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Showing posts with label Notes. Show all posts
Showing posts with label Notes. Show all posts

Friday, 26 November 2021

COLOSTOMY

November 26, 2021 0
COLOSTOMY

 COLOSTOMY

Definition:- Artificial opening of the colon (large intestine) through the anterior abdominal wall.

Purpose:- escape the flatus and stool.

Indication:-

1.Intestinal Obstruction.

2.Rectal Tumor and cancer.

3.Intestinal Cancer.

4. Imperforate of anus

Classification:-

According to Placement:-

1.Wet Colostomy 

2.Dry Colostomy

Wet Colostomy:- 

  • stool is passed out in liquid form by the client.
  • Incision is making in ascending colon.
  • ascending wet colostomy is performing for short term/Temporary.
  • Time:- 6-8 weeks.
  • Opening :-opening of colostomy on the right side of abdomen .

Dry Colostomy.

  • Incision is making in sigmoid colon.
  • Stool is passing out in normal form.
  • sigmoid colostomy is performing for long time or permanent based.
  • Opening:- end colostomy or left side of abdominal.

Procedure:-

  • nurse role before procedure precaution.
  • stop the high fiber diet before 2-3 day from procedure.
  • doctor explain procedure.
  • doctor collect consent.
  • collect investigation and report of patient.
  • NBM 8-12 hours before colostomy to prevent risk of aspiration.
  • prepare part.
  • best time for part preparation(before 30 minute form the surgery)
  • Site prepare:- just below the nipple to mid thigh.
  • Solution:- 7.5% betadine or 7.5% savlon.

Position:-

  • 1.Supine position:-during general anesthesia use in surgery
  • 2. Trendelenburg:-when spinal anesthesia use during surgery.

Care of colostomy:-

  • Check the vital sign.
  • Provide side line or lateral position.
  • Clean the outer site of stoma with betadine gauze then use dry gauze.
  • Advantage:-prevent the growth of bacteria and microorganism.
  • prevent skin irritation due to stool and HCL produce irritation.
  • maintain soft dry to the stoma.
  • cover to the stoma with a water  patch.

Advantage:-

  • to prevent leakage of stool.
  • water should be use/cut 1/8 inch more diameter than stoma.
  • connect colostomy bag with ring of water.
  • provide psychological support due to disturbed body image of client.

observe form stool:-

  1. Ascending colon:-Liquid
  2. Transverse:- Semi solid
  3. Sigmoid:-Normal

Observe the color of stoma:-

  • Bright red or pink:-Normal finding.
  • Pale Pink:-Normal in anemic patient.
  • Black or dusky:-abnormal finding due to compromised of blood circulation.(inform to doctor)
  • Malodorous/foul smell form stoma upto  72 hr. after colostomy is normal finding.
  • foul smell form stoma after 72 hr. due to infection then nurse inform to doctor.
  • colostomy bag empty when fill upto 1/3 lelvel.
  • change the water and colostomy bag in 72 hrs in or 3 days.





Saturday, 13 November 2021

MASK VENTURE MASK

November 13, 2021 0
MASK VENTURE MASK

MASK:-VENTURE MASK

1.Use in severe hypoxia to the client.

2. 8-10 Liter per minute flow rate delivered by mask.

3.avoid less than 5 Liter per minute flow rate by mask Except Venture mask.

Venture Mask:-

1.Use according to color coding.

2.Also known as higher flow mask.

3.Venture mask deliver accurate concentration of oxygen to the patient.

4.Blue:- 2 Liter per minute and 24 %

5.White:- 4 Liter per minute and 28 %

6.Orange:- 6 Liter per minute and 31%

7.Yellow:-8 Liter per minute and 35%

8.Red:-10 Liter per minute and 40%

9.Green:-12-15 Liter per minute and 60%


Friday, 12 November 2021

NASAL CANNULA

November 12, 2021 0
NASAL CANNULA

 NASAL CANNULA

1. 1.5 cm long probe are insert in both nostril.

2.Flow Rate:- 1-4 L/Min.

3.In advance stage:-1-6 L/Min.

4.Concentration:-24-44%

5.Every 2nd hourly replace nasal cannula to prevent dry mucosa and ulcer.

6.Use in COPD use for long time oxygen inhalation.


NASAL CATHETER

November 12, 2021 0
NASAL CATHETER

 NASAL CATHETER

1.The nasal catheter most commonly useful method use in clinical practice.

2.Flow Rate 1-6/Minute.

3.Concentration 22-30% oxygen is delivered by nasal catheter.

4.Procedure:-

Position of Patient:-Rose Position where patient is lying on back with hyper extended of head(1st Priority)

5.High fowler position (2nd Priority)

6.1-2 Liter/ min by nasal cannula in COPD Patient.

7.Measure length of nasal catheter:- tip of nose to ear lobe(10 cm)

8.Replace the nasal catheter of nasal catheter every 8 hourly to prevent stenosis  by mucus.

9.Catherter:-4-6 French.

10.Nasal catheter insert in left nostril and avoid right nostril increase risk of injury. 


Sunday, 28 April 2019

CHOLESTEROL LDL HDL

April 28, 2019 0
CHOLESTEROL LDL HDL

CHOLESTEROL LDL HDL

Cholesterol can,t dissolve in the blood. it has to be transported to and from the cells by carries called lipoproteins.Low Density Lipoprotein,or LDL, is Known as "Bad" Cholesterol. High- density Lipoprotein or HDL, IS KNOWN AS "GOOD" Cholesterol.

LDL/LOW DENSITY LIPOPROTEIN:-
When too much LDL(BAD) cholesterol circulates in blood, it can slowly build up in the inner wals of the arteries that feed the heart and brain, if a clot forms and blocks a narrowed artery, heat attack or stroke can result.
HDL/HIGH DENSITY LIPOPROTEIN:-
About 1/4 th to 1/3 cholesterol carried by HDL. HDL cholesterol is known as GOOD cholesterol,because high levels of HDL seem to protect against heat attack.Low levels of HDL <40 mg/dl also increase to risk of heart disease.
                                                                                                                     
Normal lab values:-
LDL:-<100 mg/dl
HDL:->50 mg/dl                                                                                                      source-vikaspedia

Blood Sampling Vial Colour Codding

April 28, 2019 0
Blood Sampling Vial Colour Codding

BLOOD SAMPLING VIAL

As we Know there are many types of blood tubes used for lab investigations.
1.Black Top Tube:- Sodium Citrate 20% used as anticoagulant for test ESR.
2.Purple Top Tube:-EDTA(Ethylenediaminetetraacetic Acid) used as Anticoagulant for test Hb,CBC.
3.Red Top Tube:-Plain vial Contains in vial Blood coagulate result in Serum (take one Hour)
4.Green Top Tube:-small sillica beadsplasma used for biochemistry investigation like renal,electrolytes,ammonia.
5.Grey Top Tube:-Tube contains Fluoride oxalate. that inhibits glycolysis used for test Glucose.
6.Red Top Tube:-contains clot activator like small sillica beads for speed up coagulation.(take 20 min.)
7.Yellow Top Tube:-contains small silica beads with separator gel resulting sample serum.
8.Blue Top Tube:-Sodium Citrate 10% used Coagulation investigation like PT-INR,APTT. 

Monday, 18 February 2019

General Awareness For Esic Staff Nurse

February 18, 2019 0
General Awareness For Esic Staff Nurse

Monday, 4 February 2019

Important Health Days

February 04, 2019 1
Important Health Days

HEALTH DAYS

January:-                                                              
1. 12 National Youth Day
2.  31 Anti Leprosy Day
February:-
1. 4 World Cancer Day
March:-
1. 4 National Safety Day
2. 8 International Women's Day
3. 12 World Kidney Day
4. 15 World Consumer Rights Day
5.  22 World Disable Day
6. 23 World Water day
7. 24 World Tuberculosis Day
April:-
1. 7 World Health Day
2. 11 World Parkinson Day
3. 11 National safe motherhood Day
4. 17 World Hemophilia Day
5. 22 Earth Day
May:-
1. 05 World Asthma Day
2.  08World Thalassemia Day
3. 12  International Nurses Day
4. 19 World Hepatitis Day
5. 28 International Day of Action for Woman's Health
6. 31 Anti Tobacco Day
June:-
1. 05 World Environment Day
2. 14 World Blood Donor Day
3. 17 World Day to Combat Desertification and Drought
4. 26 International Day Against Drug Abuse and illegal Trafficking
July:-
1. 01 Doctor's Day
2. 11 World Population Day
August:-
1. 01-07 World Breast Feeding Day
2. 12 International Youth Day
3. 15 Independence Day
September:-
1. 01-07 National Nutrition Week
2. 04-11 World Pharmacy Week
3. 08 Literacy Day
4. 16 World Ozone Day
October:-
1. 11 World Mental Health Day
2. 12 World Arthritis Day
3. 16 World Anesthesia Day
4. 20 World Malaria Day
5. 21 World Iodine Deficiency Disorder Day
6. 24 UN Day
7. 31 Universal Children Day
November:-
1. 10 World Immunization Day
2. 13 World Alzheimer Day
3.  14 Children's Day
December:-
1. 01 World AIDS Day
2. 03 World Disability Day
3. 10 Human Right Day

source www.rajswasthya.nic


Antidote and Drug of Choice Prophylaxis of choice

February 04, 2019 0
Antidote and Drug of Choice Prophylaxis of choice

ANTIDOTE AND DRUG OF CHOICE PROPHYLAXIS(Dx/Px):-

1.Drug for PCM poisoning :- N acetylecystine (mucomyst)
2. DOC for Acute Asthma:- Salbutamol
3.DOC for Chronic Asthma:- Salmetrol
4.Drug of choice for bipolar disorder:- Lithium
5.Drug of choice for mania:- Lithium
6.Drug of choice for acute mania:-Haloperidol
7.Drug of choice for chronic mania:-Lithum
8.Drug of choice for hyperkalamia:- Kayxalate/sodium natropuroside/insuline+dextrose
9.Drug of choice for Ketoacidosis:- Insuline+dextrose
10.Prophylaxis for Asthma:-Montalucast
11.Drug for Digitalis Toxicity:-Digibind
12.Drug of choice for Acute migraine:-Sumatripatan
13 Drug of choice for ADHD:-Methylphenidate(Amphetamine)
14.Drug of choice for Alzeihmers disease:-Tacrine/donepzil/Rivastigmine
15.Drug of choice for Myasthenia gravis:-Neostigmine
16.Drug of choice for Anaphylactic Shock:-Adrenaline
17.Drug of choice for Hyperthyroidism in pregnancy/Lactation:-Propylthiouracil
18.Drug of choice for Atonic Seizures:-Sodium valproate
19.Drug of choice for Febrile Seizures:-Diazepam
20.Antidote for Aspirine poisoning:-Sodium bicarbonate
21.Antidote for organophosphate poisoning:-Atropine
22.Drug of choice for Central Diabetic Insipidus:-Vasoprassin/desmopressin
23.DOC for Chemotherapy induced vomiting:-Ondasteron
24.DOC for chloroquine resistant malaria:-Quinine
25.DOC for cholera:Tetracycline
26.Antidote for Benzodiazapine poisoning:-Flumazenil
27.Antidote for Barbiturate poisoning:-Sodium bicarbonate 
28.Antidote for Atropine poisoning:-Physostigmine
29.DOC for Chese reaction:-Phentolamine
30.DOC for Acute Gout:-Indomethacin
31.DOC for Chronic Gout:-Allopurinol
32.DOC for complicated Malaria:-Artesunate
33.Antidote for Cyanide poisoning:-Amyl nitrate
34.DOC for Depression:-Any of SSRI                 drug(Citalopram,Escitalopram,Fluoetine,Paroxetine,Sertraline,Vilazodone)
35.DOC for disease modifying anti Rheumatic drug(DMARD):-Methotrexate
36.DOC for drug induced parkinson disease:-Benzhexol
37.Choice of Muscle relaxant for Endotracheal intubation:-Succinylcholine
38.Choice for Relaxant for ECT:-succinylcholine
39.Treatment of choice for severe Depression:-ECT
40.DOC for Enteric Fever:-Ceftrixone
41.DOC for Epilepsy in pregnancy:-Lamotrigine
42.Antidote for Fibrinolytics:-Aminocaproic acid
43.DOC for BPH(Benign prostate hypertrophy):-Prozosin
44.Antidote for Heparine Toxicity:-Protamine sulphate
45.prophylaxis for herpes:-Acyclovir
46.prophylaxis for rheumatic fever:-Benzathaine penicilline
47.prophylaxis for MI:-Asprine
48.DOC for Malaria:-Chloroquine 
49.DOC for hypertensive emergency:-Sodium nitroprusside
50.DOC for hypertension in pregnancy:-Lobetalol
51.DOC for Eclampsia:-Mgso4
52.DOC for Hypothyroidism:-Levothyroxin
53.DOC for hypovolemic Shock:-IV fluids
54.Antidote for Iron toxicity :-Desferoxamine
55.DOC for Methanol poisoning:-Fomepizole
56.DOC FOR Methicillin resistant staphylococcus aureus :- Vencomycin
57.Mydriatic of choice in Adults:-Tropicamide
58.Mydriatic of choice in children:-Atropine
59.DOC for syphillis:-Benzathine penicilline
60.DOC for noctural enuresis :- Desmopressin/imipramine
61.DOC for obsessive compulsive disorders:-SSRI
drug(Citalopram,Escitalopram,Fluoetine,Paroxetine,Sertraline,Vilazodone)
62.Antidote for Opiod poisoning:-Nalaxone
63. DOC for oral hypoglycemic drug in obese :- metformine
64.DOC for oral hypoglycemic drug in thin:-Sulfonylureas
65.DOC for cardiogenic Shock:-Dobutamine
66.DOC for cardiogenic Shock with Oligourea:-Dopamine
67.Doc for Status Epilepticus:-Mgso4
68.DOC for prevent surgical site infection:-Cefazolin
69.Doc for patent ductus arteriosus:-Indomethacin
70.Doc for PPH:-Carbaprost
71.Doc for Anovulation:-Clomiphene Citrate
72.Antidote for warferin:- Vita. K
73.DOC for Parkinson disease:-Levodopa+carbdopa
74.DOC for hyperprolactinemia:-Bromocriptine
75.safest ATT Drug in pregnancy:-Rifampicin
76.Drug for prevent for Vertical Transmission:-Nevirapine


Sunday, 3 June 2018

CISPLASTIN

June 03, 2018 0
CISPLASTIN

CISPLATIN

Cisplatin is  a heavy metal complex containing an atom of platinum in he center surrounded by two ammonia molecules and two chloride atoms and it is platinum based chemotherapy drug used to treat various types of cancers.

Action and pharmacology:-
Cisplatin is thought to act by producing inter-strand and cross-links of cellular DNA in a similar manner  to bifunctional ALKYLATING AGENTS. It does not appear to be cell-cycle specific.

Half life :-25 to 49 minutes and terminal half life of 58 to 73 hours was calculated.

INDICATIONS:-METASTATIC TESTICULAR TUMORS
                            METASTATIC OVARIAN TUMOR
                           ADVANCED BLADDER CA

CONTRAINDICATION:-HYPERSENSITIVITY TO CISPLATIN OF OTHER Pt contains.
                                           pregnancy
                                            laction
                                              renal impairment
                                                hearing impirment
                                                  myelosuppression

ADMINISTRATION:-
NIDDLE OR INTRAVENOUS SETS CONTAINING ALUMINUM PARTS THAT MAY COME IN CONTACT WITH CISPLATIN SHOULD NOT BE USED FOR PREPARATION OR ADMINISTRATION. ALUMINUM REACTS WITH CISPLATIN CAUSING PERCIPITATE FORMATION AND A LOSS OF POTENCY.

DRUG INTERACTIONS:- Live vaccines (contraindicated)
                                                aspirin and alcohol (GI bleeding chances)
                                                   with ototoxic and nephrotoxic durgs.
SIDE EFFECTS :- Thinned or bittle hair
                                 loss of appetite or weight
                                 diarrhoea 
                                 nausea and vommitting 
                                 change in taste
                                  tingling sensation
                                 unusual bruising or bleeding 
                                 black,tarry stools 
                                 fever chills dizziness  or feeling of faintnesspain in back
                                 swelling of the feet 
                                 seizures 
                                 rash 
                                 shortness of breath
(Ref:- united biotech private limited)

Sunday, 9 July 2017

COLD CHAIN

July 09, 2017 0
COLD CHAIN

The cold chain is a system of storing and transporting vaccines of recommended temperatures from the point of manufacture to the point of use the key elements of cold chain are:-


* PERSONNEL:- To manage vaccine store and distribution.
* EQUIPMENTS:- To store and transport vaccine and to monitor Temperature.
*PROCUDURES:- To ensure that vaccines are stored and transported at appropriate temperatures.

Keeping vaccine at the right temperature is not an easy task, but the consequencys of not doing so can be disastrous once vaccine potency is lost, it cannot be regained , the damage vaccines must be destroyed, leading to inadequate vaccine stoks and wastage of expensive vaccine, moreover, children and women who receive a vaccine that is not potent are not protected.


** AT THE PHC LEVEL ALL VACCINES ARE KEPT IN THE ILR FOR A PERIOD OF ONE MONTH AT TEMPERATURE OF +2 C TO +8 C. 

** VACCINE SENSITIVITY TO HEAT:-BCG (after reconstitution) >OPV >MEASLES> DPT > BCG (before reconstitution) > DT/TT/HEPB/JE.

** VVM:-( VACCINE VIAL MONITOR):- A VVM is a label containing a heat sensitive material which is placed on a vaccine vial to register cumulative heat exposure over time. The combined effects of time and temperature cause the inner square of the vvm to darken gradually and irreversibly. before opening a vial check the status of the vial vvm. 


STAGES OF VVM:-
1. THE INNER SQUARE IS LIGHTER THAN THE OUTER CIRCLE. IF THE EXPIRY DATE HAS NOT BEEN PASSED:- USE THE VACCINE.

2. THE INNER SQUARE IS STILL LIGHTER THAN THE OUTER CIRCLE IF THE EXPIRY DATE HAS NOT BEEN PASSED:- USE THE VACCINE.

DISCARD POINT:- 

3. THE COLOR OF THE INNER SQUARE MATCHES THE COLOR OF THE OUTER CIRCLE :- DO NOT USE THE VACCINE.

BEYOND THE DISCARD POINT:-

4.BEYOND THE DISCARD POINT THE COLOR OF THE SQUARE IS DARKEN THAN THE OUTER CIRCLE : DO NOT USE THE VACCINE.

PLACEMENT OF VACCINES IN ILR :- 
(TOP TO BOTTOM)           1. DILUTES
                                             2. HEP. B
                                             3. PANTAVALENT
                                             4. DPT
                                             5. TT
                                             6. BCG
                                             7.MEASLES
                                             8.OPV

Q2. Which vaccine placed at bottom in ILR?
A. TT    B. BCG   C. MEASLES    D. OPV    
ans. OPV (D)

Q3. Which vaccine place at bottom in ILR?
A. MEASLES  B. TT  C. BCG  D. DPT 
ans. MEASLES (A)


                                                                   
                                                         COLD CHAIN ILR AT PHC
               Vaccine
     TEMPERATURE AT PHC
               BCG
+2C TO +8 C
               OPV
+2C TO +8 C
               MEASLES
+2C TO +8 C
               DPT
+2C TO +8 C
               HEPATITIS B
+2C TO +8 C
               DT
+2C TO +8 C
               TT
+2C TO +8 C

IMMUNITY (VACCINE) III

July 09, 2017 0
IMMUNITY (VACCINE) III
                                      REACTIONS OF VACCINES
    VACCINE
                                   REACTION
          INTERVAL
     
     BCG
1.SUPPURATIVE ADENITITIS
2.BCG OSTEITIS.
3.DISSEMINATED BCG INFECTION.
1.2-6 MONTHS
2.UPTO SEVERAL YEAR
3.1-12 MONTHS.
    HIB      
NONE KNOWN
-
    HEP B
ANAPHYLAXSIS
0-1 HOUR
    MEASLES/MMR
1.FEBRILE SEIZURES
2.THROMBOCYTOPENIA (LOW PLATELETS)
3.ANAPHYLAXSIS
1.5-12 DAYS
2.60 DAYS
3.0-1 HOUR
   OPV
VACCCINE ASSOCIATED PARALYTIC POLIOMYELITIS
4-30 DAYS
 TETANUS
1.BACTERAIAL NEURITIS
2.ANAPHYLAXSIS
3.STERILE ABSCESS
1.2-28 DAYS
2.0-1 HOUR
3.1-6 WEEKS
DPT
1.PERSISTANT (.3HR.) INCONSOLABLE SCREAMING.
2.SEIZURES.
3.HYPOTONIC HYPORESPONSIVE EPISODE (HHC)
4.ANAPHYLACTIC SHOCK
1.0-48 HOUR
2.0-3 DAYS
3.0-24 HOUR
4.0-1 HOUR
JE(JAPANES ENCEPHALITIS)
<![if !supportLists]>1.      <![endif]>SERIOUS ALLERGIC REACTION
<![if !supportLists]>2.      <![endif]>NEUROLOGICAL EVENT
1.0-2WEEKS
2.0-2 WEEKS
                             TREATMENT FOR VACCINE REACTION CASES
         REACTION
              TREATMENT
          VACCINE NAME
*VACCINE ASSOCIATED PARALYTIC POLIOMYELITIS
NO SPECIFIC TREATMENT AVAILABLE: SUPPORTIVE CARE
OPV
*ACUTE HYPERSENSITIVE REACTION
SELF  LIMITING ANTI HISTAMINS MAY BE USEFUL
ALL
*ANAPHYLAXSIS
ADRENALINE INJECTION
ALL
*DISSEMINATED BCSG INFECTION
SHOULD BE TREATED WITH ANTI TUBERCULOSIS REGIMENS INCLUDING ISONIAZID AND RIFAMPICINE
BCG
*ENCEPHALOPATHY
NO SPECIFIC TREATMENT AVAILABLE: SUPPORTIVE CARE
MEASLES /  PERTUSIS
*FEVER
SYMPTOMATIC: PARACETAMOL GIVE EXTRA ORAL FLUID,TEPID SPONGING,OR BATH. IN CASE OF HIGH AND EXTREME FEVER,OTHER SIGNS AND SYMPTOMS SHOULD BE SOUGHT AND REPORTED/MANAGED AS APPROPRIATE.
   
ALL
*HYPOTONIC HYPORESPONSIVE EPISODE
THE EPISODE IS TRANSIENT AND SELF LIMITING AND  DOES NOT REQUIRE SPECIFIC TREATMENT IT IS NOT A CONTRAINDICATION TO FURTHER DOSES OF THE VACCINE.
MAINLY DPT RARELY OTHERS
*LYMPHADENITIS
HEAT SPONTANEOUSLY OVER MONTHS AND BEST NOT TO TREAT IF LESION IS STICKING TO SKIN OR ALREADY DRAINING SURGICALLY DRAINAGE LOCAL INSTILLATION OF ANTI-TUBERCULOSIS DRUG.
BCG
*INJECTION SITE ABSCESS
INCISE AND DRAIN:ANTIBIOTIC (IF BACTERIAL)
ALL INJECTABLE VACCINES
*OSTEITIS
SHOULD BE TREATED WITH ANTI-TUBERCULOSIS REGIMENS
BCG
*SEVERE LOCAL REACTION
SETTLE SPONTANEOUSLY WITHIN A FEW DAY TO A WEEK SYMPTOMATIC TREATMENT WITH ANALGESICS(ANTIBIOTICS ARE INAPPROPRIATE)
ALL INJECTABLE VACCINES


COLOSTOMY

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