The Nurse Learnersguide

ACUTE RENAL FAILURE

DEF: Acute renal failure is the sudden loss of the ability of the kidneys to remove waste and concentrate urine without losing electrolytes.

SIGNS AND SYMPTOMS

Oedema due to water retention

Mental confusion, nausea, vomiting and hiccup due to Uremia

Oliguria which may last 4 to 10 days( may progress to Anura)

Pruritis due to accumulation of end products of metabolism

Dry skin and mucus membranes due to dehydration

Cardiac arrhythmia and cardiac arrest due to an increase in potassium

Breath may have odor of urine due to urea

SURFACES OF THE PLACENTA

It has two surfaces

1. THE MATERNAL SURFACE
The maternal surface, blood gives this surface a dark red colour.
The surface is arranged in about 16- 20 lobes ( cotyledons) which are separated by grooves or SULCI( Furrows)

2. THE FETAL SURFACE

The amnion covering the fetal surface gives it a white shinny appearance.

FUNCTIONS OF PROTEINS
# Growth and repair of body cells and tissues
of enzymes,plasma proteins, antibodies and some hormones
# provision of energy. This is normally a secondary function which becomes important only when there is not enough carbohydrates in the diet and fats are depleted

NURSING care Tips

1. Actual problem

Problem

Acute pain

Nursing diagnosis
Acute pain related to inflammation evidenced by facial expression or verbalization

AIM

Patient will be relieved of pain within 30minutes of hospitalisation

NURSING interventions

I will access the level of pain from the scale of 0 to 1, 0 to 4 being mild, 5 moderate 8 to 10 being severe.

I will provide diversion therapy such as giving the patient a newspaper of a book to read in order to divert attention to pain

I will admister prescribed analgesic such as paracetamol to block transmission of pain impulses thereby relieving pain

SURGERY
NURSING DIAGNOSIS OF PATIENT WITH ORAL DISORDERS ( e.g oral cancer)

1. Impaired oral mucous membrane related to pathologic condition, infection or trauma

2. Imbalanced nutrition,less than body requirements related to inability to ingest adquate nutrients

3. Disturbed body image related to a physical change in appearance resulting from the disease/condition or Trauma

4. Fear of pain & social isolation related to disease or change in physical appearance

5.Risk of infection related to reduced immunity secondary to treatment plan.

OSCE TUTORIALS
Whatsapp 0977927926

Michael Chibale a 13 year old from a well-known sickle cell parent has been brought to your ward in a sickle cell crisis.

a) Explain 4 types of sickle cell crisis

1. HEMOLYTIC CRISIS
This is the type of sickle cell crisis characterized by excessive destruction of malshaped ( sickled) red blood cells by the spleen detected as foreign bodies.

2. VASO OCCLUSION CRISIS
This is the type of sickle cell crisis resulting from lodging of sickle shaped red blood cells into the peripheral or extremity blood vessels,brain,joints blood vessels characterized by severe joint pains, backache, headache.

3. SPLEEN SEQUESTRATION
This is type of sickle cell crisis caused by pooling of defective red blood cells for destruction by the spleen resulting in enlargement of the spleen. This condition is known as hepatomegaly and comes as a result of spleen work overload

4 APLASTIC CRISIS
This is the type of sickle crisis due to bone marrow suppression in response increase productivity of immature red blood cells to compasate destroyed sickled red blood cell.

MENTAL RETARDATION
This is a disorder in which a person's overall intellectual functioning is well below average,with an intelligence quotient (IQ) around 70 or less.

DEGREE OF SEVERITY
1. MILD RETARDATION
(IQ range 50-55 to about 70

2. MODERATE RETARDATION
(IQ range 35-40 to 50-55)

3. SEVERE RETARDATION
(IQ range 20-25 to 35-40)

4. PROFOUND RETARDATION
( IQ level below 20-25)

CAUSES OF MENTAL RETARDATION

1. Genetic
2. Disorders that occur as the fetus develops during pregnancy
3.Problems during pr after birth

3.pr

SPECIFIC NURSING CARE

Looks at managing unique signs and symptoms of a particular condition.

You just pick specific parts of AEPROPHENEMA

Don't lift everything for every condition as your care will become general.

Nursing care problems for Laryngo-tracheal bronchitis (CROUP)

1. ineffective airway clearance.
2. Ineffective breathing pattern.
3. Altered thermoregulation.
4. Altered nutrition less than body requirements.
5. Risk of fluid volume deficit.