January 2021 ~ Medical diseases and trems ,symptoms causes TREATMENT

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Does axes blade cause AIDS? HIV INFECTION CAUSE RISK FECTORS, MODE OF TRANSMISSION


             HUMAM IMMUNODEFICIENCY VIRUS   OR

    AQUIRED IMMUNE DEFICIENCY SYNDROME

   HIV is viral disease caused by HIV virus . It is a single stranded ritroviral RNA virus which belong from lenti virus family . 

   HIV and AIDS are not same , AIDS is the untreated infection of HIV.

   International AIDS day is 1st December every year.

 HIV Enter in the Human body 

       If  HIV virus enter in human body by any mode of transmission such as unprotected sex, infected blood transfusion, infected axes blade .

                                      🠟

                      HIV replicate in the CD cell

                                     🠟

                            CD 4 cell death    

                                      🠟

                  CD 4 cell count decrease

                                       🠟

           increase opportunistic infection 

                                       🠟

                                     AIDS And Death

     The fluid that are not risk for HIV infection

                * Seliva

                     *  Tear

                     * sweat 

                     * Urine 

                     * feaces unless they have visible blood

    The body fluid which are at risk for HIV infection

         * seaman , vaginal discharge, CSF, peritoneal fluid, pericardial fluid, breast milk, amniotic fluid.

MODE OF TRANSMISSION OF HIV

   1. Unprotected sex with HIV positive person

   2. Infected blood transfusion.

   3. Infected IV needle drugs user.

   4. Occupational exposer and reusing infected instruments.

   5. Pregnancy and child birth.

   6. Breast feeding.

 

Rajasthan CHO Documents required in CHO documents verification process

 ❇️❇️

*राजस्थान सामुदायिक स्वास्थ्य अधिकारी (CHO)  के लिए दस्तावेज सत्यापन के लिए लगने वाले दस्तावेज*✍️✍️✍️

👇🏿👇🏿👇🏿👇🏿👇🏿👇🏿👇🏿👇🏿

 

1 *10वी की मार्कसीट व प्रमाण पत्र*

2 *12 वी की मार्कशीट ओर प्रमाण पत्र*

3 *जी एन एम के लिए तीन साल की मार्कसीट या पोस्ट बेसिक नर्सिंग की उसका मार्कसीट*

4 *बी एस नर्सिंग के लिए चार साल की मार्कसीट*

 *एवं एम एस सी नर्सिंग की हो तो उसकी मार्कशीट*

5 *जाती प्रमाण पत्र*

*ओबीसी के लिए 6 महीने से पुराना नही होना चाइए*

6 *मूल निवास प्रमाण पत्र*

7 *विशेष मूलनिवास जो टी एस पी क्षेत्र के लिए जो भारत सरकार की अधिसूचना 2018 का बना हुआ हो*

8 *राजस्थान नर्सिंग कोंसिल का सर्टिफिकेट*

9 *बी एस सी नर्सिंग की डिग्री व एम एस सी नर्सिंग की हो तो उसकी डिग्री* 

10 *चरित्र प्रमाण पत्र जो लास्ट क्वाली फिकेशन कॉलेज से बना हुवा हो*

11 *दो चरित्र प्रमाण पत्र राजपत्रिक अधिकारी से सत्यापित हो*

12 *मूल आवेदन जो 2019 का एवं 2020 का हो*

13 *जी एन एम के लिए इन्टरसिप प्रमाण पत्र*

14 *500 का नॉन ज्यूडिशियल स्टाम्प जिसमे 5 लाख का बांड या 5 वर्ष नोकरी करने का मेंशन किया हो*

15 *विवाह प्रमाण पत्र*

16 *दहेज न लेना का प्रमाण पत्र*

17 *एक से अधिक जीवित पत्नी  न होने का प्रमाण पत्र*

18 *खेल कोटे से हो तो खेल प्रमाण पत्र*

19 *एन सी सी केंडिडेट के लिए ए लेवल का प्रमाण पत्र*

20 *दो से अधिक  बच्चे नही होने का प्रमाण पत्र*

21 *इन सब के 3 सेट बनाने जो स्वयं सत्यापन किये हो*

22 *एक हेल्थ सर्टिफिकेट जो सरकारी मेडिकल ऑफिसर से बना हुआ हो*

23 *पुलिस सत्यापन जो वेरिफिकेशन के बाद लगेगा*

24 *अगर राजस्थान से बाहर से नर्सिंग किये हुवे केंडिडेट के लिए वहा के विश्व विद्यालय से माइग्रेशन*


Regards

Mahaveer Choudhary 

Erythroblastosis Fetalis causes ,sign and symptom , pathophysiology , complication , treatment

                         ERYTHROBLATOSIS FETALIS

     


   Erythroblastosis fetalis is hemolytic anemia in the in the fetus cause by transplacental transmission of maternal antibodies to fetus red blood cells. the disorder usually result from incompatibility between maternal and fetal blood groups, often Rho [D] antigen. Diagnosis begins with prenatal maternal antigenic and antibody screening may require prenatal screening , serial measurement of maternal antibody titers and fetal testing.

 PATHOPHYSIOLOGY

                When mother is Rh negative and baby is Rh positive.

                                                      🠟

      There is no problem in the first baby during the delivery of first baby some amount of blood reach in the mother blood.

                                                      🠟

     Which result production of antibody against D - antigen in the mother blood .

                                                      🠟

    During the development of next Rh positive baby, the antibodies cross the placenta and reach to the babies blood .

                                                      🠟

   Antigen - Antibody reaction occur which result hemolysis .

                                                      🠟

   There is rapid RBC production in the fetus blood which result immature RBC count in the fetus blood in erythroblastic state .

                                                     🠟

   Number of erythroblast cell increase in the fetus blood .

                                                     🠟

                                   Erythroblastosis fetalis.  

COMPLICATION TO THE FETUS -

             * Hemolytic  anemia .

             * Hemolytic jaundice

             * Kernicterus

             * Renal failure

             * Hydrops fetalis  

  DIAGNOSIS

  • Maternal blood and Rh typing and reflex antibody screening

  • Serial antibody level measurements and middle cerebral artery blood flow measurements for pregnancies considered at risk

  • Cell-free fetal DNA screening.

TREATMENT / MANAGEMENT

         * Baby admit in NICU.

         * Put him/ her on ventilator .

         * INJ. Dexamethasone to increase lunges maturity .

          * Administer blood transfusion .

         * Rh negative should be administer to the Rh positive blood for initial 24 hours after birth.

         * Phototherapy for jaundice.

   PRIVENTION OF ERYTHROBLASTOSIS FETALIS

        - The RHOGAM { Anti - D gamma globulin } which is antibody should be administered to the Rh negative mother who delivered a Rh positive baby with in 72 hour after birth .

       - Dose of RhoGAM 1500 IU or 300 mcg 

               route intramuscular         

GUILLAIN BARRE SYNDROME , Cause , sign and symptom , treatment

                             GUILLAIN BARRE SYNDROME



      * It is the disorder of peripheral nerve system . In this condition cranial nerve and spinal nerve are affected . In this condition destruction of schwann cell occur so the demyelination of the neurons will occur in the PNS. 

      The nerve transmission is effected due to damage in myelin sheath.

 CAUSES / ETIOLOGY

        *     Auto immunity - The immune system become hyper active and auto antibodies are formed against the schwann cell .

        *    The patient has the history of GIT or Respiratory infection few day back .

        *     The campylobacter Jejuni infection is commonly associated with GB syndrome .

  SIGN AND SYMPTOM

        * The symptom initially appear in the lower extremities .

        *Paresthesia occur [ Burning and Tingling sensation ]

        * Muscles weakness in lower extremities .

        * Ascending paralysis .

        * The danger complication of GB syndrome is Respiratory paralysis.

DIAGNOSIS

       * CT OR MRI

       * Antibodies detection test

       * nerve conduction Test.

MANAGEMENT/ TREATMENT

     Medical management 

                - Immunoglobulin therapy   - These antibodies destruct the auto antibodies.

               - Plasmapheresis - In this procedure the auto antibodies are remove from the circulation.

               - Immunosuppressive therapy

               - Steroid therapy 

    Nursing Management

          * Continuous monitor the respiratory system.

          * The tracheostomy set and mechanical ventilator should always be available at the bed side .

          * Prevent injury to the patient because peripheral sensation and movement become disturbed . 

PARKINSON'S DISEASE RISK FACTOR , SIGN AND SYMPTOM , DIAGNOSIS , TREATMENT

                                             PARKINSON DISEASE



         It is a degenerative disease and also progressive in nature , in this condition the level of dopamine neurotransmitter become decrease in the brain.

        * In this condition the substantia nigra of the basal ganglia become disturbed so dopamine production become decrease . In this condition the globus pallidus release excessive ACH.

  RISK FACTOR

           * Old age more then 50 year .

           * Head injury .

           * Patient receiving antipsychotic drug .

  SING AND SYMPTOM

        * Symptom appear due to two reason 

                               - decrease dopamine level

                               - Increase ACH level.[ Acetylcholine hormone ]

        * Tremors - Resting tremors occur 

                          - These tremors only appear during resting condition and the tremors does not appear during any physical activity and also during sleeping .

        * Pill rolling tremors occur. 

        * Rigidity - Cog wheel rigidity.

        * bradykinesia.

        * Micrographia 

        * Drooling of saliva

        * stooped posture 

        * Propulsive walk

        * Mask like face.

        * Monotonous speech.

 DIAGNOSIS

         Physical examination.

         CT Scan

         MRI Scan

 TREATMENT

    MEDICAL MANEGEMENT

          The drug of choice is levodopa but it should be administer with Carbidopa.

  The carbidopa is Dopamine decarboxylase enzyme inhibitor . so it prevent the metabolism of levodopa in the liver .

* The other choice is Bromocriptine and cabergoline.

 * The symptomatic treatment can be provided for tremors and seizures.

 * The anti cholinergic medication should be administered .

 NURSING MANAGEMENT 

    * Prevent injury to the patient during ambulation .

    * Advise the patient to sleep in the on the frame surface .

    * Advise to the patient to avoid vitamin B6.

     

DIABETIC KETO ACIDOSIS , RISK FECTOR, SYMPTOMS , INVESTIGATION AND TREATMENT

                           DIABETIC KETO ACIDOSIS 


It occur in the patient of type 1st Diabetes mellitus . It can also occur in 

the late condition of type 2nd DM. In the type 1st DM insulin is absent

 so fat break down will occur . Ketone bodies formation will occur due to

 fat break down . These ketone bodies are acidic in nature and causes

 metabolic acidosis.

RISK FACTOR 

                * Missed dose of insulin 

                * Infection commonly in urinary track infection -

                                     During infection inflammation occur so the anti 

 inflammatory hormone , steroid level become increased . This excessive

 steroid increase blood sugar level and also increase the demand of insulin.

SIGN AND SYMPTOMS

      * Hyperglycemia  .

      * Glycosuria 

      * polyurea

      * Nausea and vomiting 

      * Dehydration 

      *  Shock

      * Metabolic acidosis

      * kussmaul respiration

      * Acetone breath 

      * Hypokalemia

Investigation / diagnosis 

    *  Blood sugar level more then 350 mg/dl.

    * PH less then 7.35

   *  sodabicarb less then 15 meq/lit

   *  blood ketone positive

   *  Urinary ketone positive .

TREATMENT

    Maintain patent airway .

 * Provide oxygen therapy 

 * Start insulin therapy.

 * Start IV fluid therapy with normal saline.

 * Continuously monitor the patient .

Complication

      There is two major complications occur during insulin therapy such as

           1. Hypokalemia - It can be prevented by add by potassium  in the fluid .

           2. Hypoglycemia - To prevent hypoglycemia check blood sugar level every one hour and if the blood sugar level is less then 250 mg/dl then start iv dextrose therapy .


          

Blood Transfusion ,why would you need a blood transfusion

                                 BLOOD TRANSFUSION

    Matching 

                     Determination of recipient blood group is known as matching .

   Cross Matching 

          Mixing of donner antigen with recipient antibody is known as cross matching.

  Mismatch blood transfusion reaction 

            1. Clinical feature of transfusion reaction -

                      - Rigor , chills , fever , itching , Tachycardia , palpitation , Tachypnoea ,                                  Dyspnoea , sweating  .

            2. Nursing priority during Transfusion reaction 

                   - Stop the transfusion 

                   - Administer normal saline

                   - Call the physician 

                   - Inform to blood bank 

                   - send the  blood sample and urine sample 

                   - Documentation the finding 

      Precautions

          * The nurse should stay with the client for 10 to 15 minute during initial blood transfusion .

          * The blood bag { Temperature 2-8°C } should be kept in the blood warmer before transfusion .

            * Normal transfusion take 4 hour if , it take more then 4 hour then there will be risk of septicemia  or it take less then 4 hour , it may cause fluid over load risk.


  Drug administration after blood transfusion reaction 

        Inj. Avil [ pheniramine maleate] 

         Inj. Dexona

        Inj. calcium gluconat  if Hypo calcium.

        Inj. Lasix  , to decrease fluid over load .