GNC-SOLVED PAPER-2018

🟡Q-1 a. list the common sites to develop decubitus ulcer. – Make a list of common places where decubitus ulcers occur. 03

• Back of the head-occipital region
• Bake
• hip
• buttx
• Ankle
• tail bone
• elbow joint
• Shoulder
• knee
• scapula
• Iliac crest
• Melioles
• Toe
• Ear
• Acromium process
• Greater trochanter

🟡b. Write the causes of Decubitus ulcer. – There are millions of causes of decubitus ulcers. 04

ANS –

Pressure In patients with chronic disease, sleeping in one position, the weight of his whole body falls on the linen of his bed, that is, the pressure comes on the skin of the back, so that gradually the skin becomes thinner in the place where the bony prominence is, as a result, there is a possibility of bed sore in this place. Living

Fiction: In friction, the friction of the patient’s back skin with the bed linen is especially important. In addition, when there are wrinkles anywhere in the bedlinen, the formation of these wrinkles in the back skin causes the skin to thin. Then all these things scratch the skin of the back and cause friction. Many patients have pressure on the back while dressing or a bandage is tied on the abdomen. In addition, sometimes rough handling while giving the bed pan to the patient may cause injury to that part. and can result in bed sores

Moisture: While performing the procedure on the patient, if the bed or linen is left moist, the bed is kept wet by the patient, for example, if the patient has tea, breakfast and feeding in the bed, the bed remains wet and due to this moisture, the patient’s back is wet. Bedsores are likely to occur in the skin. Among the other causes of bedsores, many minor causes can be mentioned, but mainly pressure, friction and destruction are important. Other causes are known as follows.

• Pre-disposing factor
• older age
• Overweight or obesity
• Prolonged illness
• Bed ridden patient
• In AD and
• Vic body structure

🟡c. Describe the role of nurse in prevention of Decubitus ulcer. – . 05

• Prevention of bedsores
• Relieving pressure
• Using an aircushion or an earring
• Relieve pressure by applying a cotton ring to the front of the elbow hill
• Gentle handling while giving bed pan
• Tie a tight or loose bandage as needed
• Back care of serious patient every four hours and change of position every two hours
• Inform the physician if the plastered patient experiences pressure anywhere in the bone
• Prevent muscle
• The patient’s clothing should be changed as soon as it becomes wet for any reason
• Bed linen should be changed as soon as it becomes wet
• Careful care should be taken during the nursing procedure using a draw seat making toss to prevent wetting of the nipples
• If the patient has excessive diarrhea, provide ventilation, provide a dry environment and change wet clothing.

Avoid friction

Never use rough and broken bed pan

While providing the bedpan, the patient should be raised and given in such a way as not to cause friction and the same care should be taken while taking it. The bed should always be kept clean and free of wrinkles. Use of water mattress as needed Regular back care Regular monitoring of body prominent parts of the body and gentle massage on pressure points with speed should be done To maintain the patient’s bed level, change bed sheets regularly and keep the bed regularly clean if there is food particles and garbage in the bed

OR

🟡a. Write the definition of Health given by WHO. – 03

WH.O. The definition of health has a very broad meaning.

Health means that a person is completely healthy physically, mentally, socially and religiously and does not have any kind of disease or deformity.

🟡b. List the different departments of Hospital. – 04

List of Clinical Departments in a Hospital:

• Casualty Department: To provide emergency medical care
• Operation Theater (OT): Performing surgical procedures.
• Intensive Care Unit (ICU): For specially critical patients
• Department of Anesthesiology : Administration of anesthesia
• Cardiology : For heart
• ENT : Eye, Ear and Throat
• Department of Gynecology :- For female diseases
• Pediatric Department :- For children
• Department of Neurology
• Oncology Department for Cancer
• Department of Ophthalmology for the eye
• Orthopedic Department Department of Bones
• Department of Urology
• Department of Psychiatry Department of Mental Diseases
• Indoor Patient Department (IPD): For inpatients
• Outdoor Department
• Department of Nursing
• Department of Pharmacy
• Laboratory Department
• Administrative Department

🟡c. Write the functions of Hospital. – 05

Function of Hospital

Patient care

Patient care All patients admitted to the hospital are cared for from admission to discharge, nursing care and other needs are met and in addition 24 hours emergency treatment is provided.

Prevention of Diseases

Prevention Is Better prevents the disease of the patient in collaboration with the doctor of the hospital. In order to prevent the disease, immunization is done for him in advance. In addition, cleaning and other operations necessary to prevent diseases in the hospital are done by the hospital.

Promotion of Health

To improve the health of the patients admitted to the hospital, disease-related counseling is also provided by the hospital itself, health education is also provided to the patient’s relatives to improve their health, and any person associated with health in the hospital provides this type of health education. can

Investigation

In modern times, medical science has made huge progress in diagnosis and treatment. New investigations and tools are also invented for the diagnosis of each patient so that the disease can be diagnosed quickly. It is an important function of the hospital to start his necessary treatment

Rehabilitation

Every person admitted to a rehabilitation and occupational therapy hospital is someone who wants to recover and settle back into their society or profession.

Medical Education

Medical Education All activities in a hospital include many types of education and it is provided by doctors, nurses, physiotherapists, pharmacists and technicians. In addition, medical education is planned where required. In-service education is planned for staff within the hospital as needed To train everyone and this kind of education is given according to new discoveries and new health programs etc.

Medical Research

Different patients are admitted in 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. Although many branches of the hospital do many types of research and they should be known by everyone. New education can be gained by knowing the skills

Social Services

That is, the social services are taken into consideration by the hospital and the security is especially given to the patients, for this there is also a social welfare department where the social workers give proper advice to everyone. Fitness age certificate Handicap certificate forms etc. are provided along with injured patient certificate and deceased patient 10 certificate birth and post mortem report for body are also provided.

Administration of Institute

A hospital is a large organization and all its employees are managed by the administrative office of the hospital.Records about the service of each employee are to be kept.Records Hospitals keep many types of records including patient admission to discharge records, birth and death records, infectious disease records, and some other types of records. Statistical information is recorded and written records of this matter are regularly sent to necessary places so this operation is very essential for the hospital.

🟡Q.2 a. Describe the principles of documentation of patient’s records and reports. – 08

• A hospital record is a legal document that shows a type of staff performance
• It is not enough that the cord should always look neat, clean and tidy, but the information written in it should be comprehensible, the writing should be clear and accurate and readable.
• The record should be signed by each person writing it.
• Taking care not to make any mistake in the record. If anything is forgotten or a mistake is noticed, it should be dated and initialed.
• Records should be written in chronological order by date and time when giving medicine, treatment should be noted the exact time and date on which day they are carried out.
• Hospital records are preserved for a long time. So organize and save accordingly
• Each page of the record should be properly identified with name, age, CR number, bed number, ward, date etc.
• Records should be correct, concise and complete. It should include all services rendered to patients, daily observations made on patients and results of treatment etc.
• The record should be for a specific purpose which should be clearly understandable.
• The wording should be easily understood, and instructions should be included to facilitate interpretation where doubt is likely to arise.
• A simple system of record keeping should be used; It should always be maintained in proper form and in proper register.
• There should be sufficient number of filing cabinets and suitable equipment
• Provision should be made for periodic review of all records.
• There should be adequate, safe and fireproof storage arrangements.
• Records should be audited by trained peer auditors at regular intervals Records should contain only relevant information and records should not be duplicated.

🟡 b. Write the care of patient’s belongings. – 04

• Care of patient means taking care of patient belongings
• Usually patients have a lot of expectations when admitted to a government hospital such as total care apart from what they envision.
• That all their needs will be met by the hospital but not everything will be met.

• In government hospitals, only bed and bed leader are provided but the patient has to bring his clothes from home, if there are facilities in many hospitals, clothes are also provided to the patient from the hospital.

• We should organize the things that the patient has brought from home in the word orderly in the bed side locker. Many patients keep their valuables in the locker, then all the responsibility about it remains with the patient.

• But in some circumstances, if you want to keep this item in the hospital, in such a case, fill the form regarding the item and get the signature of the next of kin, and then keep it in the ward. If the item is lost, it is the responsibility of the hospital to replace it.

• But the patient himself is responsible for finding the item kept in the locker

• Do not dispose of any belongings of the patient without asking the t-shirt. For example, bad clothes. If there are too many clothes of the patient, inform the senior nurse because such clothes have to be boiled in hot water and auto lab. Understanding should be given

• Valuables given by the patient such as jewelery money etc should be properly listed and handed over to the ward in-charge at the ease of the witness.We should return all the belongings of the patient while transferring or discharging from one ward to another.

OR

🟡a. Explain the role of nurse in prevention of cross infection in the hospital. – 08

As a nurse, we must know how to protect ourselves and patients from exposure to pathogens.

It is very important for the nurse to understand and follow the infection control policy of the organization such as use of personal protective equipment, environmental sanitation, etc.

1. Standard Precautions :- To break the chain of infection, standard precautions should be taken to prevent transmission from body fluids containing pathogens.
2. Hand hygiene :-:This is the number one weapon in preventing cross infection. The most spread of micro organism is through the hands so hand washing should be done before and after every procedure. It is very important to wash hands after touching every contaminated object
3. Aseptic technique: Using contact precautions and aseptic technique during the procedure. Use only sterile items in invasive procedures
4. Environmental infection control measures: The equipment used in the hospital and the surrounding environment should be kept clean and the floor of the hospital should be cleaned with anti-septic solution. Bio-medical waste generated during procedures or work should be properly disinfected and disposed of.
5. Droplet Precaution: Mask should always be worn while working in the hospital and infected patients should also wear it, precautions should be taken while cuffing, sneezing etc. should be explained.
6. P.P.E: Personal protective equipment to prevent cross infection from nurse and patient, which cap, mask, gown are used. which should be worn during the care of highly infectious patients.
7. Health Education :- Provide health education to patients and staff working under them to prevent spread of infection in the hospital.

🟡b. Write the factors affecting blood pressure. – 04

1.Age:- Blood pressure increases with age. The normal range in adults is 120/80 mm/Hg.

2 Emotions :- Stress, serious emotions. Anxiety, fear, pain, stress, sympathetic activation of the nervous system, vasoconstriction, increased heart contraction, resulting in changes in blood pressure.

3 Gender :- After puberty, males have higher blood pressure than females. But then Menopausal women have higher BP than men of the same age

4.Ethnicity: African-Americans have higher rates of high blood pressure than African-Americans

5.Life style :– People who eat food rich in salt and unsaturated fatty acids, have high 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 lowers blood pressure H Normally a person’s BP is early in the morning and low.

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: The vasomotor center plays a major role in the regulation of blood pressure.Chemoreceptors located throughout the vessel system are sensitive to barotroper 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.

🟡Q.3 Write Short Answers (Any Two) 6×2=12

🟡a. Write about care of medicine cupboard, –

ANS Each ward should have a separate cup board system for keeping drugs in which all drugs can be stored and preserved Medicine board should be in a separate room as far as possible.

This room should be close to the nurse’s room. Medicine room should have running water and sink. This room should have identify lighting so that the label of drugs can be clearly read. The cells of the cup board should be kept narrow.

So that only two road drug bottles can be placed in one cellwama, the drug bottles should be arranged alphabetically till each bottle should be of equal size, by doing this, the drugs can be easily handled. This cup board should be with lock and key. It should happen.

A separate register should be maintained for counting.Alcoholic preparations in liquid medicine are disturbed if left open.Tablets also should not be exposed to air.Each bottle should have a neat and clean label. It should be sent back or disposed of properly.

Some drugs have to be kept in the refrigerator for its preservation, for example, vaccine serum etc. should be kept in a separate track of emergency jokes so that it can be found immediately when required.

Drugs should be adequately indented as needed Medicine board should be kept neat and clean Medicine cabinet should be locked Medicine board should be kept away from place of excessive heat moisture etc. Key should be kept by responsible person.

So that the chemical properties of the medicine do not change Stock should be checked at regular intervals Drugs can also be organized according to their group Records should be maintained properly Manufacturing date Expiry date Batch number of drugs should be checked Proper handling and original label should be maintained

🟡b. Write First aid treatment in food poisoning. –

ANS If you think someone has food poisoning, advise them to lie down and rest.

If they are vomiting, give them small sips of water to drink as this will help prevent dehydration.

If they only have diarrhea or diarrhea, it’s even more important to try to replace lost fluids and salts.

You can advise them to take oral rehydration solution (ORS) as directed on the packet from your local pharmacy. This is especially important in more vulnerable people such as the elderly, people with other health conditions and children.

When they feel hungry again, advise them to eat light, bland, easily digestible foods, such as bread, rice, crackers, or bananas.

Do not drink alcohol, caffeine or fizzy drinks.

If they worsen and vomiting and diarrhea persist, especially in the elderly, infants, or young children, seek medical advice. Call 999 or 112 for emergency help.

Do not take anti-diarrheal medications unless specifically advised by a healthcare professional.

To prevent the spread of infection, always practice and encourage hand hygiene.

Stay away from work or school for at least 48 hours after the last episode of diarrhea or vomiting.

🟡c. Explain different routes of giving injection. –

ANS

• 1) Given in hypo dermal -subcutaneous -areolar tissue
• 2) Intra-muscular – deltoid, gluteal and vastus lateralis
• 3) Intra-dermal- in the skin
• 4) Intra osseous – in the bone marrow
• 6) Intrathecal -spinal cord
• 7) Intra-cardiac
• 8) Intra-venous – given into blood vessels

🟡d. Importance and effect of exercise on the body. –

ANS exercise can increase the functional processes of all body systems Exercise has many physiological, psychological and social benefits Exercise protects against coronary heart disease Hypertension and diabetes and obesity Regular exercise increases muscle mass Increases work capacity There are clauses, the female officiency increases, digestion improves, the mantle is found, sleep operator improvement is observed, the hemoglobin level in the blood increases, the position decreases, the blood pressure decreases, and the cholesterol level in the blood also decreases.

🟡Q.4 Give reasons for the following (Any Four) 4×3=12

🔸 a. Sharp instrument should not be boiled.

ANS Boiling a sharp instrument will destroy its edge and the instrument will not work well.

🔸 b. Mercury used in thermometer.

ANS thermometers has a high coefficient of expansion so that even normal changes in temperature cause it to expand as required so we can calibrate the thermometer.

🔸 c. Left lateral position is given while giving enema.

ANS The structure of the colon is such that a rectal tube can be easily inserted in the left lateral position and injury is minimized.

🔸 d. Water should be given before giving medicine.

ANS Water helps the medicine to pass through the mouth and stomach and also helps it to pass in time so that the medicine can be well absorbed and give the desired action without water if the medicine is formulated it cannot be active well and In many cases its undesirable side effects are also seen so water is given before and with the medicine.

🔸 e. Hot water bag should not be given to paralytic patient. A hot water bag should not be given to a patient with paralysis. If a hot water bag is given to a patient of

ANS paralysis, it causes damage to the patient because the nerve is not working well, so the nerve may be damaged, the sensation may not be normalized, and it may get burned because the part does not know how much heat is there. can

🔸f. Hard water should not be used in sterilizer.

ANS When hard water is pressure steamed or boiled, the steam generator causes the salts and minerals in the hard water to deposit inside the valves and pipes. Over time, this residue forms a large layer and then damages the autoclave and boiler, so hard water should not be used in sterilizer machines.

🟡Q.5 Define the following (Any Six)

🔸1.Biomedical waste – (biological waste)

ANS WHO defines any waste generated by medical health care activities ranging from used needles and syringes to soiled dressings, body parts, diagnostic specimens, blood, chemicals, Includes pharmaceuticals, medical devices and radioactive materials.

🔸2.Insomnia – Insomnia is a sleep disorder characterized by difficulty falling asleep or staying asleep. This condition may be short-term (acute) or long-lasting (chronic). It may come and go. Acute insomnia lasts from 1 night to a few weeks. Chronic insomnia is when it occurs at least 3 nights a week for 3 months or more.

🔸3.Anaphylavus – Anaphylaxis An acute allergic reaction to an antigen (eg bee sting) to which the body has become hypersensitive is called anaphylaxis.

🔸4.Contamination – means making something impure, un-clean, polluted or poisoning, especially something or a person coming into contact with bacteria, viruses, fungi, etc.

🔸5.Nosocomial Infection – is also known as Healthcare-Associated Infection (HAI-Hospital Acquired Infection), which occurs while receiving health care services i.e. after admission to the hospital. This infection does not occur on admission

🔸6.Hypoxia – Hypoxia is a condition in which oxygen is not available in sufficient quantity at the tissue level to maintain adequate homeostasis; This can result from insufficient oxygen delivery to tissues due to low blood supply or low oxygen content in the blood (hypoxemia).

🔸7.Halitosis-

Halitosis i.e. bad breath or foul-smelling breath in which there is a bad smell from the mouth is a chronic situation of breathing or it can be acute which requires oral hygiene, bacterial growth in the oral cavity, plaque formation and consumption of food items like garlic, onions and spices. But foul smell is also present in dry mouth, gingivitis or periodontitis infection, diabetes, liver disease and halitosis is also caused by smoking and tobacco use.

🔸8.Tachycardia means that your heart beats faster than normal, usually more than 100 beats per minute. Sinus tachycardia is your body’s normal response to stress. Supraventricular tachycardia and ventricular tachycardia can be dangerous or even fatal. Q.6

🟡B. State whether the following statements are True or False. 05 –

1. Heat regulation center is Hypothalmus. True –
2. Bland diet given to client with G.I.disease. True –
3. Examination with the help of stethoscope is called palpation. False –
4. Client should be addressed by their disease, False –
5. Tuning Fork is used to test vision, false –

🟡C. Match the following, 05

‘A’ ‘B’

a.Inflammation of tongue i. Blood in pleural cavity –

b. Diuretics states ii. Collapsing Pulse

c. Haemothorax iii. Lithotomy Position –

d. Vaginal examination iv. Increase flow of urine –

e. Water Hammer Pulse iv. Glossitis –

ANSWER :-

• A-v
• B- iv
• C- i
• D- iii
• E- ii

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