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***