This document provides information about appendicitis including:
1) The appendix is a small finger-shaped pouch located where the small and large intestines meet that is prone to obstruction and infection.
2) Appendicitis is an inflammation of the appendix that most commonly affects adolescents and young adults. It can be acute, chronic, simple, or complex depending on symptoms and complications.
3) Risk factors include age, sex, family history, infection, and obstruction. Symptoms are evaluated and diagnostic tests like blood tests, imaging, and urine tests are used to confirm appendicitis.
An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food. If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage.
Intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas.
Cholelithiasis (calculi or gallstones) usually form in the gallbladder from the solid constituents of bile and vary greatly in size, shape and composition.
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food. If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage.
Intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas.
Cholelithiasis (calculi or gallstones) usually form in the gallbladder from the solid constituents of bile and vary greatly in size, shape and composition.
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
Intestinal obstruction is a significant or mechanical blockage of intestine that occurs when food or stool can not move through the intestine.
These obstruction may be complete or partial.
Image result for ulcerative colitis
Ulcerative colitis (UL-sur-uh-tiv koe-LIE-tis) is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly.
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Ulcerative colitis (UC) is an inflammatory bowel disease. It causes irritation, inflammation, and ulcers in the lining of your large intestine (also called your colon). There's no cure, and people usually have symptoms off and on for life
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
Acid reflux occurs when the sphincter muscle at the lower end of your esophagus relaxes at the wrong time, allowing stomach acid to back up into your esophagus.
Intestinal obstruction is a significant or mechanical blockage of intestine that occurs when food or stool can not move through the intestine.
These obstruction may be complete or partial.
Image result for ulcerative colitis
Ulcerative colitis (UL-sur-uh-tiv koe-LIE-tis) is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly.
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Ulcerative colitis (UC) is an inflammatory bowel disease. It causes irritation, inflammation, and ulcers in the lining of your large intestine (also called your colon). There's no cure, and people usually have symptoms off and on for life
This PPT contains all necessary detail about cholecystitis and its management and covers all aspects of this disease according to nursing point of view. Helpful for studetns.
Acid reflux occurs when the sphincter muscle at the lower end of your esophagus relaxes at the wrong time, allowing stomach acid to back up into your esophagus.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
1. APPENDICITIS
Mrs. D. Melba Sahaya Sweety RN,RM
PhD Nursing , MSc (Pediatric Nursing), B.Sc Nursing
Associate Professor
Enam Nursing College,
Savar, Bangladesh.
2. ● The appendix is a 4 inches (8 – 10cm)long finger-shaped pouch
present at the junction of the small and large intestine. It is
normally present in the lower right abdomen.
INTRODUCTION
The appendix fills with by product of
digestion and empties regularly in to
the cecum. Because of its empties
inefficiently and its lumen is small,
the appendix is prone to obstruction
and is particularly vulnerable to
infection.
3. DFINITION
Appendicitis is an inflammation of
the appendix that develops most common in
adolescents and young adults.
( Joyce M Black)
4. TYPES OF APPENDICITIS
Types of
Appendicitis
Based on the
Onset
Acute
Appendicitis
Chronic
Appendicitis
Based on
the
Difficulties
Simple
Appendicitis
Complex
Appendicitis
5. Acute appendicitis: This condition manifests itself within a few
days to hours and necessitates immediate medical attention or
surgery.
Chronic appendicitis: Chronic appendicitis is an inflammation
that can last for a long time. . It is a rare illness.
Simple appendicitis : Complication-free cases are
called simple appendicitis.
Complex appendicitis : Appendix rupture or
abscess are common consequences in cases of
complex appendicitis.
TYPES OF APPENDICITIS
6. 01 02
04
03
ETIOLOGY
Faecal impaction and/or
a feacality : A layered
build up of calcium salts and
faecal debris around a piece
of faecal material within the
appendix
Lymphoid Hyperplasia:
The appendix contains
lymphoid (immune system)
tissue that can become
inflamed as a result of
infection or inflammatory
bowel disease (IBD)
Parasites :
Examples -
Schistosomes species,
pinworms,
Strongyloides,
stercoralis
Uncommon Causes: 1. Tumors
2. Foreign Material : A wide variety of
foreign objects can become lodged in the
appendix. Some of these include: shotgun
pellets, tongue studs, and activated
charcoal , intestinal worms, lymphadenitis
7. 1, Infection,
possibly stomach
infection that has
travelled to the
site of appendix.
2,Obstruction such
as a hard piece of
stool getting
trapped in the
appendix leading to
infection of the
appendix.
RISK FACTORS
3,Age. Appendicitis most
often affects teens and
people in their
20sTrusted Source, but it
can occur at any age.
4,Sex. Appendicitis is
more common in males
than females.
5, Family
history. People
who have a family
history of
appendicitis are at
heightened risk of
developing it.
8. Due to etiological and Risk factors
PATHOPHYSIOLOGY
Obstruction of the Appendiceal lumen
Build up of Mucous in the appendix
Increased Lumen pressure
Ulceration of the appendix mucosal lining
Decreased oxygen supply and Blood flow to the appendix
Bacterial Invasion and Proliferation Inflammation, swelling and
Appendicitis
10. CLINICAL MANIFESTATION
REBOUND TENDERNESS
(ie, production or intensification
of pain when pressure is
released) may be present.
Symptoms
ROVSING’S SIGN: The
Rovsing’s sign is positive
when pressure over the
patient’s left lower quadrant
causes pain in the right lower
quadrant.
11. CLINICAL MANIFESTATION
OBTURATOR’S SIGN : Pain on
passive internal rotation of the flexed
thigh. Examiner moves lower leg
laterally while applying resistance to
the lateral side of the knee resulting in
internal rotation of the femur.
PSOA’S SIGN: Psoas sign is right
lower-quadrant pain that is produced with
the patient extending the hip due to
inflammation of the peritoneum.
Straightening out the leg causes the pain
because it stretches the muscles.
12. CLINICAL MANIFESTATION
DUNPHY'S SIGN:
Increased pain in the right
lower quadrant with
coughing.
.
MCBURNEY’S SIGN : Mc Burney’s Point is two third
away from umbilicus to Anterior superior iliac spine
To elicit Mcburney’s sign patient should be in supine position
with his knees slightly flexed and his abdominal muscles
relaxed. Palpate deeply and slowly in the right lower quadrant
over McBurney’s point ,located about 2” from the Right
Anterior Superior Iliac Spine, On a line between the spine and
umbilicus. Pain and tenderness is a positive sign and indicates
appendicitis.
13. History Collection and Physical Examination :
Collect history regarding the signs and symptoms and
conduct physical examination to rule out the signs of
Appendicitis
DIAGNOSTIC EVALUATION
Blood test: to check for a high white blood cell count,
which may indicate an infection.
Imaging tests: An abdominal X-ray, an abdominal
ultrasound, computerized tomography (CT) scan or
magnetic resonance imaging (MRI) to help confirm
appendicitis or find other causes for pain.
Urine test: to make sure that a urinary tract infection or
a kidney stone isn't causing your pain.
14. COMPLICATION
Gangrene or perforation of the
appendix
Peritonitis ( reptured appendix
cause Peritonitis
Abscess formation or portal
pylephebitis ( which is septic thrombosis
of the portal vein caused by vegetative
emboli that arises from septic intestine.
Sepsis (Bacteria from a ruptured
appendix can get into your bloodstream)
15. MANAGEMENT
MEDICAL MANAGEMENT
To correct or prevent fluid and electrolyte imbalance, dehydration, and
sepsis,
Antibiotics and IV fluids are given until surgery is performed.
Antibiotics (Cefotaxime 250mg, 500mg • Levofloxacin 500 mg •
Metronidazole 500mg/100ml, 400 mg tablet) Analgesics can be
administered after the diagnosis is made. (Morphine sulphate 10 mg/ml)
SURGICAL MANAGEMENT
Appendectomy : most appendectomies are done
laparoscopically. Laparoscopic procedures take place with a
scope through small incisions. This minimally invasive approach
helps you heal faster, with less pain. Major abdominal surgery
(laparotomy) is done if the appendix ruptures.
16. MANAGEMENT
NURSING MANAGEMENT
Nursing management include:
Relieving pain.
Preventing fluid volume deficit.
Reducing anxiety.
Eliminating infection due to the
potential or actual disruption of the
GI tract.
Maintaining skin integrity.
Attaining optimal nutrition.
17. Pre-Operative care:
Assessment History taking physical examinations, Regarding pain, nausea
vomiting, abdominal rebound tenderness, Anorexia
Monitor vital signs B.P., Temperature for baseline data
NPO and I.V. Fluids be started
Naso-gastric aspiration
Monitor for signs of ruptured appendix and peritonitis
Position right-side lying or low to semi fowler position to promote comfort.
Auscultate Bowel Sounds
Administer antibiotics as prescribed
Preparation for surgery i.e. physically & psychologically
Alley anxiety & fears
Obtain written consent for surgery
Prepare and send the patient for surgery without delay
OT clothes and pre medications to be given 45 minutes before operation
NURSING MANAGEMENT
18. Post-Operative Nursing care:
Clear airway ,Proper breathing and adequate tissue perfusion by IVF
Naso-gastric suction to be done regularly to relieve tension on sutures
Provide safety & effective care environment to the patient
Care of all drainage tubes and Care of surgical wounds.
Watch for soakage/bleeding ,Daily A.S. dressing and watch for signs of infections
Nutritional status maintained by I.V. fluids
Observe for return of bowel sounds, and Maintaine Intake and output chart
Monitor vital signs & fluid, electrolytes balance
Encourage early ambulation to prevent post operation complications.
Maintain NPO till bowel sounds return then start clear fluids orally
Medication as per prescription (Drugs – Antibiotics, analgesic & Anticholenergies i.e.
Injection Aciloc as per prescription)
After surgery, the nurse places the patient in a semi-Fowler position this position
reduces the tension on the incision and abdominal organs, helping to reduce pain.
NURSING MANAGEMENT
19. NURSING DIAGNOSIS
Acute Pain May be related to, Distension of intestinal tissues by
inflammation or Presence of surgical incision as evidenced by report of
pain
Risk for Fluid Volume Deficit, may related to, Preoperative vomiting,
postoperative restrictions (e.g., NPO)/, Hypermetabolic state (e.g., fever,
healing process)/ Inflammation of peritoneum with sequestration of
fluid /as evidenced by dry lips, skin and sunken eyes.
Risk for Infection, may related to, Inadequate primary defenses;
perforation/rupture of the appendix; peritonitis; abscess formation,
Invasive procedures, surgical incision as evidenced by fever, tenderness,
Redness and pus formation on surgical incision.
Deficient Knowledge May be related to Lack of exposure/recall;
information misinterpretation, Unfamiliarity with information resources
as evidenced by asking questions
Anxiety related to impending surgery as manifested by facial expression.