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
Caring for perioperative clients
Contents Outline
Objectives.
Introduction.
Phases of perioperative care.
Types of surgery.
Categories of surgery based on urgency.
Preoperative assessment.
Surgical risk factors.
Preoperative preparation.
Nursing diagnosis and intervention in preoperative phase.
Postoperative care.
Nursing diagnosis and intervention in postoperative period.
Postoperative complications.
This contains wound and wound dressing,classification of wound,
signs and symptoms of wound
Diagnostic evaluation od wound
Wound healing process,
Factors affecting wound healing
Complication of wound
Wound Dressing
Types of dressing
Articles need in wound dreassing
Caring for perioperative clients
Contents Outline
Objectives.
Introduction.
Phases of perioperative care.
Types of surgery.
Categories of surgery based on urgency.
Preoperative assessment.
Surgical risk factors.
Preoperative preparation.
Nursing diagnosis and intervention in preoperative phase.
Postoperative care.
Nursing diagnosis and intervention in postoperative period.
Postoperative complications.
This contains wound and wound dressing,classification of wound,
signs and symptoms of wound
Diagnostic evaluation od wound
Wound healing process,
Factors affecting wound healing
Complication of wound
Wound Dressing
Types of dressing
Articles need in wound dreassing
This slide includes the nursing management for bed sore and its preventive measures. It is very helpful for the nursing students. It is very necessary to detect at early stage for proper management. # Share to Others. # NURSING
Burns are tissue damage that results from heat, overexposure to the sun or other radiation, or chemical or electrical contact. Burns can be minor medical problems or life-threatening emergencies. The treatment of burns depends on the location and severity of the damage.
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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.
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View all Thalassemia (thal-uh-SEE-me-uh) is an inherited blood disorder that causes your body to have less hemoglobin than normal.
Hemorrhagic shock occurs when the body begins to shut down due to large amounts of blood loss. People suffering injuries that involve heavy bleeding may go into hemorrhagic shock if the bleeding isn't stopped immediately. Common causes of hemorrhagic shock include: severe burns.
Hemophilia is a rare disorder in which your blood doesn't clot normally because it lacks sufficient blood-clotting proteins (clotting factors). If you have hemophilia, you may bleed for a longer time after an injury than you would if your blood clotted normally. Small cuts usually aren't much of a problem.
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A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a number of types. Most commonly they involve the abdomen, specifically the groin. Groin hernias are most commonly of the inguinal type but may also be femoral.
Diarrhoea is usually a symptom of an infection in the intestinal tract, which can be caused by a variety of bacterial, viral and parasitic organisms. Infection is spread through contaminated food or drinking-water, or from person-to-person as a result of poor hygiene.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
1. P R E S E N T E D B Y
J A G D I S H S A M B A D
I K D R C C O L L E G E O F N U R S I N G
WOUND AND WOUND
DRESSING
2. DEFINITION OF WOUND
A wound is a break or cut in the continuity
of any body structure, internal or external
caused by physical means.
3. CLASSIFICATION OF WOUND
According to status of skin integrity
Open wound
Closed wound
According to the cause of the wound
Intentional or surgical wound
Unintentional wound
4. CON…
According to severity of injury
Superficial (Abraded) wound
Penetrating wound
Perforated wound
Puncture or stab wound
According to cleanliness / contamination
Clean wound
Contaminated wound
Infected or septic wound
Colonized wound
6. Inflammatory phase
• Within few seconds after injury, inflammation begins and
lasts for about 3 days.
• Injured tissues and mast cells secrete histamine, resulting in
vasodilation of surrounding capillaries and exudation of
serum and while blood cells into damaged tissues.
• Leukocytes reach the wound within few hours. The neutrophil
begins to ingest bacteria and small debris. The neutrophil dies
in a few days.
• During this period the monocyte which transforms into
macrophages cells clean the wound bacteria, dead cells and
debris.
• This process continues for about 48 hours. Finally a thin layer
of epithelial tissue forms over the wound, which is later
absorbed.
7. Destructive phase
This begins before the inflammatory phase ends and
lasts for about 2 to 5 days.
Macrophages continue its cleaning process and
stimulate the formation of fibroblast.
8. Proliferative phase
This phase begins with the appearance of the new
blood vessels and lasts from 3 to 24 days. Fibroblasts
appear alongside the capillaries. These two together
constitute the granulation tissue.
Subsequently there is epithelization. All the cells
forming the surface epithelium undergoes rapid
division and migrates as a thin film covering the
wound.
The wound appears pink owing to the new capillaries
in the granulation tissue and the area is soft and
tender.
9. Maturation phase
This final phase may take more than one year there
is scar formation by the fibroblasts. The capillaries
and lymphatic endothelial buds in the new tissues
disappear and the scar then shrinks. The collagen
scar continues to regain strength over several
months.
10. FACTORS AFFECTING HEALING PROCESS
Nutrition
Age
Blood supply
Hormones
Drugs
Extent of the injury
Infection
Chronic diseases
Smoking
Obesity
Radiation
Wound stress
11. COMPLICATION
Hemorrhage
Infections
Wound dehiscence
Wound evisceration
Fistula
Abscess formation
Cellulitis
Necrosis or Gangrene
Keloids
Pain
Fluid collection
Interference with organ function
12. DEFINITION OF WOUND DRESSING
It is a sterile protective covering applied to a
wound/incision with aseptic technique with or without
medications.
13. TYPES OF DRESSINGS
Dressings are vary by type of material and mode of
application.
Gauze dressings
Non-antiseptic dressings
Antiseptic dressings
Wet dressings
Pressure dressings
Non-adherent gauze dressings
Self-adhesive transparent film
14. PURPOSES OF WOUND DRESSINGS
To prevent infection.
To prevent further tissue damage.
To promote healing.
To absorb inflammatory exudate and to promote drainages.
To convert the contaminated wound into a clean wound.
To prevent hemorrhage.
To prevent skin excoriation.
To apply medication in place.
To restore the function of the part.
To provide physical and mental comfort to the patient.
To promote thermal insulation to the wound surface area.
To provide maintenance of high humidity between the wound and
dressing.
15. PRINCIPLES INVOLVED IN WOUND
DRESSINGS
Micro-organisms are present in environment, on the
articles and on the skin. Pathogenic organisms are
transmitted from the source to the new host directly or
indirectly.
Bacteria travel along with the dust particles.
Cleaning the area where there is less number of
organisms, before cleaning an area where there is more
organisms. Minimize the spread of organisms to the clean
area.
A break in the skin and mucus membrane acts as the
portal of entry for the pathogenic organisms.
16. CON..
Respiratory tract harbors micro-organisms that can enter
the wound.
Nutrients and oxygen are carried to the wound via blood
stream and are essential for collagen formation.
Moisture facilitates growth and movement of micro-
organisms.
Fluid moves downwards as a result of gravitational pull.
Fluids move through materials by capillary action.
Unfamiliar situations produce anxiety.
Systematic ways of working saves time, energy and
material.
17. GENERAL INSTRUCTIONS FOR THE WOUND
DRESSING
Practice strict aseptic technique to prevent cross infection to the
wound and from the wound. All materials touching to the wound
should be sterile.
All articles should be disinfected thoroughly to make sure that they
are free from pathogens. Special care must be taken when there is
any reason to suspect the presence of pathogenic spores particularly
those causing the dreaded wound infections of gas gangrene and
tetanus. These spores are destroyed only by the sterilization with
steam under pressure.
Wash hands thoroughly before and after procedure.
Instruments used for one dressing can not be used for another until
they have been re-sterilized.
Use masks, sterile gloves and gowns for large dressings to minimize
the wound contamination.
18. CON..
Dressings are not changed for at-least 15 minutes after the room has
been swept or cleaned. Sweeping and dusting of the room will raise
the dust and the wound will be contaminated.
Use individually wrapped sterile dressings and equipment for the
greatest safety of the wound. The practice of storing dressings and
instruments in large trays and drums and opening them every now
and then should be condemned.
Create a sterile field around the wound by spreading sterile towels.
Avoid talking, coughing and sneezing when the wound is opened.
During the procedure the nurse works carefully to avoid
contaminating the patient’s skin. Clothing and bed linen with soiled
instruments and dressings. All the soiled dressings and contaminated
instruments should be carefully collected and disposed safely.
19. CON…
Cleaning of the wound should be done from the most clean area to the less
clean area. Consider the wound area cleaner than the skin area even if the
wound is infected. Therefore clean the wound from its center to the periphery.
When cleaning the circular wound, start from the center of the wound and go
to the periphery. When cleaning a linear wound, the first swab cleanses the
wound line and the subsequent swabs cleanse the skin on either side of the
wound.
If the dressings are adherent to the wound due to the drying of the secretions or
blood, wet it with physiologic saline before it is removed from the wound.
When dressing the wound, keep the wound edges as near as possible to
promote healing.
When drains are in place, anticipate drainage and re-enforce the dressings
accordingly. The dressings over the drains should not combined with the
dressings on the wound line. This enables a nurse to change the dressings over
the drains without disturbing the wound dressings and thereby minimizing the
wound infections.
20. CON..
The amount of discharge from the wound should be accurately
measured by recording the number and size of the dressings
changed. Note the colour, odour, amount and consistency of
the drainage.
When the wound drainage is diminished the drains are to be
shortened. This should be done in consultation with the doctor.
Usually the doctor gives a written order.
Before doing the dressings, inspect the wound for any
complications such as dehiscence and evisceration. If present,
report it immediately to the surgeon and immediate steps are to
be taken.
Avoid meal timing.
Give an analgesics prior to the painful dressings.
21. PREPARATION OF ARTICLES
Articles Purpose
A sterile tray containing
Artery forceps - 1 To clean the wound
Dissecting forceps – 2
Scissors - 1 For the debridement of the wound if
necessary or to cut the gauze pieces to fit
around the drainage tubes etc.
Sinus forceps - 1 To open the sinus tract or to pack the sinus
tract if necessary.
Small bowl - 1 To take the cleaning solution.
Safety pins - 1 To fix the drain in case the drains are cut
short.
Gloves, mask and gown To use when large wounds are dressed.
Cotton balls, gauze pieces, cotton pads etc.
as necessary
To clean and dress the wound.
Slit or dressing towel To create a sterile field around the wound.
22. CON..
An unsterile tray containing
Cleaning solution as necessary To clean the wound and surrounding skin
area.
Ointment and powders as ordered To apply on the wound.
Vaseline gauze in sterile containers To prevent the dressing adhering to the
wound.
Ribbon gauze in sterile containers To pack the sinus tract or a penetrating
wound.
Swab stick in a sterile containers To apply the medication if necessary.
Transfer forceps in a sterile containers To handle the sterile supplies.
Bandages, binders, pins, adhesive
plaster and scissors
To fix the dressing in place.
A large bowl with disinfectant solution To discard the used instruments.
Kidney tray and paper bag To collect the wastes.
Mackintosh and towel To protect the bed linens.
23. TOPICALAGENTS FOR CLEANSING WOUND
Mercurochrome 1 to 2.5% Skin antiseptic
Tr. Iodine 1 – 2%
Savlon 5%
Cetavlon 1%
Normal saline/ Eusol solution
0.5 to 1%
Non irritating antiseptics used for
cleaning of wounds
Hydrogen peroxide 1.5 to 3% It is an oxidizing agent useful for
softening and removing crusted
exudate and debris.
Acetone, ether, turpentine Used for removing adhesive
marks from the skin
24. PRELIMINARY ASSESSMENT
Check the diagnosis and the general condition of the patient.
Check the purpose for which the dressing is to be done.
Check the condition of the wound- the type of the wound, the types of suturing
applied, the type of dressing to be applied etc.
Check the physician’s order for the type of dressing to be applied and the
specific instructions, if any, regarding the cleaning solutions, removal of
sutures, drains and the application of the medications etc.
Check the patient’s name, bed number and other identification.
Check the nurse’s records to find out the general condition of the wound.
Check the abilities and limitations of the patient.
Check the consciousness of the patient and the ability to follow instructions.
Check the articles available in the unit.
25. PREPARATION OF THE PATIENT AND
ENVIRONMENT
Identify the patient and explain the procedure to win his
confidence and co-operation.
Provide privacy with curtains and drapes.
Apply restraints in case of children.
As far as possible avoid meal timings. The dressings may
be done either one hour before of the meals or after meals.
Offer bedpan or urinal prior to the dressing.
Give some analgesics if the patient is in pain.
See the cleaning of the room is done at least one hour
before the expected time of the dressing.
26. CON…
Shave the areas if necessary. Removal of adhesive is more painful
if hair is present.
Placed the patient in a comfortable position and relaxed position
depending on the area to be dressed.
Give proper support to the body parts to the body parts if the
patient has to raise and hold it in position for considerable time.
See that patient’s room is in order with no unnecessary articles.
Clear the bedside table, so that there is sufficient space to set up a
sterile field and to arrange needed supplies and equipment.
Close the doors and windows to prevent drafts. Put off fan.
27. CON..
Adjust the height of the bed for the comfortable working of the
doctors and nurses so that they have neither to stop nor over
reach to do the dressing. Bring the patient to the edge to the
bed. Call for assistance if necessary.
Protect the bed with a mackintosh and towel.
Fold back the upper bedding towards the foot end of the bed
leaving a bath blanket or sheet over the patient. Expose the part
as necessary.
Untie the bandage or adhesive and remove them. Make sure
that the dressing is not removed from it place until the nurse is
ready to do dressing.
Turn the head of the patient to one side, so that the patient may
not see the wound and get worried about it.
28. STEPS OF THE PROCEDURE
Steps of the procedure Reason
Tie the mask To prevent wound contamination with
droplets
Wash hands thoroughly To prevent cross infection
Put on gown (if necessary), gloves To ensure asepsis
Open the sterile tray. Spread the sterile
towel around the wound
To create a sterile field around the wound
Pick up a dissecting forceps and remove
the dressings and put into kidney. Discard
the dissecting forceps in the bowl of
lotion.
To prevent contamination of the hands with
soiled dressings. If the dressing is adherent
to the wound, pour physiologic saline and
wet it before removal.
Note the type and amount of drainage
present.
Ask the assistant to pour small amount of
cleansing solution into the bowl.
To prevent contaminating the hands of the
nurse by the outside of the bottle.
29. CON..
Clean the wound from center to
periphery discarding each swab after
each stroke.
Cleaning the wound should be done from
the cleanest area to the less clean area.
Wound line is considered cleaner than
the surrounding area even if the wound
is infected.
After thoroughly cleaning of the wound,
dry the wound with dry swabs using the
same precautions. Discard the forceps in
the bowl of lotion.
To keep the wound as dry as possible.
Apply medications if ordered. To apply the ointment directly to the wound
may be difficult. Apply a small portion on
the dressing that goes directly over the
wound.
30. CON..
Apply the sterile dressings. Apply the
gauze pieces first and then the cotton
pads. Reinforce the dressing on the
dependent parts where the drainage
may collect.
Cotton placed directly onto the wound
may stick on the wound, when the
discharge dries.
Reinforcing the dressing will prevent
oozing of the drainage onto the bed of
the patient.
Remove the gloves and discard it into
the bowl with lotion.
Gloves worn during the dressing will be
highly contaminated.
Secure the dressings with bandage or
adhesive tapes.
31. AFTER CARE OF THE PATIENT AND ARTICLES
Help the patient to dress up and to take comfortable
position in the bed. Change the garments if soiled with
drainage.
Replace the bed linen.
Remove the mackintosh and towel.
Take all articles to the utility room. Discard the soiled
dressing into a covered container and send for
incineration. Remove the instruments and other articles
from the disinfectant solution and clean them
thoroughly. Dry them. Re-set the tray and send them for
autoclaving. Replace all other articles to their proper
places. Send the soiled linen to the laundry bag for the
washing (remove blood stains before sending them).
32. CON..
Wash hands.
Record the procedure on nurse’s record with date
and time. Record the condition of the wound, type
and amount of drainage, condition of the sutures etc.
on the nurse’s record. Report to the surgeon if any
abnormality found.
Return to the bedside to assess the comfort of the
patient. Special instruction in the care of the wound
are to be communicated to the patient.
Tidy up the bed and unit of the patient.