GNC MEDICAL SURGICAL NURSING I
12/09/2022
⏩Q-1⏪
🔸 a. Define Bronchial Asthma Define bronchial asthma.
Asthma is a chronic inflammatory respiratory disorder. In which the airways become hyper-responsive to certain stimuli, the airways become inflamed and narrowing, and the airways become obstructed due to mucus production.
Asthma differs from COPD in being a reversible process.
b. Explain the types of Asthma. Explain the types of asthma.
Bronchial asthma known as asthma is classified into different types based on triggers, symptoms and mechanisms.
Here are some common types of asthma.
1) Allergic Asthma:
This type of asthma is the most common form of type A asthma caused by exposure to allergens such as pollen, pet dander, mold spores, and dust mites.
2) Non Allergic Asthma:
Unlike allergic asthma, non-allergic asthma is caused by triggers other than allergens, such as cold air, exercise (which causes bronchoconstriction), respiratory infections, smoke, strong odors, and air pollution.
3) Occupational Asthma:
This type of asthma is caused by exposure to certain substances in the workplace. such as chemicals, dust or fumes.
Occupational asthma can occur in people who did not have an asthmatic condition before entering the occupation.
4) Exercise Induced Asthma (EIA):
This type of asthma is triggered by physical activity and exercise. This type of asthma occurs during and after exercise and is usually more common in people with pre-existing asthma conditions and a family history of asthma.
5) Childhood Asthma:
This type of asthma starts during childhood and can continue into adulthood.
Childhood asthma has allergic triggers and can worsen or improve over time.
6) In adult onset asthma:
This type of asthma develops for the first time during adulthood with no history of childhood asthma. Adult-onset asthma can be triggered by respiratory infections, hormonal changes, or environmental factors.
7) Severe Asthma:
Severe asthma is asthma that is difficult to control even with high doses of medication. People with severe asthma require specialized treatment and have frequent asthma attacks.
8) Brittle Asthma:
This is a rare and severe form of asthma characterized by unpredictable and sudden, severe asthma attacks.
9) Aspirin induced asthma:
In some people, taking aspirin or another non-steroidal anti-inflammatory drug (NSAID) can cause asthma symptoms to develop.
10) Cough Variant Asthma:
In this asthma, instead of typical asthma symptoms like wheezing sound and shortness of breath, persistent dry cough is seen as the main symptom of asthma.
These types of asthma may overlap and a person may experience more than one symptom. Effective management usually involves identifying the triggering factor and controlling asthma symptoms and preventing asthma attacks from occurring.
c. Describe the nursing care of Bronchial Asthma.
Describe the nursing care of bronchial asthma.
Impaired gas exchange related to altered oxygen supply, obstruction of airway
Improve gas exchange
To monitor vital signs.
Assess respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Provide Fowler position to the patient and restrict his activities.
Explain and anchor the patient about deepbreathing and cuffing exercises.
To provide knowledge to patients about pursed lip breathing and diaphragmatic breathing.
Anchoring the patient to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the patient.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain records and reports.
Ineffective airway clearance related to obstruction from narrowed lumen Maintain patent airway
To monitor vital signs.
Assess respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Provide Fowler position to the patient and restrict his activities.
Explain and anchor the patient about deepbreathing and cuffing exercises.
To provide knowledge to patients about pursed lip breathing and diaphragmatic breathing.
Anchoring the patient to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the patient.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain records and reports.
Ineffective breathing pattern related to bronchospasm Improving breathing pattern
To monitor vital signs.
Assess respiratory rate, rhythm and breathing pattern.
Assessing breath sound and chest movement.
Monitor pulse oximetry and arterial blood gas values.
Provide Fowler position to the patient and restrict his activities.
Explain and anchor the patient about deepbreathing and cuffing exercises.
To provide knowledge to patients about pursed lip breathing and diaphragmatic breathing.
Anchoring the patient to cough expectorate if secretions are present.
Provide oxygen therapy if spo2 level is low.
Providing nebulization to the patient.
Administer the medicine (bronchodilator) prescribed by the doctor.
To maintain records and reports.
Anxiety related to disease condition, hospitalization Reduce anxiety
Assess the patient’s condition.
Paying attention to the psychological needs of the patient and listening carefully to the patient.
Encouraging the patient to express his feelings, discomfort and anxiety.
To solve all doubts and queries of patients.
Providing knowledge to the patient about his condition and treatment so that his anxiety is removed and the patient becomes confident.
Providing psychological support to the patient.
Providing mind diversional therapy and recreational therapy to patients.
Activity intolerance related to fatigue, dyspnea increases activity level (increasing activity level)
Assess the patient’s condition.
Checking the patient’s activity level.
Provide bed rest to the patient initially.
Then gradually anchor the patient to range of motion exercises.
Assisting the patient with his activities.
2 Provide rest to the patient between activities.
To check if the patient has any kind of breathing difficulty during the activity.
If breathing difficulty is found, stop the patient’s activity and provide rest.
⏩OR⏪
🔸 a. Write definition of Hernia. Write the definition of hernia.
Hernia is a condition in which a body organ or muscular wall of the organ protrudes from its normal cavity.
=> Abdominal cavity has a muscular wall which plays an important part for the support of the abdominal organs.
=> When this muscular wall develops from some place, then the abdominal organ protrudes from the week area into another cavity.
=> Hernia means any organ protrudes from its normal cavity into another cavity, it is called hernia.
••{Hernia := hernia may be defined as a protrusion of the organ from its normal body cavity to the other body cavity.
b. Explain classification of Hernia. Explain the classification of hernia.
There are total three types of hernia.
1)Reducibal hernia (reducible hernia),
2) Irreducible hernia,
3) strangulated hernia
••••••>
1)Reducibal hernia (reducible hernia),
=> Reducible hernia can be placed back to its normal place.
=> Reducible hernia can return to its normal place if the protruding organ is pushed.
=> People with this type of hernia wear a special type of hernia belt due to which the protruding organ stays in its normal place.
2) Irreducible hernia,
=> Irreducible hernia is a type of hernia in which the protruding organ cannot be placed back to its normal place.
=> This is irreducible mainly because the organ is blocked by another intestine at the protruded site.
=> Irreducible hernia mainly requires surgery to treat.
3) strangulated hernia
=> The main protruding organ in strangulated hernia is the intestine
There is a twist (twist) and the blood supply is impeded there.
=> Due to this blood supply being impaired, formation of ischemia, necrosis and gangrene occurs.
=> Strangulated hernia requires immediate surgery.
3) Explain the classification of the hernia. (State the classification of hernia.)
=> There are total ten classifications of hernia.
1) inguinal hernia (inguinal hernia),
2) Femoral hernia,
3) umbelical hernia,
4) Incisional hernia (incisional hernia),
5) Hiatal hernia,
6) Epigastric hernia,
7) Obturator hernia (obturator hernia),
8) Spigelial hernia,
9) ventral hernia
10) Herniation of intervertebral disc.
1) inguinal hernia (inguinal hernia),
=> Inguinal hernia This is mainly groin region
(the area between the abdomen and thigh) occurs.
=> Inguinal hernia is mainly when the intestine protrudes from the week point of the inguinal canal and the abdominal muscles near the groin region in a triangular shape.
(triangle shape) is made.
=> Mainly
•>Obesity (obesity),
•> Pregnancy (pregnancy),
•> Heavy lifting (heavy lifting),
•> Straining during stool pass (Strain during stool pass) is seen at the time.
2) Femoral hernia,
=> Inguinal hernia is mainly
It is found in the area between abdomen and thigh (situated between abdomen and thigh).
=> Femoral hernia is a bulge-like structure that appears mainly in the upper part of the thigh.
=> Femoral hernia occurs in the lower part of the inguinal ligament.
=> Femoral hernia is mainly found in •>women, •>pregnant women and •>obese people.
3)umbelical hernia (umbelical hernia),
=> Umbilical hernia is mainly seen when the umbilical cord
Abdominal wall around a
Wicked.
=> Umbilical hernia mainly protrudes from umbilical cord and nearer area of umbelical cord.
=> Umbilical hernia is mainly seen in newborns, children, and adults.
4) Incisional hernia (incisional hernia),
=> Incisional hernia is mainly when the intestine protrudes from the surgery area after previous abdominal surgery, it is called incisional hernia.
=> This hernia is mainly seen in elderly or overweight person.
5) Hiatal hernia,
=> Hiatal hernia is mainly an abdominal organ that protrudes from the abdominal cavity through the diaphragm (Diaphragm) muscles into the chest cavity.
=> Due to this symptoms like heart burn and stomach acid are seen.
6) Epigastric hernia,
=> Epigastric hernia mainly when upper middle abdomen
(upper middle abdomen) As muscles are weak, abdominal organ protrudes.
=> Epigastric hernia is mainly seen more in women than man.
=> This is mainly seen in people between 20 to 50 years of age.
7) Obturator hernia (obturator hernia),
=> Obturator hernia is mainly the front part of the pelvis and the abdominal organ protrudes from the gap in the bone.
8) Spigelial hernia,
=> In Spigelian hernia, the abdominal organ protrudes mainly from the Spigelial facia.
9) ventral hernia
=> Ventral hernia is mainly when scar tissues develop in the abdominal wall.
If it becomes wick and the abdominal organ protrudes from there, it is called ventral hernia.
10) Herniation of intervertebral disc.
=> It is said due to increase in pressure in inter vertebral disc.
=> Inter vertebral disc herniation is mainly seen when lifting any heavy object.
c. Write first 24 hours nursing management for patient with hernioplasty. Write the first 24 hours of nursing management of a patient undergoing hernioplasty.
Management of Hernioplasty Patient
Advise the patient to avoid heavy object, weight lifting.
Advise the patient to wear a supporting belt.
Monitoring the patient regularly.
Provide proton pump inhibitor medicine to the patient.
Advise the patient to take fruit and high fiber fruit.
Advise the patient to perform nasogastric suctioning.
Providing analgesic medicine to relieve the patient’s pain.
Provide antibiotic medicine to the patient.
Proper health assessment of the patient.
Assess the patient’s hernia type.
Assess the patient for signs and symptoms of any hernia.
To provide complete information about the surgical procedure to the patient.
To prepare the patient properly for surgery.
Provide analgesic medicine to relieve the patient’s pain.
Advising the patient to perform daily routine activities in properly small amounts and frequent amounts.
Monitor the patient whether there is redness, itching, infection in the surgical incision or not.
Proper wound assessment of the patient.
Provide high fiber diet, high fluid and stool softener to the patient.
To assess whether the patient has any kind of complication or not.
Provide proper psychological support to the patient.
Advise the patient to follow up regularly.
Properly dressing the patient’s surgical area.
To provide a calm and comfortable environment to the patient.
Provide fluid intravenously to the patient properly.
Provide proper mind diversional therapy to the patient.
Advise the patient to do small amounts of physical activity.
Advise the patient to do moderate daily routine activities.
⏩Q-2 ⏪
🔸a. What is meningitis? Write down clinical manifestations and Nursing Management of Meningitis. What is meningitis? Write the symptoms and signs and nursing management of meningitis.
Meningies:= Meninges is a protective membrane of the brain and spinal cord that covers the brain and spinal cord.
There are three other 3 layers in this meninges.
1) Duramater (outer most layer),
2) Arachnoid mater (intermidiate layer),
3) Pia Mater (Innermost layer)
Thus, there are three layers of meninges that cover and protect the brain and spinal cord.
Meningitis: If there is infection and inflammation in the meninges layer surrounding the brain and spinal cord, the condition is called meningitis. This infection can be caused by bacteria, viruses, and microorganisms.
{ Meningitis:= infection and inflammation of the Meningies layer that should be covered to the brain and Spinal cord }
Cause of meningitis
Due to bacterial infection.
Ex:=
Mycobacterium Tuberculosis,
Streptococcus pneumoniae,
Neisseria meningitidis,
Haemophilus influenzae,
Listeria monocytogenes.
Due to viral infection.
mumps,
Herpes simplex virus,
Epstein barr viral,
Varicella-zoster viral,
Measles,
Influenza.
Due to fungal infection.
Candida, due to systemic lupus erythematosus (SLE),
Due to certain types of medication.
Due to head injury.
Due to trauma in the head and spinal cord.
Cancer.
due to tobacco use.
Due to impaired immune system.
Due to over crowding.
Due to brain surgery.
Symptoms and signs of meningitis
Headache,
very high fever,
Alteration of maintain status.
Confusion.
Altered consciousness.
Vomiting.
Photophobia (An inability to tolerate light).
Irritability.
Drowsiness.
Confusion.
Altered Consciousness.
Vomiting.
Sign of meningeal irritation.
Nuchal rigidity (Neck Stiffness).
headache.
Altered mental status.
to be startled
Joint pain.
Muscle ache.
Positive Brudzinski Sign:=
Brudzinski’s sign When the patient is placed in the supine position and his neck is flexed towards the chest, his hip and ankle are automatically flexed, this is called Brudzinski’s sign.
Kerning sign:= (kerning sign)
In the kerning sign, when the patient is provided with supine position and then the patient’s knee and hip are flexed, if the patient’s knee is again extended, it is called kerning sign.
K:= Knee,
E:= Extent
R:= Resistance
That is, directly extending the knee causes pain to the patient.
Diagnostic evaluation of the meningitis Wada patient
History taking and physical examination.
Blood culture.
Lumbar puncture.
Chest x-ray.
CSF examination.
ct scan.
Gram stain.
CSF culture.
MRI test.
Management of patients with meningitis
Provide antibiotic medicine if the patient has any bacterial infection.
Ex:=
Rifampicin,
Cefotaxime,
Vancomycin.
Provide antiviral medicine if the patient has any viral infection.
If the patient is in pain, provide analgesic medicine.
Ex:= Acetaminophen, NSAID (Non steroidal anti inflammatory drug).
Provide intravenous fluid to the patient.
If the patient has fever, then give antipyretic medicine.
If the patient has fever, provide anticonvulsant medication.
Continuous close monitoring of the patient.
Continuously close monitoring of patient’s vital signs.
If the patient has inflammation, provide corticosteroid medicine.
If the patient has the condition of meningitis, keep him properly isolated.
Properly monitor patient’s hydration status.
Provide proper nutritional support to the patient.
Provide proper intravenous fluid to the patient.
Nursing Management of Meningitis Wada Patient
Properly assess the patient.
To continuously monitor the patient’s vital signs.
Properly assess the patient’s hydration status.
Maintain proper fluid and electrolyte levels of the patient.
If the patient is in pain, provide analgesic medicine.
Properly assess the neurological status of the patient.
If the patient has seizures, provide anticonvulsant medicine.
Provide proper nutritional support to the patient.
Providing proper psychological support to the patient.
To provide proper education to the patient about his disease, its causes, and its symptoms and signs.
Continuously monitor the patient’s intake output.
Continuous monitoring of patient’s vital signs and neurological status.
Continuously monitor the patient’s level of consciousness.
Advising the patient to take medicine regularly.
Advising the patient to follow up regularly.
Provide proper psychological support to the patient.
b. Explain Glasgow coma scale. Explain the Glasgow Coma Scale.
In the Glasgow coma scale, any type of stimulus is provided to the patient and the response provided by the patient is assessed.
Consciousness level of patient is checked by glassgo coma scale.
Mainly three components are assessed in GCS.
1) Eye opening
2) Verbal Response
3) Motor Response
1) Eye opening
A total of four scores are given in Eye Opening.
1) Spontaneous (Spontaneous:= In this, if the patient opens and closes the eye by himself) := { 4 }
2) To voice
(to voice:= in this the patient is asked to open and close his eyes and if the patient follows) := { 3 } ,
3) To pain
(to pain := in this if the patient is pinched in the body and the patient makes an eye expression):= { 2 }
4) No response
(No Response := If no response is received from the patient) := { 1 }
2) Verbal Response
Verbal response has a total score of five.
1) Oriented (Oriented:= if the person is asked about the time, place and person and the person gives the correct answer) := { 5 } ,
2) Confused (Confused:= if patient is asked about time, place and person and patient is confused):= { 4 } ,
3) Inappropriate word
(Inappropriate word:= if we ask a question to the patient and the patient gives a different answer) := { 3 },
4) Incomprehensive sound (incomprehensive sound := if the patient is asked any question and he only makes sound through mouth) := { 2 },
5) No response
( no response := if no response ) := { 1 }
3) Motor Response
There are mainly six scores in motor response.
1) Obey command
(obey command:= whatever the patient is told if the patient follows it properly) := { 6 } ,
2) Localized pain ( Localized pain := if the patient is pinched and the patient provides a response) := { 5 } ,
3) Withdraw pain (Withdraw pain := if the patient is pinched and the patient tries to withdraw the hand) := { 4 },
4) Flexion
( Flexion := When any mid area of the patient’s body is pressed and the patient’s body flexes) := { 3 } ,
5) Extension (Extension := if providing any stimulus causes extension of patient’s body) := { 2 },
6) No response
(No response := if the patient does not provide any kind of response) := { 1 }
Thus Glasgow Coma scale has a minimum score of 3 and a maximum score of 15.
result:=
{ 3 } score achieve:= then the patient has severe neurological damage.
{ 7 } score Achieve:= So the patient is in coma condition.
{ 8-12} score Achieve:= then the patient has moderate neurological damage.
{ 13-14} score Achieve:= then the patient has minor neurological damage.
{ 15 } score Achieve:= So the patient is fully conscious and oriented.
Thus, the level of consciousness of the patient is assessed from the Glasgow Coma scale.
⏩OR⏪
🔸 a. Describe special considerations in care of elderly. Describe special considerations for geriatric care.
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.
Attractive mills should be prepared in which to make good smelling food.
Spoiled food should not be given to eat
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.
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.
Fluid intake should be increased
Reduce fluid intake before bedtime
Clothes that can be easily removed should be worn
Using an absorb pad
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.
b. What is Halitosis? Write down causes of Halitosis.
What is halitosis? Write the causes of halitosis.
Halitosis is called bad breath.
=> In halitosis, an unpleasant odor is present when the breath is exhaled.
=> Halitosis is mainly seen due to dental decay, poor dental care, any gum disease, and bacterial infection.
State the cause of a patient with halitosis.
1) Due to consumption of certain types of food.
Ex:= due to Onion,Garlic,Fish,Cheese,Spices etc.
2) Due to tobacco product:=
=> Bad breadh comes from the mouth due to gum disease due to smoking.
3) Poor dental hygiene:=
=> If the mouth is not cleaned properly, bed bread can come from the mouth.
4) Oral disease :=
=> Gingivais
dental decay,
Halitosis is also seen due to Ulceration etc.
5)other cause:=
=> Due to chronic rhinosinusitis.
=> Due to tonsillitis.
=>gastro esophageal reflux disease (GERD),
=> Due to lower respiratory tract infection.
=> Due to renal failure.
=> Due to nasal infection.
=> Due to renal infection.
=> Due to diabetes mellitus (smell of acetone breath).
⏩Q-3 Write Short Answers (Any Two) Write the answers in short. (Any two) 2×6=12
🔸 a. Write the nursing management of patient having Acute Renal Failure.
Describe the nursing management of a patient with acute renal failure.
Nursing management of the patient with acute renal failure
Properly assess the patient.
To monitor patient’s vital signs properly.
Properly monitor the patient’s fluid balance.
Properly monitoring the patient’s intake output chart.
Monitor patient’s blood urea nitrogen level.
Assess the patient for any signs and symptoms of fluid overload.
Collaborating with health care members.
Monitor the patient’s electrolyte levels.
Provide proper medication to the patient.
Provide antihypertensive medicine to the patient.
Provide proper nutritional support to the patient.
Advise the patient on fluid restriction.
To provide proper dialysis care to the patient.
Provide proper skin care to the patient.
Properly monitor the patient’s skin integrity.
Advise the patient to do dietary restriction.
Provide psychological support to patients.
Advise the patient to maintain proper hygienic condition.
Proper collaboration of the patient with the health care member.
Monitor the patient’s intake output chart.
Monitor the patient’s weight daily.
Properly monitor the patient’s blood pressure.
Monitor the patient’s blood urea nitrogen level, creatinine and electrolyte levels.
Monitoring the nutritional status of the patient.
High calorie to the patient,
Provide low protein, low sodium, low potassium diet and vitamin supplementation.
Provide food to the patient in small and frequent amounts.
Advise patient to maintain streak aseptic technique.
To provide good oral care to the patient.
Properly monitor the patient’s heart activity.
b. Write down about Rheumatoid Arthritis. Write about Rheumatoid Arthritis.
Rheumatoid arthritis is a chronic, systemic, autoimmune connective tissue disorder that creates inflammation of the synovial membrane surrounding the joints.
Along with destruction and proliferation of synovial members.
Due to this, destruction (Vinas), Ankylosis (Stiffness of joint) and deformity (Physical loss) comes in the joint.
Auto immune means that the body’s tissue mistakenly identifies itself, affects the body’s own connective tissue and mainly involves the joint, causing joint pain, stiffness,
Immobility ensues.
Rheumatoid arthritis mainly affects other organs of the body including
Skin, eyes, lungs, and blood vessels are also involved.
Causes of Rheumatoid Arthritis
The exact cause of rheumatoid arthritis is unknown.
Due to genetic factors (if a parent has this disease, there is a possibility of it coming to the child),
Due to taking stress.
sex:=women are more likely to develop rheumatoid arthritis.
Due to any infectious agent.
Age mainly between 30 to 60 years of age.
Due to environmental factors.
Being a family history.
Due to hormonal effect.
Due to long term smoking.
Betabolic and
Because of the line in the biochemical Abnor.
Due to any bacterial, fungal, virus infection.
Due to immunological response.
Stages of Rheumatoid Arthritis
1) SINOVITIS (Synovitis),
2) pannus formation
3) Fibrous tissues Ankylosis
4) Bony Ankylosis
1) synovitis:=
In this, when an infection occurs in the body, the infection mainly affects the synovial membrane of the joint and due to this, infection and inflammation occurs in the synovial members and thus synovitis occurs.
And synovial fluid increases.
2) Pannus formation
This synovial fluid becomes inward and becomes very thick and this fluid increases around the capsule of the joint.
3) Ankylosis of fibrous tissues:=
In this the synovial fluid increases significantly and becomes stiff and gets stuck around the joint forming a hard structure.
4) Bony Ankylosis:=
In this, the fibrous tissue creates a very hard structure and bone-like formation, and due to this, the joint is immobilized and stiffened.
Due to any etiological factor.
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Infection of synovial membrane occurs.
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Inflammation of synovial members occurs.
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Synovial fluid is secreted from synovial members.
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This fluid progresses and accumulates in the bone.
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And the bone becomes very hard and stiff bone which is immobilized bone.
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Rheumatoid arthritis.
Symptoms and signs
The affected joint becomes red and warm.
Joints become inflamed and stiff and tender.
Pain in the joint.
Morning stiffness occurs in the joint.
Arthritis occurs in more than three bones.
The joint becomes swollen (sponge like).
Arthritis occurs in the hand joint.
firm bumps of tissues under the skin on arms.
Rheumatoid nodules form.
Rh factor positive.
Fluid accumulation occurs in the ankles.
The joint loses its range of motion and becomes deformed.
muscular atrophy around affected joint.
ulnar deviation
In this the finger is deviated towards the ulnar surface.
Swan neck deformity
In this the finger becomes a swan sap.
Bouterine deformity
This finger is bent.
knock knee.
Difficulty in sleep.
numbness and tingling sensation.
burning sensation in hands and feet.
Module formation within the skin.
Burning sensation in the eye.
Itching and discharge.
Dry mouth and eyes.
Chest pain.
Weakness.
Difficulty breathing.
Weakness.
feel tired
Loss of appetite.
Weight loss.
Getting a low grade fever.
malaise.
Depression.
lymphadenopathy.
Inflammation in the blood vessels.
Having involvement of multiple organs (pericarditis, osteoporosis, anemia, subcutaneous nodules, vasculities, neuropathy, fibrotic lungs disease).
Diagnostic evaluation
history taking and physical examination.
Rheumatoid factor test:= RA positive.
antinuclear antibody test.
erythrocyte sedimentation rate (ESR).
c-reactive protein (crp test).
complete blood count test.
Comprehensive metabolic panel (to monitor kidney and liver function).
synovial fluid analysis (synovial fluid changes from transparent to milky, cloudy, and dark yellow fluid).
arthroscopic examination.
X Ray.
joint ultrasound.
MRI.
Management of rheumatoid arthritis
medical management
1)NSAID (NON STEROIDAL ANTI INFLAMMATORY DRUG) (This medicine is used to remove paint and inflammation.)
Ex:= ibuprofen,
Naproxen sodium.
2)DMARDs (disease modifying antirheumatic drugs) :=
This is mainly given in moderate to severe rheumatoid arthritis conditions.
Ex:=imuran,
Antimalarial medication,
Panicillamine and mithotrexate.
3) Antimalarial medication:=
This medicine mainly uses hydroxychloroquine along with methotrexate.
4)Corticosteroids: =
Coticosteroids are primarily used to relieve inflammation.
5) Biological agent:=
Tnf-a antagonist targets B cell, T cell.
actemra in biological agent,
Rituxan,
Remicade,
Enbrel,
Kindred,
Is included.
6) Immunosuppressants :=
This medication mainly weakens the immune system which is out of control in rheumatoid arthritis.
Ex:=azathioprine( imuran, azasan), Cyclosporine.
7)(tumor necrosis factor a):=
This medicine mainly inhibits inflammatory chemicals that inhibit tumor necrosis factor.
surgical management:=
1) joint fusion:=
This involves surgically fusing the joint to stabilize the joint.
2) synovectomy:=
This mainly involves removing the joint lining.
This is mainly used to remove the inflamed tissues that create the pain.
Synovectomy is primarily used to reduce swelling and slow joint damage.
3) Tendon repairs:=
The tendon around the joint is inflamed and damaged due to which the tendon is lost, so the surgery is to repair the tendon around the joint.
and keeps it stable.
4) total joint replacement:=
In joint replacement, the surgeon removes the damaged joint part and inserts a prosthesis, which is made of metal or plastic, in its place.
nursing management
Assess the patient’s pain level.
To assess the amount of morning stiffness the patient has.
provide comfortable position to the patient.
Encouraging patients for non-pharmacological management.
Such as yoga, relaxation techniques, guided imagery, and rhythmic breathing.
Advising patients on hot and cold applications.
Providing the prescribed medicine to the patient.
Asking the patient to rest between activities.
Ask the patient to take frequent rest.
Asking the patient to do physical activity like walking swimming etc.
Instruct the patient to use assistive devices.
Asking the patient to verbalize his feelings.
To provide complete education to the patient about the disease and its treatment.
Ask the patient to maintain streak aseptic technique.
Provide education to the patient to participate in self care activities.
Encourage the patient to join self help groups and support groups.
c. Describe the types of Anesthesia.
Describe the types of anesthesia.
Anesthesia is a group of chemical agents that cause partial or complete loss of sensation.
There are three types of anesthesia.
1)Local Anesthesia:-
It affects a limited area of the body (local part). This usually affects the same part of the body where the surgery is to be performed or the part that needs to be numbed.
The following chemicals are used in local anesthesia.
Xylocaine hydrochloride
Lignocaine hydrochloride
Amethocaine Hydrochloride
Procaine hydrochloride
2) Spinal Anesthesia :-
There are two types of this-
1) Epidural anesthesia:- When anesthesia is injected into the epidural part of the spinal cord, it is called epidural anesthesia.
2)Spinal anesthesia:- When anesthesia is injected into the subarachnoid space of the spinal cord, it is called spinal anesthesia.
Uses of Spinal Anesthesia:-
Orchidectomy
Cesarean
Hernia surgery
Hydrocele surgery
Penile surgery
Prostate surgery etc.
Complication :-
Urinary retention
Meningitis
CSF leakage
Hypotension
Paralysis
Allergies, headaches etc…
3) General Anesthesia:- When sensation is to be lost in the whole body, the person is rendered unconscious. It is called general anesthesia. General anesthesia can be given as follows-
by intravenous
By Intravenous:-
I.V. The following drugs are used in general anesthesia by injection.
Thiopental sodium 2.5%
Hexabarbitone 10%
Methohexital Sodium 1%
Propofol
Midazolam
Fentanyl
Ketamine hydrochloride
Droperidol
Inhalation anesthetics:-
This anesthesia is given through inhalation which renders the patient unconscious.
Before this anesthesia is administered, the patient is given some sedative, then an endotracheal tube is inserted into the airway, and then it is given by inhalation.
The following medicines are used in this.
Sevoflurane
Nitrous oxide
Ether
Cyclopropane
Methoxyflurane
Enflurane
Panthrene
⏩Q-4 Write Short notes (Any Three) Write short notes. (Any three) 3×4=12
🔸 a. Techniques for physical assessment – Methods for physical assessment
Physical examination uses systemic assessment techniques and visual, auditory, textile, and all sense senses. All these senses will be used in specific assessment techniques.
For example, it is often detected by changes in body odor and fluid.
Four specific techniques are used in physical examination. including inspection, palpation, percussion, and auscultation.
Inspection is a visual examination of the patient. And there is a visual examination of the body, in which the patient’s general appearance, body size, gait, size, shape, posture, etc. are done carefully. This starts as soon as the nurse makes contact with the patient.
During the inspection phase of the physical assessment, the nurse uses observation skills to systematically collect observable data.
This includes measuring the patient’s respiratory effort, skin color, and wound size.
General Appearance
State of Conscious Personal Grooming
Expression: Concerned, Comfortable, Alert, Nervous. Body Build: Thin, Fatty, Moderate.
It also combines the patient’s words with no body language.
For example a patient’s pain experience is related to their body language.
Visualize the maximum area of the body in the inspection and compare it with the side of the other body.
Comparing the width of the right hand with the width of the left hand.
Adequate exposure of the body area is very important. In which looking at color, texture, mobility, symmetry, nutritional status etc.
Palpation
Palpation means feeling the texture, size, shape, placement, location, etc. of the organ using touch hands and fingers. In which the temperature, pulse, texture, moisture, mass, tenderness, and pain of the skin are assessed using the finger tips of the hand.
Assess skin, pulse, palpation, and tenderness by gentle palpation by pressing as deep as 1 cm.
Then press about 4 cm with the help of both hands which is deep palpation. With the help of it determine the size of organ and deep organ (liver).
What to keep in mind while doing palpation?
It is very important to always explain to the patient before palpation because touch is very important in our culture.
Keep hands warm and nails short before palpation. The palmar surface of the finger is more sensitive than the finger tips with the ulnar surface being more sensitive to vibration and the dorsal surface being used for temperature.
Palpation also helps to determine the size of the lymph node.
Always proceed with gentle palpation first followed by deep palpation. Because it can disrupt tenderness or fluidity.
The size and shape of the kidneys and uterus are assessed between the finger tips and organs using both hands.
Percussion
In simple words it is called tapping. To get the sound quality, the sound is heard against the patient’s body by tapping it with a finger. which is used to reflect the density of internal organs. Sound, vibration, and impedance are produced with different densities and vary from organ to organ. And it is used to know the size, shape, position of the internal organ and also to detect the fluid field organ.
Percussion is a technique that determines the consistency of physician practice nurse tissue.
Tapping in percussion involves making short or sharp strokes on the body surface to produce various palpable vibrational sounds.
Percussion is used to detect the sound, location, size, shape, size of many organs of the body. In which the examiner taps the patient. The middle finger of the non-dominant hand is usually placed over the percussion area to produce the sound. And placing the middle finger of the dominant hand on the non-dominant.
In which percussion is done in two ways.
Direct percussion
This is used for infant’s chest and adult’s sinuses. Specific parts of the body are struck with the help of finger tips.
In tenderness of the kidneys. Listen to the vibrations created.
It is necessary to select on the same point two or three times before doing on another. is done to get accurate readings. Fatty patient needs strong cushion.
_Percussion tones: air la ut, fluid dull and solid area soft.
Indirect percussion
This varies from area to area with the fingers of the non-dominant hand resting palm down on the CVA and gently striking the fingers of the dominant hand e.g. T.. in kidney….
_Thorax: The middle finger of the dominant hand strikes the interphalangeal joint of the non-dominant hand against the patient’s skin.
Percussion produces sound that has many sounds and different characteristics.
Characteristics of sound
Tympany is usually heard above the abdomen.
Resonance J in normal lung tissue.
Hyper resonance j in inflated lungs.
Dullness on the lungs.
On flatness muscles.
Auscultation
Auscultation is usually performed with a stethoscope. A stethoscope is used to block out extraneous sounds while assessing the condition of the heart, blood vessels, lungs, pleura, and bowels.
Which includes breath sound, heart vascular sound and bowel sound etc.
It is commonly used to detect the presence of abdominal sounds and assess their loudness, speech, quality, frequency, and duration.
The most common sounds heard are those of the lungs heart and abdomin and blood vessels.
The chest is auscultated to listen for heart sounds. Lung sounds are heard anteriorly and posteriorly for normal and spontaneous lung sounds. Abdomen is auscultated for bowel sounds.
Sound characteristics?
Intensity: Loud, Medium, Soft.
Pitch: Low, High, Medium.
Duration: Short, Long, Medium.
Quality: Booming, hollow, dull and drum-like.
b. Clinical manifestations of Cushing’s syndrome – Signs and symptoms of Cushing’s syndrome.
Increase in body weight.
Upper body obesity occurs and arms and legs become thin.
The patient’s face is round and red.
fatty buffalo hump in the neck region.
Its growth is also seen slow in children.
skin changes are:=
Skin infection is seen.
Acne is found in the body.
Straie (white color stretch marks on the abdominal skin) are seen on the skin of the abdomen, thigh, and breast.
skin with easily brushing.
The skin becomes thin, fragile.
muscles and bone changes include:=
Backache while doing routine activities.
Pain and tenderness in the bone.
Difficulty climbing stairs due to proximal muscles weakness.
Collection of fat between two shoulders (buffalo hump).
Fractures in rib and spinal cord due to bone thinning.
Muscle weakness.
Women with Cushing syndrome often have:
Cushing’s syndrome in women causes excessive growth of hair (hirsutism) in the face, neck, chest, thigh.
Irregular menstrual cycle.
man may have :=
decrease or no desire of sexual activity.
impotence
(ejaculatory failure).
other symptoms of Cushing syndrome are:=
Psychological problem: Depression, anxiety and behavioral changes are seen.
Blood pressure increases.
Bon a week.
Sleep disturbances are seen.
Excessive catabolism of proteins occurs.
Muscle wasting is seen.
Retention of sodium and water occurs.
Moon face appearance of the patient is seen.
Hyperglycemia in the patient
(hyperGlycemia) condition is seen.
polyuria (increased frequency of urination).
Polydypsia (Increase thirst).
c. Difference between gastric ulcer and duodenal ulcer – difference between gastric ulcer and duodenal ulcer.
(Student should write the answer given here in difference form.)
Gastric ulcer and duodenal ulcer are two types of peptic ulcers that occur in different parts of the gastrointestinal tract.
Here are the main differences between gastric ulcer and duodenal ulcer:
Gastric Ulcers Gastric ulcers occur in the lining of the stomach.
Duodenal ulcer
Duodenal ulcers occur in the beginning of the small intestine, known as the duodenum.
2) Symptoms:
Gastric ulcer
Pain in this ulcer arises immediately after eating while the stomach is full.
Pain is not relieved after eating but it is more severe.
Other symptoms include nausea, vomiting and weight loss.
Duodenal ulcer
Pain in duodenal ulcers occurs two to three hours after a meal and occurs when the stomach is empty, such as before meals or at night.
Duodenal ulcer pain is relieved after eating because food temporarily neutralizes stomach acid and acts as a cover around the ulcer.
3) Age and Gender Distribution:
Gastric ulcer
Gastric ulcer is more common in older adults i.e. above 60 years of age and there is usually no gender difference.
Duodenal ulcer
Duodenal ulcers are usually more common in young individuals, especially between the ages of 30 and 50 years.
Duodenal ulcers are generally more common in men than women.
4) Cause:
Common Causes for Both Ulcers:
Helicobacter pylori (H.pylori) infection: Major cause of both types of ulcers.
Non-steroidal anti-inflammatory drugs (NSAIDs): such as aspirin and ibuprofen that damage the stomach lining.
Lifestyle factors: Stress, smoking, excessive alcohol consumption and certain types of diet are responsible for developing ulcers.
SPECIFIC DIFFERENCES: Gastric ulcers are more commonly associated with nonsteroidal anti-inflammatory drug (NSAID) use and less frequently due to Helicobacter pylori (H.pylori) infection, compared to duodenal ulcers.
5) Complications:
Gastric ulcer
There is a higher risk of bleeding, especially if the blood vessels are affected, and there may be a higher risk of becoming malignant (cancerous).
Duodenal ulcer:
The risk of perforation is high in these ulcers where the ulcer creates a hole in the duodenal wall, the risk of malignancy is low in comparison to gastric ulcers.
6) Diagnosis:
Both types of ulcers are diagnosed using similar methods.
1) Endoscopy
In this procedure, a thin and flexible tube containing a camera is inserted through the mouth to visualize the stomach and duodenum.
2) Barium swallow X ray
This procedure is currently used less frequently but is used to visualize whether an ulcer is present or not.
3)H.pylori test
Blood, blood and stool tests are done in this and biopsy is also done at the time of endoscopy.
7) Treatment
Both are general treatment approaches for ulcers.
1)H.pylori eradication
Antibiotics should be provided if H.pylori is present.
2) Proton pump inhibitors (PPIs) or H2 receptor antagonists
To reduce stomach acid production and promote healing.
3) Discontinuation of Non-Steroidal Anti-Inflammatory Drug (NSAID)
If a non-steroidal anti-inflammatory drug (NSAID) is the cause.
4) Lifestyle modification
Such as dietary changes, reducing alcohol intake, stopping smoking and managing stress.
Understanding the difference between gastric and duodenal ulcers helps in their diagnosis and management, as well as providing appropriate treatment and reducing complications.
d. Inflammation – Inflammation
Definition (Definition).
The local response given by the living cell due to the injury of the body caused by any agent (microorganism) is called inflammation.
Inflammation is the body’s response to an ingested antigen.
Due to the inflammation process, mal function is seen in the immune system of the body.
Inflammation is a process in which the body’s white blood cells and chemicals protect the body from foreign substances or infectious agents.
which is a protective reaction of localized tissue causing localized pain, redness, swelling and sometimes loss of function
Tissues damaged by injury stimulate the entire process of inflammation. Which is a local response given by the skin and other tissues. Due to which redness, heat, swelling are seen. Due to increased blood supply, it is also seen as aria hot.
All these elements are caused by the activity of immune cells
Types of Inflammation (Type of Inflammation).
Acute Inflammation (Acute Inflammation).
Acute inflammation is characterized by rapid onset. In which local vascular and exudative changes are seen. Its duration is less than two weeks. An immediate response is seen in acute inflammation. When the injurious agent (microorganism) is removed, inflammation subsides and healing begins with return to normal function. Finally the structure is normalized.
Chronic Inflammation (Chronic Inflammation).
Chronic inflammation occurs when the agent causes continuous injury. It has long duration of symptoms. Which is up to month or year.
In chronic inflammation, proliferative changes are seen at the injury site. This cycle results in cellular infiltration, necrosis and fibrosis leading to permanent tissue damage.
Sub Acute Inflammation (Sub Acute Inflammation).
Sub acute inflammation is between acute inflammation and chronic inflammation. In which the element is activated as in the acute phase and repair occurs as in the chronic phase.
Etiology.
Exogenous factors
(1) Physical factors
A mechanical agent
In which inflammation occurs due to fracture, foreign substance
Thermal agent
Inflammation occurs due to burns, freezing
Chemical agent
Inflammation is caused by chemicals like toxic gases, acid bases, drugs and venoms.
(2) Biological factors
Bacteria
virus
Parasites and fungi cause inflammation
Endogenous factors.
Circulation Dis Order
Thrombosis
Infarction
Hemorrhage
All the above causes inflammation.
Systemic and Local Signs of Inflammation
Redness _ Due to vasodilatation, the blood pooled there due to which redness is observed.
Warm _ Vasodilatation increases the blood flow due to which the local area is warm.
Edema (swelling). Edema occurs due to the entry of leukocytes and fluid into the circulatory system. Swelling is also seen due to increased blood supply to the site of inflammation and limited venous return from that site.
Purulent exudate
Pain. _ Due to compression on its nerve endings due to swelling in the local area.
Loss of function
Fever
Wickness
Increase respiration
Increase pulse
Increase in WBC count
Treatment of Inflammation (Treatment of Inflammation).
Inflammation is the body’s short-term or long-term response to a stimulus. Treatment is necessary to minimize the changes and discomfort that develop in the body during this response. Following are the treatments given during inflammation.
Non-Steroidal Anti-Inflammatory Drug (NSAID)
This drug inhibits the production of prostaglandin from that cell
Medicines like paracetamol, ibuprofen etc. can be given.
Corticosteroids
Steroids block the formation of prostaglandins and inhibit the function of white blood cells that play an important role in the inflammatory process. It also suppresses the body’s temporary immunity so as to minimize the body’s resistance.
Antihistamine
Histamine is a chemical. Which is produced by WBC and connective tissue cells. such as basophils and mast cells that secrete histamine in an allergic response. Antihistamines can relieve symptoms of local inflammation and block the production of basophils and mast cells.
Hot and cold therapy
Cold therapy causes narrowing of the blood vessels, which inhibits inflammation and numbs the area, reducing pain.
Hot application increases the symptoms of inflammation but it helps if there are spasms or cramps in the muscles.
Nursing Management of Inflammation
assessment
Asking the client about risk factors, nutrition, medicine use, location, duration, redness, pain, swallowing.
To check the movement and circulation of the injured part and to check whether there is any discharge or not.
Nursing Management
Pain
Know the level of pain by using pain scale
Comfort majors such as back rubs, providing a comfortable position and engaging in mind diversional activities.
Administering analgesic and anti-inflammatory drugs as per doctor’s order.
Anchoring for a rest.
Giving hot and cold applications to relieve pain.
Elevate the inflamed part if possible.
Tissue integrity
Providing nutritional food for the healing process
Check the circulation in the affected part and the skin of the surrounding area.
Use sterile water or normal saline to clean the inflamed part.
Clean and dry the inflamed area. Keep it open to air for better healing.
Prevent infection
Check the wound for signs of infection like oozing, slow healing, bad smell etc. If pus is found, send it for culture.
Checking vital signs like temperature, pulse, BP, respiration
Do a WBC count test and do a complete blood examination.
Give fluids and give nutritional diet
If there is a wound then dressing with aseptic technique.
Washing hands before touching the inflamed area and washing hands after touching it
Giving foods rich in vitamin C speeds up the healing process.
⏩Q-5 Write Definitions (Any Six) Write definitions. (any six) 2×6=12
🔸 a. BIOPSY
A biopsy is a medical procedure. In which a small sample of tissue is collected from the body for examination under a microscope.
These are done to diagnose diseases, usually to determine whether a tumor is non-cancerous or malignant (cancerous).
A biopsy can be done on any part of the body and is usually done using a needle, but sometimes requires a surgical procedure.
The collected tissue is examined by a pathologist, who provides a detailed report on the presence, type and severity of any abnormalities observed.
b. Hemorrhoids –
Hemorrhoids are enlarged blood vessels located near the anus and rectum.
It can develop both internally and externally of the anus and rectum.
Common symptoms include pain, itching, swelling and bleeding.
Hemorrhoids are caused by increased pressure on the lower anus due to chronic constipation or diarrhea, obesity, pregnancy and heavy weight lifting.
c. Pleural effusion
A pleural effusion is the accumulation of excess fluid outside the lungs between the layers of the pleura. The pleura is a thin layer that covers the inside of the lungs and chest cavity and helps facilitate lung movement during respiration.
When excess fluid builds up in the pleural space, it can cause symptoms such as chest pain, shortness of breath, and cough.
d. Colostomy
A colostomy is a surgical procedure in which a portion of the large intestine (colon) is removed to create a stoma (opening) in the abdominal wall, called a colostomy.
A pouch attached to the stoma through this opening is useful for expelling faecal matter i.e. stool.
🔸 e. Quadriplegia
Quadriplegia, also known as tetraplegia, is a medical condition characterized by complete paralysis of both upper arms and legs.
This condition is usually caused by damage to the cervical (upper) spinal cord, resulting in loss of motor and sensory function below the level of injury.
f. Hyponatremia
Hyponatremia is a medical condition characterized by a lower than normal amount of sodium in the blood.
Sodium is an essential electrolyte that helps regulate water balance, nerve function, and muscle function.
Normal values for blood sodium levels are usually between 135 and 145 milliliters (mEq/L). Hyponatremia occurs when the level falls below 135 mEq/L.
🔸g. Pneumothorax
A pneumothorax, commonly referred to as a collapsed lung, is a medical condition in which air enters the pleural space, the area between the lungs and the chest wall.
Pneumothorax means filling of air in the pleural space.
This air pressure causes the lungs to collapse, leading to problems in lung function.
🔸һ. Нуроxemia.
Hypoxemia is a medical condition characterized by a lower than normal amount of oxygen in the blood.
A lower-than-normal oxygen level in the arterial blood, in particular, is termed hypoxemia.
It is a complicated condition because the body’s cells and tissues need oxygen to function properly.
⏩Q-6. ⏪ 🔸 a.Write Multiple Choice Questions Choose the correct answer from the following. 05
🔸1.In which disease convulsion occurs?
a) Meningitis
B) C.R.F – C.R.F
C) C.C.F – c. C. F.
D) Babinski response – Babinski response
🔸2.Removal of an entire lung is known as
(a) Bi-lobectomy – bi lobectomy
(b) Lobectomy Lobectomy
(c) Pneumonectomy Pneumonectomy
(d) Pleurectomy – Pleurectomy
🔸3.Hypophysectomy Means…… Hypophysectomy Means……
a) Surgical Removal of Adrenal gland Adrenal gland to be removed by surgery
b) Surgical Removal of Thymus gland
(c) Surgical Removal of Hypothalamus – Surgical removal of hypothalamus
(d) Surgical Removal of Pituitary gland – Removal of pituitary gland by surgery
(a) 80 to 120 mEq/L
(b) 135 to 145 mEq/L
(c) 70 to 110 mEq/L
(d) 3.5 to 5 mEq/L
5.An abnormal accumulation of interstitial fluid is termed as abnormal accumulation of interstitial fluid.
(a) Inflammation
(b) Necrosis
(c) Hypernatremia
(d) Edema
B. Fill the blanks 05
🔸 1.Inflammation of gastric mucosa is known as an infection in gastric mucosa is called…….. Gastritis.
🔸2.Blood present in the sputum is known as…… says hemoptysis.
🔸3.Painful urination is known as……. Painful pe .shab is known as …….. Dysuria.
🔸4.M.R.I stand for……. Full Name of MRI……. is Magnetic Resonance Imaging.
🔸5. Xerostomia means…… Dryness of Mouth
⏩C. State whether the following statements are true or false.
State whether the following statements are true or false 05
🔸1.Stone formation in urinary bladder is known as cholithiasis. A condition in which stone formation occurs in the urinary bladder is called cholethiasis. wrong
🔸 2. Deficiency of calcium called hypokalemia Deficiency of calcium is called hypokalemia. wrong
🔸3.Inflammation of nerve is known as Neuritis. Inflammation of a nerve is called neuritis. True.
🔸 4. Head trauma is the most common factor for Alzheimer disease. A major cause of Alzheimer’s disease is head injury. wrong