Monday, January 16, 2012

Pathophysiology of Hirschsprung| Patofisiologi Hirschsprung

click picture to enlarge| klik gambarnya untuk memperbesar





Nursing diagnoses that may arise in patients with hirschsprung, among others:
  1. Pain associated with postoperative wound
  2. High risk of infection associated with skin irritation
  3. Lack of family knowledge about stoma care associated with the presence of postoperative wound

Sunday, January 15, 2012

Pathophysiology of Acute Otitis Media| Patofisiologi Otitis Media Akut

click picture to enlarge| klik gambarnya untuk memperbesar
Nursing diagnoses that may arise in patients with acute otitis media, among others:
  1. Pain associated with the presence of inflammation
  2. Auditory perception of sensory disturbances associated with the accumulation of exudate in the middle ear

Thursday, December 29, 2011

Nursing Career Options

One of the great strengths of the nursing profession is the variety of career paths, specialties and work environments from which a nurse can choose. The opportunities available to nurses only continue to expand, driven by a number of trends.
Additionally, new technologies are creating new positions for nurses.
From acupuncturist nurse to wound/ostomy/continence care nurse practitioner, the new book,201 Careers in Nursing, outlines the basic job description, educational requirements and core competencies and skills needed for more than 200 different nursing roles.

Our health care system is changing and creating more opportunities for nurses to assume responsibilities and increased leadership in health care.”
“Because nurses are at the bedside, and know patients well, this emphasis on quality and safety of care creates opportunities for nurses to be at the forefront of the health care conversation,” Ea said.
Among the more unique careers included in the book are aromatherapist, cruise ship/resort nurse, veterinarian nurse, editor of a book or journal and missionary.
“We all talk about the shortage of staff nurses, but that includes a shortage of nurse faculty.  We need more nurse educators to educate more nurses--this is an area with huge potential.”
Fitzpatrick mentioned that other areas experiencing growth are informatics--where nurses can combine clinical and information management skills--and the legal field, which has a need for nurse attorneys , legal nurse consultants and forensic nurses.
“Also in high demand, and among the highest paid nurses, are nurse anesthetists,” she added. “The majority of anesthesia in the United States is delivered by nurse anesthetists. Sometimes these nurses have their own practice and sometimes they work in collaborative practices with anesthesiologists. Positions as critical care nurses and nurse practitioners, depending on the type, are often financially rewarding. 
original article from www.nursezone.com

Increase Earning Potential of Nurse

One solution is personal professional development--acquiring advanced skill sets, meeting qualifications for specialty certifications and earning advanced degrees. Nurses can also use skills they already possess as the foundation for building a business that is an extension of their nursing experience.
Nan Brown, RN, BSN, and Lil Bogdan, RN, BSN, believe nurses are particularly gifted with the skills required to increase their earning power and achieve their dreams. We have said many times that the skills we already had as nurses contributed greatly to our financial success,” stated Brown.
It is difficult to build wealth and be economically successful when you are in debt,” commented Dean Burke, M.D., author of The Millionaire Nurse book and blog.
Advance practice nurses such as nurse anesthetists, nurse midwives and nurse practitioners are all top earners in the profession. And the salaries of nurse managers in large facilities can be quite competitive. But Burke encourages nurses to consider what it is they want to do for the next 20 to 30 years.
“If you are using financial rewards as a guide, be aware that your choice may take you down a different career path than if you are looking for intellectual rewards, for instance,” reflected Kathleen Dracup, RN, DNSc, professor and former dean at the University of California San Francisco School of Nursing. “If you look across average earnings you will see that administration pays more than clinical and that industry pays more than academia. For instance, a nurse anesthetist will typically make $20,000 more a year than an acute care nurse practitioner.”
According to Dracup, earning a doctorate degree can have differing effects on income. An advanced practice nurse who is earning $150,000 a year in a clinical setting, might go back to school for a Ph.D. and be hired at $80,000 a year in academia. Taking a Ph.D.-level role in a hospital, such as director of nursing education and research or director of quality improvement, will likely pay 50 to 100 percent more than a Ph.D.-level role in academia.
“Right now a key area of growth is in primary care, so equipping yourself to work in that field can create earning power in the future.”

Cynthia Ward, MSN, RN-BC, CMSRN, ACNS-BC, Registered Nurse 4 at Centra Lynchburg General Hospital in Virginia and president of the Medical-Surgical Nursing Certification Board, says the goal of certification is to show increased clinical expertise which improves clinical outcomes, but the increased pay is an added benefit.

“Certification in many hospitals does offer an opportunity for more pay,” Ward said. In other institutions, certification will allow you to advance on a clinical ladder that offers more pay. Magnet hospitals particularly look for certified nurses.”
Participating in a professional association can also contribute to a successful career.
“Professional associations are committed to providing value to their members and the one that I belong to, the American Academy of Ambulatory Care Nursing (AAACN), has exceeded my expectations,” commented Traci Haynes, MSN, RN, BA, CEN, president of the AAACN. The collegiality and opportunities for networking in a professional association, as well as the educational opportunities and learning about leadership, has helped me achieve my career goals.”
Nurses can also achieve financial success by starting their own business, as Brown and Bogdan did.
“Because nursing is considered one of the most trusted professions, individual nurses can tap into that reputation when they are working to start a new business. “It is amazing how many people are willing to help nurses by answering questions and finding resources.”
Many times people plan and plan and plan and they never start. If you have a passion and an interest it is amazing how far you can go with the skills you already have from your degree,” encouraged Brown.
The pair feels strongly that nurses need to care for themselves.
 “I see nurses who are working hard to achieve an advanced degree while continuing shift work, but there is a light in their eyes because they are passionate about reaching their goal,” observed Bogdan.
original article from http://www.nursezone.com

Monday, December 5, 2011

Naso Gastric Tube (NGT)


TUBE FITTING NASO GASTRIC (NGT)
Definition
Install tube / pipe through special channels for direct digestion in the stomach ended

Purpose

  • Incorporating food, medicine patients who can not eat by mouth
  • Preventing gastric distention
  • Do rinse the hull
  • Taking specimens of gastric acid to be examined in the laboratory
Indication
  • Patients who can not eat by mouth
  • Patients who Illeus abdoment trauma or peritonitis (for decompression)
  • Patients bleeding gastric / stomach rinse

Preparation tools

  • TubeNGT
  • Clamp
  • 10 cc syringe
  • Stethoscope or a glass of boiled water
  • Plaster & scissors
  • Gauze pads
  • Lubricants (jelly)
  • Base / Waterproof
  • Crooked
  • Gloves


Implementation procedures
1. Phase pre-Interaction
  • Therapy program checks
  • Washing hands
  • Placing the device near the patient
2. Orientation phase
  • Greets the patient's name and address
  • Explaining the objectives and implementation procedures
  • Asking for approval and the client's readiness
3. Stage Work
  • Maintaining privacy
  • Adjust the position of the patient in semi-Fowler's or Fowler's position (if no contraindications)
  • Wearing gloves
  • Clean the patient's nostrils
  • Installing base / waterproof above chest
  • Measure the length of NGT and signals (from prosessus xipoideus to the nose and ears turn)
  • Smearing jelly tip with the length NGT NGT to be in pairs
  • Adjust the position of the patient in flexion of the head, and gently insert the tip of NGT through the nose (if the patient is conscious encourage patients to swallow repeatedly)
  • Ensuring NGT into the stomach by the way: to inspire with a syringe or NGT 10 cc of air entering while on auscultation in the region of the stomach or put in a glass of water)
  • Closing the end of the NGT with a syringe / or adapted for the purpose clamp fitting
  • Doing fixation NGT in front of the nose and cheeks
4. Termination phase
  • To evaluate the action
  • Saying farewell to the client
  • Cleaning tools
  • Washing hands
  • Recorded activity in the maintenance record sheet