GNM-S.Y-MSN-II-GNC-PAPER-2017

⏩Q-1 50 years old Ramanbhai is just admitted in ward with congestive cardiac failure.Answer the following.

🔸a. What is C.C.F.?

C.C.F. stands for Congestive Cardiac Failure.

In congestive cardiac failure, the heart is unable to pump blood effectively throughout the body due to inadequate functioning. This leads to accumulation of fluid around the heart and in other parts of the body. As a result, blood cannot reach all body tissues and organs in sufficient amounts, depriving them of oxygen and nutrients.

This condition occurs when the heart’s function is compromised, affecting its ability to maintain normal circulation.

🔸b. Write the causes and risk factors of C.C.F.

Congestive Cardiac Failure (C.C.F.) is primarily caused by abnormalities in the heart muscles, leading to its inadequate functioning. Here are the main causes:

1. Myocardial infarction (heart attack)
2. Hypertension (high blood pressure)
3. Valvular heart disease
4. Cardiomyopathies (diseases of the heart muscle)
5. Arrhythmias (abnormal heart rhythms)
6. Chronic lung diseases
7. Hemorrhage (severe bleeding)
8. Anemia (low red blood cell count)
9. Anesthesia and surgery
10. Physical or emotional stress
11. Excessive sodium intake

Risk factors associated with C.C.F. include:

1. Hypertension
2. Hyperlipidemia (high cholesterol levels)
3. Diabetes mellitus
4. Coronary artery disease
5. Family history of heart disease
6. Smoking
7. Alcohol consumption
8. Use of cardiotoxic drugs

These factors and conditions contribute to the development or exacerbation of congestive cardiac failure by affecting the heart’s ability to pump blood effectively. Early identification and management of these risk factors are crucial in preventing or managing C.C.F.

🔸c. Explain the nursing management & life style modification of this condition in detail. 05

Here is the nursing management for congestive heart failure (C.C.F.):

Obtain Comprehensive Patient Information:

• Gather detailed medical history and conduct all necessary laboratory tests.

Assess Sleep Pattern:

• Understand the patient’s sleep habits and address any issues related to sleep quality.

Implement Complete Bed Rest:

• Ensure the patient adheres to complete bed rest to reduce cardiac workload.

Monitor Vital Signs:

• Regularly check temperature, pulse rate, respiratory rate, and blood pressure.

Assess Heart Sounds:

• Listen to the patient’s heart sounds for any abnormalities.

Examine Nails, Skin, Face, Tongue for Signs of Edema:

• Inspect nails, skin, face, and tongue for signs of fluid retention or congestion.

Administer Prescribed Medications:

• Ensure timely administration of prescribed medications.

Position Patient in Fowler’s Position:

• Position the patient comfortably in a semi-upright position to facilitate breathing.

Monitor Lung Sounds:

• Auscultate lung sounds to detect any abnormalities indicating fluid accumulation.

Listen to Respiratory Sounds and Identify Abnormalities:

• Assess respiratory sounds to identify any abnormalities or signs of distress.

Change Patient’s Position Every Two Hours:

• Rotate the patient’s position regularly to prevent pressure ulcers and improve circulation.

Encourage Deep Breathing Exercises Every 1 to 2 Hours:

• Instruct the patient to perform deep breathing exercises regularly.

Provide Small, Frequent Meals and Fluids:

• Offer small, frequent meals and monitor fluid intake.

Administer Oxygen If Necessary:

• Administer supplemental oxygen if the patient requires it.

Prescribe Diuretic Medication:

• Administer diuretic medications to manage fluid balance.

Monitor Intake and Output:

• Keep track of the patient’s fluid intake and output.

Monitor Weight Daily:

• Weigh the patient daily to track fluid retention.

Provide Potassium Supplements If Indicated:

• Administer potassium supplements as prescribed.

Monitor for Signs of Cardiac Decompensation:

• Continuously monitor the patient for any signs of worsening heart failure.

Educate Patient and Family About Disease and Treatment:

• Educate the patient and their family about congestive heart failure, its management, and the importance of adhering to treatment.

Encourage Gradual Increase in Activity:

• Gradually increase the patient’s activity level as tolerated.

Instruct Patient to Rest Between Activities:

• Emphasize the importance of resting between activities.

Provide Psychological Support:

• Offer psychological support to the patient and their family.

Assist with Lifestyle Modification:

• Help the patient make necessary dietary and lifestyle changes.

Ensure Proper Follow-Up and Compliance:

• Ensure the patient understands the follow-up plan and complies with medications and lifestyle modifications.

This comprehensive nursing management plan aims to stabilize the patient’s condition, manage symptoms, and improve quality of life while preventing complications associated with congestive heart failure.

🔸OR🔸
⏩Q-1 Mr. Popatbhai is admitted in your ward with lung cancer. Answer the following.

🔸a. What is lung cancer?

Lung cancer refers to the malignant growth of epithelial cells within the lungs. Due to its frequent occurrence in both the large and small airways (bronchi and bronchioles), lung cancer is often termed Bronchiogenic cancer or Bronchiogenic carcinoma.

It can also originate from the mesothelial cells lining the pleura (pleural cavity), in which case it is known as mesothelioma.

Additionally, lung cancer can develop from other supporting tissues besides epithelial cells, such as blood vessels.

The lungs are a common organ from which cancer can easily metastasize (spread to other organs).

🔸b. Write the post-operative care in lung cancer. 05

Monitor Chest Sounds, Respiratory Rate, Pattern, and Depth:

• Assess for any abnormal sounds or changes in respiratory parameters which may indicate complications.

Arterial Blood Gas (ABG) Assessment:

• Regularly check ABG levels to monitor for hypoxia and carbon dioxide retention.

Assessment of Pulmonary Status:

• Monitor for any changes in pulmonary status that could indicate complications such as wound or surgical scar leakage.

Skin Assessment:

• Regularly inspect the patient’s skin for signs such as pallor, coolness, or moisture, which may indicate shock or infection at the site of wound or surgical scar.

Infection Prevention:

• Maintain aseptic techniques during wound care and dressing changes to prevent infection.
• Monitor for signs of infection such as redness, warmth, swelling, or discharge from the wound.

Temperature Monitoring:

• Measure temperature every 4 hours to detect any signs of infection or sepsis.

Monitoring for Respiratory Complications:

• Watch for signs of fever, confusion, or respiratory distress, which may indicate the development of pneumonia or other respiratory infections.

Antibiotic Medication:

• Administer antibiotics as prescribed to reduce the risk of infection.

Maintain Positioning:

• Ensure the patient returns to a semi-fowler or upright position once vital signs normalize. Proper positioning supports chest expansion and facilitates adequate oxygen delivery to both lungs.

Analgesic Medication:

• Administer pain medication as prescribed to alleviate discomfort and monitor its effectiveness using a pain chart.

Encourage Exercises:

• Encourage deep breathing and coughing exercises hourly to help clear secretions from the lungs and prevent infections and atelectasis (lung collapse).

Education on Chest Tube and Drainage:

• Instruct the patient on how to support the chest tube or surgical scar to prevent tension on the wound, which can lead to dehiscence or reopening.

Chest Physiotherapy and Postural Drainage:

• Perform chest physiotherapy and postural drainage to assist in the removal of secretions from the lungs using gravity assistance.

Oxygen Therapy:

• Administer supplemental oxygen as needed to prevent hypoxia. Oxygen inhalation should maintain proper hydration and avoid drying of mucous membranes, which can lead to soreness and infection.

Deep Vein Thrombosis (DVT) Prevention:

• Encourage leg exercises to promote blood circulation and reduce the risk of DVT. Administer prescribed heparin injections as a prophylaxis against blood clot formation.

Apply Anti-embolism Stockings:

• Apply anti-embolism stockings to improve venous return, preventing venous stasis and the formation of emboli.

Maintain Chest Tube and Drainage System:

• Monitor the drainage system closely and ensure the chest tube remains patent and connected. Avoid clamping the drainage tube without surgeon’s orders to prevent air from entering the drainage system, which can cause pneumothorax.

Sterile Water Bottle:

• Keep a sterile water bottle at the bedside to use immediately if the drainage system breaks or leaks. Replace the drainage system promptly to prevent the development of pneumothorax or fluid reaccumulation in the pleural space.

Immediate Action for Accidental Removal of Drainage Tube:

• If the drainage tube accidentally dislodges, quickly wear gloves and pinch the skin with fingers where the tube has exited. Apply a dressing 2 inches around the site and promptly notify the surgeon.

This comprehensive post-operative care plan ensures that patients recovering from lung cancer surgery receive diligent monitoring and interventions to prevent complications and promote recovery.

🔸c. Health education on prevention of lung cancer. 04

SMOKING – Avoid Smoking

Smoking (cigarette) contains alkaloid products such as nicotine which can promote cancer growth. Therefore, it is harmful not only to smokers but also to passive smokers (people living in the surrounding areas).

FAMILIAL PREDISPOSITION

If there is a history of cancer in the family, it is advisable to maintain a healthy lifestyle from the beginning, stay away from addictions, and exercise regularly to prevent familial predisposition.

According to the research by the International Agency for Research on Cancer (IARC), it has been found that due to small region mutations, cancer can also occur.

PRIOR HISTORY OF LUNG CANCER

If cancer has occurred once, it is advisable to stay away from factors that cause cancer. If smoking has been quit once, it should not be started again and a simple lifestyle should be adopted.

NUTRITION

Eating fruits and vegetables such as green vegetables and carrots reduces the risk of lung cancer by half. Vitamin supplements can also be taken.

LUNG DISEASE

The chances of lung cancer increase due to lung diseases.

AIR POLLUTION

Due to smoke from vehicles, industries, and power plants, the risk of lung cancer increases, so contact with it should be avoided for a long time.

ASBESTOS FIBERS

Asbestos is a silicate fiber that can remain in the lungs for a lifetime. Generally, it can be found in thermal plants. Smoking increases the chances of cancer due to asbestos exposure. Individuals exposed to asbestos should never smoke.

This translation covers the main points and recommendations provided in the Gujarati text regarding smoking, familial predisposition, nutrition, lung disease, air pollution, and asbestos fibers.

⏩Q – 2 A 20 years old Arunaben is admitted in ward with ulna radius fracture of right hand. Answer the following. 08

🔸(i) Assessment of Musculoskeletal Functions

HISTORY

Subjective Data (What the patient complains of)
Objective Data (Symptoms observed by staff)

Patient’s Personal History

• Name, age, ethnicity, surname, bed number, registration number, diagnosis

Chief Complaint

• Current patient discomforts such as pain, discomfort, etc.

Previous Health History

Psychological History

Lifestyle Data

History of any accidents or injuries

Mechanism of Injury: How it occurred? Have there been any changes in symptoms?

Medical History: What medications are you currently taking? Have you had any illnesses before or been admitted to the hospital or taking any medication daily? If yes, complete information should be obtained about it.

Social History: Inquire about employment, exercise, work, any bad habits, and all of these things.

PHYSICAL EXAMINATION

General Musculoskeletal Examination

• Mobility (Check the hands for mobility)
• General Joint Mobility and check for abnormalities.
• Muscles (Muscles)
• Muscle tone
• Hypertrophy
• Tension of muscles
• Which questions should the patient ask?
• Can you see that the muscles are paralyzed and they are not contracting.
• If you have previously supported extremity pain, can you perform a full range of motion?
• When should we worry about gravity?
  place at heard or Whether you head from now on Whether 36

Examining his joints and bones.

• Is the cementary of both hands equal?
  -Does the patient have swelling at the site of injury?

Does the patient have any deformities?
-Does the joint make a grinding noise or does it feel like there is wear in the shaft?

To check the patient’s reflexes and also to check whether enough blood is reaching the injured area or not.

The patient should also check if the skin is hot or cold at the affected area or if there are any rashes or abrasions.
DIAGNOSTIC TEST

• x ray
• CT scan
• MRI
• Bone scan
• To perform laboratory tests.

🔸(ii) Nursing intervention during traction.

a – patient education

• Explain traction to patient and apply traction as ordered by surgeon.
• Telling the patient how much you can move your arm and also explaining how to move.
• Explain to the patient about the same body position.

b – Maintain traction continuously as long as prescribed by the doctor.

• Occasionally check if the traction rope is straight and if the pulleys are aligned.
• Ensure that the weight applied in traction hangs freely under the patient’s bed.
• Pay attention that there is no friction in the ropes applied in traction.
• Do not add or remove weight in traction.
• Check the Thomas splint and ensure that if the ring appears to have loosened, then fit the ring without removing the traction.

c – Skin Care

– Instruct the patient to inform if they feel reduced pressure when the bandage is reapplied.
– Ensure that the skin does not get damaged due to the force applied by traction.
– Check areas where rings are present due to traction to ensure there are no indentations. Apply powder when bathing to keep those areas dry.
– Check if there are no scratches, injuries, or wounds due to traction. If found, reduce pressure and readjust traction.
– Keep the pin site (where applicable) clean and dry. Clean with hydrogen peroxide or povidone iodine solution.

d – Toileting

– When needing to use the bathroom, utilize a bedpan.
– For female patients, use a waterproof material along with the bedpan.

🔸B. Standard safety precautions for HIV infection. 04

• Never reuse a needle or syringe in a hospital setting.
• HIV testing is mandatory during pregnancy to prevent transmission to infants.
• Use condoms during sexual intercourse.
• Avoid having multiple sexual partners.
• Ensure condoms do not break during use.
• Test for HIV before receiving a blood transfusion.
• Inform individuals who test HIV-positive about antiretroviral therapy.
• Educate all healthcare workers, whether acute, chronic, or home care, and dental workers about safety precautions.
• Many people are drug abusers and may share needles, which can spread HIV.
• Provide education and increase awareness among the public about HIV.

⏩Q-3 Write short Answer(ANY TWO) 2X6=12

🔸a. Control of infection

Controlling infection, especially in healthcare settings, involves a comprehensive approach to prevent the transmission of pathogens. Here’s a detailed look at various strategies and practices used to control infection:

1. Hand Hygiene

• Importance: Hand hygiene is crucial as it prevents the spread of infections.
• Practices:
  • Handwashing: Use soap and water for at least 20 seconds.
  • Hand Sanitizers: Use alcohol-based hand rubs with at least 60% alcohol when soap and water are not available.
  • Technique: Ensure thorough coverage of all surfaces of hands and wrists.

2. Personal Protective Equipment (PPE)

• Types: Gloves, masks, gowns, face shields, and goggles.
• Usage: Wear appropriate PPE based on the type of exposure risk (contact, droplet, airborne).
• Training: Ensure staff are trained on proper donning and doffing techniques to prevent contamination.

3. Environmental Cleaning and Disinfection

• Cleaning Protocols: Regular cleaning of surfaces and equipment using approved disinfectants.
• Focus Areas: High-touch surfaces like bed rails, door handles, and medical equipment.
• Standards: Follow guidelines such as those from the CDC or WHO for specific cleaning protocols.

4. Sterilization of Medical Instruments

• Methods: Autoclaving (steam sterilization), ethylene oxide gas, or hydrogen peroxide plasma.
• Monitoring: Use biological indicators and chemical indicators to ensure sterilization efficacy.

5. Vaccination

• Programs: Implement vaccination programs for healthcare workers and patients.
• Vaccines: Include influenza, hepatitis B, and COVID-19 vaccines as part of the routine immunization schedule.

6. Isolation and Cohorting

• Isolation Precautions: Place infected patients in isolation rooms with appropriate signage.
• Cohorting: Group patients with the same infection to minimize cross-contamination.

7. Antimicrobial Stewardship

• Guidelines: Develop and implement protocols for the appropriate use of antibiotics.
• Monitoring: Track and review antibiotic use and resistance patterns to prevent the development of antimicrobial resistance.

8. Surveillance and Monitoring

• Infection Surveillance: Implement systems to monitor and report infections, such as hospital-acquired infections (HAIs).
• Data Analysis: Use data to identify trends, outbreaks, and areas for improvement.

9. Education and Training

• Programs: Conduct regular training sessions for healthcare staff on infection control practices.
• Updates: Keep staff informed about the latest guidelines and best practices.

10. Policies and Protocols

• Development: Create and update infection control policies and procedures based on current guidelines.
• Compliance: Ensure compliance through regular audits and feedback mechanisms.

11. Patient and Visitor Education

• Information: Provide information on infection prevention practices to patients and visitors.
• Signs and Symptoms: Educate them on recognizing signs of infection and the importance of reporting symptoms promptly.

12. Use of Technology

• Automated Systems: Implement electronic health records (EHRs) and surveillance systems to track infections and antimicrobial use.
• Innovation: Explore technologies like UV-C light for surface disinfection and air filtration systems to reduce airborne pathogens.

13. Collaboration and Partnerships

• Local and Global Networks: Engage with public health authorities, professional organizations, and international bodies to share knowledge and resources.
• Research and Development: Support research in infection control methods, vaccines, and treatments.

14. Crisis Management

• Preparedness Plans: Develop and regularly update emergency preparedness plans for outbreaks and pandemics.
• Response Drills: Conduct simulation exercises to ensure readiness and coordination during actual events.

Conclusion

Effective infection control requires a multi-faceted approach involving strict adherence to hygiene practices, use of PPE, rigorous cleaning and sterilization protocols, and ongoing education and monitoring. By integrating these strategies, healthcare settings can significantly reduce the risk of infections and protect patients, staff, and visitors.

🔸b. Etiology of sensorineural hearing loss–

🔸b. Etiology of sensorineural hearing loss:

Sensorineural hearing loss can be congenital (present at birth) or acquired.

1.Congenital:

• Incomplete development of the cochlea (a part of the inner ear).
• Chromosomal syndromes.
• Hereditary factors.
• Infections in the cochlea at birth.
• TORCH infections during pregnancy.

2.Acquired:

• Commonly seen in older individuals.
• Tumors, benign or malignant, such as acoustic neuromas, meningiomas, and brain tumors.
• Medications like antimalarials, aminoglycosides, antineoplastics, and Viagra.
• Childhood infections like measles, mumps, cytomegalovirus, herpes, and syphilis.
• Premature birth.
• Fetal alcohol syndrome.
• Congenital malformations.
• Damage to the myelin sheath covering the auditory nerve (demyelinating diseases).
• Prolonged exposure to loud noises causing damage to the cochlea.
• Meniere’s disease.
• Viral infections in the inner ear (labrynthitis).
• Otosclerosis.
• Physical trauma.
• Autoimmune diseases.

HIV/AIDS directly affects the cochlea and central auditory system.

Newborn babies may experience hearing loss due to infections like cytomegalovirus.

Exposure to chemicals that harm the ear (toluene, carbon monoxide, lead, mercury, etc.) can also lead to hearing loss.

🔸c. Psoriasis

Definition:
Psoriasis is a chronic inflammatory disorder that is non-infectious and often recurrent.

It involves increased keratin synthesis. It is characterized by red and round plaques, usually covered with silvery white scales. When these silvery white scales are removed, pinpoint bleeding can occur, known as the ‘Auspitz phenomenon’.

Types of Psoriasis:

Plaque Psoriasis :

• Caused by streptococcal pharyngitis.

Generalized Psoriasisand Localized Psoriasis

• May require hospital admission due to symptoms like fever, chills, hypokalemia, and soreness. Previous history may show erythematous and scaly lesions.

Erythematous Psoriasis

• Red-colored lesions are visible throughout the body. It is difficult to control the patient’s body temperature, hypoalbuminemia, and inflammatory vasodilation. Complications of psoriasis include psoriatic arthritis.

MEDICAL MANAGEMENT

• Topical keratolytic agents such as salicylic acid and emoniated mercury
• Topical corticosteroids
• Moist dressing to reduce inflammation
• The use of emollients (they soften the skin and smooth it out), helping to reduce psoriatic plague and also its thickness. If patients are allergic to emollients, use colt ( it is a product of petroleum jelly).

⏩.Q-4 Write short notes (ANY THREE)ટૂંકનોંધ લખો(કોઈપણ ત્રણ) 3X4=12

🔸a. Different between hypotension & hypertension.

1 – HYPERTENSION
DEFINITION – Hypertension is when blood pressure exceeds normal levels (blood pressure > 120/80 mm of Hg).

CAUSES

• Genetic factors
• Lifestyle factors (sedentary lifestyle, lack of physical activity, obesity, stress, etc.)
• Smoking
• Age > 65 years
• High salt intake
• Alcohol addiction

SYMPTOMS

• Headaches
• Shortness of breath
• Nosebleeds
• Confusion
• Chest tightness

COMPLICATIONS

Hypertension can lead to complications such as heart attack, stroke, kidney failure, and other cardiovascular and eye diseases.

PREVENTION

• Eat fruits and vegetables
• Avoid oily food
• Limit salt intake
• Quit smoking
• Avoid alcohol consumption
• Eat fish
• Avoid red meat
• Exercise daily
• Regular health check-ups

TREATMENT

Several medications are available to lower high blood pressure. Treatment involves taking prescribed medications as directed by your physician and making lifestyle improvements accordingly.

Refusing to take medication

HYPOTENSION

DEFINITION

Hypotension occurs when blood pressure drops below normal levels (blood pressure < 90/60 mm of Hg).

CAUSES

• Genetic factors
• Prolonged fasting
• Medical conditions (infections or hormonal disorders)
• Pregnancy
• Blood loss
• Medication

SYMPTOMS

• Blurred vision
• Dizziness and lightheadedness
• Fatigue
• Nausea
• Trouble concentrating

COMPLICATIONS

• Fainting spells
• Fatigue
• Increased risk of injury due to falls

PREVENTION

• Drink plenty of fluids
• Avoid prolonged fasting
• Increase salt intake
• Avoid prolonged standing
• Wear compression stockings

TREATMENT

If someone experiences a sudden drop in blood pressure, they should immediately consume something salty and drink fluids. If a person consistently suffers from hypotension, regular medication may be prescribed to manage it, which can help stabilize their condition.

🔸b. Describe the symptoms of tuberculosis of the initial stage of disease.

These symptoms are characteristic of pulmonary tuberculosis (TB), which affects the lungs and is known as pulmonary TB. Here are the symptoms typically associated with active pulmonary TB:

• A bad cough that lasts 3 weeks or longer: Persistent coughing is a primary symptom of pulmonary TB.
• Coughing up blood or sputum (phlegm from deep inside the lungs): This can include coughing up blood-tinged sputum.
• Pain in the chest: Chest pain or discomfort may occur, especially during coughing or deep breathing.
• Weakness or fatigue: Feeling tired or weak can be a sign of the infection affecting the body.
• Weight loss and loss of appetite: Significant weight loss and a decreased appetite are common due to the impact of the infection on overall health.
• Night sweats: Experiencing drenching sweats during sleep, often disrupting normal rest.
• Fever: Mild to moderate fever is often present, especially in the later stages of the disease.
• Chills: Episodes of feeling cold and shivering may accompany fever.

If someone experiences these symptoms, especially coughing that lasts for several weeks, coughing up blood, or unexplained weight loss, they should seek medical attention promptly for evaluation and possible testing for tuberculosis. Early diagnosis and treatment are crucial for managing and controlling the spread of the disease.

🔸c.Health education to prevent low back pain.

1. Use proper body mechanics.
2. Avoid frequent bending, twisting, lifting, and running.
3. Change positions slowly.
4. Limit activities to 20 to 50 minutes based on comfort level.
5. Rest completely in bed for 1 to 2 days. Gradually resume daily activities.
6. Stand upright for such a long time, rest one leg on a small stool or platform when pain occurs. Rest between activities.
7. Use proper body mechanics when lifting or bending to protect the body.
8. Daily exercise is important in relieving back pain.
9. Wear comfortable, flat shoes and walk daily.
10. Eat a balanced diet with plenty of fruits and vegetables to prevent constipation and low-fat intake.
11. Get good support on hard floors.
12. Immediate doctor’s advice for worsening pain or new symptoms.
13. Reduce weight and exercise regularly every day.
14. Encourage self-care activities when the back pain is less.
15. Advise the patient to avoid long periods of sitting, standing, or walking.
16. The patient is comfortable lying on a firm mattress. Suggest rolling to one side and gently pulling out of bed.
17. Encourage the patient to maintain a regular exercise program and regular exercises for the back.
18. Encourage them to improve their posture and regularly use body mechanics.
19. Avoid activities such as horseback riding and weight lifting.
20. Use lumbar support for coughs.
21. Avoid heavy objects, lifting, and bending.
22. Avoid continuous activities with constant movement.
23. The combined work with constant vibration

🔸d. Prevention of scabies

Prevention of Scabies

1. Wash all clothing and linen: Clean all clothes, towels, and linens thoroughly. Use hot water and detergent, and dry them completely using a hot dryer cycle, especially for items that cannot be washed in hot water.

2. Dry-Clean items: Items that cannot be washed in hot water should be dry-cleaned to prevent the spread of mites.

3. Starve the mites: Store items that cannot be washed or dry-cleaned in a sealed plastic bag for at least three days in a warm place such as a garage. Mites will die if they do not feed for a week.

4. Identify and serve all staff, volunteers, and contacts who have come into contact with scabies patients or used clothing, towels, or furniture in the same scabies contact.:

Use appropriate barrier measures during patient care: Ensure direct skin-to-skin contact is avoided. Use gloves when handling the patient or their belongings, and wash hands thoroughly afterwards.

Confirm diagnosis of scabies: Properly diagnose and confirm the case of scabies through clinical examination. Initiate treatment promptly upon confirmation.

Comprehensive care and follow-up: Provide thorough care and follow-up for the case, ensuring all prescribed medications are completed. Monitor the patient’s progress closely.

Profiled care for those who have had long-term skin contact with the affected case: Conduct skin-to-skin contact with the patient for a minimum of eight hours after the skin contact is avoided should be discouraged

Barrier precautions during patient care: All caregivers and contacts should use protective garments such as gowns, gloves, and shoe covers to prevent direct skin-to-skin contact and reduce the risk of transmission.

Cleaning and disinfection of the patient’s room: Ensure thorough cleaning and disinfection of the room where the affected person resides. Use hot water and hot dryer cycles to launder bedding and clothing used by the affected individual.

Isolation and restriction of contact: Ideally, isolate the patient in a single room until the scabies is effectively treated. Minimize contact with other individuals, especially those who may have compromised immune systems or are at higher risk.

Education and training: Educate all caregivers, healthcare staff, and family members on proper hygiene practices and the use of protective equipment. Emphasize the importance of strict adherence to these measures to prevent spread.

Follow-up care and monitoring: Conduct regular follow-up visits with the patient to monitor their progress and ensure that treatment is effective. Maintain vigilance for any signs of recurrence or complications.

Coordination and communication: Maintain clear communication among healthcare providers, caregivers, and family members to ensure everyone is informed about the necessary precautions and protocols.

When a person experiences their first scabies infestation, symptoms of itching can typically appear within weeks. However, in the case of crusted scabies, individuals may spread the infestation asymptomatically for extended periods, complicating early detection and treatment.

For those affected by crusted scabies, intensive treatment typically involves repeated and meticulous skin care over a period of at least two weeks. Successful strategies often include local treatments with permethrin or oral treatments with ivermectin. These approaches are crucial to effectively manage and prevent the spread of crusted scabies among individuals who may be more susceptible or vulnerable.

⏩Q-5 Give Meaning (ANY SIX) 2X6=12

🔸a. Extravasation – Extravasation refers to the leakage of medication or fluid from a vein into the surrounding subcutaneous tissue. This occurs especially with blood or blood cells.

Inflammation can lead to the movement of white blood cells through the walls of capillaries, causing leakage into nearby tissues.

🔸b. Phlebotomy – Phlebotomy is a surgical procedure in which an opening is made into a vein.

It involves the use of a needle to remove blood.

This procedure is used to diagnose many medical conditions and to treat them.

There are two types: venipuncture and capillary puncture.

🔸c. Chancroid – Chancroid is a sexually transmitted disease caused by the gram-negative bacterium Haemophilus ducreyi.

It produces painful, irregular, deep genital ulcers, which may be accompanied by papules (fluid-filled bumps) and pustules (pus-filled bumps).

Often, it is associated with swollen lymph nodes and can be seen with HIV infection.

🔸d. Exenteration – Exenteration is a surgical procedure in which a body part or cavity is completely removed, especially used more in cases of malignant cancer.

Examples include orbital exenteration, pelvic exenteration, digestive exenteration, and others.

🔸e. Myelosuppression – Myelosuppression is a condition where the bone marrow is unable to produce enough blood cells (RBCs, WBCs, and platelets).

Due to myelosuppression, there is an increased risk of blood disorders such as anemia, infections, and bleeding.

Many people experience myelosuppression as a result of chemotherapy.

🔸f. Incubation period – The incubation period is the time interval during which a harmful pathogen (such as bacteria, viruses, fungi, etc.) enters a person’s body and the person comes into contact with the infection before showing the first symptoms.

For example, the incubation period for tetanus (lockjaw) is 3-21 days. This means that symptoms of tetanus may appear anytime between 3 to 21 days after the tetanus bacteria enter the body.

🔸g. Neoplasm – A neoplasm refers to an abnormal process of cell division where cells initially grow smaller and then proliferate to become larger. When these cells come into contact with each other, their division becomes inhibited, known as contact inhibition. However, when the cells become neoplastic, this process of contact inhibition breaks down, leading to uncontrolled growth of new cells, which can be referred to as neoplasia or cancer cells.

Neoplasms, or cancer cells, now exhibit irregular growth due to their inability to follow normal cellular growth and inhibition processes.

🔸h. Sprain – A sprain is an injury to a ligament caused by overstretching of a body part (limbs) due to excessive stress. This can result in damage to the connective tissue fibers of another ligament’s joint, leading to an inflammatory response such as swelling, redness, pain, etc.

There are three types of sprains:
1. Mild: In this type, there is a slight tear of ligament fibers, causing minimal disruption to its function and the ligament remains stable.
2. Moderate: This type involves a more significant tear of ligament fibers, leading to some loss of function.
3. Severe: Here, the ligament fibers are completely torn, resulting in total loss of its functional ability.

⏩Q-6 A. Fill in the blanks. 05

1.HIV virus is ______virus. Retro virus

2.______are taken from a donor of same species. Allograft (homograft

3.Atropine sulphate is used to pupil. Dilatation

4.Aerochordons is also called _______tags Skin tags

5._______organism causes filariasis Nematodes (roundworms)

⏩B. State whether following statements are True or False. 05

Lice and mite are parasity infection. correct

Types of Diaster are natural and manmade. correct

Normal pulse pressure is 40 mm/Hg.correct

Pott’s fracture means fracture of medial malleolus of the Tibia & Fibula.correct

The causative organism of swine flu is HjNj. correct

⏩C. Match the following:- 05

a. Disarticulation– i. Brudzinsk’s sign

b. Rheumatic Fever ii.MonoclonalAntibodies-

c. Biological Response Modifier iii. Bordetella pertusis

d. Meningitis – iv. Amputation through a joint

e. Whooping cough V. Polyarthrietis –

ANSWER :-

a – iv
b – v
c – ii
d – i
e – iii

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