...Title: Pain, Coping and Sleep in Children and Adolescents with Sickle Cell Disease (Quantitative?) Abstract: Purpose The study examined the relationships among pain, pain coping, and sleep, and assessed factors (age, gender, frequency, and intensity of pain) that affect pain, coping, and sleep in children with sickle cell disease ( SCD). Methods Participants (66) were 39 children ( M = 11.5 years) and 27 adolescents ( M = 15.5 years) with SCD who completed an electronic visual analog scale ( eVAS), Pain Coping Questionnaire, and Pittsburg Sleep Quality Index. Results About two-thirds of the children reported pain the previous month. No significant differences were found between pain and age, gender, pain intensity, or frequency. Most children coped with pain by seeking information, problem solving, seeking social support, and positive self-statements. There were significant negative correlations in males between worse pain severity and behavioral distraction and internalizing or catastrophizing. The majority (91.2%) had mild to severe sleep disturbances, with 18.2% requiring sleeping medication three or more times a week. There were no significant differences between sleep and age, gender, pain intensity, or frequency. Conclusion Children with SCD experience pain that affects sleep patterns and the way they cope with pain. Nurses need to concurrently assess pain, coping, and sleep and promote sleep hygiene and positive coping strategies during pain episodes. Graves, J. K....
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...which require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly because of the risk of rupture leading to infection and inflammation of the intestinal lining (peritoneum) and eventual sepsis, clinically known as peritonitis which can lead to circulatory shock. Reginald Fitz first described acute and chronic appendicitis in 1886, and it has been recognized as one of the most common causes of severe acute abdominal pain worldwide. A correctly diagnosed non-acute form of appendicitis is known as "rumbling appendicitis". Appendicitis is most common between the ages of 5 and 40; the median age is 28. It tends to affect males, those in lower income groups, and, for unknown reasons, people living in rural areas. The term "pseudoappendicitis" is used to describe a condition mimicking appendicitis. It can be associated with Yersinia enterocolitica. acute appendicitis appendicitis of acute onset, requiring prompt surgery, and usually marked by pain in the right lower abdominal quadrant, referred rebound tenderness, overlying muscle spasm, and cutaneous hyperesthesia. chronic appendicitis 1. that characterized by fibrotic thickening of the organ wall due to previous acute inflammation. 2. formerly, chronic or recurrent pain in the appendiceal area, without evidence of acute inflammation. fulminating appendicitis that marked by sudden onset and usually death. gangrenous appendicitis that complicated by gangrene of the organ...
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...The most dangerous part of surgery has been around for many years. For some reason, the initial penetration using a tool called a Trocar has caused many complications with surgeries. The device is pushed against human tissue during laparoscopic surgery until it stabs all the way through the skin, very similar to drilling into a wall. Once the trocar has been pushed all the way through the skin, there is a high risk of damage that could be caused on the internal side of the skin. Nikolai Begg has redesigned the trocar to cause less harm to the internal parts of the human body. His design has a retractable blade that retracts into the device once the pressure of pushing on the skin is relieved. The blunt sheath the blade retracts into keeps...
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...concerns of short-term mortality and long-term morbidity after aesthetic surgery. The present case report describes a 42-year-old female who survived after an episode of bilateral PE after undergoing an elective abdominoplasty. A literature review was conducted to explore the prevalence, pathophysiological presentation and use of prophylactic practice among plastic surgery patient to prevent...
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...of the appendix (Peate, 2020), leading to serious complications such as peritonitis, abscess formation or adhesions (Waugh & Grant, 2018). Normally located in the abdominal right lower quadrant, the appendix can become inflamed due to the accumulation...
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...Introduction: Despite the many advantages associated with laparoscopic surgery such as reduced postoperative pain, faster recovery to baseline functional status, and shorter hospital stays, there remains significant complications and risks related to this approach. The majority of operative complications related to laparoscopy include subcutaneous emphysema, gas embolization, bowel or bladder perforation, pneumothorax, pneumomediastinum and acute hemorrhage. Reported events of perforated abdominal organs range from 0.5-2.2% in all cases. Injuries to the bladder and ureters remain rare complications of laparoscopy. We report a very rare complication of laparoscopy that involved insufflation of the bladder. There are very few case reports...
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...Draft of Intern’s Project Penetrating Abdominal Injuries at Georgetown Public Hospital Corporation (GPHC). Investigator: Hemraj Ramcharran Supervisors: Dr Shilendra Rajkumar Dr Madan Rambaran Abstract Many cases of penetrating abdominal injuries present to the Georgetown Public Hospital all of which are managed by the department of Surgery. No audit has been conducted on the management of these injuries and their success rates. Hence this prospective study “Penetrating abdominal Injuries at Georgetown Public Hospital (GPHC)” seeks to shed some light in these areas in terms of percentage of abdominal injuries managed surgically or conservatively and diagnostic adjuncts used in the management of these patients. Studies done in other countries clearly show that there is a steady and progressive movement away from surgical management of penetrating abdominal wounds towards conservative management. The study is a prospective one that will extend over the period (April 01 – Sept 31). The study population will consist of persons over 12 years old and admitted for penetrating abdominal injury. Data will be collected by means of a form shown in appendix 2. This form has three parts which are biodata, immediate management and subsequent management. These forms will be in the accident and emergency room and the surgical wards. On admission of the patient, the on call surgical GMO or Intern will fill out the...
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...RATE OF DEVELOPMENT OF INCISIONAL HERNIA ONE YEAR AFTER URGENT MIDLINE LAPAROTOMY Abd-El-Aal A. Saleem1, Hassan A. Abdallah1, Osama A. Abdul Raheem1, Mohamed Yousef A1. 1 Department of General Surgery, Faculty of Medicine, Aswan University, Aswan, Egypt. Correspondence to Abd-El-Aal A. Saleem, MD, Department of General Surgery, Faculty of Medicine, Aswan University, Aswan, Egypt. Tel.: 0934608283 - 01001203179 e-mail:dr.abdelaal@yahoo.com ABSTRACT OBJECTIVE To determine the rate of development of incisional hernia six months and one year follow up in patients suffering from peritonitis ( potentially septic wounds) and other patients suffering...
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...is characterized by diarrhea (up to 20 stools during acute exacerbation), crampy abdominal pain, and exacerbations (“flare-ups”)/remissions. B. Pathophysiology Ulcerative colitis usually starts in the rectum and moves in a continual fashion toward the cecum. Although there is sometimes mild inflammation in the terminal ileum, ulcerative colitis is a disease of the colon and the rectum. The inflammation and ulcerations occur in the mucosal layer, the inner-most layer of the bowel wall. Since it does not extend through all bowel wall layers, fistulas and abscesses are rare. Water and electrolytes cannot be absorbed through inflamed mucosa. Diarrhea with large fluid and electrolyte losses is a characteristic feature of damage to the colonic mucosa epithelium. Breakdown of cells results in protein loss through stool. Areas of inflamed mucosa form pseudo-polyps, tongue-like projections into the bowel lumen. C. Common signs & symptoms or clinical manifestations The common signs of ulcerative colitis include diarrhea, bloody stools, weight loss, abdominal pain, fever and fatigue. It is considered a chronic disorder a chronic disorder with mild to severe acute exacerbations that occur at unpredictable intervals over many years. The primary manifestations of ulcerative colitis are bloody diarrhea and abdominal pain. Pain may vary from the mild lower abdominal cramping associated with diarrhea to the severe, constant pain associated with acute...
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...factors, clinical manifestations, and management of thoracic and abdominal aneurysms, venous insufficiency, venous stasis ulcers, PAD, acute arterial ischemia. (be sure to know the difference in venous and arterial disease!) PAD (thickening of the artery walls, which results in the progressive narrowing of the arteries of the upper and lower extremities) -risk factors: tobacco use (most important), hyperlipidemia, elevated high sensitivity C-reactive protein, diabetes (occurs much earlier), uncontrolled hypertension, increases with age, African Americans, 2 times higher in Mexican/Hispanic American women then white women -PAD is a marker for advanced systemic artherosclerosis** -atherosclerosis is the leading cause** -these patients are more likely to suffer from CAD and cerebral artery disease -artherosclerosis= migration and replication of smooth muscle cell, deposition of connective tissue, lymphocyte and macrophage infiltration, and accumulation of lipids -clinical symptoms occur when the vessel is 60 to 70 percent occluded Thoracic and Abdominal aortic aneurysms -aneuryisms happen more in men than women, increases with age - most occur as abdominal aortic aneurisms -thoracic= often asymptomatic, chest pain extending into interscapular area (most common symptom), hoarseness, dysphagia -abdominal= often asymptomatic, abdominal pain, back pain, pulsatile mass pre-umbilical and slightly to the left -abdominals a. are caused by artherosclerosis (male gender, over 65, high...
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...disease is an inflammatory bowel disease, (IBD), named after an American gastroenterologist, Dr. Burill B. Crohn. This debilitating disease was further investigated by Dr. Crohn when an Italian physician Giovanni Battista Morgagni in 1969 diagnosed a young man with chronic diarrhea. Because of its symptoms, Crohn’s disease is often misdiagnosed, and conditions for patients only become worse. In 1913, Scottish physician T. Kennedy Dalziel reported nine cases in which patients were suffering from intestinal obstructions. This physician closely examined the patients inflamed bowel and found a characteristic of Crohn’s as describe by Dr. Crohn. The bowel had transmural inflammation with abdominal cramps, fever, diarrhea, and weight loss. This disease was affecting typical young adults in the 1920’s and 1930’s. After several other findings reportedly being documented, Dr Crohn and his colleagues presented a paper on terminal ileitis describing the symptoms and findings of Crohn’s disease to the American Medical Association on May 13, 1932. The findings were given significant recognition, making it the fist time this condition was familiarized with the public in a widely-read journal. Crohn’s disease, also known as granulomatous enteritis and colitis, is an inflammatory disease that can affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms. Most of these symptoms however include abdominal pain, diarrhea which could be blood if inflammation...
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...Transpyloric tube placement or placement into the jejunum is used when physiologic condition warrant feeding the pt below the pyloric sphincter. Special Indications – anorexia, orofacial fractures, head and neck cancer, neurologic or psychiatric conditions that prevent oral intake, extensive burns and those who are receiving chemotherapy or radiation therapy. Procedure for tube feeding 1. Patient position – 30-45 degrees position. Head remain elevated for 30-60 mins 2. Patency of tube – Tube should be irrigated with water before and after each feeing to ensure patency. 3. Tube Position – Placement of tube is checked before each feeing or every 8 hours with continuous feeings. Checking methods; aspiration and pH. 4. Formula 5. Administration of feeding – feeing are given either by gravity drip method or by feeding pump. 6. General Nursing Considerations – daily weight, accurate I’s and O’s. Blood glucose check. Complication Related To tube and feeding - Vomiting and or Aspiration - Diarrhea - Constipation - Dehydration ---------------------------------------- Central PN – is indicated when long term parenteral support is necessary or when the patient has high protein and caloric requirements. Peripheral PN – is used when; - nutritional support is needed for only a short time - protein and caloric requirement are not high. - The risk of a CPN is...
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...hormones while the fallopian tubes provide passage for the eggs from the ovaries to the uterus. The cervix is the lower end of the uterus that joins the vagina. Unfortunately, with a hysterectomy part or all of the reproductive organs will be removed, leaving the patient unable to bear children. If the patient has not yet reached menopause by the procedure and she keeps her ovaries during the hysterectomy, she may enter menopause at an earlier age than most women. If the ovaries are removed during the hysterectomy, the patient will enter menopause. You can talk with your doctor about ways to manage menopausal symptoms, such as hot flashes and vaginal dryness. [ (Edward L. Trimble) ] Hysterectomies are the second most frequent operation (after cesarean section) performed on adult American women; it has been estimated that one-third of them undergo the procedure by age 60 [ (Keshavarz H) ] The most common reason hysterectomy is performed is for uterine fibroids. Uterine fibroids (also known as uterine leiomyomata) are benign growths of the...
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...Tabor College Wichita Instructor: Marlene Pietrocola NUR 410: Evidence Based Nursing Practice January 25, 2015 I chose the article titled “The effect of nurse-performed preoperative skin preparation on post-operative surgical site infections in abdominal surgery”. This quantitative research article is an experimental study to determine the effect of preoperative skin preparation procedures by nurses on post-surgical site infections in abdominal surgeries. The research question that the authors Dizer et. al are asking is if pre-operative skin preparation will decrease the risk of post-operative skin infections in abdominal surgeries. This study was based on previous research done that states pre-surgical skin cleansing with antibacterial agents greatly reduce the risk of infections. This study is to provide more evidence to support its use into nursing practice. The research design was experimental in that there was an intervention; preoperative skin preparation, a sample group that received the intervention and a control group to compare the sample group to. The methods used to answer the question were that the experimental subjects of the study were 272 patients that had been hospitalized and underwent abdominal surgery during a specified time period. The population of patients that made up the two groups met certain criteria for the study, and then were randomly separated into the sample and control groups. In the control group of patients; the amounts of wound...
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...Side effects can include headache or abdominal pain. Imodium—2mg one capsule after each episode of diarrhea, not to exceed 8mg daily. Side effects can include bloating, constipation, loss of appetite, and stomach pain (severe) with nausea and vomiting. After initial chemotherapy and surgery were completed Mya continued on maintenance medications which included: Anastrozole—1mg daily—to block estrogen production in the adrenal glands, she will continue this medication for the recommended 5 years after initial treatment. Side effects can include Constipation, diarrhea, nausea, vomiting, upset stomach, loss of appetite, body aches and pains, breast swelling/tenderness/pain, headache, dry mouth, scratchy throat, increased cough, dizziness, trouble sleeping, tiredness/weakness, flushing and sweating (hot flashes/hot flushes), vaginal bleeding, hair thinning, and weight change can occur. Vitamin D—50000units weekly—to increased vitamin d Most people do not commonly experience side effects with vitamin D, unless...
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