M.S.N.:-1-2019

2019 PAPER SOLUTION

Q-1.a. What is Acute Renal Failure? What is acute renal failure? 03 This is a kidney disease in which kidney function suddenly decreases or stops for some reason. It is called acute renal failure. In this condition, due to reduced kidney function, the waste product is not removed from the blood and it accumulates in the blood itself.

B. b. Write down clinical manifestations of Acute Renal Failure. 04

Write the signs and symptoms of acute renal failure. Following symptoms are seen in ARF-

• Protein in the urine (proteinuria)
• Blood pressure first falls and then rises.
• (Hypertension followed by initial hypotension)
• Irregular heartbeat (cardiac arrhythmia)
• Excess fluid in the body. (Hypervolemia)
• Cystic edema
• Decreased urine output or no urine (oliguria and anuria)
• Low amount of sodium in the body (hyponatremia)
• Increased amount of potassium in the body (hyperkalemia)
• Itching all over the body
• (systematic pruritis)
• Pulmonary edema
• Anorexia
• Nausea, vomiting
• Hematemesis
• Uremic breath
• Paler
• Caesar
• headache
• Kusumal Breathing

C. Describe nursing management of a patient having Acute Renal Failure Describe the nursing management of a patient with acute renal failure. 05

a.pain :–

■ Analgesic drugs are administered to the patient as per the doctor’s orders.

The patient should be given proper position.

Other antibiotics should also be given to the patient at appropriate times

In case of severe pain, the doctor should be notified immediately and opioids should be given if ordered.

b) Fever:-

• The patient’s body temperature should be checked
• Antipyretics should be given to the patient if there is high fever.
• If the patient feels cold, an extra blanket should be given
• A wet cloth should be kept on the patient’s head.

c) Anxiety:-

• The patient should be treated with courtesy
• Patient and their relatives should be informed about the hospital and ward setup.
• If possible, a relative should be allowed to stay with the patient at all times
• All patient questions should be answered calmly and positively

D) Body fluid overload or electrolyte imbalance :-

• Antiemetics should be given for vomiting
• The patient should be examined for overhydration and edema and the severity of edema should be monitored.
• Administer diuretic drugs to patient as per doctor order
• The patient should be encouraged to drink small amounts of fluids
• The patient’s daily body weight should be checked and recorded
• The level of pitting edema in the patient should be recorded
• A patient intake and output chart should be maintained.

E) Altered Nutrition less than body requirement :-

• Based on the patient’s age, weight and blood glucose level and also calculated according to the nutritional requirements and should be encouraged to take diet accordingly.
• The blood glucose level of the patient should be checked regularly
• The patient should be given the following diet
• High calorie
• Low protein
• Low salt or no salt
• Low fluid
• The patient should be given vitamins and iron supplements.

F) prevent complication:-

• Regular observation of the patient should be done.
• Patient’s TPR and BP chart should be maintained
• The patient’s problem should be listened to carefully and signs of complications should be noted.
• If any type of complication is found in the patient, the doctor should be informed immediately.
• An emergency medicine tray should always be kept ready with the patient

G) Restlessness:-

• The patient should be given a comfortable position.
• Give oxygen therapy if the patient has difficulty breathing
• Diuretic medicines should be given to the patient only in the morning and afternoon. Should not be given in the evening and at night because of which, the patient may experience nocturia due to which the patient cannot sleep.
• If the patient has a catheter inserted, it should be kept in the correct position and the insertion site should be kept clean.

H) Unhygienic conditions:-

• Diapers should also be given to the patient if necessary
• The patient should be assisted in maintaining personal hygiene.
• Seasonally appropriate water should be made available for bathing.
• Perform oral care if the patient is unable to perform oral care himself
• If necessary, give a bed bath

Additional Information :-

Types of acute renal failure :-

1) Pre-renal failure: In this condition, the blood supply to the kidney decreases. Due to which the efficiency of the kidney decreases.

2) Intrinsic renal failure :- In this kidney damage begins and acute tubular necrosis is seen.

3) Post renal failure :- No outflow of urine from both the kidneys stops and the kidneys stop working.

Etiology (Cause) :-

• The causes of pre renal failure are as follows.
• Hypo volemia
• Renal thrombo-embolism
• Severe hemorrhage
• Cardiovascular disorders
• Ascites
• Profuse burns
• mourning
• Auto immunodisorder
• Haemolytic disorders

2) The causes of intrinsic renal failure are as follows.

• Glomerulonephritis
• Systematic lupus erythematosus
• Sickle cell anemia
• Renal vein thrombosis
• Renal cancer
• Nephrotoxin overdose
• Pyclonephritis

3) Causes of postrenal failure are as follows

• Renal stone or renal calculi
• Renal papillary necrosis.
• Renal tumor
• Benign prostatic hyperplasia
• Stichure urethra
• Prolong catheterization
• Diagnostic Evaluation:-
• History taking
• Physical exercise
• Urea, creatinine, potassium
• The level of nitrogen is found to be higher
• When pH, sodium, bicarbonate, hemoglobin decreases.
• Renal ultrasonography
• KUB
• Renal scan
• Nephrotomography
• Renal biopsy
• like this. R. eye.

Medical management:-

• Acute renal failure can be cured by quickly diagnosing and treating the cause.
• Management has the following characteristics:
• Finding the cause of the problem
• Reducing renal damage
• To repair the damage that has been done.
• To reduce hypervolemia from the body
• If there is an obstruction, surgery is done.
• Antibiotics are given if there is an infection. Like Norfloxacin, Piperacillin
• Diuretic drugs are given to the patient to reduce fluid overload.
• DAT:- Frusemide, Thiazide, Mannitol
• IV to correct the electrolyte im balance in the patient’s body. Fluids are given but in very small amounts.
• Catheterization if necessary
• Antipyretics, antiemetics are also given to the patient

Special point :- Dynapar or Vovran injection should never be given to a patient in this condition.

Hemodialysis :- If medical management is not effective, the patient is also treated with dialysis in which urea, creatinine and excess waste products are removed from the body.

Peritoneal dialysis:-A saline infusion is infused into the patient’s peritoneal cavity and then re-drained. Because of this, waste products are released from the body.

OR:-

Q.1 a. What is Parkinson’s disease? What is Parkinson’s Disease? 03

Definition:– This is a disease in which the level of dopamine decreases due to which there is obstruction of nerve impulse transmission and this is a neuro degenerative disorder. In which the following symptoms are seen

• Tremor
• Muscle rigidity
• Akinesia
• Amnesia

Q.1 B.Write down clinical manifestations of Parkinson’s disease. 04 Signs and Symptoms of Parkinson’s Disease :-

• Muscle rigidity
• Brady kinesia or akinesia
• Postural instability
• Tremor
• Hypotension
• Urinary incontinence
• Myalgia
• Dysphagia
• Mask like face
• Amnesia
• Closed eyelids
• High pitched voice

Q.1 C) Describe pathophysiology of Parkinson’s disease. 05 Briefly describe the pathophysiology of Parkinson’s disease

Because of the risk factor

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Due to which dopamine cells are destroyed.

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So that there is a deficiency of dopamine

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Abnormal conduction of brain impulses or abnormalities in brain signals

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So poor muscle tone, abnormal movement, or slow movement is seen.

Additional Information:-

Cause of parkinsonism:-

• Brain infection
• Encephalitis
• Meningitis
• Head injury
• Old Age

Diagnosis :-

• History taking
• Physical Examination
• Blood examination
• Urine analysis
• Dopamine levels
• CT scan
• Check the symptoms

Medical management:-

• Levodopa or carbidopa is given to the patient
• Anticholinergics are given if levodopa does not work
• Anti-histaminic and anti-viral medicines are also given

Nursing management :-

Impaired Respiratory Function :-

• Giving high fowler position
• Give steam inhalation if necessary
• Check SPO2 and give oxygen if less than 85
• If the patient is unconscious, suction should be done if necessary

Anxiety:-

• A quiet environment should be provided to the patient
• An IPR should be maintained with the patient
• If possible, let another similar patient stay with him
• Prior to any procedure the patient should be informed so as to minimize their anxiety

Fluid electrolyte imbalance:-

• IV infusion should be given as per doctor order
• To maintain intake and output chart
• If necessary, give blood transfusion as per doctor’s order
• If needed, give electrolyte as per doctor’s order

Inadequate Nutrition:-

• If there is no contraindication in the patient then give high protein and high calorie diet
• Iron supplement should be given to the patient
• Vitamin supplements are also given to the patient.
• Teeth :- vit b complex
• Administer mild laxatives to relieve constipation

In Adequate Rest :-

• Position the patient comfortably
• The patient should be encouraged to get enough sleep
• Use dim light while sleeping at night
• Providing a quiet environment while sleeping at night
• Sedation can be given if needed.

Q 2. a. Describe special considerations in care of elderly.:- 08 Describe special considerations for the care of elderly persons.

1) Promotion of Self Respect and Dignity:-

• Some institutes or groups usually have some restrictions on individual choice and freedom.
• The feelings and emotions of older persons should be respected.
• When staff make positive efforts to develop good relationships with patients and earn their personal respect and friendship.
• By cultivating good relationships, the group can be controlled and difficult situations can also be made easier.

2) Promotion of Comfort:

Relaxation is essential for physical and mental comfort There are many factors that contribute to the comfort of the elderly such as skin care, care of bony structure, maintaining temperature and fluid balance.

3) Safety:–

Arranging unpolished floors, good lighting, proper bed height, proper walking equipment

4) Daily Living Activities:-

Encourage the patient to do as much daily activity as possible to avoid complications such as dehydration, thrombosis, pressure sores, contractures, etc.

5) Promotion of independence:-

Encourage the patient to self-care as much as possible and ask him to make his own decisions.

• 6) To encourage mobility and movement
• 7) Asking to take necessary medicines and giving enough knowledge about those medicines like side effects of medicine, its use.
• 8) If the patient is rehabilitated according to his condition.

Additional Information:-

Skin care :-

• Mild soap should be used
• Bath should be taken once or twice a week
• Daily hair care and brushing
• Use moisturizers
• Nails should be kept short
• Use sunscreen, hat, long sleeve clothes
• Avoid things like hot water bottles.
• Sufficient attention should be paid to the footwear so that sores do not occur
• Avoid Sun stroke

Supporting Changes in Bones and Joints:–

• Light exercise should be done
• Not to fall
• Take precautions
• Give a balanced diet including calcium and vitamin D supplements
• If the patient is in pain, monitor him and give him appropriate treatment
• Give the patient more time as they may take longer to work.

Supporting Changes in Vision:-

• Proper lighting should be provided to the patient
• If necessary, the patient should be assisted in choosing clothes
• A natural tear product should be used.
• The patient should be contacted directly.

Supporting Changes to Hearing:-

• Excess noise should be reduced while conversing.
• Putting oneself in the patient’s place so as to understand the patient’s needs
• Before speaking, make sure that the person’s attention is on you.
• Get checked by a doctor and get the wax removed if necessary
• Arrange hearing assessment and provide hearing aid if required.

5. Supporting Changes in Smell and Taste :-

• Attractive mills should be prepared in which to make good smelling food.
• Spoiled food should not be given to eat

6. Supporting Changes in the Cardiovascular System:-

• People tire more easily due to cardio vascular changes so they should be given more rest.
• Regular blood pressure monitoring should be done as per healthcare professionals
• If the person is unable to move on their own, they should be changed position frequently
• Ask to drink plenty of fluids and seek immediate medical help if the patient is dehydrated.

7. Supporting Changes in the Respiratory System:-

• Short term activities should be planned
• More time is required for rest.
• If the person is unable to move on their own, they should be changed position frequently
• If a person has a persistent cough during or after a meal, ask them to consult a doctor
• Keeping body alignment and position proper
• Stay away from polluted air
• Give oxygen therapy if needed

8.Digestive Care:-

• Maintain oral hygiene
• In case of tooth damage, get proper treatment
• Providing a comfortable environment for eating
• High fiber, high protein food with different taste and texture should be given.
• Ask to take more fluids
• Giving calcium and vitamin D supplements to prevent osteoporosis

9.Supporting Changes in Elimination:-

• Maintaining daily activities
• Plan for a washroom when going out
• Reduce caffeine intake
• Fiber should be taken in plenty
• Light exercise should be done
• Provide emotional support.
• Everything should be given according to need.

10. Urinary Care:-

• Fluid intake should be increased
• Reduce fluid intake before bedtime
• Clothes that can be easily removed should be worn
• Using an absorb pad

11. Elderly care at home:-

• If there is a wound, it should be taken care of and regular dressing should be done
• Monitoring vital signs and administering medicine on time.
• If the patient has pain or feels any kind of discomfort then manage it
• Helping to meet daily hygienic needs.

Q.2 b. What is Halitosis? Write down causes of Halitosis. 04 What is halitosis? Write the causes of halitosis

Definition:-

• Halitosis means bad breath.
• Some things like oral cavity diseases or inflammatory conditions of the mouth cause bad breath. But if the smell of the mouth does not go away, then they have the disease of halitosis which can affect other parts of the body as well.

Causes of halitosis:-

• Poor oral hygiene
• Harmful bacteria
• Dry mouth
• Head and Neck Cancer
• Tonsil stone
• Gum disease
• Nose, Throat and Lungs Infection
• Diabetes
• Liver disease
• Kidney disease

Additional Information:-Signs and symptoms of halitosis include bad breath.

PREVENTION:-

• Brushing should be done twice and that too for at least 2 minutes and tongue scraper should be used to clean the tongue.
• Alcohol free mouth wash should be used
• Have a regular check up with the dentist
• Drink more fluids to avoid dry mouth
• Sugar free chewing gum should be eaten to boost saliva
• Alcohol, caffeine, and tobacco should be avoided

OR

Q.2 a. Define immunity and explain types of immunity. 08 Define immunity and explain its types.

IMMUNITY :- Immunity is the chemical power present in the blood of every person which has different individual power to resist the infectious disease. Or

Immunity is the ability of an individual to resist infectious disease and infection.

There are two types of immunity in which . Innate immunity and acquired or adaptive immunity.

Classification of Immunity:-

A) Innate Immunity –

(a) Species Immunity

(b) Racial Immunity

(c) Familial Immunity

(d) Inborn Immunity

(e) Individual Immunity

(B) Acquired Immunity:-

(1) Active Immunity –

(A) Natural:-

• Attack of Disease
• Inoculation

(B) Artificial

• Vaccine
• Toxoide

(2) Passive Immunity:-

(A) Natural

• Placental
• Colostrum

(B) Artificial

• Antiserum
• Modified Toxin

Innate immunity:-

• Innate Immunity means resistance to disease acquired from birth. which is received from parents. which provides lifetime protection.

• A person has innate immunity based on his genetic and constitutional makeup. Because it is not stimulated by specific antigens, innate immunity is usually non-specific. It is different from acquired immunity and is also called natural immunity.

Active Immunity:-

• The natural adaptive immune system is formed when a person is exposed to a live pathogen and provides a primary immune response when disease occurs.

• Artificially acquired active immunity is given intentionally by antigen-containing substances known as vaccines.

• The antigen present in the vaccine stimulates a primary response against the antigen even in the absence of any disease symptoms. Active immunity provides permanent immunity and the body is protected from disease for its entire life.

Active Immunity is produced when a person comes in contact with a pathogen.

• The body then produces antibodies against that antigen.

• In this way specific immunity is generated for a particular disease. E.g. Typhoid, chicken pox or measles

• Immunity can be acquired either by infection with a pathogen or by vaccination. Active immunity may last a few weeks to a few months but may last a lifetime.

Passive Immunity:-

• Artificially acquired passive immunity is a short-term immunity to diseases introduced into the body by direct injection of antibodies. And this is not produced by the recipient cell.

• Naturally acquired passive immunity is the transfer of immunity from parent to child. During this pregnancy, the mother’s antibodies enter the baby’s bloodstream.

• Due to this immunity, fits are protected from harmful substances.

• Passive immunity is also provided to the fetus due to IgA antibodies present in breast milk. which protects them against intestinal bacterial infections.

• Passive immunity is not permanent it is temporary.

Additional Information:-

ALTERED IMMUNE RESPONSE:-

When the body’s immune system recognizes the active foreign particle, it is called immunity. Hypersensitivity diseases such as allergies and auto-immune diseases occur when the immune system overreacts.

Hypersensitivity Reactions:-

Hypersensitivity reaction means that the body overreacts when a foreign antigen enters the body or cannot maintain self-tolerance so that the tissue is damaged.

Autoimmune disease begins when the body’s immune system reacts against its own antigens.

Classification:-

Type I, II, III are types of hypersensitivity antigen-antibody reactions. And this is the type of humoral immunity. Type IV is the type of delayed hypersensitivity.

And this is antigen-lymphocyte reaction and cell mediated response.

1. Type I – IgE Mediated Response:-

Type 1 is anaphylactic reaction (Hypersensitivity). This is seen in individuals who are sensitive to specific allergens:- Type 1 is seen in those who are highly sensitive to bee or wasp venom, drugs.

And the body produces IgE in response to the allergen, which is accompanied by mast cells and basophils

Allergic symptoms:-

• Hypotension
• increased secretions of mucous,
• itching,
• allergic rhinitis (hay fever), allergic conjunctivitis
• Hives and anaphylactic shock are common reactions.

2. Type II cytotoxic hypersensitivity:- Type II reaction is caused by an exogenous antigen. In this, the normal structure of the body that the body perceives as a foreign body is called cytotoxic hypersensitivity.

The reason for this may be cross reactions of antibody. As a result cell and tissue damage is seen.

In this the IgG or igM antibody wraps around the cell. As a result, an antigen antibody reaction occurs and destroys the cell to which the antibody is bound.

This type of reaction is seen in Myasthenia gravis, hemolytic anemia, Rh-hemolytic disease of newborn, thyroiditis.

3. Type III Immune Complex Mediated Hypersensitivity:- This type of reaction occurs when the antigen binds with the antibody and forms an immune complex.

This type of reaction is seen in systemic lupus erythematosus and rheumatoid arthritis.

4.Delayed Type (Type IV) Hypersensitivity:-

This hypersensitivity is also known as cellular hypersensitivity. This cellular hypersensitivity is seen 24 to 72 hours after exposure to the allergen.

Tooth :- Contact Dermatitis

Its symptoms include redness, itching, and thickening of the part exposed to the antigen.

Q.2 b. Explain the role of a Scrub nurse in Operation Theater. 04 Explain the role of scrub nurse in operation theatre.

Responsibilities of a scrub nurse:-

• Welcome patient
• Preoperative nursing assessment
• Checklist before scrubbing
• Scrubbing in
• Assembling instruments, counting before surgery

1)Welcoming patient:-

• Welcoming the patient
• Give your own introduction
• Obtaining the patient’s personal information
• Ask if the patient needs anything or help
• Giving information about the surrounding environment
• Removal of patient’s jewelry

2) Preoperative nursing assessment:-

• Ask about the patient’s age, any allergies and any present infections.
• To check patient’s vital signs
• Ask if any medication is on, such as heparin, warfarin,
• Viewing nutritional status
• To check all patient reports

3) Checklist before scrubbing

• Checking the conset of the patient
• Conform about the surgical procedure
• To check instruments
• Check supply

4) SCRUBBING IN”:-

• Wash hands and arms regularly with antibacterial soap. Then wearing a sterile mask, cap, gown and gloves to avoid infection when coming into contact with the patient’s body during surgery.

5) ASSEMBLY INSTRUMENTS

• Open the inner sterile set and place the sterile instruments on the myo tray and trolley
• Counting all
• Place the surgical blade
• Prepare the suture

6) ASSISTANCE DURING SURGERY:-

• Provide equipment to the surgeon in proper condition and safely
• Pass the scalpel into the kidney dish
• Keep the skin knife away from the working area

7) Assistance during surgery:-

• Retract the tissue if necessary
• Remove the arterial tip as directed by the surgeon
• Cut the suture with scissors and help in suturing
• Help in the coterie
• Keep tools, sutures, sponges ready before surgery
• Keeping the sterile field clean
• Maintaining streak aseptic technique
• Reduce talking and go to the side if sneezing or coughing occurs

8) End of procedure:-

• Counting sponges, sharp instruments when the surgeon completes the operation
• Dressing the wound with non-touch technique
• Cover soiled instruments before placing in autoclave
• To remove gown and gloves.

Q.3 Write Short Answers (Any Two) Write short answers. (Any A)

Q .3 a. Describe nursing management of pharyngitis, 2X6=12 Describe nursing management of pharyngitis.

Following is the nursing management of pharyngitis, an infection of the pharynx.

1) Increase fluid intake:- Fluids such as water, juice, tea, and hot soups help replace fluids lost during mucus production or fever. Avoiding substances like alcohol and caffeine which can cause dehydration.

2) Gargle with warm salt water:- Mix 1/2 teaspoon of salt in a full glass of warm water, gargle and then spit out the water. This will remove the mucus from the throat and make the throat smooth.

3) Use honey and lemon:-

• Stir in a glass of very hot water with honey and lemon to taste, let cool to room temperature before drinking.
• Honey makes the throat smooth. Lemon reduces mucus.

4) Suck on a throat lozenge or hard candy :-

It stimulates the production of mucus, and clears the throat.

5) Humidify the air:-

Adding moisture to the air prevents mucous membranes from coming off. This can reduce inflammation and make it easier to fall asleep

6) Avoid smoke and other air pollutants:-

Smoke irritates the throat. Stop smoking and stay away from all fumes from household cleaners and paints

7) Rest your voice.:-

If the voice box (larynx) is affected due to sore throat, talking can cause irritation and laryngitis.

8) Avoid infecting others:-

If you are not feeling well, stay away for a few days and cover your mouth when you cough or sneeze to avoid spreading germs to others.

Additional Information:-

Pharyngitis:-

Pharynx is called an infection.

TYPES OF PHARYNGITIS:-

1) Acute pharyngitis:-

• Usually caused by a viral infection. Today viral infections also cause common cold.
• Symptoms of acute pharyngitis usually last a week or less.

2)Chronic Pharyngitis :- This causes constant sore throat. Symptoms of chronic pharyngitis last longer than those of acute pharyngitis.

Etiology:-

• Bacterial pharyngitis
• Viral pharyngitis
• Oral thrush
• Cold and flu
• Allergy
• smoking
• Chemical irritant

Clinical Manifestation:-

• Sore or red throat
• Feeling of lump in the throat
• Fever
• headache
• Ear pain
• Swelling of the gland
• Swelling of the lymph gland
• Difficulty breathing
• Difficulty speaking or swallowing

Diagnostic Evaluation:-

Throat swab culture

Management:-

• Giving Antibiotics Therapy
• Give corticosteroids
• Give Antifungal Agents
• Giving Pain Medications

Q .3 b. What is disease? Write about causes of disease. What is disease? Write the causes of disease.

Concept of disease :- (Concept of disease)

• This is a medical term. In this, there is a change in the structure and function of the body and the capacity of the body decreases.
• W.H.O has given the definition of health but not given the definition of disease because many spectrum of diseases are seen in diseases.
• Any type of change in the body due to injury or infection in its normal structure or function is called a disease.

Cause of disease :-

• Diseases are abnormal conditions. It is a medical condition with specific signs and symptoms.
• This is usually due to external factors such as infectious diseases or due to internal dysfunction.

Mechanical Cause:-

In mechanical causes, body structure is damaged, and this is seen due to trauma and excessive temperature.

Biological Causes:-

Biological causes of disease affect the body functions which include genetic defect, infection, alteration of immune system, alteration of normal organ secretion.

Normative Cause:-

Normative causes are psychological in which body and mind interaction is involved. Physical manifestation is seen due to psychological disturbance.

Nutritional Causes:-

• The main cause of disease
• There is nutritional deficiency.

Environmental Causes:-

According to some researchers, many environmental factors are responsible for causing the disease. Like chemicals, dust, pollution,

Additional Information:-

Theory of disease causation :-

Germs theory of disease:-

According to the germs theory, disease is caused by the presence of different micro-organisms in the body and their action.

Disease agent —- Man——-disease

Epidemiological Triad :-

The traditional model of the causes of infectious diseases is called epidemiological triad. Epidemiological triad includes agent, host and environmental factors.

Agent:- Agent is the first step in the chain for spreading the disease.

Agent means any living or dead thing that causes disease whether it is present or not is called agent.

A. Biological agents- including viruses, bacteria, fungi, protozoa

B. Nutrient agents include protein, fats, carbohydrate, vitamins, minerals

C. Physical agents- which includes heat, cold, humidity, pressure, radiation, electricity, sound

D. Chemical agents

a. Endogenous- which is produced inside the body

Teeth :- serum bilirubin (Jaundice), uric acid (Gout)

b. Exogenous- It is produced outside the body.

Dat ., allergens, fumes, dust, gases, metals.

E. Mechanical forces in mechanical agents like crushing, friction

2. Host :- The person who is sick is called the host.

Host factors have different characteristics.

A. Demographic characteristics like Age, Sex, Ethnicity are included

B. Biological characteristics include genetic makeup, immunity

C. Social characteristics include socioeconomic status, occupation

D. Lifestyle factors include fitness, nutritional habits, physical exercise, behavioral patterns.

Environment:- That means an environment in which any disease spreads.

In other words, the living and non-living things outside the person with which one is in constant contact.

1. Physical environment in which Air, water, soil, radiation Is included
2. Biological environment which includes microbial agents, animals, plants
3. Psychological environment which includes culture, customs, beliefs

Multi factorial causation :- Illness occurs due to many reasons.

• Like coronary heart disease and cancer it is seen due to many reasons like
• Consuming too much fat
• smoking
• Obesity
• Do not exercise

3. Natural history of disease :-

Natural history is a description of how a disease “behaves” and what factors influence its spread. Disease occurs as a result of a complex interaction between the agent, the host (human) and the environment. The stage of a disease from its prepathogenesis (prior to the onset of the disease) phase to its termination, in the absence of treatment or prevention, until recovery, disability or death.

Q.3 C. Explain about Hemodialysis. Explain about hemodialysis.

Definition:- Hemodialysis is a method of removing excess waste from the body in case of renal failure, in which excess waste is removed from the blood.

After removing harmful substances, purified blood is returned to the patient’s body.

Purpose :-

• To remove excess waste from the patient’s body.
• To make the body’s buffer system positive
• To remove excess fluid from the body
• To reduce water retention
• To prevent other complications
• To maintain the level of electrolytes in the body

Indications:-

• Acute renal failure
• Chronic renal failure
• Uremia
• Renal encephalopathy
• Severe edema
• Metabolic acidosis

Procedure :-

Hemodialysis consists of a machine (dialyzer) for blood purification in which blood is taken from a vessel in the patient’s body and sent to the dialyzer. The wastes in the blood are filtered then become pure blood which is injected into the patient through other vessels.

A fistula is created in hemodialysis. From where impure blood is taken out and pure blood is introduced.

This fistula can be made on wrist, arm and neck.

Complication:-

• Dehydration
• Hypo volemia
• Hypo tension
• Hypovolemic shock
• Septicemia
• Death

Care during hemodialysis:-

• Checking and recording the patient’s weight.
• Written consent is obtained from the patient for dialysis.
• Explaining the dialysis procedure to the patient so as to reduce their anxiety
• Position the patient comfortably
• Ask the patient to stop antihypertensive and vasodilator medications if they are on before dialysis because dialysis causes hypotension.
• Check and monitor vital signs
• If there is any problem during dialysis, the patient should be asked about it and if necessary, the doctor should be informed immediately.
• Check the patient’s fistula site regularly because the use of heparin during the procedure slows the clotting process and increases the chance of bleeding.
• All emergency medicines should be kept ready with the patient
• Necessary medicines should be given to the patient.
• After hemodialysis is completed, the patient’s weight should be rechecked
• After hemodialysis the patient should be given the necessary drugs.

Q.3 d. Write nursing management of patient with cirrhosis of liver. Write the nursing management of a patient with cirrhosis of liver.

1)Oedema or Fluid Overload:-

• Fluids should be given to the patient in limited quantities
• Patient intake and output should be maintained
• Diuretic should be given as per doctor order
• Sodium should be taken less in food
• The patient’s weight and abdominal circumference should be checked daily and recorded

2) Relieve anxiety :-

• An IPR should be maintained with the patient
• The patient should be addressed by name with respect
• The patient’s questions should be answered truthfully and positively.
• If possible, a relative should be allowed to stay with the patient

3. Fluid electrolyte imbalance:-

• The patient should be monitored for dehydration or overhydration
• The patient should be encouraged to take adequate amounts of liquid food.
• If the patient cannot take orally, I.V. by line. Fluids should be given.
• Maintaining patient intake-output chart

4. Rest and Sleep :-

• While giving medicine to the patient, care should be taken to relax and the patient should not be disturbed unnecessarily
• The patient should be given a wrinkle free bed
• Medications such as those that disturb sleep should be given on time
• Dental:- Lasix should be given in the morning.
• Evening medications should be given at bedtime

5. Prevent complication:-

• Regular observation of the patient should be done including checking vital signs including TPR, B.P and recording.
• An intake and output chart of the patient should be maintained
• If any complication is found then the doctor should be informed immediately.
• An emergency medicine tray should always be prepared and kept in a place where all patients are as close as possible.

Additional Information:-

Liver Cirrhosis:-

Definition:-

Liver cirrhosis is a chronic hepatic disease. In which destruction and regeneration of hepatic cells takes place.

Liver cirrhosis is a serious disease. It also causes death

Etiology:-

• Alcoholism
• Wilson’s disease
• Hepatitis -A,B,C,D,E
• By using hepatotoxic drugs
• Severe mal nutrition
• Biliary obstruction
• Auto Immune Diseases
• Chronic Bowel Inflammation

Clinical Manifestation :-

• Wickness
• Fatigue
• Lose weight
• Muscle cramps
• Anorexia
• Indization
• Nozia
• Vomiting
• Diarrhea
• Abdominal pain
• Hepatomegaly
• Pleural effusion
• Ascites
• Hypokalemia
• Anemia
• Bleeding tendancy
• Laws of Libido
• Palmar erythema
• Jaundice
• Adytamus leg
• Enlarge abdominal vein
• Megali of Splendid
• Macular atrophy
• Hepatic encephalopathy

Diagnostic Evaluation:-

• History Collection
• Physical Examination
• Chest and Abdominal X Ray
• Sonography
• CT scan
• Liver biopsy
• Doppler Ultra Sonography
• like this. R.I
• Endoscopy
• Blood Investigation
• Liver function test

Complication:-

• Liver failure
• Portal hypertension
• Hepatic encephalopathy
• Ascites
• Severe mal nutrition
• Death

Medical management:-

• Know the causes of liver cirrhosis and treat it
• To prevent complications
• Giving antibiotics to prevent infection
• Administer diuretics to reduce edema
• Stop alcohol
• Administer vit-k and Ternexamic acid to stop bleeding
• If necessary, give blood transfusion and fresh frozen plasma
• Administer Antiemetics to prevent Nausea
• Giving drugs like Timolol, Labetalol to reduce portal hypertension
• Giving lactulose orally to reduce the level of ammonia in the blood
• In Liver Cirrhosis Diet
• High calorie, less protein
• Low sodium diet (400-800 ug/day)
• Vitamin supplements
• Low fluid intake (1-1.5 Itr /day)
• Q-4 Write Short notes (Any Three) Write short notes. (Any three) 3X4=12
• Q.4 a Write the steps of nursing process
• – Write the steps of nursing process
• It is a systemic process of providing nursing care to any patient whose steps are as follows.

1.Nursing Assessment:-

Definition:-

• Assessment means collecting and interpreting clinical information.
• It collects information about the patient’s wellness, functional ability, physical status, strength, actual and potential health problems.

Purpose of assessment:-

• To get information about the health of the patient
• To know the normal functions of the patient
• To arrange the information received
• To investigate a nursing problem
• To frame a nursing diagnosis
• To identify health problems
• To identify the client’s strength
• To identify the need for health teaching

Type of Assessment:-

Initial assessment:-

This assessment is done at the time of admission Dat :- Nursing admission

B.Problem focused assessment:-

Early assessment is done to identify specific problems.

Dental :- Fluid intake and urine output are checked every hour to assess the problem of urination.

C. Emergency Assessment:-

Rapid assessment is done to identify the patient’s physiological crisis like life threatening problem.

Dat:- Assessment of client airway,

Monitoring breathing status and secretions after cardiac arrest.

D. Time lapsed assessment:-

In this the data is compared with the initial assessment Reassessment is done in this the present condition of the client is compared with the base line data taken earlier.

Component of assessment:-

• Collecting data
• Organizing data
• Validating data

• Recording data

1.Collecting data:-

• The process of obtaining information about the client’s health status is called data collection. In which nursing health history, physical assessment,
• Includes physical examination, laboratory results and diagnostic tests.
• Data includes past history as well as present complaint.
• Following points should be kept in mind while collecting data.

1. Data collection should be systematic and continuous so that errors in data can be prevented.
2. Data should not be based on actual or potential health problems.
3. Data should be descriptive, clear, concise, complete

Type of Data :-

• There are two types of data.
• Subjective data
• Objective data

Subjective data:-

• This is known as symptoms or covert data.
• Subjective data is given by the patient himself.
• In this data, the patient himself describes his previous experience, as well as filling, emotions in his own words.

Objective data :-

• This is known as sign or overt data.
• Objective data is taken by the health team like observation, physical examination, and measured through diagnostic test.

Source of data :-

Primary sources:-

In this, data is obtained directly from the patient in which physical examination and interview are used.

Secondary sources:-

In this, the data is obtained from the patient’s relatives as well as the patient’s medical records, charts and other members of the health team.

Method of Data Collection :-

1.Observation:-

In this, information is obtained by observing the patient.

2. Interview:- An interview is a planned and purposeful communication with the patient to obtain information. In which information is collected for identifying the client’s problem, teaching the patient, and counseling.

3.Examination:-

Systematic data is collected to identify health problems, including physical examination technique, laboratory results.

Includes interpretation, measurement.

Cephalo caudal approach :– Head to Toe examination

Body system approach:– Examining the body system

Review of system approach:- Examining particular area

Organizing Data :-

From the patient

The nurse organizes the data by collecting it.

3. Validating data:– Validation means, in simple words, to cross check the information obtained. The information obtained is confirmed whether it is factual or true.
4. Recording data :- It is important to record the document. The record should be accessible, understable and complete, legible.

Recording it Systematically (Methodically)

should do

2.Nursing Diagnosis:-

• Nursing diagnosis is the second step of the nursing process. which follows the nursing assessment.
• In this phase, the collected data is analyzed from which the problem is identified and a nursing diagnosis is made. Based on this, nursing care is given.
• The North American Nursing Diagnosis Association (NANDA 1992) has defined Nursing Diagnosis as follows.
• “The clinical judgment of an individual, family, or community’s actual or potential health problem. Nursing diagnosis provides information for the selection of nursing intervention to achieve that outcome.”
• Let’s write the nursing diagnosis in written format “PES”.

says

P=Problemstatement/diagnostic label/definition

E = Etiology/related factors/causes

S=Defining

characteristics/signs and symptoms

PURPOSES OF NURSING DIAGNOSIS:-

• A to analyze the collected data.
• B. To identify the client’s normal functional level statement.
• C. To identify the client’s strengths and weaknesses.
• D. To make up for diagnostic weaknesses.

CHARACTERISTICS OF NURSING DIAGNOSIS:-

1. It clearly and concisely states the health problem
2. Information is drawn from existing evidence about the client
3. It is potentially useful in providing nursing therapy (care).
4. It is no base for planning nursing care as well as providing nursing care.

TYPES OF NURSING DIAGNOSIS :-

1. Actual Nursing Diagnosis:-

The problem that occurs during nursing assessment (Problem + Etiology + Signs/Symptoms) is called Actual Nursing Diagnosis. And this depends on the patient’s current signs and symptoms

Teeth :-

• Imbalanced Nutrition: Less than body.
• Secretions Acute Pain (Chest) related to coughs secondary to pneumonia
• Activity intolerance related to general weakness.

1. High Risk Diagnosis :- This is also called potential problem. It has no signs or symptoms. This is a clinical judgment. But this does not present a problem but a risk factor.

D. T.:-

1) Risk for impaired skin integrity related to surgery. In this, there is a risk of bed sore in the patient due to long bed rest and not changing the position.

2) High risk for infection related to hospitalization immuno suppressed medication.

In this, the patient is at risk of infection due to immunosuppressant drugs.

3. Wellness Diagnosis:-

It is a clinical judgment which is a process of changing individual, family, community specific level of wellness to higher level of wellness. (Carpenito 1993)

Dat: Birth of new born twins.

4. Syndrome Diagnosis: This is a set of actual or high risk nursing diagnoses that are based on an event or situation. (Carpenito 1993)

Dat:-a Rape ,Trauma Syndrome

STATEMENT OF NURSING DIAGNOSIS:-

Nursing diagnosis provides guidance for planning to provide goal oriented nursing care.

Nursing diagnostic statement has three parts which are problem, etiology & defining characteristics.

(1) Problem:

• It describes the patient’s response to which nursing care is provided. The nurse explains clearly and concisely the area of ​​the problem that has occurred.
• Teeth:– Knowledge deficit, Acute, Chronic, Ineffective, Altered, Decreased etc

2) Etiology:

Etiology is the component used to identify one or more health problems. Etiology guides the planning of nursing interventions. This helps the nurse to give personalized care to the patient because both patients have the same problem but the causes are different.

Tooth :- 1) Anxiety related to hospitalization

2) Anxiety related to diagnostic test

Problem:- Anxiety

Etiology:- Hospitalization, Diagnostic test.

(3) Defining characteristics:

These are the signs and symptoms of the problem, which help in making a nursing diagnosis. These include subjective or objective data.

Teeth :- 1. Fluid volume deficit related to decreased oral intake manifested by dry skin and mucous membranes.

2. Risk for impaired skin integrity related to immobility manifested by redness on skin.

NANDA Diagnosis:-

NANDA diagnosis is a list of diagnosis. (North American Nursing Association)

3. Planning :- Planning is an important step in the nursing process. It is a purposeful activity. It involves critical thinking. One can decide what to do, when to do it, where to do it and who will do it, and also know how to evaluate the results.

Definition:-

According to Cozier (1975) “planning is a systematic phase of the nursing process that involves decision making and problem solving.

Purpose of planning:-

To guide the activities for client care

To maintain continuity of care

Granting permission to perform specific activities

Type of planning:-

There are three types of planning

Initial planning:–

The planning done after initial assessment is called initial planning. Because of the trend toward shorter hospital stays, planning should begin early.

Ongoing planning :-

On going planning is done by all nurses who care for the client. This planning includes daily planning.

Discharge planning :-

Planning is the process of planning what the patient will need after discharge and is an important part of comprehensive care. This is included in every nursing care plan.

Phase of planning:-

• Planning is the phase in which the nurse determines how to provide individual, goal-oriented nursing care.
• There are 4 stages of planning.
• Setting priorities
• To determine the goal
• Determining nursing strategies
• Developing a nursing care plan.

4. Implementation:-

Simply put, implementation is the process of putting the plan into action. It is the fourth step in the nursing process in which the nurse uses her knowledge and skills to provide nursing care.

PURPOSE OF IMPLEMENTATION:-

• To provide technical nursing care
• To provide therapeutic nursing care
• To help the client achieve health at optimum level.

Performing Nursing Intervention:-

• Nursing intervention is an activity performed by a nurse to prevent illness, improve and maintain health of a patient. Nursing interventions are as follows
• Perform patient activities by yourself:- Bed bath, mouth care, vital check
• Assist in patient activities
• Teeth:- Do range of motion exercises.

Supervising the patient’s own activities.

5. Evaluation :– Evaluation is the fifth step of the nursing process. which follows the implementation.

• In the evaluation phase, the nurse checks whether the nursing care plan has been effective or not and whether the goal has been achieved.
• Evaluation is a continuous process in which the nurse assesses and reassesses the program to determine whether the patient’s goals have been achieved.

Purpose of Evaluation:-

• To make judgments about obtaining data from nursing care provided
• To check patient’s behavioral response to nursing intervention
• To compare pre-determined criteria and current patient no response
• To find out the flaws in the care plan
• To check the quality of nursing care

Activity in Evaluation phase :-

• To review patient objectives and criteria, outcomes
• to get the data
• To achieve the goal
• To modify nursing care
• Revise the patient’s intention and look at the outcome criteria.

Q.4 b. Nursing care of a patient with hypokalemia – Nursing care of a patient with hypokalemia

NURSING CARE FOR HYPOKALEMIA:

• Hypokalemia is a metabolic disorder caused by potassium deficiency, in which serum or plasma potassium levels fall below 3.5 meq/L. Her nursing care is as follows.
• If the patient is taking diuretic medication, keep checking the potassium level.
• Monitor vital signs and check peripheral pulses
• Advise patient to take potassium rich food.
• When giving potassium intravenously – carefully monitor the rate of infusion (do not give faster than 10-20 meq/hr).
• Maintaining intake and output chart
• Examining bowel sounds.

HYPOKALEMIA (POTASSIUM DEFICIT):-

Hypokalemia is a metabolic disorder caused by potassium deficiency, in which serum or plasma potassium levels fall below 3.5 meq/L.

CUASE:-

• Not getting enough potassium in food.
• Due to excessive loss of potassium by the kidneys.
• From excessive sweating.
• G.I. Loosening through the track such as vomiting, diarrhea and prolonged GI suctioning, ileostomy.
• Diabetic ketoacidosis.
• Adrenal gland tumor.
• Aldosteronism or Cushing’s syndrome
• Antibiotics: due to amphotericin B, carbenicillin and gentamicin
• Renal tubular acidosis
• Bulimia and eating disorders

Clinical Manifestations:-

• Cardiac arrhythmia or dysrhythmia
• Orthostatic (postural) hypotension
• Hypo reflexia
• Polyuria, Nocturia, Thrust
• Rhabdomyolysis
• Fatig
• Anorexia, nosia, vomiting
• Paralysis
• Constipation and decrease in gastric size
• Respiratory depression

DIAGNOSTIC EVALUATION:-

Serum potassium < 35 mEq/L

Metabolic alkalosis (increased pH or >7.45)

24-hour urine potassium excretion test

ECG changes such as flattened T wave, elevated U wave and depressed ST segment and prolonged PR intervals are seen.

B.U.N. And get a creatinine test done

Medical management:-

Reduce potassium intake

Replacement of potassium

Assessing toxicity

Investigate the reason why this episode does not occur again.

Q.4 c. Nursing management of a patient with GOUT

1. Manage pain of patient.-

Elevating the affected joint and providing a comfortable position

Administering medicines as per doctor order

Immobilize the affected joint

Use a bed cradle or footboard to prevent the weight of the bedclothes from falling

The patient should be checked for activity and disability

2. Explain to the patient about diet precautions including fluid intake of 2-3 liters a day
3. The patient should be persuaded to abstain from alcohol
4. Necessary advice should be given to the patient for healthy life style.

Explain to have a proper balance diet

Explain the importance of rest and exercise

Additional Information:-

Gout :-

Definition:-

Gout is a recurrent attack of inflammatory arthritis. In which red color, swelling, hotness is seen in the joint. Which is seen due to the increase of uric acid in the blood. Uric acid crystals are deposited in the joints, tendons and surrounding tissues.

Etiology:-

• (Medullary Cystic Kidney Disease in Genetic Causes)
• After surgery
• Diabetes Mellitus
• Hyperlipidemia
• Metabolic syndrome
• Hemolytic anemia
• Hypertension
• Chemotherapeutic drugs
• Taking immunosuppressive drugs
• Renal disease
• Use of diuretic drugs

Clinical Manifestation:-

• Inflammatory arthritis in which the part is red in color, swelling, hot mainly on the big toe with metatarsal phalangeal
• Joint pain is accompanied by fatigue and fever
• Tophy is seen
• Hyperuricemia

Diagnostic test :-

• In a blood test. Uric acid is found above 6mg/dl
• X-ray joint
• e. S.R
• Kidney function test
• Electrolyte
• Blood count
• Treatment:- acute gout
• Calchicine & steroids are given along with NSAIDS.
• Tooth:- Ibuprofen.
• Medicines such as allopurinol and febuxostate that are given to lower uric acid levels
• Steriods are given in the joint for swallowing.

Q.4 D. Clinical manifestations of Cushing’s syndrome – Signs and symptoms of Cushing’s syndrome

• It is a disease of the endocrine system caused by excessive secretion of glucocorticoids from the cortex portion of the adrenal gland. Its signs and symptoms are as follows.
• Main symptoms include moon face, and fat deposits on the face, neck, and trunk
• Buffalo Hump
• Purple streaks are seen on the skin.
• In other features
• Diabetes Mellitus
• Glycosuria
• Hypokalemia
• Muscular weakness
• Fracture
• Peptic ulcer
• Hypernatremia
• Depression-mania or bipolar disorder
• Hirsutism (in women)
• Buffalo Hump
• Arms and legs become thin
• Water retention and edema
• Hypertension
• Left ventricular hypertrophy
• Kidney stone
• Frequent infections
• Bone demineralization
• Oligomenorrhea or amenorrhea
• Clitoral hypertrophy
• Additional Information:-

Definition:-

It is a disease of the endocrine system caused by excessive secretion of glucocorticoids from the cortex portion of the adrenal gland.

Etiology:-

• Adrenal neoplasia
• Overuse of glucocorticoids
• Adrenal tumor
• In pancreatic carcinoma

Diagnosis:-

• History Collection
• Physical Examination
• Check the symptoms
• Dexamethasone suppression test
• X-ray
• Bone scan
• Ultrasonography
• CT scan
• MRI

Complications:-

• Diabetes
• Psychosis
• Osteoporosis
• Pathological fracture
• Nephrolithiasis
• Peptic ulcer

Treatment:-

• If Cushing’s syndrome is caused by excessive secretion of ACTH from the pituitary gland, the treatment is trans-sphenoidal hypophysectomy. And radiation therapy and drug therapy are also used.
• If there is any kind of tumor it is removed by surgery.
• The following medicines are given to the patient. These drugs lower cortisol levels
• Aminoglutethimide
• Mitotank
• Metyrapone
• Ketoconazole
• Antihypertensive treatment is given to the patient to treat hypertension
• Propranolol, Timolol
• Insulin therapy and oral antidiabetics are given to control diabetes.
• If both adrenal glands are surgically removed, corticoid therapy is continued for life.

Nursing management:-

• Position the patient comfortably
• If the pain is severe then the doctor’s prescription analgesic drugs are given accordingly.
• All medicines, including antibiotics, are given to a patient to prevent or treat an infection
• If the patient has fever, take temperature
• If the patient does not feel cold, his clothes should be loosened and unnecessary clothes should be removed
• The patient should be wiped with a cloth soaked in warm water
• In case of hyperpyrexia, the doctor should be informed immediately
• The patient should be cared for with warmth and love so that the patient’s anxiety is reduced
• If possible, a relative of the patient should be allowed to stay with him, so that he can share his problems with him and reduce his anxiety.
• The patient’s questions should be answered positively
• The patient should be asked about his problems daily and written in the nursing notes
• An intake output chart of the patient should be maintained
• Adequate fluids should be given if necessary, ORS solution may also be given
• If necessary for the patient. I.V. Fluids should be given
• The patient should be checked for AD
• Blood glucose levels should be checked and recorded regularly in diabetic patients
• The patient should be encouraged to take the diet at regular intervals.
• Encourage the patient to walk during the day if the patient is able to walk
• The patient should also be given a fiber rich diet
• Regular observation of the patient
• The patient’s problems should be asked and recorded daily so that any complications are known
• Maintaining patient’s (TPR) and blood pressure (BP) chart
• Also maintain a chart of the patient’s blood glucose level

Q.4 e. Absorbable and non-absorbable sutures – Absorbable and non-absorbable sutures

(A) Absorbable Materials:

They are self-dissolving.

(1) Catgut :-

It is made from the intestine of sheep. The sutures and ligatures used are sterilized with gamma radiation and do not need to be removed.

Type of Catgut :-

Plain Catgut :-

It is natural made from tendon and fascia and is absorbed in 10 days.

Chromic Catgut:-

This is natural made from tendon and fascia. A chromic sol is applied over a plain catgate on this. Due to which its strength is maintained and irritation in the tissue can be reduced. It is absorbed in 20 to 40 days.

2) Poly glycolic acid :- (P.G.A.)

The synthetic catgut is also absorbable.

3) Living suture :-

It is made from the patient’s own tissues which are made from muscles and tendons. It is especially used in hernioplasty.

B) Non Absorbable sutures:-

These cannot dissolve

(a) Silkworm gut:-

It is made from the saliva of silkworms. Which is made in the form of thread. The length of which is kept as 12 inches and the thickness is different

These are purple or pink in color and are used in skin sutures.

B) Nylon thread or mono-filament:-

This is similar to silkworm gut

C) Linen thread or Poly-filament:-

It is made from cotton. It is made by weaving. These are especially used in gastro intestinal surgery and come in 90, 60, 35 and 25 numbers.

D) Silk thread :-

These are made from silk. Which is used especially in skin, vascular, ophthalmic and oral surgery. It is available in different types.

E) Metal wire :-

• These are made from silicone metal
• These are used for herniorrhaphy, prolapse rectum and orthopedic surgery and are available in different sizes.

Q 5 Write Definition (Any Slx). Write the definitions. (any six) 6X2=12

1.Colostomy:-

This is a surgical operation in which an opening is made in the large intestine and the damaged part of the colon is removed, the colon is shortened and the cut part is attached to the abdominal wall. “

2. Kussmaul Breathing – Kussmaul Breathing is a deep and labored breathing pattern associated with metabolic acidosis. Especially with diabetic ketoacidosis. This is a type of hyperventilation due to which the carbon dioxide content in the blood decreases due to increased respiration rate and depth.

3.Osmosis:-

Osmosis is the process of fluid moving towards higher concentration in the presence of a semipermeable membrane and this process continues until the concentration on both sides is equal.

4. Anaphylaxis:- This is an acute allergic reaction to an antigen in which the body becomes hypersensitive. Antigen antibody reaction takes place in this body. This type of reaction is seen in the body against a specific substance.

This is a severe and life threatening allergy.

5.Scrubbing:-

The process of cleaning (something) with soap and water, often with a brush, is called scrubbing. This procedure is done especially for hand wash before the operation.

6. Anesthesia:-

Anesthesia is a medicine used for pain during a procedure or surgery that blocks sensory signals from the brain to the temporary nerves at the site of surgery. This procedure is called anesthesia.

7.Spirometry:-

Spirometry is the most common type of pulmonary function and breathing test.

This measures how much air you can inhale and exhale, as well as how easily and quickly you can expel air from your lungs. It can be known about it. By this the vital capacity of the lung can be known. This is also a useful method for a type of lung exercise.

8. Addison’s disease:-

Addison’s disease is also known as hypocortisolism. This is a disorder. In which the adrenal gland does not produce enough hormones. So this happens.

While adrenal gland it is seen due to insufficient production of cortisol hormone and aldosterone.

Q.6 B. Fill the blanks 05

1. Abnormal fluid collection in the pleural cavity is called __ Pleural effusion
2. M.R.I stands for. _ The full name of MRI is Magnetic resonance imaging
3. Sialadenitis means Sialadenitis means______ Inflammation of salivary glands
4. Xerostomia means _ Xerostomia means___ Dry mouth
5. Orchitis Means_______ Orchitis means __ Inflammation of testes

C. Match the following pairs. 05

Answers :-

1) Apnea :- Cessation of breathing

2) Atelectasis:- Collapse of the lungs tissue

3) Empysema:- Over distended alveoli

4) Dysphagia:- Difficulty in swallowing Dysphagia is difficulty in swallowing

5) Myxedema:- Hypothyroidism Myxedema hypothyroidism

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