The document discusses the anatomy and causes of a deviated nasal septum. It describes how the nasal septum can develop bends or become damaged by injury, causing it to deviate to one side and block airflow through the nose. Common causes of a deviated septum include birth trauma, injury from sports or accidents, and abnormal growth. Symptoms include nasal congestion, difficulty breathing, and recurrent sinus infections. Diagnosis involves physical examination and CT scan of the paranasal sinuses.
The patient, a 59-year-old obese female, presented with right calf pain and swelling after prolonged periods of television watching without breaks. Diagnostic testing revealed deep vein thrombosis (DVT) in the right leg and pulmonary embolisms (PE). She was started on anticoagulation therapy with heparin and rivaroxaban. Her symptoms improved and she was discharged with lifestyle and medication recommendations to prevent further clots.
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
- Status epilepticus has a worldwide incidence of 3.8 to 38 per 100,000 people per year, with peaks in children and the elderly. Around 31-44% of cases are refractory to initial treatment.
- Initial treatment involves benzodiazepines like lorazepam or diazepam. If seizures continue, second-line drugs like phenytoin, fosphenytoin, or valproate are used.
- Refractory status epilepticus is defined as failure to control seizures with benzodiazepines and other antiepileptics. It requires general anesthesia with drugs like propofol, thiopental, or midazolam along with
Ch15 eec3Diabetic Emergencies and Altered Mental Statusparamedicbob
This document provides information on diabetic emergencies, altered mental status, seizures, strokes, dizziness, and syncope. It discusses signs and symptoms, patient assessment, and emergency care steps. Key points include administering oral glucose for hypoglycemic patients who can swallow, positioning seizure patients on their side and protecting airway after, and using the Cincinnati Prehospital Stroke Scale to assess for facial droop, arm drift, and slurred speech to identify potential stroke patients.
1. Status epilepticus is defined as a seizure lasting more than 5 minutes or recurrent seizures without recovery in between.
2. It can be generalized convulsive seizures or non-convulsive without motor symptoms but ongoing EEG seizure activity.
3. Treatment involves stabilizing the patient, identifying and treating the underlying cause, giving benzodiazepines as first line, then fosphenytoin, phenytoin, phenobarbital or levetiracetam if still seizing, with escalation to anesthetic drugs, coma or general anesthesia if refractory.
Pediatrics pharmacology: Anticonvulsant Therapy Azad Haleem
This document discusses definitions of seizures and epilepsy, basic principles of antiepileptic drug (AED) therapy including initiation, adding a second drug, monotherapy vs polytherapy, and drug interactions. It describes factors that increase risk of seizure recurrence and targets of AEDs such as inhibitory neurotransmitters and ion channels. Several common AEDs are described including their indications, mechanisms of action, and side effects. Guidelines are provided around treating or not treating a first seizure, duration of treatment, and assessing intractability.
How to manage status epilepticus, what drugs should be used and when to use what to avoid and need to know
everything you should have about status epilepticus is here.
The patient, a 59-year-old obese female, presented with right calf pain and swelling after prolonged periods of television watching without breaks. Diagnostic testing revealed deep vein thrombosis (DVT) in the right leg and pulmonary embolisms (PE). She was started on anticoagulation therapy with heparin and rivaroxaban. Her symptoms improved and she was discharged with lifestyle and medication recommendations to prevent further clots.
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
- Status epilepticus has a worldwide incidence of 3.8 to 38 per 100,000 people per year, with peaks in children and the elderly. Around 31-44% of cases are refractory to initial treatment.
- Initial treatment involves benzodiazepines like lorazepam or diazepam. If seizures continue, second-line drugs like phenytoin, fosphenytoin, or valproate are used.
- Refractory status epilepticus is defined as failure to control seizures with benzodiazepines and other antiepileptics. It requires general anesthesia with drugs like propofol, thiopental, or midazolam along with
Ch15 eec3Diabetic Emergencies and Altered Mental Statusparamedicbob
This document provides information on diabetic emergencies, altered mental status, seizures, strokes, dizziness, and syncope. It discusses signs and symptoms, patient assessment, and emergency care steps. Key points include administering oral glucose for hypoglycemic patients who can swallow, positioning seizure patients on their side and protecting airway after, and using the Cincinnati Prehospital Stroke Scale to assess for facial droop, arm drift, and slurred speech to identify potential stroke patients.
1. Status epilepticus is defined as a seizure lasting more than 5 minutes or recurrent seizures without recovery in between.
2. It can be generalized convulsive seizures or non-convulsive without motor symptoms but ongoing EEG seizure activity.
3. Treatment involves stabilizing the patient, identifying and treating the underlying cause, giving benzodiazepines as first line, then fosphenytoin, phenytoin, phenobarbital or levetiracetam if still seizing, with escalation to anesthetic drugs, coma or general anesthesia if refractory.
Pediatrics pharmacology: Anticonvulsant Therapy Azad Haleem
This document discusses definitions of seizures and epilepsy, basic principles of antiepileptic drug (AED) therapy including initiation, adding a second drug, monotherapy vs polytherapy, and drug interactions. It describes factors that increase risk of seizure recurrence and targets of AEDs such as inhibitory neurotransmitters and ion channels. Several common AEDs are described including their indications, mechanisms of action, and side effects. Guidelines are provided around treating or not treating a first seizure, duration of treatment, and assessing intractability.
How to manage status epilepticus, what drugs should be used and when to use what to avoid and need to know
everything you should have about status epilepticus is here.
The document discusses various topics related to the medical and surgical management of epilepsy including:
1. Classification of epilepsy, diagnostic testing such as EEG and neuroimaging, medication options and monitoring, management during pregnancy, and surgical treatment options.
2. Key factors in determining treatment include the epilepsy type, underlying causes, age of onset, control of seizures, and location of the epileptic focus.
3. Surgical options like temporal lobectomy can provide seizure freedom for 50% of patients after 2 years when the epileptic focus is in the temporal lobe.
Epilepsy is a common condition, encountered by neurologists, pediatricians, physicians and other doctors. It can be easily treated with anti-epileptic drugs. The current presentation discusses the approach to management of epilepsy, focussing on diagnosis and treatment.
This document provides information on various medical emergencies that may occur in a dental practice setting. It discusses conditions that may arise due to anxiety of the procedure like hyperventilation and vasovagal syncope. It also covers emergencies related to prior medical conditions of the patient such as asthma, cardiac issues, epilepsy, and diabetes. Procedures that could potentially cause emergencies like anaphylaxis from anesthetic drugs or choking from a foreign object are also outlined. Each condition discusses signs, symptoms and recommended management approaches.
Diabetes Mellitus in children for medical students Azad Haleem
This document defines type 1 diabetes, discusses its epidemiology, diagnosis, etiology, physiology, presentation, investigations, management, treatment, and complications. The key points are:
- Type 1 diabetes is an autoimmune disease resulting from insulin deficiency. It peaks in children aged 5-7 and during puberty.
- Diagnosis is based on symptoms plus random blood glucose ≥200 mg/dL or fasting blood glucose ≥126 mg/dL.
- Management requires a team approach including specialists, nurses, dietitians, and psychologists. Treatment involves insulin administration and nutrition management.
- Presentations include diabetic ketoacidosis and hyperglycemia. Investigations include blood glucose, HbA1c
Status epilepticus is a life-threatening condition defined as one continuous seizure lasting more than 30 minutes or recurrent seizures without regaining consciousness between seizures for over 30 minutes. It is most common in people with epilepsy due to insufficient medication but can also occur in new epileptics or those with brain disorders, infections, tumors or trauma. Immediate treatment with benzodiazepines like lorazepam is recommended to stop the seizures, with barbiturates, anesthetics or other drugs used if initial treatment fails. Permanent neurological damage can occur if status epilepticus is not terminated rapidly.
Status epilepticus (SE) is a medical emergency defined by continuous seizure activity lasting more than 5 minutes for generalized seizures or more than 10 minutes for focal seizures. The condition requires rapid treatment to prevent neuronal injury and death from prolonged excitatory activity. Management involves initial airway and hemodynamic stabilization, followed by benzodiazepines as first-line treatment. If seizures continue, second-line drugs like phenytoin are used. Refractory SE fails to respond to first- and second-line drugs, while super-refractory SE continues despite anesthesia with midazolam or barbiturates. Early, aggressive treatment is needed to terminate seizures and prevent neurological complications.
Landau-Kleffner syndrome (LKS) is a rare childhood epilepsy syndrome characterized by the gradual loss of language skills and the development of seizures. A 12-year-old girl presented with a gradual loss of speech and language at age 7 and was later diagnosed with LKS. Her symptoms included seizures, attention issues, and language regression. Testing found continuous spike-wave discharges during sleep on EEG. She was treated with medications, IVIG, and steroids, which stabilized her seizures and improved her language skills. LKS is typically treated with anti-seizure medications, steroids, IVIG, and speech therapy, with the prognosis generally being best when symptoms start after age 6.
Slides describing the Status Epilepticus especially in regards to children.
References:
1. https://www.uptodate.com/contents/seizures-and-epilepsy-in-children-initial-treatment-and monitoring?search=seizure%20initial%20treatment&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H2
2. Sculier, C, Gaínza‐Lein, M, Sánchez Fernández, I, Loddenkemper, T. Long‐term outcomes of status epilepticus: A critical assessment. Epilepsia. 2018; 59( S2): 155– 169. https://doi.org/10.1111/epi.14515
3. Paeds protocol on section Status Epilepticus
4. ILAE: EPIGRAPH VOL. 20 ISSUE 2, FALL 2018 Time is Brain: Treating status epilepticus
This document summarizes the medical history and current status of a 16-year-old female patient presenting with immune thrombocytopenia (ITP) and suspected systemic lupus erythematosus (SLE). Five years ago at age 11, the patient developed purpuric rashes and was diagnosed with ITP. She was treated for two years but defaulted from treatment. Recently she presented with relapsed rashes as well as joint pain and swelling, and was found to have low platelet count and positive ANA and anti-dsDNA, consistent with suspected SLE. Her current symptoms are improved on treatment with prednisone, hydroxychloroquine, and azathioprine.
Status epilepticus is defined as continuous seizure activity or intermittent seizures without full recovery between seizures. It can be convulsive or non-convulsive. Initial treatment involves stabilizing the airway, breathing, and circulation, followed by benzodiazepines like lorazepam or diazepam to stop seizures. If seizures continue, second line drugs like fosphenytoin or levetiracetam are used. For refractory cases, continuous infusions of midazolam, pentobarbital or propofol may be needed. The most common adverse effect is respiratory depression, so patients require monitoring. No significant difference in effectiveness exists between lorazepam and diazepam as initial
This document summarizes guidelines from the American Epilepsy Society and Indian Pediatrics for the treatment of status epilepticus in children and adults. It defines status epilepticus and evaluates questions around effective initial and subsequent anticonvulsant therapies. For initial treatment, lorazepam, diazepam, and midazolam are recommended benzodiazepines, with midazolam preferred without IV access. Phenytoin or fosphenytoin are suggested as second line therapies. The treatment success rates decline with each subsequent therapy, and refractory cases may require anesthetic doses of midazolam, pentobarbital, propofol or thiopental with EEG monitoring. Rectal
This document discusses hypoglycemia, defining it as low plasma glucose levels leading to symptoms that are resolved by raising glucose levels. It notes hypoglycemia is common in type 1 diabetes and less frequent in type 2 diabetes. The defenses against hypoglycemia are impaired in diabetes due to defective insulin, glucagon, and epinephrine responses. Recent low blood sugar can cause hypoglycemia-associated autonomic failure, increasing risk of future episodes. Causes of hypoglycemia include medications, medical conditions, and nonislet cell tumors.
Status epilepticus is a life-threatening condition defined as a seizure lasting more than 5 minutes or recurrent seizures without regaining consciousness. It can be caused by changes in medication, infection, stroke, or other medical conditions. Symptoms include muscle spasms, confusion, and impaired consciousness. Diagnosis involves examination and electroencephalography. Treatment goals are resuscitation, terminating seizures, decreasing cerebral metabolism, and treating underlying causes. First-line treatments are benzodiazepines while refractory cases may require barbiturates, propofol, or midazolam infusion. Prognosis depends on duration and cause, with prolonged seizures carrying higher mortality and worse outcomes.
Status epilepticus is a life-threatening condition involving prolonged or repeated seizures without recovery between seizures. Intravenous administration of anti-seizure medications is required for treatment. Diazepam or lorazepam are usually effective for terminating seizures in the short-term, while phenytoin or fosphenytoin are preferred for prolonged therapy due to being highly effective with less sedation. If seizures are not controlled by first-line treatments, phenobarbital may be used, and refractory cases may require general anesthesia. Close monitoring is important due to risks of respiratory depression, hypotension, and cardiotoxicity from some medications.
Status epilepticus is defined as continuous convulsions lasting over 30 minutes or serial convulsions without regained consciousness. Convulsive status epilepticus is more dangerous and can cause mortality in 3-10% of cases mainly due to underlying brain conditions. Common causes include prolonged febrile convulsions, unknown etiology, brain abnormalities or metabolic disorders, and meningitis. Management goals are stabilization, stopping seizures, preventing recurrence, and identifying the cause. Treatment involves emergency medication like diazepam, lorazepam, phenytoin, or midazolam to stop seizures along with monitoring, investigation of the cause, and management of any underlying conditions.
This document discusses epilepsy and status epilepticus. It defines epilepsy and provides classification of seizures based on where they begin in the brain and the level of awareness during the seizure. Focal seizures start in one area of the brain while generalized seizures involve both sides. Seizures can be motor or non-motor. The document also covers risk factors, clinical features, investigation including EEG, diagnosis, differential diagnosis, management including lifestyle modifications and medications, special considerations in pregnancy/reproduction, and other interventions for epilepsy.
Status epilepticus is a medical emergency defined as continuous seizure activity lasting more than 5 minutes or recurrent seizures without regaining consciousness. It has an incidence rate of 10-60 per 100,000 people and is most common in children under 5 years old. Causes include infections, brain injuries, genetic conditions, and noncompliance with anti-seizure medications. The pathophysiology involves excessive excitation and reduced inhibition in the brain. Treatment involves stabilizing the patient, identifying and treating the underlying cause, giving benzodiazepines and other anti-seizure medications, and controlling refractory cases in the ICU with anesthetic medications. Early intervention is important to prevent neurological damage from prolonged seizures.
This document defines epilepsy and seizures, and discusses their incidence, causes, classification, evaluation, and management. Some key points:
- Epilepsy is defined as recurrent seizures unrelated to fever or acute brain injury. Seizures affect 3-5% of children.
- Causes of epilepsy include hypoxia, infection, trauma, developmental defects, and genetic conditions like tuberous sclerosis.
- Seizures are classified as partial/focal or generalized. Common generalized seizures include grand mal and absence seizures.
- Evaluation involves medical history, physical exam, and in some cases tests like EEG. Management focuses on anticonvulsant drugs tailored to seizure type. Surgery may be an option for drug-
GLAUCOMA of human eye for certificate nursesokumuatanas1
This document provides information about glaucoma, including:
1. Glaucoma is a group of eye conditions marked by increased pressure in the eye that can damage the optic nerve and lead to vision loss.
2. The two main types are open-angle glaucoma, the most common type caused by blocked drainage canals, and angle-closure glaucoma caused by a narrowed drainage angle.
3. Risk factors include age over 40, family history, and other medical conditions. Treatment involves medications, laser treatments, or surgeries to lower pressure and improve drainage in the eye.
The document discusses various topics related to the medical and surgical management of epilepsy including:
1. Classification of epilepsy, diagnostic testing such as EEG and neuroimaging, medication options and monitoring, management during pregnancy, and surgical treatment options.
2. Key factors in determining treatment include the epilepsy type, underlying causes, age of onset, control of seizures, and location of the epileptic focus.
3. Surgical options like temporal lobectomy can provide seizure freedom for 50% of patients after 2 years when the epileptic focus is in the temporal lobe.
Epilepsy is a common condition, encountered by neurologists, pediatricians, physicians and other doctors. It can be easily treated with anti-epileptic drugs. The current presentation discusses the approach to management of epilepsy, focussing on diagnosis and treatment.
This document provides information on various medical emergencies that may occur in a dental practice setting. It discusses conditions that may arise due to anxiety of the procedure like hyperventilation and vasovagal syncope. It also covers emergencies related to prior medical conditions of the patient such as asthma, cardiac issues, epilepsy, and diabetes. Procedures that could potentially cause emergencies like anaphylaxis from anesthetic drugs or choking from a foreign object are also outlined. Each condition discusses signs, symptoms and recommended management approaches.
Diabetes Mellitus in children for medical students Azad Haleem
This document defines type 1 diabetes, discusses its epidemiology, diagnosis, etiology, physiology, presentation, investigations, management, treatment, and complications. The key points are:
- Type 1 diabetes is an autoimmune disease resulting from insulin deficiency. It peaks in children aged 5-7 and during puberty.
- Diagnosis is based on symptoms plus random blood glucose ≥200 mg/dL or fasting blood glucose ≥126 mg/dL.
- Management requires a team approach including specialists, nurses, dietitians, and psychologists. Treatment involves insulin administration and nutrition management.
- Presentations include diabetic ketoacidosis and hyperglycemia. Investigations include blood glucose, HbA1c
Status epilepticus is a life-threatening condition defined as one continuous seizure lasting more than 30 minutes or recurrent seizures without regaining consciousness between seizures for over 30 minutes. It is most common in people with epilepsy due to insufficient medication but can also occur in new epileptics or those with brain disorders, infections, tumors or trauma. Immediate treatment with benzodiazepines like lorazepam is recommended to stop the seizures, with barbiturates, anesthetics or other drugs used if initial treatment fails. Permanent neurological damage can occur if status epilepticus is not terminated rapidly.
Status epilepticus (SE) is a medical emergency defined by continuous seizure activity lasting more than 5 minutes for generalized seizures or more than 10 minutes for focal seizures. The condition requires rapid treatment to prevent neuronal injury and death from prolonged excitatory activity. Management involves initial airway and hemodynamic stabilization, followed by benzodiazepines as first-line treatment. If seizures continue, second-line drugs like phenytoin are used. Refractory SE fails to respond to first- and second-line drugs, while super-refractory SE continues despite anesthesia with midazolam or barbiturates. Early, aggressive treatment is needed to terminate seizures and prevent neurological complications.
Landau-Kleffner syndrome (LKS) is a rare childhood epilepsy syndrome characterized by the gradual loss of language skills and the development of seizures. A 12-year-old girl presented with a gradual loss of speech and language at age 7 and was later diagnosed with LKS. Her symptoms included seizures, attention issues, and language regression. Testing found continuous spike-wave discharges during sleep on EEG. She was treated with medications, IVIG, and steroids, which stabilized her seizures and improved her language skills. LKS is typically treated with anti-seizure medications, steroids, IVIG, and speech therapy, with the prognosis generally being best when symptoms start after age 6.
Slides describing the Status Epilepticus especially in regards to children.
References:
1. https://www.uptodate.com/contents/seizures-and-epilepsy-in-children-initial-treatment-and monitoring?search=seizure%20initial%20treatment&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H2
2. Sculier, C, Gaínza‐Lein, M, Sánchez Fernández, I, Loddenkemper, T. Long‐term outcomes of status epilepticus: A critical assessment. Epilepsia. 2018; 59( S2): 155– 169. https://doi.org/10.1111/epi.14515
3. Paeds protocol on section Status Epilepticus
4. ILAE: EPIGRAPH VOL. 20 ISSUE 2, FALL 2018 Time is Brain: Treating status epilepticus
This document summarizes the medical history and current status of a 16-year-old female patient presenting with immune thrombocytopenia (ITP) and suspected systemic lupus erythematosus (SLE). Five years ago at age 11, the patient developed purpuric rashes and was diagnosed with ITP. She was treated for two years but defaulted from treatment. Recently she presented with relapsed rashes as well as joint pain and swelling, and was found to have low platelet count and positive ANA and anti-dsDNA, consistent with suspected SLE. Her current symptoms are improved on treatment with prednisone, hydroxychloroquine, and azathioprine.
Status epilepticus is defined as continuous seizure activity or intermittent seizures without full recovery between seizures. It can be convulsive or non-convulsive. Initial treatment involves stabilizing the airway, breathing, and circulation, followed by benzodiazepines like lorazepam or diazepam to stop seizures. If seizures continue, second line drugs like fosphenytoin or levetiracetam are used. For refractory cases, continuous infusions of midazolam, pentobarbital or propofol may be needed. The most common adverse effect is respiratory depression, so patients require monitoring. No significant difference in effectiveness exists between lorazepam and diazepam as initial
This document summarizes guidelines from the American Epilepsy Society and Indian Pediatrics for the treatment of status epilepticus in children and adults. It defines status epilepticus and evaluates questions around effective initial and subsequent anticonvulsant therapies. For initial treatment, lorazepam, diazepam, and midazolam are recommended benzodiazepines, with midazolam preferred without IV access. Phenytoin or fosphenytoin are suggested as second line therapies. The treatment success rates decline with each subsequent therapy, and refractory cases may require anesthetic doses of midazolam, pentobarbital, propofol or thiopental with EEG monitoring. Rectal
This document discusses hypoglycemia, defining it as low plasma glucose levels leading to symptoms that are resolved by raising glucose levels. It notes hypoglycemia is common in type 1 diabetes and less frequent in type 2 diabetes. The defenses against hypoglycemia are impaired in diabetes due to defective insulin, glucagon, and epinephrine responses. Recent low blood sugar can cause hypoglycemia-associated autonomic failure, increasing risk of future episodes. Causes of hypoglycemia include medications, medical conditions, and nonislet cell tumors.
Status epilepticus is a life-threatening condition defined as a seizure lasting more than 5 minutes or recurrent seizures without regaining consciousness. It can be caused by changes in medication, infection, stroke, or other medical conditions. Symptoms include muscle spasms, confusion, and impaired consciousness. Diagnosis involves examination and electroencephalography. Treatment goals are resuscitation, terminating seizures, decreasing cerebral metabolism, and treating underlying causes. First-line treatments are benzodiazepines while refractory cases may require barbiturates, propofol, or midazolam infusion. Prognosis depends on duration and cause, with prolonged seizures carrying higher mortality and worse outcomes.
Status epilepticus is a life-threatening condition involving prolonged or repeated seizures without recovery between seizures. Intravenous administration of anti-seizure medications is required for treatment. Diazepam or lorazepam are usually effective for terminating seizures in the short-term, while phenytoin or fosphenytoin are preferred for prolonged therapy due to being highly effective with less sedation. If seizures are not controlled by first-line treatments, phenobarbital may be used, and refractory cases may require general anesthesia. Close monitoring is important due to risks of respiratory depression, hypotension, and cardiotoxicity from some medications.
Status epilepticus is defined as continuous convulsions lasting over 30 minutes or serial convulsions without regained consciousness. Convulsive status epilepticus is more dangerous and can cause mortality in 3-10% of cases mainly due to underlying brain conditions. Common causes include prolonged febrile convulsions, unknown etiology, brain abnormalities or metabolic disorders, and meningitis. Management goals are stabilization, stopping seizures, preventing recurrence, and identifying the cause. Treatment involves emergency medication like diazepam, lorazepam, phenytoin, or midazolam to stop seizures along with monitoring, investigation of the cause, and management of any underlying conditions.
This document discusses epilepsy and status epilepticus. It defines epilepsy and provides classification of seizures based on where they begin in the brain and the level of awareness during the seizure. Focal seizures start in one area of the brain while generalized seizures involve both sides. Seizures can be motor or non-motor. The document also covers risk factors, clinical features, investigation including EEG, diagnosis, differential diagnosis, management including lifestyle modifications and medications, special considerations in pregnancy/reproduction, and other interventions for epilepsy.
Status epilepticus is a medical emergency defined as continuous seizure activity lasting more than 5 minutes or recurrent seizures without regaining consciousness. It has an incidence rate of 10-60 per 100,000 people and is most common in children under 5 years old. Causes include infections, brain injuries, genetic conditions, and noncompliance with anti-seizure medications. The pathophysiology involves excessive excitation and reduced inhibition in the brain. Treatment involves stabilizing the patient, identifying and treating the underlying cause, giving benzodiazepines and other anti-seizure medications, and controlling refractory cases in the ICU with anesthetic medications. Early intervention is important to prevent neurological damage from prolonged seizures.
This document defines epilepsy and seizures, and discusses their incidence, causes, classification, evaluation, and management. Some key points:
- Epilepsy is defined as recurrent seizures unrelated to fever or acute brain injury. Seizures affect 3-5% of children.
- Causes of epilepsy include hypoxia, infection, trauma, developmental defects, and genetic conditions like tuberous sclerosis.
- Seizures are classified as partial/focal or generalized. Common generalized seizures include grand mal and absence seizures.
- Evaluation involves medical history, physical exam, and in some cases tests like EEG. Management focuses on anticonvulsant drugs tailored to seizure type. Surgery may be an option for drug-
GLAUCOMA of human eye for certificate nursesokumuatanas1
This document provides information about glaucoma, including:
1. Glaucoma is a group of eye conditions marked by increased pressure in the eye that can damage the optic nerve and lead to vision loss.
2. The two main types are open-angle glaucoma, the most common type caused by blocked drainage canals, and angle-closure glaucoma caused by a narrowed drainage angle.
3. Risk factors include age over 40, family history, and other medical conditions. Treatment involves medications, laser treatments, or surgeries to lower pressure and improve drainage in the eye.
Cranial_Nerves_examination Cranial nerve examination frequently appears in OS...Zachm5
Cranial nerve examination frequently appears in OSCEs. You’ll be expected to assess a subset of the twelve cranial nerves and identify abnormalities using your clinical skills
This document provides information about glaucoma, including:
- Glaucoma is a disease of the optic nerve that can cause vision loss and blindness if left untreated. It has no symptoms in its early stages.
- The two main types are open-angle glaucoma, which accounts for 95% of cases, and closed-angle glaucoma, which develops more rapidly.
- Risk factors include family history, age over 40 for African Americans and 60 for others, high eye pressure, thin corneas, and certain medical conditions.
- Regular eye exams including tonometry to measure pressure and examination of the optic nerve are important for early detection and treatment to prevent vision loss. Glau
This document provides information on eye disorders, specifically cataracts and glaucoma. It defines cataracts as a lens opacity and discusses causes, types, symptoms, and treatment including medication and surgery. For glaucoma, it describes the condition as optic nerve damage related to intraocular pressure, lists types, discusses evaluation and treatment with medication, laser procedures, and nursing care post-surgery. The document aims to educate on these common age-related eye conditions.
This document provides an overview of glaucoma, including its definition, causes, risk factors, symptoms, diagnostic tests, treatment options, and post-operative complications. Glaucoma is an eye disease where damage to the optic nerve leads to vision loss. It is often caused by abnormally high pressure within the eye. Diagnostic tests include visual field testing, tonometry, ophthalmoscopy and gonioscopy. Treatment may involve eye drops, oral medication, laser procedures or surgery to improve fluid drainage from the eye. Surgical options include trabeculectomy, laser treatments, and the use of aqueous shunt devices. Post-operative risks include infection, shallow anterior chamber and over or under filtration of fluid from the eye
Retinal detachment occurs when the retina separates from the back of the eye. It is a medical emergency that can cause permanent vision loss if not repaired. The retina is made up of layers and receives images that the brain interprets as vision. Retinal detachment can be rhegmatogenous, tractional, or exudative and risks include nearsightedness, eye surgery or injury. Diagnosis involves eye exams and ultrasound. Treatment may involve laser, cryotherapy, scleral buckle surgery, pneumatic retinopexy or vitrectomy to seal retinal breaks and reattach the retina. Nursing care focuses on medication administration, activity safety, and education on signs of recurrence and postoperative care.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased pressure within the eye. It can be classified as open angle or angle closure glaucoma. Risk factors include family history, age, race, and certain medical conditions. Diagnosis involves tests to measure eye pressure, examine the optic nerve, and map the visual field. Treatment may include eye drop medications, laser trabeculoplasty, or filtering surgeries to lower pressure and prevent further nerve damage. Nursing care focuses on educating patients about glaucoma management and maintaining vision.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased pressure within the eye. It can be classified as open angle or angle closure glaucoma. Risk factors include family history, age, race, and certain medical conditions. Diagnosis involves tests to measure eye pressure, examine the optic nerve, and map the visual field. Treatment may include eye drop medications, laser trabeculoplasty, or filtering surgeries to lower pressure and prevent further nerve damage. Nursing care focuses on educating patients about glaucoma management and maintaining vision.
Glaucoma is a group of eye conditions characterized by optic nerve damage and vision loss caused by increased pressure within the eye. It can be classified as open angle or angle closure glaucoma. Risk factors include family history, age, race, and certain medical conditions. Diagnosis involves tests to measure eye pressure, examine the optic nerve, and map the visual field. Treatment may include eye drop medications, laser trabeculoplasty, or filtering surgeries to lower pressure and prevent further nerve damage. Nursing care focuses on educating patients about glaucoma management and maintaining vision.
1. Glaucoma is a group of eye disorders characterized by increased intraocular pressure and optic nerve damage that can lead to vision loss.
2. Risk factors include age, family history, diabetes, eye injuries or abnormalities.
3. Treatment involves lifelong use of eye drops or surgery to lower pressure and prevent further vision loss.
This document summarizes information about glaucoma, including its causes, types, symptoms, risk factors, tests, and treatments. Glaucoma is a group of eye disorders characterized by abnormally high pressure in the eye (intraocular pressure) that can damage the optic nerve and lead to vision loss. The two main types are open-angle glaucoma, which develops slowly and has no initial symptoms, and angle-closure glaucoma, which causes sudden severe eye pain and blurred vision. Risk factors include family history, high eye pressure, severe nearsightedness, eye injuries, and prolonged steroid use. Treatments may include medications like pilocarpine, laser procedures, or surgery to improve fluid drainage from
Mr. Jaydip J. Ninama is a lecturer in the department of medical surgical nursing. The document discusses the anatomy and physiology of the lens, causes and types of cataracts, signs and symptoms, diagnosis, and treatment. The main types of cataracts discussed are nuclear, cortical, subcapsular, and age-related cataracts. Treatment involves removing the cloudy lens surgically, usually through phacoemulsification. Post-operative care and potential complications are also outlined.
1. Cataracts are opacities or cloudiness in the lens of the eye that impair vision. They are most commonly age-related but can be caused by eye injuries, medical conditions like diabetes, or exposure to radiation.
2. Symptoms include reduced visual acuity, glare, distorted vision, and difficulty seeing colors. Examination reveals a dim red reflex and opacity visible through a slit lamp.
3. Treatment is usually surgical removal of the cloudy lens, most commonly through phacoemulsification which uses ultrasound to break up the lens for removal. Post-operative care involves steroid and antibiotic eye drops. Potential complications include infection, bleeding, inflammation, and refractive errors.
L11-1434 vision L1 .pdf special senses.luckymbasela
This document provides an overview of the physiology of the special senses, with a focus on vision. It describes the anatomy of the eye, including the layers, tissues, humors, and role of each component. Key points covered include refraction of light as it passes through the eye, accommodation through the lens, and the roles of the retina, fovea and optic nerve in visual processing. Common vision conditions like glaucoma, cataracts and errors of refraction are explained. The document also discusses binocular vision and its advantages over monocular vision.
A cataract is a clouding or opacity that
develops in the crystalline lens of the eye or in its envelope, varying in degree from slight opacity to obstructing the passage of light.
Progressive, painless clouding of the natural, internal lens of the eye.
Glaucoma is a group of eye diseases characterized by increased intraocular pressure, optic nerve damage, and visual field loss. It is a leading cause of blindness worldwide. Cataracts are cloudy lenses that reduce vision and are most often age-related. They occur when the lens becomes less transparent over time. Risk factors for cataracts include diabetes, corticosteroid use, and glaucoma. Both conditions are generally treated surgically by removing the opaque lens or reducing eye pressure, but vision lost from glaucoma cannot be recovered. A combined study found diabetes significantly increases cataract risk while glaucoma is also an independent risk factor, potentially causing 5% of all cataracts.
This document provides an overview of the visual system, including:
- Anatomy of the eye and visual pathways in the brain
- Embryology and cellular organization of the retina
- Physiology of photoreceptors and visual processing
- Common pathologies that can cause visual disturbances, such as glaucoma, optic neuritis, retinal detachment and more.
- Examination techniques to assess the eye, optic nerve and visual fields.
Special Senses (Eye -vision & Ear-hearing).RupaSingh83
The document provides an overview of the special senses and their anatomy and function. It describes the five special senses - vision, hearing, balance, smell, and taste. For vision, it details the anatomy of the eye including the cornea, retina, lens, and other structures. It also discusses common eye defects like macular degeneration and glaucoma. For hearing and balance, it outlines the anatomy of the outer, middle and inner ear including the tympanic membrane, ossicles, cochlea and semicircular canals. The functions of vision in capturing light and hearing in transducing sound are summarized.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Hiranandani Hospital in Powai, Mumbai, is a premier healthcare institution that has been serving the community with exceptional medical care since its establishment. As a part of the renowned Hiranandani Group, the hospital is committed to delivering world-class healthcare services across a wide range of specialties, including kidney transplantation. With its state-of-the-art facilities, advanced medical technology, and a team of highly skilled healthcare professionals, Hiranandani Hospital has earned a reputation as a trusted name in the healthcare industry. The hospital's patient-centric approach, coupled with its focus on innovation and excellence, ensures that patients receive the highest standard of care in a compassionate and supportive environment.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
2. BASIC ANATOMY OF THE EYE:
Eye. The organ of sight.
Parts of the eye;
1. Cornea: The clear front window of the eye. The
cornea transmits and focuses light into the eye.
2. Iris: The colored part of the eye. The iris helps
regulate the amount of light that enters the eye.
3. Lens: The transparent structure inside the eye that
focuses light rays onto the retina.
4. Macula: A small area in the retina that contains
special light-sensitive cells. The macula allows us to
see fine details clearly.
3. 5. Optic Nerve: The nerve that connects the eye to the
brain. The optic nerve carries the impulses formed by
the retina to the brain, which interprets them as
images.
6. Pupil: The dark center in the middle of the iris. The
pupil determines how much light is let into the eye. It
changes sizes to accommodate for the amount of light
that is available.
7. Retina: The nerve layer that lines the back of the eye.
The retina senses light and creates impulses that are
sent through the optic nerve to the brain.
8. Vitreous: The clear, jelly-like substance that fills the
middle of the eye.
cataracts 3
7. CATARACT:
• Cataract is a lens opacity or
cloudiness or blurred vision.
• Cataracts rank behind only
arthritis and heart disease as
a leading cause of disability in
older adults
• According to WHO, cataracts
is the leading cause of
blindness in world
cataracts 7
8. PATHOPHYSIOLOGY:
• Cataract can be develop in
one or both eyes at any age
• Three most common type of
senile (aged-related)
cataracts are defined by the
location in the lens
Nuclear:
• Central opacity in lens
• Associated with myopia
• Worsen on progression
cataracts 8
9. Cont…
• Cortical:
• Involve the interior and posterior
equatorial cortex of the lens
• Worst in very bright light
• Posterior sub capsular :
• occurs in front of posterior capsule
• Mostly occurs in youngers
• Associated with prolonged use of
corticosteroids, diabetes, ocular
trauma
• Near vision is diminished
cataracts 9
10. CAUSES AND RISK FACTORS:
• Cigarette smoking
• Long term use of corticosteroids, especially
high doses
• Sun light and ionizing radiation
• Diabetes
• Obesity
• Eye injuries
cataracts 10
11. CLINICAL MANIFESTATIONS:
• Painless, blurred vision
• The person perceived that surroundings
are dimmer
• Light scattering is common
• Monocular diplopia
• Reduce visual acuity
cataracts 11
12. ASSESSMENT AND DIAGNOSTIC
FINDINGS:
• Decrease visual
acuity is directly
proportionality to
cataract density
• Snellen visual acuity
test
• Ophthalmoscopy
• Slit-lamp bio
microscopic
examination
cataracts 12
13. MANAGEMENT:
MEDICAL MANAGEMENT
• No nonsurgical (medication, eye drops, eye glasses)
treatment cures cataract or prevent age related
cataracts
• Anti-oxidant supplement, vit:C and E, β-Carotene are
not too much beneficial
• Glasses or contacts, bifocal or magnifying lens may
improve vision
• Mydratics can be used short term (eye dilating
agents)
cataracts 13
14. SURGICAL MANAGEMENT:
• If reduced vision from cataract doesn’t interfere
with normal activities, surgery is not needed
• Surgical options include
1. Extra capsular cataract surgery
2. Lens replacement
• Cataracts are removed under local anesthesia
• When both eyes have cataracts, one eye is
treated first with at least several weeks or
months then other
cataracts 14
15. NURSING MANAGEMENT:
• Pre and post-operative care
• Promoting home and community based care
• Anticoagulants therapy may continue
• Administer dilating drops every 10 min for 04 doses at
least 1 hour before surgery
• Administer antibiotics, corticosteroids and anti-
inflammatory drops prophylactically
• Educate patients to protect eye, administer medication,
recognize signs and complications and obtain emergency
care
• Continue the care up to recovery
cataracts 15
16.
17. GLAUCOMA:
Definition:
• Glaucoma is characterized by abnormally
elevated intraocular pressure (IOP), which can
damage the optic nerve. This nerve carries
visual information from the eye to the brain.
TYPES:
• Chronic open-angle glaucoma
• Acute closed-angle (or narrow-angle) glaucoma
18.
19. 19
OPEN-ANGLE GLAUCOMA:
• Also called wide-angle glaucoma, this is the
most common type of glaucoma. The
structures of the eye appear normal, but fluid
in the eye does not flow properly through the
drain of the eye, called the trabecular
meshwork.
20. 20
ANGLE-CLOSURE GLAUCOMA:
• Also called acute or chronic angle-closure or
narrow-angle glaucoma, this type of glaucoma
is less common but can cause a sudden
buildup of pressure in the eye. Drainage may
be poor because the angle between the iris
and the cornea (where a drainage channel for
the eye is located) is too narrow.
22. 22
PATHOPHYSIOLOGY:
• Axons of retinal ganglion cells travel through
the optic nerve carrying images from the eye
to the brain.
• Damage to these axons causes ganglion cell
death with resultant optic nerve atrophy and
patchy vision loss.
• Elevated IOP (in unaffected eyes, the average
range is 11 to 21 mm Hg) plays a role in axonal
damage, either by direct nerve compression
or diminution of blood flow.
24. 24
CLINICAL MENIFESTATION:
Primary open-angle glaucoma signs and
symptoms include:
• Gradual loss of peripheral vision, usually in both
eyes
• Tunnel vision in the advanced stages
Acute angle-closure glaucoma signs and
symptoms include:
• Eye pain
• Nausea and vomiting (accompanying the severe
eye pain)
25. 25
• Sudden onset of visual disturbance, often in
low light
• Blurred vision
• Halos around lights
• Reddening of the eye
26. 26
RISK FACTORS:
• Are over age 40.
• Have a family history of glaucoma.
• Black racial ancestry
• Have poor vision.
• Have diabetes.
• Trauma
• Take certain steroid medications, such as
prednisone.
27. 27
COMPLICATIONS:
• If left untreated, glaucoma will cause
progressive vision loss, normally in these
stages:
1.Blind spots in your peripheral vision
2.Tunnel vision
3.Total blindness
28. 28
DIAGNOSIS:
1.Eye-pressure test-
The doctor uses a tonometer, a device which
measures intraocular pressure (pressure inside
the eye). Some anesthetic and a dye is placed
in the cornea, and a blue light is held against
the eye to measure pressure. This test can
diagnose ocular hypertension; a risk factor for
open-angle glaucoma.
29. 29
2.Pachymetry-The doctor also measures corneal
thickness, because it affects how the pressure
inside the eye is interpreted.
3.Gonioscopy-This examines the area where the
fluid drains out of the eye. It helps determine
whether the angle between the cornea and the
iris is open or blocked (closed).
30. 30
4.Perimetry test-
• Also known as a visual field test. It determines
which area of the patient's vision is missing.
• The patient is shown a sequence of light spots
and asked to identify them.
• Some of the dots are located where the person's
peripheral vision is; the part of vision that is
initially affected by glaucoma.
• If the patient cannot see those peripheral dots,
it means that some vision damage has already
occurred.
31. 5.Optic nerve damage-
The ophthalmologist (eye doctor) uses
instruments to look at the back of the eye,
which can reveal any slight changes which
may also point towards glaucoma onset.
33. 33
NURSING MANAGEMENT:
• Monitor for any pain or visual changes.
• Monitor the patient’s compliance with medications
and follow-up care.
• Administer antiemetics as directed to prevent
vomiting, which will increase IOP.
• Administer medications I.V., orally or topically, as
directed, and explain the importance of
medications, the proper procedure for
administration of drops, and possible adverse
reactions.
• After surgery, elevate head of the bed 30 degrees to
promote drainage of aqueous humor after a
trabeculectomy.
34. 34
• Administer medications (steroids and
cycloplegics) as directed after peripheral
iridectomy to decrease inflammation and to
dilate the pupil.
• Alert the patient to avoid prolonged coughing
or vomiting, emotional upsets such as worry,
fear, anger; exertion such as pushing and
heavy lifting.
• Instruct the patient’s family how to modify the
patient’s environment for safety.
37. 37
EPISTAXIS:
Definition:
• Epistaxis (from Greek: (epistazo) to bleed from the
nose: (epi) - "above", "over" + (stazo) - "to drip [from
the nostrils]")
OR
Epistaxis is defined as acute hemorrhage from the
nostril, nasal cavity, or nasopharynx.
. There are two types: anterior (the most common),
and posterior (less common, more likely to require
medical attention).
38. 38
ANATOMY OF NOSE:
• The nose is the part of the respiratory tract that sits front
and center on your face. You use it to breathe air in and to
stop and smell the roses. The nose’s exterior anatomy
includes the nasal cavity, paranasal sinuses, nerves, blood
supply, and lymphatics.
• The external part of the nose includes the root (between
the eyes), the dorsum that runs down the middle, and the
apex at the tip of the nose. Two openings called nostrils
(nares) allow air in. They’re divided by the nasal septum
(dividing wall of cartilage and bone), and the parts that
surround the nostrils are called the alae (ala singular).
• Nose is supplied by oflactory nerve.
40. 40
PATHOPHYSIOLOGY:
• The physiological demands of the nose require
a healthy blood supply. Loss of mucosal
integrity, for any reason, exposes underlying
vessels, which may be break and bleed.
• Vasoconstriction and activation of the clotting
mechanism normally regains haemostasis.
Impairment of these processes may prolong
bleeding.
42. 42
CAUSES:
• The most common cause is due to rupture of blood
vessels in the nose as a result of minor trauma
during nose blowing, rubbing, pricking and
sneezing.
• Other more definite trauma to the nose such as a
blow or a fall with nose hitting against object can
obviously results in epistaxis.
• Tumour of the nose or nasopharynx is also a
common cause.
• Epistaxis is also commonly seen in patient with
bleeding tendency e.g. platelet insufficiency.
43. 43
SING AND SYMPTOMS
• Dark or bright red bleeding from one or both
nostrils is the most common sign of epistaxis.
• You may also have trouble breathing,
• smelling, or
• talking if blood clots block your nostrils.
44. 44
RISK FACTORS FOR EPISTASIX :
• Risk factors for nosebleeds include:
• Colds
• Sinusitis
• Dry climate
• High blood pressure
• Allergic rhinitis
• Nose injury
45. 45
COMPLICATIONS:
• Acute bacterial rhinosinusitis(inflammation or
infection of the mucosa of the nasal passages
and at least one of the paranasal sinuses.)
• Cardiovascular compromise associated with
extensive bleeding
• Toxic shock syndrome
• Hypoxia
• Recurrent epistaxis
46. 46
DIAGNOSTIC TESTS:
• Blood tests- Complete blood count and
analysis of blood coagulation factors
• Measurement of the blood pressure.
• Nasal endoscopy
• X-rays of the skull and sinuses.
• CT scan of the nose and sinuses.
47. 47
MEDICAL MANAGEMENT:
• Medical approaches to the treatment of
epistaxis may include the following:
• Oral and topical antibiotics to prevent
rhinosinusitis and possibly toxic shock
syndrome
• Avoidance of aspirin and other nonsteroidal
anti-inflammatory drugs (NSAIDs)
• Medications to control underlying medical
problems (e.g, hypertension, vitamin K
deficiency).
48. 48
NURSING MANAGEMENT:
• Place patient in an upright position, leaning
forward to reduce venous pressure
• Avoiding the patient to talk and let to breathe
through his mouth
• Tell the Patient to firmly grasp and pinch his entire
nose between the thumb and fingers for at least
10 minutes
• Compress the soft outer portion of the nose
against the midline septum for about 5-10
minutes continuously
49. 49
Cont…
• Keep the head of the bed elevated 30 to 45
degrees for the next 4 hours.
• Tell to the patient not to blow his/her nose for
several hours and to avoid lifting objects or
bending at the waist for the next 24 hours.
• Psychological support to the patient specially if
he feels uncomfortable.
51. 51
ANATOMY OF NASAL SEPTUM:
• The nasal septum is the wall dividing the nasal
cavity into halves.
• The septum is composed of cartilage and bone
covered on each side by mucous membrane
53. 53
DEFINATION OF DAVIATED NASAL
SEPTUM:
• The nasal septum
may develop bends
as it grows or be
damaged by injury to
the nose – called
nasal septum
deviation – causing a
blocked nose.
56. 56
• Spurs - They are seen at the cartilago-bony
junction of the septum.Thickened septum post
trauma
57. 57
• Deviations - May be C shaped or S shaped.
These can occur in either vertical or horizontal
plane. It may also involve both cartilage and
bone.
• Dislocations - In this the lower border of the
septal cartilages displaced from its medial
position and projects into one of the nostrils.
58. 58
C - shaped nasal septal deviated causing
contour changes in the nose.
60. 60
CAUSES:
• Birth Moulding theory: Abnormal intrauterine
posture and second stage of labour lasting more
than 15 minutes in primipara.However these are
postulated theories.
• Trauma: Commonest cause of deviation.
• Secondary to a tumour, mass or polyps in the nose
to compression.
• Developmental Buckling: If the septum starts
growing rapidly it gets buckled to one side to
accommodate itself.
62. 62
RISK FACTORS:
• Playing contact sports
• Not wearing your seat belt while riding in a
motorized vehicle.
63. 63
COMPLICATIONS:
1. Nasal septum perforation : Due to bilateral
trauma of the mucoperichondrial flaps
opposite each other.
2. Septal haematoma and septal abscess.
3. Adhesions and synachiae: between septal
mucosa and lateral nasal wall.
4. Saddle nose: Due to over resection of the
dorsal wall of the septal cartilage.
5. Dropped nasal tip: Due to resection of the
caudal margin
65. 65
TREATMENT/ MANAGEMENT:
• Managing symptoms-such as nasal congestion
and postnasal drip. Your doctor may prescribe:
• Decongestants
• Antihistamines
• Antibiotics
• Nasal steroid sprays.
• Surgical repair (septoplasty)
• Rhinoplasty
66. 66
NURSING MANAGEMENT:
• To treat epistaxis, elevate the head of bed,
compress the outer portion of nose against the
septum for 10-15 min. & apply ice packs. if
bleeding persist, notify the doctor
• Warn the patient with perforation or severe
deviation against blowing his nose.
• To relieve nasal congestion, instill saline nasal
drops.
• Teach the patient about rebound effects of
continual use of decongestant nasal sprays.
68. A) DEFINITION:
• The separation of the retina
from the choroid (a dense
membrane that is located
between retina & sclera)
• or “Retinal detachment” is the
moving away of the retina from
the middle wall of the eyeball.
68
RETINAL DETACHMENT
The condition of being “separated or disconnected”
69. B) PATHOPHYSIOLOGY
• There are 3 layers of eye
outer fibrous, Middle
vascular, inner retina.
• Retina is a thin layer of light
sensitive tissue on the eye. It
sends image as neural
impulses to brain via Optic
nerve.
• Retinal Detachment is a
disorder of eye in which the
retina peels away from its
supportive layer choroid.
69
70. Cont…
• Initial detachment may be localized, but
without rapid treatment the entire retina may
detached, leading to vision loss or blindness.
• Retina may be due to trauma, increased age
or family history.
CONTNUOUS 70
71. C) ETIOLOGY OR CAUSES:
Several conditions may cause retinal
detachment:
• Shrinkage of the vitreous can pull
the retina inward.
• Small tears in the retina allow
liquid to leak behind the retina
and push it forward.
• Injury to the eye can lose retina.
71
72. Cont…
• Bleeding behind the retina.
• Injury can push it forward, this is occurs more
often in the elderly people.
• Tumors can cause the retina to detach.
• If most of the retina is detached, there may be
only a small part of vision remaining.
73. D ) CLINICAL MANIFESTATIONS :
Symptoms may include:
• The sensation of a shade or curtain coming
across the vision of one eye.
• Bright flashing lights or Spots before the eyes.
• Shadows or black areas in the field of vision.
• The sensation of spots or moving particles in
the field of vision.
• Cloudy vision or loss of a portion of the visual
field. 73
74. E) DIAGNOSIS:
• May be made on
basis of clinical
signs and
symptoms
• Ophthalmoscopic
examination
• Scleral depressor
(for assessing
rotating eye ball )
74
76. G) SURGICAL MANAGEMENT:
There are four known surgical treatment of retinal
detachment
1) Laser photo coagulation:
If detachment is small, By Laser surgery we can seal the retina
against the choroid.
76
77. 2) Cryopexy:
• It uses nitrous oxide to freeze the tissue behind the retinal
tear, stimulating scar tissue formation that will seal the edges
of the tear.
CONTNUOUS 77
Cont…
78. 3) Pneumatic Retinopexy:
A small gas bubble injected into vitreous body, the bubble
rises and pressure against retina ,pushing it against the
choroid. The gas bubble is slowly absorbed over the next 1 or
2 weeks.
CONTNUOUS 78
Cont…
79. 4) Scleral Buckling:
To place the retina back in contact with choroid this method is
used. The sclera is actually depressed from the outside by rubber
like “silicon” or “bands” that are sutured in place permanently,
intraocular injection of “air” or “sulfur hexafluoride gas” bubble
is used to apply pressure on retina from the inside of eye, this
holds retina by force during healing phase.
79
Cont…
80. H) NURSING MANAGEMNENT:
• Nursing care focuses on reducing the fears
related to loss of vision.
• Nurse should observe the eye for any drainage.
• Assess the level of pain.
• Teach the patient that avoid from any
movement if an air or gas bubble has been
injected.
• Provide suggestion for comfort and support
with the positioning (pillows under elbows or
ankles).
80
81. Cont...
• Encourage the client to resume a regular diet and fluid
as tolerated.
• Administrate Acetazolamide (Diuretic) intravenous; it
may reduce increased intra ocular pressure
• Provide Pre and postoperative care.
• Postoperative eye medication generally includes an
antibiotic steroid combination eye drop to prevent
infection & reduce inflammation.
• Instruct the patient to clean eye with warm tap water.
• Home and Self care.
81
83. BURN:
Definition:
A burn is a type of injury to flesh or skin
caused by heat,
electricity, chemicals, friction, or radiation
83
84. CLASSIFICATION OF BURN:
• Superficial (first degree burn)
• Superficial partial thickness(second degree burn)
• Deep partial thickness(third degree burn)
• Full thickness (fourth degree burn)
85. SUPERFICIAL BURN (1ST DEGREE)
•Includes only the outer layer of skin, the epidermis
•Skin is usually red and very painful.
•Equivalent to superficial sunburn without blisters
•Dry in appearance
•Healing occurs in 3-5 days, injured epithelium peels
away from the healthy skin
85
87. SUPERFICIAL PARTIAL-THICKNESS (FIRST DEGREE)
Can be classified as partial or full thickness.
• Partial thickness
– Blisters can be present
– Involve the entire epidermis and upper layers of the
dermis
– Wound will be pink, red in color, painful and wet
appearing
– Wound will blanch (turn white) when pressure is applied
– Should heal in several weeks (10-21 days) without
grafting, scarring is usually minimal.
87
88. Cont...
Full thickness
•Can be red or white in appearance, but will appear dry.
•Involves the destruction of the entire epidermis and most of the
dermis
•Sensation can be present, but diminished
•Blanching is sluggish or absent
•Full thickness will most likely need excision & skin grafting to heal
88
89. DEEP PARTIAL THICKNESS(THIRD DEGREE)
• All layers of the skin is destroyed
• Extend into the subcutaneous tissues
• Areas can appear, black or white and will be
dry
• Can appear leathery in texture
• Will not blanch when pressure is applied
• No pain
89
91. CAUSES:
Burns are caused by a variety of external sources
classified into;
• Thermal
• Chemical
• Electrical
• Radiation
91
92. Thermal
• It is most commonly occurs from
exposure to hot drinks, high
temperature tap water in baths or
showers, hot cooking oil or steam.
92
93. Chemical
• it occur due to exposure of common
agents include: sulfuric acid as found in
toilet cleaners, sodium hypochlorite as
found in bleach, and halogenated
hydrocarbons as found in paint remover.
93
94. Electrical
• It occurs due to exposure of electrical
things, Electrical injuries primarily
result in burns they may also
cause fractures and trauma.
94
95. Radiation
Radiation burns may be caused by exposure
to ultraviolet light (such as from the
sun, tanning booths or arc welding) ionizing
radiation (such as from radiation therapy, X-
rays or radioactive fallout). Sun exposure is
the most common cause of radiation burns
and the most common cause of superficial
burns overall.
95
98. MANAGEMENT OF BURN:
• Maintain I/v line
• Administer I/v Ringer lactate
• Wash the wounds with normal saline
solution and dressing the wound as order.
• Administer analgesics to reduce the pain
i.e. ibuprofen, morphine
98
99. Cont…
• Administer intravenous antibiotics i.e.
ceftriaxone.
• Prepare for surgery (skin grafting)
• Honey has been used since ancient times to aid
wound healing and may be beneficial in first
and second degree burns. There is little
evidence that vitamin E helps with keloids(
scars).