PAPER NO-07
23/06/2014
⏩Q-1 🔸a. What is anesthesia? What is anesthesia? 02
Anesthesia is a medical practice that prevents pain during surgery or other procedures. Anesthetic agents in anesthesia are a group of chemical agents that cause partial or complete loss of sensation. This anesthesia can prevent the patient’s discomfort and improve their cooperation.
The medicine given in anesthesia blocks the nerve signals so that the sensation of pain stops going to the brain and the pain is not felt so that the surgical procedure can be performed easily.
Purpose of Anesthesia:-
🔸b. List the types of anesthesia. List the types of anesthesia. 03
There are three types of anesthesia.
1) Local Anesthesia:-
This affects a limited area (local part) of the body. This usually affects the 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.
2) Spinal Anesthesia (Spinal Anesthesia) :-
There are two types of There are-
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.
3) General Anesthesia:-
When the sensation in the whole body is to be lost, the person is rendered unconscious. It is called general anesthesia. General anesthesia can be given as follows-
🔸c. Describe any one type of anesthesia in detail.
Discuss each type of anesthesia in detail. 07
General Anesthesia:-
When the sensation in the whole body is to be lost, the person is rendered unconscious. It is called general anesthesia. General anesthesia can be given as follows-
Through Intravenous:-
I.V. The following drugs are used in general anesthesia by injection
This anesthesia is given through inhalation, which makes the patient unconscious.
Before giving this anesthesia, the patient is given some sedatives, then an endotracheal tube is inserted into the airway, and then this is given.
The following drugs are used in this.
Responsibility of Nurse:-
⏩Q-2 A. Define following (ANY Three) :- Define the following. (Any Three) 06
🔸a. Ascites
Ascites means the accumulation of fluid in the peritoneal cavity in the abdominal cavity. When more fluid than normal collects in this peritoneal cavity, it is called ascites.
This condition is seen to arise due to liver disease, kidney disease, heart failure or infection of the abdominal cavity.
In this condition, an increase in the size of the abdominal cavity can be seen.
🔸b. Homen’s Sign – Omens Sign
Omens Sign is a sign indicating the clinical diagnosis of deep vein thrombosis, which is a blood clot that forms in the deep veins of the leg. This clinical sign is positive due to thrombosis.
When the foot is dorsiflexed, pain is felt in the back of the knee and calf.
🔸c. Cholecystitis -Cholecystitis
Cholecystitis is an inflammation of the gallbladder. The condition in which the gallbladder, located behind the liver, becomes infected for any reason is known as cholecystitis.
Severe abdominal pain is seen in this condition. This condition is mainly seen due to stone formation in the gall bladder.
🔸d. Crohn’s Disease- Cohen’s Disease
Crohn’s Disease is a type of inflammatory bowel disease. In which chronic inflammation is seen in the gastrointestinal tract. Crohn’s disease mainly affects the latter part of the small intestine and the beginning part of the large intestine. In this condition, inflammation spreads to the deep layers, so serious signs and symptoms can be seen.
Crohn’s disease is a chronic disease. There is no complete cure for it, so the disease condition can be managed with lifestyle modification and medicine.
⏩B. Write the Action and Side effects of the following drugs :-(ANY THREE) 06
🔸a. Asprin- Aspirin
Aspirin is also known as acetylsalicylic acid. It is used for pain relief, fever reduction, antiplatelet agents, etc.
Action.
It is useful in relieving pain by reducing the production of prostaglandins.
Anti-inflammatory It is also useful in reducing inflammation by reducing the synthesis of prostaglandins.
It reduces body temperature by affecting the hypothalamus, so it also has an antipyretic effect.
It reduces platelet aggregation and is therefore also useful as an antiplatelet.
Side Effects.
Gastrointestinal side effects.
Nausea, vomiting, indigestion, gastric ulcer and bleeding from any part of the gastrointestinal tract may occur.
Bleeding.
This medicine increases the tendency for blood to clot and has antiplatelet effects, which increases the chances of blood clots forming in the nose, gastrointestinal tract, or any internal organ. There is a possibility of prolonged bleeding from any wound or cut.
Hypersensitivity reactions.
This can lead to anaphylaxis or hypersensitivity reactions.
In many individuals, aspirin may increase the risk of respiratory diseases such as bronchospasm and respiratory distress, which can be stimulated by it.
Long-term use of aspirin may alter kidney function.
Aspirin It is also associated with Reyes syndrome, which is especially common in children and adolescents with its use. This is a rare and serious condition that causes liver and brain dysfunction.
Aspirin overdose can cause tinnitus, a ringing sensation in the ears, and hearing loss.
🔸b. Morphine
Morphine is a powerful opioid analgesic. It is given to relieve moderate to severe pain.
It helps control pain by binding to opioid receptors in the brain and spinal cord.
Action.
Analgesics. It is used specifically as a pain reliever in severe pain.
Sedation. Its use produces drowsiness and relaxation.
Euphoria. Due to its use, a feeling of mood elevation is observed.
Cough suppression. It depresses the cough center of the brain, thereby reducing coughing.
Side effects.
Respiratory depression
Hypotension
Bradycardia
Urinary retention
Constipation
Nausea and vomiting
Euphoria
Withdrawal symptoms of this medicine are also seen. In which signs and symptoms such as restlessness, irritability, muscle pain, insomnia, yawning etc. are seen.
🔸c. Diuretic Drugs- Diuretic Drugs
Diuretic drugs are medicines that increase the production of urine and remove excess fluid from the body through urine.
These types of drugs are given in conditions such as hypertension, heart failure, kidney disease, and swelling in the body.
Action.
Increased urine output
Reduction of blood volume.
Decreased edema
Diuretic drugs reduce the reabsorption of sodium in the distal convoluted tubules and loop of Henle, so that fluid is not absorbed and fluid is excreted from the body through urine.
Side effects.
Electrolytes imbalance.
Dehydration.
Nausea and vomiting.
Hypotension.
Metabolic disturbances.
Rashes and allergic reaction.
🔸d. Dobutamine
►Group
Inotropic agent-heart contractant
►Mode of action
►Side effects
⏩Q-3. A. Mr.Kanubhai 35 years old is diagnosed as pulmonary Tuberculosis. 35 years old Kanubhai is diagnosed with pulmonary tuberculosis.
🔸a. Define pulmonary Tuberculosis 02
Define pulmonary tuberculosis.
Pulmonary tuberculosis is a serious infection caused by the bacterium Mycobacterium tuberculosis.
Which mainly affects the lungs but can also spread to other areas of the body. Pulmonary tuberculosis is spread through the air, that is, by coming into contact with an infected person coughing or sneezing.
Infection of the lungs by Mycobacterium tubercle bacilli is called pulmonary tuberculosis. This is the most common of all forms of T.B.
🔸b. What health education will you give to this patient? 04
What health education would you provide to this patient?
Explain the high risk factors for pulmonary tuberculosis to the patient, which are as follows.
Risk Factors of Pulmonary Tuberculosis
Explain the management of pulmonary tuberculosis and precautions to be taken in it.
🔸B. Write the nursing care of patient with colostomy. 06
Write the nursing care of a colostomy patient.
The management of a patient with colostomy involves comprehensive care to ensure the physical and emotional well-being of the patient.
The main aspects of nursing management of a patient with colostomy are as follows:
1) Pre-operative care:
Patient education
Provide proper explanation of the colostomy procedure, its reasons and post-operative expectations to the patient and his family members.
Explain to the patient the changes in his lifestyle and emotional impact due to colostomy.
Physical Preparation
Assess the patient’s nutritional status, fluid balance and skin condition pre-operatively.
2) Post-operative Care:
Assessment and Monitoring
Properly assess the patient’s vital signs, pain level, and surgical site infection post-operatively to determine if there are any complications.
Then assess the condition of the stoma, including the color, size, shape, and output of the stoma. A healthy stoma is usually red or pink in color.
Pain Management
Provide the patient with prescribed analgesia medication.
Provide non-pharmacological management to relieve pain, including providing proper positioning and advising on relaxation techniques.
Stoma Care
How to care for the stoma and how to change the colostomy bag Provide education to the patient and family members about this.
Keep the skin around the stoma clean and dry to prevent irritation and infection.
Apply a skin barrier or protective paste to prevent skin breakdown and protect the skin.
Diet and Nutrition
Advise the patient to avoid foods that may cause gas, odor, or blockage.
Advise the patient to eat a balanced diet to promote healing and overall health.
Fluid and Electrolyte Balance
Monitor the patient’s fluid intake output chart to prevent the patient from developing a condition of dehydration.
Assess the patient’s electrolyte levels and correct any imbalances properly.
Psychological Support
Provide appropriate emotional support and counseling to the patient to help them with body image changes and lifestyle adjustments.
Refer the patient to support groups and counseling services, if needed.
Education and Training
Provide education to the patient and their family members about colostomy care and advise them to seek medical help if any complications arise.
Provide written materials and resources for home care.
Rehabilitation and Follow-up
Encourage the patient to gradually resume activities as tolerated.
Advise the patient to have regular follow-up appointments to assess the patient’s overall health condition and stoma.
Infection
Properly assess the stoma for signs and symptoms of infection such as redness, swelling, oozing, or drainage.
Monitor for stoma retraction, prolapse, or necrosis
Report any changes in the color or output of the stoma immediately.
Skin irritation
Properly check the site around the stoma for any irritation or skin breakdown.
Use a proper skin barrier and ensure that the ostomy appliance fits properly.
Dehydration
Assess whether the patient has any signs of dehydration. Assess especially when the output of the colostomy is high.
Nutritional Deficiency
Properly ensure that the patient is receiving an adequate nutritious diet and monitor for any symptoms of malnutrition.
Effective nursing management of the patient with a colostomy requires proper education, careful care, and continuous support.
The patient’s physical Keeping in mind both the physical and emotional needs, the nurse plays a crucial role in helping the patient adopt life with a colostomy and maintain a good quality of life.
⏩Q-4 Write the shortnotes on ANY THREE of the following :-12
Write the shortnotes on ANY THREE of the following :-12
Write the shortnotes on any>
Pain management is a crucial aspect of health care, the main objective of which is to eliminate pain and improve the health quality of life of individuals or patients who experience discomfort or pain.
Effective pain management includes the following points.
Pain assessment.
For the assessment of pain, tools such as rating scales, visual scales or Wong Baker Face Pain Scale are used to determine the intensity of pain. Comes.
In addition, physical sign data such as increased heart rate, hypertension, restlessness, anxiety or irritability, etc. are useful in determining the degree of pain through physical examination.
Determining the characteristics of pain such as the location of the pain, how long the pain has been present, its intensity, factors that increase or decrease the pain, etc. The characteristics of pain are determined by factors such as.
According to the above data, after assessing the pain, pain management is mainly done according to pharmacological and non-pharmacological interventions, which are as follows is.
Pharmacological Interventions.
For mild and moderate pain, non-opioid analgesics i.e. non-steroidal anti-inflammatory drugs (NSAIDs) i.e. acetaminophen, ibuprofen etc. are given.
If the severity of pain is high, then opioid analgesics like morphine are given.
In addition, antidepressants and muscle relaxation medicines are also given for pain management.
These medicines are given for pain management, their dosage and their timely evaluation are done as per the doctor’s order.
Non pharmacological Interventions.
In these types of interventions, pain is managed using exercises, massage, heat and cold therapy, as well as different types of mind diversionary therapy.
Different techniques for relaxation are explained to the patient. Also, interventions for pain management are done through acupuncture and various herbal supplements or home remedies.
In addition, interventions for pain management are done with the help of transcutaneous electrical nerve stimulation (TENS) and heat and cold therapy.
A multi-modal approach should be implemented for the patient’s pain management. In which pharmacological and different types of non-pharmacological management techniques should be used to relieve the patient’s pain.
In addition, the patient should be educated about pain and its triggering factors, as well as taught techniques for its management.
To carry out an evolution for pain, in which different techniques should be used to check whether pain relief has been achieved.
Pain management is an important factor for the patient’s quality of life and health care facility.
🔸b. Importance of therapeutic diet in illness – Importance of therapeutic diet in illness.
A therapeutic diet is a diet prescribed for the management of a specific disease condition.
A diet is a diet that is prescribed for the management of a specific disease condition, keeping in mind the medical condition, fulfilling the nutritional demands of the patient and ensuring a speedy recovery from the illness.
A therapeutic diet is a diet that is prescribed to manage a disease, such as a specific type of diet that reduces the symptoms of the disease. For example, a low sodium diet is given in hypertension, a low fat diet is given in diseases related to the gallbladder, a high fiber diet is given in medical conditions like constipation.
A therapeutic diet is very important in promoting health as well as in getting quick recovery from diseases. For example, giving a high protein diet during any disease speeds up tissue repair and also boosts immunity, thereby promoting health and getting quick recovery from diseases.
In addition, vitamins and minerals help in wound healing and speedy recovery.
A therapeutic diet is very important for the management of chronic disease conditions. Just as in the case of diabetes, carbohydrate control is very important for the control of the disease, a low-fat and low-cholesterol diet is very important for the management of heart disease.
A therapeutic diet is also very important for the prevention of complications of any disease. Just as a patient with kidney disease can be prevented from further damage to the kidneys by giving protein, phosphorus and potassium in small amounts, in the case of celiac disease, avoiding a specific type of dietary gluten diet can prevent allergic hyperreactions related to it.
A therapeutic diet is very important for maintaining the patient’s overall health and well-being.
🔸c. Metabolic Acidosis – Metabolic Acidosis.
Metabolic acidosis is a disturbance of the acid-base balance in the body. In which the acidic environment in the body and body tissues increases.
In this, the blood pH is lower than normal and bicarbonate (hco3) is also found in the blood less than normal.
Metabolic acidosis occurs when there is excess acid production in the body and bicarbonate loss.
Causes
When the condition of lactic acidosis arises in the body, acid production increases and metabolic acidosis is seen, the causes of which are as follows.
Hypoxia
Severe Anemia
Respiratory Failure
Sepsis
Severe liver Disease
This condition can also arise due to ketoacidosis, the causes of which are as follows.
Diabetic ketoacidosis
Alcoholic ketoacidosis
Starvation
Metabolic acidosis can also be seen due to toxic injection of a toxic substance such as methanol.
This condition can also arise due to excessive loss of bicarbonate in the body, the causes of which are as follows.
Diarrhea
Kidney diseases
Clinical manifestations.
Fatigue
Confusion
Headache
Nausea and vomiting
Deep breathing kussmaul respiration
Low pH
Low bicaronate
Hypotension
Tachycardia
Arrhythmias
Coma
Diagnostic evaluation.
Physical examination, which looks for signs of dehydration, fruity breath odor, which indicates ketoacidosis.
ABG analysis
Serum electrolytes
Blood glucose
Renal function test
Treatment.
It involves finding and treating the cause of metabolic acidosis. For example, if there is uncontrolled diabetes, it is treated, in which insulin therapy is given.
If there are kidney problems, dialysis is done if necessary.
If there is diarrhea, it is managed. If any toxic substance has entered the body, its antidotes are given.
Electrolyte monitoring is done and supplementation of depleted electrolytes is done.
Intravenous fluid therapy is given.
After monitoring the patient’s arterial blood gas analysis, the treatment is modified as needed and management is done according to the severity.
Continuous observation of the patient and close monitoring of his input and output To do.
🔸d. Pre-operative nursing management
General Examination
Do a physical examination, including checking and recording vital signs.
Drug and Alcohol Use
Check nutritional and fluid status.
Check respiratory status and check for any infection.
Cardiovascular Status
Laboratory and diagnostic tests to be performed as needed.
Psychological Preparation
Pre-medication
Antiemetic Drugs
Sedative drugs
Preoperative Preparation
Informed concert
Pri operative teaching
⏩Q-5 Answer the following:- Answer the following:
🔸a. Write the sources of drugs. 04
The sources of different types of medicines used for the treatment of patients are found as follows.
Natural sources.
plants.
Medicines can be obtained from natural sources in which different types of plants can be obtained from different types of plants. Medicines such as digoxin, morphine, aspirin etc. are obtained from plants.
Animal.
Medicines such as insulin, heparin etc. are obtained from animal sources. These medicines are obtained from different types of animals and used.
Minerals.
Different medicines are also obtained from minerals in the natural source of medicines. Such as iron supplements, magnesium sulfate, etc. are medicines obtained from mineral sources.
Synthetic Sources.
Different types of medicines are obtained through chemical synthesis. Which are currently used in large quantities. These drugs include antibiotics, antihypertensives, analgesics, etc., which are obtained from different synthetic chemical sources.
Semi Synthetic Sources.
In this, natural compounds are chemically modified and this type of source is used to increase their effectiveness. Its side effects are also reduced. Many antibiotics are obtained in this way.
Microbial sources.
Different types of medicines are obtained from different types of microorganisms. Mainly antibiotic medicines are obtained from this type of source.
🔸b. What are the possible causes of epilepsy? 04
Write the causes of epilepsy (seizures).
Epilepsy is a neurological disorder. In which recurrent involuntary seizures are seen. Its causes are as follows.
Genetic causes. This condition is also seen to come from the mother and father’s side.
Brain injuries. This condition can arise due to falls or brain injuries.
Stroke. Due to causes such as Cerebro Vascular Accidents.
Epilepsy can also be seen due to brain tumors or brain lesions.
Infections such as meningitis, encephalitis, etc.
This condition is also seen in children due to congenital brain abnormalities.
Metabolic abnormalities
Epilepsy can also be seen due to electrolyte imbalance.
Hypoglycemia is also one of its causes.
Epilepsy can also be seen due to hypoxia.
It is seen due to the above reasons.
🔸C. Explain the role of a nurse in organ donation of brain dead person. Which has responsibility in many areas as follows.
The nurse should identify the brain dead person and identify the criteria for brain dead.
The brain dead person should be immediately referred to the organization for organ donation or should be informed by the people of that organization so that they can reach the person in time and perform the procedure of organ donation.
Assist the doctor during the clinical assessment to declare brain dead and maintain all medical records related to him accurately and keep a record of his condition, treatment and every Add details correctly.
Communicate with the family of the brain dead person and provide reassurance and emotional support to his family members.
Monitor the vital signs of the brain dead person and monitor and stabilize his hemodynamic stability, electrolytes.
Take informed consultation and maintain confidentiality for it.
Surgically prepare the person receiving the organ and provide pre-operative care and interventions To take.
Maintain proper care and communication after donation and provide support to the donor’s family and inform them that the donation has been completed.
To spread education about organ donation among all individuals, work related to health education should be done to spread awareness among the people that this process can save a person’s life.
⏩Q-6 a. State whether following statement are true or false.10
1.Myelin sheath destroy in Guillain barr syndrome. ✅
2.H5N1 virus is responsible for Swine-flu. ❌
3.In appendicitis pain occurs at Mc burney’s point. ✅
4.Coarse tremor occurs in cirrhosis of liver.
Coarse tremor occurs in cirrhosis of liver. ❌
5.In Billroth-1 operation, gastroduodenostomy is to be done. In Billroth-1 operation, gastroduodenostomy is to be done. ✅
6.Regular insulin is a long acting insulin. Regular insulin is a long acting insulin. ❌
7.Normal serum potassium is 3.5 to 5 mEq/L. ✅
8.Normal level of carbondioxide in arterial blood gas is 35-60 mm Hg.❌
9.Intensity of pain is depends on age also. ✅
10.Blood sugar level is decreased in stress condition. ❌
⏩b. Match the following:- Match the following pairs:-
1 – 6 1.Heparin-Heparin 1.Isotonic
2 – 4 2.Deriphylline-Deriphylline 2.Hypertonic
3 – 1 3.0.9% Sodium chloride 3.Antihypertensive – 0.9 % sodium chloride
4 – 5 4.0.45% Sodium chloride 4.Bronchodilator
5 – 3. 5.Atenolo-Atenol 5.Hypotonic
6.Anticoagulant
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