FOUNDATION OF NURSING
Date: 13/10/2023

Q-1👉 a. Define physical examination- 03

A detailed inspection or study of the physical and psychological condition of the patient is called physical examination.

Examination to know the general physical condition or function of any part of the body through detailed inspection is called physical examination.

👉B. Describe methods of physical examination. – 04

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

Methods of physical examination:–

Inspection: In this method, the general condition of the patient is known from the observation of his body, which means that the general appearance of the patient is seen, what is the color of the patient’s skin, whether there are any rashes on the skin or if there is any deformity anywhere in the body, the patient’s diet history is checked. In the inspection, the doctor listens to all the complaints of the patient and accordingly a history is written, so through the inspection, the history of the patient’s illness, the present complaint and body function can be known.

Palpation: It is the act of examining the body parts by feeling them. Fingers are used for palpation to determine the size and position of the organ. Also, this exam is done when there is any tumor in the neck or tenderness in an axilla or groin. is

Percussion: In percussion the body parts of the patient are tapped by keeping the fingers on it. By tapping, the sound of the internal organs is observed by listening, from which the condition of the internal organs is understood. Whether the patient’s bladder is full or empty can be known through percussion. Besides, the chest, abdominal And examination can be done by percussion on part of the back.

Auscultation: This involves listening for sounds inside the patient’s body with a stethoscope or fetoscope, listening for chest sounds, listening for heart rate, and taking blood pressure.

Manipulation: This method is used to find out the flexibility of the organ eg neck stiffness, arm flexion, abduction movements etc.

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

👉C. Explain importance of patient’s records and reports in ward. Explain the importance of patient records and reports in the ward.05

A code is a permanent written communication that documents information related to a client’s health care management.

Or

A record is a clinical, scientific, administrative and legal document relating to nursing care provided to an individual family or community.

1. Good records avoid duplication of effort as work is done by a single person

2.Patients receive better care when reports are complete and provide all relevant data

3. A complete record gives a sense of security that comes from knowing all the factors of a situation.

4.Helps in efficient management of the ward.

5.Helps in legal matters, gets judicial protection

.Helps in evaluation

7. Helps in research

8. To improve the quality

9. To facilitate the administrative process

10. To justify one’s work

11. To know the progress of patient and work

12. Very important for quality audit

🔸OR🔸

👉A. Define nursing process – 03

Nursing process is an active approach to provide nursing need and solve the patient’s problem by systematically planning appropriate decision to take nursing care of the patient in which each step is sequentially inter-related and interdependent is called nursing process.

👉b. Explain steps of the nursing process. – 04

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

A. Nursing History Taking:-:A history of the patient’s illness and wellness is obtained.Along with the history, data is collected.Adjustment, mutual trust, confidence, respect and relationship are established with the patient.

B.Physical Examination:-:Physical problems of the patient are known.Limitations of the patient are known.

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

C. Nursing Diagnosis: The data collected from history examination and other sources are organized and summarized. From the summarized data, the specific characteristics and etiology of the patient’s health problem are known and then the nursing diagnosis is determined accordingly.

Planning:

• Prioritizing the most urgent and critical problems among the health problems we encounter after diagnosis
• Goals for nursing interventions are set for which the nurse and patient work together to determine short-term intermediate long-term intermediate goals.
• A nursing care plan is created as the goals are determined and the plan should be systematic, realistic and flexible. Next, to formulate a nursing care plan, prioritize the nursing diagnoses in it.
• The care plan should include the patient, family, friends and members of the health team

Implementation:

• In order to put the nursing care plan into action i.e. to implement it, the ideas of the patient family friends and members of the health team should be coordinated.
• Ability limitations of team members should be considered
• Nursing interventions should be supervised
• Objectively record the patient’s response to nursing interventions
• The information we record should be related to the nursing diagnosis
• In the meantime, if any additional information is found, it should be included in the assessment as additional data

Evaluation

• The patient’s response to care should be noted
• We should see whether it is achieved as per the set goals
• The assessment should note the patient’s wellness

👉c. Write down care of unconscious client.- Write down care of unconscious client. 05

NURSING MANAGEMENT:
(1) position :
Generally, the patient is given prone lateral or Sim’s position. The patient should be given such a position that he cannot inhale vomits and secretions. Do not lay the patient on his back.
2) Airway:
Patient’s airway should be maintained. For which the patient’s jaw should be kept forward. Patient’s clothes should be loose and free. So that the movement of chest and abdomen can be done easily. Frequent suction should be done as needed to maintain the airway. Sufficient ventilation should be provided to the patient.
3) Observation and chatting:
Patient’s level of consciousness, reaction to vocal stimulation, size of people, reaction of light on pupils etc. should be observed and chatted every hour.
TPR should be recorded every two hours. TPR has to be taken frequently in cases like head injury.
Blood pressure recording is based on the cause of unconsciousness.
If the patient is experiencing muscular spasm, it should also be recorded. The area affected and the duration of the fit etc. should be recorded.
Urine analysis chart should be maintained in conditions like diabetes mellitus and renal failure.
4) Hygiene:
Patient should be given mosquito net. It should have a well-observable net. It also protects the patient from mosquitoes and flies.
The patient should be sponged as needed. Tepid sponge should be given in febrile condition. Sufficient care should be taken of the pressure area while giving sponging and the limb should be given passive exercise. Exercise prevents stiffening of joints, muscular contractions and venous stasis.
It is necessary to give frequent mouth care to prevent dryness of mouth and tongue.
The patient should be given eye care which prevents discharge from the lid margin. Prevents conjunctiva from drying and also prevents corneal ulcer. For this, eyedrops should also be applied as per the doctor’s order.

5) Care of pressure areas and the prevention of foot drop:
The patient should be placed on a ripple mattress.
Bed linen should be kept dry, linen should be changed as soon as it gets wet.
A bed cradle should be used so that the weight of bed clothes does not fall on the patient.
A pillow should be kept over bony prominences like knee and ankle.
The position of the patient should be changed every hour.
The pressure area should be massaged every two hours.
If redness or injury is seen in these parts, it should be reported immediately.
Foot drop should be prevented, tight tuck of bed clothes can cause foot drop.
By using a footrest at the bottom, pressure and the weight of bed clothes on the feet can be prevented.
Passing Physiotherapy keeps ankle and feet in good condition. A splint is also useful to keep it in the correct position. To prevent wrist drop, a splint should be given to the bands.
6) Nutrition:
The patient should be given a diet that provides enough nutrients. Ryles tube or gastric tube feeding should be given. Full care should be taken for this, the patient is given milk, fruit juice and water in a high protein diet. Keep the patient well nourished.
7) Elimination:
Observe the patient for signs of retention of urine and constipation.
Glycerine suppository is placed as per order for constipation problem.
The patient may also have the problem of incontinence of urine. For urinary problems, the patient needs to undergo continuous catheterization.
Accurate recording of fluid balance should be done.
8) Relatives:
Patient’s relatives and friends are under tension. They should be reassured, informed about the patient’s condition. Make him meet with the M.O. (medical officer) of the Unit.

Q-2 👉a) Define decubitus ulcer. Write about prevention and treatment of decubitus ulcer. 08

Definition of decubitus ulcer

• A decubitus ulcer, also known as a pressure ulcer or pressure sore or bed sore, is a localized injury to the skin and underlying tissue, especially in the area of ​​bony prominence because this Long-term pressure of the bone or repeated friction in the skin. This effect is more common in patients who are bed ridden or in wheel chairs.

Treatment of decubitus ulcers

Pressure Relief
Regular repositioning of the patient especially to keep the pressure area slightly elevated can be done using special mattress cushions and pressure reducing pads.

Wound Care
Clean the wound using an appropriate solution e.g. normal saline (N.S) If necrotic tissue is present then debride it, often surgically or mechanically.
Provide appropriate dressings to absorb agro data and prevent contamination of pigs.

Infection Control
Monitoring for signs of infection and if necessary
Giving a typical antibiotic.

Nutritional Support
Adequate and proper nutrition should be given so that the wound healing takes place early in which such patients should take more protein and vitamins especially vitamin C and zinc as well as minerals.

Pain Management
Pain management is done using appropriate analgesics

Surgical Intervention
In severe cases, surgery is performed to restore the integrity of the wound and tissue.

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 doctor if the plastered patient feels 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🔸

👉b) Write down principles of first aid. Write principles of first aid. 04

• 1)The place of accident should be reached as soon as possible
• 2) Do not ask unnecessary questions
• 3) Know the cause of injury or illness as soon as possible.
• 4) Immediately remove the thing that caused the injury or remove the person from it, such as burns, remove the person and pour water, if there is an electric shock, remove it with the help of a stick from electricity.
• 5 ) Patient is unconscious or semi-conscious or alive or dead.
• 6) Suggestion of which treatment to do first: Like first try to start the heart if it is stopped, regulate respiration or try to stop it if bleeding is happening etc.
• 7) Obtaining medical treatment
• 8) Knowing and recording patient details
• 9) Keeping the patient more comfortable
• 11) Arrange the necessary equipment from the present item, such as using a napkin without waiting for the bandage if bleeding occurs.
• 12) If the patient is conscious, give sedation.

🔸OR🔸

👉A. Write down general instructions in moving & lifting of 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 fever. Describe stages of fever. 04

• Fever is also known as ‘pyrexia’. In which there is a temporary increase in body temperature due to an underlying condition (mostly infection). is a common medical sign. In which the body temperature is seen higher than its normal range (36.1°C – 37.2°C or 97°F – 99°F).

Stages of fever

1) Prodromal Stage (Initial Phase):

• In this stage the body temperature starts to rise but it is found within the normal range i.e. the temperature rises slightly. Due to which the filling of fatigue, malaise, muscles one, unwellness is seen.

2) Onset Stage (Chill Phase):

• In this stage the body temperature is seen at a peak level i.e. the hypothalamus which regulates the body temperature sets a higher temperature and creates a set point which causes the body to generate and retain heat. Due to which sudden increase in body temperature is seen. Apart from this, shivering, cold feeling and goosebumps (pyloerection) are seen.

3) Flush Stage (Plateau Phase):

• In this stage, the body temperature stabilizes at a higher level. Due to increased blood flow, the skin is warm and flushed. During this time sweating starts which tries to cool the body so the person feels less cold and sweaty.

4) Deferral Stage (Fever Break) :

• In this stage, the body temperature falls within the normal range. In which the hypothalamus resets the body temperature to normal. Also causes heat loss through vasodilation and sweating. Hence excessive sweating, warm filling and dehydration are seen in this stage. (Dehydration is seen due to excessive sweating) Also, the fever resolves and the person feels better.

Patterns of fever

A different type of pattern is seen in fever depending on its underlying cause.

Intermittent Fever: In intermittent fever, the body temperature fluctuates between normal and febrile levels within 24 hours. This fever is mainly seen in malarial conditions.

Remittent fever: In remittent fever the body temperature fluctuates but the temperature does not return to normal levels. Remittent fever is seen in cases with infective endocarditis.

Continuous (sustained) fever: In continuous fever, the body temperature is continuously high with minimal fluctuation. Typhoid often presents with continuous fever.

Relapsing fever: In relapsing fever high body temperature and normal body temperature are seen alternately i.e. body temperature increases then body temperature falls to normal level then body temperature increases again and normal level is observed again i.e. fever rises descends. Relapsing fever is mainly caused by Borrelia species

Hectic fever: In hectic fever, there are wide swings or changes in body temperature. Which is mainly seen in the condition of septicemia.

Causes of fever

Fever occurs due to many causes. Which are as follows :

• Infection: Fever is caused by bacterial, viral, fungal or parasitic infection.
• Inflammatory conditions: Inflammatory conditions such as rheumatoid arthritis, inflammatory bowel disease cause high body temperature.
• Malignancy: Some cancers like lymphoma, leukemia cause fever.
• Medication: Fever can occur due to reaction to certain medicines.
• Heat Related Illness : High grade fever occurs due to heat stroke.
• Other medical conditions: Other medical conditions like hyperthyroidism, blood clots and chronic conditions can cause fever.

Management of fever

• Antipyretic Medicines: Use antipyretic medicines like acetaminophen and ibuprofen to relieve fever.
• Hydration: Adequate fluid intake to prevent dehydration.
• Rest: Adequate rest. So that the body can recover.
• Addressing Underlying Causes: Identifying and treating the main cause of fever. Such as giving antibiotics to treat bacterial infections and antiviral medications to treat viral infections.

👉Q-3 Write short answer (any two) 6×2=12

👉a) Describe care of the person after death. –

It is very important to take care of dieg patient for which his -relative is sent out.
-Gently close the patient’s eyes and mouth.

• Lay the patient upright to straighten the arms and legs.
• To move extra pillows, air cooler, oxygen cylinder, suction machine from the bed, leave only one pillow under the head.

• To remove catheters, drainage tubes, Rilas tubes, IV infusion tubes, etc. and to plug cotton in body openings so that body discharge and blood do not come out and infection does not spread.

• To give a sponge bath and to dress neatly Ask the relative to give it or remove it if there is jewelry Put an identification card on the wrist containing the patient’s name Address Age Ward No. Bed No. Date and Time

• The identification card is done when the patient is to be sent to the mortuary room, but if it is to be handed over to a relative, signature is taken in the case paper.

• If you want to send to the mortuary room, take the signature of the room man and the policeman and put the buckle number, besides this, fill the mortuary room slip or form and if there is a police case, inform the police. Filled in two copies.

• Recording in death register Recording in case paper Reporting death or informing death authorized person.

• To prevent the spread of infection in the community

• The HIV virus is killed in half an hour by sodium hydrochloride solution for proper disinspection of the patient’s used medical instruments etc.

• Handing over the dead body of the patient with dignity and respect so that infection does not spread in the ward

👉b) Describe the physical methods of sterilization.

Sterilization is a process that involves eliminating and killing microbial life in all its forms. These include bacteria, viruses, spores and fungi. The following methods are used in sterilization:

1) Heat sterilization

Heat is the most common and effective method of sterilization. There are mainly two methods used for heat sterilization:

• Moist hit sterilization
• Dry hit sterilization

✓ Moist Hit Sterilization :

Autoclaving:

Autoclaving uses a saturated stream as well as a pressurizer. In which the infected instrument or material is kept in an autoclave machine at a temperature of 121°C, at a pressure of 15 pascal for 15-20 minutes. This method is used to sterilize surgical instruments, labware, culture media and other items.

Boiling:

In this method, the infected item or material is kept in 100°C water for 30 minutes and the item is disinfected. An item cannot be completely sterilized by boiling. This method is mainly used for disinfecting heat stable materials and water.

Pasteurization:

In the pasteurization method, the food item or beverage is heated to a lower temperature (63°C for 30 minutes or 72°C for 15 seconds). In this method, pathogenic microorganisms are killed without affecting the quality and taste of food and beverages. Like heating milk.

✓ Dry hit sterilization:

Hot Air Oven:

In this method dry air in an oven whose temperature is between 160°C to 170°C is kept for 2-3 hours. Hot air oven use glassware, metal instruments

Incineration:

In incineration, infected material is burned and converted to ash. Incineration method is used to sterilize or dispose of biohazard waste. Like contaminated dressings, animal carcasses (carcasses)

2) Filtration:

Filtration sterilization is used to sterilize heat sensitive liquids as well as gases. In which microorganisms are removed through physical separation.

Membrane filter:

Membrane filters use thin membranes with pore sizes ranging from 0.22 micrometers to 0.45 micrometers. So that bacteria and large microorganisms can be trapped in it. This method is used to filter pharmaceuticals, culture media as well as in clean rooms.

HEPA Filter:

High efficiency particulate air filters are used to remove particles smaller than 0.3 micrometers. Which has 99.97% efficiency. It is used in air purifiers, laminar flow hoods and HVAC systems used in hospitals and labs.

3) Radiation

In radiation sterilization, microorganisms are killed using ionizing as well as non-ionizing radiation.

✓ Ionizing radiation:

Gamma Radiation:

High energy gamma rays are generated using cobalt 60 or cesium 137 isotopes in gamma radiation. Gamma radiation is used to sterilize disposable medical equipment (syringes, gloves), pharmaceuticals and certain food items.

Electro Beam:

Rapid sterilization is done using high energy electrons in an electro beam. Electro beam method is used to sterilize medical devices, pharmaceuticals and packing materials.

✓ Non ionizing radiation

Ultraviolet (UV) light:

In this method, UV-C light (200-280 nm) is used to damage and inactivate the RNA and DNA of the microorganism. Ultraviolet light is used to disinfect surfaces, air and water. UV sterilization is less penetrative. Hence it is more suitable for surface sterilization than bulk items.

4) Other methods

Microwave radiation:

Microwave radiation uses microwaves to generate hits that kill microorganisms. Moisture is often used along with microwaves to increase effectiveness. Microwave radiation is used to sterilize certain food products as well as waste materials.

Plasma Sterilization:

Plasma sterilization is an advanced method in which low temperature plasma is created from hydrogen peroxide vapor and sterilized using it. This method is used to sterilize heat and moisture sensitive instruments or materials.

👉c) Write down the types and hazards of restraint.

• Restraint is a type of measure. Which limits the movement and freedom of an individual i.e. Restraint is used to mobilize any body part i.e. restrict the movement of any body part. Restraints are used in health care, psychiatric and correctional settings. Restraints are divided into several types as follows:

Types of Restraints:

✓ Physical Restraint:

Manual Restraint:

Manual restraint uses the hands and body to hold the person in place

Mechanical Restraint:

A mechanical restraint uses a mechanical device to restrict movement. Like belts, straps, cuffs. For example Wrist and Ankle Restraint, Restraint Chair.

Positional Restraint:

Positional restraint involves placing the patient in a position that restricts the patient’s movement. Like prone position, supine position

✓ Chemical Restraint:

Chemical restraint involves the use of medication to control the patient’s behavior or restrict movement. In which sedative, antipsychotic drug, anxiolytic drug are used as medicine.

✓ Environmental Restraint :

Environmental restraint involves modifying the environment around the patient to restrict movement. Like locking the door, seclusion room

✓ Psychological restraint:

Psychological restraint involves the use of verbal commands, intimidation, and coercion to control a person’s behavior.

Hazards of restraints

✓ Physical Hazard :

Injury:

Physical restraints can cause bruises, cuts, fractures, nerve damage and pressure ulcers.

Asphyxiation (suffocation):

Positional restraints including prone restraints may cause breathing difficulties and suffocation.

Circulatory Issues: Blood circulation is impaired due to prolonged use of Restrain. Due to which deep vein thrombosis can occur.

Musculoskeletal Damage: Prolonged immobility leads to muscular atrophy and joint issues.

Death: In extreme cases, improper use of restraints can often lead to cardiac arrest and respiratory failure.

✓ Psychological Hazard :

Trauma: Restrain can lead to psychological trauma, anxiety and post-traumatic stress disorder.

Loss of Dignity: Prolonged restraint affects a person’s self-esteem and mental well-being.

Fear and Distrust: Restraint can lead to fear and distrust of health care personnel.

✓ Ethical and Legal Hazard:

• Human Rights Violence: Inappropriate use of restraints violates human rights such as freedom and autonomy.

• Legal Consequences: Misuse and overuse of restraints can also lead to legal action such as penalties to individuals or institutions.

• Regulatory Compliance: Failure to follow restraint related guidelines and regulations can result in sectioning from the regulatory body i.e. banning from doing that thing.

• Mitigating Hazard The following practices and guidelines are followed to mitigate hazards associated with restraints:

• Assessment: Carefully assess the need for restraint. While considering the physical and psychological condition of the patient.
• Alternatives: Using less restrictive alternatives before restoring restraint means using alternatives that are less restrictive in lieu of restraint.
• Monitoring: Continuously monitor the restrained person for distress and complications.
• Training: All staff members should be trained in the safe and ethical use of restraints.
• Documentation: Documenting reasons for restraint use, type of restraint, and duration.
• Review: Review policies and practices for restraint use so we can follow current standards and ethical guidelines.

👉Q-4 Write short notes. (any three) 12

👉a) Importance of diet in illness

• The sick person usually has some disturbance in the gastrointestinal function, the sick person feels less appetite.

• Digestion is a problem, absorption of nutrients is not done, so the nutritional needs of a sick person are slightly different than a healthy person.

• The amount of food is also reduced due to the reduced movement and exercise of the sick patient

• Metabolism and catabolism processes are normal in a healthy person whereas in a diseased person these processes are disturbed.

• Because of this, the body does not get enough nutrients, so the sick person has to be given additional 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.

👉b) Barriers of communication

Physiological barrier: in which the sensory organs are not functioning like hearing, seeing, etc. and not being able to express. Cannot receive or deliver messages.

Psychological Barrier: This includes emotional factors such as anxiety, stress, fear, intelligence, ego, etc.

Environmental barrier: Insufficient light and ventilation, too low temperature, too much noise or congestion.

Cultural barrier: It includes the cultural aspects of people like their religion, their attitude, language, personality traits, their knowledge, understanding, power, etc.

👉c) Nurse’s role in collection of specimen –

Specimen collection is a very important task of the nurse. The nurse is very important to collect the sample with 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 how much the patient’s specimen is to be taken should be specifically explained.

• While collecting specimens, the outer side of the container should not be dirty, otherwise the worker may have difficulty in handling and infection may also spread.

• The container in which the sample is to be collected should be clean unbreakable and should not be damaged at any place.

• For culture investigation, the specific sample content for the specific test should be such that the label affixed to the sample is clearly visible.

• Most specimens should be collected fresh and early in the morning.

• Correct method of collection should be adopted. Specimens should be collected in separate bulbs from the laboratory for some type of investigation.

• Apart from this, the hospital has different test tubes for the collection of different samples, as indicated in different colors, the samples should be collected in tubes of the proper color.

• In female patients, collection of urine and stool samples should be avoided during the period of menstrual cycle or, if collected, it should be collected with proper technique so that it is not contaminated by 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 according to the sample requirement as follows.
• A large mouth glass bottle is used to collect the urine sample.
• A small glass bottle is used for stool examination.
• A large glass bottle is used for 24 hour urine collection.
• Glass lidded jars are used to collect sputum and stool.
• A sterile test tube or bottle is used for culture examination.
• A clean slide is used to make the smear.

👉d) care of medicine cupboard

• 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 one 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

👉Q-5 Define following (any six) Write the following definition. (any six)

👉a) Diuret-

• A diuretic is a medication or a substance that increases the production and excretion of urine in the body when the body has too much phthaloide. It is used to remove deposits when they are deposited.
• It is given in hypertension, kidney failure, liver disease etc.

👉b) Cyanosis –

• Cyanosis is a medical condition characterized by bluish discoloration of the skin, mucus membranes and nail beds, indicating low levels of oxygen in the blood, resulting in increased deoxygenation of hemoglobin. This sign is usually associated with respiratory and cardiovascular problems. So that the cause can be known and proper treatment can be given

👉c) Temperature –

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

👉d) Enuresis –

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

👉e) Anaphylaxis –

• An acute allergic reaction to an antigen (eg bee sting) to which the body has become hypersensitive is called anaphylaxis.

👉f) Nursing-Nursing

• Nursing is an art and a science. With the help of which one can protect the life of a sick person by giving careful care and can prevent the disease from happening, can increase the health and also can treat the sick patient to restore the condition is called nursing.

👉G) Nasocomial infection –

• A nosocomial infection, also known as a healthcare-associated infection (HAI-hospital acquired infection), is an infection that occurs while receiving health care services, i.e. after being admitted to a hospital rather than at the time of admission.

👉h) Tachycardia-

• A higher than normal heart rate that is faster than normal, or more than 100 beats per minute at rest is called tachycardia.

👉Q-6(A) Fill in the blanks 05

1.Lack of oxygen in blood is———– called. Hypoxemia

2.1 ounce=———-ml. 30 ML

3.Instrument used for rectal examination is———— Proctoscope

4.Intravenous injection is given at ——– angle. 25 degrees

5.Autoscope is used to examine——— EAR

👉B) True or False – 05

1.Right lateral position is given while giving enema. FALSE

2.Benedict solution is used for urine albumin test. FALSE

3.Tepid sponge reduces the body temperature. TRUE

4.Excessive excretion of urine is called polyuria. – TRUE

5.Air cushion is given to support the head. FALSE

Air cushion and or gel cushion, are specially designed seat pads, which reduce pressure on vulnerable points of the body to prevent pressure sores and ulcers.

👉C) Match the following. 05

(A) Anorexia- (A) Pulse less than 20 per minute

(B) Acetic acid (B) Urine contains pus

(C) Bradycardia (C) Loss of appetite

(D) Pyuria (D) Heart rate less than 60 per minute

(E) Asepsis (E) Hot test for urine

(F) Free of pathogenic microorganisms

ANSWER :-

A-C

B-E

C–D

D-B

E-F

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