Craniotomy
A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated.
During open brain surgery, it is done to remove tumors, clip off an aneurysm, drain blood or fluid from an infection & remove abnormal brain tissue
Decompressive craniectomy
It is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure.
Increased intracranial pressure is defined as cerebrospinal fluid pressure greater than 15 mm Hg.
Infections
Tumors
Stroke
Aneurysm
Epilepsy
Seizures
Hydrocephalus
Hypertensive brain injury
Hypoxemia
Meningitis
Due to etiological factors
Components of ICP is disturbed- brain tissue, CSF, blood volume
An increase in the volume of ANY ONE component must be accompanied by a reciprocal decrease in one of the other components.
When this volume-pressure relationship becomes unbalanced, ICP increases.
Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin.
When your cells don't get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are chemicals that the body creates when it breaks down fat to use for energy. The body does this when it doesn’t have enough insulin to use glucose, the body’s normal source of energy. When ketones build up in the blood, they make it more acidic.
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
Craniotomy
A craniotomy involves making an incision in the scalp and creating a hole known as a bone flap in the skull. The hole and incision are made near the area of the brain being treated.
During open brain surgery, it is done to remove tumors, clip off an aneurysm, drain blood or fluid from an infection & remove abnormal brain tissue
Decompressive craniectomy
It is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury, stroke and other conditions associated with raised intracranial pressure.
Increased intracranial pressure is defined as cerebrospinal fluid pressure greater than 15 mm Hg.
Infections
Tumors
Stroke
Aneurysm
Epilepsy
Seizures
Hydrocephalus
Hypertensive brain injury
Hypoxemia
Meningitis
Due to etiological factors
Components of ICP is disturbed- brain tissue, CSF, blood volume
An increase in the volume of ANY ONE component must be accompanied by a reciprocal decrease in one of the other components.
When this volume-pressure relationship becomes unbalanced, ICP increases.
Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin.
When your cells don't get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are chemicals that the body creates when it breaks down fat to use for energy. The body does this when it doesn’t have enough insulin to use glucose, the body’s normal source of energy. When ketones build up in the blood, they make it more acidic.
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
Hyperglycemia is the specialized term for high blood (glucose). High glucose happens when the body has too little insulin or when the body can't utilize insulin appropriately.
Hyperglycemia is a condition where the measure of flowing glucose (or sugar) in the circulation system is higher than ordinary. At the point when nourishment enters the stomach related framework, it is separated into glucose and enters the circulation system. This triggers a procedure that causes the pancreas to discharge insulin. Insulin is a hormone discharged by the pancreas that helps maneuver glucose into the cells of the body, where it is changed over into fuel and vitality.
Iowa State University's College of Veterinary Medicine student Taylor Morrison presents a case of Diabetic Ketoacidosis in a feline patient as seen at Iowa Veterinary Specialties.
DKA is a life-threatening condition that develops when cells in the body are unable to get the glucose they need for energy because deficiency of the insulin.
Without enough insulin, the body begins to break down fat as fuel.
This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
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.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
2. OVERVIEW
Diabetic ketoacidosis is a serious complication of diabetes
that occurs when your body produces high levels of blood
acids called ketones.
The condition develops when your body can't produce
enough insulin.
Insulin normally plays a key role in helping sugar (glucose)
— a major source of energy for your muscles and other
tissues — enter your cells. Without enough insulin, your
body begins to break down fat as fuel.
This process produces a buildup of acids in the bloodstream
called ketones, eventually leading to diabetic ketoacidosis if
untreated
3.
4.
5. SIGHNS AND SYMPTOMS
Diabetic ketoacidosis signs and symptoms often develop
quickly, sometimes within 24 hours. For some, these signs and
symptoms may be the first indication of having diabetes. You
may notice:
Excessive thirst
Frequent urination
Nausea and vomiting
Abdominal pain
Weakness or fatigue
Shortness of breath
Fruity-scented breath
Confusion
6. More-specific signs of diabetic ketoacidosis —
which can be detected through home blood and
urine testing kits — include:
High blood sugar level (hyperglycemia)
High ketone levels in your urine
7.
8. When to see a doctor
• If you feel ill or stressed or you've had a recent illness or
injury, check your blood sugar level often. You might also
try an over-the-counter urine ketones testing kit.
Contact your doctor immediately if:
• You're vomiting and unable to tolerate food or liquid
• Your blood sugar level is higher than your target range
and doesn't respond to home treatment
• Your urine ketone level is moderate or high
9. PATHOPHYSIOLOGY
Diabetic ketoacidosis (DKA) is a complex disordered
metabolic state characterized by hyperglycemia,
ketoacidosis, and ketonuria.
DKA occurs as a consequence of absolute or relative
insulin deficiency that is accompanied by an increase in
counter-regulatory hormones (ie, glucagon, cortisol,
growth hormone, epinephrine).
The hormonal imbalance enhances hepatic
gluconeogenesis, glycogenolysis, and lipolysis.
10. Hepatic gluconeogenesis, glycogenolysis secondary to
insulin deficiency, and counter-regulatory hormone excess
result in severe hyperglycemia
Lipolysis increases serum free fatty acids.
Hepatic metabolism of free fatty acids as an alternative
energy source (ketogenesis) results in accumulation of
acidic intermediate and end metabolites (ketones).
Ketones include acetone, beta-hydroxybutyrate, and
acetoacetate.
11.
12. Seek emergency care if:
• Your blood sugar level is consistently higher than 300
milligrams per deciliter (mg/dL), or 16.7 millimoles per liter
(mmol/L)
• You have ketones in your urine and can't reach your doctor for
advice
• You have multiple signs and symptoms of diabetic ketoacidosis
— excessive thirst, frequent urination, nausea and vomiting,
abdominal pain, shortness of breath, fruity-scented breath,
confusion
• Remember, untreated diabetic ketoacidosis can be fatal.
13. RISK FACTORS
The risk of diabetic ketoacidosis is highest if
you:
• Have type 1 diabetes
• Frequently miss insulin doses
• Uncommonly, diabetic ketoacidosis can occur if
you have type 2 diabetes.
• In some cases, diabetic ketoacidosis may be
the first sign that a person has diabetes.
14. DIAGNOSIS
If your doctor suspects diabetic ketoacidosis, he or
she will do a physical exam and various blood tests.
In some cases, additional tests may be needed to
help determine what triggered the diabetic
ketoacidosis.
15. Blood sugar level.
If there isn't enough insulin in your body to allow sugar to
enter your cells, your blood sugar level will rise
(hyperglycemia). As your body breaks down fat and protein for
energy, your blood sugar level will continue to rise.
Ketone level.
When your body breaks down fat and protein for energy, acids
known as ketones enter your bloodstream.
Blood acidity.
If you have excess ketones in your blood, your blood will
become acidic (acidosis). This can alter the normal function of
organs throughout your body.
16. Additional tests
Your doctor may order tests to identify underlying health
problems that might have contributed to diabetic
ketoacidosis and to check for complications. Tests might
include:
Blood electrolyte tests
Urinalysis
Chest X-ray
A recording of the electrical activity of the heart
(electrocardiogram)
17.
18. COMPLICATIONS
Diabetic ketoacidosis is treated with fluids,
electrolytes — such as sodium, potassium and
chloride — and insulin. Perhaps surprisingly, the
most common complications of diabetic
ketoacidosis are related to this lifesaving
treatment.
19. TREATMENT COMPLICATIONS INCLUDE
Low blood sugar (hypoglycemia).
Insulin allows sugar to enter your cells, causing your
blood sugar level to drop. If your blood sugar level drops too
quickly, you can develop low blood sugar.
Low potassium (hypokalemia).
The fluids and insulin used to treat diabetic ketoacidosis
can cause your potassium level to drop too low. A low
potassium level can impair the activities of your heart,
muscles and nerves.
20. Swelling in the brain (cerebral edema).
Adjusting your blood sugar level too quickly can produce
swelling in your brain. This complication appears to be
more common in children, especially those with newly
diagnosed diabetes.
Left untreated, the risks are much greater. Diabetic
ketoacidosis can lead to loss of consciousness and,
eventually, it can be fatal.
21. TREATMENT
If you're diagnosed with diabetic ketoacidosis, you might be
treated in the emergency room or admitted to the hospital.
Treatment usually involves:
Fluid replacement.
You'll receive fluids — either by mouth or through a vein
(intravenously) — until you're rehydrated. The fluids will
replace those you've lost through excessive urination, as
well as help dilute the excess sugar in your blood
22. Electrolyte replacement.
Electrolytes are minerals in your blood that carry an
electric charge, such as sodium, potassium and chloride.
The absence of insulin can lower the level of several
electrolytes in your blood. You'll receive electrolytes
through a vein to help keep your heart, muscles and nerve
cells functioning normally.
23. Insulin therapy.
Insulin reverses the processes that cause diabetic
ketoacidosis. In addition to fluids and electrolytes, you'll
receive insulin therapy — usually through a vein.
When your blood sugar level falls below 240 mg/dL
(13.3 mmol/L) and your blood is no longer acidic, you may
be able to stop intravenous insulin therapy and resume
your normal insulin therapy.
24. PREVENTION
There's much you can do to prevent diabetic ketoacidosis and other
diabetes complications.
Commit to managing your diabetes.
Make healthy eating and physical activity part of your daily
routine. Take oral diabetes medications or insulin as directed.
Monitor your blood sugar level.
You might need to check and record your blood sugar level
at least three to four times a day — more often if you're ill or
under stress. Careful monitoring is the only way to make sure
your blood sugar level remains within your target range.
25. Adjust your insulin dosage as needed.
Talk to your doctor or diabetes educator about how to
adjust your insulin dosage in relation to your blood sugar
level, what you eat, how active you are, whether you're ill
and other factors. If your blood sugar level begins to rise,
follow your diabetes treatment plan to return your blood
sugar level to your target range.
26. Check your ketone level.
When you're ill or under stress, test your urine for excess
ketones with an over-the-counter urine ketones test kit. If
your ketone level is moderate or high, contact your doctor
right away or seek emergency care. If you have low levels of
ketones, you may need to take more insulin.
Be prepared to act quickly.
If you suspect that you have diabetic ketoacidosis — your
blood sugar level is high, and you have excess ketones in
your urine — seek emergency care.
27. Diabetes complications are scary.
But don't let fear keep you from taking good care of
yourself. Follow your diabetes treatment plan
carefully, and ask your diabetes treatment team for
help when you need it.
28. DIABETIC KETOACIDOSIS NURSING CARE PLANS
The nursing care plan for clients with Diabetic
Ketoacidosis includes provision of information
about disease process/prognosis, self-care, and
treatment needs, monitoring and assistance of
cardiovascular, pulmonary, renal, and central
nervous system (CNS) function, avoiding
dehydration, and correcting hyperglycemia and
hyperglycemia complications.
29. Here are four (4) nursing care plans (NCP) for Diabetic
Ketoacidosis and Hyperglycemic Hyperosmolar
Nonketotic Syndrome:
1. Risk For Fluid Volume Deficit
2. Risk For Infection
3. Deficient Knowledge
4. Imbalanced Nutrition: Less Than Body Requirements
30. 1. Risk For Fluid Volume Deficit
Assess precipitating factors such as other illnesses,
new-onset diabetes, or poor compliance with
treatment regimen. .
Assess skin turgor, mucous membranes, and thirst.
Monitor hourly intake and output.
Monitor vital signs:
Assess neurological status every two (2) hours.
Weigh client daily.
Monitor laboratory.
31. Monitor ABG for metabolic acidosis.
Insert indwelling urinary catheter as indicated.
.
Administer fluid as indicated
Administer IV potassium and other electrolytes as
indicated.
Administer bicarbonate as indicated.
Administer an IV bolus dose of regular insulin,
followed by a continuous infusion of regular
insulin.
32. 2. Risk For Infection
Assess for signs of infection and inflammation.
Observe client’s feet for ulcers, infected toenails, or
other medical problems. Due to impaired
circulation in diabetes, foot injuries are predisposed
to poor wound healing.
Observe aseptic technique during IV insertion and
medication administration.
Provide skin care. .
Encourage proper handwashing technique.
Encourage adequate oral fluid intake (2-3 liters a
day unless contraindicated).
Encourage deep breathing exercise;
Administer antibiotics as indicated.
33. 3. Imbalanced Nutrition: Less Than Body
Requirements
Determine client’s dietary program and usual pattern.
Monitor weight daily or as indicated.
Auscultation bowel sounds, note the presence of abdominal
pain/abdominal bloating, nausea or vomiting.
Maintain on NPO status, as indicated.
Involve patients in planning family as indicated.
Recognize signs of hypoglycemia.
34. Monitor laboratory studies (Serum glucose, pH, HCO3,
acetone).
Perform fingerstick glucose testing. .
Administer glucose solution, e.g., dextrose and half
normal saline.
Administer regular insulin by intermittent or continuous
IV method.
Collaborate with a dietician for initiation of resumption of
oral inta
Provide a diet consisting of 60% Carbohydrates, 20%
fats, 20% proteins in designated number of meals.
Administer medication as prescribed to control nausea
and vomiting.
35. 4.Deficient Knowledge
Establish rapport and trust.
Explain the signs and symptoms of diabetic ketoacidosis
Discuss the following with the client:
• Normal blood glucose level.
• Risk factors.
• Client’s type of diabetes.
• The relationship between elevated glucose level and insulin
deficiency.
Baseline knowledge enables the client to make informed
lifestyle choices.
36. Demonstrate proper blood glucose testing using the
glucometer. Instruct client to check the urine for ketones
once blood glucose reaches 250 mg/dL or higher.
Teach signs of hypoglycemia:
• Dizziness.
• Sweating.
• Hunger.
• Pallor.
• Diaphoresis.
• Nervousness.
• Tremors.
These are signs of excessive insulin dosage, resulting in
hypoglycemia.
37. Teach client that polyuria, polydipsia, and polyphagia are
signs of hyperglycemia which requires increased dosage
of insulin.
Explain the importance of having a dietary plan:
• Limit intake of simple sugar, fat, salt and alcohol.
• Increase intake of whole grains, fruits, and vegetables.
Medical nutrition therapy is important in managing
diabetes and preventing the rate of development of
diabetes complications.
38. A high-fiber diet can slow the absorption of glucose, decreased
excess insulin levels and lowered lipid concentrations in clients
with type 2 diabetes.
Teach client to monitor blood glucose during periods of
exercise and adjust insulin dose.
Advise the client the importance of daily examination of the
feet and foot care.
Advise the client the importance of routine eye examination..
Review of medication regimen, including, onset, peak, and
duration of prescribed insulin, as applicable with the client.
Discuss timing of insulin injection and mealtime.
Discuss the use of a medical alert bracelet.
Stress the importance of strict follow-up care.
: Isotonic solution (0.9% NaCl). Initial goal of therapy is to correct circulatory fluid volume deficit. Isotonic normal saline will rapidly expand extracellular fluid volume without causing a rapid fall in plasma osmolality. Clients typically need 2 to 3 liters within the first 2 hours of treatment.
Administer succeeding IV therapy: Hypotonic solution such as 0.45% normal saline. Continuation of IV administration depends on the degree of fluid deficit, urinary output, and serum electrolyte values.
Add dextrose to IV fluid when serum blood glucose level is less than 250 mg/dL in DKA or less than 300 mg/dL
Potaasium is added to the IV once serum potassium drops below 5.5 mEq/L to prevent hypokalemia. The administration of insulin to lower blood glucose promotes the movement of potassium intracellularly.
Regular insulin has a rapid onset and therefore immediately helps move glucose intracellularly. IV route is the initial route because subcutaneous injection of insulin may be absorbed unpredictably. While a continuous infusion is an optimal way to consistently administer insulin to prevent hypoglycemia