The document discusses disorders of the parathyroid gland. It begins by describing the location and function of the parathyroid glands. It then discusses the anatomy of the parathyroid glands including their location, blood supply, lymphatics, and nerves. The document proceeds to describe hyperparathyroidism including its causes, symptoms, diagnosis, and treatment. It concludes by discussing hypoparathyroidism, its causes, signs and symptoms, and treatment options.
Hyperparathyroidism is medical condition where overactivity of one or more of the body's four parathyroid glands leads to excess of parathyroid hormone in the bloodstream.
Hyperparathyroidism is medical condition where overactivity of one or more of the body's four parathyroid glands leads to excess of parathyroid hormone in the bloodstream.
Diabetes insipidus is an uncommon disorder that causes an imbalance of fluids in the body. This imbalance makes you very thirsty even if you've had something to drink. It also leads you to produce large amounts of urine
When too much growth hormone is secreted that augments the growth of muscle, bones, and connective tissue in childhood or adolescence before the end of puberty, the condition is called Gigantism.
Hyperthyroidism (overactive thyroid) occurs when your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body's metabolism, causing unintentional weight loss and a rapid or irregular heartbeat
Hypothyroidism (underactive thyroid) is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones.
Benign prostatic hyperplasia is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue and developing upward into the bladder and obstructing the outflow of urine.
Diabetes insipidus is an uncommon disorder that causes an imbalance of fluids in the body. This imbalance makes you very thirsty even if you've had something to drink. It also leads you to produce large amounts of urine
When too much growth hormone is secreted that augments the growth of muscle, bones, and connective tissue in childhood or adolescence before the end of puberty, the condition is called Gigantism.
Hyperthyroidism (overactive thyroid) occurs when your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body's metabolism, causing unintentional weight loss and a rapid or irregular heartbeat
Hypothyroidism (underactive thyroid) is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones.
Benign prostatic hyperplasia is an enlargement of the prostate gland resulting from an increase in the number of epithelial cells and stromal tissue and developing upward into the bladder and obstructing the outflow of urine.
After the class the students will be able
Explain the structures and function of Parathyroid gland.
Explain the age affect on parathyroid gland.
Describe the definition, etiology, risk factors, pathophysiology, medical management, surgical management and Nursing management of Hyperparathyroidism.
Describe the definition, etiology, risk factors, pathophysiology, medical management, surgical management and Nursing management of Hypothyroidism.
List down the health education for Hyperparathyroidism and Hypoparathyroidism.
hyperparathyroidism with detailed discussion of primary Primary hyperparathyroidism, presentation , workup management & surgery & post operative management
Hyperparahyroidsm is an endocrinal disorder majorly affecting the parathyroid glands which secrete parathyroid hormone and calcitonin.
A condition characterised by excessive secretion of calcium in blood and Bone resorption and inanbility to metabolise calcium in blood.
This presentation is about Parathyroid Disorders which are hypo and hyperparathyroidism and their relationship to teeth and oral cavity including oral and dental manifestation of these disorders , and correct management patients seeking dental care with these disorders.
Hyperparathyroidism – causes, symptoms, diagnosis & treatmentMeghaSingh194
Hyperparathyroidism is a condition when our body produces excess calcium in blood and tissues. Your body needs calcium, but a high level of calcium is not good for our body. It has no relevance to how much calcium you consume through dairy products.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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
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
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.
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
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.
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.
2. The parathyroid glands are small endocrine glands located in the anterior neck.
They are responsible for the production of parathyroid hormone, which acts to
control calcium levels in the body.
This article will consider the anatomical location, vessels and nerves of the
parathyroid glands, as well as some clinical correlations.
3. The parathyroid glands are located on the posterior aspect of the lateral
lobes of the thyroid gland. They are flattened and oval in shape,
situated external to the gland itself, but within its sheath.
The majority of people have four parathyroid glands, although
variation in number is common. Anatomically, the glands can be
divided into two pairs:
Superior parathyroid glands – Derived embryologically from the
fourth pharyngeal pouch. They are located approximately 1cm
superior to the entry of the inferior thyroid arteries into the thyroid
gland (at level of the inferior border of the cricoid cartilage).
4. Inferior parathyroid glands – Derived embryologically from the
third pharyngeal pouch. Although inconsistent in location between
individuals, the inferior parathyroid glands are usually found near the
inferior poles of the thyroid gland. In a small percentage of people, the
glands can be found as far inferiorly as the superior mediastinum.
Vascular Supply
The posterior aspect of the thyroid gland is supplied by the inferior
thyroid arteries. Thus, its branches also supply the nearby
parathyroid glands. Collateral circulation is delivered by the superior
thyroid arteries, thyroid artery, and laryngeal, tracheal and oesophageal
arteries.
The parathyroid veins drain into the thyroid plexus of veins.
5. Lymphatics
The lymphatic vessels of the parathyroid glands drain (along
with those of the thyroid gland) into the deep cervical lymph
nodes and paratracheal lymph nodes.
Nerves
The parathyroid glands have an extensive supply of nerves,
derived from thyroid branches of the cervical (sympathetic)
ganglia.
It is important to note that these nerves are vasomotor, not
secretomotor – endocrine secretion of parathyroid hormone is
controlled hormonally.
6. HYPERPARATHYROIDSM
It is a disorder caused by overactivity of one more of
the parathyroid gland resulting in overproduction of
parathormones. Over production of parathormone is
characterized by bone decalcification and
development of renal calculi. [kidney stones]
containing calcium.
7. It occurs 2-4 times more often in women than in men
and most common in people between 60-70 years of
age.
The disorder is rare in children younger than 15 yrs. of
age but incidence increases tenfold between the ages
of 15 to 65 years.
8. There are three main types of hyperparathyroidism.
Primary hyperparathyroidism means the underlying problem starts
in the parathyroid glands. Secondary and tertiary hyperparathyroidism
means that another disease in the body has caused the parathyroid
glands to be overactive.
In secondary hyperparathyroidism, there is a signal to the gland to
produce more parathyroid hormone (for example, a low vitamin
D level).
In tertiary hyperparathyroidism, the glands continue to over-secrete
parathyroid hormone even though the signal is gone. These conditions
may be seen in kidney disease.
9. In the majority of cases the cause of hyperparathyroidism is
not known. In most people, hyperparathyroidism occurs
sporadically.
In some cases, however, there can be a genetic basis for
developing the disorder. A rare inherited syndrome called
familial multiple endocrine neoplasia type 1 is associated
with hyperparathyroidism.
In some cases, all four of the parathyroid glands are
somewhat enlarged and secrete excessive amounts of
hormones. This is referred to as hyperplasia.
10. Excessive calcium may cause high blood
pressure or hypertension. Symptoms are often
described as "moans, stones, groans, and
bones".
Moans (gastrointestinal conditions)
Constipation
Nausea and vomiting
Decreased appetite
Abdominal pain
Peptic ulcer disease
Frequent heartburn
Stones (kidney-related conditions)
Kidney stones
Groans (psychological conditions)
Confusion
Dementia
Memory loss
Depression
Personality changes
Bones (bone pain and bone-related
conditions)
Bone aches and pains
Fractures
Curving of the spine and loss of height
Flank pain
Frequent urination
11. Blood tests. calcium levels in the blood are elevated, and the blood PTH
levels are also inappropriately high for the serum calcium
X-rays of bone structures may reveal fractures and other changes in bone.
Bone mineral density test. Dual energy x-ray absorptiometry,
sometimes called a DXA or DEXA scan, uses low-dose x rays to measure bone
density
12. Computerized tomography (CT) scan.
Ultrasound.
Urine collection.
25-hydroxy-vitamin D blood test.
This test is recommended because vitamin D deficiency is common in
people with primary hyperparathyroidism.
13. Drug therapy can include medications that inhibit bone
resorption, such as bisphosphonates and oestrogen plus
progestin, or vitamin D analogues,
Thiazide, a specific type of diuretic that may be prescribed
for patients with very high calcium levels.
Physical activity, moderate vitamin D and calcium intake
should be coupled with monitoring disease progression with
tests such as serum calcium, creatinine, and bone density.
14. Surgery is indicated if the patient has very high calcium levels, or if the person
is symptomatic with renal stones, multiple fractures, or has osteoporosis or
bone rumours.
Minimally invasive parathyroidectomy. This type of surgery, which can be
done on an outpatient basis, may be used when only one of the parathyroid
glands is likely to be overactive. Guided by a tumour-imaging test, the surgeon
makes a small incision in the neck to remove the gland. The small incision
means that patients typically have less pain and a quicker recovery than with
more invasive surgery. Local or general anaesthesia may be used for this type
of surgery.
15. Standard neck exploration. This type of surgery involves a
larger incision that allows the surgeon to access and examine
all four parathyroid glands and remove the overactive ones.
This type of surgery is more extensive and typically requires a
hospital stay of 1 to 2 days. Surgeons use this approach if they
plan to inspect more than one gland. General anaesthesia is
used for this type of surgery.
16. Monitor serum potassium, calcium, phosphate and magnesium levels
because these values may change abruptly during treatment.
Encourage the patient to regular exercise, including strength training,
helps maintain strong bones. Because the patient is predispose to
pathologic fracture, take safety precautions to minimize risk of
injury. Assist the patient with walking, keep bed at its lowest position
and raise side rails. Lift immobilized patient carefully to minimize
bone stress.
Encourage the patient to drink plenty of water.
17. Drink at least six to eight glasses of water daily to lessen the
risk of kidney stones. Instruct the patient to avoid smoking.
Smoking may increase bone loss as well as increase risk of a
number of serious health problems.
Instruct the patient to avoid calcium- raising drugs
Certain medications, including some diuretics and lithium,
can raise calcium levels. Administer oestrogens to
postmenopausal women who are not able to undergo surgery.
Oestrogen may preserve bone mass and reduce calcium
levels.
18. Hypoparathyroidism is an uncommon condition in which
body secretes abnormally low levels of parathyroid hormone
(PTH). PTH is key to regulating and maintaining a balance
of body's levels of two minerals calcium and phosphorus.
The low production of PTH in hypoparathyroidism leads to
abnormally low calcium levels in blood and bones and to an
increase of phosphorus in blood.
19. Recent neck surgery, particularly if the thyroid was
involved
A family history of hypoparathyroidism
Having certain autoimmune or endocrine conditions,
such as Addison's disease — which causes adrenal
glands to produce too little of its hormones
20. Post-surgical hypoparathyroidism.
Autoimmune disease. Immune system creates antibodies
against the parathyroid tissues, trying to reject them as if
they were foreign bodies. In the process, the parathyroid
glands stop manufacturing their hormone.
Hereditary hypoparathyroidism.
Extensive cancer radiation treatment of face or neck.
Low levels of magnesium in blood.
21. Tingling or burning (paraesthesia) in fingertips, toes and lips
Muscle aches or cramps in legs, feet, abdomen or face
Twitching or spasms of muscles, particularly around mouth, but also in your
hands, arms and throat
Fatigue or weakness
Painful menstruation
Patchy hair loss
Dry, coarse skin
Brittle nails
Depression or anxiety
23. Oral calcium carbonate tablets. Oral calcium supplements can increase calcium
levels in blood. However, at high doses, calcium supplements can cause
gastrointestinal side effects, such as constipation, in some people.
Vitamin D. High doses of vitamin D, generally in the form of calcitriol, can help
body absorb calcium and eliminate phosphorus.
Parathyroid hormone (Natpara). The Food and Drug Administration has approved
this once-daily injection for treatment of low blood calcium due to
hyperparathyroidism. Because of the potential risk of bone cancer
(osteosarcoma), at least in animal studies, this drug is available only through a
restricted program to people whose calcium levels can't be controlled with
calcium and vitamin D supplements and who understand the risks.
24. Diet
Rich in calcium. This includes dairy products, green leafy vegetables,
broccoli and foods with added calcium, such as some orange juice and
breakfast cereals.
Low in phosphorus. This means avoiding carbonated soft drinks,
which contain phosphorus in the form of phosphoric acid, and limiting
meats, hard cheeses and whole grains.
Intravenous infusion
Monitoring
Blood tests, because hypoparathyroidism is usually a long-lasting
(chronic) disorder, treatment generally is lifelong, as are regular
blood tests to determine whether calcium in particular is at normal
levels. doctor will adjust dose of supplemental calcium if blood-
calcium levels rise or fall.
25. Reversible complications
Tetany.
Paraesthesia’s. These are characterized by
odd, tingling sensations or pins and needles
feelings in your lips, tongue, fingers and
toes.
Loss of consciousness with
convulsions (grand mal seizures).
Malformed teeth, affecting dental enamel
and roots.
Impaired kidney function.
Heart arrhythmias and fainting, even heart
failure.
Irreversible complications
Stunted growth (short stature)
Slow mental development in children
Calcium deposits in the brain, which can
cause balance problems and seizures
Cataracts
26. There are no specific actions to prevent hypoparathyroidism.
If had surgery involving your thyroid or neck, watch for
signs and symptoms that could indicate hypoparathyroidism,
such as a tingling or burning sensation in your fingers, toes or
lips, or muscle twitching or cramping. If they occur, doctor
might recommend prompt treatment with calcium and
vitamin D to minimize the effects of the disorder.
27. Thyroxine[t4], triiodothyronine [t3], and calcitonin
are hormones produced by the thyroid gland that
affect metabolic rate, growth and development, and
serum calcium regulation. Hyperthyroidism is the
abnormally increased production of thyroid hormones
that may be treatment with anti-thyroid drugs,
surgery, or radiation therapy.
28. ANSARI AND KAUR “A TEXT BOOK OF MEDICAL AND SURGICAL NURSING- 1ST,” PEEVEE
PUBLICATIONS, PAGE NO: 1337-1339
BONITA BOYLES” MEDICAL SURGICAL NURSING CLINICAL COMPANION” PUBLISHED BY
CAROLINAACADEMIC PRESS. PAGE NO:845-848.
BRUNNER AND SUDDARTH, “TEXT BOOK OF MEDICAL AND SURGICAL NURSING”, 12TH
EDITION, WOLTER KLUWER INDIA PRIVATE LIMITED, PAGE NUMBER:1272-1275.
LEWIS, HEITKEMPER DIRKSEN, “MEDICAL SURGICAL NURSING” 6TH EDITION, MOSBY
PUBLICATIONS, PAGE NO: 1291-1295
S.M. MOGOTLANE ET.AL “JUTAS MANUAL OF NURSING MEDICAL SURGICAL NURSING PART
2: THE SYSTEMS”, VOLUME 4 JUTA PUBLICATIONS, PAGE NO: 11-16 11-19
IGNATIVUS, WORKMAN “MEDICAL AND SURGICAL NURSING” 7TH EDITION, ELSEVIER
PUBLICATIONS, PAGE NO: 653-658
29. SWEARINGENS, “MANUAL OF MEDICAL SURGICAL NURSING” 7TH
EDITION, ELSIVER AND MOSBY PUBLICATIONS, PAGE NO:80-83
LINTON, “INTRODUCTION TO MEDICAL SURGICAL NURSING” 4TH
EDITION, ELSIVER PUBLICATIONS, PAGE NO:562-566.
USHA RAVINDRAN “TEXT BOOK OF MEDICAL SURGICAL” JAYPEE
PUBLICATIONS PAGE NO: 62-65.
LYNDA JUALL CARPENITO {2004} “NURSING CARE PLANS AND
DOCUMENTATION” 4TH EDITION PUBLISHED BY LIPPINCOTT WILLIAMS
AND WILKINS, PAGE NO: 566-568.