punk rock jalanan

community posting at KUDAT..hehe

ni kali dkt kudat..bestnya dpt jln2 p kudat hehe..mula2 smpai d kudat kitorng jln2 dkt pekan sikuati. Bnyak smpah di sekitar dia..dlm fikiran sy, 'pekan ni kotor sngt la..'.tp sy lupa yg hari tu ada tamu dekat pekan 2.that is why nampak kotor lgpn ptg dh msa 2.. hari strusnya pekan tu bersih dh.. next dy praktikal dh dkt klinik 2. staff klinik KKIA bgus2 orgnya. layanan mereka sma kami xda diskriminasi, maklumlah kitorng ni bukn KKM student.

sepanjang minggu 2 kmi hbiskn peluang yg ada utk jln2 d sekitar daerah kudat..
akhirnya sy dpt menjejakkn kaki d SIMPANG MENGAYAU hehe..

ni pic yg smpt kmi amk msa dkt kudat..

p/s: Kudat daerah yg cantik!!

community nursing..

otw to kudat right now..lord bless our journey.

harap2 smua berjalan lancar.. i can't predict anything other than put hoping on it..mcm sy akan lonely sna nnt tp i will never let it happen to me..ramai kwn2 sy jga 2. even maybe dia xmw kwn but the others friend will do. qka, sabar ja ko..learn to say i can n owez think positives okey..

monthly Nurses Mass @ CDC

wah best ni..300 org students termasuk bbrpa org staff hospital. thanx Lord for bring me n my friends to attend the yesterday's mass.. tuhan, berkati juga mereka yg x berkesempatan dtg 2 misa.

emm..
kmi p jumpa mdm. sylvia, CI nursing aseana slps misa..kmi kenal dia sebb dia 2 ramah n baik sma kami hehehe..cerita pnya cerita, ni ayat best dia yg sy suka.. "semua yg kita bg sma org len dengan ikhls, kita akn dpt balik dengan berganda..".sy sokong pa mdm sylvia ckp..



p/s: jadi, janganlah kedekut. harta kita ni milik Tuhan. He have the power to take it back from us..

How to calculate period of gestation (POG) manually

1. know the last menstrual period (LMP)
2. calculate from date of LMP until the date of today

eg: LMP : 14.4.2011

       14.5
       14.6
       14.7
                   this 3 month is 13 week = 13/52

so today is 20.7.2011, minus 14 from 20 (20-14) = 6day

so, plus the week and the day = 13/52 + 6/7..

52 is total of week per year
7 is total of day per week.

Promosi Kesihatan di Kampung Batu Putih, Kinabatangan

health promotion??

Health promotion atau promosi kesihatan diadakan dengan tujuan meningkatkan taraf kesihatan orang ramai (komuniti), penduduk luar bandar terutamanya.

last week starting from 25hb June - 6hb July, we held this health campaign program at Kinabatangan, Sandakan. what a such wonderful and memorable memory. There are lots of things i have learned from this program. 

Actually ni program diwakili bukan student nursing sahaja tetapi didominasikan oleh pelatih doktor. Kami seramai 14 orang, 2 orang pelajar makmal perubatan, 5 pelajar nursing & 9 orang student doctor. kami tidak kenal antara satu sama lain sebelum ni. tetapi, kerana matlamat program kami ni sama so kami menjadi team yang baru. the best things to remember, student doctor ni baik2 n x sombong begitu juga dgn medical lab student. sporting2 ja ni smua..

selama 10hari program ni berlansung, kami menyewa sebuah rumah milik salah satu kluarga dlm kampung tu. team kesihatan dari UMS menjadi keluarga yg baru d sana hehehe. rumah baru 2, kami yg rasmi hehe.

bestnya d kg. batu putih 2..penduduk dia dekat 2ribu orang. punya ramai tu..ada sekolah rendh, klinik desa, masjid dan ada mini museum, museum Batu Tulug. gambar- gamabar ada di bawah..jom kita tngk..

larian satu malaysia day..

pic atas batu putih

keranda berukir dalam gua d museum batu tulug

ajar budak sekolah rendah proper handwashing

team health campaign

hehehe

teach how to brush teeth (proper way)

hand washing

batu putih yg ada human figure

bersama payau peliharaan, called Manis

cheers!!

Bersama Ketua Kampung n JKKK kg. Batu Putih, serta Supervisor..

ni link berita harian pasal agop batu tulug d kampung ini..
http://www.bharian.com.my/bharian/articles/MisteriEtnik_Disambutsenyumanukirankepalabinatang/Article

community??

 last night i was asked how to induce unwanted pregnancy by someone i used to closet. i just duno what to say. i'm quite shocked. her urine pregnancy test (UPT) were found positive. she just tell me that she was pregnant about 6weeks. i really sorry for her but i can't help much. she also still student just like me. but she study under goverment so she really will be punished because of getting pregnancy during studying. she just engage last year. she ask me what she should do. honestly i just have no idea. she then persuade me to tell her how to kill the fetus since i were studying nurse. my dear friend, i haven't taught or teach how to kill that poor fetus. we just taught n teach how to improve community's healthy life. if i teach you how to kill then what the point of mine to study this nursing course. for me, nursing is all about learning how to love the other person..

i really get stuck last night. are she going to kidding me or it is true?.. what should i say to answer her request? finally i just leave my que to my trusted clinical instructor. sorry la ar ms.i disturb u with my friends problem..anyway..thnx God. i just have an idea what exactly i should say to my friend after my CI gave the best answer. what my CI say was, 'u just ask her to go n c doctor. do not give her any advise because if she get misunderstanding than get severe complication than you will be blamed.let the doctor solve her problem'. ya ms..u are right. thanx 4 d advise. and still, i have to help her to find another best solution. i believe there's must something that can help us out of this trouble situation.

i pray to the Lord. Amen. 

p/s: yea, studying in nursing is not easy as we can see. its really challenge my faith.

anyway..i prefer to leave all my worries and difficulty in His hand. since He promised to care for me.thanx Lord.. (1 peter 5:7)

 this is the best website to do revision..all da best myself^^

http://highered.mcgraw-hill.com/sites/0070272468/student_view0/

next week will be the new semester..i'm going to sem6. the last sem actually. i don't know  what will happen n how it will b going. i just hope for the best. i do believe that this way was given by lord. even sometimes i can't stand strong i still have a hope that never fade. its because of presence of Lord Jesus in my life. thanx Lord..You never stop to pray for me.

Lord, why You choose me to b a nurse??

i believe You will answered me because You promised me to answer all my question (Jeremiah 33:3).

what i ask You Lord just now is a Spirit of wisdom and Spirit of strength..Thanx Lord 4 give me that Spirit.Amen^^

Prepare to Meet your God, Angelica Zambrano (23 Horas Muerta)

Prepare to Meet your God, Angelica Zambrano (23 Horas Muerta)

posting at PCU ward.

ni hari pertama dlm week terakhir posting d PCU for this sem. next sem is sem6. td bh kn, skit ja ni nursing care kmi dpt bt. bukn apa tp patient sy n kwn sy 2 seja sbb yg seorg bru ja discharge n seorg lg mw discharge. apapn sy enjoy la jga. kmi check medication stock td. 

td bh kna tnya ni apa 2 ubt dextamethasone. sy nda ingt ow..bila buka buku bru sy ingt blik.rupanya ubt 2 utk manage adrenocortical insufficiency. dia 2 corticosteroid tp long acting pnya. therapeutic effect dia ialh supression of inflammation and modification of the normal immune response.

lagi ubt ialah hyoscine N-Butylbromide a.k.a buscopan. ubt ni digunakan utk mengurangkan sakit perut (in medical word: control of gastric secretion).

slps rest td kn, ms kmi sempt share a little bit about nursing. bnyk dia c kongsi. tym dia bcrita 2 sometym kmi x rasa yg dia 2 tutor kmi tp lebih kpd kwn baik yg bg nasihat.. i love it. ms ckp, mw jdi nurse ni mmg bnyk cabaran. kna marah 2 perkara normal n dont ever take it too hard. sbnarnya dorang yg sllu marah kita 2 care for us. they didn't want us become useless nurse but a knowledgeable nurse. bh ylh kn..if teda yg tegur kita 2 kita pn xkn tw pa sbnar mslah kita. dorng pn x mw kna bg nursing care yg teruk if they fall sick one day.

tnpa sy sedar sy pn jadi peka atw sensitive tntg ksihatn n kbersihan berbanding sblm sy amk ni kos nurse. awal2 dlu mmg sy rasa mw jdi nurse ni satu penyeksaan ja sbb sy mmg x minat. tp sy percaya Tuhan ada rencana sendiri utk sy. He want me to serve the other people. Br. Derek ckp, studying of nurse means learn how to love and care for the other people. i deadly agree wif that. now i realize that this my calling. my passion is to care and make other people happy by give them comfortable no matter what type of care i gave. i guess la.sbb i will more happy when the people around me especially my loves happy with what i have done to them/ help them.. 

nurses are agents of changes^^

wow!! its awesome, wonderful, amazing, and passionate. that's all i can say about the retreat that held a retreat centre, Kionsom Inanam.

i gain a new experience about christian life through all activities. Thanx Lord. U are the greatest Master in this poor world.

the theme of the retreat was " Nurses agents of changes"..

this are some pictures;

 camp^^

candle within paper cup

that's why this camp called fire camp..^^

family photo^^

 

here we are..smiling faces..

God is always presents.. He never leave us.
studying of nurses is means learn how to LOVE the others.
remember!! To choose means to LovE^^

13 May

ptg ni p Kionsom..mw ikut 2 retret yg bertemakn nurses are agent of change..klu nda silap sy la..
harap2 smua berjalan dgn lancar jga.Amen^^

nurses Day celebration..

thanx Lord..smua aktiviti berjalan lancar td spt yg Engkau ingini. thnx sbb menghadirkn kwn2 yg bgi kerjasam serta mereka2 yg kami jemput..x sangka plan yg dibuat secara mendadak( plan yg hari 2) n hari 4 mlm kmi jalankan..thnx kpd smua yg terlibat sbb menjayakn nurses day celebration dgn baik..kmi percaya smuanya dtg dari kebaikanMu Tuhan.. kmi ada exchange gift kn, sy dpt tmpt pensil yg cantik..ni rupa dia..

lawa kn..sungguh bermakna^^

ni pla rupa 2 balang kaca bila kmi sdh siap masukkn stars n decorate it..lawa jga la.

haha org yg dapat teka jumlah bintang dlm balang ni lelaki..bh sabar ja la ko ar..knpa pla?? hadiah pemenang dia, termasuklah ni balang kaca yg ada bintang dlm dia..

that's all 4 2nite^^

health promotion??

next sem ada health promotion..2 weeks. what i didn't expect are, my name was accidentally swapped with another my friend. just because we have the same name. tp xpa la..mna tw sy dpt sstu yg sy x prnah trfkir sblm ni. klu dulu sy mw  sngt p sandakan tp skg hilang minat dh..sbb sy dh setkn minda yg nnt tym p health promotion d kota marudu ja...but now, TERpg d sandakan pla..k la,xpa.apa pn biarlh.mna tw ada sejarah terindah akan tercipta d sana haha..paris sandakan wait for me k..ahaha

again and..again..

finally paeds case study finished even though not yet completed. i just need to put the contents and my reflections. now..i'm going to continue my psychiatric cases study. hopefully 2moro night i could complete both of my case study (assigmnt)..otherwise gagal..ama..i don't want ow..punya penat ni.

last week i have planned to go back to my villages but i still have no time. i really miss my family at kampung..

hopefully next week i could go back freely. no doubt that being a student nurse is a challenges. now i'm yr 3 but i still not competence.. there's a lot of things to do..but i just can't manage my time sometimes.

next sem is the new story. i have to prepare it from now on. i know i can't do nothing without God. anyway, i have to go on.. i have my own mission. to get it, i must climb the mountain no matter how stiff it is.

13 June is first day of last sem.. 6th semester. community, critical care and management is the focus one.

anyway...all da best. just believe that God always within u q'ka^^.

my Saturday with case study^^

doing 2 case study in one time make me headache. pediatric case study will b finish soon(this evening i hope).then i will proceed to complete the psychiatric case study. 2moro is the busy time. 2moro is time for God n not for my assigmnt..Lord, give me a strength to go through all of this.

^^

OSCE (O&G) reflection..

finally O&G OSCE is over.. Thanx Lord for Ur assistance. i realize that i can't do nothing without U. i already done my best. whatever the outcome is, I present it to U. once again i discover my weakness. i just want to improve it but i duno how..before the exam, i already make a full preparation but when the OSCE's come, i become blur and i will act like i haven't practice it before.

i should improve my communication skills and the knowledge as well.ada ka patut sy jawab other source of calcium other than milk is leafy veges. saboo je la.. broccoli, dairy milk, sardines are supposed to be.

the day after exam(OSCE) one of my tutors ask me and 13 of my friends to demonstrate breast self examination (BSE) and give health education to our junior (yr1 student nursing) 5 students per group. i thought maybe we are the worst during exam that day that is why she ask us to demonstrate it once again. whatever the reasons is, i accepts it. i think my tutor want us to improve our self confident.

the next day (29/4/11), my tutor show us the feedback from our junior (just happened yesterday). what i didn't expect are the positives comments is reach 17 comments while the negatives is only 2 whereas the suggestion is 4. they suggest me to do more practices to prevent me to stuck to remember the next point, improves English Grammar (hahaha), and be relax during giving health education. 

thanx juniorku..your feedback really meaningful to me.. with your feedback, i can discover my weakness and realize my talents(haha knun la..) 

anyway thanx ms. sally and the junior^^..GBU.

my PEDIATRICS case study

i have choose TB meningitis with hydrocephalus. i found it was a difficult case for me coz i just duno how to elaborate this diagnosis. i think i have to plan it properly so that i can present it and the most important, i should understand what i'm going to do...

some my internet reference for this diagnosis.

http://www.meningitis.org/disease-info/types-causes/tb-meningitis

due date is on 3rd of May..Lord please guide me^^

Food sources for specific nutrients

nutrient
1.  potassium- main base ion of ICF (functional of nerves and muscle)
                 = bananas, broccoli, honey dew, meats, milk, nuts, pumpkin, sunflower seeds, tomatoes.




2. sodium- to maintain acid- base balance and functional in controlled of ECF volume
            = baking mixes( pancakes, muffin), barbecue sauce, butter/margarine, canned seafood, macaroni and    cheese, pickles, salt




3. calcium- for bones and teeth
           = broccoli, milk& dairy products, oysters, canned salmon/sardines, refried bean, tofu, spinach 




4. irons - essential component in the transfer of oxygen in the body.
        = cereals, dried beans & peas, leafy vegetables, lean red meats, organ meats




5. vitamin K- for blood clotting
               = asparagus, beans, broccoli, cabbage, cauliflower, green tea, milk, yogurt, spinach, mustard green




6. vitamin D - fat soluble vitamin that enhance the absorption of calcium and phosphorus from intestine
               = canned salmon, sardines, cereals, fish, fish liver oil, fortified milk.


7. Vitamin A, D, K = fat soluble vitamin.




references:
 Judith Hopfer Deglin & April Hazard Vallerand., Davis Drug's Guide for NURSES. 11 Edition.

Oral Contraceptive Pills (OCP)

for OSCE preparation^^

1. common type of OCP
    a) 21 pills (combined pills- oestrogen & progesterone) [available at]: http://www.patient.co.uk/health/Combined-Oral-Contraceptive-Pill.htm

    b) 28 pills (progesterone only)

2. indication: inhibit ovulation, change the vulva mucus/ovum, change the endometrium (implantation site can't  hold the embryo)

3. Contraindication: pregnant, DM

4. how/ when to take the pills?
    - take it at the first day of menstrual cycle (R: we are not pregnant that time). take continuesly until finish the pills.
- for 21 pills: take the pills everyday until pills is finished. then break for 7 days (1 week). during this week, menses are expected to occur. but if throughout the 7 days no periods, go to see doctor (in case u are pregnant).
if u have periods around the 7 days, than at the 8th days , continue to take OCP.

for 28 pills: its same as the 21 pills. but for 28 pills there is extra 7 pills. it means, we have to take the pills every day (rather than 21 pills, we can break for 7 days- during menses). but actually the another 7 pills that we eat after 21 days we take the pills has no any effect..

5. side effect: deep vein thrombosis, pigmentation at face

QUESTION..
> how if i forget to take the pills.
   a). a day - then the next day take 2 pills (1st pills @ am & 2nd pills @ pm)
   b). 2 days- the next day, take two pills n the next- next day take 2 pills also.
   c). 3 pills & > :go and see the doctor^^

HYPEREMESIS GRAVIDARUM

Hyperemesis gravidarum refers to persistent severe nausea and vomiting which results in dehydration, ketouria,    and possible weight loss. The exact cause is unknown. If left untreated, it can cause fetal death.


b. Nursing implications include the following:

(1) Record accurate intake and output to include emesis.

(2) Monitor intravenously (IV) solutions ordered by the physician.

(3) Record the patient's weight daily.

(4) Assess the patient for skin damage if dehydration is obvious.

(5) Implement prophylactic measures (lotions, massages, op-site) to prevent skin breakdown.

(6) Be alert to the psychological needs of the patient. She may be concerned about this crisis and of the results on herself and the fetus

source: obstetric and newborn care (from conception to newborn), sweetHeven publishing.(online). available at: http://www.waybuilder.net/sweethaven/MedTech/ObsNewborn/default.asp?iNum=20103.   

some revision about menstruation^^

menstrual cycle without OCP n With OCP..
try this link.it's really helpful..
http://cdn.pharmacologycorner.com/animations/sf.swf

health education of breast feeding..(malay version)

susu ibu sahaja (exclusive bf) : selama 6 bulan pertama(umur baby) & meneruskannya selama 2 thn.
makanan pelengkap perlu dimulakan selepas baby berumur 6 buln & >.

Faedah2 kolostrum
1. kaya antibody- melindungi bayi dari jangkitan & alahan
2. kaya sel darah putih- melindungi drpd jangkitan
3. kaya vit. A & E
4. faktor pertumbuhan- kematangan usus (reduce risk of nectrotizingenterocolitis (NEC)) 
5. sejenis laksatif_ mengeluarkan mekonium dan mencegah jaundis.




****to b continued***

psychiatrict nursing diagnosis

1. violence, potential related to panic state
    expected outcome:
                              1. patient maintain self control
                              2. patient reports feeling of losing control

2. violence, potential: self- directed related to suicide attempts
    expected outcome:
                               1. patient recovers from suicidal episode
                               2. patient discusses feeling that participated suicidal attempts
                               3. patient consult mental health professional
                               4. patient voices improvement in self- worth