Sabtu, 30 April 2011

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Nursing Resume & Job Search Tips

Posted: 30 Apr 2011 07:10 AM PDT


Nursing Resume & Job Search Tips

It is broadly agreed upon in the employment sector that the need for Nursing positions will grow faster
than the national job average for the next few years. This is great news for all you interested in Nursing as a career.

Just like in any growing profession there is the inevitable competition for these very desirable nursing positions.

How do you get a head of the competition?

First…Know your stuff. You have to be good at your job. So learn your job well.

Second…Have confidence in yourself, be proud of what you do.

Third…You need an outstanding Resume built specifically for the Nursing Profession.

Remember you are competing for a job in a profession that is growing and you are competing in the
in the age of the email application process. (That means there are hundreds of resumes sent in by
email for each position advertised.)

Once your training is complete and you begin your job search you are stepping out of the world
of medicine and stepping into the world Of “Marketing and Sales”.

Your Resume has to have all the important Technical aspects of your training and all the applicable
experience that you also have to offer and every bit of relevant education. But your Resume also has
to stand out from the crowd, and it has to quickly grab the attention of the reader.

Another thing to be aware of, as a result of the volume of resumes generally received for an advertised position, Resumes are not typically read all the way through, they are quickly “scanned”.

Did you know that the typical resume is looked at for only about 7 to 8 seconds! Now you see what I mean when I say you have to GRAB the ATTENTION of the READER FAST!

An Outstanding Resume is just as important to your job search as making sure that a patient’s Meds are administered correctly o the patients.

Every situation has it’s challenges whether you are entry level an RN, BSN, whatever your level of education and experience, there is a need to be thorough and yet maintain a quality of Interest in your resume.

Most hiring managers hire nurses based on their experience or knowledge (education if you are new) in a specific area of the nursing profession. Make this stand out when writing your resume.

While detailing your License Qualifications, grants, academic honors, fellowships, scholarships, GPA, your clinical rotations, or your nursing mentorships is an important thing to do while writing your resume, remember also that your resume format, layout, structure, phrasing, and design are just as important!

In many many cases it is a smart thing to have a professional resume prepared for you. A certified resume writer with experience in the Nursing Field can help you get a better job with higher pay much faster than if you wrote it on your own.

If you go with a professional resume here are a couple of things to look out for:

1: Don’t go with a Resume Template. (They don’t work)

2. Go with a Professional Certified Resume Writer, experienced in Nursing,
that will guarantee their product. (if it is good it will be guaranteed)

3. Don’t skimp on your Resume. This is your career. It is important. Treat it like it is
important and don’t go to the $.99 Resume Service. (A cheap resume isn’t worth the price.)


Nursing Resume Writing


Surgical Dressings

Posted: 29 Apr 2011 08:22 PM PDT

Rapid covering and healing of both acute skin defects and chronic skin defects are important objectives for wound healing. The best way to heal a wound is to close it according to surgical standards as quickly as possible after injury. However, this procedure is limited to those wounds and those anatomical regions that allow both excision and adaptation of wound borders to close the wound by primary intention or per primam (Latin term meaning to close the wound by suturing [or equivalent method] and restructuring of the skin continuity).

In large-surface and deep wounds in which the primary wound closure is not possible or not practicable, the most important issue is to dress the wound with appropriate materials to allow the following: (1) to keep the wound free of infection, (2) to reduce or eliminate pain, (3) to reduce or eliminate all potential factors inhibiting natural healing (eg, dead tissue in burns, superficial fibrosis, necrotic tissue), and (4) to replace or substitute the missing tissue as much as possible.
Wound repair

Wound repair involves the timed and balanced activity of inflammatory, vascular, connective tissue, and epithelial cells. All of these components need an extracellular matrix to balance the healing process. Skin wounds heal by the formation of epithelialized scars of different contraction ability rather than by the regeneration of a true full-thickness tissue. To minimize scar formation and to accelerate healing time, different wound dressings and different techniques of skin substitution have been introduced in the last decades.

Autologous skin grafting in the form of split- or full-thickness skin is still a criterion standard. However, in many patients, this technique may not be practicable for a variety of reasons, and the wound must be allowed to heal by second intention. Moreover, in cases in which skin grafts are used, a new wound is created on the donor side. Thus, eliminating a new wound to close the old one and to close as many tissue defects as possible without the risk of large area infection, necrosis, tissue hypertrophy, and contraction, as well as deformation of wound borders, is a necessity. The next important problem is to reduce or eliminate scar formation, particularly in the field of large-surface wounds.

Traditional management of large-surface or deep wounds involves open and closed methods. In the open method, the wounds are left in a warm, dry environment to crust over, whereas, in the closed method, wounds are covered with different kinds of temporary dressings and topical treatment, including antibiotics, until healing by secondary intention. The early removal of the dead tissue (eg, in burns) reduced pain, the number of surgical procedures, and the length of the hospital stay.

The surgical intervention (ie, tangential excision of partial- or full-thickness wound) followed by wound closure with autografts or temporary dressings is one of the currently used methods. In large-surface, full-thickness wounds, the wound can be excised down to the fat or the fascia, particularly if infection is present. Excision to the fat induces the removal of the subdermal plexus of blood vessels and decreases the take of autografts because this tissue is less vascularized. Excision down to the fascia induces better take of the autografts but has aesthetic disadvantages.

Wound debridement can also be achieved by enzyme digestion of the dead tissues. Proteolytic enzymes (eg, collagenases used topically) allow a more specific destruction of necrotic tissues, while preserving viable dermis and avoiding blood loss, but the treatment can be painful and can increase the risk of local infection. In addition, it takes a long time to achieve a clean wound bed.
Wound coverings

Currently available wound coverings can be divided into 2 categories: (1) permanent coverings, such as autografts, and (2) temporary coverings, such as allografts (including de-epidermized cadaver skin and in vitro reconstructed epidermal sheets), xenografts (ie, conserved pig skin), and synthetic dressings.

Conventional autograft (epidermis and a significant amount of dermis) obtained from healthy skin areas is considered the optimum wound cover in that its viability yields immediate take (incorporation into the wound bed) and resistance to wound infection. However, harvesting of autograft creates a second wound in the healthy tissue, a donor wound. This open wound increases the risk of infection and fluid/electrolyte imbalance. Repeated conventional harvests of autograft from a donor wound site can result in contour defects or scarring. Optimizing the healing of both main wounds and donor wounds becomes a later goal of patient management and the development of different surgical dressings, which can be used based on the principle of phase-adapted wound healing.

Most recently, developed wound dressings are in use only as temporary dressings because of their synthetic or chemical components, limited persistence on the wound surface, and foreign body character.

Primary closure versus second-intention treatment of skin punch biopsy sites was evaluated in a randomized trial.[1] Punch biopsy sites healed by second intention appear at least as good as biopsy sites closed primarily with sutures. Volunteers preferred suturing for 8-mm biopsy sites and had no preference for 4-mm sites. Elimination of suturing of punch biopsy wounds results in personnel efficiency and economic savings for both patients and medical institutions.

The wounds had been dressed with petroleum jelly under an occlusive dressing that consisted of gauze covered by a transparent dressing (Tegaderm; 3M, St Paul, Minn) and were left in place for 3 days. After that time, the gel foam was removed from the second-intention site and both biopsy sites were cleansed with water to remove any exudate. Then, an occlusive transparent dressing was reapplied to both sites. After this initial dressing change, dressings were changed weekly or more often at the volunteers’ discretion until the biopsy sites were completely healed or reepithelialized. Efficient wound dressings can be important for both small and large wounds.

Some of the currently available surgical dressings used in dermatologic and dermatosurgical practice are discussed.
source Surgical Dressings : http://emedicine.medscape.com/article/1127868-overview


Nursing Interventions for Pericarditis

Posted: 29 Apr 2011 08:16 PM PDT

Nursing Interventions for Pericarditis

Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.

Nursing Interventions: Pericarditis

1. Stress the importance of bed rest,
2. Assist the patient with bathing if necessary.
3. Provide a bedside commode because this method puts less stress on the heart rather than using a bed pan.
4. Place the patient in upright position to relieve dyspnea and chest pain.
5. Provide analgesics to relieve pain and oxygen to prevent tissue hypoxia.
6. Assess the patient's cardiovascular status frequently, watching for signs of cardiac tamponade.
7. Monitor the patient's pain level and the effectiveness of analgesics.
8. Explain all tests and treatments to the patient.
9. Before giving antibiotics, obtain a patient history for allergy.
10. Tell the patient to resume his daily activities slowly and to schedule rest periods into his daily routine for a while.


Acetabular Fractures for nurse

Posted: 29 Apr 2011 08:08 PM PDT

Acetabular Fractures for nurse

* Usually caused by force applied to the femur which is translated to the acetabulum.
* In young adults, acetabular fractures are due to high energy injuries, primarily motor vehicle accidents.
* The majority of patients are evaluated for and have associated injuries that require initial evaluation of the multiple trauma patient.
* There are also minority of patients, which are elderly, and suffer relatively minor trauma causing acetabular fractures.

Pathophysiology

* Fractures maybe caused by direct trauma to the bone.
* Disruption of blood vessel in cortex periostrum.
* Soft tissue bleeding from damage end of bone.
* Hematoma formation
* Bone tissue death
* Necrosis
* Stimulation of inflammatory response vasodilation
* Exudation of plasma
* Increase leukocytes and infiltration of wbc

Signs and Symptoms

* Crepitus
* Deformity
* Pain
* Tenderness at the site
* Swelling
* Loss of function
* Discoloration
* Dislocation of bone
* Bleeding from an open wound with protrusion of bone ends.
* Fever
* Dysfunction
* Hematoma on the site
* Abnormal or decrease sensation of the affected extremity
* Change in size
* Moderate or severe edema joint point
* Dyspnea
* Rapid weal pulse
* Mental confusion apprehension due to hypoxia
* Mental aberration before signs of infection
* Metabolic disturbance

Assessment

1. Remove clothing so that entire extremity may be visualized. Cut clothing along seems when necessary.
2. Assess for neurovascular changes distal to fracture.
3. Assess for change in length, shape or alignment.
4. Support joint extremity at all times; including joints above and below the suspected injury.
5. If fracture is impacted the patient may be able to bear weight and walk for a short period of time after the initial injury.
6. History of simple fall.
7. Decrease range of motion.
8. Affected limb shortened abducted and externally rotated.
9. Greater thochanter may be displaced into the buttock.

Complications

1. Pulmonary embolism
2. Fat embolism
3. Gas gangrene
4. Tetanus
5. Loss of bone substance
6. Soft tissue interposed between bone ends.
7. Infection
8. Loss of circulation
9. Interrupted or improper immobilization
10. Inadequate fixation
11. Necrosis due to fixation devices
12. Metabolic disturbance

Nursing Diagnoses

1. Altered health maintenance
2. Risk for infection
3. Risk for injury
4. Impaired skin integrity
5. Impaired tissue integrity
6. Self-care deficit
7. Impaired physical mobility
8. Activity intolerance
9. Anxiety
10. Pain
11. Fear
12. Disturbed body image

Nursing Interventions

1. Assist the patient or significant others to identify self-care deficits.
2. Develop plan with patient for self-care, adapting, and organizing care as necessary.
3. Assist the patient to maintain and manage usual health practices during period of wellness or when progressive illness.
4. Provide for communication and coordination between the healthcare facility team.
5. Monitor lesion or wound daily for changes.
6. Promote good nutrition with increase protein intake to facilitate healing.
7. Encourage adequate period of rest and sleep.
8. Provide devices that aid in comfort or healing.
9. Discuss importance of early detection and reporting of changes in condition or any unusual physical discomforts and changes.
10. Identify required changes in lifestyle.
11. Encourage verbalization of feeling about pain.
12. Provide comfort measure like backrubbing.
13. Encourage patient to do deep breathing exercises during pain.
source Acetabular Fractures for nurse


nursing care with Apendiksitis inflamation

Posted: 29 Apr 2011 05:32 PM PDT

DEFINITIONS
Apendiksitis is an inflammation that often occurs in the appendix which is a serious case of abdominal surgery that most often occurs.

Aetiology
Apendiksitis a bacterial infection caused by obstruction or blockage due to:

1. Hyperplasia of lymphoid follicles
2. The presence in the lumen of the appendix fekalit
3. Tumors of the appendix
4. The presence of foreign objects such as worms Ascariasis
5. Erosion of the mucosa of the appendix due to parasites such as E. Histilitica.
According to research, epidemiology shows eating low-fiber foods will lead to constipation which can cause apendiksitis. This will increase intra sekal pressure, causing a functional obstruction of the appendix and improve the growth of bacteria flora in the colon.

SIGNS AND SYMPTOMS

Pain felt in the lower quadrant of the abdomen and is usually accompanied by mild fever, nausea, vomiting and loss of appetite. Local tenderness at the point of Mc. Burney pressure when done. Tenderness may be found out.
Degree of tenderness, muscle spasm, and if there is constipation or diarrhea does not depend on the severity of infection and location of the appendix. If the appendix at the back of the caecal circular, pain and tenderness can be felt in the lumbar region; when the tip is in the pelvis, these signs can only diketahuipada rectal examination. Pain at defecation shows that the tip of the appendix close to the bladder or ureter. Kekeakuan existence at the bottom right of the rectum muscle may occur.
Tand Rovsing may arise by the left lower quadrant palpation, which is paradoxical causes pain felt in the lower right quadrant. If the appendix has ruptured, the pain and can be more diffuse; abdominal distension caused by ileus paralitikdan client’s condition deteriorated

COMPLICATIONS
The main complication is apendiksitis perforated appendix, which can progress to peritonitis, or abscess. Incidence of perforation was 105 to 32%. Higher incidence in small children and the elderly. Perforation generally occurs 24 hours after awitan pain. Symptoms include fever with a temperature of 37.7 o C or higher, abdominal tenderness kontinue.

Management

In acute apendiksitis, the best treatment is surgery of the appendix. Within 48 hours must be done. Patients in obsevarsi, rest in Fowler’s position, given antibiotics and are given food that does not stimulate persitaltik, if there is perforated drain given the lower right stomach.
a. Pre operative action, including the hospitalized patients, given antibiotics and compress to reduce the temperature of the patient, the patient was asked to tirabaring and dipuasakan
b. Operative actions; apendiktomi
c. Post operative actions, one day post-surgical clients are encouraged to sit up in bed for 2 x 30 minutes, soft foods the next day and stood upright outside the room, the seventh day of stitches removed, clients go home


ACUTE LIMPHOSITYC LEUCEMIA

Posted: 28 Apr 2011 07:43 PM PDT

ACUTE LIMPHOSITYC LEUCEMIA

A. DEFINITIONS ACUTE LIMPHOSITYC LEUCEMIA

Acute limphosityc leukemia is the proliferation of malignant / malignant limphoblast in bone marrow cells caused by a single core that can be systemic. (Ngastiyah, 1997; Smeltzer & Bare, 2002; Tucker, 1997; Reeves & Lockart, 2002).

B. CAUSE ACUTE LIMPHOSITYC LEUCEMIA

The cause of leukemia acute limphosityc until now not yet clear, probably due to suspected virus (oncogenic viruses) and other factors that may play a role, namely:

1. Exogenous factors

a. X-rays, radioactive rays.

b. Hormone.

c. Chemicals such as benzene, arsenic, sulfate preparations, chloramphinecol, anti-neoplastic agent).

2. Endogenous factors

a. Race (the Jews is more easily affected than black people)

b. Congenital (chromosomal abnormalities, particularly in children with Down syndrome).

c. Hereditary (or twin sisters one egg).

(Ngastiyah, 1997)

C. Pathophysiology ACUTE LIMPHOSITYC LEUCEMIA

Cancer cells produce immature leukocytes / abnormal excessive amounts. This immature leukocytes infiltrated into various organs, including bone marrow and replace the elements of normal cells. Immature lymphocytes proliferate in the bone marrow and peripheral tissue that interfere with normal cell growth. This causes the normal haemopoesis inhibited, resulting in decrease in the number of leucosit, red blood cells and platelets. Cancer cell infiltration into various organs causing pembersaran liver, spleen, limfodenopati, headache, vomiting, and pain in bones and joints. Decrease in the number of red blood cells cause anemia, decrease in the number of platelets facilitate the occurrence of bleeding (echimosis, bleeding gums, etc. epistaksis.). The presence of cancer cells also affect retikuloendotelial system that can cause the body’s defense system, thus susceptible to infection. Existence kaker cells that also interfere with cell metabolism of food shortages. (Ngastiyah, 1997; & Bare Smeltzer, 2002; Suriadi and Rita Yuliani, 2001, Betz & Sowden, 2002).

D. SIGNS AND SYMPTOMS ACUTE LIMPHOSITYC LEUCEMIA

Clinical manifestations of leukemia acute limphosityc include:

1. Colds do not heal

2. Pale, listless, easily stimulated

3. Fever, anorexia, nausea, vomiting

4. Weight loss

5. Ptechiae, epistaksis, bleeding gums, bruising for no reason

6. Bone and joint pain

7. Abdominal pain

8. Hepatosplenomegaly, lymphadenopathy

9. WBC abnormalities

10. Headache

E. DIAGNOSTIC EXAMINATION IN ACUTE LIMPHOSITYC LEUCEMIA

Diagnostic tests are commonly done in children with leukemia acute limphosityc are:

1. Bone marrow examination (BMP / Bone Marrow Punction):

a. Found excessive blast cells

b. Increased protein

2. Peripheral blood examination

a. Pansitopenia (anemia, lekopenia, trombositopneia)

b. Increased serum uric acid

c. Increased copper (Cu) serum

d. Decreased levels of Zinc (Zn)

e. Increased leukocytes can occur (from 20,000 to 200,000 / ?l), but in the form of blast cells / primitive cell

3. Biopsy liver, spleen, kidney, bone to examine the involvement / infiltration of cancer cells to these organs

4. Fotothorax to assess the involvement of the mediastinum

5. Sitogenik:

50-60% of ALL and AML patients have abnormalities in the form:

a. Number of chromosome abnormalities, such as the diploid (2n), haploid (2n-a), hiperploid (2n + a)

b. Increases or loss of chromosomes (delection partial)

c. There are marker chromosomes, which are morphological elements that are not normal components of chromosomes that form a very large to very small

TREATMENT AT ALL

1. Blood transfusion, is usually given when the Hb levels less than 6 g%. In severe thrombocytopenia and massive bleeding, platelet transfusions can be given and if there are signs DIC can be given heparin.

2. Corticosteroids (prednisone, cortisone, dexamethasone, etc.). Achieved remission after the dose is reduced gradually and eventually discontinued.

3. Sitostatika. In addition to the long sitostatika (6 merkaptopurin or 6 mp, methotrexate, or MTX) was used at the same time new and more potent as vinkristin (oncovin), rubidomisin (daunorubycine), cytosine, arabinosid, L asparaginase, cyclophosphamide, or CPA, adriamycin and the like . Sitostatika generally given in combination with prednisone joint. In giving this drug there is often a side effect alopecia, stomatitis, leukopenia, infection or secondary kandidiagis. Berhziti should be more caution when jumiah less than 2.000/mm3 leukocytes.

4. Secondary infection avoided (if possible the patient was isolated in a sterile room).

5. Immunotherapy is the newest way of treatment. Having achieved remission and the number of leukemia cells was low (105 106), Immunotherapy began to be given. Treatment is done by assigning aspesifik immunization with BCG or Corynae bacterium and is intended to form antibodies that can strengthen the immune system. Specific treatment is done by injecting the leukemia cells that have been irradiated. In this way are expected to form specific antibodies against leukemia cells, so that all the pathological cells will be destroyed so that leukemia patients can expect a complete recovery.

6. Treatments.

Each clinic has its own way depending on experience. Generally, treatment directed toward the prevention of relapse and obtain a longer remission. To achieve that state, in principle, the basic pattern of medication use as follows:

a. Induction

Intended to achieve remission, namely the provision of various drugs mentioned above, both systemic and intrathecal until blast cells in bone marrow less than 5%.

b. Consolidation

Namely that the remaining cells no longer multiply rapidly.

c. Rumat (maintenance)

To maintain the remission, as far as dapatnya a long period of remission. Usually done by giving a half dose sitostatika ordinary.

d. Reinduksi

Intended to prevent relapse. Reinduksi usually done every 6 months to 3 drug delivery such as the induction drug for 10 14 days.

e. Prevent the occurrence of central nervous system leukemia.

For this intrathecal MTX was given at the time of induction to prevent meningeal leukemia and cranial radiation as much 2.4002.500 rad. to prevent meningeal leukemia and cerebral leukemia. This radiation is not repeated in reinduksi.

f. Medical imunologik

It is expected that all leukemia cells in the body will vanish altogether, and thus patients can expect a complete recovery.


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Rabu, 27 April 2011

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Sample Family Nursing Care Plan

Posted: 27 Apr 2011 01:40 AM PDT

Concepts found within family nursing theory revolve around the ability of the family to cope with medical problems and maintain positive lifestyles. The family, in other words, can serve as the real impetus for healthy lifestyles by continually assisting family members to take care of themselves

Family Nursing Care Plan


Decreased Cardiac Output

Posted: 26 Apr 2011 07:17 PM PDT

Inadequate blood is pumped by the heart to meet the metabolic demands of the body. It resulted from a systemic vasoconstriction in the body caused by preeclampsia. Vasoconstriction is the decrease in the diameter of the blood vessels which occur in diseases like pregnancy-induced hypertension. Decreased blood supply leads to a decrease in venous return, thus there is a relatively smaller amount of blood expelled by the ventricles of the heart.


source : http://nurseslabs.com/nursing-care-plans/pre-eclampsia-nursing-care-plans/


anger care plan

Posted: 26 Apr 2011 07:57 AM PDT

What is anger?
Anger is a basic human emotion that is experienced by all people. Typically triggered by an emotional hurt, anger is usually experienced as an unpleasant feeling that occurs when we think we have been injured, mistreated, opposed in our long-held views, or when we are faced with obstacles that keep us from attaining personal goals.

The experience of anger varies widely; how often anger occurs, how intensely it is felt, and how long it lasts are different for each person. People also vary in how easily they get angry (their anger threshold), as well as how comfortable they are with feeling angry. Some people are always getting angry while others seldom feel angry. Some people are very aware of their anger, while others fail to recognize anger when it occurs. Some experts suggest that the average adult gets angry about once a day and annoyed or peeved about three times a day. Other anger management experts suggest that getting angry fifteen times a day is more likely a realistic average. Regardless of how often we actually experience anger, it is a common and unavoidable emotion. (http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=5803)

Nursing care plan for anger / Anger NCP

RESIDENT_____________________________________

DATE PROBLEM GOAL TO DATE INTERVENTIONS RESP

DISC

Anger

related to

Recently changed environment or lifestyle

Cognitive deficit or decline

ADL decline

Loss of home or possessions

Loss of family member/ friend

Loss of pet

Mental / Emotional Illness

As evidenced by:

Persistent anger with self or others

Unpleasant mood in the morning

Verbalizes anger over loss

Verbalizes non-acceptance over change of status

Demonstrates ineffective coping skills

Resident will demonstrate effective coping behavior

Resident will verbalize a positive aspect of new situation

Resident will participate in activities

Allow resident to talk about feelings, and let resident know staff is empathetic

Assist resident to process feelings and find positive outcomes

Encourage contact with support system

Assist resident to participate in religious / spiritual activities

Plan activities that draw on resident̢۪s experience and knowledge

Do not argue with resident, but redirect by asking benign questions

Observe for nonverbal signs of anger: rigid body position, clenched fists

Psychiatric evaluation if indicated

Draw on resident̢۪s strength:

source : http://www.ltcsbooks.com/Forms/angercp.htm


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Selasa, 26 April 2011

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Pap Smear Test

Posted: 25 Apr 2011 04:47 PM PDT

PAP SMEAR

pap smear testPAP-TEST merupakan pemeriksaan sitologi untuk mendeteksi kanker leher rahim (kanker serviks) secara dini. Pemeriksaan ini dapat dilakukan dengan cepat, mudah dan tidak menyakitkan karena tidak merusak jaringan. Cara pemeriksaan ini ditemukan oleh seorang ahli anatomi dari Amerika yaitu  Dr. G. N. Papnicolau.

Perlunya PAP-TEST

Di indonesia, kanker yang banyak ditemukan pada wanita adalah kanker payudara dan kanker leher rahim. Pada stadium dini,kanker leher rahim tidak menunjukkan gejala atau kelainan pada penderita sehingga penderita kurang waspada dan penyakit ditemukan setelah stadium lanjut, dimana tingkat keberhasilan pengobatan mnjadi kecil bahkan sering berakibat fatal. Padahal, keberhasilan pengobatan dapat menjadi 100% bila penyakit ditemukan pada stadium dini.

Dengan melakukan PAP-TEST, secara teratur pada kurun waktu tertentu, awal terjadinya peruahan sel menjadi sel kanker dapat diketahui. Dengan demikian, kanker leher rahim dapat ditemukan pada stadium sedini mungkin.

Bagaimana Cara Melakukan PAP-TEST?

Dokter, perawat atau petugas laboratorium akan memasukkan alat yang diseut spekulum kedalam vagina untuk memuka dinding vagina agar leher rahim diambil dengan mengusapkan spatula atau cervix brush pada permukaan leher rahim secara perlahan-lahan sambil diputar agar diperoleh contoh sel yang memadai.

Contoh sel yang menempel pada spatula atau cervix brush dioleskan pada permukaan kaca benda.

Proses berikutnya adalah : direndam dalam alkohol, dieri pewarnaan, lalu diperiksa diawah mikroskop oleh seorang dokter ahli patologi anatomi.

Apa Yang Ditunjukkkan Oleh

PAP-TEST?

Sel yang normal, mempunyai ukuran, bentuk dan warna inti sel tertentu yang dapat berubah jika sel terseut menjadi sel kanker. Sel kanker mempunyai inti sel yang lebih besar dan warna yang leih gelap dibandingkan dengan sel normal. Derajat peruahan ini trgantung pada keparahan penyakit.

Pada PAP-TEST, hasil pengamatan dibawah mikroskop dapat menunjukkan apakah contoh sel normal atau dicurigai kanker. Bahkan apabila ada sedikit perubahan sel karena infeksi pada vagina atau leher rahim, dapat juga ditemukan dari hasil pengamatan ini.

Siapa Dan kapan Perlu PAP-TEST?

PAP-TEST dianjurkan untuk dilakukan secara rutin bagi wanita yang sudah melakukan huungan seksual dan berusia leih dari 25 tahun hingga usia 60 tahun.

Sebaiknya PAP-TEST dilakukan setiap tahun atau bila hasil pemeriksaan dua kali berturut-turut normal, pemeriksaan oleh dilakukan 2 tahu sekali atau sesuai dengan petunjuk dari dokter.

Pengambilan bahan pemeriksaan dapat dilakukan kapan saja kecuali pada saat haid. Waktu terbaik untuk pengamilan bahan pemeriksaan adalah 10-16 hari menstruasi.

Dimana Melakukan PAP-TEST?

PAP-TEST dapat dilakukan di Laoratorium Klinik Rumah Sakit, Klinik Bersalin atau di Puskesmas yang telah ditunjuk dan mempunyai peralatan untuk keperluan pemeriksaan.

Apa Yang Harus Diperhatikan Sebelum PAP-TEST?

Berikan informasi sejujurnya kepada dokter anda tentang riwayat kesehatan dan penyakit yang pernah anda derita, terutama penyakit yang ditularkan melalui hubungan seksual.

Hindari pemakaian obat-obatan yang dimasukkan ke dalam vagina 48 jam sebelum pemeriksaan.

Bila anda sedang minum obat tertentu, informasikan kepada dokter anda karena ada beberapa jenis obat yang dapat mempengaruhi hasil analisis sel.

Beritahukan kepada dokter anda bila anda merasakan gejala-gejala yang mencurigakan, meskipun meskipun hasil PAP-TEST negatif.

Apa Yang Harus Dilakukan Setelah PAP-TEST?

Apabila hasil PAP-TEST normal, ulangi pemeriksaan setahun kemudian. Apabila hasil PAP-TEST menunjukkan adanya sel-sel yang abnormal, segera huungi dokter ahli kandungan untuk diperiksa lebih lanjut dan diberi pengobatan yang tepat, kanker leher rahim dapat disembuhkan secara sempurna.

Bagaimana Cara Menghindari Ancaman Kanker Leher Rahim?

Melakukan PAP-TEST secara teratur

menghindari hal-hal yang dapat meningkatkan risiko timbulnya kanker leher rahim, misalnya : berganti-ganti pasangan seksual, merokok, dll.

Menjaga kebersihan organ intim.

Selalu waspada dan segera ke dokter bila mengalami tanda-tanda yang mencurigakan seperti:

Keputihan dan pengeluaran cairan yang berbau usuk dari vagina,

Perdarahan setelah persetubuhan,

Perdarahan atau haid yang abnormal

Luangkan Sedikit Waktu Anda Untuk Melakukan PAP-TEST Secara Teratur Dan Hindari Ancaman kanker Leher Rahim


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Senin, 25 April 2011

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The importance of pap smear test for you ladies, do not ignore a pap smear test

Posted: 25 Apr 2011 06:24 AM PDT

Pap Smear test

pap smear testpap smear is test / PAP-TEST cytologic examination to detect cervical cancer (cervical cancer) early. This examination can be done quickly, easily and does not hurt because they do not damage the tissue. The way this investigation was found by an American anatomist Dr. G. N. Papnicolau.

Need for PAP-TEST

A lot of cancer found in women is breast cancer and cervical cancer. In the early stages, cervical cancer has no symptoms or abnormalities in people, so people are less aware and the disease was found after an advanced stage, where the success rate of treatment small mnjadi often fatal. In fact, the success of treatment can be 100% if the disease is found in early stages.

By doing PAP-TEST, regularly at a certain time period, the beginning of peruahan cells into cancer cells can be identified. Thus, cervical cancer can be found at the earliest possible stage.

How to Do the PAP-TEST?

Doctors, nurses or laboratory staff will insert an instrument called a speculum into the vagina diseut to memuka vaginal wall to the cervix is taken by rubbing a spatula or brush on the surface of the cervix cervix slowly while playing to obtain an adequate cell sample.

Examples of cells attached to the spatula or cervix brush applied on the surface of glass objects.

The next process is: soaked in alcohol, dieri coloring, and then examined by a microscope diawah doctor anatomical pathologist.

PAP-TEST?

Normal cells, has the size, shape and color of a particular cell nucleus that can change if terseut cells into cancer cells. Cancer cells have a cell nucleus is larger and darker colors Leih than normal cells. This peruahan degrees trgantung on disease severity.

In the PAP-TEST, observations under a microscope can show whether the sample of normal cells or suspected cancer. Even when there is little change in the cell because of infection in the vagina or cervix, may also be found from these observations.

Who and when should the PAP-TEST?

PAP-TEST recommended to be done routinely for women who have done huungan Leih sex and age from 25 years to 60 years of age.

PAP-TEST should be done every year or when the results of two consecutive normal examinations conducted by one or 2 out in accordance with instructions from the doctor.

Obtaining examination materials can be done anytime except during menstruation. The best time to pengamilan material is 10-16 day inspection period.

Where Do PAP-TEST?

PAP-TEST can be done in Laoratorium Clinic Hospital, Maternity Clinic or at the health center has been appointed and has equipment for inspection purposes.

What to Look For Before PAP-TEST?

Provide honest information to your doctor about medical history and disease that you have suffered, particularly diseases transmitted through sexual intercourse.

Avoid the use of drugs that is inserted into the vagina 48 hours before the examination.

If you are taking certain medications, inform your doctor because there are several types of drugs that can affect the results of cell analysis.

Tell your doctor if you experience symptoms suspicious, even though the results of the PAP-TEST negative.

What to Do After the PAP-TEST?

If the results of the PAP-TEST normal, repeat examination a year later. If the PAP-TEST results indicate that cells are abnormal, immediately huungi gynecologist for further examined and given proper treatment, cervical cancer can be cured completely.

How To Avoid Cervical Cancer Threat?

PAP-TEST conduct regular

avoid the things that can increase the risk of cervical cancer, for example: changing sexual partners, smoking, etc..

Organ intimate hygiene.

Always be alert and immediately to your doctor if you experience signs of suspicious such as:

And whitish discharge that smells usuk from the vagina,

Bleeding after intercourse,

Bleeding or abnormal menstrual

Spend a little time You To Do PAP-TEST In Organized And Avoid Cervical Cancer Threat


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Rabu, 13 April 2011

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Types of Osteogenesis imperfecta / OI : A Guide for Nurses

Posted: 12 Apr 2011 11:40 PM PDT

The Types of Osteogenesis imperfecta / OI

In 1979, Sillence and others devised a classification scheme that divides OI into four types based on clinical, radiographic, and genetic distinctions. Features of OI vary not only between types but within each type as well. Patients with OI may present with some but not all of the clinical features. Children and adults with milder OI may have few obvious signs. Some patients appear to have characteristics of several types. Patients may walk unassisted; require the assistance of walkers, crutches, or braces; or be wheelchair-dependent. All types of OI may include dentinogenesis imperfecta and varying degrees of blue sclera. The frequency of fractures may decrease after puberty. An increase in fractures may be seen in women following menopause and in men in later life.

While the Sillence classification is part of the commonly accepted language of OI, nurses are urged to look beyond type alone. The key to optimal care is to be aware of the patient’s specific symptoms and capabilities and to treat each patient individually. See Appendix 2: Sillence Classifications of OI for a summary of information about the types of OI.

* Type I – Mildest form of the disorder. Manifests with relatively few fractures, minimal limb deformities, blue sclera, and high incidence of hearing loss. Stature may be average or slightly shorter than average for the unaffected family members. Hearing loss onset is primarily in young adulthood but may occur in early childhood. Some patients have few fractures or obvious signs of OI. Some patients experience multiple fractures of the long bones, compression fractures of the vertebrae, and have chronic pain. Dentinogenesis imperfecta may or may not be present. Life expectancy seems to be normal.
* Type II – Most severe form; features severe osteoporosis. Infants are frequently premature or stillborn and are small for gestational age. Multiple fractures in the womb lead to bowing and shortening of the long bones at birth. The head is large for body size, with severe undermineralization. The rib cage is small and narrow, and palpation of the rib cage reveals “beading” from calluses due to rib fractures in utero. The sclerae are almost uniformly dark blue/gray. In the newborn period, it can be difficult to distinguish between Type II and severe Type III OI. Infants with Type II usually die in the immediate postnatal period from respiratory and cardiac complications. Rare cases of infants surviving into childhood have been reported.
* Type III – Most severe type for those patients who survive the perinatal period. Multiple long bone fractures may be present at birth but without the severe thoracic malformation seen in Type II OI. Frequent fractures of the long bones, tension of muscle on soft bone, and disruption of the growth plates lead to bowing and progressive malformation with short stature. Marked short stature, kyphoscoliosis, compression fractures of the vertebrae, and pectus carinatum or pectus excavatum occur frequently. The head is large for body size. Sclera may be white or tinted blue, purple, or grey, and dentinogenesis imperfecta may be present or absent. Patients with Type III are generally diagnosed at birth due to multiple fractures. Many patients with Type III use wheelchairs or other mobility aids. Some are independent ambulators within the home. Use of assistive devices to independently perform activities of daily living is common. Surgery may be required to support and straighten bowed limbs. Life span may be somewhat reduced. While some individuals are living into their sixties and seventies, there appear to be clusters of mortality due to pulmonary complications in early childhood, teens, and thirties to forties.
* Type IV – Moderately affected, with the diagnosis possibly made at birth but more frequently later, because the child may not fracture until he or she is ambulatory. Bowing of the long bones is present to a lesser extent than in Type III. Patients have moderate-to-severe growth retardation, which is one factor that distinguishes them clinically from Type I OI. Scoliosis and ligamentous laxity may also be present. Dentinogenesis imperfecta may be present or absent. Although the Sillence classification indicates that patients have white sclera, blue sclera have also been seen. Type IV OI can range in severity from similar to Type I to resembling Type III. Life span is not affected.

Recently, researchers have reported additional types that do not involve a defect of type I collagen. Clinically, these patients are similar to Type IV OI. Additional radiographic or histologic data are required to diagnose Types V and VI.

* Type V – Moderate in severity and similar to Type IV but also characterized by large hypertrophic calluses that develop at sites of fractures or surgical procedures. Calcification of the membrane between the radius and ulna restricts forearm rotation.
* Type VI – Extremely rare, moderate in severity, and only identified through bone biopsy.

Diagnosis  Osteogenesis imperfecta / OI

The diagnostic process may include:

* physical exam
* medical history, including pregnancy and childbirth information
* family history
* bone density testing
* x rays
* collagen (protein) testing using a skin biopsy
* molecular testing
* blood and urine tests to rule out conditions other than OI.

The physical exam includes assessment for abnormalities in:

* skull formation
* fontanel closure
* head circumference
* facial shape
* scleral hue
* dentition
* hearing
* chest shape
* shape of spine, presence/degree of scoliosis, and kyphosis
* shape of long bones
* segment measurements (upper and lower extremities)
* height/length (compared to unaffected children)
* body proportions
* bruising/scarring
* joint mobility
* development (physical and cognitive).

Some characteristics are age-dependent. Hearing loss may not be apparent in infancy or childhood. Bone malformation may not be present in an infant or young child with mild disorder. Pale blue sclerae are normal up to 18 months of age. Intense scleral hue and its presence past 2 years of age can suggest the need for further evaluation for OI. While tinted sclerae are a characteristic of OI, it is important to note that only some patients exhibit blue sclera. See Appendix 2: Sillence Classifications of OI for additional information.

for further information Types of Osteogenesis imperfecta / OI


Basic Facts Osteogenesis Imperfecta (OI): A Guide for Nurses

Posted: 12 Apr 2011 11:33 PM PDT

Basic Facts Osteogenesis Imperfecta (OI)

Osteogenesis imperfecta / OI , also known as brittle bone disease, is a genetic disorder of connective tissue characterized by bones that fracture easily, often from little or no apparent trauma. It is highly variable in severity from patient to patient, ranging from very mild to lethal. In addition to having fractures, people with OI often have muscle weakness, joint laxity, skeletal malformations, and other connective tissue problems.

The prevalence of Osteogenesis Imperfecta

The prevalence of OI is approximately 1 in 20,000, including patients diagnosed after birth. OI occurs with equal frequency among males and females and among all racial and ethnic groups. Patients with OI have the full range of intellectual capabilities as seen in the general population. There is nothing inherent in the disorder that affects cognitive abilities. Life expectancy varies according to the underlying severity of the disorder and ranges from very brief (Type II OI) to average. Medical treatment for OI is increasingly understood.

Patients with osteogenesis imperfecta usually have a faulty gene that instructs their bodies to make too little type I collagen or poor quality type I collagen. Type I collagen is the protein “scaffolding” of bone and other connective tissues. Inheritance, in nearly all cases, follows an autosomal dominant pattern, although sporadic cases are common. When there is no family history of OI, the disease is caused by new dominant mutations.

Patients are often knowledgeable about their health status and the problems associated with OI. Accordingly, the opinions, requests, and instructions of adult patients and parents of children with OI should be respected.

Depending on the severity of Osteogenesis Imperfecta or OI, the following characteristics may be seen:

* skeletal malformation
* short stature – Growth impairment is severe in all those individuals with Type II and Type III OI, moderate in those with Type IV, and relatively less in those with Type I.
* muscle weakness
* ligamentous laxity
* smooth, thin skin
* triangular face
* dental manifestations – Dentinogenesis imperfecta is present in about 50 percent of patients with OI. Deciduous teeth are usually more severely affected than permanent teeth.
* blue sclerae – Approximately 50 percent of people with OI have blue, purple, or gray-tinted sclerae.
* respiratory complications – Lung complications, such as pneumonia, represent a significant cause of death for those with Type II and III OI. Pneumonias are seen in children and adults, and cor pulmonale, a type of heart failure, is seen in adults.
* cardiac complications – Mitral valve prolapse (laxity) is seen but is not as common as in some other connective tissue disorders.
* hearing loss – In those with OI, hearing loss is frequent.
* thermal instability – Those with OI experience slightly higher than normal body temperature, sensitivity to heat and cold, excessive sweating, pseudomalignant hyperthermia after anesthesia.
* blood vessel fragility – Patients may exhibit easy bruising, frequent nosebleeds, and, in a small number of patients, profuse bleeding when injured.
* neurologic manifestations – Basilar invagination of the skull, hydrocephalus, and syringohydromyelia of the spinal cord may be seen in patients with the more severe forms of OI.

source Basic Facts Osteogenesis Imperfecta (OI): A Guide for Nurses


Questions and Answers about Rosacea

Posted: 12 Apr 2011 11:18 PM PDT

About Rosacea
What Is Rosacea?

Rosacea is a chronic (long-term) disease that affects the skin and sometimes the eyes. The disorder is characterized by redness, pimples, and, in advanced stages, thickened skin. Rosacea usually affects the face. Skin on other parts of the upper body is only rarely involved.
Who Gets Rosacea?

Approximately 14 million people in the United States have rosacea. It most often affects adults between the ages of 30 and 60. Rosacea is more common in women (particularly during menopause) than men. Although rosacea can develop in people of any skin color, it tends to occur most frequently and is most apparent in people with fair skin.
What Does RosaceaLook Like?

There are several symptoms and conditions associated with rosacea. These include frequent flushing, vascular rosacea, inflammatory rosacea, and several other conditions involving the skin, eyes, and nose.

Frequent flushing of the center of the face, which may include the forehead, nose, cheeks, and chin, occurs in the earliest stage of rosacea. The flushing often is accompanied by a burning sensation, particularly when creams or cosmetics are applied to the face. Sometimes the face is swollen slightly.

A condition called vascular rosacea causes persistent flushing and redness. Blood vessels under the skin of the face may dilate (enlarge), showing through the skin as small red lines. This is called telangiectasia (tel-AN-je-ek-tay-ze-ah). The affected skin may be swollen slightly and feel warm.

A condition called inflammatory Rosacea causes persistent redness and papules (pink bumps) and pustules (bumps containing pus) on the skin. Eye inflammation and sensitivity as well as telangiectasia also may occur.

In the most advanced stage of rosacea, the skin becomes a deep shade of red and inflammation of the eye is more apparent. Numerous telangiectases are often present, and nodules in the skin may become painful. A condition called rhinophyma also may develop in some men; it is rare in women. Rhinophyma is characterized by an enlarged, bulbous, and red nose resulting from enlargement of the sebaceous (oil-producing) glands beneath the surface of the skin on the nose. People who have rosacea also may develop a thickening of the skin on the forehead, chin, cheeks, or other areas.
How Is the Eye Affected?

In addition to skin problems, up to 50 percent of people who have rosacea have eye problems caused by the condition. Typical symptoms include redness, dryness, itching, burning, tearing, and the sensation of having sand in the eye. The eyelids may become inflamed and swollen. Some people say their eyes are sensitive to light and their vision is blurred or otherwise impaired.
What Causes Rosacea?

Doctors do not know the exact cause of rosacea but believe that some people may inherit a tendency to develop the disorder. People who blush frequently may be more likely to develop rosacea. Some researchers believe that rosacea is a disorder where blood vessels dilate too easily, resulting in flushing and redness.

Factors that cause rosacea to flare up in one person may have no effect on another person. Although the following factors have not been well-researched, some people claim that one or more of them have aggravated their rosacea: heat (including hot baths), strenuous exercise, sunlight, wind, very cold temperatures, hot or spicy foods and drinks, alcohol consumption, menopause, emotional stress, and long-term use of topical steroids on the face. Patients affected by pustules may assume they are caused by bacteria, but researchers have not established a link between rosacea and bacteria or other organisms on the skin, in the hair follicles, or elsewhere in the body.
Can Rosacea Be Cured?

Although there is no cure for rosacea, it can be treated and controlled. A dermatologist (a medical doctor who specializes in diseases of the skin) usually treats rosacea. The goals of treatment are to control the condition and improve the appearance of the patient's skin. It may take several weeks or months of treatment before a person notices an improvement of the skin.

Some doctors will prescribe a topical antibiotic, such as metronidazole, which is applied directly to the affected skin. For people with more severe cases, doctors often prescribe an oral (taken by mouth) antibiotic. Tetracycline, minocycline, erythromycin, and doxycycline are the most common antibiotics used to treat rosacea. The papules and pustules symptomatic of rosacea may respond quickly to treatment, but the redness and flushing are less likely to improve.

Some people who have rosacea become depressed by the changes in the appearance of their skin. People who have rosacea may experience low self-esteem, feel embarrassed by their appearance, and claim their social and professional interactions with others are adversely affected. A doctor should be consulted if a person feels unusually sad or has other symptoms of depression, such as loss of appetite or trouble concentrating.

Doctors usually treat the eye problems of rosacea with oral antibiotics, particularly tetracycline or doxycycline. People who develop infections of the eyelids must practice frequent eyelid hygiene. The doctor may recommend scrubbing the eyelids gently with diluted baby shampoo or an over-the-counter eyelid cleaner and applying warm (but not hot) compresses several times a day. When eyes are severely affected, doctors may prescribe steroid eye drops.

Electrosurgery and laser surgery are treatment options if red lines caused by dilated blood vessels appear in the skin or if rhinophyma develops. For some patients, laser surgery may improve the skin's appearance with little scarring or damage. For patients with rhinophyma, surgical removal of the excess tissue to reduce the size of the nose usually will improve the patient's appearance.

source Questions and Answers about Rosacea


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