A fracture is a break in the continuity of bone that can be caused by direct blows, crushing forces, twisting motions or muscle contractions. There are two main types - complete fractures where the bone is broken across its entire cross-section, and incomplete fractures where the break is only partial. Fractures can be open (compound) if the bone protrudes through skin, or closed (simple) without skin breakage. Clinical signs include pain, deformity, swelling and loss of function. Treatment involves reduction, immobilization using casts, splints or traction, and restoring mobility while the bone heals. Complications can include nonunion, infection and compartment syndrome.
this topic is on bed sores. discusses the definition, etiology , pathophysiology of bed sore development as well as prevention and managemene of pressure sores
this topic is on bed sores. discusses the definition, etiology , pathophysiology of bed sore development as well as prevention and managemene of pressure sores
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
Definition
Type of Hernia
risk factor
pathophysiology
diagnostic procedure
physical assessment
management for hernia
Nursing Diagnosis
Health Education
A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle. It typically takes a major force to cause this type of broken leg. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures.
this presentation explain about the fracture, don't miss to take a look on it, it will help you, you will find a useful knowledge through this a brief presentation.
fracture is the breakdown in the continutity of the bone alignment this has many types as the fracure this topic include its definition , etiology, pathophysiology, clinical menisfestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from fracture and for learning for their examination and knowledge purpose
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
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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
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
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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
4. Types of fracture
a. Complete fracture : a break across the entire
cross-section of the bone.
b. An incomplete fracture the break occurs through
only part of the cross-section of the bone.
5. a. Closed fracture (simple fracture) is one that does
not cause a break in the skin.
b. An open fracture (compound, or complex, fracture)
is one in which the skin or mucous membrane
wound extends to the fractured bone.
Open fractures are graded according to the
following criteria:
• Grade I is a clean wound less than 1 cm long.
• Grade II is a larger wound without extensive soft
tissue damage.
• Grade III is highly contaminated, has extensive soft
tissue damage, and is the most severe.
12. Compression Fracture
A fracture caused by compression, the act of
pressing together. Compression fractures of the
vertebrae are especially common with
osteoporosis.
13. Other fracture
• Avulsion: fracture which occurs when a fragment
of bone tears away from the main mass of bone.
• Depressed: A fracture in which fragments are
driven inward (seen frequently in fractures of skull
and facial bones)
14. • Pathologic: it occurs through an area of diseased
bone (eg, osteoporosis, bone cyst, bony
metastasis, tumor);
can occur without trauma or a fall
• Stress: A fracture that results from repeated
loading without bone and muscle recovery
15. Pathophysiology
Due to any etiology(crushing movement)
|
Fracture occurs , muscle that were attached to bone
are disrupted and cause spasm
|
Proximal portion of bone remains in place, the distal
portion can become displaced in response to both
causative force & spasm in the associated muscles
16. In addition, the periosteum and blood vessels in the
cortex and marrow are disrupted
|
Soft tissue damage occurs, leads to bleeding and
formation of hematoma between the fracture
fragment and beneath the periosteum
|
Bone tissue surroundings the fracture site dies,
creating an intense inflammatory response
21. MEDICAL /SURGICAL
MANAGEMENT OF FRACTURES:
1.Reduction
Reduction of a fracture (“setting” the bone) refers to
restoration of the fracture fragments to anatomic
alignment and rotation.
It’s a surgical approach, the fracture fragments are
reduced.
External/Internal fixation devices (metallic pins,
wires, screws, plates, nails, or rods) may be used
to hold the bone fragments in position until solid
bone healing occurs.
25. Closed reduction
• closed reduction is accomplished by bringing the
bone fragments into apposition (ie, placing the
ends in contact) through manipulation and manual
traction.
• Extremity is held in the desired position while the
physician applies a cast, splint, or other device.
• X - rays are obtained to verify that the bone
fragments are correctly aligned.
• Traction (skin or skeletal) may be used to effect
fracture reduction and immobilization.
26. 2.Immobilization
• Immobilization may be accomplished by external or
internal fixation.
• Methods of external fixation include bandages,
casts, splints, continuous traction, and external
fixators.
• Metal implants used for internal fixation serve as
internal splints to immobilize the fracture.
27. Traction
Traction is the use of weights, ropes and pulleys to
apply force to tissues surrounding a broken bone.
28. Traction
1. Skin traction-
• Bucks traction used for knee,hip bone
fracture
• Weight usually 5-7 pounds attach to skin
2. Skeletal traction –
• Needs invasive procedure
• Weight is upto 10 kg attached to bone
29. • Splinting is the most common procedure
for immobilizing an injury.
Splinting
30. • To stabilize the extremity
Why Do We Splint?
• To decrease pain
• Actually treat the injury
31. • Soft materials. Towels, blankets, or pillows,
tied with bandaging materials or soft cloths.
• Rigid materials. A board, metal strip, folded
magazine or newspaper, or other rigid item.
Possible items for Splinting
32. • Splinting Using a Towel
• Splinting using a towel, in which the
towel is rolled up and wrapped
around the limb, then tied in place.
Soft Splints
33. 1. Support the injured area.
2. Splint injury in the position
that you find it.
3. Don’t try to realign bones.
4. Check for color, warmth, and
sensation.
5. Immobilize above and below
the injury.
Guidelines for Splinting
34. The splint should go beyond the joints above and
below the fractured or dislocated bone to prevent
these from moving
35.
36. 3. Maintaining and restoring
function
• Restlessness, anxiety, and discomfort are controlled
with a variety of approaches, such as reassurance,
position changes, and pain relief strategies, including
use of analgesics.
• exercises are encouraged to minimize disuse atrophy
and to promote circulation.
• Participation in activities of daily living (ADLs) is
encouraged to promote independent functioning
and self-esteem.
37. • Do not draw exposed bones back into tissue.
Treating an Open Fracture
38. DO:
• Cover wound.
• Splint fracture without disturbing wound.
• Place a moist 4" x 4" dressing over bone end
to prevent drying.
• Assist the surgeon in debridement of wound
Treating an Open Fracture
41. Compartment syndrome
• develops when tissue perfusion in the
muscles is less than that required for tissue
viability.
• patient complains of deep, severe pain,
which is not controlled by opioids.
42. Compartment syndrome
• Reduction in size of muscle compartment
• It increase pressure in the muscle
compartment
• Reduce microcircualtion,leads to muscle
and nerve anoxia and necrosis
43. FAT EMBOLISM SYNDROME
• occurs most frequently in young adults
• fat globules may move into the blood
because the marrow pressure is greater
than the capillary pressure
• usually occurring within 24 to 72 hours
44. NURSING MANAGEMENT
Patients with closed fractures:
• Encourage patient not to mobilize fracture
site.
• exercises to maintain the health of
unaffected muscles for using assistive
devices (eg, crutches, walker).
45. • teach patients how to use assistive devices
safely.
• Patient teaching includes self-care,
medication information, monitoring for
potential complications, and the need for
continuing health care supervision.
46. Patients with open fractures:
• administers tetanus prophylaxis if indicated.
• wound irrigation and debridement in the
operating room are necessary.
• Intravenous antibiotics are prescribed to prevent
or treat infection.
• wound is cultured.
47. • fracture is carefully reduced and stabilized by
external fixation or intramedullary nails.
• Any damage to blood vessels, soft tissue, muscles,
nerves, and tendons is treated.
• Heavily contaminated wounds are left unsutured
and dressed with sterile gauze to permit swelling
and wound drainage.
48. Care of client with cast
Before application of a cast preparation of the
client includes:
• Detailed explanation of the procedure
• Skin preparation involves through cleansing of the
skin
• Presence of unremovable particle or dust should be
reported to the physician
• Roll the cast material are individually submerged in
clean water and excess water is squeezed from the
roll ,apply bandage is applied to encircle the
injured the body parts
49. • As the water evaporates the cast will dry
• plaster cast generates while drying so instruct
patient for heat sensation
• Do not cover the cast
• Windowing or bivalving a cast means cutting a
cast along both sides then splitting it to decrease
pressure on underlying tissue.
• Window may also be cut into cast to allow the
physician or nurse to visualize wounds under the
cast or removes drains.
51. • Neurovascular assessment: It should be performed
every 30 minutes for 4 hours.
• Assess the cast extremity for color, warmth, pulse
distal to the cast, capillary refill.
• Movement of the distal fingers or toes, awareness of
light touch distal to the cast, change in the
sensation.
• Assessment of the pain: Assess the degree of pain
52. • Assessment of the cast: The skin around the
cast edges should be observed for damage or
swelling.
“Hot spots” areas of the cast that feel warmer
than other section may indicate tissue necrosis
or infection under the cast.
“Wet spots” may indicate drainage under the
cast
53. Care of external fixation
• Assessment- pain, nerve supply,infection,pin
site etc.
• Small bleeding from pin site is normal
• Critical, If extend more than 24 hours
• Administer antibiotics, analgesic medicine
54. Care of traction
• Assessment – skin breakdown, pain,
neurovascular ,constipation
• Stool softner
• Plenty of fluids
• Provide bedpan and urinals for elimination
• Encourage clients activity
56. Acute pain related breakdown of continuity of the
bone as evidenced by facial expressions and
verbalization of patient.
• Goals: Patient will not feel pain
• Intervention:
• Assess the onset, duration, location, severity and intensity
of pain.
• Administer the analgesic according to physician order.
• Provide comfort devices like sand bags for immobilization
of affected parts.
• Provide diversion therapy
57. Impaired physical mobility related to
application of traction or cast as evidenced by
assessment
• Goal: Patient will able to move unaffected area.
• Intervention:
• Provide range of motion exercises to the patient.
• Assist the patient in ambulation after recovery of
fracture.
• Provide assistance while using walker or crutches if
required.
• Prevent from complication which usually occurs due to
immobility.
•
58. Self care deficit related to fracture as evidenced by
poor personal hygiene.
• Goal: Patient will maintain the personal hygiene
• Intervention:
• Assess the need of self care
• Encourage the patient or relatives to do self care activity
• Head to foot care to be provided to the patient.
• Educate about importance of maintaining personal
hygiene.
59. Imbalanced nutrition less than body requirement
relate to increase demand of nutrient for bone
healing as evidenced by observation.
• Goal: Maintain the nutritional status of the patient
• Intervention:
• Assess the nutritional status by intake/output chart,
biochemical measures, body mass.
• Maintain intake output chart daily.
• Encourages the patient to take protein rich diet.
• Plenty of fluids and frequent intake of meal is necessary.
• Try to assess the daily weight of the client
60. References
• Joyce M. Black Jane Hokanson, medical
surgical nursing,7th edition, Elsevier
publication, volume 1,page no. 619-651
• Suddarth’s & burnner, text book of medical
surgical nursing, eleventh edition,Wolters
publication, Page no. 2079 -2104
• www.authorstream.com
• www.slideshare.com