THROMBOCYTOPENIA is decreased platelet count we call it thrombocytopenias. causes of this are called an infection, cancer condition, some type of the drugs like heparin, etc. signs and symptoms of the is bleeding tendency patiche, purpuraetc/ the management of this is plasma transfusion admin situation of some of the drug immunotherapy is helpful for this condition. surgery splenectomy.
It is a malignant disease of a blood forming organs. The common feature of leukemia is an unregulated proliferation of white blood cells (WBCs) in the bone marrow.
THROMBOCYTOPENIA is decreased platelet count we call it thrombocytopenias. causes of this are called an infection, cancer condition, some type of the drugs like heparin, etc. signs and symptoms of the is bleeding tendency patiche, purpuraetc/ the management of this is plasma transfusion admin situation of some of the drug immunotherapy is helpful for this condition. surgery splenectomy.
It is a malignant disease of a blood forming organs. The common feature of leukemia is an unregulated proliferation of white blood cells (WBCs) in the bone marrow.
An acute or chronic disease in humans and other warm-blooded animals characterized by an abnormal increase in the number of white blood cells in the tissues and often in the blood.
Pleural effusion, sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing.
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
An acute or chronic disease in humans and other warm-blooded animals characterized by an abnormal increase in the number of white blood cells in the tissues and often in the blood.
Pleural effusion, sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing.
Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum)
an abnormally increased concentration of haemoglobin in the blood, either through reduction of plasma volume or increase in red cell numbers. It may be a primary disease of unknown cause, or a secondary condition linked to respiratory or circulatory disorder or cancer.
A malignant progressive disease in which the bone marrow and other blood-forming organs produce increased numbers of immature or abnormal leucocytes. These suppress the production of normal blood cells, leading to anemia and other symptoms.
The incidence of childhood ALL is approximately 3- 4 cases per 100,000 children under the age of 15 years
Investigations in hemorrhegic disorders ppt Prashant MunePrashant Munde
Clinical assessment, pertinent history, and family history are good indicators for determining patient's bleeding tendencies.
The most appropriate laboratory tests performed are Routine screening tests include a complete blood cell count, platelet count, and evaluation of a peripheral blood sample, a prothrombin time, and an activated partial thromboplastin time.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
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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
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2. It is an abnormally increased concentration of
haemoglobin in the blood, either through
reduction of plasma volume or increase in red
cell numbers.
DEFINITION
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3. NORMAL RANGE
Haemoglobin:- 14 to 17 gm/dL (M)
12 to 15 gm/dL. (F)
Hematocrit:- 41.5% to 50.4% (M)
36.9% to 44.6% (F)
Red blood cell:-
4.5 million to 5.9 million cells/mcL (M)
4.1 million to 5.1 million cells/mcL. (F)
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5. RISK FACTORS
• Chronic hypoxia
long-term cigarette smoking
familial and genetic predisposition
living in high altitudes
long-term exposure to carbon monoxide (tunnel
workers, car garage attendants, residents of
highly polluted cities)
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7. PRIMARY POLYCYTHEMIA
Primary Polycythemia occurs when excess
red blood cells are produced as a result of an
abnormality of the bone marrow.
• Often, excess white blood cells and platelets
are also produced
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8. SECONDARY POLYCYTHEMIA
Secondary polycythemia is usually due to
increased erythropoietin (EPO) production either
in response to chronic hypoxia (low blood
oxygen level) or from an erythropoietin secreting
tumor.
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10. RELATIVE POLYCYTHEMIA
• It is an increase in RBC numbers without an
increase in total RBC mass.
• Usually, this is caused by loss of plasma v o l u me
with resultant hemo-concentration, as seen in
severe dehydration related to vomiting and
diarrhoea.
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11. STRESS POLYCYTHEMIA
Stress Polycythemia is a term applied to a
chronic (long standing) state of low plasma
volume which is seen commonly in active, hard
working, anxious, middle-aged men. In these
people, the red blood cell volume is normal, but
the plasma volume is low.
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12. CLINICAL MANIFESTATIONS
Symptoms results from increased blood volume:
Cyanosis
Reddened face with engorged retinal veins
Itching after bath
Feeling of fullness in head with headache
Weakness, fatigue and dizziness
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13. Tinnitus (ringing or buzzing in the ears.)
Parasthesia, numbness, burning or weakness in
hands and legs.
Visual disturbances
Nose bleeding
Abdominal bloating
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14. Symptoms from increased viscosity:
Angina
Dyspnea
Hypoxia
Bone and joint pain
Thrombophlebitis
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15. Other symptoms are
Weight loss
Breathing difficulty when lying down
Chronic cough
Night sweats and sleep disturbances
Burning sensation over fingers or toes
Splenomegaly and hepatomegaly
Formation of blood clots in the blood vessels
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16. DIAGNOSIS
• History collection and physical examination:
Smoking
Living at high altitudes
Breathing difficulty
Sleep disturbances and chronic cough.
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17. Blood tests
The blood studies will show
An increase in the number of red blood cells
Elevated hematocrit measurement
Elevated levels of hemoglobin
Very low levels of erythropoietin
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18. Bone marrow aspiration orbiopsy
If an examination of the bone marrow
shows that it's producing higher than normal
numbers of blood cells, it may be a sign of
polycythemia.
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19. Other diagnosting meassures are,
Chest X-Ray
Electrocardiogram
Echocardiogram
SpO2 measurement
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20. MANAGEMENT
20
PHLEBOTOMY:
Drawing a certain amount of blood out of
the veins in a procedure called phlebotomy is usually
the first treatment option for people with
polycythemia.
• Reduces the number of blood cells
• Decreases blood volume
• Blood to function properly.
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21. Low-dose aspirin
•low dose of aspirin to reduce risk of blood
clots.
•May also help reduce burning pain in feet or
hands.
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22. Medication to decrease blood cells
•Hydroxyurea (Droxia, Hydrea) :- to suppress the
bone marrow's ability to produce blood cells
•Interferon alpha:- stimulate the immune system to
fight the overproduction of red blood cells.
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23. Therapy to reduceitching
Itching - antihistamines, or ultraviolet light
treatment to relieve discomfort.
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24. Lifestyle and homeremedies
24
Exercise.
•Moderate exercise can improve the blood flow,
which decreases risk of blood clots.
•Leg and ankle stretches and exercises also can
improve the blood circulation.
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25. Avoidtobacco.
Blood vessels to narrow, increasing the risk of
heart attack or stroke due to blood clots.
Watch for sores.
Poor circulation can make it difficult for sores to
heal, particularly on the hands and feet. Inspect the
feet regularly and tell the doctor about any sores.
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26. Avoid extreme temperatures
•Poor blood flow increases the risk of injury from
hot and cold temperatures.
•Always wear warm clothing (hands and feet). In
hot weather -drink plenty of liquids.
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27. NURSING MANAGEMENT
27
Monitor for peripheral and cerebral thrombosis.
Assist the patient for ambulation
Perform phlebotomy as per doctors order
Administer iv fluids and encourage to take oral fluids
Administer pain management measures
Advice to do regular exercise
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28. Instruct to avoidtobacco
Advise to maintain skinhygiene
Avoid extremetemperatures
Provide psychological support to the patient.
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29. NURSING DIAGNOSIS
• Impaired tissue perfusion related to phlebotomy as
evidenced by cyanosis.
• Acute pain related to surgical intervention as
evidenced by verbalization
• Impaired breath pattern related to decreased level of
RBC in blood as evidenced by dyspnea.
• Imbalanced nutrition less than body requirement
related to less oral intake of food as evidenced by
weight loss. 2911/24/2020 Melvin Jacob
30. CONCLUSION
Polycythemia is an increase in the number of
red blood cells in the body. Doctors may
discover it as part of a routine blood check, or
they might diagnose it once the person starts
experiencing symptoms.
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31. REFERENCE
• Smeltzer – Brunner & Suddharth Textbook of
Medical Surgical Nursing, Wolters kluwer
publishers, 12th edition 2009.
• Black – Medical Surgical Nursing, Elsevier
publishers, 8th edition 2009.
• Nettina – Lippincott manual of Nursing Practice,
Wolters kluwer publishers, 7th edition 2014.
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