nursing care of the patient with a nasogastric tube

... surgery, approximately 40 percent of patients with a retinal detachment have had prior cataract extraction.73 Cataract patients with extracapsular cataract extraction (ECCE) and intraocular lens ... Retinal Dialysis A retinal tear that occurs at the ora serrata, concentric with the ora, is called a retinal dialysis Most of these tears are less than 90 degrees, and they are rarely bilateral The ... retina appears more red than the surrounding retina, and the apex of the tear almost always points to the Retinal tufts are small areas of gliotic degeneration of the retina associated with vitreous...

Ngày tải lên: 22/03/2014, 09:20

... perspiring Tears Sharp intake of breath, gasping Breath holding 0 1 2 3 NA NA 0 1 2 3 NA NA NA 1 2 3 NA NA 0 0 0 1 1 1 2 2 2 3 3 3 NA NA NA NA NA NA 1 1 1 2 2 2 3 3 3 NA NA NA NA NA NA 1 2 3 NA NA NA Physiological ... evidence of papilledema and/or retinal hemorrhages The former is a sign of IICP, generally of a gradual and long-standing nature The latter is a sign of traumatic injury to the retina as a result of ... neurological assessment Neonate Aside from head shape and size and assessment of the fontanels, there are other aspects unique to the neurological exam of the neonate and/or infant These are important...

Ngày tải lên: 16/02/2014, 22:20

... formulate a differential diagnosis (Table 52-4) For instance, the finding of scaling papules (present in patients with psoriasis or atopic dermatitis) places the patient in a different diagnostic ... lesions If the examiner focuses on linear erosions overlying an area of erythema and scaling, he or she may incorrectly assume that the erosion is the primary lesion and the redness and scale are secondary, ... raised, often translucent lesion >0.5 cm in diameter Wheal: A raised, erythematous, edematous papule or plaque, usually representing short-lived vasodilatation and vasopermeability Telangiectasia:...

Ngày tải lên: 06/07/2014, 20:20

... and are caused by scratching Atrophy: An acquired loss of substance In the skin, this may appear as a depression with intact epidermis (i.e., loss of dermal or subcutaneous tissue) or as sites of ... or character Sites on hair-bearing areas may be characterized by destruction of hair follicles Table 52-3 Common Dermatologic Terms Alopecia: Hair loss; it may be partial or complete Annular: ... of epidermis without an associated loss of dermis Ulcer: Loss of epidermis and at least a portion of the underlying dermis Excoriation: Linear, angular erosions that may be covered by crust and...

Ngày tải lên: 06/07/2014, 20:20

... lesions, the shape of individual lesions, and the arrangement of the lesions An ideal skin examination includes evaluation of the skin, hair, and nails as well as the mucous membranes of the mouth, ... lesions and make it possible to assess the distribution of the eruption accurately The patient should first be viewed from a distance of about 1.5–2 m (4–6 ft) so that the general character of the ... erythematous exanthem is more likely to have a drug eruption than is a patient with a similar rash limited to the sun-exposed portions of the face Once the distribution of the lesions has been established,...

Ngày tải lên: 06/07/2014, 20:20

... A D The distribution of some common dermatologic diseases and lesions Figure 52-7 Psoriasis This papulosquamous skin disease is characterized by small and large erythematous papules and plaques ... skin disease is characterized by small and large erythematous papules and plaques with overlying adherent silvery scale Figure 52-8 ...

Ngày tải lên: 06/07/2014, 20:20

... contact (Fig 52-10) or primary irritant dermatitis In contrast, lesions with a generalized arrangement are common and suggest a systemic etiology Figure 52-9 Erythema multiforme This ... This eruption is characterized by multiple erythematous plaques with a target or iris morphology It usually represents a hypersensitivity reaction to drugs (e.g., sulfonylamides) or infections ... reaction to drugs (e.g., sulfonylamides) or infections (e.g., HSV) (Courtesy of the Yale Resident's Slide Collection; with permission.) Figure 52-10 ...

Ngày tải lên: 06/07/2014, 20:20

... psoriasis, or acne) 10 Social, sexual, or travel history as relevant to the patient DIAGNOSTIC TECHNIQUES Many skin diseases can be diagnosed on gross clinical appearance, but sometimes relatively ... or saucerized with a scalpel or removed by punch biopsy In the latter technique, a punch is pressed against the surface of the skin and rotated with downward pressure until it penetrates to the ... blade, and the removed scale is collected on a glass microscope slide then treated with to drops of a solution of 10–20% KOH KOH dissolves keratin and allows easier visualization of fungal elements...

Ngày tải lên: 06/07/2014, 20:20

... noting the amount of blanching that occurs Granulomas often have an opaque to transparent, brown-pink "apple jelly" appearance on diascopy Figure 52-11 Urticaria Discrete and confluent, edematous, ... erythematous papules and plaques are characteristic of this whealing eruption Wood's Light A Wood's lamp generates 360-nm ultraviolet (or "black") light that can be used to aid the evaluation of ... under a Wood's lamp, and previously unsuspected areas of involvement often become apparent A Wood's lamp may also aid in the demonstration of tinea versicolor and in recognition of ash leaf spots...

Ngày tải lên: 06/07/2014, 20:20

... histiocytoma, two cases each of myxofibrosarcoma and high-grade leiomyosarcoma, and one case of clear cell sarcoma were diagnosed Four of the seven cases of synovial sarcoma, two of the three cases of alveolar ... one case of synovial sarcoma (Figure 1) and one case of alveolar soft part sarcoma showed calcification on plain radiographs In all three cases of alveolar soft part Figure A plain radiograph ... form the basis of a diagnosis According to Lawrence et al [3], approximately 50% of soft tissue sarcoma patients are diagnosed at about months after patient recognition, and an additional 20% are...

Ngày tải lên: 09/08/2014, 03:22

... Neither of our patients showed a significant lower flow after a median follow-up time of 22 months, and no further operation was necessary in either case Neither patient showed complications of ... urethral stricture was found Biodegradable grafts seem to be an ideal solution for the repair of the urethra as well as other segments of the urinary tract SIS acts like a framework for the host-tissue ... (Figures 2B and 3B) The percutanous cystostomy catheter was removed on day 25 in both patients Postoperative uroflowmetry performed on the first patient on day 25 revealed a maximal uroflow of 49.1ml/sec...

Ngày tải lên: 11/08/2014, 17:21

... initial management of the patient and reviewed the manuscript NS was the senior author responsible for the management of the patient References Figure Antero-posterior radiograph of hand Antero-posterior ... Lateral radiograph of hand debridement and washout was performed The wound was then reviewed after 48 hours and a delayed primary closure performed The patient had regained good hand function and ... from the patient for publication of this case report and accompanying images A copy of the written consent is available for review by the Editor-in-Chief of this journal Competing interests The authors...

Ngày tải lên: 11/08/2014, 19:21

... anaesthesia Anaesthetic equipment Airways Anaesthesia Analgesia Patient preparation Fasting Premedication Loose teeth and nail polish Hearing aids and glasses Jewellery Preparation prior to patient ... Western Australia, Australia, and is an Honorary Professor in the Department of Paediatrics and Child Health, The University of Queensland, Brisbane, Queensland, Australia She maintains a small clinical ... have a minimal risk of post-operative haemorrhage, a minimal risk of post-operative airway compromise and controllable pain that can be managed with oral analgesics at home (Australia New Zealand...

Ngày tải lên: 29/03/2014, 11:21

... length of the fatty acid on the acyoxyacyl group to be mainly 15, confirming the result of the compositional analysis In the minor triacylated lipid A, the fragmentation patterns of the parent ion at ... mass spectrum revealed the presence of a monophosphoryl lipid A (Fig 3A) The molecular mass heterogeneity can be explained by the degree of acylation and the chain length of the fatty acid The ... OPS-rich fraction (30%) Mainly two sugars, Rha and Man, were detected in the OPS-rich fraction on analysis of the sugar constituents (Table 1) The approximate molar ratio of Rha to Man was : Absolute...

Ngày tải lên: 31/03/2014, 23:20

... angioma of the spleen in a patient with hepatocellular carcinoma J Formos Med Assoc 2005, 104:282-285 15 Ercin C, Gurbuz Y, Hacihanefioglu A, Turgut Karakaya A: Multiple littoral cell angioma of the ... Bisceglia M, Sickel JZ, Giangaspero F, Gomes V, Amini M, Michal M: Littoral cell angioma of the spleen: an additional report of four cases with emphasis on the association with visceral organ cancers ... about one-third of the reported cases Our case presentation supports the assumption of an association of LCA and an altered immune status, hypothesizing a TNF-arelated pathogenesis of this splenic...

Ngày tải lên: 09/08/2014, 02:21

... drainage A presumptive diagnosis of necrotizing fasciitis of the left thigh was made, and the patient was immediately taken to the operation room A wide debridement of the external fascia was ... reported case highlights the importance of the removal of the primary tumor in an aymptomatic patient as an attempt to avoid concomitant serious complications Retroperitoneal abscess and NF are rare ... complications of colorectal cancers that can potentially be fatal, particularly in patients who are immunocompromised because of chemotherapy In the presence of these unclear risk factors, accurate...

Ngày tải lên: 09/08/2014, 04:21

... Assessment of patient satisfaction by means of the PASS criteria can be approached in a number of ways: satisfaction at the end of a study period, time taken to achieve patient satisfaction, or time taken ... variables – OA pain, patient' s global assessment of disease activity, and WOMAC™ LK 3.1 Function – was originally estimated using the least square means obtained from an analysis of covariance with ... Research & Therapy Vol No Dougados et al Figure Patient' s global assessment of disease activity (a) Percentage of patients considering their state as satisfactory according to Patient Acceptable activity...

Ngày tải lên: 09/08/2014, 10:20

... data analysis and drafted the manuscript CS conducted data analysis and helped to draft the manuscript LP participated in study design, data collection and analysis, and helped to draft the manuscript ... implementation Limitations Because we base our findings on experiences within the VA, they are most applicable to large managed care systems and may be less applicable to small healthcare organizations ... implementation and the value added to the organization by the EHR Participants’ recommendations may help healthcare administrators anticipate barriers to EHR implementation and work to address them,...

Ngày tải lên: 10/08/2014, 10:23

... this article as: Papandreou et al.: Primary osteosarcoma of the urinary bladder treated with external radiotherapy in a patient with a history of transitional cell carcinoma: a case report Journal ... review of the literature Arch Pathol Lab Med 2001, 125:793-795 10 Kato T, Kubota Y, Saitu M, Yaguchi H, Sasagawa I, Nakada T, Yuda F: Osteosarcoma of the bladder successfully treated with partial ... writing of the manuscript AS performed the histological examination and reviewed the literature GK was involved in radiological evaluation of our patient HD was involved in patient care and writing...

Ngày tải lên: 11/08/2014, 11:23

... esophagus, paranasal sinus, or nose wings accompanying insertion of the nasogastric tube was observed Compliance of the large-bore nasogastric tube was favorable, and he did not try to remove the tube ... himself With continuous maintenance of the tube, no obstruction was observed Administration of anti-tuberculosis drugs was continued via the nasogastric tube without any adverse effects, and tubercle ... patients with intractable diarrhea who had been administered with liquid nutrition Improvement of diarrhea was observed in out of 14, or 64.2% of patients (unpublished data) The third advantage...

Ngày tải lên: 11/08/2014, 14:21