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B.Sc. NURSING [Post Basic (1styear), , MEDICAL SURGICAL NURSING, June-2008, , Time: 3 hrs., Note:, , Q.1., , Q.2., , M.M.:70, , Attempt all questions., a) Define cholecystitis., , What, , are, , the, , predisposing factors, , and syriptoms of the disease., (5), (6) Write the pre operative and post operative nursing care, of a 50 years old lady admitted in the, hospital., (a) What is meningitis. Which microorganisms cause (10), the, infection. List down the specific sign and, , symptoms., , (b) Describe the nursing, , Q.3., Q.4., , Q.5., , patient., , management, , of, , 5), an, , unconscious, , (10), Explain various types of fractures. What is the, nursing care, required for a patient in plaster cast., (5+10 15), (a) Write the, of, pathophysiology, adults. What are its signs and diabetes mellitus among, symptoms., (b) Explain the nursing, (10), management, of patient on, therapy., insulin, Write short notes on any five, of, (a) Prevention of HIV/AIDS. the, (b) Legal issues related to, disaster,, , (c) Corneal donation and, , (d) Chicken pox., (e) Nursing process., , (fChemotherapy., , 84, , following:, , transplant, , (5), , (2x5-10)

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85, , Medicel Surgical Nursing (June-2008), , sOLVED PAPER, , QUESTION-1, (a) Define cholecystitis. What, , (b), , are, , the, , predisposing factors and, , symptoms of the disease., Write the pre operative and post operative nursing, , care, , of, , a 50 years old lady admitted in the hospital., , ANSWER 1(a), Cholecystitis, , is the inflammation of the gall, , bladder, often caused by, , cholelithiasis., , Pre disposing factors of Cholecystitis:, , Following is a, , list, , ofcauses or underlying conditions that could possibly, , cause Cholecystitis:, Gallstones, Bile duct blockage, Secondary infection from gut organisms, , Inspissation of bile, , Impacted stone|, E-coli, , Typhoid fever cholecystitis, Sjogren's Syndrome - cholecystitis, , Bile stasis, , Cholelithiasis, Symptoms of Cholecystitis:, , ne list of signs and symptoms mentioned in various sources for, , Cholecystitis includes the 21 symptoms, , listed below:, , Upper right-side abdominal pain, abdominal pain, Biliary colic spasmodic upper, -, , Biliary colic after a fatty meal, Abdominal discomfort, Low grade Fever, , Nausea

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SES Post Basic, , 86, , (1st Yean, B.Sc. Nursing(1st, , Vomiting, Flatulence, Jaundice, , Itching skin, Pale stool, , Thickening of gallbladder, Shrinking of gallbladder, Gallbladder inflammation, , Indigestion, Yellow skin, Yellow whites of the eyes, In later stages, severe, , symptoms such, , high fever, shock, , as, , and, , jaundice indicate the development of complications such as abscess, formation, perforation or ascending cholangitis, Chronic, , cholecystitis manifests, , such as nausea,, vague, , with, , non-specific, , symptoms, abdominal pain, belching, and, diarrhoea., , ANSWER-1 (b), Pre operative care, , Nursing responsibilities, 1., , Case sheet, , preparation containing:, , Admission case sheet, , Recent lab investigation, , General anesthesia check, Vital sign chart, , 2., , keep reports, , Monitor vital sign, , 3Ask for constipationregularly, 4. Check, present give enema, patency of I/Vifline, prior, 6., 7., , 8., 9., , Send blood for blood, , Check for any, transfusion, if, allergy, Check for any sign of to drugs and required, , Check blood glucose infection, Chek for site care if and BP prior, take bath, , 10. Teach, , deep, , any, , synthetic substances, , patient is able the, day, to, , breathing exercises, , of, , carry outoperation, , activities, ask to

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Medical Surgicel Nursing (June-2008), , 87, , Psychological support and consent, ., , Educate about the procedure, Take consent, Educate about the chances of success of, surgery, , Answer, , queries of patient, , Nutrition:, Keep patient at nil per orally before 24 hours., Medical care:, , Give premedication as prescribed, With hold other continuing medication, Check for hypersensitivity of any drug, , (penicillin), , Post operative care:, , (immediate), Receive the patient with case sheet and operation note, Check vital sign, Provide the prescribed fluid, , Maintain input/output chart, Provide O, administration till patient recover from anesthesia if, required, Provide sideline position to prevent aspiration, Keep record treatment of patient, Keep the patient warm, P a i n management by, , giving analgesic, , Phase 2, Check for sign of infection, Note drainage and its quantity,color,.consistency, Site care: check for foul smell., Pus accumulation., , Healing process, If client is, , diabetic,keep check on, , blood sugar., , Provide fluid rich diet, , Collect blood sent for lab investigation, , Exercise teaching., , Teaching, , Check up knowledge about follow up

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SES Post Basic, , 88, , B.Sc., , Nursing (1st Ya, , Year, , QUESTION-2, , (a), , microorganisms cause, se th., the, is meningitis. Which, and symptoms., infection. List down the specific sign, , (b), , Describe the nursing, , What, , management, , of an, , unconsciou, , patient., , ANSWER-2(a), Meningitis is inflammation of the protective, , membranes, , covering the, , brain and spinal cord, known collectively as the meninges. The, , inflammation may be caused by infection with viruses, bacteria, or, other microorganisms, and less commonly by certain drugs, The types of bacteria that cause bacterial meningitis vary by age, group., In premature babies and newborns up to three, common causes are group B, streptococci, , months old,, , Listeria monocytogenes may affect the newborn and, , epidemics., Older children, , are more, , occurs, , in, , commonly affected by Neisseria, , meningitis (meningococcus), Streptococcus, pneumoniae., Those under five by Haemophilus, influenzae type B (in countries, that do not offer, vaccination,, In adults,, N.meningitis and S.pneumoniae, of all cases of, together, , monocytogenes, , 80%, with increased, risk of L., 50 years old, , meningitis,, in, those, , Sign and symptoms:, , over, , Brudzinski's sign, Kernig's sign, Photophobia, Nuchal rigidity, Fever, , Tachycardia, Petechial rash, , or, , purpuric rash, , Nausea, vomiting, Confusion and Seizures, , cause

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Medicel Surgical Nursing (June-2008), , 89, , ANSWER-2 (b), Nursing Management of Unconscious Patient:, Unconsciousness is defined as the state in which a patient is totally, , unaware of both self and external surroundings and unable to respond, meaningfuly to an external stimuli., Nursing management:, , Goal: The main goal of nursing management, , is to prevent, , complications, Assessment:, , Airway, Vital signs, ICP, , Pupils response, Assess ABCs, , Assess for signs of likely etiology, Trauma, toxic, infection, ischemia, tumor, Conduct a systematic neurological exam, , Consider EEG monitoring, , Nursing diagnosis:, 1., 2., 3, , Ineffective airway clearance related to loss of gag reflex., Fluid volume deficit related to unconsciousness., Altered nutrition less than body requirement related to inability, to eat and swallow, , 4., 4., , 5., , Alteration in body temperature, Impaired skin integrity related to immobility, , 6., , Bowel incontinence related to inability to respond to normal, , evacuation, 7., 8., , Altered nutrition less than body requirement, Self care deficit related to unconsciousness, , 9., Activity intolerance, 10. Potential to, altered skin, ., , integrity., , Potential for complications

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SES Post Basic, , B.Sa, , Nursing (1st, , 90, , Yea, , Interventions:, , Minimizing secondary brain injury:, Monitor, onset, , for change, , of cranial, , in, , nerve, , neurologic, , functions,, , deficits, , decreasedLo, , interventions., , Monitorresponse to pharmacological, Monitor lab data, CSF cultures, for patency,, Assess neurologic drains/dressings, , characteristics for drainage., for increased ICP,, and neurovascular compromise, , Institute, , cerebral, , measures, , risk of increasing ICP,, neutral position, reduce hip flexion, , Adjust care to reduce, in, , a, , security, urity anda, , edema, seizunr, , body positionine, , Maintain temperature status., , Maintain normothermia., Maintaning an effective airway:, , Position patient to prevent tongue from obstructing the airway, , encourage drainage of respiratory secretions and promote, adequate exchange of oxygen and carbon dioxide., , Keep the airway, , free from secretions with, , suctioning, , Maintaining fluid and electrolyte balance, , Monitor prescribed IV Fluid carefully,, , maintaining its balance., Maintain hydration and enhance nutritional, of, status with use, , enteral or parenteral fluids., , Measure urine output and specific, gravity., Evaluate pulses, measure BP, , Maintain circulation, support the BP, , cardiac dysrhythmias,, , Maintaining, , healthy, , oral, , and treat life, , threatening, , mucous, , membranes:, dentures., Inspect, inflammation and the, patient', Remove, K move denture, , presence of, , mouth, , for Iryness,, , dryness*, crusting., with appropriate, brushing teeth and, ate, solutions, t, Ising the, mout, every two to cleansing, four hours to preven, Apply lipemollient, em, to, maintain, hydration and, prevent dryness, dryn, Provide mou, outh care, , parotitis., , by

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Medical Surgical Nursing (June-2008), Maintaining skin integrity:, , Keep the skin clean, dry, well-lubricated and free from pressure, , because comatose patients are susceptible to the formation of, pressure ulcers., Turn the patient from the side to side on a regular schedule to, , relieve pressure, , areas, , and, , help, , secretions., , clear lungs by, , mobilizing, , Reposition carefully after turning to prevent ischemia and shearing, over pressure areas., , Position extremities in functional, , underneath splints, , neuropathies., , positions, , and monitor skin, to prevent skin breakdown and, pressure, , Perform ROM exercises of extremities at least four times, Maintaining corneal integrity:, Protect the eyes from corneal irritation:, Make sure the patients eye is not, , daily., , rubbing against bedding, , if, , blinking and corneal reflexes are absent., Inspect the condition of eyes with a flashlight., Remove contact lenses, if worn., irrigate eyes with normal saline or prescribed solution to remove, , discharge and debris., Instill, , prescribed ophthalmic, , ointment in each eye, , to, , prevent, , sites of infection( respiratory, CNS,, when fever is present in an unconscious, , urinary, patient., , glazing and corneal ulceration., , Apply eye patches, when indicated., , Reducing fever:, Look for, , possible, , tract, wound), , Monitor temperature frequently, Control persistent elevations of, , continuously., temperature., , or, , Maintain a cool ambient temperature., Minimize excess covering on bed., , Administer prescribed antipyretics., Use, , tepid, , sponging and an electric fan, Increase surface cooling., water

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SES Post, , Nursing (1st, , Basic B. Sc., , 92, Promoting urinary elimination:, , for, urethral catheter, , short ferm, , ements, , managem, , Insert an indwelling, for distension as, as, catherterization, bladder, Use intermittent, of infection., risk, minimize, to, as possible, Monitor for fever and, Initiate, , a, , cloudy urine., , as, bladder training programme, , jon, , sOon as, , Yean, soon, , consciousnea., , is regained., Promoting bowel elimination:, Observe constipation due to immobility, Provide stool softner, , or, , and lack of dietary fibre, , laxative, scheduled, , or as, , needed., , Monitor for diarrhoea resulting from infection, antibiotics, enteric, feedings etc.Use meticulous skin care if patient has fecal, , incontinence., Auscultate for bowel sounds, palpate lower abdomen for, distension., , QUESTION-3, Explain, , various types of fractures. What is, the, required for a patient in plaster cast., , nursing, , care, , ANSWER-3, Fracture:, , A, , fracture, , is defined as a, living bone, involving injury to the, adjacent soft tissues., Types of fracture:, , disruption in the integrity ofa, bone marrow,, periosteum and, , Based upon fracture line, , Go, , across the, , At an, , Spiral, , bone, , angle (Oblique)(transverse), , Comminutediin, Greenstick, , multiple pieces, , Depressed, , Compression, Pathologic, , Complete and, , incomplete fracture

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93, , Medicel Surgical Nursing (June-2008), , Closed and open fractures, Open fracture, , Grade, Grade I1, , Grade l1l, Greenstick, , Spiral, , Comminuted, , Transverse Compound, , Vertebral, , Compression, , **, , Typical Bone Fractures, , Cast care:, Definition: A cast is a rigid dressing used to immobilize a fractured, bone or soft tissue, , injury., , A cast is a supportive bandage that is solid, and wraps all the, way around the extremity., , Purpose of Cast:, T o support and protect the bones and soft tissue., To reduce the pain, swelling, and muscle spasms following the, , injury. If the bone is broken, Cast is made of Plaster, Fiberglass, Preparation of patient for plaster cast, , Explain the procedure to patient, ASsess general health of patient and particular part, , Check vitals specially from involved limbs, , Shaving the area.

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SES Post Basic B.Sc., , 94, , rsing (1st, , Special attention to skin, bony area, , Yean, , Plaster bandages as per required size and number, Nursing care prior to application of plaster cast:, , Take consent, , Explain procedure, Clean limb with soap solution, Be, , gentle while scrubbing, Remove tight clothes and ornaments, keep bandage rolls, readyN, Take halfbucket of water full of lukewarm water and, , a stand., , keep it on, , Make the, , patient sit comfortably on a stool or a table in a, ventilated and a bright room., To prevent, soiling of patient clothes and ground put, , rubber, , sheets., , Pad the, sores., , well, , pressure points, , adequately to prevent future pressure, , Nursing care during plaster, 1., Here nurse assists the application:, , 2., 2, , doctor in, , putting the POP., of, Unwrap the required no.theofpatient to perform various stages., bandages and keep ready for, immersion., Immerse in a, Stand on the right side, bowl of, , Change water frequentlyclean, tepid water until, bubbles cease., Remove bandage and, expel surplus water. gently squeeze it from, dges to center, edges, center toto, Normal setting time is 3-4, mins,, Do not mould the, cast after, No weight, mins., bearing before 485-6 mi, Hold the limb t, e, , While the plaster is, , hours., , in its, plastered, being, functional, , applied,, position., otherwise, the hold the limb, ineffective., plaster will breakfimly,, mly, do not, no, Do, po not apply pres, pressure with, and become, will be indentati, allowiit to move,, , tionsskin the plast, fingers over the, er athe, pressurendent, over, the skinne, plaster., be, , become, once the, This may plaster,T, asas there, ther, plaster is cause alized, , on, , dry., , 1localize"

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Medical Surgical Nursing (June-2008), , 95, , AS soon as the plaster application is complete, polish the plaster surface, , with wet cloth, cotton or with the foils of the plaster rolls. This gives, a, , neat and, , glistening finish., , Nursing care post cast application:, Keep the cast dry., , Don't stick sticks under the case., , Try to keep objects out from under the cast. Especially avoid, the urge to stick coat hangers under the cast-this can cause, damage to both skin and the cast material., Relieve itching the right way., To relieve itching under the cast, try pointing a hairdryer on a, cool-air setting down the cast. This usually helps to relieve these, symptoms., Watch the cast carefully., Watch for distal limb edema., Watch for bluish discoloration of the fingers and toes. If present,, immediately split the plaster., Inspect the cast regularly, and alert doctor. if it cracks, breaks,, or becomes loose. Also look for redened or raw skin around the, cast edges- doctor can pad these areas to prevent problems., , Elevate, , the cast, , Elevate the injured extremity. This is most important to prevent, swelling in the initial days following the injury., , Exercise the extremity., Instruct the patient to report doctor if client develops one or, of the following symptoms:, fever greater than 101° F, more, , increased pain, increased swelling above or below the cast, complaints of numbness or tingling, drainage or foul odour from the cast, cool or cold fingers or toes, , Nursing care after removal of plaster:, , moval is easy in case of slabs but may require, , in case of cast, , ster can be cut preferably by using an electric plaster cutter, or, , the manual, , plaster cutter.

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SES Post, , 96, After, , plaster,, removal of, , thoroughly, , not wipe, gently. Do, , dry and mop it, of skin., , Vursing (1st, , Basic B.Sc., , wash the, , limb, , with wae, , with, , it forcibly Tor, for fear of, ofpe, p, it torcibiy, , of pelia, , method of wearing, , bandage, , event po, , to prevent., , Teach patient the, edema, removal limb, , plaster, , QUESTION-4, , (a), , Write the, , pathophysiology, , of diabetes, , mellitus, , signs and symptoms., of patient, the nursing management, Explain, (6), adults. What, , are, , its, , on, , amo, insul, , therapy., , ANSWER-4(a), Diabetes mellitus is a group of metabolic diseases in which a person, , has high blood sugar, either because the body does not produce enough, insulin, or because cells do not respond to the insulin that is produced, It is characterized by classical symptoms of polyuria (frequenl, , urination), polydipsia (increased thirst), hunger)., , and, , polyphagia (increase, , Pathophysiology:, Insulin is secreted by beta cells, which are, , one, , storage hormone., , Insulin is, , in the islets, , of Langerhans in the pancreas., , of four types of ces, , when a, person eats a meal,, increases and moves, glucose from the, blood into, In, cells., those, fat, cells,, , insulin:, , an, , anabolic, o", , insulin secretiO, a, musclé, liver, and, , Transports and metabolizes, Stimulatess, glucose for energy., Stimulates, of, storage, glucose in the liver and, of glycogen), (in the, the 10for, muscle(in, signals the liver to stop the, release of, Enhances storage of, dietary fat in glucose., Accelerates, transport of amino adipose tissue., protein) into cells., , sulinn also inhi, , inhibits the, , acids, , breakdown of store, , (derived from dieetar, , glucose, protein, protein and:, a

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Medicel Surgicel Nursing (June-2008), , 97, , During fasting periods(between meals and overnight), the, pancreas continuously releases a small amount of insulin(basal, , insulin);another pancreatic hormone called glucagons (secreted by, the alpha cells of the islets of langerhans)is released when blood, glucose, levels decrease and stimulates the liver to release stored glucose. The, insulin and the glucagons together maintain a constant level, , ofglucose, , in the blood by stimulating the release the glucose from the liver., Produce:, , Initially, the liver produce glucose through the breakdown of glycogen, , (glycogenolysis). After 8 12hrs without food, the liver forms the, glucose from the breakdown of non-carbohydrates substances,, , including amino acids (gluconeogenesis), Pathophysiology of type 1 diabetes mellitus, , INSULIN LACK, Decreased glucose utilization, by muscles, fat and liver, Decreased production by liver, , Hyperglycemia|, , Increase breakdown of fat, , Acetone, breath, appetite, Poor, , Blurred vision|, , Increase, , Increase fatty acids, , Increase ketone, , Lbodies, , Urination, , Nausea, , Weakness, , Dehydration, Headache, , Vomiting, , >Acidosis|, , Abdominal, Pain, , Increase Thirst, , Increase, , Respirations

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SES Post Basic B. Sc. Nursing (1st, , (1st Yean, , 98, , diabetes mellitus, Pathophysiology of type II, ENVIRONMENT, INFECTION, OR EMOTIONAL, , STRESSOR, , Lack ofinsulin, Breakdownhof, , Breakdown of, , fat in cells, , glycogen to glucose, , Free fatty, acids to live, , | Hyperglycemia, , Formationof, , Protein breakdown, , Decreased use, of glucosea, , Formation ofIncrease, , new glucose, , BUN, , Osmotic diuresis |, , ketone bodies, , Dehydration, , Electrolyte imbalance, , Ketones in urine||, , L, , and blood, , In the presence of mild,, , Hyperosmolaility, Hemoconcentration, , moderate, or severe, , dehydration:, , Decreased HCO3, Increased K (mild):, decreased K (severe), Decreased Na, , ACIDOSIS, , (moderate to severe), , COMA, , Decreased Ca, Mg, P04. PH, , ANSWER-4 (b), , Nursing management of patient on, , Prepare the client for insulin, , ., , Storage and dose, , refrigerators., , insulin, therapy:, , preparation-s, , Syringes-the insulin syringe, Iml., , Blood, , Blood glucose, gblood, regular, glucose, olucose, Interpretati of, , therapy:, , the insulinin medications in, , contains 40, , medications in, , units which is, , equal to, monitoring-before, and, regular ton level of the during the, patient should beinsulinlin therapy, be accomplished. results-proper, , Frequency of testing, , recording and, , monito, itored., monitored., reporting should

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99, , Medical Surgical Nursing (June-2008), , Proper skin and foot care-daily skin and foot care should be, given to the patient in order to prevent any cuts and infection., , Proper Eye Exam-to prevent retinopathy., , Life style modification and exercise, , Keep biscuit or toffee always in pocket.-to prevent hypoglycemia., Proper diet and fluids-to maintain the normal fluid and, , electrolyte balance., Observe for complications:, , Diabetic Neuropathy, Diabetic Retinopathy, Diabetic Nephropathy, Diabetic gastro paresis, , QUESTION-5, Write short notes on any five of the following:, , (a) Prevention of HIVIAIDS., , (b) Legal, (c), , issues related to disaster., , Corneal donation and transplant., , (d) Chicken pox., , e) Nursing process., Chemotherapy., , ANSWER-5 (a), Prevention of HIVIAIDS:, , Education about check up regularly., Avoid needle stick injury, Counseling of couples related, , to, , the, , precautions during sexual, , intercourse., Avoid sex with multiple partners, Prevent the use of single needle, , In emergency condition avoid use of unscreened blood ,1st wve, have to check the screened blood before the transfusion of blood., , AIDS is a disease of human immune system caused by the human, , immunodeficiency virus.

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SES, , Post Basic, , 100, , ofany, , In case, , Maintain, , minor, , regular, illness, take, , risk, hygiene and prevent, , Nutritious diet, administration, , B.Sc., , Nursing (1st, , Yean, , treatment, , ofinfection, , of health, , strateegies, , Proper use and, avoid needle sharing, inembers to, Teaching of client and family, , ANSWER-5 (b), Legal, , issues related to disaster, , Definition:, A disaster is, , a, , made hazard that causes significant, to the, destruction, loss of life or drastic change, , natural, , physical damage, , or, , or man, , natural environment., , Every injured should be instantly given medical aid to preserve, the life and these after loss should be allowed to operate to avoid, neglect. Saving person is top priority., Preservation of human life is important since once life is lost, and status cannot be restored., , Providing adequate facilities for citizens is an essential part of, the obligation undertaken by, government is to be discharged by, health, centers, that, running, provide medical as well as, nursing, care., , Medical council of India, experts of, medical as well as nursing, team, advice health team to, give medical care., Code of medical, ethics,, , to treat, , the client, , freely., , onation and, , Corneal donati., front part of the, the, , must not be, , ANSWER-5 (), uransplant:, , The, eye that, covers the, chamber.Corneal trans, by, , a, , damaged, tissue (the, (the, , as, , corneal, 1s, diseased, a, part (lamellar graft) in its corneagrafting,, is, keratoplasty). entirely replacea, trating, , orneal, in, , corneal, , keratoplasty) or, , cornea is the, , parent, ransplantation, also knowniris, pupil andtransparent, anterior, anterior, , surgical procedure whe, where, donated, , neglected. A physician, physician has, , or, , (penetrating

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Medical Surgical Nursing (June-2008), , 101, , Indications:, , Optical: To improve visual acuity by replacing the opaque or, , distorted host tissue by clear, healthy donor tissue., , Eg:pseudophakic bullous keratopathy, keratoconus, corneal, degeneration, keratoglobus and dystrophy, as well as scarring, due to keratitis and trauma., , Tectonic/reconstructive: To preserve corneal anatomy and, integrity in patients with stromal thinning and descemetoceles,, or, , to, , reconstruct the anatomy of the eye, e.g. after corneal, , perforation., , Therapeutic: To remove inflamed corneal tissue unresponsive, to treatment by antibiotics or anti-viral., Cosmetic: To improve the appearance of patients with corneal, scars that have given a whitish or opaque lack to the cornea., Pre operative instructions:, , Written consent, Discuss the risk and benefits of surgery, Before surgery, patient has to undergo for ordered lab tests,, such as blood work, X-rays, or an EKG., , Procedure: Only the central portion ofthe cornea is involved in, transplantation.The surgeon excises an appropriate circular disc, of the patient's cornea and replaces it with a similarly sized disc, of donor cornea, which is then sutured into place. It can be, , done by penetrating keratoplasty or Lamellar keratoplasty., Risks for a corneal transplant are:, , Bleeding, Infection of the eye, Glaucoma (high pressure in the eye that can cause vision loss), , Swelling of the front of the eye, Graft rejection, The risks for, any, , anesthesia are:, Allergic reactions to mediciness, , Breathing problems

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SES Post Basic B.Sc. Nursing (1st Yearn, , 102, , ANSWER-5 (d), Chicken pox:, common, , Chickenpox is, , a, , highly contagious, , illness, , that is, , 12. It is caused, in children, particularly those under age, , the varicella-zoster virus., , are the, , by, , only animal, , Chickenpox does not infect chickens (humans, red pimples resembled, infected by the VZV), but it was felt that the, It is most contagious the, chick peas, hence the name "chickenpox"., day before the rash appears., direct contact with, It spreads from person to person through, the, virus. One, by touching a blister, through, the, , may, , get, , air(coughing or sneezing)., A, , can pass it on to her baby, pregnant woman with chickenpox, , before birth., Mothers with chickenpox can also give it to their, , newborn babies, , after birth., Prodromal or early symptoms, include fever, a vague feeling of, sickness, or decreased appetite. Within a few days, a rash appears., The rash looks like small red pimples or blisters., Symptoms:, , A rash that usually begins on the body and face and later often spreads, to the scalp and limbs., It may also spread to the mucous membranes especially in the, mouth and on the genitals., , The rash is often itchy., It begins as small red spots which, couple of hours., , After, , one or, , develop, , into blisters in, , a, , two days, the, , blisters turn into scabs., New blisters may appear after three to, six days., The number of blistersS difiers, greatly from one person to another., These symptoms are mild in, , children., Chickenpox lasts 7 to 10 daysyoung, in children and, Adults can feel very ll and, longer in adults., take, to, more likely than, children to longer recover. They are also, suffer, , complications.

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(June-2008), Medical Surgical Nursing, , 103, , Contagiousness:, , before the rash appears, Chickenpox is contagious from about 2 days, A client with chickenpox, and lasts until all the blisters are crusted over., 1 week., should be isolated until all blisters have dried, usually about, Treatments:, , Chickenpox rash tends, be used at home to, , to, , help a, , be extremely itchy. Several treatments, child feel better., , can, , Trimming fingernails can help prevent infection from scratching, the blisters., , Cover the infant's hands with mittens to minimize scratching, Never give aspirin to a client because aspirin has been associated, with Reye syndrome., , Occasionally a client will develop blisters in the mouth, making, eating or drinking painful. A person must continue to drink fluids, to prevent dehydration. To alleviate pain, provide cold fluids (ice, pops are one suggestion) and soft bland foods., Avoid any foods that are spicy, hot, or acidic (for instance,, , orange juice)., Wash hands, , Maintain hygiene, , ANSWER-5 (e), Nursing process: Nursing process is defined as an orderly, systematic, way of identifying the clients problem, make plans to solve them,, , initiating or implementing the plans and evaluating to which extent the, plan was effective in resolving the problem identified. Nursing, process, IS a, deliberate, problem identification and problem solving approach, , 0, , meet, , the health, , Purpose, 1o, , care, , and, , nursing needs of patients., , of the, , nursing process:, achieve scientifically- based, holistic, individualized care for, , the client, 10, , achieve the opportunity to work collaboratively with, clients,, , others, To achieve, , continuity of care

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SES Post, , Basic B. Sc., , Nursing, , 104, Characteristics, , of nursing process:, , (1st Yean, , red sequenca, sequence of, (a)Systematic: The nursing, the accuracy ofthe acti, depends on, ivity, process, , has, , an ordered, , activities and each activity, , (6), , it., , following, influences the activity, and, it, that precedes, has great interaction and, and, process, The, nursing, Dynamic:, each activity flows into th, the activities and, overlapping among, next activity, , (c), , Interpersonal: The, client-centered, , nursing, , process, , ensures, , that nurses are, , and encourages them, rather than task-centered, , strengths and meet human needs, is a means for nurses and, (d) Goakdirected: The nursing process, clients to work together to identify specific goals (wellness, promotion, disease and illness prevention, health restoration) that, to work to enhance client's, , are most important to the client, and to match them with the, appropriate nursing actions, (e), , Universally applicable: The nursing process allows nurses to, practice nursing with well or ill people, young or old, in any, type of practice setting., , Steps of nursing process:, , Assessment, nursing diagnosis, planning, , implementation and evaluation., , Assessment: Systematic collection of data to determine the, , health status and to 1dentify any actual or, , patients, , ASsessment is the deliberate, andpotential health problem., systematic and logical, ollection of data that helpful to, identify and, are, , before the nurse, , proceeds to, , plan, , The steps of assessment are:, (a) Conduct the health, , his care., , define client's problem, , problem, , historv., , (b), the health, ( Perform s:lnspection,Palpation,Percussion,, Auscultation, , assessment by, these, following, thes, Formulation of, nursing diagnosis:, Identify the, 1., patient's nursing, the, Aentify the, 2. Identify, problem., ldentify the defining characteristic, 3., etiology of nursing of the, problems, problems. nursingng problems.

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105, , Medical Surgical Nursing (June-2008), , 4., , State nursing diagnoses concisely and precisely., , 5., , Use NANDA (North American Nursing Diagnosis Association), , approved nursing diagnosis., e.g, , 1. Activityintolerance, , 2., , Adjustment, impaired, , 3, , Airway clearance, ineffective, , Planning: It involves development of goal and plan of care., , 1., 2., , Assign priority to the nursing diagnosis, Specify the goals:, , (a) Develop immediate, intermediate and long term goals., (b) State the goals in realistic and measurable terms., 3., , Identify nursing intervention appropriate for goal attainment., , 4 Establish expected outcomes:, (a) Make sure that the outcomes are realistic and measurable., (b) Identify critical times for the attainment of outcomes., , Implementation:, Implementation refers to carrying out the proposed care plan., 1., , Putting the nursing care plan into action., , 2., , Coordinate the activities of the patient, his family and significant, others., , 3., , The immediate, intermediate and long term goals are used as a, , focus for, 4., , While implementing nursing care, the nurse continually assess, the, , ., , implementation of designed care plan., , patient and his response to the nursing care, , She also continues data collection and modifies the, as neededd, , 6., , plan of care, , Documents Care provided, , aluation: Determination of patient's response, , interventions., The, , to, , nursing, , measuring of the extent to which client goals have been met, valuation involves not only analyzing the success of the, goals, and, interventions, but examining the need for adjustments and, , changes as well.

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Nursing (1st, , Basic B.SC., SES Post, , 106, , all input, The evaluation incorporates, team, including the patient., , from the entire, , Yean, , health.Care, , In this phase, nurse, , desired goals/outcome, achievement of, clients, the, Measures, client's a u c c e s s or railur, te, to the, contribute, that, factors, Identifies, Modifies, , Thus, , the plan, , of care, if indicated decision, , nursing process is, , a, , making process, modification as feedback, subsequent, , data collecting,, , and, , that incorporates evaluation, that promotes the, ultimate resolution, mechanism that promote the, involves looking at the whole, process, The, nursing, diaznoses., , nursing, patient at all times., , ANSWER-5 (), often shortened to just "chemo*",, Chemotherapy: Chemotherapy,, which means it affects the whole body by, is a systemic therapy,, or, the bloodstream. Chemotherapy is used to destroy, , going through, , possible, to shrink, In some cases, chemotherapy is given before surgery, is used for client's benefit but it, the cancer cells. As chemotherapy, damage the, , cancer, , cells, , as, , much, , as, , also have many side effects. Side effects along with their management, are given below:, , Nausea and vomiting: This is a common side effect ofchemotherapy, , It can be controlled with anti-emetics drugs., Fatigue: Take rest in between activities. Takeing, , short naps, , may help., , Hair loss: This, , compress, , is the least, , around the, , harmful side effect.The use of a, , scalp when, , col, , chemotherapy helps, etop hair loss to some extent. Hair taking, will, , quickly once treatment is over., Susceptibility to, When, cells, they, also, they also., , hich, , infections:, destroy normal cells, , grow back, , the, , drugs, , surprisingiy, , Ct, act, , on cancer, , blood cells,, including white blood, When, ce, white, the body's im, blood cells are in short, immune system is, hort supply, supp, to infections, weakened, ns. Fever, making clientsusceptible, should, which fight, fight inf, infections., , abody's, , be, , reported to doctor. suscep

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Medical Surgical Nursing (June-2008), , 107, , Deerease in blood cell count: During chemotherapy, client may, does not, become anemic. Regular blood tests are done to ensure this, happen. If necessary, blood transfusions are given., Mouth sores and ulcers: Some times chemotherapy cause sores, , and ulcers in the mouth. Regular use ofa mouthwash is very important., Guidelines for administering chemotherapy:, Wash hands, Wear personnel protective devices: gown, gloves, goggles, mask., , Before beginning,collect all articles to administer chemotherapy:, IV tubings, NS/D5, chemotherapy drugs, spirit swabs, articles, for IV line, Explain procedure to client, Administer chemotherapy in a calm environment, Follow aseptic technique, Explain all potential side effects of the drug, Discard all chemotherapy and equipment in proper container., Documentation.