Points to keep in mind for giving practical exam:-

Special things to keep in mind for the students who are going to appear for GNC / UNIVERSITY PRACTICAL EXAMINATION.

During the practical examination your uniform should be clean and pressed, nails trimmed, all ornaments removed, hair tied and hair netted.

If a male student, saving should be done and hair should be cut and hair oil should be applied.
Your seat number should be clearly tagged.

Keep enough stationery items like ball pen, pencil, rubber, sketch pen, blank poster etc. in the exam.

Do not carry electronic items or mobiles with you during the practical examination.

Maintain complete confidence during the practical viva.

Entering the practical examination room with permission, wishing the examiner and thanking him when asked to sit.

Maintaining eye contact with the examiner during the viva.

The examiner takes the items in question and points to each part with a pointer.

Not to interact with other students and maintain discipline during practical examination.

SAMPLE VIVA [RACTICAL.

💖 Adrenaline (Epinephrine):

Form:

Epinephrine injection: These are available in various concentrations and forms, including pre-filled syringes, ampoules and auto-injectors.

Indication

1. Anaphylaxis (Anaphylaxis)

Severe allergic reactions

Primary treatment (first line treatment) such as due to insect bites (sting bites), food or medicine allergies.

2. Cardiac Arrest

It is used during cardiopulmonary resuscitation (CPR) to support heart function

3.Severe asthma or respiratory problems:*

In some cases, adrenaline may be used to relieve severe trachea constriction and improve breathing.

Dosage:

The dose of adrenaline depends on the specific indication, the patient’s weight and the way of administration of the medicine.

• In anaphylaxis, the typical adult dose is 0.3 to 0.5 mg (0.3 to 0.5 ml of a 1:1000 solution) given intramuscularly (Im) in the flank thigh. The dose of this medicine in children depends on the weight of the child.
• In cardiac arrest, higher doses may be used, and are usually given intravenously.

Route of Administration

Intramuscular (IM): Treatment of anaphylaxis involves intramuscular (IM) injection into the thigh.

Intravenous (IV): In cardiac arrest or other emergency (critical) situations, adrenaline can be given directly into a vein (vein). This is usually done by a healthcare professional (health care provider).

(Auto-injector) Auto-injectors:

• Adrenaline auto-injectors are pre-filled devices designed for easy and quick administration by individuals or caregivers in critical situations.
• These devices come with specific instructions, and dosages are usually standardized.

Sometimes it is also given directly into the heart which is called intracardiac

Contra Indication Contra Indication-

• Adrenaline should be used with caution in patients with certain medical conditions such as heart disease, hypertension and hyperthyroidism.
• Do not take this medicine if you have an allergy to sulphites or other components of the medicine.

Side effects

• After administration, the patient should be closely monitored for any improvement in symptoms or worsening of the condition.
• Adrenaline side effects may include increased heart rate, increased blood pressure, anxiety, tremors, and possible cardiac arrhythmias.

Nursing Intervention

Assessment of lung sounds, blood pressure, and pulse during continuous therapy

Check for chest pain and blood glucose level as it increases. Monitor for bronchospasm.

The correct administration of adrenaline should be trained and the given protocol should be followed.

In emergency situations, the immediate administration of adrenaline can save lives, but it should be part of a comprehensive emergency response plan.

Warning:

Great care is needed when calculating and preparing the dose of epinephrine. Because epinephrine is a highly potent drug.

If there is even a small error in calculating the dose or in preparing it, it leads to serious Edwards effect.

Double checking and verifying when calculating pediatric doses.

Use only small doses for a short period of time. Epinephrine fastness (which is a form of drug tolerance) occurs if it is used for a long time.

Protect the drug solution from light, excessive heat and freezing (extremely cold temperatures).

Do not use if the solution is brown or pink in color.

Drug solution should be clear and colorless.

Shake well before withdrawing the solution.
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Rotate the subcutaneous injection site after injection to prevent necrosis.

Monitor the injection site frequently.

In case of excessive hypertensive reaction, keep a rapid acting alpha adrenergic blocker (phentolamine) or a vasodilator (nitrate) ready (keep available).

Keep an alpha adrenergic blocker and intermittent positive pressure breathing ready in cases with pulmonary edema.

Keep a beta adrenergic blocker ready in case of cardiac arrhythmia. (Propanolol, cardiac selective beta adrenergic blockers such as atenolol used in patients with respiratory distress)

Be careful not to exceed the prescribed dosage of the inhalation product.

Administer pressurized inhalation drug during second half inspiration. Because the airways become wider and the airway distribution becomes wider.

If a second inhalation drug is required, the previously given dose should be given at peak level (three to five minutes).
Give a second dose when needed.

Use topical nasal solution only for acute condition. Do not use it for more than three to five days and do not give more than the prescribed dose.

After the vasoconstriction subsides, rebound nasal congestion occurs i.e. severe stuffy nose.

✚ 1.Thermometer:

♦ Normal value of temperature (normal body temperature):-
Oral temperature: 37°C / 98.6°F

Rectal temperature:
37.5°C/ 99.5°F (oral temperature greater than 0.5°C)

Axillary temperature:
36.5°C/ 97.7°F (less than oral temperature)

Conversion Formula for temperature:-
°F=(°C×9/5) + 32
°C=(°F- 32) ×5/9

Thermometer is used to measure body temperature during physical examination.

♦ Normal value of temperature (normal body temperature):–
Oral temperature: 37°C / 98.6°F

Rectal temperature:
37.5°C/ 99.5°F (0.5°C higher than oral temperature)

Axillary temperature:
36.5°C/ 97.7°F (oral temperature less than 1°F)

Conversion Formula for temperature:-
°F=(°C×9/5) + 32
°C=(°F- 32) ×5/9

(Apart from this, thermometers of different types and their details are given below)

How to clean the thermometer..?

The thermometer is cleaned with cotton swab through normal saline or spirit.

In it digital and clinical thermometer…
Bulb to stem is cleaned before using the thermometer.
And after use, stem to bulb is cleaned.

NOTE:
During the procedure, the thermometer is kept with savlon solution and cotton swab.
The main goal of keeping a cotton swab in it is that if there is a cotton swab, the thermometer should be kept in a bowl with savlon during the procedure

GENERAL DRUGS

✚ PARACETAMOL-PCM (Paracetamol)

Anti Inflammatory (NSAID-Non Steroid Anti Inflammatory Drugs)

♦ Dosages
250,500,650mg
1 gm in adults.

♦ Group
► Antipyretic
► Analgesic

♦ Brand Name-Brand name
Panadol
Calpol
Tylenol
Alvedon

♦ Mode of Action
Paracetamol inhibits the synthesis of prostaglandin which is reduced by the active forms cox 1 and cox 2.
It exerts a central analgesic effect through activation of the descending cerato-nergic pathway.

♦ Indication
►Fever
►Head-ache-head one
►Tension-Tension
►Migrane ►Back ache ►Muscle pain Toothache-Muscle pain Toothache
►Menstrual pain-menstrual pain
►A cold
► Sore throat-pain in the throat
►Pain in the sinuses-Pain in the sinuses

♦ Contra-Indication (Contra-indication should not be given)
► Allergic reaction ► Liver and kidney problem (because PCM is hepatotoxic)

♦Side effects – Side effects
►Feel tired
►If there is high blood pressure, hard disease and stroke can occur – If there is high blood pressure, hard disease and stroke can occur. ►Difficulty breathing lips and fingers turn blue ►Anemia-Anemia

♦ Nursing Responsibility

5 ‘R’ check before giving medicine to patient.

1.Right patient

2.Right medicine

3. Right dose

4.Right time

5.Right route

Assess the patient’s pain before giving the meditation.

Checking the pain level.

Which will help the health care provider to identify the dose.

Checking the temperature.

Check for allergic reactions.

General Instruments-Example

✚ Kidney Tray

A kidney tray is a kidney-shaped basin. It is mostly used in surgical procedures. In which dressing bandage is done in a small instrument and another medical vest.

Another name for kidney tray is kidney dish or emesis basin.

Use -use -use

Dressing is done in surgery etc. Wet waste has to be collected.

It has many functions like holding or transporting drugs, cotton dressings, syringe needles etc.

Collecting medical waste involves collecting human tissue and blood etc. in dental procedures.

Sharp instruments have to be transferred safely.

After Care –

First clean it with a soft brush or soft cloth.

Clean only a small amount. Do not use metal brushes.

Then sterilize it by autoclave.

✚ Kelly clamp

Parts Name –

If with serrated
Serrated is not sharp so it does not cut soft material. If the mother can hold the object due to the shirred and prevent it from falling asleep.

joint
The joint holds the jaw with the help of a ratchet.

Richet

There are clamp, catch and crush in the ratchet with the help of which we can catch, clamp and crush the object.

Finger ring

The instrument can be held by the finger through the finger ring and used.

Use of Kelly clamp-Use of Kelly clamp

This instrument is used to hold large blood vessels as well as tissue.

To manipulate heavy tissue.

Dissection of soft tissue

Appendectomy Doctomy

General surgery

Gynecological Procedures

Hysterectomy surgery.

To manually remove the placenta after birth.

To remove small foreign bodies.

Compressing the bleeding vessels to stop the bleeding.

To hold the future during a surgical procedure.

Size

Size of Kelly Clamp
14-14.5 cm
can be seen.

Operating Principle of Kelly Clamp

Jo is accompanied by chirping which is used to grip and hold objects.

If it is locked by a ratcheting mechanism.

After Care of Cali Clamp

(1) Cleaning

Proper cleaning after surgery or after use.

Clean the instrument with soapy water, detergent or runny water and remove visible debris with a scrub brush.

(2) Drying

After cleaning, dry the instrument with a cloth, micro filter.

(3) Inspection

After drawing check the instrument for any debris present, also for break, crack present in the instrument.

Checking that it is functioning well before re-use.

Lubricate the catch with a lubricant.

(4) Packing of instrument

Packing the instrument before autoclaving it.

Double wrapping the instrument tray.

Instrument train should have proper weight and metal mass as per instrument.

Position the instrument so that the steam comes in contact with the surface.

Covering the peep with a tip protector.

(5) Sterilization

Autoclave

121 degree Celsius temperature

15 pascal pressure

30 minutes

Autoclave is done as mentioned above.

(6) Storage and Transport

Sterile instruments should be kept in an environment where there is less chance of contamination.

Also, the instrument should be stored in an area that is free of moisture, excessive humidity, insects, excessive air pressure, and contact with micro-organisms.

Lane bone clamp

Introduction

The Lane Bone Clam is named after its inventor, Dr. William W. Lane.

It consists of two parallel arms with serrated jaws at their ends and enables surgeons to perform complex procedures on bone with precision and control.

Uses

A lane bone clamp is a surgical instrument used in orthopedic procedures.

It is used to grasp and stabilize the bone during surgery such as joint reconstruction and fixation of the femur.

Its primary function is to hold the bone in place.

Prevents surgeons from misaligning bone during the procedure so that there is no change in the exact procedure.

Indications

1).Fracture fixation :-

To hold the fractured bone in place during surgical repair.

2).Joint Reconstruction :-

such as ni (knee) or solder (pillar) procedures
Helps stabilize bone during reconstructive surgeries.

3). Corrective Osteotomy :-

To help realign the bone by securing the bone in the desired position during corrective surgeries.

4). Internal Fixation :-

To support the position of screws or plates used for internal fixation of bone

Martin bone holding forceps:

It is made of stainless steel.

Usage:
This is a cartilage seizing forceps used in orthopedic surgery.
These forceps are used to clamp, retract and hold the tissue and cartilage of the bone surface.
The serration in the tip of the forceps strongly grasps the bone.

Size:
19 cm

Weitlaner self retaining retractor

Function

To open a narrow tunnel

Applying pressure around the cavity wall on its own

To leave the assistant’s hands free
Identification points

Four prongs
It consists of four prongs which apply pressure on the wall of the shallow wound to keep it in proper position.
Use

Exposing the cerebellum in neurosurgery

In nerve or tendon surgery
-In Herniotomy, Plastic Surgery, Orthopedic Procedures, Mastoid Surgery etc.