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Mobile nursing plays a crucial role in clinical trials, offering direct patient care and enhancing their experience, ultimately improving recruitment and retention. However, the uptake of mobile nursing visits isn’t always as high as we’d expect due to various factors like investigator discretion, patient preferences, and logistical challenges. Are you interested in learning how to increase the uptake of mobile nursing visits? HomeNurse4U, as a specialized provider of mobile nursing services for clinical trials, has successfully navigated these challenges. We have developed strategies that not only improve the adoption of mobile nursing visits but also foster better collaboration with clinical sites. Our whitepaper provides an in-depth analysis of how to effectively leverage mobile nursing services to enhance both uptake and trust in clinical trials.

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Male patients confined to bed usually prefer to use the urinal for voiding. The use of a urinal in the standing position facilitates emptying of the bladder If the patient is unable to stand, the urinal may be used in bed. Patients may also use a urinal in the bathroom to facilitate measurement of urinary output. Provide skin care and perineal hygiene after urinal use and maintain a professional manner EQUIPMENT Urinal with end cover (usually attached) Toilet tissue Clean gloves Additional PPE, as indicated ASSESSMENT Assess the patient’s normal elimination habits. Determine why the patient needs to use a urinal, such as a physician’s order for strict bed rest or immobilization. Assess the patient’s degree of limitation and ability to help with activity Assess for activity limitations, such as hip surgery or spinal injury, which would contraindicate certain actions by the patient. Check for the presence of drains, dressings, intravenous fluid infusion sites/equipment, traction, or any other devices that could interfere with the patient’s ability to help with the procedure or that could become dislodged. Assess the characteristics of the urine and the patient’s skin. Document the patient’s tolerance of the activity. Record the amount of urine voided on the intake and output record, if appropriate. Document any other assessments, such as unusual urine characteristics or alterations in the patient’s skin. SPECIAL CONSIDERATION Urinal should not be left in place for extended periods because pressure and irritation to the patient’s skin can result. If patient is unable to use alone or with assistance, consider other interventions, such as commode or external condom catheter. It may be necessary to assist patients who have difficulty holding the urinal in place, such as those with limited upper extremity movement or alteration in mentation, to prevent spillage of urine. The urinal may also be used standing or sitting at the bedside or in the patient’s bathroom, if patient is able to do so.

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Psoriasis is an inflammatory skin disease that is associated with multiple comorbidities and substantially diminishes patients' quality of life. Topical therapies remain the cornerstone for treating mild psoriasis. Therapeutic advancements for moderate to severe plaque psoriasis include biologics that inhibit TNF-α, p40IL-12/23, IL-17, and p19IL-23, as well as an oral phosphodiesterase 4 inhibitor.

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Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas: 1. Direct Patient Care: Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.). This includes tasks like: Monitoring vital signs and physical condition. Administering medications and treatments. Performing procedures as directed by doctors. Assisting with daily living activities (bathing, feeding). Providing emotional support and pain management. 2. Health Promotion and Education: Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare. This includes tasks like: Administering vaccinations. Providing education on nutrition, hygiene, and development. Offering breastfeeding and childbirth support. Counseling families on safety and injury prevention. 3. Collaboration and Advocacy: Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children. Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves. This includes tasks like: Communicating effectively with healthcare teams. Identifying and addressing potential risks to child welfare. Educating families about their child's condition and treatment options. 4. Professional Development and Research: Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research. Objective: Contribute to improving the quality of care for children by participating in research initiatives. This includes tasks like: Attending workshops and conferences on pediatric nursing. Participating in clinical trials related to child health. Implementing evidence-based practices into their daily routines. By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.

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Damage to the spinal cord above the sacral region causes reflex incontinence. This condition causes loss of voluntary control of urination; but the micturition reflex pathway often remains intact, allowing urination to occur without sensation of the need to void Overflow incontinence occurs when a bladder is overly full and bladder pressure exceeds sphincter pressure, resulting in involuntary leakage of urine. Causes often include head injury; spinal injury; multiple sclerosis; diabetes; trauma to the urinary system; and postanesthesia sedatives/hypnotics, tricyclics, and analgesia Hyperreflexia, a life-threatening problem affecting heart rate and blood pressure, is caused by an overly full bladder. It is usually neurogenic in nature; however, it can be caused functionally by blockage Diseases that cause irreversible damage to kidney tissue result in end-stage renal disease (ESRD). uremic syndrome- An increase in nitrogenous wastes in the blood, marked fluid and electrolyte abnormalities, nausea, vomiting, headache, coma, and convulsions characterize this syndrome. As the uremic symptoms worsen, aggressive treatment is indicated for survival Nocturia - awakening to void one or more times at night An excessive output of urine is polyuria. . A urine output that is decreased despite normal intake is called oliguria. increased urine formation (diuresis) a stoma (artificial opening) Urinary Retention. Urinary retention is an accumulation of urine resulting from an inability of the bladder to empty properly. URINE OVERFLOW- The sphincter temporarily opens to allow a small volume of urine (25 to 60 mL) to escape. With retention a patient may void small amounts of urine 2 or 3 times an hour with no real relief of discomfort or may continually dribble urine. pain or burning during urination (dysuria) as urine flows over inflamed tissues blood-tinged urine (hematuria) Urinary incontinence is the involuntary leakage of urine that is sufficient to be a problem. It can be either temporary or permanent, continuous or intermittentUrinary elimination depends on the function of the kidneys, ureters, bladder, and urethra. Kidneys remove wastes from the blood to form urine. Ureters transport urine from the kidneys to the bladder. The bladder holds urine until the urge to urinate develops. Urine leaves the body through the urethra. All organs of the urinary system must be intact and functional for successful removal of urinary wastes. Intact efferent and afferent nerves from the bladder to the spinal cord and brain must be present INTAKE AND OUTPUT OF URINE Assess the patient’s average daily fluid intake. at home, ask him or her to estimate his or her intake by showing a measurement on a commonly used glass or cup Special receptacles (urimeters) that attach between indwelling catheters and drainage bags are a convenient means of accurately measuring urine volume. A urimeter holds 100 to 200 mL of urine. After measuring urine from a urimeter, drain the cylinder

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When a patient uses a bedpan, promote comfort and normalcy and respect the patient’s privacy as much as possible. Be sure to maintain a professional manner. In addition, provide skin care and perineal hygiene after bedpan use Regular bedpans have a rounded, smooth upper end and a tapered, open lower end. The upper end fits under the patient’s buttocks toward the sacrum, with the open end toward the foot of the bed . A special bedpan called a fracture bedpan is frequently used for patients with fractures of the femur or lower spine Fracture bedpan - used for patients with fractures of the femur or lower spine. The fracture pan has a shallow, narrow upper end with a flat wide rim, and a deeper, open lower end. The upper end fits under the patient’s buttocks toward the sacrum, with the deeper, open lower end toward the foot of the bed. Ordinary Bedpan EQUIPMENTS Bedpan (regular or fracture) Toilet tissue Disposable clean gloves Additional PPE, as indicated Cover for bedpan or urinal (disposable waterproof pad or cover) ASSESSMENT Assess the patient’s normal elimination habits. Determine why the patient needs to use a bedpan (e.g., a medical order for strict bed rest or immobilization). Assess the patient’s degree of limitation and ability to help with activity. Assess for activity limitations, such as hip surgery or spinal injury, which would contraindicate certain actions by the patient. Check for the presence of drains, dressings, intravenous fluid infusion sites/equipment, traction, or any other devices that could interfere with the patient’s ability to help with the procedure or that could become dislodged. Assess the characteristics of the urine and the patient’s skin Assisting With Use of a Bedpan When the Patient Has Limited Movement Patients who are unable to lift themselves onto the bedpan or who have activity limitations that prohibit the required actions can be assisted onto the bedpan in an alternate manner using these actions

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A home-based pelvic floor muscle training and bladder training in women with urinary incontinence showed that combined pelvic floor muscle training and bladder training decreased the symptoms and improved the quality of life To strengthen your pelvic floor muscles, squeeze the muscles up to 10 times while standing, sitting or lying down. Do not hold your breath or tighten stomach, bottom or thigh muscles at the same time. When you get used to doing pelvic floor exercises, you can try holding each squeeze for one second

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CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations. Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences. The Promise: CRISPR offers exciting possibilities: Gene Therapy: Correcting genetic diseases like cystic fibrosis. Agriculture: Engineering crops resistant to pests and harsh environments. Research: Studying gene function to unlock new knowledge. The Peril: Ethical concerns demand attention: Off-target Effects: Unintended DNA edits can have unforeseen consequences. Eugenics: Misusing CRISPR for designer babies raises social and ethical questions. Equity: High costs could limit access to this potentially life-saving technology. The Path Forward: Responsible development is crucial: International Collaboration: Clear guidelines are needed for research and human trials. Public Education: Open discussions ensure informed decisions about CRISPR. Prioritize Safety and Ethics: Safety and ethical principles must be paramount. CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)

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Defecation Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool. Normal defecation is painless, resulting in passage of soft, formed stool CONSTIPATION Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces IMPACTION Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon. DIARRHEA Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration HEMORRHOIDS Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal. FLATULENCE As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus) FECAL INCONTINENCE Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY, An enema is the instillation of a solution into the rectum and sig

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From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world. With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively. The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage. Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience. See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers See the original article on Forbes here: http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b

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