paper-2019
Q1. 🔸 a. Explain Nursing is an Art & Science”. 03
Nursing is an art: Nursing is an art not everyone has it Different methods are used in nursing care Skillful care is given keeping in mind the patient’s condition and emotional fillings To learn the art of nursing empathy and forgetting oneself. A person should have the spirit of working for others
Nursing is a science: Nursing is also a science because it has to give treatment keeping in mind the scientific method and principles. The science of nursing is the same at the world level and there is no change in it. Therefore, a nurse is an anatomy, physiology, microbiology, physics to treat a patient. , Chemistry, Psychology and Economics knowledge is required
b. Write down functions of the hospital. Write about the functions of a hospital. 04
Function of Hospital
Patient Care: Taking care of the patient All types of care are provided to all patients admitted to the hospital 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 together with the doctor of the hospital prevents the disease of the patient. To prevent the disease, immunization is done in advance. Besides, cleaning and other operations necessary to prevent diseases in the hospital are done by the hospital.
Promotion of Health: In order to improve the health of the patients admitted to the hospital, they are also given disease-related advice by the hospital itself, so that the patient can improve his health, health education is also given to his relatives and any person of the hospital associated with health. Can provide type of health education
Investigation: In modern times medical science has made great progress in diagnosis and treatment. New investigations and tools have been invented for the diagnosis of each patient so that the disease can be diagnosed quickly. Accordingly, his necessary treatment is started, this is an important function of the hospital
Rehabilitation: Every person admitted to the rehabilitation and occupational therapy hospital is someone who wants to recover and re-establish himself in his society or profession.
Medical Education: Medical education involves many types of education in all activities in a hospital and is provided by doctors, nurses, physiotherapists, pharmacists and technicians. To train everyone by organizing service education and such education is imparted in line with new discoveries and new health programs etc.
Medical Research: Different patients are admitted in the medical research hospital according to which various types of research can be done by knowing their problems. This work of research is as important as medical education. New education can be gained by knowing many types of skills
Social Services: Means social services are provided by the hospital and security is taken into account, especially the patients are given social services. For this, there is also a social welfare department where the social workers give proper advice to everyone. Like Physical Fitness Age Certificate Handicap Certificate Patterns etc. are provided along with injury patient certificate and deceased patient 10 certificate birth and post mortem report for the body are also provided.
ADMINISTRATION OF INSTITUTE: A hospital is a large institution and all the employees in it are managed by the administrative office of the hospital.Records about the service of each employee have to be kept.Records There are many types of records kept by the hospital including from admission to discharge of the patient, birth record, death record, infectious disease record. Apart from this some type of statistical information is recorded and written records of this matter are regularly sent to the required places so this operation is very essential for the hospital.
c. Define Nursing and write down qualities of a nurse. Define Nursing and write about Qualities of Nurse. 05
Definition of Nursing
Nursing is the art and science of providing careful care to a sick person to protect his life and prevent disease, promote health, and treat the sick patient for rehabilitation.
Quality of Nurse
Kindness A nurse should have a sense of service, should be kind and kind, should not be mean to anyone or anything.
A health nurse should be physically and mentally healthy and capable. How can a person who is sick himself serve others? Sometimes the nurse has to work even after the duty is over. Sometimes there are hundreds of patients at the same time when there is an accident or an outbreak of disease. He needs to be in good health when he has to work for more hours at such times
A cheerful nurse should always be cheerful and enthusiastic and should always be enthusiastic. Only a cheerful person can bring joy to others.
Character A nurse should also have good character. Good character also makes the profession holy
Regularity A nurse should be regular in his working hours because he has to treat the patients regularly and in a timely manner.
Seventh Factors A nurse should not only have tolerance and modesty, but also be kind and empathetic towards the patient.
A sympathetic nurse should be empathetic, that is, put yourself in the patient’s place and think about how you feel if you find yourself behaving well. The nurse should have the ability to treat the patient without hurting his feelings.
Self-Confidence A nurse should have the confidence to fully heal the patient.
Alertness Alertness A nurse should have alertness and agility Willingness to work quickly Good behavior of a nurse increases the patient’s confidence
The app should not discriminate against any kind of discrimination, it should treat the patient as a patient and not discriminate based on caste, religion or economic status.
Honesty Nurse should be honest There are many equipment articles medicine etc. in the ward it is the responsibility of the nurse if any item gets spoiled or broken by mistake it should be reported to the authority
Scientific knowledge Nurse should work with his knowledge in view of scientific principal, not only book knowledge but also experience should be employed and should be applied with scientific principal and nurse should also have ten intelligence.
Economical Nature A nurse should be frugal in nature and should be able to do any work in a saving of time and energy.
Self-Dependent Must be self-dependent and not dependent on others for patient care.
Curiosity Nurses should always be willing to learn new things so that they can increase their knowledge over time. Next Resource Resources Resources should be able to make full use of whatever resources are available to treat the patient.
OR
🔸 a. List out the common sites of Decubitus ulcer. List the common sites of Decubitus (bedsore) 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 down the causes of decubitus ulcer. Write the causes of deubitus (bedsore). 04
Pressure In patients with chronic disease, sleeping in the same 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 thin in the place where the bone is prominent, as a result of which gradually bed sore occurs in this place. The possibility remains
In fiction friction, especially the friction of the patient’s back skin with the bed linen is important. In addition, when there are wrinkles anywhere in the bed linen, the education of these wrinkles in the back skin causes the skin to thin. All these things rub and cause friction in the skin of the back. Many patients may experience fissures due to the pressure on the back while the dressing is on or the abdomen is bandaged. Also, sometimes rough handling while giving the bed pan to the patient may cause injury to the part. and can result in bed sores
Moisture while performing the procedure on the patient, if the bed or linen is left damp, in addition, the bed is kept wet by the patient, for example, if the patient takes tea, breakfast and feeding in the bed, the bed remains wet and due to this moisture, the skin of the patient’s back is wet. Bedsores are likely to occur. Among the other causes of bedsores, many types of 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. Write down nursing role in prevention of decubitus ulcer. Write the role of nurse in preventing decubitus (bed sore). 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 changing 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 profuse diarrhoea, 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 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 wrinkle-free. Use of water mattress as per requirement Regular back care Always check the body prominent part of the body and gently massage with speed on the pressure points Always change the bed sheets to maintain the highness of the patient’s bed and keep the bed regularly clean if the bed is littered with food particles
Q.2 🔸 a. Write down the general instructions in moving and lifting of patient. Write about things to keep in mind while lifting and moving the patient. 08
A plan for patient movement should be prepared in advance
The patient should stand in the direction to be moved to prevent the vertebral column from moving.
One should stand comfortably with the legs wide apart to flex the knee and hip joints but keep the back as vertebral as possible.
Keeping the patient as close to our body as possible
Avoiding jerking and testing during lifting of patients Overweight patients should be moved by sliding method instead of lifting.
Taking help of assistant for moment and lifting of overweight patient
Keeping the bed height in a position that the nurse can maintain while moving the patient in the bed to prevent lower back injuries
Before lifting the patient, bring him to the edge of the bed so that he can be lifted upright
When there is more than one worker for patient movement, one person should head solder ribs, another person hips and third person provide ankle support as needed.
To give one two three M signals so that the same weight and power can be used while lifting
The patient should be encouraged to use his abilities if normal movement is allowed
Observe the patient for signs of orthostatic hypotension eg dizziness, sweating
Do not stretch the patient by applying pressure to the pret i.e. armpit or under the axilla as this may cause injury to major and blood vessels.
Beds and stretchers should be locked before transferring the patient
All three persons should decide their position to move the patient
The nurse should keep the knee flexed while standing.
b. Define the nursing process and list out the components of a nursing process. 04
Nursing process:- Nursing process is an active approach to provide nursing needs and solve the patient’s problem by systematically planning the nursing care of the patient, in which each step is sequentially inter-related and interdependent, it is called nursing process. is
component;
assessment
Nursing Diagnosis
Planning
Implementation
Evaluation
OR
🔸 a. Define the physical examination and explain the role of nurse in general physical examination 08
Define physical examination and explain the role of nurse in general physical examination.
physical examination –
Physical examination means detailed inspection or detailed study of physical and psychological condition of fashion is called physical examination.
Nursing Roll of Physical Examination-
The patient is informed beforehand and mentally prepared to perform a complete examination of his body to diagnose any disease.
And in this way, the nurse has a lot of responsibility in the physical examination because it is necessary to know the necessary equipment for this examination, information about the patient’s disease, etc.
1) First informing the patient that the doctor is coming for examination
2) If the patient has a separate room, then make necessary preparations to close the bed or if there is a general bed, put a skin around the bed.
3) During the physical examination, as asked to go outside the patient’s relations, keep all the necessary physical examination equipment ready for the doctor during the patient’s examination.
4) Before the doctor comes to examine the patient, the nurse should know the disease related information of the patient like TPR, BP etc.
5) There should be natural light to open the part of the patient which is to be examined or to loose the cloth and there should be sufficient light in the room if not then sufficient artificial light should be arranged in the room.
6) Examination room or unit should be kept neat, clean and tidy
7) Never leave while examining any female patient During the examination of male patient’s private parts go out after proper preparation.
8) Keeping the patient in a position compatible with the examination and giving the patient an appropriate position for the party to be examined.
9) To provide necessary equipment during examination when asked and to give all patient information when doctor asks.
b. Write down steps of prevention of cross infection in hospital. Write about measures to prevent cross infection in hospital, 04
Prevention of cross infection in hospital
Maintain general cleanliness in the hospital
Provide good ventilation
Mop hospital floors daily with antiseptic lotion
Items used for the patient should be thoroughly washed
Safe disposal of hospital waste
Provide safe water supply
Wear a glow and gown during the procedure
Isolate a patient with an infectious disease
Non-washable items should be kept under sunlight
Disinfect the room after patient 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 a mosquito net
Add lime to excrement before disposal
Q.3 Write short answer (Arty Two) Write short answer. (Any two) 2×6=12
🔸 a. What is medicine? Explain various methods (Route) of administration of drugs. What is medicine? Explain the different methods of administering medicine.
Medicine – Medicine is a science in which diseases can be cured by means of substances and preparations which are used for the prevention and cure of disease.
2) By ingestion
Ingestion means taking medicine by mouth. Drugs like mixture, tablet, capsule, powder syrup, etc. are given by mouth. Some drugs are given to the patient sublingually.
3) By inhalation
Some drugs are delivered to the lungs through inspiration. eg, ammonia.
4) By instillation
In this method, the medicine is introduced into the cavity as a drop. Eg, eye drops nasal, drops, etc. Instillation of medicine can also be done in urinary bladder.
5) By injunction
In this method medicine is messaged on the affected part. eg, ointment.
6) By insufflation
In this method, powder, gas, vapour, etc. are filled in insufflation and inserted into the wound or cavity. For example, nebusulf powder is insufflated into the wound. Cranial insufflation, endotracheal insufflation, perineal insufflation, etc. are the same methods.
7) By insertion
Rectal medicine is given by this route……….. eg, retention enema, suppository, proctolysis, (large amount of medicine to be given), etc. Drug is also introduced in vagina for local effect.
8) By implantation
Solid drugs are implanted in body tissue.
Injection
In the body cavity, in the blood vessels or in the body tissue, the process of pushing the fluid by force through a hollow tube and needle is called injection.
b. Describe care of the person after death. Write in detail the treatment of a person who has died.
Taking care of the dining patient is very necessary for which his relatives are sent out
Gently close the patient’s eyes and mouth.
Lay the patient upright keeping arms and legs straight.
Take an extra pill from the coat Aircon auto cylinder enable machine to move Just leave a pill under the head.
To remove catheter dennis tube IV infusion etc. and to plug cotton in body opening so that body discharge and blood do not come out and infection is not spread.
Placing an identification card on the wrist containing patient’s name address age ward number two number date of death and time identification card is done when the patient is to be sent to the mortuary room but if it is to be handed over to the relatives then taking signature in the case paper.
If you want to send it to the mortuary room, take the signature of the room man and the policeman and write the buckle number in addition to the mortuary room slip or fill the form and inform the police if there is a police case.
Checking whether the day certificate is filled or not This certificate is filled in two copies as per the policy of the hospital.
Recording in the death register Recording in the case paper Reporting the sighting or notifying the death to an authorized person.
c. Dcfine Enema? Write points to remember while giving enema, write the definition of enema. Write about points to keep in mind while giving enema.
An enema is a solution used to evacuate the contents of the lower bowel and an enema is a solution used to cleanse the bowel.
1) Enemas should be given only as ordered by a physician or doctor.
2) While giving enema, the amount of solution should be as suggested by the doctor and the amount of solution should be according to the age of the patient.
3) The temperature of the enema solution should be the same as that of the patient
4) Patient should be properly positioned while giving enema and comfort should be provided to the patient.
5) The height of enema can should be ideal while giving enema. Also all the articles should be clean.
d. Describe the physical methods of sterilization. Write the classification of physical methods of sterilization.
Physical agents
(1) hit
(2) Sun light
(3) Cold low-temperature
(4) Dry or desiccation.
(5) Radiation
(6) Filtration
(7) Sound Wave and Ultra Sonic Vibration Heat :-
Heat is a trusted most effective economic and wildly used agent.
The effect of heat on microbes depends on four factors.
3.Environment Factors
Direct flaming
Used to sterilize platinum copper and other metal wires, such as forceps points.
In this method the object is kept in the flame till then. That is until it becomes red hot
Burning or Incineration
Infected laboratory materials, contaminated swabs, paper sputum cups, dressings, books, magazines, clothes, mattresses, etc. are used for hospital waste disposal. Boling is a very simple method of disinfection.
Most of these vegetative forms of bacteria are killed within 10 minutes, but the spores survive.
Bolling is a suited method for sterilizing syringes, for glass ware and for clothes of infectious patients and articles that cannot be damaged by bolling Tyndallization
It is also called Tyndallization as it was developed by the British scientist John Tyndall.
In this process 100* C temp. 20 min. until required.
And this is done for 110 4 days.
In other words, repeated heating at day intervals (12 to 24 hrs) is used, it also destroys vegetative forms bacteria and spores.
In the third heating, almost all remaining organisms are destroyed, except for the preparation of culture media, this method is not used. Heat Sterilization
Ma heat unde
Autoclaving r pressure is a practical and useful agent.
15 lbs pressure in this method
Water tank, rivers, lacks Hi 24 natural method 2 sterilization is done. Among the methods used at home, this is one of the best methods of disinfecting clothes (mattresses, clothes etc.) Many types of bacterial spores and microbes can be removed by direct exposure to sunlight. Tuberculosis germs can be killed by a few hours of sunlight exposure. Germicidal action of sunlight is attributed to sunlight Hi 28 ultra violet 24 infrared rays.
and 121° C temp. 30 minutes is required for sterilization.
Pressure does not kill organisms, but steam under pressure can do the job.
Time is how much bulky material to sterilize. Depends on it. This is considered one of the best methods of sterilization. Which destroys all bacteria and spores.
The equipment used for this process is called an autoclave machine, which is similar to a home pressure cooker
Sunlight
Water tank, rivers, natural method 2 sterilization is done. Among the methods used at home, this is one of the best methods of disinfecting clothes (mattresses, clothes etc.) Many types of bacterial spores and microbes can be removed by direct exposure to sunlight. Tuberculosis germs can be killed by a few hours of sunlight exposure. Germicidal action of sunlight is attributed to sunlight Hi 28 ultra violet 24 infrared rays.
Q-4 Write short notes (Any Three) 3×4=12
🔸 a. Factors affecting dosage of drugs. Factors affecting the dosage of drugs.
1) Age (Age) Infants, children and aged patients need smaller doses of drugs than adult patients. For children up to one year old, the dose is determined by the young formula.
Dose = Age × adult dose Age + 12
Eg, castor oil GM adult dose
30 ml and it is to be given to a year old child
Dose = 4×30 = 120 = 7.5 ml
4+12 16
2) Weight: Overweight patients require a higher dose than normal. Low weight patients need less dose.
3) Sex: Male needs more dose than female.
4) Physical condition: When the pain is more, there is a need for more dose of medicine. A large dose of stimulant drugs is given in shock and collapse condition, when there is a reaction to a drug, the drug given as an antidote has to be given in a higher dose to reduce the effect of that drug.
5) Excretion (excretion): When the excretion of drugs from the body is fast, then such drugs are repeated in less hours. E.g., Penicillin, when the drug has slower excretion, the distance to give that drug is longer. eg, digitalis. If drugs with slower excretion are repeated in less hours, they produce symptoms of toxicity.
6) Tolerance: When the patient’s tolerance power is good, toxic symptoms of drugs are not produced even if more dose of drugs is given.
7) Habituation: If some drugs are taken continuously for a long time, they become habit of drugs. eg, valium
8) Addiction: Habit gradually results in addiction. By not giving drugs, craving and withdrawal symptoms are seen in the patient. The tolerance power of such a patient towards drugs also increases.
10) Effect desired
Drugs produce two types of effects.
a) local effect
b) general effect
Local effect limited area is enough, while general effect affects the whole body by studying in the blood stream. For general effect, when drugs are given orally, they are given in diluted form and when the stomach is empty. So that faster and better effect of drugs is produced.
11) method of administration
The method of giving drugs also affects the effectiveness. Drugs given by I/v root produce quick action.
b. Care of medicine cupboard. Care of the medicine cabinet.
Care of Medicine Cupbot and Drugs
Each ward should have a separate cup board arrangement for keeping drugs in which all medicines 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 read clearly.
Drugs used in axial use should be kept separate.Cup board cells should be kept narrow so that only two road drug bottles can be placed in a cell.Alphabetically arrangement of drug bottles should be kept equal size of each bottle. By doing this, easy handling of drugs can be done.
This cup board should be with lock and key. This cup board should be handled by senior staff nurse only. Separate registers should be maintained for counting. Alcoholic preparations in liquid medicine are disturbed if left open.
Tablets should also not be exposed to air. Each bottle should have a neat and clean label. If any change in color or order of the medicine is observed, the medicine should be returned to the store or properly disposed of.
Some drugs need to be kept in refrigerator for its preservation for example vaccine serum etc should be kept in a separate track of emergency jocks so that it can be found immediately when required. Indent should be done as much as necessary.
The medicine board should be kept neat and clean.The medicine cabinet should be locked.The key should be with the responsible person.
Stock should be checked at regular intervals Drugs can also be sorted according to their group Records should be properly maintained Manufacturing date Expiry date Batch number of drugs should be checked Proper handling and original label should be maintained
c. Importance of diet in illness. Importance of food in disease.
The sick person usually has some disturbance in the gastrointestinal function, the sick person feels less appetite. There is digestion problem, absorption of nutrients does not take place, so the nutritional needs of a sick person are slightly different from that of a healthy person.
Metabolism and catabolism processes are normal in a healthy person, while in a sick person, this process is disturbed due to which the body does not get enough nutrients, so the sick person has to be given extra nutrients in some way.
In a sick person, diet has to be given according to the patient’s illness, for example, salt free diet, sugar free direct etc. Many patients expel it from the body through diarrhea or vomiting, so it has to be given through fruit and nutrient medicine.
d. First aid management in burn’s patient. First aid for the burn patient
First aid care for Dazaya is as follows.
(1) Pour water over the body or wrap in a blanket to extinguish the fire. Hold the blanket in front of you. Do not walk or walk around a person who has been burned. Especially should not be allowed in open air.
(2) Immerse the burnt part in cold water. For this, keep the burnt part in cold water for 15-20 minutes in a bucket, kitchen basin or under running water and remove it after the pain subsides. If ! If not possible, apply cold water to the burned area and change it frequently. Doing so removes heat from the burnt organs. And further damage is prevented.
(3) If water is not available, cover the burn with a sterile bandage or suture with a freshly washed clean cloth. Burned part should not be exposed to air. If the big face is burnt, make a band of that shape and tie it with ears instead of mouth and nose.
(4) Some time after the burn, the burnt parts of the body become swollen. So remove rings, anklets, boots or other body ornaments.
(5) After removing the small and upper last burnt part from the water, dry it without blotting and cover it with a sterile bandage. If the burn is large, stitch it with a clean cloth.
(6) Arrange for immediate hospital transport.
(7) Apply ice in a towel and roll over the burnt parts while being taken to the hospital.
(8) Do not apply flour, butter or baking soda on the burnt part.
(9) Do not apply any paste, ointment or oil on the burnt part.
(10) Do not try to burst the blisters if they occur.
(11) Do not try to pull off the cloth stuck to the burnt part in the first aid as it causes great pain. It also tightens the skin. And peeling off the wound covering exposes the area to infection by airborne germs. Burned skin or clothing is sterilized by burning. It is more desirable than an open wound.
(12) Touch and move the patient as much as is particularly necessary.
⏩Q-5 (A)Define following (Any Three) 3×2=06
🔸 1.Diastolic Pressure– Diastolic pressure: When the heart is in a state of relaxation, the pressure measured by the blood on the wall of the artery is called diastolic pressure.
2.Bradypnoea– Bradypnoea: Bradypnoea means abnormal slow breathing. When the respiration rate is 10/min, the condition is called bradypnoea.
(B) Give the scientific reason of the following (Any Three) 3×2=06
🔸Q-6 (A) Fill in the blanks. 05
The temperature of water for sits bath is___________. (37* to 39* C)
🔸 (C) Match the following. Jodka Joda 05
1) Tachycardia Tachycardia 1) Cessation of breathing
2) Orthopnea Orthopnea 2) Pulse rate over 100 bpm – 100 beat/m. A pulse greater than
3) Stridor 3) client can breathe only in upright position – patient can breathe only in upright position
4) Dyspnea Dysnea 4) Decrease respiratory rate
5) Apnea Apnea 5) High, Pitch, Wlhistling sound during taking breath
6) Difficulty in breathing
Answer :-
1)- 2
2)- 3
3) – 5
4)- 6
5) -1