nurseionary

DEFINITION:- Bleeding from the nose is called epistaxis. It is not a disease but it is a symptom of other disease. CAUSES/RISK FACTORS:- Congenital Injury to nose Hot environment Acute rhinitis Chronic rhinitis Sinusitis Nasal diptheria T.B Syphilis Adenoiditis Nasal mucosa dryness Nasal cancer. Haemophilia Trauma in brain Malaria, Typhoid, Measles, Influenza High arterial pressure Whooping cough Diabetes mellitus Malnourishment Lack of Vit.C and Vit.K medicines (Aspirin) SIGN/SYMPTOMS:- Bleeding of Nose. If patient swallow blood, then blood comes out through vomiting. Fresh bright and red blood. Unconsciousness in case of severe bleeding. COMPLICATIONS:- Rhinitis Otitis media Maxillary and frontal sinusitis Shock. MEDICAL MANAGEMENT:- With anterior bleeds, the patient is instructed to compress the soft part of nose with index finger and thumb for 5-10 minutes to maintain pressure on the nasal septum. A coatted pledget soaked with a vasoconstricting agent may be inserted in...

DEFINITION:- It is an inflammation of Adenoids. Adenoids are lymphatic tissue near the centre of posterior wall of the nasopharynx. CAUSES:- Group A streptococci bacteria SIGN/SYMPTOMS:- Nasal obstruction Sore throat Noisy respiration Voice impairment Fever Foul breathing Voice impairment otitis media Malaise. DIAGNOSTIC FINDING:- Sore throat By signs and symptoms CBC Throat Swab cultures MEDICAL MANAGEMENT:- Antibiotic Therapy if bacterial infection present, e.g., Penicillin Amoxicillin. Anti-inflammatory Corticosteroids, e.g., Betamethasone, prednisolone Antipyretics, Analgesics, e.g., Acetaminophen, Paracetamol, Ibuprofen etc. SURGICAL MANAGEMENT:- Adenoidectomy:  Surgical removal of the adenoids. GENERAL POST OPERATIVE CARE:- Check the bleeding side or surgery side. Check the bleeding colour. Provide comfortable position. Give Health education. Use alkaline mouthwash and warm saline solution. A liquid or semi-liquid diet given for patient. Avoid spicy, hot, acidic f...

DEFINITION:- It is an inflammation of middle ear or infection of middle ear caused by entrance of pathogenic organisms TYPES:- It is mainly of three types: Acute O.M. (Suppurative otitis media) Serous O.M. Chronic O.M. Acute O.M.:  It is an acute infection of middle ear, usually lasting less than 6 weeks. Serous O.M.:  It means accumulation of serous fluid in middle ear without evidence of active infection, but fluids results from a negative pressure in the middle ear caused by Eustachian tube obstruction. Chronic O.M.:  It is the result of repeated episodes of acute O.M. causing irreversible tissue pathology and persistent perforation of tympanic membrane. It also leads to mastoid bone infection. CAUSES:- Pathogenic infections: Bacteria (streptococcus pneumonia) Virus Upper respiratory infection, e.g., sinusitis. Allergic reaction Entrance of foreign body in ear. Inadequate treatment of acute otitis media. SIGN/SYMPTOMS:- ACUTE OTITIS MEDIA: Pain Hearing loss...

DEFINITION:- It is an acute and congenital disorders of a valve charactersized by stenosis (obstruction), impaired closure and regurgitation of blood. Regurgitation (back flow). Mitral valve Disease Mitral Stenosis:  (Narrowing of Mitral valve) Mitral Regurgitation  It involves backflow of blood from left ventricular into left atrium due to failure of mitral valves. SYMPTOMS:- Dyspnoea Cough Murmur sound Dysrhythmias Low B.P Syncope Angina. DIAGNOSTIC EVALUATION:- ECG Echocardiography Cardiac catherization COMPLICATIONS:- Left side heart failure Dysrhythmia MEDICAL MANAGEMENT:- Diuretics: Example; furosemide thiazide. Positive intropic agent: (increase effectively heart ability) Example; Digoxin Dopamine. Vasodilators: Example; Nitrates. ACE inhibitors: Example; Captopril- 15-25 mg TDS. Analapril. SURGICAL MANAGEMENT:- For mitral Stenosis: Closed mitral valvotomy Open mitral valvotomy Mitral valve replacement. Valvuloplasty:  For tricus...

DEFINITION:- It is a condition of unknown cause in which arteries of finger's are unduly reactive and enter spasm (angiospasm or vasospasm) when the hands are cold. OR It is a vasospastic disorder that is brought on by an unusual sensitivity to cold, emotional stress, or autoimmune disorder. CAUSES:- Unknown Cold temperature Stress Smoking Injury Certain medicine (Beta-blocker). Chemical exposure. SIGNS AND SYMPTOMS:- Cold fingers and toes Attacks of pallor, numbness and discomfort in fingers. Colour changes (white, blue, red). DIAGNOSTIC EVALUATION:- Blood test (ESR) Physical examination Non-vasive blood flow test Gangrene or ulceration of finger tips. MEDICAL MANAGEMENT:- Calcium channel blockers (Amlodpine) Vasodilators (Nitroglycerin) Antiplatelet agents (Aspirin) SURGICAL MANAGEMENT:- Sympathectomy:  Surgical division of sympathetic nerve fibers. Nerve Surgery. NURSING DIAGNOSIS:- Acute Pain related to hyperemic stage. Disturbed sensory perception related to vasosp...

DEFINITION:- It is defined as accumulation of fat in wall of blood vessels (artery or veins) or hardening of blood vessels due to increase level of cholestrol in blood or serum. CAUSES:- Smoking Genetic Enviromental Elevated serum cholestrol Diabetes Hypertension Stress obesity Physical inactivity. PATHOPHYSIOLOGY:- There are so many theories of pathogenesis, but here we are discussing about response to injury theory. Non-specific injury (due to mechanical, chemical, hormonal, immunologic, hypertension. smoking, cholestrol etc. ↓ Inflammation in intima layer in vessels ↓ Continued exposure to source of intimal injury results in continued deposit and proliferation of smooth muscle cells ↓ Formation of plaque (Artheromas) ↓ Narrowing and obstructing blood flow Based on affected area Brain (Cerebral-arteriosclerosis) Transient ischemic attacks (TIA) Heart (CAD) Angina Pectoris MI Heart failure. Kidneys (Renal artery stenosis) Renal insufficiency Hypertension. Extre...

DEFINITION:- An aneurism is a distension of an artery brought about a weakening destruction of arterial wall. (A balloon-like swelling in the wall of an artery.) CAUSES:- Smoking Local infection Congenital weakness of vessels Syphilis Trauma Degenerative disease. PATHOPHYSIOLOGY:- Due to congenital defects or artherosclerosis ↓ Degenrative changes (Media layer) ↓ Loss of elasticity/ Weakness or dilation TYPES:- It is of two types: True Aneurysm:  In a true aneurysm, layers of vessl wall dilate in one of following ways: Saccular (A unilateral outpouching) Fusiform (A bilateral outpoching) Dissecting (outpouching with separate layers) False Aneurysm (Pseudoaneurysm):  In false aneurysm, the wall rupture, and a blood clot is retained in an outpouching of tissue. SIGNS AND SYMPTOMS:- In abdominal aortic aneurysm (AAAs) Abdominal pain with intense back and flank pain. Abdominal pain without pulsating mass Pulsating abdominal mass Shock Hypotension Tachycardia Decreased ...

DEFINITION:- An acute or chronic inflammation of pericardium (outer layer) of heart is called pericarditis. CAUSES:- Infections: Viral (Influenza virus) Bacterial (step.Meningococcus) Fungal Parasitic Tuberculosis. Chest trauma Heart surgery including pacemaker transplantation Drug induced (phenytoin) Radiation therapy. SIGNS AND SYMPTOMS:- Sharp and stabbing pain in anterior chest. Pain may be felt in neck, shoulder, back and abdomen. Orthopnea Dyspnoea Sweating Dysrhythmic Dry cough Fever Chills. DIAGNOSTIC FINDING:- Chest X-ray ECG CBC (Complete blood count) Serum urea nitrogen MRI. COMPLICATIONS:- Cardiac tamponade: A build up of blood or fluid in the pericardial sac puts pressure on heart, which may prevent it from pumping effectively. Heart failure MEDICAL MANAGEMENT:- Antiviral if viral infections Penicillin (antibiotics) Antimicrobial, e.g., cefixime Analgesics (NSAIDs) Antifungal in case of fungal infection NURSING MANAGEMENT:- To relieve pain by admini...

DEFINITION:- An acute or chronic inflammation of myocardium (middle layer between pericardium and endocardium) of heart. CAUSES:- Viral infections Bacterial infections Fungal infections Parasitic Collagen disease Due to immune suppressive therapy. SIGNS AND SYMPTOMS:- Dyspnoea Fatigue Palpitations Cardiomegaly Fever with tachycardia Abnormal heart sounds. DIAGNOSTIC FINDING:- Chest X-ray ECG CBC (Complete blood count) Serum urea nitrogen MRI. COMPLICATIONS:- Cardiac myopathy: is a disease of heart muscles in which heart muscles weakens and has difficulty to pump blood. Heart failure MEDICAL MANAGEMENT:- Antidysrhythmic drug, e.g., Xylocaine Antiviral if viral infections Penicillin (antibiotics) Antimicrobial, e.g., cefixime Analgesics (NSAIDs) Antifungal in case of fungal infection NURSING MANAGEMENT:- Nursing Diagnosis Hyperthermia related to inflammatory/infectious process. Decreased cardiac output related to decrease cardiac contractility.

DEFINITION:- An acute or chronic inflammation of endocardium (inner layer) of heart. Also known as bacterial endocarditis. CAUSES:- Bacterial infections (beta-hemolytic streptococcus): S.aurous S.viridae Enterococci Fungi: Candida Rickettsiae. SIGNS AND SYMPTOMS:- Fever Chills Sweating Anorexia Weight loss Weakness Cough Splenomegaly Pneumonitis Pleuritis Lung haemoptysis MI Melaena (blood in stool). DIAGNOSTIC FINDING:- Chest X-ray ECG CBC (Complete blood count) Serum urea nitrogen MRI. Endocardiography COMPLICATIONS:- Cardiac myopathy: is a disease of heart muscles in which heart muscles weakens and has difficulty to pump blood. Heart failure Valvular heart diseases MEDICAL MANAGEMENT:- Penicillin (antibiotics) Antimicrobial, e.g., cefixime Symptomatic drugs Antifungal in case of fungal infection NURSING MANAGEMENT:- Nursing Diagnosis Hyperthermia related to disease process. Decreased cardiac output related to decrease Cardiac contractibility. Activity intolerance related...

DEFINITION:- It is a Physiological state in which heart is incapable to pump blood according to metabolic need. Heart failure  is not a disease but group of manifestation in which inadequate pump performance of heart that leads to Pulmonary and systemic congestion. CAUSES:- Abnormal loading condition During Preload: Arterial septal defect. Congenital defect. Hypervolemia. Pulmonary valve stenosis. Mitral valve stenosis. During after load: Aortic valve stenosis. Ventricular septal defect. Coronary thrombosis. Size and thickness of ventricles. Abnormal muscles functions Myocarditis. Cardiomyopathy. Pericarditis. Others: ↑es physical and emotional stress. Dysrhythmia, e.g., Tachycardia, bradycardia. Anaemia. Pregnancy. Thyroid disorder. Hypervolemia. RISK FACTORS:-   FAILURE     Signs and Symptoms    F   Forgot medication   A   Anaemia/Arrhythmia   I   Ischemia/Infraction/infection   L...

DEFINITION :- It is Chest pain due to ischemia of heart muscles generally due to obstruction or spasm in Coronary Artery. TYPES:- Stable:  Increases Oxygen demand Unstable:  During rest chest pain Variant:  Similar to classical Angina Nocturnal:  At night associated with rapid eye movement during dreaming. Decubitis:  When patient raised up after lying Post infraction:  After myocardial infraction. CAUSES:- There are two main causes for this: Decrease blood supply in heart Coronary artery disease Circulatory disorders, e.g., Aortic valve stenosis Aortic aneurysm (distension of coronary artery lumen) Blood disorders, e.g., Severe anaemia Hypoxia (Decrease oxygen level in cell/tissue). Increase blood demand in heart Excessive exercise Excessive emotional level Excessive food intake. Others Hypertension Some other heart diseases. PATHOPHYSIOLOGY:- Due to any cause ↓ Increase oxygen demand in body ↓ Increase heart workload ↓ Heart needs more blood s...

DEFINITION:- It is defined as death of a segment of heart muscle, which follows interruption of its blood supply. In other words... When in myocardium layer of heart, blood supply coronary artery branch is interrupted or stopped then Oxygen supply also stop in any area in heart, after absence of oxygen necrosis happens there. It is called myocardial infraction or myocardial death. CAUSES :- Acute coronary thrombosis: About 90% cases of Myocardial infraction are due to severe coronary heart disease. Arteriosclerosis: Hardening of arteries. Other factors are: Sudden constriction / vasospasm of coronary arteries. CA (coronary artery) embolism. Infectious disease. Hypoxia. Smoking. Increase fatty diet intake. Excessive exercise. SIGN/SYMPTOMS :-  PULSE Signs and Symptoms   P Persistent Chest Pain/Palpation    U Upset Stomach    L Light Headache    S S.O.B    E Excessive Sweating  CLINICAL MANIFESTATIONS...

DEFINITION:- It is also known as ischemic heart disease. It is partial or complete obstruction in coronary artery Blood flow due to atherosclerosis (develop fatty plague in inner walls of arteries). TYPES:- Atherosclerosis Coronary vasospasm Coronary embolism Coronary arteritis RISK FACTORS:- Hypertension Obesity Diabetes mellitus Smoking Family historty High fatty diet Age Oral contraceptives Physical inactivity. PATHOPHYSIOLOGY:- Due to causes (e.g., high fatty diet, hereditory or other) ↓ Lipids/cholesterol formation on endothelium layer of artery ↓ Formation of fatty streak ↓ Proliferation ↓ Formation of fibrous plaque ↓ Partial/complete blockage in coronary artery SIGNS AND SYMPTOMS:- Asymptomatic in early stages. In later stage:  Sign and symptoms arises of heart disease. Anginal Chest pain Symptoms of myocardial infraction Sign and symptoms of heart failure Sudden death. DIAGNOSTIC EVALUATION:- Chest Pain By ECG (ST elevation) Nitroglycerin test (patient feel rel...

DEFINITION:- Hypertension is a disease of vascular regulation in which elevation of arterial pressure above the normal range. Normal blood pressure:  120/80mm of Hg. In Hypertension:  140/90 or above CAUSES/TYPES:- Primary Hypertension: It is due to unknown causes or without systemic cause. Example: Family history Prolonged mental tension Arterial degeneration Hormonal or metabolic disturbance. Secondary Hypertension: It is due to pathological conditions. Example: Due to kidney disease, e.g., Pyelonephritis. Due to endocrine disorders, e.g., cushing Syndrome, diabetes mellitus. Congenital deformities, e.g., Renal artery obstruction. Others: Enlarged Prostate Toxaemia in pregnancy Excessive body weight Excessive sodium intake Obesity Smoking. Borderline Hypertension: It is defined as intermittent elevation of B.P. with normal readings. Malignant Hypertension: It is a Syndrome of markedly elevated blood pressure (above 140 mm of hg). Benign Hypertension: Also known a...