Cardiomyopathy is a disease that weakens and enlarges the heart muscle, making it difficult for the heart to pump blood. There are several types including dilated cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathy. Symptoms include shortness of breath, fatigue, chest pain, and leg swelling. Diagnosis involves echocardiogram, ECG, blood tests, and cardiac catheterization. Treatment focuses on medications to improve heart function, device implantation like pacemakers, and potentially transplantation for severe cases. Nursing care emphasizes rest, diet, medication management, and health education.
Cardiomyopathy is a group of disease that affect the heart muscle. Early on there may be few or no symptoms. As the disease worsens, shortness of breath, feeling tired, and swelling of legs may occur, due to the onset of heart failure. An irregular heart beat and fainting may occur.
Cardiomyopathy is a disease of the heart muscles that makes it harder for your heart to pump blood to the rest of your body. Cardiomyopathy can lead to heart failure.
According to the structural and functional abnormalities of the heart muscle
Dilated cardiomyopathy
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy
Unclassified cardiomyopathy
Cardiomyopathy, or heart muscle disease, is a type of progressive heart disease in which the heart is abnormally enlarged, thickened, and/or stiffened. As a result, the heart muscle's ability to pump blood is less efficient, often causing heart failure and the backup of blood into the lungs or rest of the body. The disease can also cause abnormal heart rhythms.
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Ischemic heart disease is a condition of recurring chest pain or discomfort that occurs when a part of the heart does not receive enough blood. This condition occurs most often during exertion or excitement, when the heart requires greater blood flow.
Cardiomyopathy is a group of disease that affect the heart muscle. Early on there may be few or no symptoms. As the disease worsens, shortness of breath, feeling tired, and swelling of legs may occur, due to the onset of heart failure. An irregular heart beat and fainting may occur.
Cardiomyopathy is a disease of the heart muscles that makes it harder for your heart to pump blood to the rest of your body. Cardiomyopathy can lead to heart failure.
According to the structural and functional abnormalities of the heart muscle
Dilated cardiomyopathy
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy
Arrhythmogenic right ventricular cardiomyopathy
Unclassified cardiomyopathy
Cardiomyopathy, or heart muscle disease, is a type of progressive heart disease in which the heart is abnormally enlarged, thickened, and/or stiffened. As a result, the heart muscle's ability to pump blood is less efficient, often causing heart failure and the backup of blood into the lungs or rest of the body. The disease can also cause abnormal heart rhythms.
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Ischemic heart disease is a condition of recurring chest pain or discomfort that occurs when a part of the heart does not receive enough blood. This condition occurs most often during exertion or excitement, when the heart requires greater blood flow.
Myocardial infraction or Heart attack are terms used anonymously, but the preferred term is MI.
In an MI an area of the myocardium is permanently destroyed.
MI is usually caused by reduced or decreased blood flow in a coronary artery due to rupture of an atherosclerotic plaque and subsequent occlusion of the artery by a thrombus.
Myocardial infarction (MI) death of the cells of an area of the heart muscle (myocardium) as a result of oxygen deprivation, which in turn is caused by obstruction of the blood supply; commonly referred to as a “heart attack.”
MI refers to the processes by which myocardial tissue is destroyed in regions of the heart that are deprived of an adequate blood supply because of reduced coronary artery blood flow.
Eighty percent to 90% of all acute MI are secondary to thrombus formation. When thrombus develops , perfusion to the myocardium distal to the occlusion is halted, resulting in necrosis.The myocardium receives its blood supply from the two large coronary arteries and their branches.
Occlusion of one or more of these blood vessels (coronary occlusion) is one of the major causes of myocardial infarction.
The occlusion may result from the formation of a clot that develops suddenly when an athermanous plaque ruptures through the sub layers of a blood vessel, or when the narrow, roughened inner lining of a scleroses artery leads to complete thrombosis.
The acute MI process takes time. Cardiac cells can withstand in ischemic conditions for approximately 20 minutes before cellular death begins.
The earliest tissue to become ischemic is the sub endocardium (the innermost layer of tissue in the cardiac muscle)
If ischemia persists, it takes approximately 4 to 6 hours for the entire thickness if the heart muscle to become necrosis.
Myocardial infraction or Heart attack are terms used anonymously, but the preferred term is MI.
In an MI an area of the myocardium is permanently destroyed.
MI is usually caused by reduced or decreased blood flow in a coronary artery due to rupture of an atherosclerotic plaque and subsequent occlusion of the artery by a thrombus.
Myocardial infarction (MI) death of the cells of an area of the heart muscle (myocardium) as a result of oxygen deprivation, which in turn is caused by obstruction of the blood supply; commonly referred to as a “heart attack.”
MI refers to the processes by which myocardial tissue is destroyed in regions of the heart that are deprived of an adequate blood supply because of reduced coronary artery blood flow.
Eighty percent to 90% of all acute MI are secondary to thrombus formation. When thrombus develops , perfusion to the myocardium distal to the occlusion is halted, resulting in necrosis.The myocardium receives its blood supply from the two large coronary arteries and their branches.
Occlusion of one or more of these blood vessels (coronary occlusion) is one of the major causes of myocardial infarction.
The occlusion may result from the formation of a clot that develops suddenly when an athermanous plaque ruptures through the sub layers of a blood vessel, or when the narrow, roughened inner lining of a scleroses artery leads to complete thrombosis.
The acute MI process takes time. Cardiac cells can withstand in ischemic conditions for approximately 20 minutes before cellular death begins.
The earliest tissue to become ischemic is the sub endocardium (the innermost layer of tissue in the cardiac muscle)
If ischemia persists, it takes approximately 4 to 6 hours for the entire thickness if the heart muscle to become necrosis.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
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!
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Cardiomyopathy ppt
1. KAHER INSTITUTE OF NURSING SCIENCES,
BELAGAVI
CARDIOMYOPATHY
Presented By:
Ms. Tincy Thomas
Msc (N)-1
2. INTRODUCTION:
Cardiovascular system includes heart and blood
vessels.
Heart is a hollow muscular organ situated in the
middle mediastinum i.e. between the lungs.
Heart is placed behind the body of the sternum and
adjoining parts of the costal cartilages so that 1/3 of the
heart lies to the right and 2/3 of the heart lies to the left
of the medial plane.
3. It has four chambers Right Atrium,
Right Ventricle, Right Ventricle, Left ventricle.
It measures about 12x9 cm, weights
300gm in males and in 250gm females.
Layers of the heart are Pericardium,
Myocardium and Endocardium.
4. CARDIOMYOPATHY:
Cardiomyopathy is a group of disease that directly
affect the myocardial structure of function.
It is a heart muscle disease.
5. It is the weakening of the heart muscles or associated
with other problems with the heart muscle.
It may be associated with heart failure, endocarditis or
other heart problems which alter the normal
architecture of heart.
Most of the patients with cardiomyopathy
have heart failure.
8. PRIMARY CMP:
It refers to those conditions in which the etiology of the
disease is idiopathic.
The heart muscle is only involved in this case.
Other structures of the heart are unaffected.
9. SECONDARY CMP:
The cause of secondary cardiomyopathy is known and
secondary due to any other disease conditions.
Common causes are Dilated cardiomyopathy or
restrictive or hypertrophic cardiomyopathy.
12. DILATED CARDIOMYOPATHY (DCM):
It is the most common type of CMP and has a genetic
link of 30%.
Incidence is 5-8 cases per 100,000 people per year.
Dilated cardiomyopathy is a condition in which heart
becomes weak and the chambers get large as a result
the heart cannot pump enough blood out to the body.
The heart with dilated cardiomyopathy is striking in
appearance.
13. Dilated CMP is characterized by a diffuse
inflammation and rapid degeneration of the heart fibers.
This results in ventricular dilation, impaired systolic function,
atrial enlargement and stasis of blood in the left ventricle.
DCM is distinguished by significant dilation of the ventricles
without simultaneous hypertrophy and systolic dysfunction.
20. HYPERTROPHIC CMP (HCM):
It is the condition in which the heart muscle becomes
thick.
This disease is a genetically inherited disease and
affects younger people (Mean age 26).
HCM is a rare autosomal dominant condition
occurring in men, women, children with an estimated
prevalence rate of 0.05% -0.2%.
21. It is asymmetric left ventricular hypertrophy without
ventricular dilation.
The classic anatomic feature is the profound
hypertrophy of the myocardium of the left ventricle.
Hypertrophic CMP can be idiopathic, about half of all
cases have a genetic basis characterized by
inappropriate myocardial hypertrophy.
22.
23. CHARACTERISTICS:
Massive ventricular Hypertrophy
Rapid, forceful concentration of the left ventricle
Impaired relaxation
Obstruction to aortic outflow.
25. DIAGNOSTIC STUDIES:
History Collection
On Palpation- Apical impulses can be exaggerated and
displaced to the left.
Auscultation – S4 and systolic murmur between the
apex & sternal border at the 4 th Intercostals space.
ECG- Ventricular Hypertrophy, ST-T wave
abnormalities, prominent Q waves in the precordial or
inferior leads ,ventricular & atrial dysrhythmias.
27. MANAGEMENT:
Beta Blockers- (Eg: Metoprolol)
Ca channel blockers- (Eg: Verampil)
Digitalis- to treat atrial fibrillation.
Antidysrhythmic drugs- Aminodarone
Cardioverter defibrillator.
AV pacing is helping for patients with hypertrophic CMP.
28. SURGICAL MANAGEMENT:
Ventriculomytomy
Myectomy
Percutaneous Transluminal Septal Myocardial
Ablation (PTSMA)- This procedure consists of
injecting alcohol into the septal artery branching of the
left anterior descending artery. This causes ischemia
and septal wall infraction. Ablation of the septal wall
decreases the obstruction to flow and patients
symptoms decrease.
29. NURSING MANAGEMENT:
Avoid strenuous activity and Dehydration
Rest and elevation of the feet to improve venous return
to the heart can manage chest pain.
Vasodilators such as nitroglycerine should be avoided
because it may worsen the chest pain by decreasing
venous return and increasing obstruction of blood flow
from the heart.
30. RESTRICTIVE CMP:
R CMP is the least common type.
It is characterized by diastolic dysfunction caused by
rigid ventricular walls that impair diastolic fillings and
ventricular stetch.
It can be either idiopathic or can be caused by disease
that deposit abnormal substances within the
myocardium.
31. Systolic function will be normal.
Myocardial fibrosis, hypertrophy and infiltration procedure
stiffness of the ventricular wall with loss of ventricular
compliance.
Secondary causes of Restrictive CMP include amyloidosis,
endocardial fibrosis, sarcoidosis, fibrosis of different
etiology and radiation to the thorax.
With Restrictive CMP the ventricles are resistant to filling
and therefore demand high diastolic filling pressures to
maintain CO.
35. DIAGNOSTIC EVALUATION:
Chest X ray may show cardiomegaly from right and left
atrial enlargement, pulmonary congestion and pleural
effusion.
ECG may be reveal mild tachycardia.
Dysrhythmias are supraventricular or AV block.
Echocardiography may reveal left ventricle that is
normal size with a thickened wall, slightly dilated right
ventricle and dilated atria.
36. Endomyocardial biopsy
CT Scan or MRI Scan shows normal thickness of
pericardium.
Nuclear Imaging
37. ARRHYTHMOGENIC RIGHT VENTRICULAR
CARDIOMYOPATHY:
ARVC occurs when myocardium of the right ventricle
is progressively infiltrated and replaced by fibrous scar
and adipose tissue.
Localized areas of the right ventricle are affected but as
the disease progresses the entire heart is affected.
Eventually right ventricle dilates and develops poor
contractility right ventricular wall abnormalities and
dysrhythmias.
38. The prevalence of ARVC is unknown because many
cases are not recognized.
Palpitations or syncope may develop between 15 and 40
years of age.
ARVC should be suspected in patients with ventricular
tachycardia originating in the right ventricle or sudden
death especially among previously symptom-free
athletes.
First degree blood relatives should be screened for the
disease with a 12 Lead ECG, Holter monitor and
Echocardiography.
39.
40. UNCLASSIFIED CARDIOMYOPATHIES:
Unclassified cardiomyopathies are different from or
have characteristics of more than one of the previously
described types.
Examples of unclassified cardiomyopathies include
fibroelastosis, non compacted myocardium, systolic
dysfunction with minimal dilation and mitochondrial
involvement.
41. CLINICAL MANIFESTATIONS OF CMP:
Breathlessness with exertion or even at rest.
Swelling of the legs, ankles and feets.
Bloating of the abdomen due to the fluid buildup.
Fatigue
Irregular heart beats that feels rapid, pounding or
fluttering.
43. DIAGNOSTIC EVALUATION:
History Collection
Physical examination may reveal enlarged spleen and heart
size with atrophy.
Blood culture and sensitivity.
Chest X-ray
CBC
CT Scan of the chest
Echocardiogram
ECG
44. TREATMENT:
When possible the cause of cardiomyopathy is treated.
Medicines and lifestyle changes are often needed to
treat the symptoms of heart failure, angina and
abnormal heart rhythms.
Defibrillator sends an electrical impulses to stop life
threatening abnormal heart rhythms.
45. CABG surgery or angioplasty can improve blood flow
to the damaged or weakened heart muscle.
Transplantation of heart when all the treatments are
failed.
46. MANAGEMENT:
Angiotensin converting enzyme Inhibitors to improve
your hearts pumping capability such as enalapril,
lisinopril, ramipril and captopril.
Angiotensin receptor blockers for those who cannot
take ACE inhibitors such as losartan and valsartan.
Beta blockers to improve heart function such as
carvedilol and metoprolol.
47. Digoxin or digitalis to increase the strength of your
heart muscle contractions. It also tends to slow the
heart beat and reduces heart failure symptoms.
Diuretics such as bumetanide and furosemide. These
drugs decreases fluid in the lungs and breath more
easily.
Spironolactone (diuretic) is helpful in treating scarring
of the heart tissue.
48. SURGICAL MANAGEMENT:
SEPTAL MYECTOMY:
This is an open heart surgery in which the surgeon
removes part of the thickened overgrown heart muscle
wall that separates the two bottom heart chambers.
Removing the part of this overgrown muscles improves
blood flow and reduces mitral regurgitation. Myectomy
is used if medications do not relieve symptoms.
49. SEPTALABLATION:
Also called as septal alcohol ablation this is a
treatment in which a small portion of the thickened
heart muscle is destroyed by injecting alcohol through
a catheter into the artery supplying blood to it.
Possible complication of this procedure are heart block,
disruption of the heart electrical system which requires
implantation of pacemaker.
50. PACEMAKER IMPLANTATION:
A pacemaker is a small electronic device inserted under
the skin which sends electrical signals to your heart to
monitor and regulate your heart beat. Surgery to
implant pacemaker is performed under local anesthesia
and takes less than 3 hours.
51. IMPLANATBLE CARDIOVERTER DEFIBRILLATOR:
It is a device implanted in the chest like a pacemaker. An
ICD continuously monitors heart beat. If a life threatening
arrhythmia occurs ICD delivers precisely calibrated
electrical shocks to restore normal rhythm.
52. HEART TRANSPLANTATION:
The patients with severe cardiomyopathy and
medications cannot control your symptoms, heart
transplant may be an option.
53. VENTRICULAR ASSIST DEVICE:
Mechanical heart assist device can help critically ill
people as they wait for an appropriately matched donor.
These devices known as ventricular assist device
(VAD). It can help the blood to circulate through your
heart for months or even years.
54. NURSING MANAGEMENT:
Bed rest is important because it reduces myocardial
oxygen demand and usually continues until the
following criteria are meet:
Temperature remains normal without the use of
salicylates.
Resting pulse rate remains less than 100 beats/min.
ECG tracings show no manifestations of myocardial
damage.
55. Obtain a clear description of the pain or discomfort.
Administer analgesics as needed and use salicylates.
Balance rest and activity according to the degree of
pain and activity tolerance.
Provide psychological support while patient is confined
to hospital with restrictive intravenous therapy.
If patient received surgical treatment provide post
surgical care and instruction.
56. A high protein, high carbohydrate diet helps to
maintain adequate nutrition in the presence of fever
and infection.
Take care of teeth and gums obtain prompt dental care
for cavities and gingivitis.
57. NURSING DIAGNOSIS:
Acute pain related to an impaired ability of blood
vessels to supply oxygen to the tissues.
Activity intolerance related to compromised oxygen
transport system secondary to the heart muscle
dysfunction.
Risk for ineffective breathing pattern related to
decreased respiratory depth secondary to pain.
58. REFERENCES:
Lewis textbook of medical- Surgical Nursing Volume- I Elsevier
Publication 3 rd South Asia Edition Page no: 750-755.
Brunner & Suddarth’s Textbook of Medical Surgical Nursing
Volume- I Eleventh Edition Page no: 925-932.
P Hariprasanth Textbook of Cardiovascular & Thoracic Nursing
Jaypee Publications Page no: 212-215.
Deepak Sethi & Capt Kirti Rani Textbook of Medical Surgical
Nursing I&II Page no: 27-31.