Question

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Basic care and comfort: Acute infectious gastrointestinal disorder ( s/s, cause, prevention, treatment, nursing care)

Psychosocial integrity: death and dying ( what nursing assessment and care needed?)

Pharmacological and parenteral therapies: Dornase alfa ( indication, complication, contraindication, nursing intervention, education)

Answer 1

Definition.

Gastritis ( inflammation of the gastric or stomach mucosa). Is a common problem. gastritis may be acute, lasting several hours, to a few days, or chronic, resulting from repeated exposure to irritants agents for a recurring episode of acute gastritis.

Causes of acute gastritis.

1. A person takes the food that is irritating, too highly seasoned, or contaminated with disease-causing microorganisms.

2. Overuse of NSAIDs such as aspirin can cause acute gastroenteritis

3. A large number of bacterial and fungal infection can cause gastrointestinal infection such as adenovirus, Campylobacter, Clostridium difficile, E.Coli, Helicobacter pylori, rotavirus, salmonella, Staphylococcus aureus.

1. Adenovirus

it can cause conjunctivitis, infection in bladder high body temperature and rashes along with diarrhea but the most common symptom of adenovirus is an infection in the respiratory tract.

2. E.coli

E coli is the major cause of diarrhea, it enters the human body through the contaminated water ingestion with animal and human feces.

3. Helicobacter pylori.

Acute or chronic gastritis and prolonged inflammation of the stomach may be caused by benign or malignant ulcers of the stomach or by the bacteria Helicobacter pylori.

4. Rotavirus

rotavirus is the main cause of causing diarrhea in young children and about half a million deaths per year in children takes place due to infection with rotavirus.

5. Salmonella.

Semolina is the foodborne disease causes nausea, vomiting, diarrhea for 1 to 2 days, the main cause of salmonella is by consumption of the contaminated food and water.

SIGN AND SYMPTOMS.

1. Abdominal discomfort

2. Headache

3. Lassitude.

4. Nausea

5. Anorexia

6. Vomiting and hiccups which can last for a few hours to a few days.

7.heartburn after eating, belching, a sour taste in the mouth, nausea, and vomiting.

some patients may have only mild epigastric discomfort a report intolerance to spicy of fatty foods.

NURSING MANAGEMENT.

1. Maintain hygiene.

Hygiene should be maintained while eating food and drinking water and sharing the article with others.

2. Disinfecting and cleaning.

The surface should be disinfected with the bleach where the patient stays during treatment.

3. Cleaning of the articles and clothes.

proper washing and cleaning of all the articles that belong to the patient should be done.

4. if the intestinal infection is because of rotavirus in adenovirus then vaccine should be given to the patient.

Except for rotavirus and adenovirus, there is no vaccine available for any other infectious organism that causes gastrointestinal infection

5. Maintain fluid and electrolyte balance of the patient.it can be maintained by providing oral rehydration solution orally or the fluids intravenously.

6. Administer antibiotic as prescribed for viral infection.

7. Isolate the patient to prevent further infection.

8. Administer antiemetic as prescribed by a physician to stop vomiting.

9. Always wash our hands before and after dealing with the patient.

10. monitor vital signs of the patients such as increased body temperature, increased blood pressure and increased pulse.

11. Inform the physician when blood pressure is too low and administer antipyretics when body temperature is too high as directed by a physician.

2. DEATH AND DYING.

coping with the death of a loved one or with anticipation of one's own death is considered the ultimate challenge.

The idea of death is threatening and anxiety provoking for too many people. Kubler Ross stated the key to the question of death unlocks the door of life... For those who see to understand it, that is a highly creative force.

common features of those who are dying fear of the unknown, pain, suffering, loneliness, loss of the body, and loss of personal control.

in recent years, the experience of dying has changed as advances have been made in the care of chronically and terminally ill patient. technology innovation and modern therapeutic treatments have prolonged the lifespan and many deaths are now the result of chronic illness that results in progressive physiologic deterioration and subsequent multisystem failure.

The care given by the nurses to the patient who is close to death is...

providing care to patients who are close to death and being present at the time of death can be one of the most rewarding experience a nurse can have.

1. Expected physiological changes.

As death approaches and organ system begin to fail, observable, expected changes in the body take place. Nursing care measures aimed at patient comforts, such as pain medications, turning patient every two early, mouth care, eye care, positioning to facilitate draining of secretions, and measures to protect skin from urine or feces.

The nurse should consult the physician about discontinuing measure that no longer contributes to patient comforts, such as drawing blood, administering tube fittings, suctioning, and invasive monitoring.

although the exact time of death cannot be predicted, it is often possible to identify when the patient is very close to death. Hospice programs frequently provide written information for families so they know what to expect and what to do as death nears.

continuation of comfort-focused interventions and reassurance that the patient is not in any distress can do much to ease family concerns.

The death vigil.

although each death is unique, it is often possible for the experienced clinician to assess that the patient is actively or imminently dying and to prepare the family in the final days or hours leading to death.

nurses can reassure family members throughout the death vigil by being present intermittently or continuously, modeling behavior as, providing encouragement in relation to family caregiving, providing reassurance about normal physiological changes, and encouraging family rest breaks.

After death care

for patients who have received adequate management of symptoms and for families who have received adequate preparation and support, the actual time of death is commonly peaceful and occurs without struggles. Nurses may or may not be present at the time of a patient's death. in many states, nurses are authorized to make the pronouncement of death and signed death certificate when death is expected. the determination of death is made through a physical examination that includes auscultation for the absence of breathing and heart sounds. immediately on cessation of vital functions, the body begins to change. it becomes dusky or bluish, waxen appearing, and cool, blood darkens and pools independent areas of the body.immediately after death family members should be allowed and encouraged to spend time with the deceased. normal responses of family members at the time of death vary widely and range from white expressions of grief to over expressions that include wailing and prostration.

Coping with death and dying professional caregiver issues.

Whether practicing in a trauma center, ICU, hospice, long term care where patients and their families receive ambulatory services, the nurse is closely involved with complex and emotionally laden and issues surrounding the loss of life.

to be most effective and satisfied with the care he or she provides, the nurse should attend to his or her own emotional responses to the losses witnessed every day. well before the nurse exhibits symptoms of stress or burnout, he or she should acknowledge the difficulty of coping with others pain on a daily basis and put healthy practices in place that guard against emotional exhaustion.

in hospital settings, where dying, grief, and loss are expected outcome of patient care, interdisciplinary colleagues rely on one another for support, using meeting time to express frustration, sadness, anger, and other emotions, to learn coping skills from one another, and to speak about how they were affected by the lives of those patients who have died since the last meeting.in many settings, staff members organized attend memorial service is to support families and other caregivers, to find comfort in joining one another to remember and celebrate the lives of patients. finally, healthy personal habits, including diet, exercise, stress reduction activities, and sleep, help guard against the determinantal effects of stress.

The role of the nurse in death and dying is very unique, a nurse should help the members overcome from the loss by providing various types of care to the families and the dying patient.