The five stages, denial, anger, bargaining, depression and acceptance are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief.
The five stages, denial, anger, bargaining, depression and acceptance are a part of the framework that makes up our learning to live with the one we lost. They are tools to help us frame and identify what we may be feeling. But they are not stops on some linear timeline in grief.
this topic is about sleep, stages of sleep, types of sleep, factors influencing sleep, sleep disorders and their management and various interventions to promote sleep
Care of terminally ill patient full chapter fundamental of nursing pinkijat
Care of terminally ill patient,include concept of loss,grief , grieving,types of losses,type of grief,factors influencing loss and grief ,stage of grief and losses(DABDA) ,sign of clinical death,care of dying patient , palliative and hospice care, advance directive,legal documents related to advance directive,and after death care in fundamental of nursing full chapter.
this topic is about sleep, stages of sleep, types of sleep, factors influencing sleep, sleep disorders and their management and various interventions to promote sleep
Care of terminally ill patient full chapter fundamental of nursing pinkijat
Care of terminally ill patient,include concept of loss,grief , grieving,types of losses,type of grief,factors influencing loss and grief ,stage of grief and losses(DABDA) ,sign of clinical death,care of dying patient , palliative and hospice care, advance directive,legal documents related to advance directive,and after death care in fundamental of nursing full chapter.
fon Unit xv-care of terminally ill patientAtul Yadav
Unit:xv-Care of terminally ill patient
It contain ---
1.Concepts of Loss, Grief, Grieving process
2. Signs of clinical death
3. Care of dying patient
4. Special considerations
5. Advance Directive
6. Euthanasia ,willdying declaration,organ donation etc.
7.Medico-legal issues
8. Care of dead body
9.Equipment, procedure and care of unit
10. Autopsy
11.Embalming
Aging, Death, and Bereavement in behavioral sciences
Old Age
stage of ego integrity versus despair
person either has satisfaction and pride of life accomplishments
Or feels that His/Her was wasted her.
Stages of grief
Five stages:
Denial
Anger
Bargaining
Depression
Acceptance
Bipolar disorder is a mental health condition that can cause you to experience episodes of extreme highs and extreme lows. These episodes are called mania and depression.
A phobia is an excessive and irrational fear reaction. If you have a phobia, you may experience a deep sense of dread or panic when you encounter the source of your fear. The fear can be of a certain place, situation, or object. Unlike general anxiety disorders, a phobia is usually connected to something specific
Eating disorders ( Anorexia nervosa and Bulimia nervosa)kalyan kumar
Eating disorders are a range of psychological conditions that cause unhealthy eating habits to develop. They might start with an obsession with food, body weight, or body shape.
In severe cases, eating disorders can cause serious health consequences and may even result in death if left untreated.
Electroconvulsive therapy (ECT) is a treatment for certain mental illnesses. During this therapy, electrical currents are sent through the brain to induce a seizure.
The procedure has been shown to help people with clinical depression. It’s most often used to treat people who don’t respond to medication.
A sample is a subset of individuals from a larger population. Sampling means selecting the group that you will actually collect data from in your research.
The blood that flows through the fetus is actually more complicated than after the baby is born (normal heart). This is because the mother (the placenta) is doing the work that the baby’s lungs will do after birth.
The placenta accepts the blood without oxygen from the fetus through blood vessels that leave the fetus through the umbilical cord (umbilical arteries, there are two of them). When blood goes through the placenta it picks up oxygen. The oxygen rich blood then returns to the fetus via the third vessel in the umbilical cord (umbilical vein). The oxygen rich blood that enters the fetus passes through the fetal liver and enters the right side of the heart.
The oxygen rich blood goes through one of the two extra connections in the fetal heart that will close after the baby is born.
The hole between the top two heart chambers (right and left atrium) is called a patent foramen ovale (PFO). This hole allows the oxygen rich blood to go from the right atrium to left atrium and then to the left ventricle and out the aorta. As a result the blood with the most oxygen gets to the brain.
Blood coming back from the fetus’s body also enters the right atrium, but the fetus is able to send this oxygen poor blood from the right atrium to the right ventricle (the chamber that normally pumps blood to the lungs). Most of the blood that leaves the right ventricle in the fetus bypasses the lungs through the second of the two extra fetal connections known as the ductus arteriosus.
The ductus arteriosus sends the oxygen poor blood to the organs in the lower half of the fetal body. This also allows for the oxygen poor blood to leave the fetus through the umbilical arteries and get back to the placenta to pick up oxygen.
Schizophrenia is a chronic psychiatric disorder. People with this disorder experience distortions of reality, often experiencing delusions or hallucinations.
The exact cause of schizophrenia isn't known, but a combination of genetics, environment and altered brain chemistry and structure may play a role.
Schizophrenia is characterised by thoughts or experiences that seem out of touch with reality, disorganised speech or behaviour and decreased participation in daily activities. Difficulty with concentration and memory may also be present.
Treatment is usually lifelong and often involves a combination of medications, psychotherapy and coordinated speciality care services.
Nephrotic syndrome happens when damage to your kidneys causes these organs to release too much protein into your urine.
Nephrotic syndrome isn’t itself a disease. Diseases that damage blood vessels in your kidneys cause this syndrome.
Nephrotic syndrome is characterized by the following:
A high amount of protein present in the urine (proteinuria)
high cholesterol and triglyceride levels in the blood (hyperlipidemia)
Low levels of a protein called albumin in the blood (hypoalbuminemia)
Swelling (edema), particularly in your ankles and feet, and around your eyes.
Endometrial cancer is a type of uterine cancer that starts in the inner lining of the uterus. This lining is called the endometrium.
According to the National Cancer Institute, approximately 3 in 100 women will be diagnosed with uterine cancer at some point in their lives. More than 80 percent of people with uterine cancer survive for five years or longer after receiving the diagnosis.
If you have endometrial cancer, early diagnosis and treatment increases your chances of remission.
Bladder cancer occurs in the tissues of the bladder, which is the organ in the body that holds urine. According to the National Institutes of Health, approximately 45,000 men and 17,000 women per year are diagnosed with the disease.
Buerger’s disease, also called thromboangiitis obliterans, is an inflammation of small- and medium-sized blood vessels. Although any artery can be affected, it usually presents with blockages of the arteries to the feet and hands, leading to pain and tissue damage.
The disease is found worldwide and can affect people of any race and age group. However, it mainly affects Asian and Middle Eastern men between the ages of 40 and 45 who heavily use, or have heavily used, tobacco products, including chewing tobacco.
There isn’t a cure for Buerger’s disease. However, the single-most important factor in improving symptoms and preventing its progression is quitting smoking.
In rare cases, the pain may be so severe that a surgical procedure called a sympathectomy may be performed to eliminate the pain.
A pacemaker is an electrically charged medical device. Your surgeon implants it under your skin to help manage irregular heartbeats called arrhythmias.
Modern pacemakers have two parts. One part, called the pulse generator, contains the battery and the electronics that control your heartbeat. The other part is one or more leads to send electrical signals to your heart. Leads are small wires that run from the pulse generator to your heart.
Pacemakers generally treat two types of arrhythmias:
Tachycardia, a heartbeat that’s too fast
Bradycardia, a heartbeat that’s too slow.
Before receiving a pacemaker, you’ll need several tests. These tests can ensure that a pacemaker is the right choice for you.
An echocardiogram uses sound waves to measure the size and thickness of your heart muscle.
For an electrocardiogram, a nurse or doctor places sensors on your skin that measure your heart’s electrical signals.
For Holter monitoring, you wear a device that tracks your heart rhythm for 24 hours.
A stress test monitors your heart rate while you exercise.
Psychosocial aspects (Cancer patients has to cope with a variety of stressors)kalyan kumar
A diagnosis of cancer begins a long journey that can affect physical health, mental well-being, and relationships with loved ones. While getting treatment for the physical aspects of cancer, patients should not neglect the emotional issues associated with cancer. One of the best things patients can do to improve their quality of life is to learn more about their cancer. This can make the disease seem less mysterious and frightening. Information from your doctor and other credible sources can be very helpful in this respect.
Nursing Care plan ( History collection format )kalyan kumar
The care plan is a written document (either electronic or paper-based) that is used and altered constantly throughout the day. It’s based on a ‘template’ which defines the areas the care plan covers. Some templates are very simple and focus on the essentials of care – nutrition, mobility, sleeping, positioning, oral care and personal hygiene, for instance – while others can be very detailed and might include sections on issues like falls prevention, psychological needs, recording of clinical signs, communication and information.
Sutures are used by your doctor to close wounds to your skin or other tissues. When your doctor sutures a wound, they’ll use a needle attached to a length of “thread” to stitch the wound shut.
There are a variety of available materials that can be used for suturing. Your doctor will choose a material that’s appropriate for the wound or procedure.
The different types of sutures can be classified in many ways.
First, suture material can be classified as either absorbable or nonabsorbable.
Absorbable sutures don’t require your doctor to remove them. This is because enzymes found in the tissues of your body naturally digest them.
Nonabsorbable sutures will need to be removed by your doctor at a later date or in some cases left in permanently.
A stroke occurs when a blood vessel in the brain ruptures and bleeds, or when there’s a blockage in the blood supply to the brain. The rupture or blockage prevents blood and oxygen from reaching the brain’s tissues.
Without oxygen, brain cells and tissue become damaged and begin to die within minutes. Check out exactly how stroke effects the body.
Strokes fall into three main categories: transient ischemic attack (TIA), ischemic stroke, and hemorrhagic stroke.
The MRI will help see if any brain tissue or brain cells have been damaged. A CT scan will provide a detailed and clear picture of your brain that shows any bleeding or damage in the brain. It may also show other brain conditions that could be causing your symptoms.
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice.
Professional etiquette is critical for presenting yourself as a polished, confident, and professional nurse.
Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical purposes.
Local anesthetics block the nerves that connect a particular body part or region to the brain, preventing the nerves from carrying pain signals to your brain. Examples include novocaine shots, which dentists use to numb the nerves in your mouth during a root canal, and epidurals, which allow for a (relatively) painless childbirth by blocking the nerves that originate at the base of the spinal cord and serve the pelvic region.
For serious surgeries that require a patient to be completely unaware, doctors turn to general anesthesia. This renders patients unconscious with no perception or memory of the surgery (though pain from the surgical procedure will be apparent once you wake up). It also limits the physiological responses to surgical cuts, keeping blood pressure, stress hormone release and heart rate constant during the procedure.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
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
2. Loss is any situation either actual potential or perceived in
which a valued object is changed or is no longer accessible
to individual. Because change is major constant in life,
everyone experiences.
4. Actual loss: An actual loss is any loss of a person or
object that can no longer be heard,known or
experienced by the individual.
Example-
Loss of body part
Loss of child
Loss of relationship or role at work
5. Perceived loss: It is any loss that is uniquely defined by
the grieving. It may be loss obvious to others.
Example :
Loss of confidence or prestige, perceived loss are easily
overlooked or misunderstood
Maturational loss: It includes any change in
development process that is normally expected during
the life time
Example: Would be mothers feeling of loss as a child
goes to school for the first time. Events associated with
maturational loss are part of normal life transitional,
but the feelings of lost persist as grieving helps a person
cope with the change
6. Situational loss: It includes any sudden unpredictable
external event, Often this type of loss includes
multiple types of losses rather than a single loss.
Example- When a person is fired from job, the tangible
loss is income, whereas loss of self esteem is
intangible.
12. The psychological defense mechanism by which a person refuses
to believe certain information, helps people to cope initially with
reality of death. Terminally ill clients may first refuse to believe
that their diagnosis is accurate. They may speculate that test
results are wrong or their reports have been mixed-up with
other’s reports.
13. Emotional response to feeling victimized occurs because
there is no way to retaliate against fate.Clients often displace
their anger onto nurses,physicians,family members,even
God. They may express anger in less obvious way.
Example- Overreacting to even slight annoyance
14. A psychological mechanism for delaying the inevitable,
involves a process of negotiation usually with God or other
high Power. Usually dying clients are willing to accept
death but want to extend their lives temporarily until some
significant event takes place. Example- Child’s wedding
15. Sad mood indicates the realization that death will come
sooner rather than later. The sad mood is a result of
controlling social loss.
16. Attitude of complacency occurs after the clients have
dealt with their losses and completed unfinished
business. Kubler described the unfinished business in
two ways. Literally it refers to completing legal and
financial matters to provide best security for survivors.
It also refers to addressing social and spiritual matters
such as saying good bye to loved ones and making
peace with God.After tying up all the loose ends, dying
clients feel prepare to die.
17. Death is defined as the cessation of all vital functions of
the body including the heart beat, brain activity(including
brainstem) and breathing.
18. Cardiac dysfunctions: Failing cardiac function is one of
the first signs that a clients condition is worsening. At first,
heart rate increases in a futile attempt to deliver oxygen to
cells. The apical pulse rate may reach 100 or more per
minute. Cardiac output per minute increases.
19. Peripheral circulation changes: Reduced cardiac output
compromises pripheral circulation and impaires cellular
metabolism and produces less heat. Skin become pale, nail
beds and lips may appear blue,client may feel cold.
Pulmonary function impairment: Failure of heart pumping
function causes fluid to collect in pulmonary circulation.
Breath sounds become moist and client can’t exhale CO2
adequately compounding sate of Hypoxia
20. Central nervous system alterations: Client Experiences
periods of Apnea. Pain perception decreased, client may
state blankly through partially opened eyes, senses become
impaired
Renal impairement: Low cardiac output decreases the urine
volume and waste products accumulate.
Gastrointestinal tract: Peristalisis decreases, causes
intestinal contents to accumulate. This stimulates vomiting
center inducing nausea and vomiting.
21. Near death Experience: Person almost dies but is
resuscitated, have been reported for sometime. People
who experience near death experiences report similar
events such as-
Floating above their bodies
Moving rapidly toward a bright life
Seeing familiar people who have already died
Feeling warm and peaceful
Being told that it is not time yet for them to die.
22. Grief is a series of intense physical and psychological
response that occur following a loss. It is manifested in
variety of ways that are unique to an individual and
based on personal experiences, cultural expectation
and spiritual beliefs. it is normal natural,necessary
and adaptive response to loss . Grieving is a walk
through unknown territory.
23. Mourning: Coping with grief after a loss involves the
process of Mourning, the outward, social expression of
loss. It involves working through the grief until an
individual accepts and adapts to his or her expectations
to go on in life without that which was lost. It is a
behavior determined by cultural norms and values.