General Nursing & Midwifery (First Year)-FOUNDATION OF NURSING-25/09/2024-UPLOAD NO.9

FOUNDATION OF NURSING-25/09/2024

Q-1 a. Define hospital .03

Hospital is an institution for the care of patients and treatment of people injured due to accidents etc. The word Hospital is derived from Hospus. Hospus means guest, meaning the patient who comes here is a guest and the institution that takes care of him is the hospital. The work of curing the sick people is done in the hospital.

A hospital is an institution where more than one person works for the same goal. Our goal in a hospital is to work for health and where the disease of a sick person is diagnosed and comprehensive care is provided to him. The team of people working here is called a health team. This health team includes doctors, nurses, social workers, servants and technicians. The hospital is a community agency. A person from any group of society can come to the hospital for treatment and the health team provides treatment to every person without any discrimination of religion, caste, age etc. When a patient comes to the hospital, he is a guest of the hospital and he goes home after getting better. During this time, an image of the hospital is formed in him. If he has been given good treatment, then he takes a good image with him.

b. List of different departments of hospital.04

List of Clinical Departments in a Hospital:

• Casualty Department: To provide emergency medical care
• Operation Theater (OT): To perform surgical procedures.
• Intensive Care Unit (ICU): For special critical patients
• Anesthesiology Department: For giving anesthesia
• Cardiology: For heart
• ENT: Eye, ear and throat
• Gynecology Department: For women’s diseases
• Pediatric Department: For children
• Neurology Department
• Oncology Department: For cancer
• Ophthalmology Department: For eyes
• Orthopedic Department: For bones
• Urology Department: For Psychiatry Department: For mental illness
• Indoor Patient Department (IPD): For admitted patients
• Outdoor Department
• Nursing Department
• Pharmacy Department
• Laboratory Department
• Administrative Department

c. Write down functions of the hospital. 05

Function of Hospital:

Patient Care

Taking care of patients All kinds of care are taken of all patients admitted to the hospital, from admission to discharge, their nursing care and other needs are provided and in addition, 24-hour treatment is provided in emergencies

Prevention of Diseases

Prevention is Better The hospital doctors together with the hospital doctors prevent the patient’s disease. To prevent the disease from occurring, immunization is done in advance. In addition, the necessary cleaning and other work is done by the hospital to prevent diseases from occurring in the hospital

Promotion of Health

To improve the health of the patients admitted to the hospital, they are also given advice related to the disease by the hospital itself. So that the patient can improve his health, his relatives are also given health education and any person associated with health in the hospital can provide this type of health education

Investigation

In recent times, there has been a huge progress in medical science in diagnosis and treatment New investigations and related tools have also been invented for the diagnosis of each patient so that the diagnosis of the disease can be made quickly. The diagnosis of the patients admitted to the hospital is determined by conducting the necessary investigations immediately and the necessary treatment is started accordingly. This is an important function of the hospital.

Rehabilitation

Rehabilitation and Occupational Therapy Every person admitted to the hospital wants to recover and become stable in his society or profession again. Such patients are given specific guidance for which their total history is obtained from the beginning and guidance is given according to it till the last step.

Medical Education

Medical Education All the activities running in the hospital include many types of education and it is provided by doctors, nurses, physiotherapists, pharmacists and technicians. In addition, medical education is planned at the required places. In-service education is provided as per the requirement for the staff staying inside the hospital. To train everyone by planning and this type of education is given in accordance with new discoveries and new health programs etc.

Medical Research

Different patients are admitted to the medical research hospital, according to which many types of research can be done by knowing their problems. This work of research is as important as medical education, however, many types of research are done in many branches of the hospital and every person should know them. Through new research, many types of skills can be learned by knowing new knowledge.

Social Services

That is, social services are provided by the hospital and security is taken into account. In this, social is especially given to the patients. For this, there is also a social welfare department where social workers give appropriate advice to everyone. In accordance with security, many types of certificates are provided by the hospital such as physical fitness, age certificate, handicap certificate, etc. Along with this, certificates are provided to injured patients and 10 certificates to deceased patients. Birth and postmortem reports for the body are also given

Administration of Institute

Hospital is a large institution, all the employees in it are managed by the administrative office of the hospital. Records are kept about the service of each employee. Records Many types of records are kept by the hospital, including records from admission to discharge of the patient, birth and death records, infectious disease records, in addition to this, some types of statistical information are recorded. Written records of this matter are regularly sent to the necessary places, so this work is very important for the hospital

OR

a. Write down definition of health.03

In 1948, W.H.O (World Health Organization) has given the definition of health, which is as follows.

“Health is a state of complete physical, mental, social and spiritual well-being and not merely the absence of disease or infirmity.”

As per WHO

“Health is a state or complete physical, mental, social and spiritual well-being and not merely an absence of disease or infirmity.”

However, health is a constantly changing process, so it is very difficult to maintain this goal. Health is common in most cultures. In fact, every community has its own concept of health, health is a fundamental and fundamental right of every individual, which has also been included in the constitution.

b. Describe dimensions of health. 04

Physical dimension
The complete functioning of the body is a sign of good physical health.

Good complexion
Healthy skin
Bright complexion
Luscious hair and body with no excess fat
A sweet breath
Good appetite
Good sleep
Regular function of bowel and bladder
Smooth and coordinated body movements
All vitals are within normal range.

2.Mental dimension

Good signs of a mentally healthy person

Free from internal conflict, well adjusted

Accepts criticism and does not get upset easily. Seeks to identify oneself

Strong sense of self-esteem, knows oneself (needs problems and goals)

Self-control, faces problems well and tries to solve them intelligently.

3.Social dimension
The social skill level of a person, ability to function in social situations and see oneself as a member of society.

4.Spiritual dimension

It is related to the soul and feelings of a person. It is the belief in the universal aspect of the universe.

Which resolves both internal and external conflicts.

Helps individuals find the meaning and purpose of life.

Provides a philosophy of life. Direction, ethics, values and principles of living a high life.

Provides strength and confidence to face real life situations.

5.Emotional Dimension

This is related to feelings.

6. Vocational Dimension

This is a part of human existence.

Plays the role of promoting both physical and mental health.

It provides satisfaction and self-esteem.

7. Other Dimension

Philosophical Dimension Cultural Dimension

Socio-economic Dimension Educational Dimension

Nutritional Dimension Curative Dimension

_Preventive Dimension etc.

c. Discuss factors influencing on health.05

1. Lifestyle

• Diet: Not eating a satisfying and nutritious diet can lead to health problems, such as nutritional deficiencies and obesity.
• Exercise: Lack of regular exercise can lead to heart disease, obesity, and other diseases.
• Tobacco and Alcohol: Smoking and excessive alcohol consumption are harmful to the environment.
• Substance Abuse: Substance abuse can have serious health effects.

2.Diet and Nutrition

• Nutrients: Adequate intake of vitamins, proteins, and minerals is essential for health.
• Malnutrition and Overnutrition: Both deficiency or excess of nutrition harms health.

3.Environment

• Air and Water Pollution: Polluted air and water cause various diseases.
• Housing and Sanitation: Dirt and unsuitable housing conditions have a bad effect on health.

4.Economic Factors

• Economic Status: Poverty and economic difficulties are barriers to health services and nutrition.
• Employment and Occupation: The type of job and the work environment affect health.

5.Society and Culture

• Education: Lack of education is a barrier to health awareness and utilization of health services.
• Family and Social Support: Strong family and social support improves mental health and well-being.

6.Genetics

• Genetic Disorders: Diseases that run in families, such as diabetes, heart disease, and other genetic factors, affect health.

Q-2 a) Define nursing and write contribution of Florence Nightingale in development of modern nursing. 08

A nurse is a person who is qualified with basic nursing education and has been given the authority to provide nursing services in the country so that they try to prevent disease, cure it if it occurs, and increase health in the society. Along with this, they bring the patient back to normal.

Florence Nightingale was born 203 years ago in 1820 and is considered the founder of modern nursing.

She was also known as the ‘Lady with the Lamp’, because she used to treat soldiers even at night.

In 1860, she started nursing by establishing her own nursing school at St. Thomas’ Hospital in London.

This school was part of King’s College, London and is considered the first nursing school in the world.

The Florence Nightingale Medal is also considered the most prestigious internationally for nurses.

International Nurses Day is celebrated all over the world on Florence’s birthday.

The proposal to celebrate International Nurses Day on May 12 in memory of Florence Nightingale was passed in the US in January 1974.

Along with being a nurse, she was a social reformer. She brought the role of nurses and the spirit of selfless service to the people.

In 1860, she was successful in opening the Army Medical School and in the same year she also opened the Nightingale Training School for nurses and published a book called Notes on Nursing.

b) Explain rights of the patient. 04

Right to Information:- The patient has the right to get authentic information about their medical condition or disease, method and treatment options.

Right to Records and Reports:- It is the duty of the hospital authorities to provide medical records and reports to all patients or their caregivers.

Right to Emergency Medical Care:- No patient can be turned away from receiving emergency medical care from a government or private hospital.

Right to Informed Consent:- Before performing an operation, the medical professional must obtain the written consent of the patient or their caregiver, spouse or guardian (in case of a minor).

Right to Integrity, Privacy and Dignity:- All medical professionals must maintain the highest level of confidentiality regarding the private details of the patient.

Right to Second Opinion:- The patient is free to go for a second opinion to any doctor of his choice.

Right to Transparency in Rates:– All charges imposed on patients for services, tests and treatment provided by medical institutions must be made available to the public.

Right to non-discrimination:- Doctors and medical personnel cannot refuse to treat patients on the basis of gender, sexuality, race, religion, caste, place of birth or illnesses.

Right to safety and quality care according to standards:- It is the duty of medical institutions to provide a safe and clean environment for treatment.

Right to choose alternative treatment options, if available:- Once the patient or their caregiver is informed about their treatment options, they are free to choose the next course of action. They cannot be forced to follow a particular treatment against their will, even if the doctor considers it necessary.

Right to choose the source of obtaining medicines and tests:- When a patient is prescribed medicines or tests, it is up to them to decide where they want to buy them. Their right as a consumer to have access to a variety of goods or services at competitive prices is guaranteed.

Right to proper referral and transfer, free from distorting commercial influence:- All patients have the right to receive seamless service and the quality of care is maintained when the patient is referred to a different doctor or the patient is transferred to a different facility.

Right to protection for patients involved in clinical trials:- All clinical trial participants in India have rights such as the right to claim compensation in case of trial-related injury or death, confidentiality of personal information, etc.

Right to protection of participants involved in biomedical and health research:- National ethical guidelines for biomedical and health research involving human participants are followed to ensure that rights are given to participants.

Right to discharge the patient or the body of the deceased from the hospital:– At any stage of treatment, the patient is free to leave or be discharged from the hospital. They cannot be detained or forcibly kept in the hospital without their consent. Similarly, the caregivers of the deceased patient have the right to receive their body from the hospital.

Right to Patient Education:-Patients have the right to be educated about facts related to their condition and healthy lifestyle.

Right to be heard and to seek redress:-If a patient or their caregiver has a complaint against a doctor or hospital administration regarding the quality of treatment provided, they have the right to seek redress.

OR

a) Define nursing process and list out steps of it and describe first step..08

Nursing process:

Nursing process is the entire process in which nurses assess the patient, set goals, plan the type of nursing care to be provided, implement the planned care, and evaluate the implemented care. Thus, this is the nursing process that helps nurses provide patient care. Nursing process is the set of activities used to determine nursing care (assessment), plan (planning), implement (implementation), set goals (goal setting), and evaluate (evaluation).

Steps of Nursing Process:

• 1) Assessment
• 2) Nursing diagnosis
• 3) Planning
• 4) Implementation
• 5) Evaluation

1) Assessment

Assessment is the first step of the nursing process in which information or data about the patient is collected, organized, and analyzed. In which physical, emotional, psychological, and sociocultural data of the patient are collected through observation, interview, and physical examination.

Assessment means assessing the patient’s health problem and this is the first step in which

A. Taking Nursing History:-

A history of the patient’s illness and wellness is obtained. Along with the history, data is collected to establish adjustment, mutual trust, confidence, respect and relationship with the patient.

B. Physical Examination:-

The patient’s physical problems are identified. The patient’s limitations are identified.

From the patient’s health record through the members of the patient’s relative health team

b) Write down steps of prevention of cross infection in hospital.04

Prevention of cross infection in the hospital

Add lime to the excreta before disposal

Maintain general hygiene in the hospital

Provide good ventilation

Mop the hospital floor with antiseptic lotion every day

Wash the items used for the patient thoroughly

Safely dispose of hospital waste

Provide safe water supply

Wear a gown and gown during the procedure

Isolate the patient with infectious disease

Non-washable items should be kept under sunlight

Disinfect the room after the patient’s discharge

Teach the client and relatives about the spread of infection and its prevention

Reduce the number of visitors

Give special care to people with low immunity

Use mosquito nets

Q-3 Write short answer (any two) 6X2=12

a) Describe comfort devices.

Define comfort device

• A comfort device is a mechanical device that provides optimal comfort to an individual.
• A comfort device is a type of article that is used to provide comfort to a patient and relieve discomfort. It is also used to maintain correct posture.
• There are many types of devices used to provide patient comfort, including:

Enlist comfort device

• Pillow
• Back rest
• Bed cradle
• Bed blocks
• Rubber and cotton ring
• Mattress
• Cardiac table
• Air cushion
• Sand bag
• Foot board
• Knee rest
• Hand roll
• Trapeze bar
• Trochanter rolls
• Side rails

Purpose of comfort device:

• To promote comfort.
• To relieve discomfort.
• To relieve pressure on a body part.
• To prevent bedsores.
• To immobilize a body part.
• To maintain correct posture.
• To prevent falls and accidents.

Pillow:

A pillow is a type of comfort device that is useful for providing a comfortable position to the patient.

In addition, pillows are used to support various parts of the body.

Since pillows can be folded, rolled and tucked, they are used to maintain position.

In addition, pillows are used to support the head, neck, arms, legs and back.

Also, pillows relieve pain in the abdominal muscles and knee tendons.

Back rest:

A back rest is a mechanical device that provides support and rest to the back of a patient in a sitting position.

The back rest can be adjusted to the desired angle.

A back rest is used to elevate and support the head and back.

A back rest is used in patients with cardiac and pulmonary diseases.

Bed cradle:

A bed cradle is a semi-circular shaped comfort device used to take off the weight of bed linen.

Bed cradles come in different sizes and materials.

Such as wooden, metal, electronic

Bed cradles are mainly used in burn patients.

Bed blocks:

Bed blocks are mostly made of wood. They can be high or low.

Bed blocks are placed under the foot of the bed.

Bed blocks are mainly used after spinal anesthesia and tonsillectomy.

Rings:

An air ring is a type of comfort device made of circular rubber and cotton. It is inflated with air. It is also checked for leakage.

This air ring is placed under the patient’s hip and under the bony prominence area.

Air mattress & water mattress:

An air mattress is inflated with air while a water mattress is filled with water.

Air and water mattresses are used in very thin and obese patients who are prone to developing pressure sores.

These mattresses help distribute the body weight equally in all directions to prevent pressure on any one body part.

Air and water mattresses are made of plastic with two sets of chambers.

These mattresses are placed on the bed and covered with a light bottom cloth.

Air cushion:

An air cushion is a round-shaped ring-like structure made of rubber. Which is inflated with air.

An air cushion is used to take off the weight of the body.

Air cushions cannot be applied directly to the skin, so they are covered with a cover.

Sand bag:

A sand bag is a canvas, rubber, or plastic bag filled with sand.

A sand bag can be used in place of a trochanter roll.

Sand bags are available in different weights.

Foot board:

A foot board is also known as a foot rest.

A foot board is a flat panel or board made of plastic or wood.

It is used to provide a rest to the foot.

The foot board is placed parallel to the plantar surface of the patient’s foot and perpendicular to the mattress.

Knee rest:

A knee rest is used in place of a pillow.

Knee rests are placed under the knee and provide comfort to the knee.

Many doctors discourage the use of knee pillows because of the fear of thrombus formation.

Hand rolls:

A hand roll is a cylinder-shaped comfort device made of cloth. It is 4-5 inches long and has a diameter of 2-3 inches.

In a hand roll, the cloth is rolled and folded and stiffened firmly.

This roll is placed against the palmar surface.

A hand roll is mainly used to keep the thumb and fingers in a slightly flexed position.

Trapeze bar:

This triangular metal part is on the upper side of the bed which is used to move the patient and to support the weight while changing the patient’s position.

Overhead trapeze bar is a triangle shaped metal bar. Which is attached to a metal frame which is attached to the headboard and footboard of the bed.

Side rails:

Side rails are a type of bar (side). Which is installed on either side of the bed. Which is the length of the bed. Fall down can be prevented by using side rails. Also, side rails assist in moving the patient easily.

Wedge / abductor pillow:

This is a triangular shaped pillow. Which is made of heavy foam.

Cardiac table

This is a type of table-like structure. It is placed in front of the patient on the bed. On which pillows are placed so that the patient can rest and lean forward. Without pillows, this table is used for meals and writing. This table is mainly used in cardiac patients and asthmatic patients.

b) Describe care of the person after death.

It is very important to take care of the dying patient for which his -relatives should be sent out.
-Close the patient’s eyes and mouth gently.
-Make the patient lie down straight with arms and legs straight.
-Remove extra pillows, air cushions, oxygen cylinders, suction machines from the bed, leaving only one pillow under the head

• Remove catheters, drainage tubes, resuscitation tubes, i.v. infusion tubes etc. and plug cotton in the body openings so that body discharge and blood do not come out and infection does not spread.
• Give sponge bath and dress properly. If there is any jewelry, give it to the relative or ask the relative to remove it. Put an identity card on the wrist, which has the patient’s name, address, age, ward number, bed number, date and time.
• The identification card is given when the patient is to be sent to the mortuary room, but if it is to be handed over to the relative, then get the signature in the case paper.
• If it is to be sent to the mortuary room, then get the signature of the room man and the policeman and put the buckle number. In addition, fill the mortuary room slip or form and if it is a police case, inform the police. Check whether the death certificate has been filled or not. This certificate is filled in two copies as per the hospital policy.
• Record in the death register Record in the case paper Report the death or inform the authorized person.
• To prevent the infection from spreading in the community
• To ensure proper disinfection of the patient’s used instruments etc., the HIV virus is killed in half an hour with sodium hydrochloride solution.
• To prevent the infection from spreading in the ward, the patient’s dead body should be handed over with dignity and respect.

c) Explain various routes of drug administration.

Routes of Medication Administration:

The route of medication administration depends on the properties of the medication, the physical and mental condition of the patient, and the desired therapeutic effect. When the nurse administers medication, the nurse should be sure of its pharmaceutical preparation and its proper routes. The different routes for administering medication are:

• Oral route,
• Sublingual route,
• Buccal route,
• Inhalation and nebulization,
• Topical route,
• Intraocular route,
• Instillation,
• Insertion,
• Implantation,

Parenteral route

Types of Parenteral Routes:

Intradermal route (ID), Subcutaneous Subcutaneous route (SC),
Intramuscular route (IM),
Intravenous route (IV),
Intraarterial route,
Intracardiac route,
Intrathecal route,
Intraosseous route,
Intraperitoneal route,
Epidural route,
Intrapleural route,
Intraarticular route.

1) Oral route: Oral route is the easiest and most commonly used route for medication administration in which medication is given through oral route and swallowed with fluid. Oral medication has a slower onset of action and a longer duration of effect compared to parenteral route. Oral route also involves sublingual and buccal routes.

Oral administration of medication is a convenient, affordable, and safe method for most patients.

2) Sublingual route: In sublingual administration, the medication is placed under the tongue for slow, easy, and early absorption. Medications given by the sublingual route should not be swallowed as the therapeutic effect will not be achieved. For example, nitroglycerin is given by the sublingual route when the patient complains of chest pain. Do not give any fluids to drink until the medication is completely dissolved.

3) Buccal route: This involves placing a solid medication in the mouth against the mucous membrane of the cheek until the medication dissolves. The patient is instructed not to chew or swallow the medication or drink any liquid with it. It works locally in the mucosa or systemically when swallowed in the saliva of the person.

4) Inhalation and Nebulization: Medication is given by inhalation and nebulization methods to deliver the medication to the lungs either locally or for systemic effect through a nebulizer or ventilator. In the inhalation route, medication is administered through the nasal passage or a tube is placed in the mouth and delivered to the trachea. This medication has both local and systemic effects.

5) Topical Administration/Induction: It is the use of medication on the skin, which is usually due to friction, rubbing (topical).

Medications applied to the skin and mucous membranes usually have local effects. Systemic effects occur only when the client’s skin is thin and the concentration of the medication is high and the medication is in contact with the skin for a long time. Medications may have to be applied differently to the mucous membranes.

(i) Direct application of liquid or ointment e.g. throat gargles and swabbing.

(ii) Insertion of medication into body cavity e.g. suppository into rectum or vagina.

(iii) Instillation of fluid into body cavity e.g. ear drops, nasal drops, bladder or rectal instillation.

(iv) Irrigation of body cavity e.g. irrigation of eyes, ears, nose, vagina, bladder and rectum.

(v) Spray e.g. nose and throat.

6) Intraocular route: Administration of medication in contact lenses into the patient’s eyes. Pilocarpine is a medication used for glaucoma.

7) Instillation: In instillation, a drug is administered in liquid form into a body cavity or body orifice such as the eyes, ears, rectum, and vagina.

8) Insertion: In this, a solid form of the drug is introduced into an orifice of the body.

9) Implantation: In this, a solid drug is planted or put into the tissues of the body.

10) Parenteral route: In parenteral route, therapeutic agents are administered to a site other than the alimentary tract.

Types of Parenteral Routes:

( A ) Intradermal Route(ID): Intradermal route is an injection into the dermis layer below the epidermis. (Intradermal injection 10-15°)

(B) Subcutaneous Route(SC): Subcutaneous route is an injection into the tissues below the dermis layer of the skin. (Subcutaneous injection 45°)

( C ) Intramuscular route(IM): Intramuscular route is an injection into the muscles. (Intramuscular injection 90°)

( D ) Intravenous route(IV): Intravenous route is an injection into a vein. (Intravenous injection 25°)

( E )Intraarterial route: In the intra-arterial route, medication is administered directly into the arteries. This route is most commonly used in clients who have arterial clots.

( F ) Intracardiac route: In the intracardiac route, the medication is administered directly into the cardiac tissue

( G ) Intrathecal route: In the intrathecal route, the medication is administered through a catheter placed in the subarachnoid space in one of the ventricles of the brain.

( H ) Intraosseous route: This medication is infused directly into the bone marrow. It is used in infants and toddlers who have poor access to the intravascular space.

( I ) Intraperitoneal route: In the intraperitoneal route, medication is administered directly into the peritoneal cavity, where the medication is absorbed into the circulation. Mostly antibiotics and chemotherapeutics are administered through the intrapleural route.

( J ) Epidural route: Medication is administered through a catheter into the epidural space, which is placed by the anesthesiologist and is used for the administration of analgesia postoperatively.

( K ) Intrapleural route: Medication is administered intra-pleurally through the chest wall and directly into the pleural space. Chemotherapeutics, antibiotics are given through this route and are also given to resolve persistent pleural effusion.

( L )Intraarticular route: In intra-articular route, medication is administered into the joint.

Q-4 Write short notes.

a) Nurse’s role in collection of specimens

Specimen collection is a very important task of the nurse. It is very important for the nurse to collect the sample using the proper method and deliver it to the laboratory on time.

Preparation of the Patient.

• Prepare the patient physically and mentally according to the type of specimen to be taken.
• When, how and in what quantity the patient’s specimen is to be taken should be explained specifically.
• While collecting the specimen, the outer side of the container should not get dirty, otherwise the employee may have difficulty in handling it and the infection may also spread.
• The container in which the sample is to be collected should be clean, unbreakable and should not be damaged from any place.
• For specific tests for culture, the specific sample should have the same content as the label on the sample should be clearly visible.
• Most specimens should be collected fresh and early in the morning.
• Correct collection method should be adopted. For some types of tests, the specimen should be collected in a separate bulb from the laboratory.
• Apart from this, different test tubes are used in the hospital for the collection of different samples, as shown in different colors, the sample should be collected in the proper colored tube.
• In female patients, urine and stool samples should be avoided during the menstrual cycle or if they have to be collected, they should be collected with proper technique so that they are not contaminated with blood. For this, vaginal tampons can also be used.

Preparation of Equipment.

• Different types of bottles and containers are available for sample collection which are selected as per the requirement of the sample as follows.
• A wide mouth glass bottle is used to collect urine sample.
• A small glass bottle is used for stool examination.
• A large glass bottle is used for 24 hour urine collection.
• A glass jar with a cover is used to collect sputum and stool.
• A sterile test tube or bottle is used for culture examination.
• A clean slide is used to prepare smear.

b) Methods of physical examination

Physical examination is a detailed inspection or detailed study of the physical and psychological condition of a patient.

Physical examination methods:-

Inspection: In this method, the general condition of the patient is known from the observation of his body. This means that in this, the general appearance of the patient is seen. What is the color of the patient’s skin? Is there any rash on the skin or if there is a deformity anywhere in the body, it is examined. The patient’s diet history is taken. In inspection, the doctor listens to all the complaints of the patient and a history is written accordingly. Thus, through inspection, the history of the patient’s illness, current complaints and body functions can be known.

Palpation: This means examining by placing hands. The act of examining the parts of the body by feeling them. For palpation Fingers are used to determine the size and position of the organ. This exam is also done when there is any tumor in the neck or tenderness in the armpit or groin.

Percussion: In percussion, tapping is done by placing fingers on the patient’s body parts. Through tapping, the internal organs are observed by listening to the sound, which gives an idea of the condition of the internal organs. Whether the patient’s bladder is full or empty can be determined through percussion. In addition, percussion can be done on the chest, abdomen, and back.

Auscultation: In this, sounds are heard inside the patient’s body with a stethoscope or a fetoscope. This method is used to listen to the chest sound, listen to the heart rate, take blood pressure.

Manipulation: This method is used to know the flexibility of the organ, for example, rigidity of the neck, flexion of the arm, abduction movements, etc.

Special equipment: Some types of examinations are done with special equipment, for example, otoscope, ophthalmoscope, speculum scope, X-ray sonography, etc.

c) Factors affecting on blood pressure

1. Age:-Blood pressure increases with age. Normally in adults it is 120/80 mm/Hg

2 Emotions:- Stress, serious emotions. Anxiety, fear, pain, tension, sympathy activate the nervous system, vasoconstriction occurs, heart contraction increases. Due to this, changes occur in blood pressure.

3 Gender:- After puberty, blood pressure of men is higher than that of women. But then

Menopausal women have higher BP than men of the same age

4. Ethnicity: High blood pressure is more common in African-Americans than in European Americans
5. Lifestyle: People who eat a diet rich in salt and unsaturated fatty acids have higher blood pressure. Cocaine use also increases blood pressure. Taking caffeine also increases blood pressure and smoking, nicotine, etc. increase blood pressure.
6. Exercise: Regular exercise reduces blood pressure. Normally, a person’s BP is lower in the early morning and at night.
7. Medicine: Opioid analgesics, antihypertensive drugs cause changes in blood pressure
8. Chemicals: Such as epinephrine. ADH causes angiotensin II vasoconstriction

Regulation of blood pressure: Vasomotor center plays a major role in regulating blood pressure. Chemoreceptors located throughout the vascular system are sensitive to the baroreceptors of blood and its chemical composition. These receptors send impulses to the vasomotor center which can cause vasodilation or vasoconstriction to keep BP within normal limits.

d) Ethics in nursing

1. Autonomy:- It refers to the right to make one’s own decisions. The nurse should adopt the attribute of autonomy for those who are capable of making their own decisions. The nurse should also have the ability to make decisions for those who are not capable of making decisions for themselves.
2. Justice:– This includes treating all clients equally, regardless of the society or group in which they come from. The health care system is provided to all. Treatment and care are provided on the basis of their health or medical need. There is no discrimination in terms of their social status, race or gender.
3. Non-mal efficacy:- It means not causing harm to oneself or others. Therefore, one should not cause any harm to others because of oneself, or one should use one’s knowledge and skills to provide effective care so that The possibility of harm is very low
4. Benefits:- It means to promote and do good, in other words, to encourage to do good, for example, there is some discomfort during immunization, but it provides protective benefits to society and the individual
5. Fidelity:- It means to give promises that you can keep. The promises given should be followed
6. Accountability:- He is responsible for the care provided by him, so he should have knowledge for the practice and action taken by him
7. Confidentiality:- Information about the patient is kept confidential and for its protection, and the patient’s private information is limited to his own needs.

Q-5 Define following (any six)

a) Infection –

Definition of Infection:

Infection is a pathological condition caused by microorganisms such as bacteria, viruses, fungi, and parasites inside or outside the body, in which these microorganisms invade the tissues of the body and disrupt its normal functioning. Infection occurs when these microorganisms overcome the body’s immune system and spread, causing inflammation, fever, pain, fatigue, and other symptoms. In this condition, the microorganisms enter specific organs or systems of the body and spread contagion. Infection can be transmitted through direct contact, airborne droplets, contaminated food or water, or other body fluids. Prevention and treatment of infection require good hygiene, vaccination, and the use of antibiotics or antiviral drugs.

b) Cyanosis

Cyanosis is a medical condition characterized by a bluish discoloration of the skin, mucous membranes, and nail beds, which indicates low oxygen levels in the blood, resulting in increased deoxygenation of hemoglobin. This condition is usually seen in respiratory and cardiovascular problems, so that the cause can be identified and appropriate treatment can be given.

c) Oliguria

Oliguria: Oliguria is the formation and excretion of urine in an amount of less than 500ml in 24 hours. Oliguria can occur due to severely decreased fluid intake or any disease that causes excessive fluid loss from the body. For example: vomiting, diarrhea, diaphoresis, burns and bleeding.

d) Asepsis

Asepsis means being free from disease-causing microorganisms. It is used in hospitals, surgeries and laboratories to maintain a sterile field and to practice sterile practices, i.e. to prevent contamination by pathogens. The main purpose of asepsis is to reduce the risk of infection and provide a sterile environment. For this, many sterilizing equipment and antiseptic and cleaning agents are used, which prevent the growth of bacteria, viruses and other microorganisms, which is called asepsis.

e) Bradypnea –

Bradypnea means abnormally slow breathing. When the respiration rate is less than 10/min, that condition is called bradypnea.

g) Enuresis

Enuresis, commonly known as bedwetting, is the involuntary passage of urine, usually during sleep. It is very common in children but can also be seen in adults. There are two main types. Genetic factors, developmental problems, medical conditions, and psychological factors are responsible for this.

f) Rigor mortis

Rigor mortis: The stiffening of the body about 2-4 hours after death is called stiffening of the body. It is caused by the lack of adenosine triphosphate which is not synthesized due to the lack of glycogen in the body. ATP is required for the relaxation of muscle fibers. Its deficiency causes the muscles to contract which in turn immobilizes the joints. It starts with the involuntary muscles (heart, bladder etc.) and then progresses to the neck, head and trunk and finally reaches the extremities. It leaves the body about 96 hours after death.

H) Temperature

Temperature is a measure of the average kinetic energy of the particles in a substance. It indicates how hot or cold an object or environment is and is usually measured with a thermometer. Common units of temperature are Celsius (°C), Fahrenheit (°F), and Kelvin (K).

Q-6(A) Fill in the blanks 05

1.OD means……..✅ Answer: Once a day

2……….bed is provided to patient having breathing difficulty. ✅ Answer: Fowler’s bed

3.One tea spoon ………ml ✅ Answer: 5 ml

4.1 ounce ……..ml. ✅ Answer: 30 ml

5.Normal temperature and pulse ratio is …….. ✅ Answer: 1:4

(B) Match the following

Column A	Column B	✅ ❌
(A) Increased urine output	(C) Polyuria –	✅
(B) Tachycardia –	(A) Pulse rate over 100 bpm –	✅
(C) Anorexia –	(D) Loss of appetite –	✅
(D) Respiratory Centre –	(E) Medulla oblongata –	✅
(E) Vaginal examination –	(B) Lithotomy position –	✅

🔁 Final Matching Summary:

• (A) Increased urine output → (C) Polyuria
• (B) Tachycardia → (A) Pulse rate over 100 bpm
• (C) Anorexia → (D) Loss of appetite
• (D) Respiratory Centre → (E) Medulla oblongata
• (E) Vaginal examination → (B) Lithotomy position

(C) Multiple choice questions-

1.Vital signs includes

(a) Temperature

(b) Respiration

(c) Blood sugar

✅ Correct answer: (d) a and b

Rationale: Vital signs are the basic vital signs of the body such as Temperature, Respiration, Pulse, and Blood Pressure.
Blood sugar is not included here as it is not a vital sign.

2.Left lateral position is provided to

(a) Examine chest

✅ Correct answer: (b) Examine rectum

Rationale: Left lateral position means keeping the patient lying on the left side. This position is usually given for rectal examination, enemas, suppository.

(c) Examine spine

(d) Examine both ears

3.Group of drugs used to reduce body temperature is –

(a) Antihypertensive

(b) Antiemetic

✅ Correct answer: (c) Antipyretic

Rationale: Antipyretics are drugs that reduce body temperature, such as Paracetamol.

Antibiotics → for bacterial infections

Antihypertensives → for high BP

Antiemetics → for vomiting

(d) Antibiotic

4.Auscultation is done by using –

✅ Correct answer: (a) Stethoscope

Rationale: Auscultation is listening to sounds inside the body (such as heart rate, lung sounds). A stethoscope is used for this.

(b) Thermometer

(c) Sphygmomanometer

(d) None of the above

5.Insomnia means –

(a) Inability to walk

(b) Unconsciousness

✅ Correct answer: (c) Inability to sleep

Reason: Insomnia is a neurological disorder in which a person cannot fall asleep or stay asleep.

(d) Inability to eat