nurseionary

CIRRHOSIS OF LIVER DEFINITION:- Cirrhosis complication of liver disease which involve loss of liver cells and irreversible scaring of liver cells. It is chronic disease characterized by replacement or degeneration changes in normal liver cells. Tissue with diffuse fibrosis and nodules that disturbs the structure and function of liver. Also scar formation occurs due to destroyed hepatocytes. CAUSES/ETIOLOGY:- Alcoholism. Hepatitis A,B,C,D. Hepatotoxic drugs. CHF. Biliary obstruction Diabetes Glycogen storage disease Immunological causes TYPES:- Post Necrotic Cirrhosis:  Due to severe inflammation and massive necrosis of hepatocytes cells. Alcoholic Cirrhosis:  It occurs due to excessive intake of alcohol that leads to accumulation of fat in liver. Biliary Cirrhosis:  Due to severe inflammation and massive necrosis of hepatocytes cells. Cardiac Cirrhosis:  Main cause of this type of Cirrhosis is right side congestive heart failure. SIGNS/SYMPTOMS:- 1. Early symptoms du...

APPENDICITIS DEFINITION:- It is an inflammation of veriform appendix (a small, finger like appendage attached to cecum just below the ileocaecal valve). CAUSES/AETIOLOGY:- Most common in emergency abdominal surgery. Infections. Obstruction of faecal matter. Lymphoid hyperplagia. Inflammation and fibrosis of colon SIGN/SYMPTOMS:- Acute abdominal pain (6-12 hr.) in right lower quadrant area. Anorexia. Pain at most common Burney's point (located half way between the umbilicus and the anterior spine of ilium). Nausea/vomiting. Fever (101°F). Rovsing's sign (palpating the left lower-quadrant which paradoxically causes pain in right lower quadrant. Constipation. Abdominal distention. Local tenderness with pressure. PATHOPHYSIOLOGY:- Due to infection or faecal stone and obstruction ↓ Obstruction in appendix lumen ↓ Increase intra-luminal pressure ↓ Disturb blood supply ↓ Edema or swelling in appendix ↓ Rupture of appendix DIAGNOSTIC EVALUATION:- Blood studies WBC increases...

HAEMORRHOID (PILES) DEFINITION:- It is an enlargement of normal spongy blood filled cushions in the walls of anus or dilation of anal veins and lower rectum. TYPES:- External:  Always visible. Internal:  Not visible. CAUSES/AETIOLOGY:- Chronic constipation Prolonged standing Pregnancy Tumor in colon Due to rectal surgery or infection Increase intra-abdominal pressure Portal hypertension Obesity. CAUSES:- Pain during defecation Constipation Bright red bleeding from the anus Itching surrounding anal area (pruritus) Sensation of incomplete evacuation Visible palpable mass Anaemia Melaena (blood in stool) Rectal pain. PATHOPHYSIOLOGY:- Increase abdominal pressure ↓ Dilation of anal vein ↓ Chronic constipation ↓ Abdominal pressure till long time ↓ Permanent dilation of anal vein ↓ Bleeding from veins DIAGNOSTIC EVALUATION:- Pressure of signs and symptoms. Barium enema for internal digital palpation. Anoscopy. Sigmoidoscopy. Proctoscopy. COMPLICATIONS:- Anaemia. Incontinence. MEDICA...

PANCREATITIS DEFINITION:- An inflammation of pancreas is called pancreatitis CAUSES/AETIOLOGY:- It is of two types: Acute pancreatitis: It is commonly described as an autodigestion of pancreas by exocrine enzymes (Trypsin). Chronic pancreatitis: It is an inflammatory disorder characterized by progressive anatomic and functional destruction of pancreas. CAUSES:- Excessive use of alcohol Biliary duct disease (gall stones) Trauma to pancreas Hereditary Infection of pancreas Pancreatic tumour Hypercalcemia Pregnancy Hyperlipidemia Peptic ulcer. CLINICAL MANIFESTATIONS:- Pain in epigastrium region or in left upper quadrant Constant pain Low grade fever Weight loss Shock in severe condition Nausea/Vomiting Steatorrhoea (fatty stool) ↓es bowel movement Breathlessness Weak pulse Low body temperature Bluish discolouration of skin. According to this, two type of signs occur Cullen's sign: Skin discolouration in periumbilical region is known as Cullen's sign. Turner's sign...

DEFINITION:- Gastroenteritis:  An inflammation of intestine and gastric mucosa is known as Gastroenteritis. Gastritis:  It is an inflammation of mucous membrane of stomach. CAUSES/AETIOLOGY:- Bacterial infection, e.g., Salmonella, shigella, E.coli Excessive intake of alcohol Excessive use of NSAIDs drug, e.g., Aspirin Excessive intake of spicy food Stress. CLINICAL MANIFESTATION (SIGNS/SYMPTOMS):- Nausea, Vomiting Abdominal discomfort Hiccuping/Bleeding Profuse diarrhoea or watery stool Stool with Blood Abdominal cramps Weight loss Heart burn after eating Epigastric tenderness Dehydration Haemetemesis Sour taste. DIAGNOSTIC EVALUATION:- By signs and symptoms Endoscopy Biopsy with histologic examination are perfomed Serologic testing to detect the presence of H.pylori. MEDICAL MANAGEMENT:- Antidiarrheal, e.g., Amoxycillin, Tetracycline or Clarithromycin Antiemetic, e.g., Domperidone (for Stop Vomiting and nausea) Antimicrobials mostly DOC (drug of choice) is metronidazole Antac...

PSORIASIS DEFINITION:- A chronic skin disease in which scaly pink patches form on the elbows, knees, scalp and other parts of the body is known as psoriasis. CAUSES:- Current evidence supports an autoimmune basis for psoriasis. SIGN/SYMPTOMS:- Erythematous, dry, scaly patches Anxiety Stress Commonly occurs on scalp, elbow, knees, and sacral region. MEDICAL MANAGEMENT:- In mild cases, give topical therapy and sunlight. Also give corticosteroids, e.g., triamicnolone acetonide. Dithranol ointment also provide. NURSING MANAGEMENT:- The nurse assesses the impact of the disease on the patient and the coping strategies used for conducting normal activities and interactions with family and friends The Nurse should provide reassurance to the patient and familty that the condition is not infectious, not a reflection of poor personal hygiene, and not skin cancer. The nurse should provide knowledge regarding disease that although there is no cure for psoriasis and lifetime management i...

ECZEMA DEFINITION:- It is a higly pruritive chronic inflammatory skin disorder. It is a type of itching dermatosis which is characterized by Chronic pruritus Intracellular edema Inter-cellular edema. ETIOLOGY:- Contact with allergens, e.g., Acid Alkali Penicillin/Streptomycin Lipstick Nail varnish Hair Flowers pollen. OTHER CAUSES:- Hereditary Food allergies., e.g., peanut, milk, egg, wheat, tree nuts. SIGN/SYMPTOMS:- Erythema Intense itching Vesicles or papules formation Weeping skin Crusting. MEDICAL MANAGEMENT:- Topical corticosteroids therapy, e.g., Triamcinolone, betamethasone. Other drugs - Steroids:  e.g., betamethasone, prednisolone. Antibiotics, e.g., ciprofloxacin Antihistamines, e.g., levocitrizine. NURSING DIAGNOSIS:- Impaired skin integrity related to scratching Nursing Intervention Topical application of open wet dressings Prevent dry skin subacute and chronic stages. Avoid hot water and harsh soaps. Apply, e.g., Lubriderm. Within 3 min of bathing when skin is still s...

ACNE VULGARIS DEFINITION:- It is a common inflammatory disorder of sebaceous glands (increase secretion of sebum). These grease producing glands are under androgen control. It is due to obstruction and inflammation of sebaceous glands and follicles. ETIOLOGY:- Increase androgen activity Hyperactivity of sebaceous glands Obstruction in sebaceous duct Infection of sebaceous duct. SIGN/SYMPTOMS:- Closed comedones (white heads) Open comedones (black heads) Papules, Pustules, Nodules Oily skin Deep scanning. MEDICAL MANAGEMENT:- Topical antibiotics (for suppress growth of acne and decrease comedones, papules and pustules), e.g., erythromycin gel/clindamycin. Systemic antibiotics, e.g., Doxycycline 100mg OD. Topical antibacterial and comedolytic, e.g., Benzoyl peroxide gel. Topical retinoic acid (for comedolytic action), e.g., adapalene gel. Retinoid Therapy, e.g., isotretinoin (Inhibits sebum production and secretion for cystic acne). Antiandrogenic therapy, e.g., cyproterone and ethinylest...

ACNE ROSACEA DEFINITION:- It is a Chronic inflammatory eruption characterized by erythematous, pustular, papules of butterfly area of face (especially the nose). RISK FACTOR:- Age between 30-50 years Fair skinned people Intake of excessive/more coffee, tea, alcohol Spicy food intake Exposure to sunlight Hot liquids intake. SIGN/SYMPTOMS:- Diffuse redness Papules and Pustules develops over butterfly region of face Rhinophyma (hypertrophic, bulbous nose) Flushing face. MEDICAL MANAGEMENT:- Topical metronidazole gel (twice a day). Systemic antibiotics, e.g., Doxycycline, Tetracycline. NURSING MANAGEMENT:- Avoid exercise, stress, hot beverages, and spicy foods.

BONE TUMOURS DEFINITION:- Formation of tumour inside the bone is known as bone tumour. TYPES:- It is of three types: Benign bone tumour , e.g., osteoma, chondroma. Malignant bone tumour,  e.g., Multiple Myeloma, Osteosarcoma, Chondrosarcoma. Metastatic bone tumors:  It is most frequently associated with cancers of the breast, the prostate and lungs SIGNS AND SYMPTOMS:- Pain at the tumour site is severe or persistent Swelling Immobility Anaemia Tenderness Inability to hold heavy objects and things. Pathogenic or spontaneous fractures etc. DIAGNOSTIC FINDING:- By X-ray Biopsy-Bone marrow aspiration FNAC (fine needle aspiration cytology) MEDICAL MANAGEMENT:- Chemotherapy Radiotherapy NURSING MANAGEMENT:- To relieve pain by administer analgesics. To prevent pathologic fractures by maintaining hazard free environment and to help in movement of patient. To reduce patients anxiety by providing psychological support and provide supportive environment. To promote self care activities. ...

CONTUSIONS:- A contusion is a soft tissue injury produced by blunt force, such as a blow, kick, or fall, causing small blood vessels to rupture and bleed into soft tissues (ecchymosis or bruising). CAUSES:- By falls Direct blows Crust injury Motor vehicle collisions Sport injuries. MANAGEMENT:- P-  Protection R-  Rest I-  Ice C-  Compression E-  Elevation. STRAIN:- Injury to a muscle or tendon from overuse, overstretching, or excessive stress may cause strain. TYPES:- Acute:-  Acute strains can result from a single injurious incident. Chronic:-  Chronic strains result from repetitive injuries. Chronic strains can result from improper management of acute strains. DEGREES:- A first-degree strain is mild stretching of the muscle or tendon with no loss of range of motion (ROM). Signs/symptoms: Gradual onset of palpation-induced tenderness Mild muscle spasm. A second-degree strain involves moderate stretching and/or partial tearing of the muscle or tendon. ...

PAGET'S DISEASE DEFINITION:- It is a chronic skeletal disorder resulting from excessive osteoclast activity, mostly affecting the long bones and skull, backbone, pelvis. CAUSES:- Unknown cause but some risk-factors are there Family history More common in man then woman Age above 40 years. SIGNS AND SYMPTOMS:- Generally asymptomatic Pain Fracture Paget's lesions, may lead to osteoarthritis joint destruction Hearing problem due to skull enlargement Tinnitus Vertigo Bone tumour. DIAGNOSTIC FINDING:- Physical examination X-ray Bone biopsy Bone scan show paget's activity. MEDICAL MANAGEMENT:- Bone resorption antagonist, e.g., biphosphate (risedronate, pamidronate) Antineoplastic agent, e.g., plicamycin Analgesics to relieve pain. NURSING MANAGEMENT:- Nursing Diagnosis Chronic pain related to disease process. Risk for injury related to falls.

OSTEOPOROSIS DEFINITION:- It is an age related metabolic disease, in which bone matrix (mass) is lost thereby weakening the bones and making them more susceptible to fracture. In this condition, mostly three bones are affected: Wrist bone Hip bone Vertebral column.         CAUSES:- Lack of calcium and phosphate salts Post menopausal women Age above 40-50 Chronic illness Medications, e.g., corticosteroids (for excessive thyroid replacement) Calcium and vitamin D deficiency Family history Smoking and alcohol habits Excessive caffeine intake Immobilization of part Prolonged bed rest. SIGNS AND SYMPTOMS:- Generally asymptomatic until later stages Acute pain with movement Back pain while bending Pain in affected area Khyposis of dorsal spine Decline in height Multiple fracture Weakness. PATHOPHYSIOLOGY:- Bones make a balance by two process: Osteoclast (engulf old cells) Osteoblast (synthesis of new cells) If there is imbalance in between both process the ...

OSTEOMYELITIS DEFINITION:- It is an inflammation of bone due to infection, it may affect any bone. CAUSES:- Bacterial infection: - Staphylococcus Aureus - Streptococcus Viral infection Fungal infection PATHOPHYSIOLOGY:- Due to infection in medullary part of bone ↓ Infection spreads to periosteum ↓ Oedema or abscess formation ↓ Narcotic bone (sequestra) ↓ Peritonsillar abscess (Pus formation) SIGNS AND SYMPTOMS:- Fever Inability in weight bearing Signs of sepsis Erythema Chills Nausea Malaise Restlessness Spontaneous fracture. Night sweats Swelling, tenderness, and warmth at infection site.DIAGNOSTIC FINDING:- DIAGNOSTIC FINDING:- C.B.C - WBC es - ESR es X-ray C.T. scan/MRI Radionuclide bone scan COMPLICATIONS:- Non-healing wound Sepsis Immobility Amputation. MEDICAL MANAGEMENT:- Antibiotics, - Penicillin - Tetracycline - Cephalosporin, e.g., cefalexin Analgesics and antipyretics as prescribed Application of plaster cast and traction FNAC (Fine needle aspiration cytology) fo...

DEFINITION:- A break in continuity of bones is called fracture, it may be due to excessive pressure on bone and bone is unable to absorb this pressure. TYPES OF FRACTURES:- Complete fracture :It involves the entire section of the bone. Incomplete fracture : Also called greenstick fracture , break occurs only through part of the cross section of the bone. Comminuted fracture : A break with several bone fragments. Closed fracture : It is also called "simple fracture" it does not produce a break in skin. Open fracture : It is also called compound or complex fracture. A break in which the skin or mucous membrane wound extends to fractured bone. Impacted fracture : When one bone impact to another bone. Pathologic fracture : Fracture occurs due to bone disease or without any other pressure, e.g., osteoporosis bone, osteomyelitis. PATTERNS OF FRACTURE:- Greenstick fracture : One side of the bone is broken and the other side is bent. Oblique fracture : At an angle across ...

AMPUTATION DEFINITION:- The removal of a limb, part of a limb, or any other portion of the body (such as breast or rectum) is called Amputation. It is a surgical reconstructive procedure. INDICATIONS :- Peripheral vascular disease in D.M. Severe trauma Congenital deformity Malignant tumour Osteomyelitis/infection To relieve symptoms, improve function and save or improve patients quality of life TYPES OF AMPUTATION:- Open (Guillotine) Used with infection and for patients who are poor surgical risks. Wounds heals by granulation over time or secondary closure 1 week later. Closed (Myoblastic or Flap) Residual limb is covered by a flap of skin Flap of skin is sutured posteriorly. TYPES OF DRESSING:- Soft Dressing: Secure with elastic bandage. Closed Rigid Plaster Dressing: Secure with plaster. PREOPERATIVE MANAGEMENT:- To relieve anxiety. To reduce pain. To increase mobility. To maintain good nutrition. Provide Preoperative teaching. To give general preoperative care. Evaluati...

EMPHYSEMA DEFINITION:- It is defined as impaired gas exchange (Oxygen, Carbon dioxide) resulting from destruction of walls of over distended alveoli or permanent dilation of air spaces (distal to terminal bronchiole). RISK FACTORS:- Cigarette smoking. Pipe, cigar and other smoking COPD Environmental pollution Allergens Infectious agents. PATHOPHYSIOLOGY :- Due to cigarette smoking or other smoking ↓ Deficiency of alpha-1 antitrypsin ↓ Decrease antielastic activity of bronchiales or alveoli ↓ Dilation of distal terminal bronchioles SIGN/SYMPTOMS:- Sputum production Cough Dyspnea on exertion Barrel chest Cyanosis Stress anxiety depression TYPES:- Panlobular Emphysema: It is hyper inflammated alveolar duct, bronchioles. They are essentially enlarged. Centrilobular Emphysema: These are mainly in centre of secondary lobules. COMPLICATIONS :- Respiratory failure Pneumonia Atelectasis Pneumothorax. DIAGNOSTIC FINDING:- Spirometry History collection ABG (Arterial Blood Gas) Analysi...

DEFINITION:-  COPD is the progressive and partially reversible disease of the airway  Comprises primarily of two related disease- chronic bronchitis and Emphysema  Chronic obstruction of the flow of air through the airway and out of the lungs permanent and progressive obstruction over time. Chronic bronchitis is defined clinically as a daily cough with production of sputum at least 3 month per year for 2 or more consecutive year.  It involves inflammation and swelling of the lining of the air way that leads to narrowing and obstruction of the air way.  The inflammation also stimulate production of mucus which can cause further obstruction of the airway.  EMPHYSEMA  It is permanent enlargement of the alveoli due to destruction of the wall between alveoli which leads to reduce the elasticity of the lungs over all.  Loss of elasticity leads to collapse of the bronchioles, obstructing air flow out of the alveoli. Air become trapped to the alveoli and reduce the ab...

LUNG ABSCESS DEFINITION:- It is defined as collection of pus or Purulent material in a localized area of lung. It makes cavity formed by necrosis of lung tissue. CAUSES/AETIOLOGY:- Bacterial infection: Gram +ve: Strep. Pneumonia Strep. aurious. Gram -ve: H. influenza Pseudomonas Anaerobic bacteria Viral infection: Influenza virus Para influenza virus Adenovirus Fungus infection: Candidiasis Histoplasmosis Mycoplasma and protozoa in AIDS. RISK FACTORS:- Aspiration of material into lung, Risk factor for aspiration are: Alcoholism Seizure disorders Drug overdose General anaesthesia Cerebrovascular accidents Infectious agents S.areus Anaerobic bacilli. OTHER CAUSES :- Pulmonary embolism Malignant growth T.B. TYPES:- It is of two types: Extrinsic (Allergic):  Commonly occur in cildhood. Intrinsic (Non-allergic):  Commonly occur about 35 years of age. CLINICAL MANIFESTATION (SIGNS/SYMPTOMS):- Sweating Increase pulse rate Cough Purulent sputum (including food smelling) Ha...

BRONCHIECTASIS DEFINITION:- It is permanent or irreversible dilation of large airway (bronchial tree) caused by destruction of muscles and elastic tissues. TYPES :- According to pathological conditions: Saccular (in large bronchi). Cylindrical (in medium size bronchi). Fusiform. Varicose. CAUSES/AETIOLOGY :- It have same cause like Pneumonia. Bacterial Viral Endobronchial obstruction (tumours, foreign body, sputum etc.) Chronic coughing and excess mucous production. CLINICAL MANIFESTATION (SIGNS/SYMPTOMS):- Wheezing due to collection of fluid Copious sputum (excessive sputum) Cyanosis (blue discolouration of skin) Coughing Dull and flatted sound over area of mucous cough. Paroxysm of coughing on rising, moving, or when lying down position. Purulent sputum Dyspnoea Weakness Haemoptysis Fatigue Loss of appetite and weight loss. Clubbing of finger and toes. (Nail becomes convex/change the normal angle of nail.) DIAGNOSTIC EVALUATION: - History collection Chest X-ray CT scan Ph...

PULMONARY EMBOLISM DEFINITION:- Pulmonary embolism refers to the obstruction of pulmonary artery or one of its branches by an embolus. Embolus:  Material, such as blood clot, fat, air, amniotic fluid, or a foreign body that is carried by blood from one point in circulation to another point. RISK FACTORS:- Venous stasis (Slowing blood flow in vein) Hyper-coagulability Venous endothelial disease COPD Diabetes mellitus Post operative/ Post partum period Prolonged immobility SIGN/SYMPTOMS:- Chest pain Dyspnea Tachycardia Tachypnea Fever Myocardial infarction Cough Haemoptysis. Syncope (loss of consciousness due to insufficient blood supply to brain). COMPLICATIONS:- Pulmonary hypertension Cor-pulmonale DIAGNOSTIC EVALUATION:- Chest X-ray Angiography ECG ABG MEDICAL MANAGEMENT:- Anticoagulation and thrombolytic therapy. SURGICAL MANAGEMENT:- Embolectomy. NURSING MANAGEMENT:- Relieve anxiety Provide post-operative care Provide health education Manage to relieve pain with pain...

PNEUMONIA DEFINITION: - It is an inflammation of lung parenchyma which is associated with marked increase interstitial and alveolar fluid. CAUSES/AETIOLOGY:- Bacterial infection: Gram +ve: Strep. Pneumonia Strep. aurious. Gram -ve: H. influenza Pseudomonas Anaerobic bacteria Viral infection: Influenza virus Para influenza virus Adenovirus Fungus infection: Candidiasis Histoplasmosis Mycoplasma and protozoa in AIDS. CLASSIFICATION:- Community Acquired Pneumonia It occurs in normal healthy persons Bacterial infection Viral infection Hospital Acquired Pneumonia It occurs either when immunity is week or in lung disorders or anatomical abnormal lungs. TYPES:- Segmental Pneumonia:  Only in one small segmental lobes of lung. Bilateral Pneumonia:  Both side segmental lobes of lungs are affected. Lobar Pneumonia:  Complete lobe affected. Broncho Pneumonia:  Patchy like formation in the lungs. RISK FACTORS:- Air pollution/Aspiration Bed rest/prolonged immobility Ch...