperative care focuses on monitoring for signs of thyroid storm, wound healing, and
thyroid hormone replacement therapy if necessary.
*Write Notes on:*
1. *Colostomy care:* Involves proper stoma care, appliance application, skin protection, and patient
education on diet and lifestyle modifications.
2. *Renal calculi:* Also known as kidney stones, they are solid masses formed in the kidneys due to
crystallization of substances in the urine. Treatment options include hydration, pain management, and
procedures such as lithotripsy or surgical removal.
3. *ECG (Electrocardiogram):* A diagnostic test that records the electrical activity of the heart to assess
its rhythm and conduction. It helps in the diagnosis of various cardiac conditions, such as arrhythmias,
myocardial infarction, and heart failure.
4. *Rehabilitation of patient after below knee amputation:* Involves physical therapy, prosthetic fitting,
and psychological support to improve mobility and quality of life.
5. *Lumbar puncture:* A procedure involving the insertion of a needle into the spinal canal to collect
cerebrospinal fluid for diagnostic purposes, such as in suspected meningitis or subarachnoid
hemorrhage.
*Short Answer Questions:*
1. *Four cyanotic heart diseases:* Include Tetralogy of Fallot, Transposition of the Great Arteries,
Tricuspid Atresia, and Total Anomalous Pulmonary Venous Connection.
2. *Two disease conditions involved in Chronic obstructive pulmonary disease (COPD):* Include chronic
bronchitis and emphysema.
3. *Two classical signs of Tetany:* Chvostek's sign (facial muscle spasm upon tapping the facial nerve)
and Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff).
4. *Causative organism of typhoid and cholera:* Salmonella typhi (typhoid) and Vibrio cholerae
(cholera).
5. *Two indications for dialysis:* End-stage renal disease (ESRD) and acute kidney injury (AKI) with
electrolyte imbalances or fluid overload.
6. *Four symptoms of osteoarthritis:* Joint pain, stiffness, swelling, and decreased range of motion.
7. *Four methods of non-pharmacological management of pain:* Include heat or cold therapy, massage,
acupuncture, and relaxation techniques.
8. *Four signs and symptoms of fracture:* Pain, swelling, deformity, bruising, tenderness, and impaired
function.
9. *Four responsibilities of operation theatre nurse:* Include preparing the operating room, assisting the
surgical team, maintaining aseptic technique, monitoring the patient's vital signs, and ensuring proper
documentation.
10. *Two opportunistic infections in Acquired Immunodeficiency Syndrome (AIDS):* Include
Pneumocystis pneumonia (PCP) and cytomegalovirus (CMV) retinitis.
Would you like further assistance with anything else?
[5/12/2024 1:54 PM] : Certainly! Here are the answers:
### Essay Questions:
1. *Myocardial Infarction:*
a) *Definition:* Myocardial infarction (MI), commonly known as a heart attack, refers to the
irreversible damage or death of heart muscle tissue due to a prolonged lack of blood supply (ischemia)
to the heart.
b) *Causes:* Causes of myocardial infarction include atherosclerosis (buildup of plaque in the coronary
arteries), which can lead to coronary artery disease, as well as risk factors such as hypertension, high
cholesterol, smoking, diabetes, obesity, and a sedentary lifestyle.
c) *Postoperative Management of CABG:* Postoperative management of a patient who has undergone
coronary artery bypass grafting (CABG) involves close monitoring of vital signs, pain management,
wound care, administration of prescribed medications (including antiplatelets, anticoagulants, and pain
relievers), monitoring for signs of complications (such as bleeding, infection, or arrhythmias), patient
education on medication compliance, lifestyle modifications, and follow-up care.
2. *Cirrhosis of Liver:*
a) *Definition:* Cirrhosis of the liver is a chronic and progressive condition characterized by the
replacement of healthy liver tissue with scar tissue, leading to impaired liver function.
b) *Pathophysiology:* Cirrhosis results from long-term liver damage caused by various factors,
including chronic alcohol abuse, viral hepatitis (such as hepatitis B and C), non-alcoholic fatty liver
disease (NAFLD), autoimmune hepatitis, and certain genetic disorders. The continuous injury and
inflammation to the liver trigger a cascade of events leading to fibrosis and ultimately cirrhosis.
c) *Nursing Care Plan:*
- Assess and monitor liver function tests, including liver enzymes, bilirubin levels, and coagulation
studies.
- Monitor for signs of complications such as ascites, hepatic encephalopathy, and esophageal varices.
- Provide education on dietary modifications (low-sodium diet), medication adherence (such as
lactulose for hepatic encephalopathy), and alcohol cessation.
- Collaborate with the healthcare team to manage symptoms, prevent complications, and promote
optimal liver function through supportive care and interventions.
### Short Notes:
1. *Aneurysm:* Aneurysm refers to the abnormal ballooning or dilation of a blood vessel wall, which can
occur in arteries or veins and poses a risk of rupture.
2. *Role of a Nurse in Organ Donation:* Nurses play a crucial role in organ donation by facilitating the
identification of potential donors, supporting families during the donation process, coordinating organ
retrieval and transplantation procedures, and providing compassionate care to donors and their
families.
3. *Pathophysiology of Fever:* Fever, or pyrexia, is a complex physiological response to infection,
inflammation, or other stimuli. It involves the release of pyrogens, such as cytokines, which act on the
hypothalamus to raise the body's temperature set point.
4. *Raynaud’s Disease:* Raynaud's disease is a condition characterized by vasospasm of the arteries in
the extremities, leading to episodes of reduced blood flow and color changes in the fingers and toes,
often triggered by cold or stress.
5. *Hemodialysis:* Hemodialysis is a renal replacement therapy used to remove waste products and
excess fluid from the blood in patients with kidney failure. It involves circulating the patient's blood
through a dialysis machine to filter out toxins and restore electrolyte balance.
6. *Atelectasis:* Atelectasis refers to the collapse or closure of a portion of the lung, resulting in reduced
gas exchange and impaired lung function, often caused by airway obstruction, lung compression, or
surfactant deficiency.
7. *Bone Healing Process:* The bone healing process involves inflammation, repair, and remodeling
phases. Initially, hematoma formation and inflammation occur at the fracture site, followed by the
formation of soft callus and hard callus, leading to bone remodeling and eventual restoration of bone
integrity.
8. *Bio-medical Waste Management:* Bio-medical waste management involves the proper handling,
segregation, packaging, transportation, treatment, and disposal of waste generated in healthcare
settings to prevent the spread of infection and protect public health and the environment.
### Short Answer Questions:
1. *Types of Shock:* Types of shock include hypovolemic shock, cardiogenic shock, distributive shock
(such as septic shock), and obstructive shock.
2. *Phantom Pain:* Phantom pain refers to pain perceived in a body part that has been amputated,
often described as shooting, stabbing, burning, or throbbing sensations.
3. *Renal Calculus:* Renal calculus, commonly known as a kidney stone, is a solid mass formed in the
kidneys from the crystallization of substances in urine.
4. *Psoriasis:* Psoriasis is a chronic autoimmune skin condition characterized by red, scaly patches of
skin due to accelerated
skin cell turnover.
5. *Sterilization:* Sterilization is the process of killing or removing all microorganisms, including bacteria,
viruses, and fungi, from a surface or object to prevent infection.
6. *Hypospadiasis:* Hypospadias is a congenital condition characterized by an abnormal opening of the
urethra on the underside of the penis instead of at the tip.
7. *Complications of Peritonitis:* Complications of peritonitis include sepsis, septic shock, intra-
abdominal abscess formation, bowel obstruction, and multiorgan failure.
8. *Emergency Drugs Used in OT:* Emergency drugs used in the operating theater (OT) include
epinephrine, atropine, naloxone, dextrose, and vasopressors, among others, to manage life-threatening
situations such as anaphylaxis, bradycardia, opioid overdose, hypoglycemia, and shock.
9. *Nephrotic Syndrome:* Nephrotic syndrome is a kidney disorder characterized by proteinuria,
hypoalbuminemia, edema, and hyperlipidemia, often resulting from damage to the glomeruli.
10. *Hernia:* A hernia occurs when an organ or tissue protrudes through a weak spot or opening in the
surrounding muscle or fascia, resulting in a visible bulge or lump. Common types include inguinal hernia,
umbilical hernia, and hiatal hernia.
[5/12/2024 2:02 PM] : Sure, here are the answers:
### I. Elaborate on:
1. *Mrs. Radha, 65 years old female with Myocardial Infarction:*
a) *Define Myocardial Infarction:* Myocardial infarction (MI), commonly known as a heart attack,
refers to the death of heart muscle cells due to prolonged lack of oxygen supply, usually caused by a
blockage in one or more coronary arteries.
b) *Pathophysiology & Clinical Features:* MI occurs when a coronary artery becomes blocked, leading
to ischemia and subsequent necrosis of the myocardium. Clinical features include severe chest pain
(angina), which may radiate to the left arm, neck, jaw, or back, along with sweating, shortness of breath,
nausea, vomiting, and palpitations.
c) *Nursing Care Plan for Mrs. Radha:*
- Assess vital signs, including heart rate, blood pressure, respiratory rate, and oxygen saturation.
- Administer oxygen therapy to improve oxygenation and relieve symptoms of hypoxia.
- Monitor cardiac rhythm through continuous electrocardiographic (ECG) monitoring.
- Administer prescribed medications promptly, such as aspirin, nitroglycerin, and morphine, to
relieve pain and reduce cardiac workload.
- Educate Mrs. Radha and her family about the importance of lifestyle modifications, medication
adherence, and follow-up care to prevent recurrent events.
2. *Mr. Anand, 45 years old male with Hyperthyroidism:*
a) *Define Thyrotoxicosis:* Thyrotoxicosis refers to the clinical state resulting from excess thyroid
hormone production, leading to hypermetabolism and a range of systemic manifestations.
b) *Clinical Manifestations of Hyperthyroidism:* Clinical manifestations of hyperthyroidism include
weight loss, heat intolerance, sweating, palpitations, tremors, fatigue, anxiety, diarrhea, and menstrual
irregularities in women.
c) *Pre and Postoperative Management:*
- Preoperative management involves controlling symptoms with antithyroid medications (such as
methimazole or propylthiouracil), beta-blockers to control heart rate and symptoms, and iodine to
reduce thyroid vascularity.
- Postoperative care includes monitoring for signs of hypothyroidism, thyroid storm, or surgical
complications such as bleeding, infection, or injury to the recurrent laryngeal nerve. Thyroid
replacement therapy may be initiated if hypothyroidism occurs after surgery.
### II. Write notes on:
1. *Iron Deficiency Anemia:* Iron deficiency anemia is a condition characterized by low levels of
hemoglobin due to inadequate iron stores, leading to microcytic, hypochromic red blood cells and
symptoms such as fatigue, weakness, pallor, and shortness of breath.
2. *Lumbar Puncture:* Lumbar puncture, also known as a spinal tap, is a medical procedure used to
collect cerebrospinal fluid (CSF) for diagnostic purposes or to administer medications. It involves
inserting a needle into the subarachnoid space in the lower back under sterile conditions.
3. *Appendicitis:* Appendicitis is inflammation of the appendix, usually caused by obstruction of the
appendiceal lumen by fecaliths, lymphoid hyperplasia, or tumors. It presents with periumbilical pain
migrating to the right lower quadrant, anorexia, nausea, vomiting, and rebound tenderness.
4. *Duties and Responsibilities of Operation Theatre Nurse:* Operation theatre nurses are responsible
for preparing the operating room, ensuring sterility, assisting surgeons during procedures, monitoring
patient vital signs, managing surgical instruments and equipment, and providing postoperative care.
5. *Dental Caries:* Dental caries, commonly known as tooth decay or cavities, is a bacterial infection
resulting in demineralization and destruction of tooth enamel. It is caused by acid-producing bacteria in
plaque and can lead to tooth pain, sensitivity, and eventually tooth loss.
### III. Short Answer Questions:
1. *Postoperative Complications of Gastrectomy:* Complications may include anastomotic leaks,
hemorrhage, wound infection, gastric stasis, dumping syndrome, nutritional deficiencies, and
pneumonia.
2. *Types of Anesthesia:* Types include general anesthesia, regional anesthesia (e.g., spinal, epidural),
and local anesthesia.
3. *Purposes of Traction:* Traction aims to reduce and immobilize fractures, align bones, relieve pain
and muscle spasms, prevent further injury, and promote bone healing.
4. *Complications of Fracture:* Complications may include delayed union, nonunion, malunion,
compartment syndrome, neurovascular injury, and deep vein thrombosis.
5. *Surgical Procedure for BPH:* Transurethral resection of the prostate (TURP) is a common surgical
procedure for BPH, involving removal of excess prostate tissue using a resectoscope inserted through
the urethra.
6. *Complications of Cirrhosis of Liver:* Complications include ascites, hepatic encephalopathy, variceal
bleeding, hepatorenal syndrome, hepatocellular carcinoma, and spontaneous bacterial peritonitis.
7. *Congenital Malformations of Kidney:* Examples include renal agenesis, horseshoe kidney, polycystic
kidney disease, and renal dysplasia.
8. *Types of Hernia:* Types include inguinal, femoral, umbilical, incisional, and hiatal hernias.
9. *Edema:* Edema is the abnormal accumulation of fluid in interstitial spaces, leading to swelling and
tissue enlargement.
10. *Types of Emphysema:* Types include centrilobular emphysema, panlobular emphysema, and
paraseptal emphysema.
[5/12/2024 2:03 PM] : Sure, here are the answers:
### I. Elaborate on:
1. *Mr. Mani, 50 years old male with Diabetes Mellitus:*
a) *Define Diabetes Mellitus:* Diabetes mellitus is a chronic metabolic disorder characterized by high
blood glucose levels (hyperglycemia) due to either inadequate insulin production, insulin resistance, or
both.
b) *Pathophysiology & Clinical Manifestations:* Diabetes mellitus results from dysfunction in insulin
production or action, leading to elevated blood glucose levels. Clinical manifestations include polyuria,
polydipsia, polyphagia, weight loss, fatigue, blurred vision, slow wound healing, and recurrent infections.
c) *Management Methods:* Management includes lifestyle modifications (diet, exercise), oral
hypoglycemic agents or insulin therapy, regular blood glucose monitoring, weight management, and
preventive measures for complications such as diabetic neuropathy, retinopathy, and nephropathy.
d) *Nursing Care Plan for Mr. Mani:*
- Assess blood glucose levels regularly and monitor for signs of hyperglycemia or hypoglycemia.
- Educate Mr. Mani about dietary modifications, medication adherence, and the importance of
regular exercise.
- Encourage self-care practices such as foot care, regular eye exams, and monitoring for signs of
complications.
- Collaborate with other healthcare professionals to address any comorbidities or complications
associated with diabetes.
2. *Mrs. Kala, 48 years old female with Renal Calculi:*
a) *Types of Renal Calculi:* Renal calculi, or kidney stones, can be classified based on their
composition into calcium oxalate, calcium phosphate, uric acid, struvite, and cystine stones.
b) *Clinical Manifestations and Diagnostic Procedures:* Clinical manifestations of renal calculi include
severe flank pain, hematuria, urinary urgency, dysuria, and nausea/vomiting. Diagnostic procedures
include urinalysis, imaging studies (such as CT scan or ultrasound), and 24-hour urine collection for stone
analysis.
c) *Pre and Postoperative Nursing Care Plan:*
- Preoperatively, provide pain management, encourage fluid intake, and monitor for signs of urinary
tract infection or obstruction.
- Postoperatively, monitor vital signs, assess for complications (such as hemorrhage or infection),
administer analgesics as needed, encourage ambulation, and provide dietary counseling to prevent
stone recurrence.
### II. Write notes on:
1. *Hypothyroidism:* Hypothyroidism is a condition characterized by insufficient thyroid hormone
production, leading to symptoms such as fatigue, weight gain, cold intolerance, constipation, and dry
skin.
2. *Colostomy Care:* Colostomy care involves maintaining the cleanliness and integrity of the colostomy
site, changing the ostomy appliance regularly, monitoring for signs of infection or skin irritation, and
providing patient education on self-care.
3. *Hemorrhoids:* Hemorrhoids are swollen and inflamed veins in the rectum or anus, causing
symptoms such as rectal pain, itching, bleeding, and discomfort during bowel movements.
4. *Cushing’s Syndrome:* Cushing's syndrome is a disorder characterized by prolonged exposure to high
levels of cortisol, resulting in symptoms such as weight gain, central obesity, moon face, buffalo hump,
hypertension, and glucose intolerance.
5. *Aneurysm:* An aneurysm is a localized dilation or bulging of a blood vessel wall, which can occur in
arteries (e.g., aortic aneurysm) or veins (e.g., cerebral aneurysm), and may lead to rupture and life-
threatening bleeding.
### III. Short Answer Questions:
1. *Thrombo-Angitis Obliterans:* Thrombo-angitis obliterans, also known as Buerger's disease, is an
inflammatory condition characterized by segmental thrombosis and inflammation of small and medium-
sized arteries, primarily affecting the lower extremities.
2. *Phantom Pain:* Phantom pain refers to pain perceived in a body part that has been amputated,
thought to result from the brain's attempt to interpret signals from nerves that were severed during
amputation.
3. *Cardio Biomarkers:* Cardio biomarkers include troponin, creatine kinase-MB (CK-MB), myoglobin,
and brain natriuretic peptide (BNP), which are used for diagnosing myocardial infarction, heart failure,
and other cardiac conditions.
4. *Types of Jaundice:* Types include prehepatic (hemolytic), hepatic (hepatocellular), and posthepatic
(obstructive) jaundice, each caused by different mechanisms of bilirubin accumulation.
5. *ERCP:* ERCP stands for Endoscopic Retrograde Cholangiopancreatography, a procedure used to
diagnose and treat disorders of the bile ducts and pancreas, involving the insertion of an endoscope
through the mouth into the duodenum.
6. *Complications of Peritonitis:* Complications include sepsis, intra-abdominal abscess formation,
bowel obstruction, adhesion formation, and multi-organ failure.
7. *Classify Anemia:* Anemia can be classified based on the size and color of red blood cells into
microcytic hypochromic (e.g., iron deficiency anemia), normocytic normochromic (e.g., anemia of
chronic disease), and macrocytic normochromic (e.g., megaloblastic anemia).
8. *Emergency Drugs used in OT:* Emergency drugs used in operating theatres include adrenaline,
atropine, epinephrine, amiodarone, and naloxone, among others, to manage cardiac arrest, anaphylaxis,
arrhythmias, and opioid overdose.
9. *Immediate Postoperative Complications:* Immediate complications may include hemorrhage,
hypotension, hypoxemia, pain, nausea/vomiting, urinary retention, and wound dehiscence.
10. *Classical Signs of Hypocalcemia:* Classical signs include Chvostek's sign (facial muscle spasm upon
tapping the facial nerve) and Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff
above systolic pressure for a few minutes).
[5/12/2024 2:05 PM] : Sure, here are the answers:
### I. Elaborate on:
1. *Mr. Shyam, 56 years old with Chronic Renal Failure (CRF):*
a) *Define Chronic Renal Failure:* Chronic renal failure, also known as chronic kidney disease (CKD), is
a progressive loss of kidney function over time, leading to the accumulation of metabolic waste products
and electrolyte imbalances in the body.
b) *Pathophysiology and Clinical Manifestations:* Chronic renal failure typically develops over months
to years due to conditions such as diabetes, hypertension, glomerulonephritis, or polycystic kidney
disease. Clinical manifestations include fatigue, edema, hypertension, anemia, electrolyte abnormalities,
and uremic symptoms like nausea, vomiting, and pruritus.
c) *Nursing Management for Mr. Shyam:*
- Monitor fluid and electrolyte balance, vital signs, and laboratory values (e.g., serum creatinine,
potassium).
- Administer medications as prescribed (e.g., phosphate binders, erythropoietin, antihypertensives).
- Educate Mr. Shyam on dietary restrictions (e.g., low sodium, potassium, and phosphorus diet) and
fluid intake control.
- Coordinate with the healthcare team for hemodialysis or peritoneal dialysis if indicated.
2. *Bronchial Asthma:*
a) *Definition:* Bronchial asthma is a chronic inflammatory disorder of the airways characterized by
reversible airflow obstruction, bronchial hyperresponsiveness, and recurrent episodes of wheezing,
breathlessness, chest tightness, and coughing, particularly at night or in the early morning.
b) *Clinical Manifestations:* Clinical manifestations of bronchial asthma include wheezing, dyspnea,
chest tightness, coughing, increased respiratory rate, and use of accessory muscles for breathing during
exacerbations.
c) *Medical Management:* Medical management involves the use of bronchodilators (e.g., short-
acting beta-agonists, anticholinergics), inhaled corticosteroids, leukotriene modifiers, and
immunomodulators (e.g., omalizumab). Management also includes patient education on trigger
avoidance and the use of peak flow meters and action plans.
d) *Nursing Process for Bronchial Asthma:*
- Assessment: Gather information on the patient's medical history, symptoms, triggers, and
medication use.
- Diagnosis: Identify nursing diagnoses such as "Ineffective Airway Clearance" related to bronchial
constriction and "Risk for Impaired Gas Exchange" related to decreased airflow.
- Planning: Collaborate with the patient to develop goals and interventions for symptom
management, trigger avoidance, and medication adherence.
- Implementation: Provide patient education on proper inhaler technique, environmental
modifications, and lifestyle changes. Monitor respiratory status and response to treatment.
- Evaluation: Assess the effectiveness of nursing interventions in improving the patient's respiratory
function and quality of life.
### II. Write notes on:
1. *Lumbar Puncture:* A procedure used to collect cerebrospinal fluid (CSF) from the subarachnoid
space in the lumbar region of the spine for diagnostic purposes or to administer medications.
2. *Surgical Management of Peptic Ulcer:* Surgical options for peptic ulcer disease include vagotomy
(nerve severing), antrectomy (removal of the lower part of the stomach), pyloroplasty (widening of the
pylorus), and gastrectomy (partial or total removal of the stomach).
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers
Mgr university  bsc nursing adult health previous question paper with answers

More Related Content

What's hot

Health asessment
Health asessmentHealth asessment
Health asessment
Abhilasha verma
 
PATHOLOGY INTRODUCTION.pptx
PATHOLOGY INTRODUCTION.pptxPATHOLOGY INTRODUCTION.pptx
PATHOLOGY INTRODUCTION.pptx
sana usmani
 
Nursing mangement on occupational and industrial disorders [Autosaved].pptx
Nursing mangement on occupational and industrial disorders [Autosaved].pptxNursing mangement on occupational and industrial disorders [Autosaved].pptx
Nursing mangement on occupational and industrial disorders [Autosaved].pptx
DR .PALLAVI PATHANIA
 
Cardiovascular assessment
Cardiovascular assessment Cardiovascular assessment
Cardiovascular assessment
kirtipandey19
 
Wound healing
Wound healingWound healing
Wound healing
Mahesh Chand
 
HYPERTENSION || Medical surgical nursing || msn
HYPERTENSION || Medical surgical nursing || msnHYPERTENSION || Medical surgical nursing || msn
HYPERTENSION || Medical surgical nursing || msn
MrVermaasahab
 
Cirrhosis of liver
Cirrhosis of liverCirrhosis of liver
Cirrhosis of liver
shafaatullahkhatt
 
Role of nurse in medical surgical setting
Role of nurse in medical surgical setting Role of nurse in medical surgical setting
Role of nurse in medical surgical setting
RakhiYadav53
 
cardiac tamponade.pptx
cardiac tamponade.pptxcardiac tamponade.pptx
cardiac tamponade.pptx
RamanUppal3
 
VALUES IN NURSING.pptx
VALUES IN NURSING.pptxVALUES IN NURSING.pptx
VALUES IN NURSING.pptx
Krishna Gandhi
 
Aneurysm
AneurysmAneurysm
Aneurysm
Jinumol Jacob
 
Fluid & electrolyte imbalance
Fluid & electrolyte imbalanceFluid & electrolyte imbalance
Fluid & electrolyte imbalance
Assistant Professor
 
Nursing process
Nursing processNursing process
Nursing process
DR .PALLAVI PATHANIA
 
Shock and its nursing management
Shock and its nursing managementShock and its nursing management
Shock and its nursing management
Kalpana Kawan
 
Chronic renal failure (CRF)
Chronic renal failure (CRF)Chronic renal failure (CRF)
Chronic renal failure (CRF)
ROMAN BAJRANG
 
Nursing diagnosis
Nursing diagnosisNursing diagnosis
Nursing diagnosis
Arifa T N
 
Atherosclerosis
AtherosclerosisAtherosclerosis
Atherosclerosis
Shrooti Shah
 
evolution and trends in MSN.pptx
evolution and trends in MSN.pptxevolution and trends in MSN.pptx
evolution and trends in MSN.pptx
shafina27
 
Professionalism in nursing
Professionalism in nursingProfessionalism in nursing
Professionalism in nursing
Ahmad Thanin
 
myocardial infarction
myocardial infarction myocardial infarction
myocardial infarction
Sam Mathew
 

What's hot (20)

Health asessment
Health asessmentHealth asessment
Health asessment
 
PATHOLOGY INTRODUCTION.pptx
PATHOLOGY INTRODUCTION.pptxPATHOLOGY INTRODUCTION.pptx
PATHOLOGY INTRODUCTION.pptx
 
Nursing mangement on occupational and industrial disorders [Autosaved].pptx
Nursing mangement on occupational and industrial disorders [Autosaved].pptxNursing mangement on occupational and industrial disorders [Autosaved].pptx
Nursing mangement on occupational and industrial disorders [Autosaved].pptx
 
Cardiovascular assessment
Cardiovascular assessment Cardiovascular assessment
Cardiovascular assessment
 
Wound healing
Wound healingWound healing
Wound healing
 
HYPERTENSION || Medical surgical nursing || msn
HYPERTENSION || Medical surgical nursing || msnHYPERTENSION || Medical surgical nursing || msn
HYPERTENSION || Medical surgical nursing || msn
 
Cirrhosis of liver
Cirrhosis of liverCirrhosis of liver
Cirrhosis of liver
 
Role of nurse in medical surgical setting
Role of nurse in medical surgical setting Role of nurse in medical surgical setting
Role of nurse in medical surgical setting
 
cardiac tamponade.pptx
cardiac tamponade.pptxcardiac tamponade.pptx
cardiac tamponade.pptx
 
VALUES IN NURSING.pptx
VALUES IN NURSING.pptxVALUES IN NURSING.pptx
VALUES IN NURSING.pptx
 
Aneurysm
AneurysmAneurysm
Aneurysm
 
Fluid & electrolyte imbalance
Fluid & electrolyte imbalanceFluid & electrolyte imbalance
Fluid & electrolyte imbalance
 
Nursing process
Nursing processNursing process
Nursing process
 
Shock and its nursing management
Shock and its nursing managementShock and its nursing management
Shock and its nursing management
 
Chronic renal failure (CRF)
Chronic renal failure (CRF)Chronic renal failure (CRF)
Chronic renal failure (CRF)
 
Nursing diagnosis
Nursing diagnosisNursing diagnosis
Nursing diagnosis
 
Atherosclerosis
AtherosclerosisAtherosclerosis
Atherosclerosis
 
evolution and trends in MSN.pptx
evolution and trends in MSN.pptxevolution and trends in MSN.pptx
evolution and trends in MSN.pptx
 
Professionalism in nursing
Professionalism in nursingProfessionalism in nursing
Professionalism in nursing
 
myocardial infarction
myocardial infarction myocardial infarction
myocardial infarction
 

Similar to Mgr university bsc nursing adult health previous question paper with answers

Blood Disorders
Blood DisordersBlood Disorders
Blood Disorders
DR .PALLAVI PATHANIA
 
IHD ema_2020.pdf
IHD ema_2020.pdfIHD ema_2020.pdf
IHD ema_2020.pdf
Imtiyaz60
 
Atherosclerosis
AtherosclerosisAtherosclerosis
Atherosclerosis
JYOTI PACHISIA
 
Atherosclerosis
AtherosclerosisAtherosclerosis
Atherosclerosis
JYOTI PACHISIA
 
MYOCARDITIS
MYOCARDITISMYOCARDITIS
MYOCARDITIS
ShylaMercy
 
leukemia
leukemialeukemia
Leukemia
LeukemiaLeukemia
Leukemia
vijaypj17
 
Leukemia english
Leukemia englishLeukemia english
Leukemia english
Candra Dwipayana H
 
Hyperlipidemia
HyperlipidemiaHyperlipidemia
Hyperlipidemia
A-aziz Sultan
 
1. Pharmacotherapy III.pptxvgefhivklhkfvhh
1. Pharmacotherapy III.pptxvgefhivklhkfvhh1. Pharmacotherapy III.pptxvgefhivklhkfvhh
1. Pharmacotherapy III.pptxvgefhivklhkfvhh
interaman123
 
Leukemia
LeukemiaLeukemia
Leukemia
Amit Martin
 
Atherosclerosis
AtherosclerosisAtherosclerosis
Atherosclerosis
JYOTI PACHISIA
 
Acute myocardial infarction
Acute myocardial infarctionAcute myocardial infarction
Acute myocardial infarction
hatch_jane
 
Epidemiology of Chronic Non- communicable diseases and Conditions
Epidemiology of Chronic Non- communicable diseases and ConditionsEpidemiology of Chronic Non- communicable diseases and Conditions
Epidemiology of Chronic Non- communicable diseases and Conditions
Sheetal Singh
 
Coronary artery disease or Ischemic heart disease
Coronary artery disease or Ischemic heart disease Coronary artery disease or Ischemic heart disease
Coronary artery disease or Ischemic heart disease
ANILKUMAR BR
 
Cardiomyopathy
CardiomyopathyCardiomyopathy
Cardiomyopathy
qaisarshah11
 
Dic seminar pdf
Dic seminar pdfDic seminar pdf
Dic seminar pdf
Jitendra Patidar
 
Leukemia
LeukemiaLeukemia
Leukemia
VIKAS SHARMA
 
Mustard gas poisoning .By- Dr mohammadullah totakhil
Mustard gas poisoning .By- Dr mohammadullah totakhilMustard gas poisoning .By- Dr mohammadullah totakhil
Mustard gas poisoning .By- Dr mohammadullah totakhil
Mohammadullah Totakhel
 
Evaluation and approach to Pancytopenia.pptx
Evaluation and approach to Pancytopenia.pptxEvaluation and approach to Pancytopenia.pptx
Evaluation and approach to Pancytopenia.pptx
DrSrinivasJayanthur
 

Similar to Mgr university bsc nursing adult health previous question paper with answers (20)

Blood Disorders
Blood DisordersBlood Disorders
Blood Disorders
 
IHD ema_2020.pdf
IHD ema_2020.pdfIHD ema_2020.pdf
IHD ema_2020.pdf
 
Atherosclerosis
AtherosclerosisAtherosclerosis
Atherosclerosis
 
Atherosclerosis
AtherosclerosisAtherosclerosis
Atherosclerosis
 
MYOCARDITIS
MYOCARDITISMYOCARDITIS
MYOCARDITIS
 
leukemia
leukemialeukemia
leukemia
 
Leukemia
LeukemiaLeukemia
Leukemia
 
Leukemia english
Leukemia englishLeukemia english
Leukemia english
 
Hyperlipidemia
HyperlipidemiaHyperlipidemia
Hyperlipidemia
 
1. Pharmacotherapy III.pptxvgefhivklhkfvhh
1. Pharmacotherapy III.pptxvgefhivklhkfvhh1. Pharmacotherapy III.pptxvgefhivklhkfvhh
1. Pharmacotherapy III.pptxvgefhivklhkfvhh
 
Leukemia
LeukemiaLeukemia
Leukemia
 
Atherosclerosis
AtherosclerosisAtherosclerosis
Atherosclerosis
 
Acute myocardial infarction
Acute myocardial infarctionAcute myocardial infarction
Acute myocardial infarction
 
Epidemiology of Chronic Non- communicable diseases and Conditions
Epidemiology of Chronic Non- communicable diseases and ConditionsEpidemiology of Chronic Non- communicable diseases and Conditions
Epidemiology of Chronic Non- communicable diseases and Conditions
 
Coronary artery disease or Ischemic heart disease
Coronary artery disease or Ischemic heart disease Coronary artery disease or Ischemic heart disease
Coronary artery disease or Ischemic heart disease
 
Cardiomyopathy
CardiomyopathyCardiomyopathy
Cardiomyopathy
 
Dic seminar pdf
Dic seminar pdfDic seminar pdf
Dic seminar pdf
 
Leukemia
LeukemiaLeukemia
Leukemia
 
Mustard gas poisoning .By- Dr mohammadullah totakhil
Mustard gas poisoning .By- Dr mohammadullah totakhilMustard gas poisoning .By- Dr mohammadullah totakhil
Mustard gas poisoning .By- Dr mohammadullah totakhil
 
Evaluation and approach to Pancytopenia.pptx
Evaluation and approach to Pancytopenia.pptxEvaluation and approach to Pancytopenia.pptx
Evaluation and approach to Pancytopenia.pptx
 

Recently uploaded

Call Girls Kolkata 💯Call Us 🔝 7374876321 🔝 💃 Top Class Call Girl Service A...
Call Girls Kolkata   💯Call Us 🔝 7374876321 🔝 💃  Top Class Call Girl Service A...Call Girls Kolkata   💯Call Us 🔝 7374876321 🔝 💃  Top Class Call Girl Service A...
Call Girls Kolkata 💯Call Us 🔝 7374876321 🔝 💃 Top Class Call Girl Service A...
daljeetsingh9909
 
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)
GeorgeKieling1
 
Selective α1-Blocker.pptx
Selective α1-Blocker.pptxSelective α1-Blocker.pptx
Selective α1-Blocker.pptx
Madhumita Dixit
 
Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)
Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)
Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)
MuskanShingari
 
Pharmacology of Drugs for Congestive Heart Failure
Pharmacology of Drugs for Congestive Heart FailurePharmacology of Drugs for Congestive Heart Failure
Pharmacology of Drugs for Congestive Heart Failure
Dr. Nikhilkumar Sakle
 
ENVIRONMENTAL SANITATION in community setting
ENVIRONMENTAL SANITATION in community settingENVIRONMENTAL SANITATION in community setting
ENVIRONMENTAL SANITATION in community setting
ShraddhaTamshettiwar
 
Call Girls Lucknow 9024918724 Vip Call Girls Lucknow
Call Girls Lucknow 9024918724 Vip Call Girls LucknowCall Girls Lucknow 9024918724 Vip Call Girls Lucknow
Call Girls Lucknow 9024918724 Vip Call Girls Lucknow
nandinirastogi03
 
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl MumbaiCall Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Mobile Problem
 
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and SynonymsGiloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and Synonyms
Planet Ayurveda
 
RESPIRATORY DISEASES by bhavya kelavadiya
RESPIRATORY DISEASES by bhavya kelavadiyaRESPIRATORY DISEASES by bhavya kelavadiya
RESPIRATORY DISEASES by bhavya kelavadiya
Bhavyakelawadiya
 
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
Donc Test
 
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
FFragrant
 
Mechanical injuries(ICS) due to sharp force.ppt
Mechanical injuries(ICS) due to sharp force.pptMechanical injuries(ICS) due to sharp force.ppt
Mechanical injuries(ICS) due to sharp force.ppt
SatrajitRoy5
 
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Jim Jacob Roy
 
PGx Analysis in VarSeq: A User’s Perspective
PGx Analysis in VarSeq: A User’s PerspectivePGx Analysis in VarSeq: A User’s Perspective
PGx Analysis in VarSeq: A User’s Perspective
Golden Helix
 
Pharmacology of Prostaglandins, Thromboxanes and Leukotrienes
Pharmacology of Prostaglandins, Thromboxanes and LeukotrienesPharmacology of Prostaglandins, Thromboxanes and Leukotrienes
Pharmacology of Prostaglandins, Thromboxanes and Leukotrienes
Dr. Nikhilkumar Sakle
 
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.GawadHemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
NephroTube - Dr.Gawad
 
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticalsacne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
MuskanShingari
 
Nutritional deficiency disorder in Child
Nutritional deficiency disorder in ChildNutritional deficiency disorder in Child
Nutritional deficiency disorder in Child
Bhavyakelawadiya
 
Call Girl Pune 7339748667 Vip Call Girls Pune
Call Girl Pune 7339748667 Vip Call Girls PuneCall Girl Pune 7339748667 Vip Call Girls Pune
Call Girl Pune 7339748667 Vip Call Girls Pune
Mobile Problem
 

Recently uploaded (20)

Call Girls Kolkata 💯Call Us 🔝 7374876321 🔝 💃 Top Class Call Girl Service A...
Call Girls Kolkata   💯Call Us 🔝 7374876321 🔝 💃  Top Class Call Girl Service A...Call Girls Kolkata   💯Call Us 🔝 7374876321 🔝 💃  Top Class Call Girl Service A...
Call Girls Kolkata 💯Call Us 🔝 7374876321 🔝 💃 Top Class Call Girl Service A...
 
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)
 
Selective α1-Blocker.pptx
Selective α1-Blocker.pptxSelective α1-Blocker.pptx
Selective α1-Blocker.pptx
 
Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)
Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)
Gene Expression System-viral gene delivery Mpharm(Pharamaceutics)
 
Pharmacology of Drugs for Congestive Heart Failure
Pharmacology of Drugs for Congestive Heart FailurePharmacology of Drugs for Congestive Heart Failure
Pharmacology of Drugs for Congestive Heart Failure
 
ENVIRONMENTAL SANITATION in community setting
ENVIRONMENTAL SANITATION in community settingENVIRONMENTAL SANITATION in community setting
ENVIRONMENTAL SANITATION in community setting
 
Call Girls Lucknow 9024918724 Vip Call Girls Lucknow
Call Girls Lucknow 9024918724 Vip Call Girls LucknowCall Girls Lucknow 9024918724 Vip Call Girls Lucknow
Call Girls Lucknow 9024918724 Vip Call Girls Lucknow
 
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl MumbaiCall Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
 
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and SynonymsGiloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and Synonyms
 
RESPIRATORY DISEASES by bhavya kelavadiya
RESPIRATORY DISEASES by bhavya kelavadiyaRESPIRATORY DISEASES by bhavya kelavadiya
RESPIRATORY DISEASES by bhavya kelavadiya
 
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
 
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
 
Mechanical injuries(ICS) due to sharp force.ppt
Mechanical injuries(ICS) due to sharp force.pptMechanical injuries(ICS) due to sharp force.ppt
Mechanical injuries(ICS) due to sharp force.ppt
 
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
 
PGx Analysis in VarSeq: A User’s Perspective
PGx Analysis in VarSeq: A User’s PerspectivePGx Analysis in VarSeq: A User’s Perspective
PGx Analysis in VarSeq: A User’s Perspective
 
Pharmacology of Prostaglandins, Thromboxanes and Leukotrienes
Pharmacology of Prostaglandins, Thromboxanes and LeukotrienesPharmacology of Prostaglandins, Thromboxanes and Leukotrienes
Pharmacology of Prostaglandins, Thromboxanes and Leukotrienes
 
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.GawadHemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
Hemodialysis: Chapter 6, Hemodialysis Adequacy and Dose - Dr.Gawad
 
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticalsacne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
 
Nutritional deficiency disorder in Child
Nutritional deficiency disorder in ChildNutritional deficiency disorder in Child
Nutritional deficiency disorder in Child
 
Call Girl Pune 7339748667 Vip Call Girls Pune
Call Girl Pune 7339748667 Vip Call Girls PuneCall Girl Pune 7339748667 Vip Call Girls Pune
Call Girl Pune 7339748667 Vip Call Girls Pune
 

Mgr university bsc nursing adult health previous question paper with answers

  • 1. [5/12/2024 1:00 PM] Shafnafinu: Elaborate on: (2 x 15 = 30) 1. Mr. X, 65 years old male is admitted with diagnosis of Chronic Obstructive Pulmonary Disease (COPD). a) Define Chronic Obstructive Pulmonary Disease. b) Discuss the pathophysiology and signs and symptoms of Chronic Obstructive Pulmonary Disease. c) Explain the Medical and Nursing management of Chronic Obstructive Pulmonary Disease. 2. Mr. X, 42 years old male is diagnosed with Myocardial Infarction (MI). a) Define Myocardial Infarction. b) Discuss the clinical manifestation and diagnostic evaluation of Myocardial Infarction. c) Explain the collaborative management of Myocardial Infarction. II. Write notes on: (5 x 5 = 25) 1. Psoriasis. 2. Blood transfusion. 3. Stages of Wound healing. 4. Iron deficiency anaemia. 5. Hyperthyroidism. III. Short answers on: (10 x 2 = 20) 1. Dressler’s syndrome. 2. Four types of amputation. 3. Reynaud’s disease. 4. Four complication of General Anaesthesia. 5. List out four complications of Peritoneal Dialysis. 6. Difference between Osteoarthritis and Rheumatoid Arthritis. 7. Personal Protective Equipment. 8. Epispadiasis. 9. Sites of colostomy.
  • 2. 10.Four types of Breath sound. * [5/12/2024 1:02 PM] : Certainly! Let's start by elaborating on the first question: *1. Mr. X, 65 years old male is admitted with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD).* a) *Define Chronic Obstructive Pulmonary Disease (COPD):* Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease characterized by chronic inflammation of the airways and obstruction of airflow, making it difficult to breathe. It primarily includes two main conditions: chronic bronchitis and emphysema. In chronic bronchitis, the airways are inflamed and produce excess mucus, leading to coughing and difficulty breathing. Emphysema involves the destruction of the air sacs (alveoli) in the lungs, reducing their elasticity and surface area for gas exchange. b) *Discuss the pathophysiology and signs and symptoms of COPD:* The pathophysiology of COPD involves damage to the airways and lung tissue, primarily caused by long- term exposure to irritants such as cigarette smoke, air pollution, and occupational dust and chemicals. This leads to inflammation, narrowing of the airways, and destruction of lung tissue, resulting in symptoms such as chronic cough, sputum production, wheezing, shortness of breath, and chest tightness. Over time, COPD can progress, leading to respiratory failure and significant disability. c) *Explain the Medical and Nursing management of COPD:* Medical management of COPD aims to relieve symptoms, improve lung function, and prevent exacerbations. This may include bronchodilators to help open the airways, corticosteroids to reduce inflammation, oxygen therapy to improve oxygen levels, and pulmonary rehabilitation to enhance exercise tolerance and quality of life. Smoking cessation is crucial in slowing disease progression. Nursing management involves educating patients about their condition, promoting adherence to medications and treatment plans, assisting with activities of daily living, monitoring for complications, and providing emotional support. Nursing interventions also focus on promoting effective airway clearance, optimizing oxygenation, and preventing respiratory infections. If you need further elaboration on any specific aspect, feel free to ask!
  • 3. [5/12/2024 1:05 PM] : Sure, let's delve into the second question: *2. Mr. X, 42 years old male is diagnosed with Myocardial Infarction (MI).* a) *Define Myocardial Infarction (MI):* Myocardial infarction, commonly known as a heart attack, occurs when there is a sudden blockage of blood flow to a part of the heart muscle, leading to tissue damage or death due to lack of oxygen. This blockage usually results from the rupture of an atherosclerotic plaque in one of the coronary arteries, which supply oxygen-rich blood to the heart muscle. b) *Discuss the clinical manifestation and diagnostic evaluation of Myocardial Infarction:* Clinical manifestations of MI typically include severe chest pain or discomfort, often described as crushing, squeezing, or pressure-like, that may radiate to the left arm, shoulder, jaw, or back. Other symptoms may include shortness of breath, nausea, vomiting, sweating, lightheadedness, and anxiety. However, the presentation can vary, especially in atypical cases or in individuals with diabetes or older adults. Diagnostic evaluation of MI involves several tests, including an electrocardiogram (ECG or EKG) to detect changes in the heart's electrical activity, cardiac biomarker tests (such as troponin) to identify cardiac muscle damage, and imaging studies such as echocardiography or coronary angiography to assess heart function and identify the location and extent of blockages in the coronary arteries. c) *Explain the collaborative management of Myocardial Infarction:* The management of MI involves a multidisciplinary approach that includes medical interventions, reperfusion therapy, and lifestyle modifications. Medical interventions may include administering medications such as aspirin, nitroglycerin, beta- blockers, ACE inhibitors, and statins to reduce pain, prevent further clot formation, decrease cardiac workload, and improve outcomes. Reperfusion therapy aims to restore blood flow to the affected area of the heart as quickly as possible to minimize tissue damage. This may involve either thrombolytic therapy (administration of clot-busting drugs) or primary percutaneous coronary intervention (PCI), also known as angioplasty with stenting, to mechanically open the blocked coronary artery.
  • 4. Additionally, lifestyle modifications such as smoking cessation, adopting a heart-healthy diet, regular exercise, weight management, and stress reduction are essential components of long-term management to prevent recurrent events and improve overall cardiovascular health. If you need further explanation or have additional questions, feel free to ask! [5/12/2024 1:09 PM] : Certainly! Let's provide brief notes on each topic: 1. *Psoriasis:* - Psoriasis is a chronic autoimmune skin condition characterized by red, raised, scaly patches on the skin. - It occurs when the immune system mistakenly attacks healthy skin cells, leading to rapid turnover of skin cells and inflammation. - Triggers for psoriasis include genetics, environmental factors, stress, infections, and certain medications. - Treatment options include topical treatments (such as corticosteroids, vitamin D analogs), phototherapy, systemic medications (such as methotrexate, cyclosporine), and biologic agents targeting specific immune pathways. 2. *Blood transfusion:* - Blood transfusion involves the transfer of blood or blood products from a donor to a recipient to replace lost blood, improve oxygen delivery, or correct abnormalities in blood composition. - It is commonly used in medical emergencies, surgeries, and treatments for various medical conditions such as anemia, bleeding disorders, and cancer. - Blood transfusions must be carefully matched for blood type (ABO compatibility) and screened for compatibility to minimize the risk of adverse reactions. - Potential risks of blood transfusion include transfusion reactions, infections, and transfusion-related complications such as transfusion-associated circulatory overload (TACO) or transfusion-related acute lung injury (TRALI). - Blood donation is crucial for maintaining an adequate blood supply, and donated blood undergoes rigorous screening and testing for safety. 3. *Stages of Wound healing:*
  • 5. - Wound healing is a complex process involving several overlapping stages: hemostasis, inflammation, proliferation, and remodeling. - Hemostasis: Immediate response to injury involving vasoconstriction and platelet aggregation to stop bleeding. - Inflammation: Inflammatory cells (neutrophils, macrophages) remove debris and pathogens, and cytokines stimulate tissue repair. - Proliferation: Fibroblasts produce collagen, forming granulation tissue, and new blood vessels (angiogenesis) develop. - Remodeling: Collagen matures, scar tissue forms, and wound strength increases. - Factors such as age, nutrition, infection, and underlying health conditions can affect the wound healing process. 4. *Iron deficiency anemia:* - Iron deficiency anemia occurs when the body lacks sufficient iron to produce hemoglobin, resulting in decreased oxygen-carrying capacity of red blood cells. - Common causes include inadequate dietary intake of iron, blood loss (such as from menstruation or gastrointestinal bleeding), malabsorption disorders, and increased iron demands (such as during pregnancy or rapid growth). - Clinical manifestations include fatigue, weakness, pale skin, shortness of breath, dizziness, and cold intolerance. - Diagnosis is based on blood tests showing low hemoglobin, low serum iron levels, low ferritin levels, and high total iron-binding capacity (TIBC). - Treatment involves iron supplementation, dietary modifications to increase iron intake, and addressing the underlying cause if present. 5. *Hyperthyroidism:* - Hyperthyroidism is a condition characterized by excess production of thyroid hormones (T3 and T4) by the thyroid gland. - Causes include Graves' disease (autoimmune disorder), toxic multinodular goiter, thyroiditis, and thyroid nodules. - Clinical manifestations include weight loss, increased appetite, heat intolerance, palpitations, tremors, nervousness, fatigue, diarrhea, and menstrual irregularities. - Diagnosis is based on blood tests showing elevated levels of thyroid hormones (T3 and T4), low levels of thyroid-stimulating hormone (TSH), and thyroid ultrasound or nuclear imaging.
  • 6. - Treatment options include antithyroid medications (such as methimazole, propylthiouracil), radioactive iodine therapy, or surgical removal of the thyroid gland (thyroidectomy). Feel free to ask if you need further clarification on any of these topics! [5/12/2024 1:12 PM] : Certainly! Here are short answers to each of the questions: 1. *Dressler’s syndrome:* - Dressler’s syndrome, also known as post-myocardial infarction syndrome, is a type of pericarditis that occurs weeks to months after a myocardial infarction (heart attack). It is characterized by chest pain, fever, and pericardial effusion (fluid accumulation around the heart). 2. *Four types of amputation:* - Transmetatarsal: Removal of the forefoot and toes. - Syme's: Removal of the foot at the ankle joint. - Below-knee (transtibial): Removal of the leg below the knee joint. - Above-knee (transfemoral): Removal of the leg above the knee joint. 3. *Raynaud’s disease:* - Raynaud’s disease is a condition characterized by vasospasm of small arteries in response to cold or stress, resulting in reduced blood flow to the fingers and toes. - Symptoms include color changes in the skin (white, blue, red), numbness, tingling, and pain in the affected extremities. 4. *Four complications of General Anaesthesia:* - Nausea and vomiting - Postoperative confusion or cognitive dysfunction - Respiratory depression or airway obstruction - Hypotension or cardiovascular instability 5. *Four complications of Peritoneal Dialysis:*
  • 7. - Peritonitis (infection of the peritoneal membrane) - Exit site infection (infection at the catheter exit site) - Catheter-related complications (e.g., catheter malfunction, migration) - Fluid and electrolyte imbalances (e.g., hyperglycemia, hyperkalemia) 6. *Difference between Osteoarthritis and Rheumatoid Arthritis:* - Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage and overgrowth of bone at the joint margins, leading to joint pain and stiffness, typically affecting weight- bearing joints. - Rheumatoid arthritis is an autoimmune disease characterized by inflammation of the synovial membrane, leading to joint pain, swelling, and deformity, typically affecting small joints symmetrically. 7. *Personal Protective Equipment (PPE):* - Personal Protective Equipment includes items such as gloves, masks, goggles, face shields, gowns, and respirators, designed to protect healthcare workers from exposure to infectious agents, chemicals, and other hazards in the workplace. 8. *Epispadias:* - Epispadias is a congenital defect where the urethral opening is located on the upper surface of the penis (in males) or in females, on the clitoris or near the labia. - It occurs due to abnormal development of the urinary tract during fetal development. 9. *Sites of colostomy:* - Ascending colostomy (usually on the right side of the abdomen) - Transverse colostomy (usually in the upper abdomen) - Descending colostomy (usually on the left side of the abdomen) - Sigmoid colostomy (usually in the lower left quadrant of the abdomen) 10. *Four types of Breath sound:* - Vesicular breath sounds (heard over most of the lung fields) - Bronchial breath sounds (heard over the trachea and large airways)
  • 8. - Bronchovesicular breath sounds (heard over the mainstem bronchi) - Adventitious breath sounds (abnormal sounds such as crackles, wheezes, or rhonchi) Feel free to ask if you need further elaboration on any of these topics! [5/12/2024 1:17 PM] Shafnafinu: swer ALL questions. I. Essays: (2x15=30) 1. Mr.Mani 64 yrs old man is admitted with the diagnosis of Benign Prostatic hypertrophy. Answer the following: a) Define Benign prostatic hypertrophy. (2) b) List out the clinical manifestations of Benign prostatic hypertrophy.(4) c) Describe the surgical procedures done for Benign prostatic hypertrophy. (4) d) Explain the pre and postoperative management of Mr. Mani. (5) 2. Mr. Gopi, 38 years is admitted with the diagnosis of cirrhosis of liver. Answer the following: a) Define Cirrhosis of Liver. (2) b) List out the clinical manifestations of cirrhosis of liver. (4) c) Mention the complications of cirrhosis of liver. (4) d) Explain the management of cirrhosis of Liver. (5) II. Write Short Notes on : (5x5=25) 1. Care of patient with chest drainage. 2. Preparation of patient for crutch walking. 3. Suture materials. 4. Dialysis. 5. Surgical management of peptic ulcer. III. Short Answer Questions: (10x2=20) 1. Two indications of blood transfusion. 2. Two non-invasive diagnostic procedures done in cardiac diseases.
  • 9. 3. Two reasons to obtain written informed consent. 4. Two principles of applying bandages. 5. Two immediate post-operative complications. 6. Two reasons to follow rotation of site for insulin administration. 7. Two complications of general anaesthesia. 8. Two communicable diseases and its causative organism. 9. Two opportunistic infections of AIDS. 10. Two methods of administering Anaesthesia. [5/12/2024 1:20 PM] : Sure, let's tackle each question: *I. Essays:* 1. *Mr. Mani, 64 years old man is admitted with the diagnosis of Benign Prostatic Hypertrophy (BPH).* a) *Define Benign Prostatic Hypertrophy:* Benign Prostatic Hypertrophy (BPH) is a non-cancerous enlargement of the prostate gland, commonly seen in aging men. It occurs due to the proliferation of prostate cells, leading to compression of the urethra and obstructive urinary symptoms. b) *List out the clinical manifestations of Benign Prostatic Hypertrophy:* - Urinary hesitancy - Weak urine stream - Increased frequency of urination (especially at night) - Urgency - Incomplete emptying of the bladder - Urinary retention - Dribbling at the end of urination - Hematuria (blood in urine)
  • 10. c) *Describe the surgical procedures done for Benign Prostatic Hypertrophy:* - Transurethral Resection of the Prostate (TURP): Removal of excess prostate tissue using a resectoscope inserted through the urethra. - Open Prostatectomy: Surgical removal of the enlarged part of the prostate gland through an abdominal or perineal incision. - Laser Prostatectomy: Using laser energy to vaporize or remove prostate tissue, often performed as a minimally invasive procedure. d) *Explain the pre and postoperative management of Mr. Mani:* - Preoperative: Assessment of Mr. Mani's medical history, physical examination, laboratory tests (including prostate-specific antigen levels), and imaging studies. Preoperative preparation may include bowel preparation, discontinuation of anticoagulant medications, and optimization of medical conditions. Education about the procedure, risks, and postoperative expectations is essential. - Postoperative: Monitoring for complications such as bleeding, urinary retention, and infection. Pain management, bladder irrigation if indicated, monitoring of urinary output, and gradual advancement of diet and activity as tolerated. Patient education on catheter care, pelvic floor exercises, and follow-up appointments for assessment of urinary function and resolution of symptoms. 2. *Mr. Gopi, 38 years is admitted with the diagnosis of cirrhosis of the liver.* a) *Define Cirrhosis of Liver:* Cirrhosis of the liver is a chronic, progressive liver disease characterized by the replacement of healthy liver tissue with scar tissue (fibrosis), leading to impaired liver function and potential complications such as portal hypertension and liver failure. b) *List out the clinical manifestations of cirrhosis of the liver:* - Jaundice (yellowing of the skin and eyes) - Ascites (accumulation of fluid in the abdominal cavity) - Hepatic encephalopathy (confusion, altered mental status) - Easy bruising and bleeding - Peripheral edema - Spider angiomas (spider-like blood vessels on the skin) - Gynecomastia (enlargement of breast tissue in males)
  • 11. - Palmar erythema (redness of the palms) c) *Mention the complications of cirrhosis of the liver:* - Portal hypertension - Esophageal varices (risk of bleeding) - Hepatic encephalopathy - Hepatorenal syndrome - Spontaneous bacterial peritonitis - Hepatocellular carcinoma (risk of liver cancer) - Coagulopathy and bleeding disorders d) *Explain the management of cirrhosis of the Liver:* - Treatment of underlying causes (e.g., alcohol cessation, treatment of viral hepatitis) - Symptomatic management (e.g., diuretics for ascites, lactulose for hepatic encephalopathy) - Nutritional support - Surveillance for complications (e.g., screening for hepatocellular carcinoma) - Liver transplant evaluation for eligible candidates *II. Write Short Notes on:* 1. *Care of patient with chest drainage:* - Monitoring drainage output and character - Maintaining the integrity of the chest tube system - Assessing for signs of complications (e.g., air leaks, pneumothorax) - Providing pain management and respiratory support as needed 2. *Preparation of patient for crutch walking:* - Proper fitting and adjustment of crutches - Teaching proper crutch positioning and weight-bearing technique
  • 12. - Demonstrating how to navigate various surfaces and obstacles - Emphasizing safety precautions to prevent falls or injuries 3. *Suture materials:* - Absorbable (e.g., polyglycolic acid, polylactic acid) - Non-absorbable (e.g., silk, nylon) - Monofilament vs. multifilament - Natural vs. synthetic 4. *Dialysis:* - Hemodialysis: Blood is circulated through a dialyzer to remove waste products and excess fluids, then returned to the body. - Peritoneal dialysis: Dialysate fluid is introduced into the peritoneal cavity, where waste products and excess fluids diffuse across the peritoneal membrane. - Continuous renal replacement therapy (CRRT): Continuous removal of waste products and fluids in critically ill patients with acute kidney injury. 5. *Surgical management of peptic ulcer:* - Partial gastrectomy: Removal of the portion of the stomach containing the ulcer. - Vagotomy: Cutting of the vagus nerve to reduce gastric acid secretion. - Pyloroplasty: Surgical widening of the pyloric sphincter to improve gastric emptying. - Antrectomy: Removal of the lower portion of the stomach (antrum) where gastric acid is produced. *III. Short Answer Questions:* 1. *Two indications of blood transfusion:* - Severe anemia - Acute blood loss 2. *Two non-invasive diagnostic procedures done in cardiac diseases:*
  • 13. - Electrocardiogram (ECG or EKG) - Echocardiography 3. *Two reasons to obtain written informed consent:* - Ensuring patient autonomy and decision-making - Documenting the patient's understanding of risks and benefits 4. *Two principles of applying bandages:* - Maintaining proper tension for support without impairing circulation - Securing the bandage with appropriate knots or fasteners 5. *Two immediate post-operative complications:* - Hemorrhage - Respiratory distress 6. *Two reasons to follow rotation of site for insulin administration:* - Preventing lipodystrophy (localized fat deposits) - Ensuring consistent insulin absorption 7. *Two complications of general anesthesia:* - Nausea and vomiting - Respiratory depression 8. *Two communicable diseases and its causative organism:* - Tuberculosis (Mycobacterium tuberculosis) - Influenza (Influenza virus) 9. *Two opportunistic infections of AIDS:* - Pneumocystis jirovecii pneumonia (PCP)
  • 14. - Cryptococcal meningitis 10. **Two methods of administering Anesthesia:** - Inhalation anesthesia - Intravenous anesthesia Feel free to ask if you need further clarification on any of these topics! [5/12/2024 1:24 PM] : I. Essays: (2x15=30) 1. Mrs. Ananthavalli, 45 years old employed women is admitted with hyperthyroidism for surgical management. Answer the following: a) Define thyrotoxicosis. (1) b) What are its clinical manifestations? (4) c) Write down the pre and post operative care. (8) d) Mention the complications after surgery. (2) 2. Mr. Mahadevan, 25 years old is admitted with acute attack of Bronchial Asthma: a) Define Bronchial Asthma. (1) b) State its clinical manifestations. (2) c) Explain the medical management for this patient. (4) d) Applying the nursing process, plan care for Mr. Mahadevan based on three priority diagnosis. (8) II. Write Short Notes on : (5x5 =25) 1. Iron deficiency anaemia. 2. Lumbar puncture. 3. Infertility. 4. Duties and responsibilities of operation theatre nurse.
  • 15. 5. Dental caries. III. Short Answer Questions: (10x 2=20) 1. Two stages of bone healing. 2. Two stages of anesthesia. 3. Two differences between small bowel and large bowel obstruction. 4. Two complications of fracture. 5. Two surgical procedure performed in BPH (Benign Prostatic Hypertrophy). 6. Two complications of cirrhosis of liver. 7. Two congenital malformations of kidney. 8. Two conditions involved in TOF (Tetrology of Fallot). 9. Two suture materials and its uses. 10. Two differences between Empyema and Emphysema. ****** [5/12/2024 1:26 PM] : Sure, let's address each question: *I. Essays:* 1. *Mrs. Ananthavalli, 45 years old employed woman is admitted with hyperthyroidism for surgical management.* a) *Define thyrotoxicosis:* Thyrotoxicosis refers to a condition caused by excessive thyroid hormone levels in the bloodstream, leading to hyperactivity of the thyroid gland. It can result from various causes, including hyperthyroidism, thyroiditis, or exogenous thyroid hormone intake. b) *What are its clinical manifestations?* Clinical manifestations of thyrotoxicosis include: - Weight loss - Heat intolerance
  • 16. - Palpitations - Tremors - Fatigue - Increased appetite - Sweating - Anxiety - Irritability - Menstrual irregularities - Exophthalmos (bulging eyes) c) *Write down the pre and post-operative care:* - *Preoperative care:* Assessment of Mrs. Ananthavalli's medical history, physical examination, and laboratory tests (thyroid function tests). Optimization of thyroid function with antithyroid medications (if necessary). Education about the surgical procedure, risks, benefits, and postoperative expectations. NPO (nothing by mouth) status before surgery. Preoperative medications (e.g., beta-blockers to control heart rate and symptoms of thyrotoxicosis). - *Postoperative care:* Monitoring for complications such as hypocalcemia (due to potential parathyroid injury), bleeding, and infection. Assessment of airway and breathing status. Pain management. Monitoring of thyroid function tests postoperatively. Patient education on wound care, thyroid replacement therapy (if total thyroidectomy), and signs of hypothyroidism. d) *Mention the complications after surgery:* Complications after thyroid surgery may include: - Hypothyroidism (if total thyroidectomy) - Hypoparathyroidism (due to parathyroid injury) - Recurrent laryngeal nerve injury (resulting in voice changes or hoarseness) - Hemorrhage - Infection 2. *Mr. Mahadevan, 25 years old is admitted with an acute attack of Bronchial Asthma:*
  • 17. a) *Define Bronchial Asthma:* Bronchial asthma is a chronic inflammatory disorder of the airways characterized by recurrent episodes of wheezing, breathlessness, chest tightness, and cough, especially at night or in the early morning. It involves reversible airflow obstruction and airway hyperresponsiveness. b) *State its clinical manifestations:* Clinical manifestations of bronchial asthma include: - Wheezing (high-pitched whistling sound during expiration) - Dyspnea (shortness of breath) - Chest tightness - Cough, particularly at night or in the early morning - Increased respiratory rate - Use of accessory muscles for breathing - Prolonged expiration c) *Explain the medical management for this patient:* Medical management of acute asthma exacerbation may include: - Short-acting beta-agonists (e.g., albuterol) for bronchodilation - Systemic corticosteroids (e.g., prednisone) to reduce airway inflammation - Oxygen therapy to correct hypoxemia - Anticholinergics (e.g., ipratropium) for additional bronchodilation - Magnesium sulfate for severe exacerbations d) *Applying the nursing process, plan care for Mr. Mahadevan based on three priority diagnoses:* Nursing care priorities for Mr. Mahadevan may include: - Ineffective airway clearance related to bronchoconstriction and mucus production: Monitor respiratory status, administer bronchodilators and mucolytics as ordered, encourage deep breathing and coughing techniques. - Impaired gas exchange related to ventilation-perfusion imbalance: Monitor oxygen saturation, administer oxygen therapy as prescribed, assess respiratory effort and auscultate lung ķl regularly.
  • 18. - Anxiety related to dyspnea and acute exacerbation: Provide reassurance and emotional support, educate on relaxation techniques, administer anxiolytics as prescribed, encourage effective coping strategies. *II. Write Short Notes on:* 1. *Iron deficiency anemia:* - Iron deficiency anemia is a condition characterized by low levels of hemoglobin and hematocrit due to insufficient iron in the body. - Causes include inadequate dietary intake, blood loss (e.g., menstruation, gastrointestinal bleeding), and malabsorption. - Clinical manifestations include fatigue, weakness, pallor, shortness of breath, and pica (craving for non-food items). - Treatment involves iron supplementation and addressing the underlying cause. 2. *Lumbar puncture:* - Lumbar puncture, also known as spinal tap, is a procedure to collect cerebrospinal fluid (CSF) for diagnostic purposes or therapeutic interventions. - It involves inserting a needle between two lumbar vertebrae into the subarachnoid space to obtain CSF. - Indications include suspected meningitis, subarachnoid hemorrhage, and evaluation of demyelinating diseases. - Complications may include post-lumbar puncture headache, bleeding, infection, or nerve damage. 3. *Infertility:* - Infertility is defined as the inability to conceive after one year of regular, unprotected intercourse. - Causes include ovulatory disorders, tubal obstruction, uterine abnormalities, male factor infertility, and unexplained factors. - Diagnostic evaluation may include hormonal tests, imaging studies, semen analysis, and evaluation of tubal patency. - Treatment options include fertility medications, surgery, assisted reproductive technologies (e.g., in vitro fertilization), or donor gametes.
  • 19. 4. *Duties and responsibilities of operation theatre nurse:* - Preoperative responsibilities: Preparing the operating room, ensuring proper functioning of equipment, verifying surgical consent, assisting with patient positioning and preoperative preparations. - Intraoperative responsibilities: Assisting the surgical team, maintaining aseptic technique, anticipating needs of surgeons and anesthesia providers, monitoring patient vital signs, documenting intraoperative events. - Postoperative responsibilities: Monitoring patient recovery, assessing for complications, transferring the patient to the post-anesthesia care unit (PACU), providing postoperative care instructions to the patient and family. 5. *Dental caries:* - Dental caries, commonly known as tooth decay or cavities, is a multifactorial disease caused by bacterial demineralization of tooth enamel. - Risk factors include poor oral hygiene, frequent consumption of sugary foods or beverages, inadequate fluoride exposure, and decreased saliva production. - Clinical manifestations include toothache, sensitivity to hot or cold, visible pits or holes in the teeth, and tooth discoloration. - Prevention strategies include regular dental check-ups, proper oral hygiene practices, fluoridated water, and a balanced diet. *III. Short Answer Questions:* 1. *Two stages of bone healing:* - Inflammatory phase - Repair (reparative) phase 2. *Two stages of anesthesia:* - Induction - Maintenance 3
  • 20. . *Two differences between small bowel and large bowel obstruction:* - Small bowel obstruction typically presents with more severe symptoms (e.g., vomiting, colicky abdominal pain), whereas large bowel obstruction may present with more gradual onset and fewer symptoms. - Small bowel obstruction is often caused by adhesions or hernias, while large bowel obstruction may be due to colorectal cancer or diverticulitis. 4. *Two complications of fracture:* - Compartment syndrome - Delayed union or nonunion 5. *Two surgical procedures performed in BPH (Benign Prostatic Hypertrophy):* - Transurethral resection of the prostate (TURP) - Open prostatectomy 6. *Two complications of cirrhosis of the liver:* - Ascites - Hepatic encephalopathy 7. *Two congenital malformations of the kidney:* - Polycystic kidney disease - Renal agenesis 8. *Two conditions involved in TOF (Tetralogy of Fallot):* - Pulmonary stenosis - Ventricular septal defect 9. *Two suture materials and its uses:* - Absorbable sutures (e.g., polyglactin): Used for deep tissue approximation and internal suturing.
  • 21. - Non-absorbable sutures (e.g., nylon): Used for skin closure and areas requiring long-term tensile strength. 10. *Two differences between Empyema and Emphysema:* - Empyema is a collection of pus in the pleural cavity, whereas emphysema is a chronic lung condition characterized by destruction of alveolar walls. - Empyema is typically associated with infection and inflammation, whereas emphysema is primarily caused by smoking or genetic factors. [5/12/2024 1:27 PM] : Elaborate on: Pages Time Marks (Max.) (Max.) (Max.) 1. a) Define peritonitis and write the causes for peritonitis. 19 33 20 b) Enumerate the Pathophysiology and complications of peritonitis. c) Write the post-operative management of this patient based on nursing process. 2. a) Define hypertension and write the pathophysiology of hypertension. 19 33 20 b) Clinical manifestations and complications of hypertension. c) Draw a nursing care plan for this patient. II. Write Notes on: 1. Cardio Pulmonary Resuscitation. 3 8 5 2. Care of patient with anaemia. 3 8 5 3. Aetiology and nursing management for acute renal failure. 3 8 5 4. Write about infertility. 3 8 5 5. Universal precautions. 3 8 5 6. Role of a nurse during counselling. 3 8 5 7. Pathophysiology of pulmonary tuberculosis. 3 8 5 8. Wound healing process. 3 8 5 III. Short Answers on:
  • 22. 1. Fumigation. 1 5 2 2. Stages of illness. 1 5 2 3. Hepatitis B virus. 1 5 2 4. Adverse blood transfusion reaction. 1 5 2 5. Drugs used in intensive care unit. 1 5 2 6. Importance of foot care. 1 5 2 7. Thyroid storm. 1 5 2 8. Alopecia. 1 5 2 9. Meningitis. 1 5 2 10. Nephritis. 1 5 2 ***** [5/12/2024 1:30 PM] : Let's address each question: *I. Elaborate on:* 1. *a) Define peritonitis and write the causes for peritonitis:* - Peritonitis is inflammation of the peritoneum, the thin tissue lining the inner wall of the abdomen and covering the abdominal organs. - Causes of peritonitis include: - Perforation of abdominal organs (e.g., perforated peptic ulcer, appendicitis, diverticulitis) - Abdominal trauma or injury - Rupture of intra-abdominal abscess - Complications of abdominal surgery - Peritoneal dialysis-associated infections - Pancreatitis - Pelvic inflammatory disease (PID) - Foreign body ingestion *b) Enumerate the Pathophysiology and complications of peritonitis:*
  • 23. - Pathophysiology: Peritonitis results from the release of bacteria, digestive enzymes, or foreign material into the peritoneal cavity, leading to inflammation and infection. This triggers an immune response, causing vasodilation, increased capillary permeability, and the recruitment of inflammatory cells. The inflamed peritoneum leads to fluid shift, electrolyte imbalance, and systemic inflammatory response syndrome (SIRS). - Complications: Complications of peritonitis may include: - Sepsis and septic shock - Intra-abdominal abscess formation - Intestinal obstruction - Adhesive bowel disease - Multiple organ dysfunction syndrome (MODS) - Death if left untreated *c) Write the post-operative management of this patient based on the nursing process:* - Assessment: Monitor vital signs, abdominal assessment for signs of infection or complications, fluid and electrolyte balance, pain assessment. - Diagnosis: Risk for infection, impaired tissue integrity, altered fluid volume. - Planning: Prevent infection, promote wound healing, maintain fluid and electrolyte balance, manage pain. - Implementation: Administer antibiotics as prescribed, maintain aseptic technique with wound care, monitor intake and output, provide pain management, educate on signs of complications. - Evaluation: Monitor patient's response to treatment, assess for resolution of symptoms, evaluate wound healing, and prevent complications. 2. *a) Define hypertension and write the pathophysiology of hypertension:* - Hypertension is a condition characterized by elevated blood pressure persistently higher than normal levels. - Pathophysiology: Hypertension can result from increased cardiac output, increased systemic vascular resistance, or both. Contributing factors may include genetics, obesity, sedentary lifestyle, dietary factors (e.g., high sodium intake), stress, and certain medical conditions (e.g., renal disease, endocrine disorders). The renin-angiotensin-aldosterone system (RAAS), sympathetic nervous system activation, and endothelial dysfunction play key roles in regulating blood pressure.
  • 24. *b) Clinical manifestations and complications of hypertension:* - Clinical manifestations: Often asymptomatic (silent killer). Symptoms may include headache, dizziness, blurred vision, and epistaxis. Severe hypertension may present with symptoms of end-organ damage such as chest pain, dyspnea, or neurological deficits. - Complications: Complications of hypertension may include: - Cardiovascular: Coronary artery disease, heart failure, myocardial infarction, stroke, peripheral arterial disease. - Renal: Chronic kidney disease, renal failure. - Neurological: Stroke, transient ischemic attack (TIA), cognitive impairment. - Ocular: Retinopathy, vision loss. *c) Draw a nursing care plan for this patient:* - Assessment: Obtain blood pressure measurements, assess for signs of end-organ damage, review medication history, assess lifestyle factors (e.g., diet, exercise). - Diagnosis: Risk for ineffective peripheral tissue perfusion, risk for altered cerebral tissue perfusion, noncompliance with therapeutic regimen. - Planning: Lower blood pressure to target levels, promote adherence to treatment regimen, educate on lifestyle modifications. - Implementation: Administer antihypertensive medications as prescribed, monitor blood pressure response to treatment, provide education on diet (low sodium, DASH diet), exercise, stress management, smoking cessation. - Evaluation: Monitor blood pressure trends, assess for signs of complications, evaluate patient's understanding and compliance with treatment plan. *II. Write Notes on:* 1. *Cardio Pulmonary Resuscitation (CPR):* - CPR is an emergency procedure performed to manually maintain circulation and breathing in a person who is in cardiac arrest. - Steps include checking responsiveness, calling for help, initiating chest compressions, providing rescue breaths, and using an automated external defibrillator (AED) if available. - CPR aims to restore blood flow and oxygenation to vital organs until advanced medical support arrives.
  • 25. 2. *Care of patient with anaemia:* - Anaemia is a condition characterized by a deficiency of red blood cells or hemoglobin, leading to decreased oxygen-carrying capacity of the blood. - Nursing care includes monitoring vital signs, administering prescribed iron supplements or blood transfusions, promoting a diet rich in iron and other nutrients, educating on energy conservation techniques, and assessing for signs of complications such as fatigue and dyspnea. 3. *Aetiology and nursing management for acute renal failure:* - Acute renal failure is a sudden loss of kidney function, often reversible if detected early and managed promptly. - Nursing management includes monitoring fluid and electrolyte balance, administering medications to manage underlying causes (e.g., diuretics, antibiotics), providing renal replacement therapy (e.g., hemodialysis, peritoneal dialysis), and preventing complications such as fluid overload and electrolyte imbalances. 4. **Infertility: ** - Infertility is the inability to conceive after one year of regular unprotected intercourse. - Nursing considerations include providing emotional support, educating on fertility treatment options (e.g., in vitro fertilization, intrauterine insemination), facilitating access to reproductive specialists, and promoting healthy lifestyle behaviors. 5. *Universal precautions:* - Universal precautions are infection control guidelines to prevent transmission of bloodborne pathogens in healthcare settings. - Measures include hand hygiene, wearing personal protective equipment (e.g., gloves, masks), safe injection practices, proper handling and disposal of sharps, and environmental cleaning and disinfection. 6. *Role of a nurse during counseling:* - Nurses play a vital role in providing counseling and support to patients and families facing various health challenges.
  • 26. - This includes assessing psychosocial needs, providing information and education about diagnoses and treatment options, facilitating communication between patients and healthcare providers, and promoting coping strategies and emotional well-being. 7. *Pathophysiology of pulmonary tuberculosis:* - Pulmonary tuberculosis is caused by Mycobacterium tuberculosis and primarily affects the lungs. - After inhalation of infectious droplets, the bacteria invade the alveoli and are engulfed by macrophages, leading to granuloma formation and latent infection. - Reactivation of latent infection can occur, leading to active tuberculosis characterized by necrosis, cavitation, and dissemination of bacteria. 8. *Wound healing process:* - Wound healing involves four overlapping phases: hemostasis, inflammation, proliferation, and remodeling. - Hemostasis: Platelet aggregation and vasoconstriction to stop bleeding. - Inflammation: Migration of inflammatory cells to the wound site to clear debris and pathogens. - Proliferation: Granulation tissue formation, epithelialization, and angiogenesis. - Remodeling: Maturation of scar tissue and restoration of tissue strength. *III. Short Answer Questions:* 1. *Fumigation:* - Fumigation is a method of pest control that involves filling an area with gaseous pesticides to suffocate or poison pests. - It is commonly used to eliminate insects, rodents, and microorganisms in enclosed spaces such as buildings, warehouses, and agricultural commodities. 2. *Stages of illness:* - Prodromal stage - Acute stage - Convalescent stage
  • 27. 3. *Hepatitis B virus:* - Hepatitis B virus (HBV) is a DNA virus transmitted through blood and body fluids. - It causes inflammation of the liver and can lead to acute or chronic hepatitis, cirrhosis, and hepatocellular carcinoma. - Prevention includes vaccination and adherence to universal precautions. 4. *Adverse blood transfusion reaction:* - Adverse blood transfusion reactions include hemolytic reactions, febrile non-hemolytic reactions, allergic reactions, transfusion-related acute lung injury (TRALI), and transfusion-associated circulatory overload (TACO). 5. *Drugs used in the intensive care unit:* - Drugs commonly used in the ICU include vasopressors (e.g., norepinephrine), sedatives (e.g., propofol), analgesics (e.g., opioids), antibiotics, diuretics, and anticoagulants. 6. *Importance of foot care:* - Foot care is essential for preventing complications such as diabetic foot ulcers, infections, and amputations in patients with diabetes. - Measures include daily inspection of feet, proper hygiene, wearing appropriate footwear, and regular podiatry assessments. 7. *Thyroid storm:* - Thyroid storm is a life-threatening complication of hyperthyroidism characterized by severe exacerbation of symptoms such as fever, tachycardia, hypertension, and altered mental status. - Treatment involves aggressive management of symptoms, including antithyroid medications, beta- blockers, cooling measures, and supportive care in the ICU. 8. *Alopecia:* - Alopecia refers to hair loss or baldness, which can be temporary or permanent. - Causes include genetics, hormonal changes, medical conditions (e.g., thyroid disorders, autoimmune diseases), medications, and stress.
  • 28. 9. *Meningitis:* - Meningitis is inflammation of the meninges, the protective membranes covering the brain and spinal cord, usually caused by infection (bacterial, viral, fungal). - Symptoms may include headache, fever, neck stiffness, photophobia, altered mental status, and seizures. 10. *Nephritis:* - Nephritis refers to inflammation of the kidney, which can be acute or chronic and may result from various causes such as infection, autoimmune diseases, or drug toxicity. - Clinical manifestations may include hematuria, proteinuria, hypertension, edema, and impaired kidney function. [5/12/2024 1:33 PM] : Let's tackle each question: *I. Essays:* 1. *Mrs. Kala, 48 years old lady is admitted with foot ulcer and diabetes mellitus:* a) *Define diabetes:* Diabetes mellitus is a metabolic disorder characterized by elevated blood glucose levels due to inadequate insulin production, ineffective insulin action, or both. Insulin, produced by the pancreas, regulates blood sugar levels by facilitating the uptake of glucose into cells for energy or storage. b) *Clinical manifestations:* Clinical manifestations of diabetes mellitus may include polyuria (excessive urination), polydipsia (excessive thirst), polyphagia (excessive hunger), weight loss, fatigue, blurred vision, slow wound healing, and recurrent infections. c) *Etiology and investigations for diabetes:* - Etiology: Diabetes mellitus may result from genetic predisposition, environmental factors (e.g., obesity, sedentary lifestyle), autoimmune destruction of pancreatic beta cells (type 1 diabetes), or insulin resistance (type 2 diabetes).
  • 29. - Investigations: Diagnostic tests include fasting blood glucose, oral glucose tolerance test, random blood glucose, glycated hemoglobin (HbA1c), and urine analysis for glucose and ketones. d) *Various methods of management:* Management of diabetes includes lifestyle modifications (diet, exercise), pharmacological therapy (oral hypoglycemic agents, insulin), regular monitoring of blood glucose levels, and prevention and management of complications (e.g., foot care, eye exams, renal function tests). e) *Aspects considered while providing health education:* Health education for diabetes should focus on diet modification (carbohydrate counting, portion control), exercise regimen, medication adherence, blood glucose monitoring, foot care practices, recognition and management of hypo/hyperglycemia, and importance of regular medical follow-ups. 2. *Mr. R. Kannan, 42 years old man is admitted with renal calculi:* a) *Types of renal calculi:* Renal calculi, also known as kidney stones, can be classified into calcium stones (calcium oxalate or calcium phosphate), uric acid stones, struvite stones (magnesium ammonium phosphate), and cystine stones. b) *Clinical manifestations and diagnostic procedures:* Clinical manifestations of renal calculi include severe flank pain radiating to the groin, hematuria, dysuria, urinary urgency, and nausea/vomiting. Diagnostic procedures include urinalysis, imaging studies (CT scan, ultrasound), and stone analysis. c) *Probable surgical interventions:* Surgical interventions for renal calculi may include extracorporeal shock wave lithotripsy (ESWL), ureteroscopy with laser lithotripsy, percutaneous nephrolithotomy (PCNL), or open surgical stone removal (rarely performed). d) *Pre and post-operative nursing care using nursing process plan for Mr. Kannan:*
  • 30. - *Pre-operative care:* Assess patient's pain level, provide pain management, maintain hydration, monitor vital signs, administer prescribed medications, educate on the procedure and post-operative expectations. - *Post-operative care:* Monitor urinary output, assess for signs of bleeding or infection, manage pain, provide wound care, encourage ambulation, monitor for complications (e.g., urinary retention, infection), educate on discharge instructions and follow-up care. *II. Write Short Notes on:* 1. *Suture and suture material:* - Sutures are medical devices used to hold body tissues together after injury or surgery. - Suture materials include absorbable (e.g., polyglactin, polyglycolic acid) and non-absorbable (e.g., nylon, silk) sutures, each with specific indications based on tissue type, location, and desired duration of wound support. 2. *Colostomy care:* - Colostomy is a surgical procedure that creates an artificial opening (stoma) in the abdominal wall to divert feces from the colon to a stoma bag. - Colostomy care involves monitoring stoma appearance, emptying and changing the stoma bag, maintaining skin integrity around the stoma, and providing patient education on self-care and complication prevention. 3. *Renal biopsy:* - Renal biopsy is a diagnostic procedure to obtain a small sample of kidney tissue for examination under a microscope. - It is performed to diagnose renal diseases such as glomerulonephritis, nephrotic syndrome, or evaluate kidney transplant rejection. - Complications may include bleeding, infection, or injury to surrounding organs. 4. *Deep vein thrombosis:* - Deep vein thrombosis (DVT) is the formation of blood clots in deep veins, usually in the legs. - Risk factors include immobility, surgery, trauma, pregnancy, hormonal therapy, and inherited clotting disorders.
  • 31. - Complications may include pulmonary embolism (PE), post-thrombotic syndrome, and chronic venous insufficiency. 5. *Blood transfusion – safety checks:* - Safety checks before blood transfusion include verifying patient identity, matching blood type and Rh compatibility, checking expiration dates, inspecting blood bags for leaks or discoloration, and confirming consent. *III. Short Answer Questions:* 1. *Mention the stages of wound healing:* - Inflammatory phase - Proliferative phase - Remodeling phase 2. *Mention two geriatric problems:* - Falls and fractures - Polypharmacy and drug interactions 3. *Write two clinical manifestations of left ventricular failure:* - Dyspnea on exertion or at rest - Paroxysmal nocturnal dyspnea 4. *List out the types of Leukemia:* - Acute lymphoblastic leukemia (ALL) - Acute myeloid leukemia (AML) - Chronic lymphocytic leukemia (CLL) - Chronic myeloid leukemia (CML) 5. *Write two clinical manifestations of fracture:*
  • 32. - Pain at the fracture site - Swelling, bruising, or deformity 6. *What is the incubation period for poliomyelitis?* - The incubation period for poliomyelitis is typically 7 to 14 days. 7. *What are all the important components of Glasgow coma scale?* - Eye opening response - Verbal response - Motor response 8. *Mention the causative organism for whooping cough:* - Bordetella pertussis 9. *How will you assess thyroid gland enlargement?* - Assess for thyroid gland enlargement by palpating the neck for swelling or nodules, auscultating for bruits over the thyroid, and performing imaging studies such as ultrasound or thyroid scan. 10. *What is Gene therapy?* - Gene therapy is a therapeutic approach aimed at treating or preventing disease by modifying or replacing defective genes with functional ones. It holds promise for treating genetic disorders, cancer, and certain infectious diseases. [5/12/2024 1:35 PM] : Sure, let's address each question: *I. Elaborate on:* 1. *Mrs. Janakiammal, 40 years old lady admitted with diagnosed to have Fracture femur, post- operative open reduction and internal fixation first day:*
  • 33. a) *Define fracture:* A fracture is a medical condition characterized by a break or crack in a bone. Fractures can occur due to trauma, overuse, or underlying medical conditions such as osteoporosis. They can be classified based on the type of fracture line, location, and severity. b) *Explain the complication of fracture:* Complications of fractures may include: - Delayed or non-union: Failure of the fractured bone to heal within the expected timeframe. - Malunion: Healing of the bone in a misaligned position, leading to deformity or functional impairment. - Infection: Risk of bacterial contamination during the injury or surgery, leading to osteomyelitis or septic arthritis. - Compartment syndrome: Increased pressure within the muscles compartments, leading to tissue ischemia and nerve damage. - Deep vein thrombosis (DVT) and pulmonary embolism (PE) due to immobilization and venous stasis. c) *Write post-operative Nursing care applying Nursing process:* - *Assessment:* Monitor vital signs, neurovascular status, pain level, surgical site for signs of infection or complications. - *Diagnosis:* Risk for infection, impaired mobility, acute pain, risk for impaired skin integrity. - *Planning:* Prevent infection, promote mobility and wound healing, manage pain, prevent complications. - *Implementation:* Administer medications as prescribed (analgesics, antibiotics), assist with early mobilization and physiotherapy, provide wound care, monitor for signs of complications (e.g., infection, DVT), educate on self-care and follow-up. - *Evaluation:* Assess patient's response to treatment, monitor for resolution of symptoms, evaluate wound healing, and prevent complications. 2. *Mr. Govindarajan is admitted in the Medical ward with Asthma. He is 35 years old:* a) *Define Asthma:*
  • 34. Asthma is a chronic inflammatory respiratory condition characterized by reversible airflow obstruction, bronchial hyperresponsiveness, and recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, especially at night or in the early morning. b) *Write the complication of Asthma:* Complications of asthma may include: - Severe exacerbations requiring hospitalization or intensive care unit (ICU) admission. - Status asthmaticus: Life-threatening asthma attack unresponsive to standard treatment. - Respiratory failure: Severe airflow limitation leading to hypoxemia and hypercapnia. - Pneumonia: Secondary bacterial infection due to impaired airway clearance. - Chronic respiratory failure: Long-term impairment of lung function leading to disability and reduced quality of life. c) *Write the pharmacologic management:* Pharmacological management of asthma includes: - Short-acting beta agonists (e.g., albuterol) for acute symptom relief and rescue therapy. - Inhaled corticosteroids (e.g., fluticasone) for long-term anti-inflammatory control. - Long-acting beta agonists (LABAs) or leukotriene modifiers (e.g., montelukast) as adjunctive therapy for persistent asthma. - Oral corticosteroids (e.g., prednisone) for severe exacerbations or uncontrolled asthma. - Controller medications such as mast cell stabilizers (e.g., cromolyn) or anti-IgE monoclonal antibodies (e.g., omalizumab) for refractory cases. d) *Discuss Nursing care of Mr. Govindarajan:* - *Assessment:* Monitor respiratory status, oxygen saturation, lung sounds, vital signs, and response to medications. Assess for triggers and exacerbating factors. - *Diagnosis:* Impaired gas exchange, ineffective airway clearance, anxiety, risk for exacerbation. - *Planning:* Optimize respiratory function, prevent exacerbations, promote self-management, educate on asthma triggers and medications. - *Implementation:* Administer medications as prescribed, provide oxygen therapy as needed, assist with breathing techniques and airway clearance maneuvers, offer emotional support and reassurance.
  • 35. - *Evaluation:* Assess patient's response to treatment, monitor for signs of improvement or worsening, evaluate patient's understanding of asthma management and adherence to the treatment plan. *II. Write notes on:* 1. *Meningitis:* - Meningitis is inflammation of the meninges, the protective membranes covering the brain and spinal cord. - Causes include viral (e.g., enteroviruses), bacterial (e.g., Neisseria meningitidis), fungal (e.g., Cryptococcus neoformans), and parasitic (e.g., Naegleria fowleri) infections. - Symptoms may include fever, headache, neck stiffness, photophobia, altered mental status, and seizures. - Diagnosis is based on clinical presentation, cerebrospinal fluid analysis, and imaging studies. - Treatment depends on the underlying cause and may include antimicrobial therapy, supportive care, and vaccination for preventable forms of meningitis. 2. *Bronchiectasis:* - Bronchiectasis is a chronic respiratory condition characterized by irreversible dilation and thickening of the bronchial walls, leading to chronic cough, sputum production, and recurrent respiratory infections. - Causes include cystic fibrosis, recurrent respiratory infections, immunodeficiency, and inhalation of toxic gases or particulate matter. - Management involves airway clearance techniques (e.g., chest physiotherapy, postural drainage), bronchodilators, mucolytics, antibiotics, and, in severe cases, surgical resection of affected lung segments. 3. *Hemorrhoids:* - Hemorrhoids are swollen and inflamed veins in the rectum and anus, causing pain, itching, bleeding, and discomfort.
  • 36. - Risk factors include constipation, straining during bowel movements, pregnancy, obesity, and prolonged sitting or standing. - Treatment options include dietary modifications (fiber intake), topical treatments (e.g., corticosteroids, witch hazel), sitz baths, and surgical interventions (e.g., hemorrhoidectomy, rubber band ligation). 4. *Hemodialysis:* - Hemodialysis is a renal replacement therapy used to remove waste products and excess fluids from the blood in patients with kidney failure. - It involves the circulation of blood through a dialyzer (artificial kidney) to filter out toxins and return cleaned blood to the body. - Hemodialysis requires vascular access (arteriovenous fistula, graft, or catheter) and is typically performed thrice weekly in a dialysis center under the supervision of healthcare professionals. 5. *Biomedical waste management:* - Biomedical waste includes any waste generated during healthcare activities that may pose a threat to public health or the environment due to its infectious, toxic, or radioactive nature. - Proper biomedical waste management involves segregation, collection, storage, transportation, treatment, and disposal according to local regulations and guidelines to minimize risks to healthcare workers, patients, and the community. *III. Short Answer:* 1. *Mention four factors that affect wound healing:* - Nutritional status - Blood supply and oxygenation - Infection - Age and comorbidities 2. *Two complications of Tracheostomy:* - Tracheal stenosis or scarring - Infection (tracheitis, pneumonia)
  • 37. 3. *Mention four lifestyle modifications for Hypertension:* - Dietary changes (e.g., DASH diet, reduced sodium intake) - Regular exercise - Weight loss - Stress management techniques (e.g., meditation, yoga) 4. *Two classical signs of Tetany:* - Chvostek's sign (facial muscle spasm upon tapping the facial nerve) - Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff above systolic pressure) 5. *Mention two non-invasive diagnostic tests for Respiratory Problems:* - Chest X-ray - Pulmonary function tests (spirometry) 6. *Two disease conditions involved in chronic obstructive pulmonary disease:* - Chronic bronchitis - Emphysema 7. *Four clinical manifestations of pulmonary edema:* - Dyspnea - Orthopnea - Pink frothy sputum - Crackles on lung auscultation 8. *Two complications of Peptic ulcer:* - Gastrointestinal bleeding - Perforation leading to peritonitis
  • 38. 9. *Two investigations done to rule out Vascular disease:* - Duplex ultrasound - Magnetic resonance angiography (MRA) 10. *Mention two surgical approaches for Benign Prostat:* - Transurethral resection of the prostate (TURP) - Open prostatectomy [5/12/2024 1:41 PM] : Let's address each set of questions: *I. Elaborate on:* 1. *Mr. Raman, 58 years old, admitted with Chronic Obstructive Pulmonary Disease (COPD):* a) *Define Chronic Obstructive Pulmonary Disease (COPD):* COPD is a chronic lung disease characterized by airflow limitation due to chronic bronchitis and/or emphysema. It is often caused by long-term exposure to irritants such as cigarette smoke and air pollution. b) *Discuss the pathophysiology, clinical manifestations of COPD:* Pathophysiology involves chronic inflammation and narrowing of the airways, leading to airflow limitation. Clinical manifestations include dyspnea, chronic cough, sputum production, and wheezing. c) *Draw a nursing care plan for Mr. Raman using the nursing process approach:* - Assessment: Assess respiratory status, oxygen saturation, and sputum characteristics. Evaluate activity tolerance and nutritional status. - Diagnosis: Ineffective airway clearance, impaired gas exchange, activity intolerance related to dyspnea. - Planning: Goals include improving airway clearance, optimizing oxygenation, promoting pulmonary hygiene, and enhancing self-management skills. - Implementation: Administer bronchodilators, provide oxygen therapy, assist with pulmonary hygiene techniques (such as chest physiotherapy), and educate on smoking cessation and medication compliance.
  • 39. - Evaluation: Assess effectiveness of interventions, monitor respiratory status, and evaluate patient's ability to manage symptoms at home. 2. *Mrs. Reeta, 47 years old, diagnosed with Acute Renal Failure (ARF):* a) *Explain the causes of Acute Renal Failure:* ARF can be caused by various factors including acute kidney injury due to ischemia, nephrotoxic drugs, sepsis, or urinary obstruction. b) *Describe the clinical course of Acute Renal Failure:* Clinical course involves an abrupt decline in kidney function, leading to decreased urine output, electrolyte imbalances, fluid overload, and accumulation of waste products in the blood. c) *Discuss the collaborative care of a patient with Acute Renal Failure:* Collaborative care includes identifying and treating the underlying cause, managing fluid and electrolyte imbalances, providing renal replacement therapy (such as hemodialysis or continuous renal replacement therapy), and preventing complications such as uremia and metabolic acidosis. *II. Write notes on:* 1. *Unconsciousness:* - Unconsciousness refers to a state of altered consciousness where a person is not aware of their surroundings or unable to respond to stimuli. - Causes include head injury, stroke, seizures, drug overdose, or metabolic disturbances. - Management involves assessing and maintaining airway, breathing, and circulation, and identifying and treating the underlying cause. 2. *Intestinal obstruction:* - Intestinal obstruction is a blockage of the intestines that prevents the passage of food, fluids, and gas. - Causes include adhesions, hernias, tumors, and volvulus. - Symptoms include abdominal pain, distension, vomiting, and constipation.
  • 40. - Treatment depends on the cause and severity and may include bowel rest, nasogastric decompression, and surgery. 3. *Hypertension:* - Hypertension, or high blood pressure, is a chronic medical condition characterized by elevated blood pressure in the arteries. - Risk factors include obesity, sedentary lifestyle, high salt intake, and family history. - Complications include heart disease, stroke, kidney disease, and vision loss. - Management involves lifestyle modifications (diet, exercise), antihypertensive medications, and regular monitoring. 4. *Hyperthyroidism:* - Hyperthyroidism is a condition characterized by excessive production of thyroid hormones by the thyroid gland. - Symptoms include weight loss, palpitations, heat intolerance, tremors, and fatigue. - Treatment options include antithyroid medications, radioactive iodine therapy, or thyroid surgery. - Nursing care involves monitoring thyroid function, managing symptoms, and providing education on medication adherence and dietary restrictions. 5. *Nursing care of patient with above knee amputation:* - Nursing care post-amputation involves pain management, wound care, and prevention of complications such as infection and skin breakdown. - Rehabilitation includes positioning, exercises, and fitting for prosthetic devices. - Psychosocial support and education on self-care and mobility are essential for the patient's adaptation to the limb loss. *III. Short answers:* 1. *Stages of wound healing:* - Inflammatory phase - Proliferative phase
  • 41. - Remodeling phase 2. *Mention two complications of Cirrhosis of liver:* - Ascites - Hepatic encephalopathy 3. *List any four complications of Benign Prostatic Hypertrophy (BPH):* - Urinary retention - Urinary tract infections - Bladder stones - Acute urinary retention 4. *Mention the two clinical signs of Hypocalcemia:* - Chvostek's sign - Trousseau's sign 5. *Write four clinical manifestations of left-sided heart failure:* - Dyspnea - Orthopnea - Paroxysmal nocturnal dyspnea - Pulmonary crackles 6. *Mention the types of Leukemia:* - Acute lymphoblastic leukemia (ALL) - Acute myeloid leukemia (AML) - Chronic lymphoc ytic leukemia (CLL) - Chronic myeloid leukemia (CML)
  • 42. 7. *Classify Anaesthesia:* - General anesthesia - Regional anesthesia (spinal, epidural, nerve blocks) - Local anesthesia 8. *Mention two non-invasive diagnostic tests for cardiovascular disorders:* - Electrocardiogram (ECG/EKG) - Echocardiogram 9. *Mention any four chronic complications of Diabetes Mellitus:* - Diabetic neuropathy - Diabetic nephropathy - Diabetic retinopathy - Peripheral vascular disease 10. *List the types of shock:* - Hypovolemic shock - Cardiogenic shock - Distributive shock (septic, neurogenic, anaphylactic) - Obstructive shock (pulmonary embolism, cardiac tamponade) [5/12/2024 1:47 PM] : Sure, let's tackle each question: 1. *Mr. Anand:* a) *Define bronchial asthma:* Bronchial asthma is a chronic inflammatory condition of the airways characterized by reversible airflow obstruction, bronchial hyperresponsiveness, and recurrent episodes of wheezing, breathlessness, coughing, and chest tightness. b) *Clinical manifestations and medical management:* Mr. Anand may present with wheezing, dyspnea, coughing, and chest tightness. Medical management involves bronchodilators (e.g., beta-
  • 43. agonists) to relieve bronchoconstriction and anti-inflammatory agents (e.g., corticosteroids) to reduce airway inflammation. Additionally, identifying and avoiding triggers, such as allergens or irritants, is essential. c) *Nursing process and care plan:* Nursing diagnoses for Mr. Anand may include ineffective breathing pattern related to bronchial constriction, impaired gas exchange related to decreased airflow, and anxiety related to dyspnea. Nursing interventions would involve administering medications, monitoring respiratory status, providing oxygen therapy, teaching relaxation techniques, and educating the patient on self-management strategies. 2. *Mr. Mani:* a) *Define Benign prostatic hypertrophy (BPH):* BPH is a non-cancerous enlargement of the prostate gland commonly occurring in older men. It leads to urinary symptoms due to obstruction of the urethra. b) *Surgical management:* Surgical interventions for BPH include transurethral resection of the prostate (TURP), open prostatectomy, and laser therapy. These procedures aim to remove or reduce the obstructing prostate tissue. c) *Pre and postoperative nursing management:* Preoperative care involves assessing Mr. Mani's baseline urinary symptoms, optimizing his medical condition, providing education about the procedure, and obtaining informed consent. Postoperative care includes monitoring for complications such as bleeding, urinary retention, or infection, managing pain, promoting early ambulation, providing bladder training if necessary, and educating the patient on catheter care and pelvic floor exercises. *II. Write notes on:* 1. *Appendicitis:* Inflammation of the appendix, typically presenting with abdominal pain, nausea, vomiting, and fever. Requires surgical removal (appendectomy). 2. *Medical management for tuberculosis:* Involves a combination of antibiotics (e.g., isoniazid, rifampicin) for several months to eradicate the infection. 3. *Collaborative management of diabetes mellitus:* Includes lifestyle modifications (diet, exercise), pharmacological therapy (insulin, oral hypoglycemic agents), regular monitoring of blood glucose levels, and patient education. 4. *Dialysis:* Treatment for kidney failure involving the removal of waste products and excess fluid from the blood, either hemodialysis or peritoneal dialysis.
  • 44. 5. *Emergency management of patient with acute myocardial infarction:* Involves administering oxygen, aspirin, nitroglycerin, and morphine (if needed), along with reperfusion therapy (thrombolytics or percutaneous coronary intervention) to restore blood flow to the heart muscle. *III. Short answer questions:* 1. *Define congestive heart failure:* A condition where the heart's pumping ability is impaired, leading to fluid buildup in the lungs and other tissues. 2. *State the types of emphysema:* Centriacinar (centrilobular) and panacinar (panlobular) emphysema. 3. *List any four clinical manifestations of nephrotic syndrome:* Proteinuria, hypoalbuminemia, edema, hyperlipidemia. 4. *List the type of amputation:* Partial foot amputation, below-knee amputation, above-knee amputation, etc. 5. *List the types of hernia:* Inguinal, femoral, umbilical, incisional, hiatal, etc. 6. *Define psoriasis:* A chronic autoimmune skin condition characterized by red, scaly patches on the skin. 7. *Define cardio-pulmonary resuscitation:* Emergency procedure to restore cardiac and respiratory function in individuals experiencing cardiac arrest or respiratory failure. 8. *Define edema:* Abnormal accumulation of fluid in the interstitial spaces of tissues, leading to swelling. 9. *Mention any four complications of hypothyroidism:* Cardiovascular complications, myxedema coma, infertility, goiter. 10. *Purposes of traction:* To immobilize and realign fractured bones, reduce muscle spasms, and promote healing. Shall we move on to the next set of questions? [5/12/2024 1:47 PM] : Great! Let's continue: *Elaborate on:* 1. *Mr. Shanmugam:* a) *Define Diabetic ketoacidosis (DKA):* DKA is a serious complication of diabetes characterized by hyperglycemia, ketosis, and metabolic acidosis.
  • 45. b) *Pathophysiology and clinical manifestations:* DKA occurs due to insulin deficiency, leading to increased glucose production, lipolysis, and ketogenesis. Clinical manifestations include polyuria, polydipsia, nausea, vomiting, abdominal pain, fruity breath odor, and altered mental status. c) *Management of DKA for the first 48 hours:* Involves fluid resuscitation, insulin therapy, correction of electrolyte imbalances (especially potassium), and identification and treatment of precipitating factors such as infection or non-adherence to insulin therapy. 2. *Mrs. Geetha:* a) *Define Thyrotoxicosis:* Thyrotoxicosis refers to the clinical syndrome resulting from excessive thyroid hormone production. b) *Clinical manifestations of hyperthyroidism:* Include heat intolerance, weight loss, palpitations, tremors, hyperactivity, exophthalmos (in Graves' disease), and goiter. c) *Pre & postoperative management:* Preoperatively, focus on controlling hyperthyroid symptoms, optimizing thyroid function, and providing education about the procedure. Postoperatively, monitor for signs of hypothyroidism or complications such as hypocalcemia or recurrent laryngeal nerve injury, and provide supportive care. *Write Notes on:* 1. *Colostomy care:* Involves stoma care, skin protection, monitoring output, managing complications (e.g., obstruction, prolapse), and patient education. 2. *Renal calculi:* Kidney stones formed by the crystallization of minerals in the urine. Management includes pain management, hydration, dietary modifications, and sometimes surgical intervention. 3. *ECG:* Electrocardiogram, a non-invasive test used to assess the electrical activity of the heart. 4. *Rehabilitation of patient after below-knee amputation:* Focuses on mobility training, prosthetic fitting, wound care, pain management, psychological support, and education. 5. *Lumbar puncture:* Diagnostic procedure involving the insertion of a needle into the spinal canal to collect cerebrospinal fluid for analysis. *Short Answer Questions:* 1. *Four cyanotic heart diseases:* Tetralogy of Fallot, transposition of the great arteries, tricuspid atresia, total anomalous pulmonary venous connection. 2. *Two disease conditions involved in Chronic obstructive pulmonary disease:* Chronic bronchitis and emphysema.
  • 46. 3. *Two classical signs of Tetany:* Chvostek's sign (facial muscle spasm upon tapping the facial nerve) and Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff). 4. *Causative organism of typhoid and cholera:* Salmonella typhi (typhoid) and Vibrio cholerae (cholera). 5. *Two indications for dialysis:* End-stage renal disease (ESRD) and acute kidney injury (AKI). 6. *Four symptoms of osteoarthritis:* Joint pain, stiffness, swelling, and decreased range of motion. 7. *Four methods of non-pharmacological management of pain:* Heat therapy, cold therapy, massage, acupuncture. 8. *Four signs and symptoms of fracture:* Pain, swelling, deformity, loss of function. 9. *Four responsibilities of operation theatre nurse:* Preparing the operating room, assisting the surgical team, ensuring sterile technique, monitoring patient vitals. 10. *Two opportunistic infections in Acquired Immunodeficiency Syndrome (AIDS):* Pneumocystis pneumonia (PCP) and cytomegalovirus (CMV) infection. Ready for the next set? [5/12/2024 1:48 PM] : Let's proceed: *Elaborate on:* 1. *Mr. Raman:* a) *Define congestive heart failure (CHF):* CHF is a condition in which the heart is unable to pump blood effectively, leading to fluid buildup (congestion) in the lungs and other tissues. b) *Causes and pathophysiology:* Causes include coronary artery disease, hypertension, and cardiomyopathy. Pathophysiology involves impaired cardiac function, leading to decreased cardiac output and compensatory mechanisms such as neurohormonal activation and remodeling. c) *Management:* Involves medications (e.g., diuretics, ACE inhibitors), lifestyle modifications, and addressing underlying causes. Monitoring fluid intake, weight, and symptoms is crucial. 2. *Fracture of femur:* a) *Definition:* A fracture of the femur is a break or crack in the thigh bone, which is the longest and strongest bone in the human body. b) *Pathophysiology and clinical manifestations:* Fractures occur due to trauma or stress on the bone. Clinical manifestations include pain, swelling, deformity, and impaired function.
  • 47. c) *Management:* Treatment may involve immobilization with casting or splinting, surgical fixation with internal or external devices, pain management, and rehabilitation. Patient education is essential for proper healing and prevention of complications. *Write Notes on:* 1. *Bronchial asthma:* A chronic respiratory condition characterized by reversible airflow obstruction, airway inflammation, and bronchial hyperresponsiveness. Management includes medications (e.g., bronchodilators, corticosteroids), avoidance of triggers, and patient education. 2. *Renal failure:* Dysfunction of the kidneys resulting in impaired filtration and regulation of bodily fluids and electrolytes. Treatment options include dialysis and kidney transplantation. 3. *Bleeding disorder:* Conditions characterized by abnormal bleeding due to impaired clotting mechanisms. Management depends on the specific disorder and may involve medications, transfusions, and lifestyle modifications. 4. *Cushing’s syndrome:* A disorder caused by prolonged exposure to high levels of cortisol, leading to various metabolic abnormalities. Treatment involves addressing the underlying cause, such as pituitary tumors, and may include surgery, medications, or radiation therapy. 5. *Role of a nurse in blood transfusion:* Includes verifying the transfusion order, obtaining informed consent, monitoring vital signs during transfusion, and assessing for signs of transfusion reactions. *Short Answer Questions:* 1. *Define thromboangiitis obliterans:* Also known as Buerger's disease, it is a rare inflammatory condition affecting the blood vessels of the extremities, leading to ischemia and tissue damage. 2. *Types of shock:* Include hypovolemic, cardiogenic, distributive (e.g., septic shock), and obstructive shock. 3. *Two clinical manifestations of myocardial infarction:* Chest pain (angina), shortness of breath, nausea, diaphoresis, and arm or jaw pain. 4. *Define diabetic ketoacidosis:* A life-threatening complication of diabetes characterized by hyperglycemia, ketosis, metabolic acidosis, and dehydration. 5. *Classify pneumothorax:* Can be classified as spontaneous (primary or secondary), traumatic, or iatrogenic. 6. *Principles of hemodialysis:* Include diffusion, ultrafiltration, and convection, aimed at removing waste products and excess fluid from the blood. 7. *Classify anemia:* Can be classified based on morphology (e.g., microcytic, normocytic, macrocytic) or etiology (e.g., iron deficiency, hemolytic, aplastic). 8. *Types of renal calculi:* Include calcium oxalate, calcium phosphate, uric acid, and struvite stones.
  • 48. 9. *List any two immediate postoperative complications:* Include hemorrhage, infection, thrombosis, atelectasis, and ileus. 10. *Define compartment syndrome:* A serious condition characterized by increased pressure within a muscle compartment, leading to reduced blood flow and tissue ischemia. Would you like to continue with another set of questions? [5/12/2024 1:49 PM] : Great! Let's proceed: *Elaborate on:* 1. *Mr. Shanmugam:* a) *Define Diabetic ketoacidosis (DKA):* DKA is a severe complication of diabetes characterized by hyperglycemia, ketosis, metabolic acidosis, and dehydration. b) *Pathophysiology and clinical manifestations:* DKA occurs due to insulin deficiency, leading to increased lipolysis, ketogenesis, and acidosis. Clinical manifestations include polyuria, polydipsia, nausea, vomiting, abdominal pain, altered mental status, and Kussmaul breathing. c) *Management:* Initial management involves fluid resuscitation, insulin therapy, electrolyte replacement, and correction of acidosis. Close monitoring of glucose, electrolytes, and fluid balance is essential. 2. *Mrs. Geetha:* a) *Define Thyrotoxicosis:* Thyrotoxicosis refers to a state of excess thyroid hormone in the body, often caused by conditions such as hyperthyroidism or thyroiditis. b) *Clinical manifestations:* Include weight loss, heat intolerance, palpitations, tremors, anxiety, and exophthalmos (in Graves' disease). c) *Pre & postoperative management:* Preoperative management may involve anti-thyroid medications (e.g., methimazole), beta-blockers, and iodine preparations to prepare the patient for surgery. Postoperative care focuses on monitoring for signs of thyroid storm, wound healing, and thyroid hormone replacement therapy if necessary. *Write Notes on:* 1. *Colostomy care:* Involves proper stoma care, appliance application, skin protection, and patient education on diet and lifestyle modifications.
  • 49. 2. *Renal calculi:* Also known as kidney stones, they are solid masses formed in the kidneys due to crystallization of substances in the urine. Treatment options include hydration, pain management, and procedures such as lithotripsy or surgical removal. 3. *ECG (Electrocardiogram):* A diagnostic test that records the electrical activity of the heart to assess its rhythm and conduction. It helps in the diagnosis of various cardiac conditions, such as arrhythmias, myocardial infarction, and heart failure. 4. *Rehabilitation of patient after below knee amputation:* Involves physical therapy, prosthetic fitting, and psychological support to improve mobility and quality of life. 5. *Lumbar puncture:* A procedure involving the insertion of a needle into the spinal canal to collect cerebrospinal fluid for diagnostic purposes, such as in suspected meningitis or subarachnoid hemorrhage. *Short Answer Questions:* 1. *Four cyanotic heart diseases:* Include Tetralogy of Fallot, Transposition of the Great Arteries, Tricuspid Atresia, and Total Anomalous Pulmonary Venous Connection. 2. *Two disease conditions involved in Chronic obstructive pulmonary disease (COPD):* Include chronic bronchitis and emphysema. 3. *Two classical signs of Tetany:* Chvostek's sign (facial muscle spasm upon tapping the facial nerve) and Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff). 4. *Causative organism of typhoid and cholera:* Salmonella typhi (typhoid) and Vibrio cholerae (cholera). 5. *Two indications for dialysis:* End-stage renal disease (ESRD) and acute kidney injury (AKI) with electrolyte imbalances or fluid overload. 6. *Four symptoms of osteoarthritis:* Joint pain, stiffness, swelling, and decreased range of motion. 7. *Four methods of non-pharmacological management of pain:* Include heat or cold therapy, massage, acupuncture, and relaxation techniques. 8. *Four signs and symptoms of fracture:* Pain, swelling, deformity, bruising, tenderness, and impaired function. 9. *Four responsibilities of operation theatre nurse:* Include preparing the operating room, assisting the surgical team, maintaining aseptic technique, monitoring the patient's vital signs, and ensuring proper documentation. 10. *Two opportunistic infections in Acquired Immunodeficiency Syndrome (AIDS):* Include Pneumocystis pneumonia (PCP) and cytomegalovirus (CMV) retinitis. Would you like further assistance with anything else?
  • 50. [5/12/2024 1:54 PM] : Certainly! Here are the answers: ### Essay Questions: 1. *Myocardial Infarction:* a) *Definition:* Myocardial infarction (MI), commonly known as a heart attack, refers to the irreversible damage or death of heart muscle tissue due to a prolonged lack of blood supply (ischemia) to the heart. b) *Causes:* Causes of myocardial infarction include atherosclerosis (buildup of plaque in the coronary arteries), which can lead to coronary artery disease, as well as risk factors such as hypertension, high cholesterol, smoking, diabetes, obesity, and a sedentary lifestyle. c) *Postoperative Management of CABG:* Postoperative management of a patient who has undergone coronary artery bypass grafting (CABG) involves close monitoring of vital signs, pain management, wound care, administration of prescribed medications (including antiplatelets, anticoagulants, and pain relievers), monitoring for signs of complications (such as bleeding, infection, or arrhythmias), patient education on medication compliance, lifestyle modifications, and follow-up care. 2. *Cirrhosis of Liver:* a) *Definition:* Cirrhosis of the liver is a chronic and progressive condition characterized by the replacement of healthy liver tissue with scar tissue, leading to impaired liver function. b) *Pathophysiology:* Cirrhosis results from long-term liver damage caused by various factors, including chronic alcohol abuse, viral hepatitis (such as hepatitis B and C), non-alcoholic fatty liver disease (NAFLD), autoimmune hepatitis, and certain genetic disorders. The continuous injury and inflammation to the liver trigger a cascade of events leading to fibrosis and ultimately cirrhosis. c) *Nursing Care Plan:* - Assess and monitor liver function tests, including liver enzymes, bilirubin levels, and coagulation studies. - Monitor for signs of complications such as ascites, hepatic encephalopathy, and esophageal varices. - Provide education on dietary modifications (low-sodium diet), medication adherence (such as lactulose for hepatic encephalopathy), and alcohol cessation.
  • 51. - Collaborate with the healthcare team to manage symptoms, prevent complications, and promote optimal liver function through supportive care and interventions. ### Short Notes: 1. *Aneurysm:* Aneurysm refers to the abnormal ballooning or dilation of a blood vessel wall, which can occur in arteries or veins and poses a risk of rupture. 2. *Role of a Nurse in Organ Donation:* Nurses play a crucial role in organ donation by facilitating the identification of potential donors, supporting families during the donation process, coordinating organ retrieval and transplantation procedures, and providing compassionate care to donors and their families. 3. *Pathophysiology of Fever:* Fever, or pyrexia, is a complex physiological response to infection, inflammation, or other stimuli. It involves the release of pyrogens, such as cytokines, which act on the hypothalamus to raise the body's temperature set point. 4. *Raynaud’s Disease:* Raynaud's disease is a condition characterized by vasospasm of the arteries in the extremities, leading to episodes of reduced blood flow and color changes in the fingers and toes, often triggered by cold or stress. 5. *Hemodialysis:* Hemodialysis is a renal replacement therapy used to remove waste products and excess fluid from the blood in patients with kidney failure. It involves circulating the patient's blood through a dialysis machine to filter out toxins and restore electrolyte balance. 6. *Atelectasis:* Atelectasis refers to the collapse or closure of a portion of the lung, resulting in reduced gas exchange and impaired lung function, often caused by airway obstruction, lung compression, or surfactant deficiency. 7. *Bone Healing Process:* The bone healing process involves inflammation, repair, and remodeling phases. Initially, hematoma formation and inflammation occur at the fracture site, followed by the formation of soft callus and hard callus, leading to bone remodeling and eventual restoration of bone integrity. 8. *Bio-medical Waste Management:* Bio-medical waste management involves the proper handling, segregation, packaging, transportation, treatment, and disposal of waste generated in healthcare settings to prevent the spread of infection and protect public health and the environment. ### Short Answer Questions: 1. *Types of Shock:* Types of shock include hypovolemic shock, cardiogenic shock, distributive shock (such as septic shock), and obstructive shock. 2. *Phantom Pain:* Phantom pain refers to pain perceived in a body part that has been amputated, often described as shooting, stabbing, burning, or throbbing sensations.
  • 52. 3. *Renal Calculus:* Renal calculus, commonly known as a kidney stone, is a solid mass formed in the kidneys from the crystallization of substances in urine. 4. *Psoriasis:* Psoriasis is a chronic autoimmune skin condition characterized by red, scaly patches of skin due to accelerated skin cell turnover. 5. *Sterilization:* Sterilization is the process of killing or removing all microorganisms, including bacteria, viruses, and fungi, from a surface or object to prevent infection. 6. *Hypospadiasis:* Hypospadias is a congenital condition characterized by an abnormal opening of the urethra on the underside of the penis instead of at the tip. 7. *Complications of Peritonitis:* Complications of peritonitis include sepsis, septic shock, intra- abdominal abscess formation, bowel obstruction, and multiorgan failure. 8. *Emergency Drugs Used in OT:* Emergency drugs used in the operating theater (OT) include epinephrine, atropine, naloxone, dextrose, and vasopressors, among others, to manage life-threatening situations such as anaphylaxis, bradycardia, opioid overdose, hypoglycemia, and shock. 9. *Nephrotic Syndrome:* Nephrotic syndrome is a kidney disorder characterized by proteinuria, hypoalbuminemia, edema, and hyperlipidemia, often resulting from damage to the glomeruli. 10. *Hernia:* A hernia occurs when an organ or tissue protrudes through a weak spot or opening in the surrounding muscle or fascia, resulting in a visible bulge or lump. Common types include inguinal hernia, umbilical hernia, and hiatal hernia. [5/12/2024 2:02 PM] : Sure, here are the answers: ### I. Elaborate on: 1. *Mrs. Radha, 65 years old female with Myocardial Infarction:* a) *Define Myocardial Infarction:* Myocardial infarction (MI), commonly known as a heart attack, refers to the death of heart muscle cells due to prolonged lack of oxygen supply, usually caused by a blockage in one or more coronary arteries. b) *Pathophysiology & Clinical Features:* MI occurs when a coronary artery becomes blocked, leading to ischemia and subsequent necrosis of the myocardium. Clinical features include severe chest pain (angina), which may radiate to the left arm, neck, jaw, or back, along with sweating, shortness of breath, nausea, vomiting, and palpitations. c) *Nursing Care Plan for Mrs. Radha:*
  • 53. - Assess vital signs, including heart rate, blood pressure, respiratory rate, and oxygen saturation. - Administer oxygen therapy to improve oxygenation and relieve symptoms of hypoxia. - Monitor cardiac rhythm through continuous electrocardiographic (ECG) monitoring. - Administer prescribed medications promptly, such as aspirin, nitroglycerin, and morphine, to relieve pain and reduce cardiac workload. - Educate Mrs. Radha and her family about the importance of lifestyle modifications, medication adherence, and follow-up care to prevent recurrent events. 2. *Mr. Anand, 45 years old male with Hyperthyroidism:* a) *Define Thyrotoxicosis:* Thyrotoxicosis refers to the clinical state resulting from excess thyroid hormone production, leading to hypermetabolism and a range of systemic manifestations. b) *Clinical Manifestations of Hyperthyroidism:* Clinical manifestations of hyperthyroidism include weight loss, heat intolerance, sweating, palpitations, tremors, fatigue, anxiety, diarrhea, and menstrual irregularities in women. c) *Pre and Postoperative Management:* - Preoperative management involves controlling symptoms with antithyroid medications (such as methimazole or propylthiouracil), beta-blockers to control heart rate and symptoms, and iodine to reduce thyroid vascularity. - Postoperative care includes monitoring for signs of hypothyroidism, thyroid storm, or surgical complications such as bleeding, infection, or injury to the recurrent laryngeal nerve. Thyroid replacement therapy may be initiated if hypothyroidism occurs after surgery. ### II. Write notes on: 1. *Iron Deficiency Anemia:* Iron deficiency anemia is a condition characterized by low levels of hemoglobin due to inadequate iron stores, leading to microcytic, hypochromic red blood cells and symptoms such as fatigue, weakness, pallor, and shortness of breath. 2. *Lumbar Puncture:* Lumbar puncture, also known as a spinal tap, is a medical procedure used to collect cerebrospinal fluid (CSF) for diagnostic purposes or to administer medications. It involves inserting a needle into the subarachnoid space in the lower back under sterile conditions.
  • 54. 3. *Appendicitis:* Appendicitis is inflammation of the appendix, usually caused by obstruction of the appendiceal lumen by fecaliths, lymphoid hyperplasia, or tumors. It presents with periumbilical pain migrating to the right lower quadrant, anorexia, nausea, vomiting, and rebound tenderness. 4. *Duties and Responsibilities of Operation Theatre Nurse:* Operation theatre nurses are responsible for preparing the operating room, ensuring sterility, assisting surgeons during procedures, monitoring patient vital signs, managing surgical instruments and equipment, and providing postoperative care. 5. *Dental Caries:* Dental caries, commonly known as tooth decay or cavities, is a bacterial infection resulting in demineralization and destruction of tooth enamel. It is caused by acid-producing bacteria in plaque and can lead to tooth pain, sensitivity, and eventually tooth loss. ### III. Short Answer Questions: 1. *Postoperative Complications of Gastrectomy:* Complications may include anastomotic leaks, hemorrhage, wound infection, gastric stasis, dumping syndrome, nutritional deficiencies, and pneumonia. 2. *Types of Anesthesia:* Types include general anesthesia, regional anesthesia (e.g., spinal, epidural), and local anesthesia. 3. *Purposes of Traction:* Traction aims to reduce and immobilize fractures, align bones, relieve pain and muscle spasms, prevent further injury, and promote bone healing. 4. *Complications of Fracture:* Complications may include delayed union, nonunion, malunion, compartment syndrome, neurovascular injury, and deep vein thrombosis. 5. *Surgical Procedure for BPH:* Transurethral resection of the prostate (TURP) is a common surgical procedure for BPH, involving removal of excess prostate tissue using a resectoscope inserted through the urethra. 6. *Complications of Cirrhosis of Liver:* Complications include ascites, hepatic encephalopathy, variceal bleeding, hepatorenal syndrome, hepatocellular carcinoma, and spontaneous bacterial peritonitis.
  • 55. 7. *Congenital Malformations of Kidney:* Examples include renal agenesis, horseshoe kidney, polycystic kidney disease, and renal dysplasia. 8. *Types of Hernia:* Types include inguinal, femoral, umbilical, incisional, and hiatal hernias. 9. *Edema:* Edema is the abnormal accumulation of fluid in interstitial spaces, leading to swelling and tissue enlargement. 10. *Types of Emphysema:* Types include centrilobular emphysema, panlobular emphysema, and paraseptal emphysema. [5/12/2024 2:03 PM] : Sure, here are the answers: ### I. Elaborate on: 1. *Mr. Mani, 50 years old male with Diabetes Mellitus:* a) *Define Diabetes Mellitus:* Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels (hyperglycemia) due to either inadequate insulin production, insulin resistance, or both. b) *Pathophysiology & Clinical Manifestations:* Diabetes mellitus results from dysfunction in insulin production or action, leading to elevated blood glucose levels. Clinical manifestations include polyuria, polydipsia, polyphagia, weight loss, fatigue, blurred vision, slow wound healing, and recurrent infections. c) *Management Methods:* Management includes lifestyle modifications (diet, exercise), oral hypoglycemic agents or insulin therapy, regular blood glucose monitoring, weight management, and preventive measures for complications such as diabetic neuropathy, retinopathy, and nephropathy. d) *Nursing Care Plan for Mr. Mani:* - Assess blood glucose levels regularly and monitor for signs of hyperglycemia or hypoglycemia. - Educate Mr. Mani about dietary modifications, medication adherence, and the importance of regular exercise. - Encourage self-care practices such as foot care, regular eye exams, and monitoring for signs of complications.
  • 56. - Collaborate with other healthcare professionals to address any comorbidities or complications associated with diabetes. 2. *Mrs. Kala, 48 years old female with Renal Calculi:* a) *Types of Renal Calculi:* Renal calculi, or kidney stones, can be classified based on their composition into calcium oxalate, calcium phosphate, uric acid, struvite, and cystine stones. b) *Clinical Manifestations and Diagnostic Procedures:* Clinical manifestations of renal calculi include severe flank pain, hematuria, urinary urgency, dysuria, and nausea/vomiting. Diagnostic procedures include urinalysis, imaging studies (such as CT scan or ultrasound), and 24-hour urine collection for stone analysis. c) *Pre and Postoperative Nursing Care Plan:* - Preoperatively, provide pain management, encourage fluid intake, and monitor for signs of urinary tract infection or obstruction. - Postoperatively, monitor vital signs, assess for complications (such as hemorrhage or infection), administer analgesics as needed, encourage ambulation, and provide dietary counseling to prevent stone recurrence. ### II. Write notes on: 1. *Hypothyroidism:* Hypothyroidism is a condition characterized by insufficient thyroid hormone production, leading to symptoms such as fatigue, weight gain, cold intolerance, constipation, and dry skin. 2. *Colostomy Care:* Colostomy care involves maintaining the cleanliness and integrity of the colostomy site, changing the ostomy appliance regularly, monitoring for signs of infection or skin irritation, and providing patient education on self-care. 3. *Hemorrhoids:* Hemorrhoids are swollen and inflamed veins in the rectum or anus, causing symptoms such as rectal pain, itching, bleeding, and discomfort during bowel movements. 4. *Cushing’s Syndrome:* Cushing's syndrome is a disorder characterized by prolonged exposure to high levels of cortisol, resulting in symptoms such as weight gain, central obesity, moon face, buffalo hump, hypertension, and glucose intolerance.
  • 57. 5. *Aneurysm:* An aneurysm is a localized dilation or bulging of a blood vessel wall, which can occur in arteries (e.g., aortic aneurysm) or veins (e.g., cerebral aneurysm), and may lead to rupture and life- threatening bleeding. ### III. Short Answer Questions: 1. *Thrombo-Angitis Obliterans:* Thrombo-angitis obliterans, also known as Buerger's disease, is an inflammatory condition characterized by segmental thrombosis and inflammation of small and medium- sized arteries, primarily affecting the lower extremities. 2. *Phantom Pain:* Phantom pain refers to pain perceived in a body part that has been amputated, thought to result from the brain's attempt to interpret signals from nerves that were severed during amputation. 3. *Cardio Biomarkers:* Cardio biomarkers include troponin, creatine kinase-MB (CK-MB), myoglobin, and brain natriuretic peptide (BNP), which are used for diagnosing myocardial infarction, heart failure, and other cardiac conditions. 4. *Types of Jaundice:* Types include prehepatic (hemolytic), hepatic (hepatocellular), and posthepatic (obstructive) jaundice, each caused by different mechanisms of bilirubin accumulation. 5. *ERCP:* ERCP stands for Endoscopic Retrograde Cholangiopancreatography, a procedure used to diagnose and treat disorders of the bile ducts and pancreas, involving the insertion of an endoscope through the mouth into the duodenum. 6. *Complications of Peritonitis:* Complications include sepsis, intra-abdominal abscess formation, bowel obstruction, adhesion formation, and multi-organ failure. 7. *Classify Anemia:* Anemia can be classified based on the size and color of red blood cells into microcytic hypochromic (e.g., iron deficiency anemia), normocytic normochromic (e.g., anemia of chronic disease), and macrocytic normochromic (e.g., megaloblastic anemia).
  • 58. 8. *Emergency Drugs used in OT:* Emergency drugs used in operating theatres include adrenaline, atropine, epinephrine, amiodarone, and naloxone, among others, to manage cardiac arrest, anaphylaxis, arrhythmias, and opioid overdose. 9. *Immediate Postoperative Complications:* Immediate complications may include hemorrhage, hypotension, hypoxemia, pain, nausea/vomiting, urinary retention, and wound dehiscence. 10. *Classical Signs of Hypocalcemia:* Classical signs include Chvostek's sign (facial muscle spasm upon tapping the facial nerve) and Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff above systolic pressure for a few minutes). [5/12/2024 2:05 PM] : Sure, here are the answers: ### I. Elaborate on: 1. *Mr. Shyam, 56 years old with Chronic Renal Failure (CRF):* a) *Define Chronic Renal Failure:* Chronic renal failure, also known as chronic kidney disease (CKD), is a progressive loss of kidney function over time, leading to the accumulation of metabolic waste products and electrolyte imbalances in the body. b) *Pathophysiology and Clinical Manifestations:* Chronic renal failure typically develops over months to years due to conditions such as diabetes, hypertension, glomerulonephritis, or polycystic kidney disease. Clinical manifestations include fatigue, edema, hypertension, anemia, electrolyte abnormalities, and uremic symptoms like nausea, vomiting, and pruritus. c) *Nursing Management for Mr. Shyam:* - Monitor fluid and electrolyte balance, vital signs, and laboratory values (e.g., serum creatinine, potassium). - Administer medications as prescribed (e.g., phosphate binders, erythropoietin, antihypertensives). - Educate Mr. Shyam on dietary restrictions (e.g., low sodium, potassium, and phosphorus diet) and fluid intake control. - Coordinate with the healthcare team for hemodialysis or peritoneal dialysis if indicated. 2. *Bronchial Asthma:*
  • 59. a) *Definition:* Bronchial asthma is a chronic inflammatory disorder of the airways characterized by reversible airflow obstruction, bronchial hyperresponsiveness, and recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning. b) *Clinical Manifestations:* Clinical manifestations of bronchial asthma include wheezing, dyspnea, chest tightness, coughing, increased respiratory rate, and use of accessory muscles for breathing during exacerbations. c) *Medical Management:* Medical management involves the use of bronchodilators (e.g., short- acting beta-agonists, anticholinergics), inhaled corticosteroids, leukotriene modifiers, and immunomodulators (e.g., omalizumab). Management also includes patient education on trigger avoidance and the use of peak flow meters and action plans. d) *Nursing Process for Bronchial Asthma:* - Assessment: Gather information on the patient's medical history, symptoms, triggers, and medication use. - Diagnosis: Identify nursing diagnoses such as "Ineffective Airway Clearance" related to bronchial constriction and "Risk for Impaired Gas Exchange" related to decreased airflow. - Planning: Collaborate with the patient to develop goals and interventions for symptom management, trigger avoidance, and medication adherence. - Implementation: Provide patient education on proper inhaler technique, environmental modifications, and lifestyle changes. Monitor respiratory status and response to treatment. - Evaluation: Assess the effectiveness of nursing interventions in improving the patient's respiratory function and quality of life. ### II. Write notes on: 1. *Lumbar Puncture:* A procedure used to collect cerebrospinal fluid (CSF) from the subarachnoid space in the lumbar region of the spine for diagnostic purposes or to administer medications. 2. *Surgical Management of Peptic Ulcer:* Surgical options for peptic ulcer disease include vagotomy (nerve severing), antrectomy (removal of the lower part of the stomach), pyloroplasty (widening of the pylorus), and gastrectomy (partial or total removal of the stomach).