National Nursing Review : Nursing Study Resources & Health Tips

The curative surgery aims to remove the tumor while respecting a margin of safety device and, as appropriate, nearby lymph nodes (that is to say, the lymph draining the area or organ operated).
The margin of safety is supposed to sound the part that surrounds the tumor and which is then analyzed to verify the absence or presence of cancer cells.
If after analysis, the margin is positive, that is to say, it contains cancerous cells, the patient is sometimes operated again to remove that part of tissue.
The size of the margin of safety varies by cancer type and location of the tumor.
The curative surgery can be radical or conservative

• It is called radical if the body containing the tumor is removed in its entirety.
• Wherever possible and consistent with the stage of the tumor, surgeons try to preserve organ function and / or body image by making interventions called conservative.

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Rhinoplasty is surgery to reshape the nose, is one of the most common procedures plastic surgery.
Used for:

• Lowering the dorsum (hump) or wince nose.
• Reducing or refine the size of the nose.
• Define the shape of the nasal tip.
• Modify the nares (nostrils).
• Change the angle between the nose and upper lip.
• Correct birth defects or traumatic.
• Help improve breathing problems (supplemented with septoplasty).

The best candidates for rhinoplasty are people who want to improve their appearance. Achieve harmony with your face. (more…)

A – Hypotension
Is found in 20 to 30% of the sessions.
There are several etiologies: An excessive decrease in the volume, inadequate peripheral vasoconstriction (diabetic patients for example), or cardiac function improperly or failed.
Clinical: Sudden fall in blood pressure, feeling sick (hot flashes, discomfort, tachycardia, possibly loss of consciousness). Yawning is often a precursor met.
What to do:

• Reducing the speed of the pump blood ..
• Last sloping patient.
• Intake of saline (on prescription)
• Eventually, put under O2 (depends on service protocols)

Prevention:

• Never ultrafilter patients below its base weight.
• Weight gain rigorous
• Avoid taking anti-hypertensive before the dialysis session
• Rate of Na in the dialysis at a concentration equal to or lower than the patient. (Reminder: the Na profile is a prescription)

B – angina
Aggravating factors: anemia, decrease in BP, in hyper-debit FAV
What to do:

• Preventing nephrologist
• UF minimum
• Decreased blood flow
• O2 nasal + scope
• possibly following protocols, use nitroglycerin sub-lingual.
• If the crisis continues, stopping hemodialysis, restitution, perform ECGs, biology (KPC / CPKMB / LDH etc. ….), transfer in a specialized

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Recalls:
Potassium is the first intracellular cation
Usual biological values:
Extracellular: 3.5-5 mEq / L
Intracellular: 130-140 mEq / L
It achieves a critical gradient in resting membrane potential and maintains the intracellular osmolarity

Entries:
Requirements are 0.5 mmol/kg/24h
The dietary intake is essential.

Outputs:
Digestive secretions, sweat
The bulk of secretion occurs via the urine

Potassium regulation:
Definition:
Pathological state in which the potassium is greater than 5 mEq / L
Clinical signs:
Muscle fatigue, cramps
Laboratory findings: K> 5 mEq / L

Etiology:

• Failure of excretion (renal failure)
• Acidosis
• Crush syndrome
• Cell lysis
• Adrenal insufficiency
• Excess capital

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Anaphylactic shock is a shock associated with a reaction of the organism against a particular antigen. This is therefore an immunological reaction antigen-antibody (IgE) and not a nonspecific histamine release by the action of a molecule on the membrane causes mast cell degranulation her. For example, atracurium (curare) has the distinction of being histamine particularly when it is injected quickly, it is not an anaphylactic reaction, but a non-specific histamine release in this case. However, there is a molecule that can trigger a true anaphylactic reaction.
Anaphylactic shock is an emergency
The allergens most frequently implicated are the products of iodinated contrast, quaternary ammonium compounds (curare), the beta-lactams, the wasp venom, latex, sulfites …
Anaphylactic shock is classified into four grades, depending on the size of the reaction:

Grade I : Observe mainly skin reactions with swelling, hives without marked haemodynamic compromise, sometimes preceded by premonitory symptoms such itching, burning

Grade II: In addition to a fall in blood pressure accompanied by tachycardia reaction, the patient begins to experience difficulty breathing, coughing

Grade III: The patient shows signs of previous grades with a respiratory distress, bronchospame from laryngospasm, arrhythmias and conduction

Grade IV: cardio-circulatory arrest (more…)

The Schilling test explores the absorption of vitamin B12, which is normally at the terminal ileum. The absorption of this vitamin requires the presence of a factor secreted by the stomach, intrinsic factor (also called factor Castle). Mal-absorption and can guide a disease linked to lack of intrinsic factor.
Let the patient have received in the last 8 days of vitamin B12
The test is simple, but less and less used. It involves the ingestion and injection of cobalamin:
At T0: after emptying the bladder, to swallow a capsule of vitamin B12 labeled with cobalt 58; (more…)