elimination, bowel elimination, physiology of elimination, process of bowel eliminaton factor impaired bowel, factors improve bowel elimination, alteration in bowel elimination, maintenance of bowel motility, assessment of bowel elimination, characteristics of feces, type of feces, methods for maintain the bowel elimination:- enemas, rectal suppositories and colostomies, types of colostomies, colostomy care
A health assessment is a plan of care that identifies the specific needs of a person and how those needs will be addressed by the healthcare system or skilled nursing facility. Health assessment is the evaluation of the health status by performing a physical exam after taking a health history.
A health assessment is a plan of care that identifies the specific needs of a person and how those needs will be addressed by the healthcare system or skilled nursing facility. Health assessment is the evaluation of the health status by performing a physical exam after taking a health history.
Back care consists of cleaning and massaging back (from shoulder to lower level of the buttocks) by using scientific form of required strokes for maximizing cutaneous stimulation, comfort and emotional relaxation as well.
MATERIALS AND ITS TYPES
machinary , equipments and linen using in hospitals and their care
EQUIPMENTS AND ITS TYPES
CARE OF LINEN
CARE OF RUBBER GOODS
CARE OF STAINLESS STEEL GOODS
CARE OF GLASS EQUIPMENTS
CARE OF PLASTIC ITEMS
CARE OF FURNITURE
CARE OF MACHINERY EQUIPMENTS
MAINTANENCE OF WARD INVENTORY
Back care consists of cleaning and massaging back (from shoulder to lower level of the buttocks) by using scientific form of required strokes for maximizing cutaneous stimulation, comfort and emotional relaxation as well.
MATERIALS AND ITS TYPES
machinary , equipments and linen using in hospitals and their care
EQUIPMENTS AND ITS TYPES
CARE OF LINEN
CARE OF RUBBER GOODS
CARE OF STAINLESS STEEL GOODS
CARE OF GLASS EQUIPMENTS
CARE OF PLASTIC ITEMS
CARE OF FURNITURE
CARE OF MACHINERY EQUIPMENTS
MAINTANENCE OF WARD INVENTORY
After ingesting food and fluids, our body eliminates waste products through the urinary system and the gastrointestinal system. Nurses provide care for patients with commonly occuring elimination alterations, including urinary tract infections, urinary incontinence, urinary retention, constipation, diarrhea, and bowel incontinence. This chapter will provide an overview of these alterations and the associated nursing care.
This PowerPoint presentation details out the anatomy of the human digestive system. Their are general terminologies that involves the topic but over-all this work focuses on how digestion takes place in the human body. The details coming from this presentation are combined from four different and liable sources/references including Biology (Thomson Asian Edition). I can say that this presentation is brief and well-organized so I hope this could help you in your class or seminars. Thanks.
Digestion
Digestion may be defined as physiological process by which complex food particles are broken down into simple form which are suitable for absorption and subsequent utilization.
Digestive system
Digestive system is the system which involves organs that are responsible for the process of digestion.
Gastrointestinal Tract:
The digestive system is composed of a long muscular tube – the gastrointestinal (GI) tract, or alimentary canal – and a set of accessory organs.
The Human Digestive Organs and its function making it a System.pptxALVINMARCDANCEL2
This is a comprehensive powerpoit presentation on the parts and functions of digestive system.Human digestive system, system used in the human body for the process of digestion. The human digestive system consists primarily of the digestive tract, or the series of structures and organs through which food and liquids pass during their processing into forms that can be absorbed into the bloodstream. The system also consists of the structures through which wastes pass in the process of elimination and of organs that contribute juices necessary for the digestive process.
In order to function properly, the human body requires nutrients. Some such nutrients serve as raw materials for the synthesis of cellular materials, while others help regulate chemical reactions or, upon oxidation, yield energy. Many nutrients, however, are in a form that is unsuitable for immediate use by the body; to be useful, they must undergo physical and chemical changes, which are facilitated by digestion.
MALARIA
It is an infectious disease of humans caused by parasitis protozoans belonging to the genus plasmodium.
It is endemic in most parts of India and other tropical countries.
As per WHO, malaria causes one death every minute globally and about 40,000 annual deaths in India.
The disease is transmitted by the bite of an infected female Anopheles mosquito.
Four species of protozoa plasmodium can cause malaria which are P. falciparum, P. vivax, P. ovale and P. malariae.
INTRODUCTION
These are the drugs which are used for the treatment, prophylaxis and prevention of relapses of malaria.
The treatment of malaria is available since 17 century. During those times, the bark of Cinchona tree was used in the crude form.
Later in 1820, quinine was isolated from the bark.
Since 1920, quinine and other drugs are commercially available in the market
OBJECTIVES IN USE OF ANTIMALARIAL DRUGS
The various objectives are:
To prevent clinical attack of malaria.
To treat clinical attack of malaria.
To completely eradicate the parasite from the patient’s body.
To cut down human to mosquito transmission.
THERAPEUTIC CLASSIFICATION
1. CAUSAL PROPHYLACTICS: (Destroy parasite in liver cells and prevent invasion of erythrocytes)
e.g. primaquine, pyrimethamine
2.BLOOD SCHIZONTOCIDES SUPPRESIVES (destroy parasites in the RBC and terminate clinical attacks of malaria): e.g. chloroquine, quinine, mefloquine, halofantrine, pyrimethamine
3. TISSUE SCHIZONTOCIDES used to prevent relapse: act vivax and P. ovale that produce replapses. E.g. primaquine
4. GAMETOCIDAL DRUGS: primaquine, chloroquine, quinine.
1. CHLOROQUINE
It acts as erythrocytic schizontocide against all species of plasmodia.
The parasite disappears from peripheral blood in 1-3 days. It control the clinical attacks of malaria within 1-2 days.
It doesn’t have any gametocidal activity.
It is bitter in taste, so patient should be advised ‘not to chew the tablet’ it is used for the treatment of malaria during pregnancy: no teratogenic effects have been reported.
MECHANISM OF ACTION
Its gets concentrated in the infected RBCs and then is actively taken up by the susceptible plasmodia.
The chloroquine binds to the heme and forms chloroquine heme complex.
Complex inhibits the formation of hemozoin and also damages the Plasmodium memberane
PHARMACOKINETICS
It is well absorbed orally.
50% of the drug is plasma protein bound, gets concentrated in liver, spleen, kidneys, lungs, skin and leukocytes.
The plasma half life is 3-10 days, whereas the terminal half life is 1-2 months. On prolonged use, it gets accumulated selectively in the retina and causes ocular toxicity.
It is partially metabolized in liver and slowly excreted in urine.
INDICATIONS ADVERSE EFFECTS
Clinical drug of choice for malaria.
Extraintestinal amoebiasis.
Rheumatoid arthritis
Infectious mononucleosis.
Mil
These are synthetic antimicrobial having a quinolones structure.
These are active against most of the gram negative bacteria.
In 1960s the first membered of this group, Nalidixic acid, was introduced .
Flouroquinolones have:
High potency
Expanded antimicrobial spectrum
Better tissue penetration
Good tolerability profile
Very low resistance development
1. NALIDIXIC ACID
It was the first member in quinolones. It was active against gram negative bacteria. It acts by inhibiting bacterial DNA gyrase. It is bacterial in nature.
It is given orally. It attains good concentration in gut, lumen, hence useful in diarrhea.
NALIDIXIC ACID CONTD…
It is most commonly seen in children. And causes neurological toxicity present as headache, drowsiness and vertigo and contraindicated in infants and G6PD deficient patients.
It is given in a dose of 0.5-1g TDS/QID
2. FLUOROQUINOLONES
Fluoroquinolones are quinolones antimicrobials having one or more fluorine substituitions.
The first generation fluoroquinolones have one fluoro substitution and were developed in 1980s.
The second generation fluoroquinolones have additional fluoroquinolones have additional fluoro substitution, which extended the antimicrobial activity and were developed in 1990s.
MECHANISM OF ACTION
The fluoroquinolones inhibits the enzyme DNA gyrase in Gram-negative micro-organism and topoisomerase IV in gram positive micro-organism. This lead to the bactericidal effects of fluoroquinolones.
RESISTANCE
The resistance to fluoroquinolones develops when the bacteria produce a DNA gyrase or topoisomerase IV which have reduced affinity for fluoroquinolones or the bacteria produce efflux pumps across bacterial memberane which shunt out the fluoroquinolones from the bacterial cells.
CLASSIFICATION
FIRST GENERATION FLOUROQUINOLONES :
Norfloxacin
Ofloxacin
Ciprofloxacin
Pefloxacin
SECOND GENERATION FLUOROQUINOLONES:
Levofloxacin
Moxifloxacin
Lomefloxacin
Gemifloxacin
Sparfloxacin
Prulifloxacin
PHARMACOKINETICS
These are given both by oral and intravenous route.
These have good absorption, when given empty stomach and food delays the absorption. These drugs have good tissue penetrability.
These are excreted in urine by glomerular filtration as well as tubular secretion.
INDICATIONS
Bacterial gastroenteritis
Typhoid fever
UTI
Gonorrhoea
Chancroid
Bone, Soft tissue and gynaecological infections
Respiratory infections
Tuberculosis
Gram negative septicemia and meningitis
Conjuctivitis
COMMON ADVERSE EFFECTS
GI SYSTEM: Nausea, vomiting, bad taste and anorexia
CNS: Headache, anxiety, insomnia, restlessness and impairment of concentrations.
Skin: Rash, photosensitivity
Contraindicated in pregnancy.
They should be used in caution in children as a few cases of joint pain and swelling have been reported and a risk of cartilage damage is suspended.
FIRST GENERATION FLUROQUINOLONES
SECOND GENERATION FLUROQUINOLONES
DRUG INTERACTIONS
Antacids decrease the absorption
INTRODUCTION
Sulfonamides were the first effective, synthetic antibacterial agents to be used systemically in man.
They were introduced by Domagk in 1935 and in the next few years several of them were synthesized and widely used. Currently their role in therapeutics is limited because of their toxicity, development of resistance availability of safer drugs.
CLASSIFICATION
Short acting: Sulfisoxazole, Sulfadiazine
Intermediate acting: Sulfamethoxazole
Long-acting: Sulfamethoxypyridazine, sulfadoxine
Poorly absorbed: Sulfasalazine
Topical: Sulfacetamide, mefedine
Silver sulfadiazine.
ANTIBACTERIAL SPECTRUM
It is wide spectrum antibiotic.
It inhibits many gram positive and some gram negative bacteria including streptococci, H. influenza, Norcardia, E. coli, proteus, V. cholerae, some stains of staphylococci, gonococci, memingococci and pneumococci.
They are also effective against Chlamydia, plasmodium falciparum and toxoplasma gondii.
MECHANISM OF ACTION
PABA (Para-aminobenzoic acid)
Folic acid synthesis
DIHYDROFOLIC ACID
Bacteria synthesize their own folic acid from PABA with the help of the enzyme folic acid synthetase. Sulfonamides are structurally similar to PABA and competitively inhibiting the enzymes folic acid synthetase.
They inhibit the enzyme folic acid synthase so folic acid is not synthesized (which is essential bacterial growth).
PHARMACOKINETICS
Sulfonamides are well absorbed, extensively bound to plasma proteins and are well distributed to all tissues.
They are metabolized in the liver and excreted in urine.
They can cross placental barriers.
COMMON USES
SYSTEMIC USES : sulfamethoxazole is used in combination with cotrimoxazolein many bacterial infections.
It is the drug of choice in pneumocystitis in AIDS patient.
Treatment of nocardiosis, toxoplasmosis, ulcerative colitis and rheumatoid arthritis.
TOPICAL USES: ocular sulfacetamide sodium is used in trachoma/inclusion conjuctivitis.
Topical silver sulfadiazine is used for preventing infection on burn surfaces.
Mefinide is active in the presence of pus and against pseudomonas, clostridia which are not inhibited by topical sulfonamides.
USES
Because of the development of resistance and availability of better antimicrobials, which are more effective and less toxic, these are not commonly used now except in a few cases:
UTI
NOCARDIOSIS
TOXOPLASMOSIS
TRACHOMA AND INCLUSION CONJUCTIVITIS
MALARIA
TOPICAL
ULCERATIVE COLLITIS
Contraindication & Precautions: Children younger than 2yrs, Pregnant and breast feeding mother, Renal and hepatic diseases, Hypersensitivity to sulphonamides drug.
Adverse effect: Fever, Rash, Nausea/vomiting, Aplastic Anemia.
DRUG INTERACTIONS
Sulphonamides can increasing the blood thinning effect of warfarin, possibly leading to abnormal bleeding.
Increases blood level of potassium may occur when Sulfamethoxazole trimethoprim is combined with ACE inhibitors.
Su
INTRODUCTION
Erythromycin is the first member of group, and was isolated from a strain of Streptomyces erythreus in 1952.
Rest drugs are semi-synthetic derivatives of erythromycin known as newer macrolides
Some other drugs are dirithromycin, oleandomycin and troleandomycin.
MECHANISM OF ACTION
Macrolide antibiotics are bacteriostatic agents and inhibit the protein synthesis by binding reversibly to 50s ribosomal subunit of sensitive microorganism and interfere with translocation step in the protein synthesis.
Gram positive bacteria's are 100 times more sensitive than gram negative bacteria's by these drugs.
MECHANISM OF ACTION
It is bacteriostatic at low concentration & bactericidal at high concentration
Bactericidal property depends on the concentration, organism concerned and its rate of multiplication
ANTI MICROBIAL SPECTRUM
It is narrow spectrum antibiotic. These antibiotics are more active against gram positive cocci and inactive against most of the aerobic and enteric gram negative bacilli.
In addition, Campylobacter, Legionella, Branhamella catarrhalis, G. vaginalis and Mycoplasma (which are not affected by pencillin are also highly susceptible to erythromycin)
ANTI MICROBIAL SPECTRUM
Moderately sensitive to H. influenza, B. pertussis, C. trachomatis, N. meningitidis and Rickettsiae
Ineffective against Enterobacteriaceae, other gram negative bacilli.
ERYTHROMYCIN
This drug is acid labile, given as enteric coated tablets. Poorly absorbed when given empty stomach and has poor tissue penetration.
DOSE: 250-500mg QID with half life of 1.5 hrs
Indications: a drug of choice in atypical pneumonia, whooping cough and cancroids and as an alternative to penicillin in streptococcal pharyngitis, tonsillitis, mastoiditis.
SIDE EFFECTS: Epigastric distress causing nausea, vomiting and diarrhea. Allergic reactions such as fever and skin eruption.
CLARITHROMYCIN
These drugs are acid stable, good absorption occurs when given empty stomach and has good tissue penetration.
Dose: 250-500mg BD with half life of 3-6 hrs at low dose and 3-9 hrs at high dose.
Indications: upper and lower RTI, sinusitis, otitis media, atypical pneumonia, skin infections. And H. pylori infection and first line drug in combination regimens in AIDS infection
Side effects: same as erythromycin but better gastric tolerance, reversible hearing loss at high doses.
AZYTHROMYCIN
These drugs are acid stable, good absorption occurs when given empty stomach and has good tissue penetration
Dose: 500mg OD with half life >50 hrs.
Indications: pharyngitis, tonsillitis, sinusitis, otitis media pneumonias, chronic bronchitis. In the prophylaxis and treatment of AIDS infections.
Side effects: nausea vomiting, diarrhea and abdominal pain.
ROXITHROMYCIN
These drugs are acid stable, good absorption occurs when given empty stomach and has good tissue penetration
DOSE: 150mg BD with half life of 12 hrs.
Indications: alternative to erythromycin for respiratory, skin
INTRODUCTION
Aminoglycosides are a class of antibiotics used mainly in the treatment of aerobic gram-negative bacilli infections, although they are also effective against other bacteria including Staphylococci and Mycobacterium tuberculosis.
They are often used in combination with other antibiotics.
Streptomycin – 1944
Actinomycetes – Streptomyces griseus
Bactericidal antibiotics which is interfere with protein synthesis
Used to treat aerobic Gram –ve bacteria
Exhibit ototoxicity and nephrotoxicity
MECHANISM OF ACTION
These drugs inhibit protein synthesis in the bacteria, there permeability is increased and cell contents leak out and death of cell occurs. These drugs leave bactericidal action.
CLINICAL USES
Gram –ve bacillary infection – Septicaemia, pelvic & abdominal sepsis
Bacterial endocarditis – enterococcal, streptococcal or staphylococcal infection of heart valves
Pneumonias, Tuberculosis
Tularemia
Plague, Brucellosis
Topical – Neomycin, Framycetin:- Infections of conjunctiva or external ear and also used it before surgery.
COMMON INDICATIONS OF AMINOGLYCOSIDES
Gram negative bacillary infections particularly septicemia, meningitis, UTI’s renal, pelvic and abdominal sepsis.
Bacterial endocarditis: usually gentamicin is preferred as a part of regimen.
Other infections such as tuberculosis, plague, brucellosis etc.
Topical uses: neomycin, framycetin and sisomicin are used for various topical infections.
NURSING IMPLICATIONS
The renal function should be regularly monitored.
Patients should be regularly enquired about any side effects.
Patients should be warned for not driving or operating the machinery.
Patient should be advised to take plenty of water during the course.
Monitor the sign and symptoms of hearing loss.
7-aminocephalosporanic acid has been modified by addition of different side chains to create a whole family of cephalosporin antibiotics.
these have been conventionally divided into 5 generations
Mechanism of action
All cephalosporins are bactericidal.
As penicillin it also inhibit the synthesis of bacterial cell wall and causing rapid cell lysis.
Inhibition of transpeptidation (Transpeptidase enzymes then cross-link the chains to provide strength to the cell wall and enable the bacterium to resist osmotic lysis)
Imperfect cell wall
Osmotic drive
Activation of autolysin enzymes
Lysis of bacteria
BACTERICIDAL
CLASSIFICATION
Based on
antimicrobial spectrum
Chronological sequence of development
Divided into generations.
First-generation agents
Cephalexin (O)
Cefadroxil (O)
Cefazolin (i.m, i.v)
Cefalothin (withdrawn)
Exhibit good activity against gram-positive bacteria but modest activity against gram negative organisms.
Most gram-positive cocci
Strepto,
Pneumo,
Methicillin sens. Staph. are susceptible to first-generation cephalosporins
Modest activity against E. coli, K. pneumoniae & Proteus mirabilis
Second-generation agents
Cefaclor (O)
Ceforanide
Cefuroxime (i.m , i.v)
Cefoprozil
Exhibit somewhat increased activity against gram negative organisms,
but much less active than third generation agents.
Less active against gram positive cocci & bacilli compared to first gen. drugs.
Use declined
Clinically replaced by 3rd & 4th generation drugs .
Third-generation agents
Cefotaxime
Ceftriaxone
Cefdinir
Cefibuten
Cefpodoxime
Ceftizoxime
Ceftazidime
Cefoperazone (withdrawn)
Highly augmented activity against gram-negative organisms
Less active than first generation agents against gram positive cocci & anaerobes.
All are highly resistant to β-lactamases from gram negative bacteria.
Some inhibit psuedomonas as well; ceftazidime, cefoperazone(withdrawn)
Some members of this group have enhanced ability to cross the blood-brain barrier eg. Ceftriaxone and are effective in treating meningitis caused by pneumococci, meningococci, H. influenzae and susceptible gram negative rods.
Fourth-generation agents
Cefpirome (im/iv)
Cefepime (iv)
Cefozopran (im)
Highly active against G –ve organisms
Similar to third gen drugs for g +ve bacteria
The fourth generation drugs comparable to third generation but more resistant to hydrolysis by β-lactamases.
Effective against bacterial infections resistant to earlier drugs
Fifth-generation agents
Ceftobiprole
Ceftaroline
Active against, g +ve cocci especially MRSA (Methicillin-resistant Staphylococcus aureus) It's tougher to treat than most strains of staphylococcus aureus -- or staph -- because it's resistant to some commonly used antibiotics.
penicillin resistant S. pneumoniae and enterococci
Adverse reactions
Pain after im injection
Thrombophlebitis of injected vein.
Diarrhoea more common with
oral Ceferadine
P/E Cefoperazone (Banned)
DEFINITION CHEMOTHERAPY & ANTIBIOTICS
CHEMOTHERAPY: Chemotherapy is the treatment of infections by substances which destroy or suppress bacteria and other microorganism. The substances / Agents used may natural synthetic or semi – synthetic in nature.
ANTIBIOTICS: An antibiotic is a chemical substance produced by microorganism which prevents the growth of other microorganism or kills the other microorganism. These are natural substances
CHEMOTHERAPY
It is a method of therapy of infectious disease and cancer with chemical agents – chemotherapeutic medicines
ANTIBIOTICS CLASSIFIED AS:
According to the mode of action on Bacteria:
According to the type of Bacteria:
According to the effectiveness against microorganism:
According to the mode of action on Bacteria:
Bacteriostatic: These antibiotics inhibit the growth & multiplication of Bacteria. Eg. Tetracycline, Chloramphenicol, Sulphonamides, Dapsone, Erythromycin, Clindamycin.
Bactericidal: These antibiotics destroy or kill all the Bacteria in the process of multiplication. Eg. Penicillin, Aminoglycosides, Cephalosporin, Fluoroquinolones, Rifampicin, Metronidazole etc.
According to the type of Bacteria:
Gram Positive: Some Antibiotics are effective mainly against Gram Positive Bacteria Eg. Penicillin.
Gram Negative: Some Antibiotics are effective mainly against Gram Negative Bacteria Eg. Streptomycin.
According to the effectiveness against microorganism:
Broad Spectrum: The Antibiotics which acts against wide range of microorganisms. Eg. Tetracycline.
Narrow Spectrum: These Antibiotics are useful against limited microorganisms. Eg. Erythromycin
Toxic Effects: Gastrointestinal irritation, Nausea, Vomiting and diarrhea may occur when given by mouth.
Skin sensitivity may develop with Penicillin or streptomycin causing rashes.
Serious toxic effect may occur due to streptomycin on the vestibular & auditory nerve causing vertigo & deafness
Drug Resistance: Many bacteria soon develops resistance to particular drug after a period of treatment, so that the bacteria will not respond to the same drug for example tubercle bacillus develops resistance to streptomycin quickly.
Super infection: The antibiotics given by mouth kill the normal bacteria inhibiting the alimentary canal and permits the over growth of other insensitive organisms which can cause serious complications. Eg. Fungus cause thrush which may go to the lungs with fatal results.
Hypersensitivity Reaction: Chemotherapeutic agents can cause Hypersensitivity reactions from mild rashes to serve anaphylactic shock. Eg. Penicillin & Sulphonamides.
Vitamin Deficiency: Alteration in vitamin formation and absorption from the bowel take place . So there is deficiency of Vitamin B complex and Vitamin K.
Anemia: In susceptible persons chloramphenicol may produce Aplastic anemia or agranulocytosis. (Action must be taken through proper history about previous drug reaction before administering penicillin sulphonamide and cephalosporin
definition of hydronephrosis,
causes and types of hydronephrosis
pathophysiology of hydronephrosis
clinical manifestation and diagnostic test for hydronephrosis
management
BIOGRAPHY OF FAYE GLENN ABDELLAH, AS AN EDUCATOR AND RESEARCHER, INFLUENCED FAYE ANDELLAH IN THE DEVELOPMENT HER OWN MODEL OF
NURSING, ABDELLAH’S TYPOLOGY OF 21 NURSING PROBLEMS, ASSUMPTION, CONCEPT, STEPS TO IDENTIFY THE CLIENT’S PROBLEM, 11 NURSING SKILLS, USE OF 21 PROBLEMS IN THE NURSING PROCESS AND LIMITATIONS
Nursing assessment and assessment of eyeNEHA BHARTI
examination of eye, Examination by ophthalmoscope,
assessment of the functions of eye, . PUPILLARY RESPONSE, FUNCTIONAL EXAMINATION, test for Focusing power, confrontation test, Colour sense test and visual acuity testing procedure etc
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
3. ELIMINATION
Elimination is the complete removal or destruction
of something.
OR
The expulsion of waste from body is known as
elimination
4.
5. DEFINITION BOWEL
ELIMINATION
It is also known as defecation. Bowel elimination
is a natural process critical to human functioning
in which body excretes waste products of
digestion. It is a essential component of the
healthy body functioning.
OR
Defecation (bowel elimination) is the act of
expelling feces (stool) from the body. To do so, all
structures of the gastrointestinal tract, especially
the components of the large intestine must
function in a coordinated manner
6. Review of Physiology of Bowel
Elimination
GI tract also known as alimentary canal. It is a hollow
muscular tube that extend from the mouth to the anus.
Food is broken down in the stomach in to a semiliquid
mass called chyme.
Chyme leaves the stomach and enter in to the small
intestine which is divided in to three part i.e Duodenum
(10 inches long. Receive bile and pancreatic enzyme),
Jejunum (it mixes with digestive enzyme and most
nutrients are absorbed) and ileum (unabsorbed chyme
enters in to the intestine through ileum).
7. CONT…
Through large intestine and colon chyme
expel out from the body through anus.
8.
9.
10.
11. Peristalsis means the rhythmic contractions
of intestinal smooth muscle that facilitate
defecation (movement of bowel).
Peristalsis moves fiber, water, and nutritional
wastes along the ascending, transverse,
descending, and sigmoid colon toward the
rectum.
Peristalsis becomes even more active during
eating..
21. ELIMINATION PATTERNS
Because various elimination patterns can be
normal, it is essential to determine the client's
usual patterns, including characterstics,
frequency of elimination, effort required to
expel stool, and what elimination aids, if any,
he or she uses.
25. There are five common alteration
in bowel elimination:-
1. CONSTIPATION
2. FECAL
IMPACTION
3. FLATULENCE
4. DIARRHEA 5. FECAL
INCONTINENCE
26. 1. CONSTIPATION
Constipation is an elimination problem
characterized by dry, hard stool that is difficult to
pass. Various accompanying signs and symptoms
include the following:
Complaints of abdominal fullness or bloating
Abdominal distention
27. CONT…
Complaints of rectal fullness or pressure
Pain on defecation
Decreased frequency of bowel movements
Inability to pass stool
Changes in stool characteristics such as hard
small stool
28.
29. Constipation is classified into one
of four distinct types
Primary
Secondary
Iatrogenic and
Pseudoconstipation
30. 1.PRIMARY OR SIMPLE
CONSTIPATION
Primary or simple constipation is well within the
treatment domain of nurses. It results from
lifestyle factors such as inactivity, inadequate
intake of fiber, insufficient fluid intake, or
ignoring the urge to defecate
32. 3.IATROGENIC CONSTIPATION
Iatrogenic constipation occurs as a
consequence of other medical treatment. For
example, prolonged use of narcotic analgesia
tends to cause constipation.
These and other drugs slow peristalsis, delaying
transit time. The longer the stool remains in the
colon, the drier it becomes, making it more
difficult to pass.
34. 2. FECAL IMPACTION
Hardened stool that is stuck in the rectum
or lower colon due to chronic
constipation. It occurs in that people
who’ve been constipated for a long time.
35.
36. 3. FLATULENCE
Flatulence or flatus (excessive accumulation of
intestinal gas) results from swallowing air while
eating.
37. 4. DIARRHEA
Diarrhea is the urgent passage of watery
stool and commonly is accompanied by
abdominal cramping. Simple diarrhea usually
begins suddenly and lasts for a short period.
Usually diarrhea is a means of eliminating an
irritating substance such as tainted food or
intestinal pathogens.
38.
39. 5. FECAL INCONTINENCE
Fecal incontinence is the inability to control
the elimination of stool.
40.
41. 1.HEALTH HISTORY
Elimination habits:-
Determine patient’s usual pattern of bowel
elimination.
Determine the frequency and time
Find out the characteristics of the stool like
stool is watery, soft, hard and typical color.
42.
43. 2. PHYSICAL EXAMINATION
Mental status examination:- It can be evaluated by
listening to the client’s responses to questions and
by observing interaction with others
Mobility & Dexterity:- Mobility may be evaluated by
observing the client undress or move onto a table,
chair or bed. Dexterity assessed by observing the
client remove clothing; particular attention paid to
the manipulation of zippers, buttons, shoestrings
and snaps.
44. CONT…
Inspection:- Rectal examination are
particularly important for both men and
women. The cheeks of the buttocks should be
pulled apart and the anus & surrounding area
visually inspected.
The client may asked to bear down and anus
inspected for prolapse gapping, indicating
significant weakness of anal sphincters.
45. 3. DIAGNOSTIC TEST
Defecography:- X-rays images of rectum and anal
sphincter obtained during defecation
.
Anorectal ultrasonography:- It is vital accepted
popular imaging motility for evaluating lower
rectum, inner sphincter and pelvic floor in patient
with various anorectal disease
Colonoscopy:- It is used to visualization of the
colon
53. Avoid alcohol and smoking because alcohol
irritates the intestine and bowel, causing
inflammation. This effect causes increased
elimination of fluid into the stool, resulting
diarrhea.
Smoking stimulates the bowel through the
action of nicotine caused increased bowel
tone and motility result is diarrhea.
59. There are three methods:-
1. ENEMAS
2. RECTAL SUPPOSITORIES
3. COLOSTOMIES
60. 1. ENEMA
DEFINITION OF ENEMA:-
A procedure in which liquid or gas is injected
in to the rectum, to expel its contents or to
introduce drugs like Anti- helminthic.
OR
An enema is the injection of fluid into the
lower bowel by way of the rectum.
61. USES OF EMENA
To relieve constipation.
For bowel cleansing before a medical.
examination or procedure.
To administer drugs.
To relieve the gaseous distension of abdomen
63. 1. EVACUANT ENEMA
It is designed to prompt the bowel to expel
faecal matter or flatus, together with the
contents of the enema.
64. Evacuant enema is classified into three
parts:-
1. SIMPLE EVACUANT ENEMA
2. MEDICATED EVACUANT ENEMA
3. COLD EVACUANT ENEMA
65. 1. SIMPLE EVACUANT ENEMA
It is used to remove fecal martial and gaseous
distension. It is also used to clean the bowel and
rectum before investigations, surgeries and
childbirth.
Solution:- Soap water or normal saline are used
Quantity:-
For adult:- 500-1000ml solution is used.
For children:- 250-500ml solution is used
For infant:- <250ml is used.
66. 2. MEDICATED EVACUANT ENEMA
It is used to administration of medication
through the rectum. It is classified into five
parts:-
1. Oil enema
2. Astringent enema
3. Purgative enema
4. Anti- helminthic enema
5. Carminative enema
67. Contd…
1. Oil enema:- it is used to soften the feces
and relief the constipation.
2. Astringent enema:- it is used to reduce
inflammation, bleeding and mucus discharge
in colon eg:- Dysentery. 2% silver nitrate with
tannic acid and alum solution must be used
in this enema
68. Contd…
3. Purgative enema:- It helps to improve
peristalsis to empty the bowel.
Solution:- Glycerin, castor oil and water
4. Antihelminthic enema:- It is used to kill
intestinal parasitic worms.
Solution:- Soap water and hypertonic saline
solution
69. Contd…
5. Carminative enema:- It is also known as
antispasmodic anema, it is used to remove the
gaseous accumulation in abdomen.
Solution:- Milk, asafetida in soap water and
turpentine.
70. 3. COLD EVACUANT ENEMA
It is used to reduce the body temperature during
high fever.
71. 2. RETAINED ENEMA
It means injecting a solution into the rectum
specially in sigmoid colon and holding for a
specific period of time.
72. Retained enema is classified
into five parts:-
Stimulant Sedative Emollient
Anesthetic Nutrient
73. S.NO. TYPES OF
RETAINED
ENEMA
USES SOLUTION
1. STIMULANT
ENEMA
Shock, Collapse And Some
Poisoning Cases
Black coffee/ Brandy -300ml
with water and tea spoon of
coffee powder
2. SEDATIVE
ENEMA
Induce Sleep Or Sedation Paraldehyde and Potassium
Bromide
3. EMOLLIENT
ENEMA
Soften a hardened fecal
mass
Oil based fluid- 250 ml
4. ANESTHETIC
ENEMA
Produce anesthetic effect in
patient
Avertin- 150 to 300mg/kg
5. NUTRIENT
ENEMA
Administration of intent of
nutrition when normal
eating is not possible
74. ARTICLES USED IN ENEMA
Catheter size according to patient need
Lubricant
Selected solution
Left lateral position
75. 2. RECTAL SUPPOSITORIES
It is a solid dosage that is inserted into the rectum,
where it dissolved or melts and exerts local or systemic
effect.
The effect usually results in a bowel movement with in
15-60 minutes.
Glycerin belongs to a class of drugs known as
hyperosonate laxatives. It is used to relief constipation
and hemorrhoids.
76.
77. 3. COLOSTOMIES
A colostomy is a surgical procedure in which an
opening (stoma) is formed by drawing the
healthy end of the large intestine or colon
through an incision in the anterior abdominal
wall.
78. During this procedure, one end of the colon is
diverted throgh an incision in the abdominal
wall to create a stoma. A stoma is the opening
in the skin where a pouch for collecting feces I
attached.
87. PROVIDING PERISTOMAL CARE
Preventing skin breakdown is a major
challenge in ostomy care. Enzymes in stool
can quickly cause excoriation (chemical
injury of skin).
Washing the stoma and surrounding skin with
mild soap and water and patting it dry can
preserve skin integrity.