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6. No iro#<. Father "a#?t fee = &o# as %ell

Proper &reast feei#g te"h#i!e

7. Be i# a "omforta&le positio#-/ost appropriate is Upright sitii#g for this positio# a$ois te#sio#6. E#tire &oy of teh &a&y sho!l &e t!r#e to%ars the mother8s&reast.<. I#itiate feei#g &y stim!lati#g the Rooti#g refle2' &y to!"hi#g thesie of lipsC"heeks the# &a&y %ill t!r# to stim!l!s. Disappear &y %eeks' &y %eeks &a&y "a# fo"!s. Refle2 %ill &e go#e'P!rpose rooti#g' to look for foo.

S!"ki#g /e"ha#ism -&reasta. )ips of the i#fa#t sho!l "lamp a *'shape&. The to!#ge thr!sts for%ar to grasp #ipple a# areola". The #ipple is &ro!ght agai#st the ahr palate as the to!#ge p!lls theareola i#to the mo!th. the g!ms "ompresses the areola: s!e>i#g milk at the &a"k of thethroat

S!"ki#g me"ha#ism -&ottleThe large r!&&er #ipple strikes the soft palate a# i#terferes %ith thea"tio# of the to!#ge. The to!#ge mo$es for%ars agai#st the g!m to"o#trol o$erflo% of milk i# the espphago!s -same reaso# %hy e#tal

malo"ll!sio# is pro#e to &ottle fe &a&ies: &e"a!se they thr!st theirto!#ge FOR1ARD "a!si#g pro&lem i# the formatio# o the e#talar"h

9. B!rp or B!&&le the &a&y!ri#g a# after feei#g to allo% es"ape ofair -pre$e#ti#g "oli". Sit i#fa#t o# lap: fle2e for%ar: the# r!& or patthe &a"k -#ote+ a$oi Harri#g the i#fa#t

*riteria of Effe"ti$e S!"ki#ga. Ba&y?s mo!th is hike !p to areola&. /om e2perie#"es after pai#.

". Other #ipple is also flo%i#g %ith milk.

NOTE+ /ake s!re that the mother fees the &a&y at the same &reastshe last fee her &a&y. T,is is to fa"ilitate "omplete emptyi#g of the&reast a# there&y promote "omplete filli#g of milk.

*o#tra I#i"atio#s i# Breast Feei#g+



a. /ater#al *o#itio#s+7. ,I: */: ,epa B6. Re"ie$i#g *o!mai#: )ithi!m or /ethotre2ate<. has &reast "a#"er9. has herpes lesio# o# &reast

&.Ne%&or# *o#itio# ' I#&or# errors of meta&olism !s"hasErythro&astosis Fetalis ; Rh i#"ompati&ility: ,yrops Fetalis:Phe#ylketo#!ria: Gala"tosemia: Tay Sa"hs isease

Pro&lems e2perie#"e i# Breastfeei#g +

<RD ay "ha#ges i# &reast post part!ma.77E#gorge &reast' feeli#g of f!ll#ess = te#sio# i# &reast. ' sometimesa""ompa#ie &y fe$er k#o%# as /I)0 FEER./gt+1arm "ompress' for &reastfeei#g mom*ol "ompress; for &ottle feei#g = %ear s!pporti$e &ra.1he# is i#$ol!tio# of &reast' 9 %eeks

&. Sore #ipple ; "ra"ke %ith pai#f!l #ipple/gt+ 7. e2pos!re to air ; remo$e &ra = %ear ress: if #ot: e2pose to6 1att &!l&a$oi %eari#g plasti" li#er &ra'%ill "reate moist!re: "otto#o#ly

". /astitis' i#flammatio# of &reast + staphylo"o""!s a!re!sFa"tors+

7. Improper &reast emptyi#g6. U#healthy se2!al pra"ti"es' ma#!ally e2press i#flame &reastfee o# !#affe"te &reast' gi$ea#ti&ioti"s; "a# still fee o# !#affe"te &reast

Type of stools %ith iffere#t milk pro!"ts+

7. Tra#sitio#al stool ' ' gree# loose = shi#y: like iarrhea to the!#trai#e eye6. Breastfe stool

' gole# yello%: soft: m!shy %ith so!r milk smell: fre!e#tly passe' re"!r e$ery feei#g<.. Bottlefe stool ;' pale yello%: forme har %ith typi"al offe#si$e oor: selom passe:6;< 2Cay' %ith foo ae '&ro%# = ooro!s



/ei"al S!rgi"al N!rsi#g )E*TURE

By + B!ek

I ; F)UIDS AND E)E*TRO)5TES

I*F ; J

E*F ; <J

I#terstitial fl!i + 6J I#tra$as"!lar + J

Tra#s"ell!lar fl!i + ,*): ,6 a# sol!tes i# re#al t!&!les a#&laer : ple!ral fl!i: *SF.

I#fa#ts + J /ale + J Female + J

FUN*TIONS +

I*F

Normal Boy Temperat!re

I#ter#al mei!m for "ell!lar f!#"tio#

Elimi#atio# of %aste pro!"ts

E*F

/ai#tai#s B)OOD O)U/E.

Tra#sport system TO a# FRO/ the "ell.

E)E*TRO)5TES ; are "hemi"al "ompo!# i# a sol!tio# that "a#"o#!"t ele"tri"al "!rre#t.

K *ATION : ' ANION L Io#s are the *,ARGED parti"les of a#ele"trolyte.

PoPhoSo*hlo L POP,OSO*,)O + Potassi!m IN : Phosphate IN:

Soi!m OUT: *hlori#e OUT.

PiSo L PISO + Potassi!m IN: Soi!m OUT.

F4N of E)E*TRO)5TES + DIBO + Distri&!tio# M of %ater thro!gho!t the&oy

Irrita&ility M Of the m!s"le



Bala#"e M Of a"ie &ase

Osmolarity M Of the ser!m

Normal la&oratory $al!es of SERU/ E)E*TRO)5TES +

Na + 7< ; 79

0 + <. ; 9.

*a + 9. ; .

,PO9 + 7. ; 6.

*l ; '7

/g ; 7.'6.

• All !#its are i# /E@C)

Normal fl!i i#take of a# a!lt + 6: ml M Foo: 1ater

S!ggeste %ater i#take per ay + ' glasses of %ater a ay.

SU//AR5 +

7. 1hi"h Fl!i Spa"e reg!lates BOD5 TE/PERATURE 3 I*F: E*F:Tra#s"ell!lar: I#tra$as"!lar.

6. These are the ele"tri"ally "harge parti"les i# the &oy.Ele"trolytes: Io#: Osmolarity: Soi!m

<. S!ggeste i#take of %ater i# glasses per ay. ': ': <': 6'9.

9. F!#"tio#s of E) e2"ept + Reg!lates Boy Temp: Distri&!te Fl!is:/!s"!lar Irrita&ility: Osmolarity.

. Normal Ser!m )e$els for all ele"trolytes..

OS/O)ARIT5 + This is the total #!m&er of sol!tes C kg ,6 #ormal$al!e is 6'< milliosmole C )

• Thi#k that osmolarity is the #!m&er of salt i# %ater. NA L1ATER /AGNET

,yperosmolarity + L *ell!lar ehyratio# M P!t a "alama#si i# a glassof salt: Salt attra"ts %ater S,RIN0S

,ypoosmolarity + *ell!lar eema: *ere&ral Eema. S1E))S



Sie !estio#s + 7. 1hat i!reti" r!g is gi$e# to a perso# s!fferi#gfrom *EREBRA) EDE/A3

6. Dosage of the sai r!g a# its a"tio#.

<. If a perso# ro%#e at sea: %ill yo! e2pe"t *E))U)ARDE,5DRATION or EDE/A3

9. 1hat is the 6 most "ommo# symptom of a# i#"reaseI*P3

. I# a# a!lt o#set ia&etes: If the perso# fails to takefl!is a# o!tp!t i#"reases tha# i#p!t: %hat %ill &e thepossi&le e# res!lt 3 ,5PO or ,5PEROS/O)ARIT53

PRESSURES T,AT INF)UEN*ES F)UID /OE/ENT M A*TIE

TRANSPORT

7. B,P M B)OOD ,5DROSTATI* PRESSURE ; For"e e2erte &y the&loo to the "apillaries

6. *olloi Osmoti" C O#"oti" Press!re ; ,ol the fl!i IN a#opposes filtratio#.

'al&!mi# + sy#thesi>e &y the li$er

FP L B,P ; *OP + FI)TRATION PRESSURE

/OE/ENT OF F)UIDS

OS/OSIS

DIFFUSION

A*TIE TRANSPORT

1hi"h amo#g this three #ees e#ergy3 ATP "omes from gl!"ose.

Alteratio# i# press!reC /o$eme#t L EDE/A

Fl!i i#sie a "a$ity is "alle T,IRD SPA*ING.

Fl!i i#sie the perito#eal "a$ity is +

Fl!i i#sie the Ple!ral "a$ity is +

Bloo i#sie Peri"arial *a$ity is +

Bloo i#sie the Qoi#t is +



Fl!i i# the l!#g is "alle + *hara"teri>e &y + !po#per"!ssio#.

Air i# the l!#g is +

Pathophysiology of EDE/A

T4 for eema.

DIURETI*S

)ASI4 ; ho!rs

Priority + "he"k for potassi!m ser!m le$el.

,OR/ONES T,AT REGU)ATES F)UID AND E)E*TRO)5TES

7. AD,

Pro!"e &y the hypothalam!s a# store at the PPP.

Re#al t!&!les are the target tiss!e. M D*T

i#"reases %ater rea&sorptio#

e"reases !ri#e $ol!mei#"reases &loo $ol!me

e"reases &loo osmolarity

release is triggere &y+

7. e"rease &loo press!re

6. i#"rease &loo osmolarity

<. e"rease &loo $ol!me

6. RAA me"ha#ism

)o% i# soi!m: BP AND B %ill stim!late the release of RENINANGIOTENSIN.

7. 1he# &loo press!re falls -for systoli": to 7 mm ,g or lo%er:

the ki#eys release the e#>yme re#i# i#to the &loostream.

6. Re#i# splits a#giote#si#oge#: a large protei# that "ir"!lates i#the &loostream: i#to pie"es. O#e pie"e is a#giote#si# I.

<. A#giote#si# I: %hi"h is relati$ely i#a"ti$e: is split i#to pie"es &ya#giote#si#'"o#$erti#g e#>yme -A*E. O#e pie"e is a#giote#si# II:%hi"h is $ery a"ti$e.



9. A#giote#si# II: a hormo#e: "a!ses the m!s"!lar %alls of smallarteries -arterioles to "o#stri"t: i#"reasi#g &loo press!re.A#giote#si# II also triggers the release of the hormo#e alostero#efrom the are#al gla#s.

. Alostero#e "a!ses the ki#eys to retai# salt -soi!m a#e2"rete potassi!m. The soi!m "a!ses %ater to &e retai#e: th!si#"reasi#g &loo $ol!me a# &loo press!re.

E)E*TRO)5TES +

SODIU/ + attra"ts %ater #eee for &loo ser!m osmolarity:respo#si&le for #e!rom!s"!lar f!#"tio#i#g.POTASSIU/ + skeletal a# "aria" m!s"le a"ti$ity: has i#$erse

relatio#ship %ith hyroge# io#s.*A)*IU/ + promotes #e!rom!s"!lar irrita&ility a# m!s"le "o#tra"tio#.,as i#$erse relatio#ship %ith phosphate. Dire"t relatio#ship %ithal&!mi#Cprotei#.

*A)*ITONIN ( IN*REASES *A)*IU/ PT, + DE*RESEASESSERU/ *A)*IU/.

E)E*TRO)5TE I/BA)AN*E +

7. ,5PONATRE/IA ; 7< meC) 6gmsCay' "a# &e !e to soi!m loss or %ater e2"ess M ,5POC,5PERosmolarity ' Treatme#t %ith i!reti"s' )oss from GI' ADDISONS Disease M )o% alostero#e se"retio# ' Diaphoresis

,eaa"he: /!s"le %eak#ess: Fatig!e a# Apathy: Post!ral,ypote#sio#: Feeli#g of apprehe#sio#: *oma: 1T loss: A& "ramps.

/GT + I .JNA*): Plasma e2pa#ers: Repla"e other ele"trolyteseplete: Salt i# the iet: Safety pre"a!tio#.

6. ,5PERNATRE/IA ' (79 meC) 31hat is the most "ommo# sig# of ,5PERNATRE/IA3

' /ore %ater tha# soi!m is lost from the &oy



' ,igh soi!m i#take' 1ater epri$atio#

• thirst: ry sti"ky m!"!s mem&ra#e: olig!ria: re ry s%olle#

to#g!e: poor ski# t!rgor: ta"hy: restless#ess: isorie#tatio#:

hall!"i#atio#

/GT + ICO: restri"t soi!m: D1 I: Di!reti"s: Dialysis.

POTASSIU/ M IRRITABI)IT5

<. ,5PO0A)E/IA <. re$erse t : paralyti" ile!s

/gt+ 0*l : Potassi!m spari#g i!reti"s: Potassi!m ri"h foos.Mkali!m

9. ,5PER0A)E/IA (9. tall t : ele$ate st segme#t: prolo#ge rs"omple2.

/gt+ A$oi potassi!m ri"h foos. 7J gl!"ose %ith reg!lar i#s!li#:Polystere#e S!lfo#ate M 0A5E4E)ATE P.O : e#ema : Dialysis:*aGl!"o#ate: Be rest.

*al"i!m ; 6 types IONIED ( &o!# to plasma protei# FREEIONIED ( Bloo "oag!latio#: Smooth Skeletal *aria" m!s"lef!#"tio#: Ner$e f!#"tio#: Bo#e a# teeth formatio#. M IN,IBITOR5

it D a# PT, + #eee for "al"i!m a&sorptio# i# the GIT.

. ,5PO*A)*E/IA

*,OSTE0 A# TROSSEU : lary#geal strior. /ost "ommo# "a!se is ,5POPT,ism. /GT + "al"i!m gl!"o#ate: it a# pth s!ppleme#t: A) O,M Phosphate &i#er : SAFET5 + SEIURE

. ,5PER*A)*E/IA

/GT + I#"rease fl!i i#take: <'9). A"i ash iet M "ra#&erry: pr!#es H!i"es i#"rease IT *. Di!reti"s: /IT,RA/5*IN M /IT,RA*IN

S!rgi"al mgt + PARTIA) PARAT,5ROIDE*TO/5.



. ,5PO/AGNESE/IA M /AGENSIU/ IS SA/E AS *a: &oth arei#hi&itory

' TETAN5: *,OSTE0 AND TROSSEU: ,5PER DTR./gt + ietary s!ppleme#ts: mag#esi!m salts: safety a# i#H!ry:

lary#geal strior.

. ,5PER/AGNESE/IA

*a!ses + re#al fail!re: D0A: mag#esi!m o$erose./g &lo"ks a"etyl"holi#e L e"rease motor a"ti$ity.

Assessme#t + e" &p: thirst #a!sea $omiti#g: ro%si#ess a# loss ofDTR.

/gt + "a gl!"o#ate: M a#tago#i>e> /g : Dialysis.

Dis"!ss + A*ID BASE I/BA)AN*EDis"!ss + RIG,T AND )EFT SIDED FAI)URE.

Anti Depressants : A Story Towards Mastery

The Psy"hiatri" #!rsi#g part of the N)E al%ays te# to ask yo! to"lassify r!gs if they are a#tiepressa#ts: maHor tra#!ili>er:a#2iolyti"s: a#tiparki#so#s: et".

It is really har to memori>e these all. Remem&er the story of /ari#ola# Pe##y3 ,o% a&o!t Tra#2e#e3 This is o!r thir story a# hopef!lly:I "a# "ome o!t %ith the fo!rth o#e. I o#t k#o% if these thi#gs help

yo!: &!t These are the thi#gs I !se to memori>e r!gs that areimpossi&le to memori>e !si#g traitio#al methos.

This is origi#al a# #ot "opie from a#y%here else. Post a%ay a# tellme if this help so I "a# k#o% If the appli"atio# of this strategy is!#i$ersal: or o#ly %orks %ith st!e#ts %ho appre"iate stories.

This is a $ery #i"e strategy for i#str!"tors %ho %a#t to i$ert st!e#ts8



atte#tio#: fooli#g them that yo! are telli#g a story &!t i# the realesse#"e: yo! are tea"hi#g r!gs a# their "lassifi"atio#s i# a really!#e2pe"te %ay.

Si Nora, Ana at Ela.

By + B!ek

Depresse a#g mag&arkaa#g si NORA: M Norprami#e ELA M Ela$il at ANA M A#afra#il At #agp!#ta a#g tatlo sa AVENIDA M A$e#tyl Para makilahok sa %elga. Sila ay mga TOFnotchers M Tofra#il #gka#ila#g mga !#i&ersia at mga ASCENDERA M As"e#i# #gka#ika#ila#g mga a#gka#.

V IMPRISON M Impri# Dio#isio a# /aeHaW S!#!gi# SINA KUANWM Si#e!a# VIVA M i$a"tyl N!rsi#g St!e#tsW V A#g si#isiga% #gmga magkaka&arkaa at #akas!lat sa ka#ila#g rally &a##er.

D!mati#g SI LE M *ele2a A#g pi#aka FAVERITE M Fa$eri#e #a#e%s"aster sa pi#as.

Nora: A#a: Ela + V /ga PRO M Pro>a" Retake kamiW Di #ami# LUV M )!$o2 a#g mga PAIL M Pa2il #a Boar e2ami#ers #a ya#W /a&!tipa#g mag !OLO M oloft Nala#g kami at p!p!#ta saPANAMAM Par#ate: Naril: /arpla# at oo# #ala#g kami mag #!rseWA#g sagot #g mga magkaka&arkaa.

NOTE +

From NORPRA/INE !p to IA*T5) L T*AsFrom *E)E4A !p to O)OFT L SSRIPar#ate: Naril a# /arpla# are /AOI

Communia!"e Disease Nursin# Study Bu""ets

Communicable Disease Nursing

DRUG OF CHOICE

Teta#!s+ PEN " Na# DIA!EPAM $Vali%&'/e#i#gitis+ MANNITOL $os&otic (i%retic'# DEAMET)ASONE

$anti*in+la&&ator'# DILANTIN-P)ENTOIN $anti*con/%lsi/e'#PRETINOL-ENCEP)A0O L $CNS sti&%lantRa&ies a""i#es+ LSSAVAC, VERORA0



Imm!#oglo&!li#s+ ERI" or )RI1

DIAGNOSTIC TESTS

Teta#!s+ 2OUND CULTURE

/e#i#gitis+ LUM0AR PUNCTUREE#"ephalitis+ EE"Polio+ EM"# M%scle testin1Ra&ies+ 0rain 3io4s $Ne1ri 3o(ies' Fl%orescent ra3ies anti3o(

testDe#g!e+ TOURNI5UET test $R%&4el lea('/alaria+ Malarial s&ear# 50C $5%antitati/e 0%++ Coat'S"arlet+ DICK6S TEST# SC)ULT!*C)ARLTON TESTDiphtheria+ SC)ICK6S TEST# Molone6s Test

Pert!ssis+ Nasal s7a3# a1ar 4lateT!&er"!losis+ MANTOU test)eprosy+ SLIT SKIN SMEAR Pi#%orm+ SCOTC) TAPE S2A0Typhoi+ 2IDAL6S test

,ICAIDS+ ELISA# 2ESTERN 0LOT# PCT8 Pol&erase ChainReaction Test

CAUSATIVE AGENTS

Teta#!s+ CLOSTRIDIUM TETANI/e#i#go"o""emia+ NEISSERIA MENIN"ITIDIS

Ra&ies+ R)A0DOVIRUSPoliomyelitis+ LE"IO DE0ILITANS $T4e I 0r%nhil(e'# $T4e IILansin1'# $T4e III Leon'

De#g!e Fe$er+ AR0OVIRUSES $Chi9%n11%na'# $Onon1*non1'#$2est Nile'# $Fla/i/ir%ses' $Co&&on in the Phil.'

/alaria+ PLASMODIUM $4roto:oa' P. Falci4ar%& $&ost +atal'# P.

Vi/a; P. Malariae# P. O/aleFilariasis+ 2UC)ERERIA 0ANCROFTI# 0RU"IA MALAI)eprosy+ MCO0ACTERIUM LEPRAE/easles+ PARAMO VIRUS

Germa# measles+ TO"A VIRUS*hi"ke# po2+ VARICELLA !OSTER VIRUS,erpes >oster+ )ERPES !OSTER VIRUSS"arlet fe$er+ "ro%4 A )EMOLTIC STREPTOCOCCUSS"a&ies+ SARCOPTES SCA0IEI $itch &ite'

B!&o#i" plag!e+ ERSINIA PESTISDiphtheria+ KLE0S LOEFFLER

Pert!ssis+ 0ORDETELLA PERTUSSIS



T!&er"!losis+ MCO0ACTERIUM TU0ERCULOSISTyphoi+ SALMONELLA TP)I

*holera+ VI0RIO C)OLERAAmoe&iasis+ ENTAMOE0A )STOLITICA

)eptospirosis+ LEPTOSPIRA S4irochete

S"histosomiasis+ Schistoso&a <a4onic%&Go#orrhea+ N. "ONORR)EAESyphilis+ TREPONEMA PALLIDUM*hlamyia+ C. tracho&atis, T. /a1inalis

Ge#ital herpes+ )ERPES SIMPLE =

CD PHARMACOOG!

/alaria+ C)LORO5UINE

S"histosomiasis+ PRA!I5UANTELS"a&ies+ EURA- CROTAMITON*hi"ke# po2+ ACCLOVIR-!OVIRAT!&er"!losis+ R.I.P.E.S.P#e!mo#ia+ COTRIMOA!OLE# Procaine Penicillin

,elmi#ths+ ME0ENDA!OLE# PRANTEL PAMOATE

Co$sa%ie &iruses

Name after *o2sa"kie: Ne% 5ork: %here they %ere is"o$ere: the

"o2sa"kie $ir!ses are part of the e#tero$ir!s family of $ir!ses -%hi"halso i#"l!es e"ho$ir!ses: polio: a# hepatitis A $ir!ses that li$e i#the h!ma# igesti$e tra"t. They "a# sprea from perso# to perso#:!s!ally o# !#%ashe ha#s a# s!rfa"es "o#tami#ate &y fe"es:%here they "a# li$e for se$eral ays. I# tropi"al parts of the %orl:they i#fe"t people year'ro!#: &!t i# "ooler "limates: o!t&reaks of"o2sa"kie $ir!s most ofte# o""!r i# the s!mmer a# fall.

Si1ns an( S&4to&s

A&o!t half of all "hilre# %ith "o2sa"kie $ir!s i#fe"tio# ha$e #osymptoms. Some "hilre# s!e#ly e$elop fe$ers of 77 to 79egrees Fahre#heit -<.< to 9 egrees *elsi!s: heaa"he: a#m!s"le a"hes. Some also e$elop a mil sore throat: a&omi#alis"omfort: or #a!sea. A "hil %ith "o2sa"kie $ir!s may simply feel hot&!t ha$e #o other symptoms. I# most "hilre#: the fe$er lasts a&o!t <ays: the# isappears i# others: the fe$er is &iphasi": mea#i#g that itappears for 7 ay: the# isappears for 6 to < ays: the# ret!r#s for 6

http://www.kidshealth.org/parent/infections/bacterial_viral/polio.html

http://www.kidshealth.org/parent/infections/bacterial_viral/hepatitis.html

http://www.kidshealth.org/parent/general/aches/headache.html

http://www.kidshealth.org/parent/infections/bacterial_viral/polio.html

http://www.kidshealth.org/parent/infections/bacterial_viral/hepatitis.html

http://www.kidshealth.org/parent/general/aches/headache.html



to 9 ays more.

Besies "a!si#g a simple fe$er: "o2sa"kie $ir!ses "a# "a!se se$eraliffere#t patter#s of symptoms that affe"t iffere#t &oy parts+

)an(, +oot, an( &o%th (isease: a type of "o2sa"kie $ir!ssy#rome: "a!ses pai#f!l re &listers i# the throat a# o# the to#g!e:g!ms: i#sie of the "heeks: a# the palms of ha#s a# soles of thefeet.

)er4an1ina: a "o2sa"kie $ir!s i#fe"tio# of the throat: "a!ses re'ri#ge &listers a# !l"ers o# the to#sils a# soft palate: the fleshy&a"k portio# of the roof of the mo!th.

Ple%ro(nia (also called Bornholm disease) is a relate "o2sa"kie$ir!s i#fe"tio# that "a!ses pai#f!l spasms i# the m!s"les of the "hesta# !pper a&ome#. Boys %ith ple!roy#ia may also ha$e pai# i# thetesti"les &egi##i#g a&o!t 6 %eeks after the "hest pai# starts.

)e&orrha1ic con<%ncti/itis is a# i#fe"tio# that affe"ts the %hites ofthe eyes. ,emorrhagi" "o#H!#"ti$itis !s!ally starts o!t as eye pai# a#is s!e#ly follo%e &y re: %atery eyes: s%elli#g: light se#siti$ity:a# &l!rry $isio#.

*o2sa"kie $ir!ses "a# also "a!se me#i#gitis: a# i#fe"tio# of theme#i#ges -the three mem&ra#es that e#$elop the &rai# a# spi#al

"or: a# rarely: e#"ephalitis: a &rai# i#fe"tio#. They may also "a!semyo"aritis: a# i#fe"tio# of the heart m!s"le.

Ne%&or#s: %ho "a# &e i#fe"te from their mothers !ri#g or shortlyafter &irth: are more at risk for e$elopi#g serio!s i#fe"tio#: i#"l!i#gmyo"aritis: hepatitis: a# me#i#goe#"ephalitis -a# i#flammatio# ofthe &rai# a# me#i#ges.

Symptoms !s!ally o""!r %ithi# 6 %eeks after &irth a# "a# i#"l!efe$er: poor feei#g: irrita&ility: a# lethargy. I#fa#ts %ith "o2sa"kie

myo"aritis ha$e tro!&le &reathi#g a# sometimes e$elop "ya#osis: a&l!ish "olor of the ski#: lips: a# #ails "a!se &y too little o2yge# i#the &loo.

Conta1io%sness

*o2sa"kie $ir!ses are $ery "o#tagio!s. They8re !s!ally passe fromperso# to perso# o# !#%ashe ha#s a# s!rfa"es "o#tami#ate &y

http://www.kidshealth.org/parent/infections/eye/conjunctivitis.html

http://www.kidshealth.org/parent/infections/lung/meningitis.html

http://www.kidshealth.org/parent/infections/bacterial_viral/encephalitis.html

http://www.kidshealth.org/parent/infections/eye/conjunctivitis.html

http://www.kidshealth.org/parent/infections/lung/meningitis.html

http://www.kidshealth.org/parent/infections/bacterial_viral/encephalitis.html



fe"es. They "a# also &e sprea thro!gh roplets of fl!i spraye i#tothe air %he# someo#e s#ee>es or "o!ghs.

1he# a# o!t&reak of "o2sa"kie $ir!s affe"ts a "omm!#ity: risk fori#fe"tio# is highest amo#g i#fa#ts a# "hilre# yo!#ger tha# . The

$ir!s spreas easily i# gro!p setti#gs like s"hools: "hil'"are "e#ters:or s!mmer "amps. People %ho are i#fe"te %ith a "o2sa"kie $ir!s aremost "o#tagio!s the first %eek they8re si"k.

Pre/ention

There is #o $a""i#e to pre$e#t "o2sa"kie $ir!s i#fe"tio#. )an(

7ashin1 is the 3est 4re/ention. Remi# the mem&ers of yo!rfamily to %ash their ha#s fre!e#tly: parti"!larly after !si#g the toilet-espe"ially those i# p!&li" pla"es: after "ha#gi#g a iaper: &eforemeals: a# &efore prepari#g foo.Share toys i# "hil'"are "e#ters sho!l &e ro!ti#ely "lea#e %ith aisi#fe"ta#t &e"a!se the $ir!s "a# li$e o# these o&He"ts for ays.

*hilre# %ho are si"k %ith a "o2sa"kie $ir!s sho!l &e kept o!t ofs"hool or "hil "are for a fe% ays to a$oi spreai#g the i#fe"tio#.

Inc%3ation

T"e incuba#ion $erio% &#"e #ime be#'een in(ec#ion an% #"eonse# o( s)m$#oms* (or mos# co+sac,ie -irus in(ec#ions is

abou# . #o /0 %a)s1

D%ration

The !ratio# of "o2sa"kie $ir!s i#fe"tio# $aries: epe#i#g o# thespe"ifi" type. For "o2sa"kie fe$er %itho!t other symptoms: a "hil8stemperat!re may ret!r# to #ormal %ithi# 69 ho!rs: altho!gh thea$erage fe$er lasts < to 9 ays. I# ple!roy#ia: fe$er a# m!s"le pai#!s!ally last 7 to 6 ays: a# i# herpa#gi#a: symptoms ge#erally last <to ays.

Dia1nosis

Do"tors iag#ose a "o2sa"kie $ir!s &y performi#g a physi"al e2am a#looki#g for a#y of the telltale symptoms: s!"h as rash or &listers. Theymight also test stool or fl!is from the &a"k of the throat to see if the$ir!s is prese#t.

http://www.kidshealth.org/parent/general/sick/hand_washing.html






Treat&ent

Depe#i#g o# the type of i#fe"tio# a# symptoms: the o"tor maypres"ri&e mei"atio#s to make yo!r "hil feel more "omforta&le.,o%e$er: &e"a!se a#ti&ioti"s o#ly %ork agai#st &a"teria: they "a#8t &e

!se to fight a "o2sa"kie $ir!s i#fe"tio#. For me#i#gitis !e to"o2sa"kie $ir!s: there8s a# effe"ti$e a#ti$iral mei"atio#: tho!gh it8s#ot yet %iely a$aila&le.

The most se$ere forms of "o2sa"kie $ir!s i#fe"tio#: myo"aritis a#e#"ephalitis: "a# &e fatal: espe"ially i# #e%&or#s. E$e# oler "hilre#%ith "o2sa"kie myo"aritis or e#"ephalitis may #ee spe"ial "are i# ahospital. ,o%e$er: these "ompli"atio#s are rare.

/ost "hilre# %ith a simple "o2sa"kie i#fe"tio# re"o$er "ompletelyafter a fe% ays at home. If yo!r "hil has a fe$er %itho!t a#y othersymptoms: he or she sho!l rest i# &e or play !ietly i#oors.O++er 4lent o+ +l%i(s to 4re/ent (eh(ration. A"etami#ophe# may&e gi$e# to relie$e a#y mi#or a"hes a# pai#s. If the fe$er lasts formore tha# 69 ho!rs or if yo!r "hil has a#y symptoms of a moreserio!s "o2sa"kie i#fe"tio#: "all yo!r "hil8s o"tor.

Co&4lications

*hilre# %ith "o2sa"kie $ir!s may &e"ome ehyrate &e"a!se mo!thsores "a# make it pai#f!l to eat a# ri#k. If the ehyratio# is

se$ere: i#tra$e#o!s -I fl!is may &e #e"essary.

2hen to Call o%r Chil(6s Doctor

*all yo!r "hil8s o"tor immeiately if yo!r "hil e$elops a#y of thefollo%i#g symptoms+

+e/er (higher than 100.4 degrees Fahrenheit, or 38 degrees Celsius,

for infants younger than 6 months of age and higher than 10 degreesFahrenheit, or 38.8 degrees Celsius, for an older child)

4oor a44etitetro%3le +ee(in1/o&itin1

(iarrhea(i++ic%lt 3reathin1

con/%lsions%n%s%al slee4iness

http://www.kidshealth.org/parent/system/medicine/medication_safety.html

http://www.kidshealth.org/parent/general/sick/antibiotic_overuse.html

http://www.kidshealth.org/parent/firstaid_safe/emergencies/dehydration.html

http://www.kidshealth.org/parent/general/sick/fever.html

http://www.kidshealth.org/parent/system/medicine/medication_safety.html

http://www.kidshealth.org/parent/general/sick/antibiotic_overuse.html

http://www.kidshealth.org/parent/firstaid_safe/emergencies/dehydration.html

http://www.kidshealth.org/parent/general/sick/fever.html



E/en i+ o%r chil( (oesn6t ha/e a +e/er, call the (octor +or ano+ the +ollo7in18

!ain in the chest or a"domen

sores on the s#in or inside the mouth

difficulty "reathingse$ere sore throat

se$ere headache, es!ecially %ith $omiting, confusion, unusualslee!iness, or con$ulsions

nec# stiffness

red, s%ollen, and %atery eyes !ain in one or "oth testicles

In!orn Errors o' Meta!o"ism

In3orn Errors o+ Meta3olis&

">PD De+icienc*"l%cose > Phos4ate Deh(ro1enase

X Se2 li#ke re"essi$e -4'li#ke kaya there is more &oys tha# girls-&akit &oys3 Remem&er that female "o#tai#s 44 ge#es %hile male"o#tai#s 4 ge#es. So i&ig sa&ihi# if a female ha a fa!lty 4 ge#es theother 4 ge#es "a# &ala#"e the effe"t. So %ith this pri#"iples female areal%ays "arriers a# her so# %o!l &e affe"te: The# if the affe"te so#ha a female a!ghter she %ill &e a "arrier

X )a"ks e#>yme GPD res!lts i# premat!re estr!"tio# of RB* if "ellsare e2pose to o2ia#ts: ASA: leg!mes a# fla$a &ea#s

6 forms+

7. *o#ge#ital No#sphero"yti" ,emolyti" a#emia' gro!p of "o#ge#italhemolyti" a#emias i# %hi"h there is #o a&#ormal hemoglo&i# orsphero"ytosis a# i# %hi"h there is a efe"t of gly"olysis i# theerythro"yte

*hara"teri>e &y+,emolysis: Ha!#i"e: sple#omegaly a# aplasti" a#emia

6. Dr!g i#!"e

Pre"ipitati#g fa"tors+



"ha#"e that the "hil %ill &e &or# %ith the isease a# a J "ha#"ethe "hil %ill &e a "arrier for the ge#e efe"t.

Sig#sCSymptomsX /e#tal retaratio#

X Do%#%ar s!&l!2atio# of le#s -e"topia le#tisX Sle#er &!iltX Pe"t!s e2"a$at!m -oist mero# i# #ito a#g may Do%# sy#rome: thester#!m appears s!#ke# a# the "hest "o#"a$es.X A&#ormal thi##i#g a# %eak#ess of the &o#e -osteoporosis a#kyphos"oliosisX Dege#eratio# of the aorta

)a&test+Ba"terial i#hi&itio# assay for methio#i#e' Normal is 7mg(

Con1enital A(renal )4er4lasia

' A "o#itio# %here the are#al oes #ot pro!"e e#o!gh "osrtisol a#alostero#e &!t there is a# e2"essi$e pro!"tio# of a#roge#s.' This is also a!tosomal re"essi$e

REIE1WW ,ormo#es of the Are#al *orte2A#g ati#g "oe SSSSalt' /i#eralo"orti"ois -mai#ly alostero#e' respo#si&le for Narea&sorptio# a# 0 e2"retio#

S!gar'Gl!"o"orti"ois -mai#ly "ortisol: respo#si&le for gly"olisis a#gl!"o#eoge#esisSe2' Se2 hormo#esO$erse"retio#' *!shi#g?s sy#romeU#erse"retio#' Aiso#?s isease

Assessme#t+I# femaleX )arge "litoris: "lose la&ial folsX Early appeara#"e of p!&i" hair

X Deep mas"!li#e $oi"eX No &reast e$elopme#t a# me#str!atio#X E2"essi$e hair i# fa"eX -i# short #agigi#g lalaki !#g &a&ae: pramis pag #akita #yo !#gits!ra: !#g "litoris eh m!kha #a#g pe#is

I# male+at &irth' #ormal



mo#ths sig#s of se2!al pre"o"ity<'9 ; ha$e p!&i" hair a# e#large pe#is: s"rot!m a# prostate &!ttestes is #ot es"e#esterility

)a&test+,igh 7'hyro2yprogestero#e)o% ser!m Na,igh ser!m 0

Treatme#t+*orti"osteroiDiet+ ,igh soi!m: lo% potassi!m

P)ENLKETONURIA

-P0U ; efi"ie#"y of li$er e#>ymes -P,TPhe#ylala#i#ehyro2ylase Tra#sferase ; li$er e#>yme that "o#$erts*,ON to ami#o a"i

ami#o a"is+$ali#e isole#si#e tryptophaselysi#e phe#ylala#i#e

Thyro#i#e ; e"rease mala#i#e pro!"tio#

7. fair "omple2io#6. &lo# hair<. &l!e eyesThyro2i#e ; e"rease &asal meta&olism' a""!m!latio# of Phe#yl Pyr!$i" a"i9. Atopi" ermatitis. m!sty C mo!sy oor !ri#e. sei>!re ; me#tal retaratio#

Test ; GUT,RIE TEST ; spe"ime# ; &loo

' preparatio# i#"rease *,ON i#take' test if *,ON %ill "o#$ert to ami#o a"i

spe"ime# a# !ri#emi2e %ith pheri" "hlorie: prese#"e of gree# spots at iaper a sig# ofP0UDIET+)o% phe#ylala#i#e iet' foo "o#trai#i"ate' meats: "hi"ke#: milk:

http://www.nlm.nih.gov/medlineplus/ency/article/003459.htm

http://www.nlm.nih.gov/medlineplus/ency/article/003459.htm



leg!mes: "heese: pea#!tsGi$e )ofe#ala"' milk %ith sy#theti" protei#

"alactose&ia

; efi"ie#"y of li$er e#>yme' GUPT ; Gala"tose Uro$il Phosphatetra#ferase' *o#$erts gala"tose to phosphate tra#fera"e gl!"oseGala"tose ; %ill estroy &rai# "ells if !#treate ; eath %ithi# < ays

D2+Be!tler test ; get &loo 'o#e after 7st feei#gprese#"e of gl!"ose i# &loo ; sig# of gala"tosemiagala"tose free iet lifetime#e!tramige# ; milk form!la

CELIAC DISEASE ; gl!te# e#teropathy*ommo# gl!te# foo+I#tolera#"e to foo %ith &ro%B' &arleyR' ryeO' oat1' %heat

Pathophysiology+Gl!te# ; gl!tami#e - #ormal a&sorptio#'( Gliai# - to2i" to epithelial

"ells of $illi of i#testi#es: effe"ts is mala&sorptio# sy#rome

/ala&sorptio#'( Fats'( steatorrhea'(mal#!tritio# a# eema'( it D "al"i!m'(osteomali"ia'(itami# 0'(i#ae!ate &loo "oag!latio#'(&leei#g'(iro# foli" a"i'( a#emia

Early S2+7. iarrhea ; fail!re to gai# %t ff iarrheal episoes6. "o#stipatio#<. $omiti#g)ate S2+a& pai# ; protr!&era#t a& e$e# if %ith m!s"le %asti#gsteatorrhea



*elia" *risis' e2aggerate $omiti#g %ith &o%el i#flammatio#D2+la& st!ies ; stool a#alysisser!m a#tiglyai# ; "o#firmatory of isease

gl!te# free iet ; lifetimeall BRO1 ; #ot allo%eok ; ri"e = "or#

/gt+$itami# s!ppleme#tsmi#eral s!ppleme#tssterois

GOOD )U*0WWW

Identi'yin# S%in (esions

This is a g!ie i# ie#tifyi#g ski# lesio#s %hi"h %e #!rses ofte# fi#"o#f!si#g. I hope this "a# help.

ma"!leX a small spot that is #ot palpa&le C ele$ate a# is less tha# 7 "m i#

iameter

pat"hX a large spot that is #ot palpa&le C ele$ate a# that is greater tha# 7"mX may arise thro!gh "oales"e#"e of ma"!les.

pap!leX a small s!perfi"ial &!mp -i#$ol$es epiermis o#ly that is ele$atea# that is less tha# 7 "m

pla!eX a large s!perfi"ial &!mp -i#$ol$es epiermis o#ly that is ele$atea# greater tha# 7 "mX may arise thro!gh "oales"e#"e of pap!les

#o!leX a small &!mp %ith a sig#ifi"a#t eep "ompo#e#t -i#$ol$es epiermis



a# ermis a# is less tha# 7 "m

t!morX a large &!mp %ith a sig#ifi"a#t eep "ompo#e#t -i#$ol$es epiermisa# ermis a# is greater tha# 7 "m

$esi"leX a small fl!i'fille &!&&le that is !s!ally s!perfi"ial a# that is lesstha# . "m

&!llaX a large fl!i'fille &!&&le that is s!perfi"ial or eep a# that isgreater tha# . "m

p!st!leX p!s "o#tai#i#g &!&&le ofte# "ategori>e a""ori#g to %hether or #otthey are relate to hair folli"les

"ystX a sa" "o#tai#i#g fl!i or semisoli material: ie. "ell or "ell pro!"ts

s"aleX a""!m!latio# or e2"ess shei#g of the strat!m "or#e!mX typi"ally prese#t %here there is epiermal i#flammatio#

"r!st

X rie e2!ate -ie. &loo: ser!m: p!s o# the ski# s!rfa"e

e2"oriatio#X a loss of ski# !e to s"rat"hi#g or pi"ki#g

li"he#ifi"atio#X a# i#"rease i# ski# li#es a# "reases from "hro#i" r!&&i#g

ma"eratio#X ra%: %et tiss!e

fiss!reX a li#ear "ra"k i# the ski# ofte# $ery pai#f!l

erosio#X a s!perfi"ial ope# %o!# %ith loss of epiermis or m!"osa o#ly

!l"er



X a eep ope# %o!# %ith partial or "omplete loss of the ermis ors!&m!"osa

%heal or hi$eX es"ri&es a short li$e -less tha# 69 ho!rs: eemato!s: %ell

"ir"!ms"ri&e pap!le or pla!e see# i# !rti"aria

&!rro%X a small threalike "!r$ili#ear pap!le that is $irt!ally pathog#omo#i"of s"a&ies

"omeo#eX a small: pi#poi#t lesio#: typi"ally referre to as \%hiteheas] or \&la"kheas]

atrophyX a thi##i#g of the epiermal a#Cor ermal tiss!e

keloiX o$ergro%s the origi#al %o!# &o!#aries a# is "hro#i" i# #at!re

hypertrophi" s"arX oes #ot o$ergro% the %o!# &o!#aries

fi&rosis or s"lerosisX es"ri&es ermal s"arri#gCthi"ke#i#g rea"tio#s

mili!mX a small s!perfi"ial "yst "o#tai#i#g kerati# -!s!ally less tha# 7'6 mmi# si>e

aopte from Dr. Ar#i A. /agamo

New!orn Sreenin#

2hat is Ne73orn Screenin1?

Ne%&or# S"ree#i#g -NBS is a simple pro"e!re to fi# o!t if yo!r&a&y has a "o#ge#ital meta&oli" isorer that may lea to me#talretaratio# a# e$e# eath if left !#treate.



2h is it i&4ortant to ha/e Ne73orn Screenin1?

/ost &a&ies %ith meta&oli" isorers look #ormal at &irth. O#e %ill#e$er k#o% that the &a&y has the isorer !#til the o#set of sig#s a#symptoms a# more ofte# ill effe"ts are alreay irre$ersi&le.

2hen is Ne73orn Screenin1 (one?

Ne'born screening is i%eall) %one on #"e 23#" "our or a# leas#

.2 "ours (rom bir#"1 Some isorers are #ot ete"te if the test iso#e earlier tha# 69 ho!rs. The &a&y m!st &e s"ree#e agai# after 6%eeks for more a""!rate res!lts.

)o7 is Ne73orn Screenin1 (one?

Ne'born screening is a sim$le $roce%ure1 Using #"e "eel $ric,me#"o%4 a (e' %ro$s are #a,en (rom #"e bab)5s "eel an%

blo##e% on a s$ecial absorben# (il#er car%1 T"e bloo% is %rie% (or2 "ours an% sen# #o #"e Ne'born Screening abora#or)1 &N6S

ab*1

2ho 7ill collect the sa&4le +or Ne73orn Screenin1?A physi"ia#: a #!rse: a mi%ife or mei"al te"h#ologist "a# o the#e%&or# s"ree#i#g.

2here is Ne73orn Screenin1 A/aila3le?

Ne%&or# s"ree#i#g is a$aila&le i# pra"ti"i#g health i#stit!tio#s-hospitals: lyi#g'i#s: R!ral ,ealth U#its a# ,ealth *e#ters. If &a&iesare eli$ere at home: &a&ies may &e &ro!ght to the #earesti#stit!tio# offeri#g #e%&or# s"ree#i#g.

2hen is the Ne73orn Screenin1 res%lts a/aila3le?

Ne%&or# s"ree#i#g res!lts are a$aila&le %ithi# three %eeks after theNBS )a& re"ei$es a# tests the samples se#t &y the i#stit!tio#s.

Res!lts are release &y NBS )a& to the i#stit!tio#s a# are release toyo!r atte#i#g &irth atte#a#ts or physi"ia#s. Pare#ts may seek theres!lts from the i#stit!tio#s %here samples are "olle"te.

A #egati$e s"ree# mea# that the res!lt of the test is #ormal a# the&a&y is #ot s!fferi#g from a#y of the isorers &ei#g s"ree#e.

I# "ase of a positi$e s"ree#: the NBS #!rse "oori#ator %ill



immeiately i#form the "oori#ator of the i#stit!tio# %here the sample%as "olle"te for re"all of patie#ts for "o#firmatory testi#g.1hat sho!l &e o#e %he# a &a&y has a positi$e #e%&or# s"ree#i#gres!lt3

Ba&ies %ith positi$e res!lts sho!l &e referre at o#"e to the #earesthospital or spe"ialist for "o#firmatory test a# f!rther ma#ageme#t.Sho!l there &e #o spe"ialist i# the area: the NBS se"retariat offi"e %illassist its atte#i#g physi"ia#.

So!r"e+ oh.go$.ph

Anore$ia Ner)osa

A#ore2ia #er$osa

A#ore2ia #er$osa is the most serio!s of the prese#tly re"og#i>eeati#g isorers %hi"h also i#"l!e &!limia #er$osa a# &i#ge eati#gisorer.

7"ile bulimia ner-osa is c"arac#eri8e% b) ea#ing binges #"a#

are (ollo'e% b) com$ensa#or) be"a-ior suc" as -omi#ing orla+a#i-e abuse #o $re-en# 'eig"# gain an% binge ea#ing

%isor%er re(ers #o ea#ing binges 'i#"ou# $urging4 anore+ia

ner-osa in-ol-es main#aining a belo' minimall)9normal bo%)'eig"# b) res#ric#ing one:s in#a,e o( (oo%1

A&o!t half of all people %ith a#ore2ia #er$osa also s!ffer from &!limia#er$osa. Also: the eati#g isorers are ofte# asso"iate %ith otherpsy"hiatri" "o#itio#s s!"h as epressio# a# s!&sta#"e a&!se.

A#ore2ia affe"ts females more tha# males ' per"e#t of those thats!ffer from the "o#itio# are females. It is more "ommo# amo#gtee#agers tha# the other age gro!ps a# affe"ts primarily those&elo#gi#g to the mile a# !pper so"ial "lasses. I# 1ester# so"ieties:it is estimate that &et%ee# . to <. per"e#t of females %ill s!fferfrom a#ore2ia #er$osa %ithi# their lifetime.

Peo$le '"o %e-elo$ anore+ia ner-osa "a-e an e+#reme (ear o(obesi#) or gaining 'eig"#1 T"e) are obsesse% 'i#" becoming

an% remaining #"in1 7orse4 #"e) belie-e #"emsel-es #o be s#ill

(a# e-en '"en #"e) are alrea%) #"in an% emacia#e%1



People %ith a#ore2ia literally star$e themsel$es. They a$oihigh"alorie foos a# pi"k o!t a fe% foo items %hi"h they eat i# smallamo!#ts. *!rio!sly: amo#g people %ith a#ore2ia #er$osa: eati#g smallamo!#ts of foo ofte# starts as a $ol!#tary &eha$ior aime at

mai#tai#i#g o#e?s %eight to %hat so"iety "o#siers &ei#g thi#: &!t atsome poi#t: the &eha$ior &e"omes pathologi".

The e2a"t reaso# people e$elop a#ore2ia is#?t k#o%#. It is ge#erally&elie$e that the eati#g isorer is a# attempt to "ope %ith emotio#alpro&lems. Some e2perts li#k the isorer to hereitary fa"tors. B!tso"ial fa"tors efi#itely also play a role i# the o""!rre#"e of the isease&e"a!se i# most so"ieties: &ei#g slim is more esira&le tha# &ei#g fat.People %ith a#ore2ia #er$osa are !s!ally perfe"tio#ists %ith a&o$ea$erage i#tellige#"e.

Typi"ally: people %ith a#ore2ia are more tha# 7 per"e#t !#er%eight.They ha$e ry ski# a# ha$e a gro%th of fi#e hair all o$er their &oy.They ha$e lo% heart rate: &loo press!re a# &oy temperat!re s!"hthat they feel "ol all the time.

Some e$elop eema -ma#as: i# Filipi#o: %hile girls %ith the isorer!s!ally stop ha$i#g me#str!al perios.

T"e "eal#" $roblems associa#e% 'i#" anore+ia ner-osa areessen#iall) #"ose #"a# occur in malnu#ri#ion1 Malnu#ri#ion

a((ec#s $rac#icall) all organs in #"e bo%)1 I( se-ere4 i# causesli(e9#"rea#ening (lui%s an% elec#rol)#es imbalance4 abnormal"ear# r")#"ms an% "ear# (ailure1 As man) as .0 $ercen# o(

$eo$le '"o "a-e been %iagnose% 'i#" anore+ia ner-osa %ie(rom ei#"er #"e com$lica#ions o( #"e %isease &usuall) "ear#

(ailure an% elec#rol)#e imbalance* or (rom suici%e secon%ar) #o

a co9e+is#ing %e$ression1

The "o!rse of a#ore2ia #er$osa is $ery $aria&le. Sometimes it is mila# tra#sie#t %ith the perso# re"o$eri#g "ompletely after a# episoe.

At other times: it is a re"!rri#g &eha$ior. 1hile still at other times: it&e"omes a "hro#i" "o#itio# that sometimes e#s tragi"ally.

T"e #rea#men# o( anore+ia ner-osa consis#s o( #'o $ar#s1 T"e(irs# $ar# is aime% a# res#oring bo%) 'eig"# an% is bes# %one in

a "os$i#al se##ing '"ere #"e $erson is encourage% #o ea#1 I(#"is (ails4 (orce% (ee%ing -ia a nasogas#ric #ube or in#ra-enous

line can be resor#e% #o1



The se"o# part of the treatme#t: %hi"h starts %he# &oy %eight has&ee# restore: "o#sists of i#i$i!al a# family psy"hotherapy topre$e#t a relapse.

Aress i#!iries o# health matters to Dr. E!aro G. Go#>ales: D)SU*ollege of /ei"i#e: Dasmari^as: *a$ite 9779.

Note+ I itali"i>e some paragraphs &e"a!se those %ere the a#s%ers i#the !estio#s aske last Q!#e 6 e2am o# test a&o!t a#ore2ia#er$osa. This eati#g isorer is "ommo#ly aske i# the &oar e2am../ay&e this "a# gi$e yo! a hi#t kahit papa#o..

' &re%e

http+CC%%%.m&."om.phC,)T,66697<.html

Posted by brewed on Sunday, July 23, 2006 at 12:27 AM |

Masterin# ANTIEMETICS : A story towards mastery

This story %ill let yo! master all a#ti emeti" r!gs that are !s!allypres"ri&e to the patie#ts %ith #a!sea a# $omiti#g.

I "reate this story &e"a!se of fr!stratio# o# ho% to retai# those a#ti'emeti"s that are $ery $ery fre!e#tly aske i# the lo"al &oar e2ams

a# i# N*)E4 C *G Books. Also take #ote that TAGA/ET a# PEP*IDare a#ta"is !se for heart&!r# that are also !se to pre$e#t #a!seaa# $omiti#g. /AA)O4 has ma#y ma#y !ses: &!t it is mai#ly a#A#ta"i. The rest: are i#te#e for #a!sea a# $omiti#g. I i #oti#"l!e BENADR5) &e"a!se it has $ariety of p!rpose: o#e is to pre$e#t#a!sea: $omiti#g a# i>>i#ess spe"ially for patie#ts %ithE#olymphati" ,yrops M /e#ieres Disease

Si Marinol At Penn

I#ap #a I#ap MINAPRINE #a si mari#ol M/ARINO) sa kakaa#tay saka#ya#g maal M/AA)O4 #a si pe##y. MP,ENERGAN

D!mati#g #a si pe##y: MP,ENERGAN #a Tagamet'ro MTAGA/ETma#ila pa.

ofra ka #aW MOFRAN Sa&ay *ompa> M*O/PAINE #g kamay simari#ol M/ARINO) para ma#ampal.

http://www.mb.com.ph/HLTH2006072269413.html

http://www.mb.com.ph/HLTH2006072269413.html



M A)IU/ a#g ma#g )IBRE M )IBRIU/ sa ati#g ISITA M ISTARI) #g /I)03 M /I))TO1N - A#g &isita #ila that time %as ATE .MATIAN

TRAN4ENE + 0!ya: %ala#g lakas si ATE . M ATIAN sasakay pa siya

#g BUS M BUSPAR apat #ama# may e!ality M E@UANI) ito ATATM ATARA4 ka #ama#g ma#ita INDE M INDERA) /o #ama# alam a#gp!#ot !lo.

BIG BROT,ER + A&a sasagot sagot ka pa: maghi#tay ka pap!#ta #aako iya# tatamaa# ka saki#WWW

Nakaramam si TRAN4ENE #g *ABA OF T,E SE)P

M ANTI PAR0INSON8S

* ' *oge#ti#A ' Arta#eB ' Be#arylA ' Aki#eto#

S ' SymmetrelE ' Elepryl) ' )e$oopaP ' Parloel

A!domina" Assessment: A story towards mastery

A3(o&inal Assess&ent8 A stor to7ar(s &aster

By + B!ekhttp+CC%%%.pi#oy&s#.tk

Nag m!m!#i m!#i si Nars B!ek sa emerge#"y !#it #g Ospital #gFatima mei"al "e#ter. Bigla &igla#g may p!masok #a pasye#te parasa amissio#. /asakit ra% a#g ka#ya#g tya#.

I#o&ser&aha# siya #i Nars B!ek. A&a: #apaka&ilis #g ka#ya#g paghi#ga. Nam!m!tla pa a#g ka#iya#g mga la&i at para#g t!yo#g t!yo at#ag&a&ak&ak.

\A#g &ilis ri# #g ka#ya#g heart rate ah: 77 &pm: ta"hy"ari" ito:sig!ro may masama#g #araramama# o may #araramama#g sakit3]A#g #aisip #i B!ek.



A#g pasye#te #ati# ay si #a#ay ester: isa#g mata#a#g pasye#te. Siyaay 9 tao#g g!la#g #a #a may "hief "omplai#t #a \/ASA0IT ANGTI5AN 0O]

7"a# are #"e $ossible causes o( ab%ominal $ain in #"e el%erl) ;

Nurse 6u%e, #"in,s o( < Cons#i$a#ion; Gas accumula#ion; Im$ac#ion; In(lamma#or) 6o'el Disease; A$$en%ici#is;

C"olec)s#i#is; C"oleli#"iasis; Ulcers; Peri#oni#is; Colon cancer;

O-arian or u#erine cancer; PID; An% man) man) more1

\Okay #a#ay: aalhi# ko m!#a po kayo sa la& para po sa isa#g %ork!p.]

Hmm= 'or, u$; Di% nana) es#er un%ers#an%s '"a# nursebu%e, sai%=1 7OR> UP; Per"a$s4 #"is 'ill be be##er <

\Okay #a#ay: p!p!#ta #a po tayo sa la&oratoryo para po maisaga%a#ati# a#g i&at i&a#g pags!s!lit !pa#g malama# k!#g a#o po a#g sa#hi#g pa#a#akit #g i#yo#g tiya#.]

Nata#ggap #a #i Nars B!ek a#g mga la&oratory res!lts. ,mmm: 7<mgCl a#g ka#ya#g hemoglo&i# at J a#g ka#ya#g hemato"rit. A#gpotassi!m le$el #ya ay #asa . meC). A#g 1B* #ya ay #asa : C""<. 1ala #ama#g ipre#sya a#g ka#ya la& res!lts ah.

Reall); Are )ou sure #"a# all #"e lab resul#s are normal; e# usre-ie' #"e normal -alues <

76C < 34000 ? cc@ is normal1 An increase be)on% /04000 ? cc@

is in%ica#i-e o( in(ec#ion1

Hgb < Hemoglobin le-els o( aling es#er are 'i#"in normal limi#s1Meaning4 #"ere is no or minimal blee%ing1

Hc# < Hema#ocri# le-els o( aling es#er are "ig"4 in%ica#ing #"a# s"e is %e")%ra#e% or blee%ing1

> < T"e $o#assium le-el is 'i#"in #"e normal limi#s o( 21 #o 1meB?1

Using #"e selec#e% lab resul#s abo-e4 'e can #"en elimina#eman) $ossible causes o( #"e ab%ominal $ain o( aling es#er1

Remo-e < PERITONITIS4 APPENDICITIS4 INFECTION4

INFAMMATOR! 6O7E DISEASE AND UCERS1



\Ali#g ester halika po at h!miga po kayo rito at titi#g#a# ko po a#gi#yo#g tiya#.]

Di% Nurse 6u%e, use an e((ec#i-e a$$roac" on as,ing aling

es#er #o lie %o'n (or an ab%ominal assessmen#;

Ho' abou# #"is <

\Ali#g ester: A&!ti# #yo po a#g kamay ko. halika po kayo rito ataalalaya# ko kayo pap!#ta ito sa higaa# para po ti#g#a# ko a#gi#yo#g tiya#.]

T"e clien# is age 2 an% in PAIN1 I# is NOT #"era$eu#ic #o as,#"e clien# #o come an% lie %o'n on #"e e+aminers #able on "er

o'n1

\Ali#g ester: mahiga po kayo ito at titi#g#a# ko po kayo.]

7"a# s"oul% be aling es#ers $osi#ion (or an ab%ominal

assessmen#;

A1 Su$ine4 'i#" "ea% an% (ee# FAT on be%

61 Hig" (o'lers 'i#" #"e (ee# in e+#ensionC1 Prone $osi#ion

D1 o' (o'lers 'i#" #"e ,nee on (le+ion

\Ali#g ester: itataas ko #a po #g ka!#ti a#g !lo #i#yo at paki &al!ktotpo lama#g a#g i#yo#g t!ho.]

Correc# ans'er is ETTER D1 To $romo#e ab%ominal rela+a#ion4T"e "ea% o( #"e be% s"oul% be SIGHT! ele-a#e% an% #"e ,nee

o( #"e clien# on (le+e% $osi#ion1

A an% 6 'ill $romo#e ab%ominal rigi%i#) ma,ing i# "ar% (or

Nurse 6u%e, #o PAPATE #"e ab%omen1

I( )our ans'er is C4 )ou s"oul% #r) #o imagine "o' can )ouassess #"e $a#ien#:s ab%omen i( s"e is in $rone $osi#ion;

,!miga #a si ali#g ester at mag !!mpisa #a si N!rse B!ek sa pagassess #g tiya# #i ali#g ester.

7"a# s"oul% be Nurse 6u%e,:s INITIA STEP in assessing alinges#er:s ab%omen;



A1 Pal$a#ion

61 Ins$ec#ionC1 Auscul#a#ion

D1 Percussion

Ti#i#g#a# #i N!rse B!ek a#g tiya# #i ali#g ester: ,mm.. %ala#ama#g kakai&a sa tiya# #i ali#g ester. Ro!# sha: may mga stret"hmark marahil !lot #g ka#ya#g pag&!&!#tis at pa#ga#ga#ak. )!&oga#g p!so at mali#is #ama# ito. 1ala #ama# ako#g #akikita#gg!magala% gala% m!kha#g maali%alas at tahimik #ama# a#g ka#ya#gtiya# k!#g titi#g#a#.

0i#!ha #i N!rse B!ek a#g stethos"ope at ka#ya#g pi#aki#gga# a#gtiya# #i ali#g ester. \A&a ehW 1ala ako#g mari#ig #a k!#g a#o ma#.,ypoa"ti$e a#g &o%el so!# #i ali#g ester. Sa loo& #g isa#g mi#!to ay#akari#ig ako #g tatlo#g &o%el so!#.]

Ho' %i% Nurse 6u%e, conclu%e% #"a# aling es#er:s bo'el soun%

is ")$oac#i-e;

A1 T"e bo'el soun%s are more #"an @ $er minu#e

61 T"ere is NO bo'el soun%s on aling es#er:s assessmen# C1 T"ere is less #"an bo'el soun%s $er minu#e on #"e

assessmen# D1 T"e bo'el soun%s are less #"an / $er minu#e

Sa isip #i N!rse B!ek: \A#g #ormal &o%el so!#s ay '<: #a&asa koiya# kay sa!#ers #!#g akoy #ag aaral paW 0a%a%a #ama# si #a#ay:m!kha#g "o#stipate ata ah3]

\Teka #ga I a!s"!ltate ko ito sa I)EO'*E*A) A)E para makasig!rao sa aki#g &ila#g.]

7"ere is #"e IEO9CECA VAVE;

A1 e(# lo'er Bua%ran# 61 Rig"# lo'er Bua%ran# C1 e(# u$$er Bua%ran#

D1 Rig"# u$$er Bua%ran#

7") %i% Nurse 6u%e, use #"e IEO9CECA VAVE oca#ion #o(ur#"er assess aling es#ers bo'el soun%s;



A1 6ecause #"a# is #"e loca#ion '"ere bo'el soun%s are $ro%uce%

61 T"e ICV is #"e onl) loca#ion in #"e large in#es#ine '"erebo'el soun%s are "ear%

C1 6o'el soun%s are al'a)s "ear% in #"e ICV more #"an an)

o#"er Bua%ran#sD1 ICV is loca#e% in #"e small in#es#ines4 i# is '"ere gas are

(orme% an% release gi-ing a gurgling soun%

Nilagay #i N!rse B!ek a#g ka#ya#g steth sa may RIG,T )O1ER@UADRANT !pa#g mari#ig a#g t!#og sa may ileo'"e"al $al$e k!#gsaa#: parati ito#g mayroo#g &o%el so!#s k!mpara sa i&a#ga&omi#al !ara#t.

\ I per"!ss ko #a #ga a#g tiya# #i #a#ay. Ti#g#a# #ati# k!#g marami#g lama# lama# ito. \

Sa pag per"!ss #g tiya# #i ali#g ester: Nakari#ig si B!ek #g isa#gDU)) o ma&a&a#g t!#og sa may )EFT )O1ER @UADRANT #i ali#gEster. \ Aha: m!kha#g mero# ito#g isa#g hi#i ka#ais #ais #a &agayah. \

7"a# are #"e %i((eren# soun%s #"a# Nurse 6u%e, can $ercuss on

aling Es#er:s ab%omen;

/1 DUNESS < Ma) be $ercusse% on #"e R U because o( #"ei-er an% in #"e U because o( #"e s$leen1 An im$ac#ion o( (eces also $ro%uce a DU soun% on

$ercussion1

.1 H!PERRESONANCE?RESONANCE < An o-er in(la#e% area suc"

as #"e UNGS can $ro%uce a ")$erresonanec?resonan# soun%1

@1 FAT < FUID soun%s FAT on $ercussion1 Usuall) "ear% onbo'el obs#ruc#ion %ue #o -ol-ulus4 %i-er#iculosis?li#is an%

in#ussusce$#ion1

21 T!MPAN! < T"e TUNOG TAM6O4 is "ear% '"en #"e in#es#ine

or s#omac" is air (ille%1

At sa h!li#g &ahagi: ki#apa M PA)PATION #i N!rse &!ek a#g tiya# #iali#g ester. Nag !mpisa siya sa Right lo%er !ara#t: pap!#ta#g right!pper !ara#t ha#gga#g makakapa siya #g isa#g maliit at matigas #a



mass sa may left lo%er !ara#t #i ali#g ester.

\ Ito y!#g !ll #a #ari#ig ko ka#i#a \ A#g #asa&i #i B!ek.

7") %i% Nurse 6u%e, (ollo's < INSPECTION4 AUSCUTATION4

PERCUSSION AND PAPATION in e+ac# an% correc# or%er inassessing aling es#ers ab%omen;

A1 Doing Percussion an% Pal$a#ion las# 'ill "el$ limi#

s#imula#ion o( bo'el soun% #"ere(ore4 An accura#e assessmen#

o( #"e ab%ominal s#a#us is recor%e%161 Ins$ec#ion an% Auscula#ion are %one (irs# as no# #o cause

PAIN on aling es#er #"a# 'ill $re-en# "er (rom no# coo$era#ing'i#" #"e ab%ominal assessmen#1

C1 Pal$a#ion is %one las# on an el%erl) clien# because o( #"e

sensi#i-i#) o( #"e ab%ominal muscle #"a# mig"# cause se-ere%iscom(or# #o aling es#er1

D1 Ins$ec#ion is %one (irs# as #o %irec#l) obser-e #"e general s#a#us o( aling es#er:s ab%omen be(ore %oing s$eci(ic

assessmen#s o( eac" Bua%ran#s1

\,ayyy: /!kha#g alam ko #a ali#g ester k!#g &akit masakit a#g tiya##ati# ha.] A#g sa&i #i N!rse B!ek.

\Ay:WW] sa lo&lo& #i B!ek. \/ay ha#gi#g !estio# #ga pala tayo. Bakit#ga &a hi#!li ko a#g palpatio# at si#!#o a#g step #a I:A:PE:PA. O \ I

am PePa.] 0asi #ga: pag pi#alpate ko aga: ma ii stim!late ko a#g&o%el so!# #i #a#ay kaya hi#i a""!rate a#g &o%el so!# #amariri#ig ko: hi#i ko masasa&i #a ,5PO o ,5PERA*TIE a#g &o%elso!# #i #a#ay ahil #a apekt!ha# #g per"!ssio# o palpatio#. ,i#i&a: ma#ip!latio# i#"reases peristalsis: &aka mamaya mag < pa a#g&o%el so!#s #i #a#ay ester at hi#i magi#g tama a#g aki#g palagay#a kaya masakit a#g tiya# #ya ahil hypoa"ti$e a#g pag gala% #gka#ya#g &it!ka at *ONSTIPATED SI5A.]

\Na#ay ester: kaila# po kayo h!li#g #a!mi3] A#g ta#o#g #i N!rse

B!ek.

\A&ay hi#i ko #a mata#aa# iho. /alama#g isa#g li#ggo #a ako#ghi#i #a!!mi eh: iyo# &a a#g ahila# &akit masakit a#g aki#g tiya#3 \ A#g sa&i #i ali#g ester.

\A&ay opo #a#ay: apat po Isan1 (%&i 9a(a (ala7an1 ara7 poa#g pi#aka ma&a&a #i#yo#g pag !mi: sa&i po iya# saki# #g aki#g



&estfrie# #a si )ippi##"ott \ Sa&i #i N!rse B!ek.

\Nay: A#g ry ry #ama# #iya#g &i&ig #yo. Umii#om po &a kayo #gmarami#g t!&ig sa isa#g ara%3 \ Sa&i #i N!rse B!ek

\A&ay oo #ama# a#o: marami ako#g i#ii#om #a t!&ig sa isa#g ara%.]

Di% 6u%e, as,e% #"e rig"# Bues#ion; e# us see i( #"is Bues#ionis be##er=1

\Nay: a#g ry ry #ama# #iya#g &i&ig #yo: Ila#g &aso po &a#g t!&iga#g i#ii#om #yo sa isa#g ara%3] A#g ta#o#g #i N!rse B!ek.

\Nakaka tatlo#g &aso ako sa isa#g ara%: sapat #a &a iyo#3] t!go# #iali#g ester.

\ Nay: apat po >* glassess a#g i#ii#om #ati# &a%at ara%. 0aya#ama# pala hi#i kayo ma!mi #g reg!lar %ala#g pa#!lak at !lasa#g i#yo#g &it!ka eh. \ Sagot #i N!rse B!ek.

I&i#ahagi #i B!ek a#g ka#ya#g #at!klasa# kay Do"tor t!kla% #a#a#ga#galaga kay ali#g ester. Ipi#ag !tos #g oktor a#g Fleet e#emakay ali#g ester #g!#it #ag reklamo si N!rse B!ek.

7") %i% Nurse 6u%e, reac#e% an% %isagree% #o #"e %oc#orsor%er o( (lee# enema;

A1 Flee# enema is con#rain%ica#e% among el%erl) 61 Flee# enema can cause %e$en%ence

C1 Flee# enema 'ill causes (lui% o-erloa% D1 Flee# enema 'ill cause (ur#"er %e")%ra#ion

\Doktor: sa# &a kayo gra!ate3 Bat fleet e#ema eh ta#a ta#a #a #i#a#ay ehyrate pa.. g!sto #yo#g lalo#g ma ehyrate si #a#ay3]A#g matapa#g #a sagot #i B!ek

\Ah ga#!# &a3 A#o &a apat3] Sa&i #i Dr. T!kla%

\ 0asi hyperto#i" sali#e a#g fleet: Ea"h 77'm) eli$ere ose"o#tai#s 7 g mo#o&asi" soi!m phosphate mo#ohyrate a# gi&asi" soi!m phosphate heptahyrate. 0!#g hyperto#i" sha imagi#e:sisipsipi# #ito a#g t!&ig sa large i#testi#e #i #a#ay at lalo#g mat!toyosi #a#ay. Baka ma "aria" arrest pa ya# !e to hypokalemia sige ka. \A#g maya&a#g #a sa&i #i &!ek.



\ I NSS e#ema ko #ala#g i kaya tap %ater: mamili ka ok a#o a#gg!sto mo3] A#g t!go# #i B!ek.

\Bahala ka sa &!hay mo] A#g t!go# #i Dr. T!kla%

\ Ok : I orer mo ako #g NSS e#ema para %ala tayo#g pro&lema safl!i a# ele"trolate &ala#"e] A#g t!go# #i B!ek.

\ 5es o": mas!s!#o po \ A#g sagot #i Dr. T!kla%

Bi#alika# #i N!rse B!ek si #a#ay ester sa ka#ya#g sili.

\ Na#ay ester: Reay ka #a &a sa gaga%i# #ati#3] Sa&i #i B!ek.

\ Oo: reay #a.. masakit &a ya#3 A#o &a a#g gaga%i# mo sa aki#3]A#g t!go# #i ali#g ester.

\ Bali papala&asi# mo #ati# a#g mga !mi po #i#yo #a #ai%a# at&!mara #a iya# sa i#yo#g &it!ka para po hi#i #a kayo masakta# atmaisayos po #ati# a#g #ormal #a pag !mi #i#yo \ A#g sagot #i&!ek.

\ Nay: p!m!%esto #a po kayo. .]

7"a# s"oul% be aling es#er:s $os#ion '"en $re$aring #o gi-e an

enema;

A1 e(# sims $osi#ion

61 Prone $osi#ionC1 Rig"# sims $osi#ion

D1 Dorsal Recumben# $osi#ion

\ Nay: p!m!%esto #a po kayo. T!magili po kayo at h!miga sa i#yo#gkali%a at I &al!ktot #iyo po a#g ka#a#g t!ho #i#yo M )EFT SI/SPOSITION : T!l!#ga# ko po kayo] A#g sa&i #i Nars B!ek.

\ Bakit ga#ito pa apat a#g aki#g posisyo#3 A#o a#g importa#sya#ito#g ga#ito#g posisyo# #!rse3] A#g ta#o#g #i ali#g Ester.

7") is #"e $a#ien# $osi#ione% in #"e EFT SIMS $osi#ion '"en

a%minis#ering an enema;

A1 T"e e(# sims $osi#ion 'ill (acili#a#e %escen# o( #"e solu#ion



#o'ar%s #"e rec#um an% #"e colon61 T"e e(# sims $osi#ion is use% #o $re-en# inur) #o #"e

bla%%er '"en inser#ing #"e enema #ubeC1 T"e e(# sims $osi#ion 'ill $re-en# #"e solu#ion (rom going

in#o #"e ,i%ne)s #"a# 'ill cause ")%rone$"rosis

D1 Female clien#s are $u# in #"e EFT SIMS $osi#ion #o $re-en#lea,age o( #"e solu#ion #o'ar%s #"e cer-i+ #"a# 'ill cause se-er

in(lamma#or) reac#ion1

\Nay: kasi po a#g re"t!m po #ati# ay PABABA pag tayoy #aka leftsims. 0!#g #aka right sims ka eh &a&alik la#g po y!#g t!&ig pala&asahil po paa#gat po a#g kaala#ga# #iya#g al!ya#: hi#i po siyamakakarati#g #g tama sa "olo#] A#g t!go# #i B!ek. MRefer to the#ormal a#atomy of the large i#testi#e

At #a#g matapos #a #i N!rse B!ek a#g pag I e#ema kay #a#ay:)ima#g malalaki#g &ilog &ilog #a kasi#glaki #g "hi"o a#g ka#ya#g#ak!ha at matapos #ito: malalam&ot #a a#g !mi #a l!ma&as kay#a#ay Ester.

\,ayyy: g!maa# #a a#g aki#g pakiramam N!rse B!ek: salamat sat!lo#g mo ha.. hi#i #a siya masakit] A#g pasasalamat #i #a#ay Ester.

Ng!miti si &!ek sa&ay &igkas \ Nay: ta#aa# t!&ig t!&ig t!&ig atmas!sta#sya at &ala#se#g pagkai# #a mataas sa fi&er t!la #g g!layat pr!tas para hi#i #a ma#gyari iya# !let sa i#yo. ]

Napa#giti si ali#g ester at siya ay para#g #asala#git sa gaa# #gka#ya#g pakiramam at gi#ha%a#g #araramama#.

Follow up questions :

Answer the following questions :

1. What is the minimum and maximum height of the enema can?

2. How long should bude insert the rectal tube? What ind of lubricant should he

use?

!. What should be nurses bude"s first inter#ention in case cramping occurs duringenema instillation?

$. When should nurse bude %&'( irrigating aling ester"s colon?

). What are the contraindications when administering an enema?



1. What s the !n!u! and !a"!u! he#ht o$ the ene!a %an&

' 12 n%hes !n!u! u( to 1) n%hes !a"!u!.

2. *ow lon# should bude+ nsert the re%tal tube& What +nd o$ lubr%ant should he

use&

' 3- n%hes , water soluble lubr%ant / Jelly

3. What should be nurses bude+s $rst nterenton n %ase %ra!(n# o%%urs

durn# ene!a nstllaton&

' Sto( the $olow o$ the rr#ant by %la!(n# the tube

-. When should nurse bude+ S45P rr#atn# aln# esters %olon&

' When the returns are %lear

. What are the %ontrand%atons when ad!nstern# an ene!a&

' ontrand%atons are but not l!ted to : Pertonts, 8l%erate olts, hrons

9sease, A((end%ts, 9ert%ults, etro(ertoneal Abs%ess.

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