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Certificate of Overdoes Training-Peyman ADL DOUSTI HAGH

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Module Title: Building Friendships and Community This document highlights some of the most important parts of your completed module. Summary People with disabilities have experienced abuse, discrimination, and worse. Often they find they are deprived of ordinary opportunities to be part of community life and to form friendships. However, the people we support can make great citizens and form wonderful friendships and loving partnerships. Assumptions About Community and Friendships We often make assumptions and develop our own ideas about what is best and what community and friendships should mean for the people we support. In some instances we have been so keen to run away from anything that resembled the institution and segregation that we neglected to think about or ask what people with

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The United Nations is failing its obligation to protect Iranians from crime against humanity. It is the mandate of the United Nations with the Responsibility to Protect (R2P or RtoP). It is a global political commitment that was endorsed by all member states of the United Nations at the 2005 World Summit to address its four key concerns to prevent genocide, war crimes, ethnic cleansing and crimes against humanity. It is according to the United Nations "138. Each state has the responsibility to protect its populations from genocide, war crimes, ethnic cleansing, and crimes against humanity. This responsibility entails the prevention of such crimes, including their incitement, through appropriate and necessary means. We accept that responsibility and will act in accordance with it. The international community should as appropriate, encourage and help States to exercise this responsibility and support the United Nations in establishing an early warning capability."1

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Catheterization of the bladder involves introducing a latex or plastic tube through the urethra and into the bladder. The catheter provides a continuous flow of urine in patients unable to control micturition or those with obstructions. It also provides a means of assessing urine output in hemodynamically unstable patients. Because bladder catheterization carries the risk of UTI, blockage, and trauma to the urethra, it is preferable to rely on other measures for either specimen collection or management of incontinence. Types of Catheterization. Intermittent and indwelling retention catheterizations are the two forms of catheter insertion INTERMITTENT CATHETERIZATION introduce a straight single-use catheter long enough to drain the bladder (5 to 10 minutes When the bladder is empty, you immediately withdraw the catheter. COMPLICATION- increases risk of trauma and infection. INDICATION- It is common for people with spinal cord injury or other neurological problems such as multiple sclerosis to perform self– intermittent catheterization up to every 4 hours daily for months or years. UTI rate is lower than for patients with long-term indwelling catheters. INDWELLING CATHETERIZATION- remains in place for a longer period, until a patient is able to void voluntarily or continuous accurate urine measurements are no longer needed The straight single-use catheter has a single lumen with a small opening about 1.3 cm ( 1 2 inch) from the tip. . Urine drains from the tip, through the lumen, and to a receptacle. An indwelling Foley catheter has a small inflatable balloon that encircles the catheter just above the tip. When inflated the balloon rests against the bladder outlet to anchor the catheter in place. The indwelling retention catheter often has two or three lumens within the body of the catheter . One lumen drains urine through the catheter to a collecting tube. A second lumen carries sterile water to and from the balloon when it is inflated or deflated. A third (optional) lumen is sometimes used to instill fluids or medications into the bladder. It is easy to determine the number of lumens by the number of drainage and injection ports at the end of the catheter A second type of intermittent catheter has a curved tip A Coudé catheter is used on male patients who may have enlarged prostates that partly obstruct the urethra. It is less traumatic during insertion because it is stiffer and easier to control than the straight-tip catheter Plastic catheters are suitable only for intermittent use because of their inflexibility Latex catheters are recommended for use up to 3 weeks. Be aware of allergies. Pure silicon or Teflon catheters are best suited for long-term use (2 to 3 months) because of less encrustation at the urethral meatus Balloon sizes range from 3 mL (pediatric) to large postoperative volumes (75 mL). In adults the 5-mL and 30-mL sizes are the most common: The 5-mL size allows for optimal drainage, whereas the 30-mL size is used after pros

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