Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
47 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
How does breast cancer develop? |
Breast cancer can start in the ducts or lobules of the breast. Sometimes cancer cells stay in the ducts and lobules of the breast. This is called non-invasive breast cancer. If the cancer cells spread into the surrounding tissue, this is called invasive breast cancer. The site where the cancer starts is called the primary cancer.Sometimes, breast cancer cells travel in the bloodstream or lymphatic system to other parts of the body such as the bones or liver. This is called metastatic breast cancer (or secondary or advanced breast cancer). |
Ducts Non-invasive |
|
|
What are risks of breast cancer? |
Age, obesity, diet, family history, alcohol consumption, gender.
|
|
|
|
What are some signs and symptoms of breast cancer? |
breast changes include: - a new lump or lumpiness, especially if it's only in one breast - a change in the size or shape of the breast - a change to the nipple, such as crusting, ulcer, redness or inversion - a nipple discharge that occurs without squeezing - a change in the skin of the breast such as redness or dimpling - an unusual pain that doesn't go away. |
Size, colour, pain |
|
|
What treatment options are available for breast cancer? |
- surgery -chemotherapy - hormone therapy - radiation |
|
|
|
how does lung cancer develop? |
Lung cancer is the uncontrolled growth of abnormal cells that start off in one or both lungs; usually in the cells that line the air passages. The abnormal cells do not develop into healthy lung tissue, they divide rapidly and form tumors. |
Smoking causes the majority of lung cancers — both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked and in those who never had prolonged exposure to secondhand smoke. In these cases, there may be no clear cause of lung cancer. |
|
|
what are some symptoms of lung cancer? |
Localised symptoms • worsening cough • haemoptysis (Coughing up blood-stained sputum) • shortness of breath • wheezingGeneralised symptoms • fatigue • weight loss • bone pain • liver function tests • Neurological changes • paraneoplastic syndrome (e.g. ADH secretion) |
|
|
|
benign (oma) cancers |
local, no metastasis, slow growing, well differentiated |
|
|
|
malignant cancers |
invasive, rapidly growing, poorly differentiated, often lethal. |
|
|
|
normal cell regulation |
mitosis adds/replaces cells apoptosis removes cells a disruption causes cancer |
|
|
|
somatic vs germline mutations |
somatic: are nonheritable germiline: present in egg and sperm and are heritable. |
|
|
|
Hayflick’s Limit |
-The number of times a normal human cell population will divide until cell division stops.-Cells can divide a maximum of approximately 50 times - In vitro observation of fibroblasts- Slower the cellular reproduction the longer the lifespan |
Divide |
|
|
Telomere Theory |
- Chromosome ends have a repeating nucleotide sequence (telomeres) which protects the DNA strand from damage or fusion -Each replication shortens the telomere - Can be restored by telomere reverse transcriptase (enzyme) |
Shorten |
|
|
Immunological Theory |
-The rate of ageing is controlled by the immune system -Immune system programmed to decline -Increased vulnerability to disease -increased inflammation - Cellular stress and death -The immune system theory of aging believes that many age-related conditions are caused by a decrease in the function of the immune system |
|
|
|
System Changes |
Musculoskeletal Effects -Skeletal muscle atrophy -physical inactivity -reduced number of neurones to muscle cells -reduced muscle tone (after 30 years) -nerve cells in spinal cord lost after 80 years -ligaments, tendons and joints increasingly stiff due to cross linking and wear -reduced level of subcutaneous layer -reduced level of activity of sweat glands Changes in Body Weight -Decline in lean body mass and a loss of body water -Overall percentage of adipose tissue increases by 16% (25-75 YEARS) -Intracellular collagen and elastin reduced- less tissue resilience Cardiac Changes -By age 60, 35% less blood flow overall -Cardiac contraction is prolonged due to slowed calcium release into myoplasm during systole -Decreased output is not problematic until the system is under stress - Circulation time is doubled by age 70 -Cardiac response is less efficient and requires more overall energy expenditure -Circulation in coronary arteries decreases by 35% after 70 years of age Respiratory Changes -Reduced efficiency of ventilation and gas exchange - Little reserve in the older person’s body - Decrease in the number and efficiency of cilia -Decreased amount of bronchial epithelium -Lungs become ‘flabbier’ - reduction of elastin and collagen reduces outward movement and inward pull - Diminished inspiratory and expiratory muscle strength -Incomplete lung expansion occurs -Airway collapse reduces emptying of lungs -increased demand on cardiac function to increase cardiac output to compensate for reduced PO2 levels -Increased potential for respiratory problems Renal -Up to 50% loss of nephrons with little or no change in homeostatic ability -Kidney size shrinks by 30% by 80 -Renal blood flow reduces from 1200 mls/min to 600 mls/min by the age of 80- GFR reduced -Changes do not significantly alter the effectiveness of the kidneys -Reduced ability to concentrate urine -Increased susceptibility to fluid and electrolyte imbalance and medication related renal damage Endocrine -Insulin receptor sites altered - less effective at transporting glucose through cellular membrane -Reduced levels of adrenaline, noradrenaline and dopamine produced Sexual Changes -General decline in libido in both genders due to decrease in oestrogen and testosterone -Sex can become painful to an older woman and her vagina may be injured Older men -are likely to have fewer and weaker erections -are more likely to be sexually active than women Post menopausal women -Oestrogen drops -Vaginal walls thin -Decreased in natural lubricant -Vagina shortens -Labia atrophies -The cervix can move into the vaginal vault Neurological -Conduction time of peripheral nerves is slower -Orientation levels alter Taste Changes -Reduced number of taste buds -higher threshold for sweet, sour, salty and bitter -Reduced perception of smell due to loss of cells in the olfactory bulb Pain Perception -reduced level of pain perception Visual Changes Older individuals require 3 times the amount of light as 20 year oldsLighting is more effective in concentrated spots rather than in general Colours change with blue, greens and violets less visible and reds oranges and yellows more visibleImpact on ability to read coloured text-potential safety issue |
Skeletal muscle atrophy Body weight Cardiac Respiratory Renal Endocrine Sexual Changes Neurological Taste changes Pain perception |
|
|
Three Ages of Ageing |
+Middle adult years, 40-65years +Older adulthood starts at 65 years onwards Three periods - Young old~60-74, Middle old~75-84, Frail old~85years onwards +Changes of ageing increasingly impact on physical capacity and ability to manage, psychological capacity and ways of dealing with change and increasing impact/dependence |
|
|
|
Fail Older Adults |
-poor mental and physical health -low socioeconomic status -predominantly female-possibly isolated living conditions-more and longer hospital stays-more money spent on healthcare and drugsOlder people’s perception of good quality of life-includes health and autonomy, attention, resources, family relationships, social relationships |
|
|
|
Aged care in the community |
Provide pt with resources, education and information -Particularly through ‘Aged Care Assessment Team (ACAT) and Community care servicesCommunity Care Services - Home and community Care (HACC) program, funded by state and Australian government. - Support for carers, funded by Australian government - Respite care, offers support to older people who may need a break or extra care for a short period |
|
|
|
Genetic basis of cancer (Aetiology) |
-Caused by two types of genetic mutations -overactivity of porto-oncogenes -Inactivity of tutor suppression genes virus infections can add oncogenes. Hep B and C virus (liver cancer) HPV (cervical cancer) |
2 types over or inactive |
|
|
Characteristics of cancerous tissues |
Increase in cell number (due to increased cell devision or decreased apoptosis)Pleomorphism (different shapes and forms) Angiogenesis (growth of new blood vessels)Growth causes obstruction and imbalance |
Amount Shapes |
|
|
Ovarian Cancer Signs and Symptoms |
- Asymptomatic or vague- Abdominal pain, swelling, bloating - Increased abdominal circumference - Constipation - Frequent urination - Pelvic pain - Shortness of breath - Fatigue |
|
|
|
Ovarian Cancer Diagnosis |
-Pelvic examination -Transvaginal ultrasound imaging - Surgery and biopsy -CT, PET, X-ray imaging |
|
|
|
Ovarian Treatment |
-Guided by grade and stage -Surgery, remove one or both ovaries; plus uterus and uterine tubes -Chemotherapy, adverse effects before and after surgery. -Radiation -Immunotherapy |
|
|
|
Palliative Care- what are the 3 forms |
-A Palliative approach - All HCPs - Specialist palliative care - provided by trained multi-professional team - End of life care - Dying with dignity Aim of palliative care is to reduce suffering and improve quality of life |
|
|
|
What are the Palliative care stages of assessment and management |
- Grieving - shock dealing with diagnosis - Stable - establishment of care - Deteriorating - specific care plan and regular review - Terminal - focus of care on physical, emotional & spiritual issues - Bereaved - care of those left behind |
|
|
|
What are some assessments of the age person |
Physical Drowsiness, fatigue, dyspnoea, vomiting/nausea, pain, constipation, sleep problems, diarrhoeaCan the pt perform ADLs? Is there a caregiver to assist the pt?Physiological Is the pt experiencing sustained lowering of mood, tearfulness, guilt or irritability, loss of pleasure or interest in usual activities?Is the pt experiencing feelings of apprehension, tension, anger, fearfulness or nervousness, hopelessness or a sense of isolation?Is the pt particularly concerned about the impact of illness on the caregiver or family?Socio-Cultural Are there financial concerns relating to loss of income or costs of treatment, travel expenses, or equipment?Are there conflicting opinions between patient and family relating to legal issues such as end-of-life care options and advanced care plans?Is the patient and family aware of financial help available?Spiritual/ExistentialIs the patient feeling isolated or hopeless?Does the pt feel life has no meaning or that their time is being wasted?Does the pt require assistance in finding appropriate spiritual resources or services? |
Physical Socio-cultural Physiological Spiritual |
|
|
What are the three categories of support/ Approach to Palliative Care |
1. Pain management. Vital for comfort and to reduce pts distress. 2. Symptom management. Treating symptoms other than pain such as nausea, weakness, bowel and bladder problems, mental confusion, fatigue and difficulty breathing 3. Emotional and spiritual support. Both for families and pt |
P S E |
|
|
Issues surrounding Medication |
-Adverse effects of the medication will be exaggerated in the older person may result in delirium, falls and increase confusion- Changes in absorption and physiology changes pts ability to metabolise medication -Physical issues related to opening containers -Dilution and storage of medication affect safety -Increased chance of polypharmacy due to multiple conditions -Increased complications due to reduce fluid proportion -Reduced renal function can result in increased potential for renal damage as a result of medications |
|
|
|
Gender theories and Gender issues in ageing |
-Feminist perspective hypothesis:the experiences of women are often ignored in understanding the human condition. -Women live longer but have poorer physical and psychological health than men until very old age when it becomes even -Because women live longer older men tend to become invisible -Lesbian, gay and transgender people need a better representation |
|
|
|
Theories of Ageing |
-Role theory, how well individuals adjust to ageing is assumed to depend on how well they accept the role changes typical of later years -Disengagement theory, Cummings and Henry, ageing is an inevitable, mutual withdrawal or disengagement, resulting in decreased interaction between the ageing person and others. The theory claims it is natural and acceptable for older adults to withdraw from society -Activity theory, adjustment to age related changes such as retirement, poor health. Increases activity = increased satisfaction -Continuity theory of normal aging states that older adults will usually maintain the same activities, behaviors, personalities, and relationships as they did in their earlier years of life. -Continuity theory/Spiritual self, Two components: patterns of religious behaviour and inner sacred experiences |
|
|
|
Transparency of ageing |
-Older people feel ignored -People ignore the person of diagnosis -Nurse needs to listen to the pt and their story |
|
|
|
What is hypothyroidism |
Hypothyroidism is a disease in which the thyroid gland is under active and does not produce enough thyroxine, a hormone, which is important for controlling your metabolism. Symptoms of hypothyroidism include tiredness, muscle weakness and cramps; feeling the cold; a slow heart rate; dry and flaky ski |
|
|
|
Hypothyroidism Nursing Management |
Promoting Home and Community-Based CareTEACHING SELF-CARE • Oral and written instructions should be provided regarding the following: • Desired actions and side effects of medications • Correct medication administration • Importance of continuing to take the medications as prescribed even after symptoms improve • When to seek medical attention • Importance of nutrition and diet to promote weight loss and normal bowel patterns • Importance of periodic follow-up testingCONTINUING CARE • Monitor the patient’s recovery and ability to cope with the recent changes, along with the patient’s physical and cognitive status and the patient’s and family’s understanding of the instructions provided before hospital discharge. • Document and report to the patient’s primary health care provider subtle signs and symptoms that may indicate either inadequate or excessive thyroid hormone |
|
|
|
Hypothyroidism medications |
• Carbidopa/Levodopa 25/100 q8h - Parkinson’s Disease - The combination of levodopa and carbidopa is used to treat the symptoms of Parkinson's disease. Levodopa is in a class of medications called central nervous system agents. It works by being converted to dopamine in the brain. Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preventing levodopa from being broken down before it reaches the brain. This allows for a lower dose of levodopa, which causes less nausea and vomiting. • Entacapone 200 mg q8h - Parkinson’s Disease - It is used in combination with levodopa and carbidopa (Sinemet) to treat the end-of-dose 'wearing-off' symptoms of Parkinson's disease. Entacapone helps the levodopa and carbidopa work better by allowing more of it to reach the brain, where it has its effects. |
Thyroxine Carbidopa/Levodopa Entacapone |
|
|
What is COPD |
Chronic Obstructive Pulmonary Disease (COPD) is a term used to describe a number of lung conditions that are long-term, gradually worsen, and cause shortness of breath by reducing the normal flow of air through the airways. |
|
|
|
COPD nursing priorities and discharge goals |
Nursing Priorities 1 Maintain airway patency. Ineffective Airway Clearance Possibly evidenced by difficulty breathing, changes in depth/rate of respirations, use of accessory muscles. Nursing Interventions include; auscultate breath sounds, assess and monitor respirations and breath sounds, noting rate, encourage abdominal or pursed-lip breathing exercises. 2 Assist with measures to facilitate gas exchange. Nursing interventions include assessing respiratory rate, auscultate breath sounds, 3 Enhance nutritional intake. May be related to Dyspnea; sputum production, medication side effects; anorexia, nausea/vomiting or fatigue. Possibly evidenced by weight loss; loss of muscle mass, poor muscle tone or due to reported altered taste sensation; aversion to eating, lac k of interest in food. Nursing interventions include assessing dietary habits, encourage rest periods, smaller meals, regular weighs. 4 Prevent complications, slow progression of condition. 5 Provide information about disease process/prognosis and treatment regimen. Nursing interventions provide information, education and resources. Discharge Goals 1 Ventilation/oxygenation adequate to meet self-care needs. 2 Nutritional intake meeting caloric needs. 3 Infection treated/prevented. 4 Disease process/prognosis and therapeutic regimen understood. 5 Plan in place to meet needs after discharge. |
|
|
|
COPD medications |
•Salbutamol 2 puffs PRN - Beta2-Adrenoreceptor stimulant. Relief of bronchospasm (asthma, COPD) •Prednisone 5mg BD / Prednisolone is a steroid. It prevents the release of substances in the body that cause inflammation. •Theophylline 500 mg BD - Theophylline is a bronchodilator. It works by relaxing muscles in the lungs and chest, making the lungs less sensitive to allergens and other causes of bronchospasm. Theophylline is used to treat symptoms such as wheezing or shortness of breath caused by asthma, bronchitis, emphysema, and other breathing conditions •Metoprolol 40mg BD - Metoprolol is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins). Metoprolol is used to treat angina (chest pain) and hypertension (high blood pressure). People with COPD have more constricted arteries, veins etc because of low O2 levels in the alveoli so Jane would have a condition called secondary pulmonary hypertension. It also means her blood vessels thicken and puts her at risk of CHF |
Salbutamol Prednisone Theophylline Metoprolol |
|
|
Haemorrhagic left Cerebrovascular Accident (CVA) |
Cerebrovascular Accident- A cerebrovascular accident is the medical term for a stroke. It is the sudden death of some brain cells due to lack of oxygen when the blood flow to the brain is impaired by blockage or rupture of an artery to the brain. Hemorrhagic strokes result from a weakened vessel that ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding brain tissue. The two types of hemorrhagic strokes are intracerebral hemorrhage or subarachnoid hemorrhage. Hemorrhagic strokes have the slowest recovery of all types of stroke. |
|
|
|
CVA Nursing Priorities, Interventions and evaluation |
Nursing Priorities 1 Promote adequate cerebral perfusion and oxygenation. 2 Prevent/minimize complications and permanent disabilities. 3 Assist patient to gain independence in ADLs. 4 Support coping process and integration of changes into self-concept. 5 Provide information about disease process/prognosis and treatment/rehabilitation needs. 1.Nursing Interventions Enhancing Self Care Encourage personal hygiene activities as soon as the patient can sit up; select suitable self care activities that can be carried out with one hand, Help patient to set realistic goals; add a new task daily, Improve morale by making sure patient is fully dressed during ambulatory activities, Assist with dressing activities (eg, clothing with Velcro closures; put garment on the affected side rst); keep environment uncluttered and organized, Provide emotional support and encouragement to prevent fatigue and discouragement. 2.Assisting with Nutrition Observe patient for paroxysms of coughing, food dribbling out or pooling in one side of the mouth, food retained for long periods in the mouth, or nasal regurgitation when swallowing liquids, Consult with speech therapist to evaluate gag reexes; assist in teaching alternate swallowing techniques, advise patient to take smaller boluses of food, and inform patient of foods that are easier to swallow; provide thicker liquids or pureed diet as indicated, Have patient sit upright, preferably on chair, when eating and drinking; advance diet as tolerated. 3.Improving Family Coping. Provide counseling and support to famil, Involve others in patient’s care; teach stress management techniques and maintenance of personal health for family copin, Give family information about the expected outcome of the stroke, and counsel them to avoid doing things for patient that he or she can do, Develop attainable goals for patient at home by involving the total health care team, patient, and family. Evaluation Expected Patient Outcomes • Achieves improved mobility. • Has no complaints of pain. • Achieves self care; performs hygiene care; uses adaptive equipment. • Demonstrates techniques to compensate for altered sensory reception, such as turning the head to see people or objects. • Demonstrates safe swallowing. • Achieves normal bowel and bladder elimination. • Participates in cognitive improvement program. • Demonstrates improved communication. • Maintains intact skin without breakdown. • Family members demonstrate a positive attitude and coping mechanisms. • Develops alternative approaches to sexual expression. |
|
|
|
Case 3 medications |
• Aspirin 150 mg daily - Aspirin is used to treat pain, and reduce fever or inflammation. It is sometimes used to treat or prevent heart attacks, strokes, and chest pain (angina). • Paracetamol 1 gram -a pain reliever and a fever reducer. • Salbutamol 2 puffs PRN • Telmisartan and Hydrochlorothiazide 80/12.5 mgs mane - Hypertension |
Aspirin Paracetamol Salbutamol Telmisartan and Hydrochlorothiazide |
|
|
Mastectomy Care Plan |
Nursing Care Plan 1. Fear/Anxiety - Check out and explore what information patient has about diagnosis, expected surgical intervention, and future therapies. Note presence of denial or extreme anxiety. Encourage questions and provide time for expression of fears. Tell patient that stress related to breast cancer can persist for many months and to seek help and support. 2. Impaired Skin Integrity - Inspect dressings anteriorly and posteriorly for characteristics of drainage. Monitor amount of oedema, redness, and pain in the incision. Perform routine assessment of involved arm. Elevate hand or arm with shoulder positioned at appropriate angles and forearm resting on wedge or pillow, through preventing or minimising oedema it reduces the discomfort and complications associated with it. Elevation of affected arm facilitates drainage and resolution of oedema. 3. Acute Pain - Discuss normality of phantom breast sensations. Splint or support chest during coughing and deep-breathing exercises as this facilitates participation in activity without undue discomfort. Carry out appropriate pain medication on a regular schedule before pain is severe and before activities are scheduled this Carry out appropriate pain medication on a regular schedule before pain is severe and before activities are scheduled. 4. Situational Low Self-Esteem - Encourage patient to express feelings like anger, hostility, and grief. Open up about signs and symptoms of depression with patient. Ascertain feelings and concerns of partner regarding sexual aspects, and provide information and support. Provide temporary soft prosthesis, if indicated, this may promote social acceptance and allow patient to feel more comfortable about body image at the time of discharge. 5. Impaired Physical Mobility - Elevate affected arm as indicated, this Promotes venous return, lessening possibility of lymphedema. Encourage patient to use affected arm for personal hygiene this Increases circulation, helps minimize edema, and maintains strength and function of the arm and hand. Help with self-care activities as necessary. 6. Deficient Knowledge- Have patient demonstrate care of drains and wound sites. Demonstrate holding affected arm appropriately by not dangling the arm, swinging arms with elbows bent when walking, placing arm above heart level when sitting or lying down this helps prevent or minimise lymphedema. Stress importance of regular medical follow-up. |
|
|
|
Lymphedema |
Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling. Treat pain by treating lymphedema, analgesia may also be necessary |
|
|
|
Case 4 medications |
• Oxycodone CR 10 mg bd Oxycodone IR 5 mg p.r.n., no more than twice a day Oxycodone is a pure agonist opioid whose principal therapeutic action is analgesia. Other members of the class known as opioid agonists include substances such as morphine, hydromorphone, fentanyl, codeine, and hydrocodone. Pharmacological effects of opioid agonists include anxiolysis, euphoria, feelings of relaxation, respiratory depression, constipation, miosis, and cough suppression, as well as analgesia. Oxycodone produces respiratory depression by direct action on brain stem respiratory centers. Oxycodone depresses the cough reflex by direct effect on the cough center in the medulla. Pinpoint pupils are a sign of opioid overdose • Gabapentin 300 mg q8h - Gabapentin is used with other medications to prevent and control seizures. It is also used to relieve nerve pain following shingles. Possible use in neuropathic cancer related pain • Dexamethasone 4mg q6h - Dexamethasone is a corticosteroid that prevents the release of substances in the body that cause inflammation. Possible use to treat lymphedema. Many drugs can interact with dexamethasone • Coloxyl and Senna tabs ii nocte - Constipation • Temazepam 10 mg nocte (nocte- at night) - Temazepam is a drug that is used for treating anxiety. It is in the benzodiazepine class of drugs. Can also be used to treat insomnia symptoms, such as trouble falling or staying asleep. • Tamoxifen 20 mg daily - Tamoxifen blocks the actions of estrogen, a female hormone. Certain types of breast cancer require estrogen to grow. Tamoxifen is used to treat some types of breast cancer in men and women. It is also used to lower a woman's chance of developing breast cancer if she has a high risk (such as a family history of breast cancer). |
Oxycodone Gabapentin Dexamethasone Coloxyl Temazepam Tamoxifen |
|
|
Peripheral vascular disease |
Peripheral vascular disease is the reduced circulation of blood to a body part other than the brain or heart. It is caused by a narrowed or blocked blood vessel. The main cause is atherosclerosis, which is the build-up of fatty deposits that narrow a blood vessel, usually an artery. The narrowed blood vessel reduces the circulation of blood to the associated body part. |
Management is centred around stressors |
|
|
Haemoptysis (symptom) |
Haemoptysis is the coughing of blood from a source below the glottis. It can range from a small amount of blood-streaked sputum to massive bleeding with life-threatening consequences due to airway obstruction and haemodynamic instability. Haemoptysis is the coughing of blood originating from the respiratory tract below the level of the larynx |
|
|
|
Case 5 medications |
• salbutamol via nebuliser 5 mg three times a day • salbutamol puffer two puffs as needed, no more than four times a day -Used to relieve bronchospasm in bronchial asthama, chronic bronchitis, emphysema and other airway resistance diseases. After oral administration, approximately 50% of salbutamol is absorbed from the intestinal tract with a slower onset of action, reaching a peak at about 2 hours after intake. After inhalation, salbutamol reaches the lungs directly and acts within 3-5 minutes with a peak at 15-20 minutes. Overall duration of action of salbutamol is 4-6 hours. It is metabolized in the intestinal tract and in the liver and is excreted via the urine. • domperidone 10 mg an hour before meals -used to treat nausea and vomiting. Can also be used to treat complaints of the stomach, which occur with delayed emptying of the stomach. This can result in symptoms such as feeling full (during or just after eating), bloating, belching, nausea, heartburn and stomach ache. • paracetamol 500 mg with codeine 30 mg 2 tablets every 6 hours. Paracetamol is a pain reliever and a fever reducer. Codeine is an opioid pain medication that is a sleep-inducing and analgesic drug derived from morphine. • multivitamin tab i daily |
Salbutamol Domperidone Paracetamol multivitamin |
|
|
Decreased nutrition nursing interventions and rationale |
1. Monitor daily food intake; have patient keep food diary as indicated. This Identifies nutritional strengths and deficiencies.2. Assess skin and mucous membranes for pallor, delayed wound healing, enlarged parotid glands. Helps in identification of protein-calorie malnutrition, especially when weight and anthropometric measurements are less than normal.3. Encourage patient to eat high-calorie, nutrient-rich diet, with adequate fluid intake. Encourage use of supplements and frequent or smaller meals spaced throughout the day. |
|
|
|
How to include patient dignity and maintain autonomy across patient care |
In Western countries, measures to maintain dignity in patients' care include maintaining privacy of the body, providing spatial privacy, giving sufficient time, treating patients as a whole person and allowing patients to have autonomy-Nurses' measures to maintain dignity in patient care were captured in five themes: respect, protecting privacy, emotional support, treating all patients alike and maintaining body image. |
|
