Glaucoma Specific Characteristics

Glaucoma is an eye condition that affects the optic nerve, causing an increase in intraocular pressure or pressure in the eye. If you ever feel pressure in the eye, you should contact an eye-care professional as soon as possible. Even people with healthy eyes and regular pressure may experience glaucoma in the future. An eye expert can let you know if you have glaucoma. Testing for this disorder is one of the main reasons that regular eye exams are important. Glaucoma damages the nerve over a period of time and if this condition is left untreated it is a leading cause of eye damage and blindness.

Glaucoma is the leading cause of blindness in adults over 40 years old. Without symptoms or warning that you have the condition it is difficult to know if you have it. It is not yet known the exact cause of glaucoma and it is important that you always remain on the lookout with regards to your eye health. It is crucial that you consider protecting your eyes regularly.

Specific characteristics make an individual more disposed to having glaucoma:
  • The main consideration is age. The older someone becomes, the greater the chance of glaucoma developing.
  • Someone suffering from short-sightedness or myopia also has a greater chance to develop glaucoma.
  • Another significant factor is one's family history in identifying those people who can be at risk for glaucoma. If you have a family member with glaucoma, your chances of developing the condition are considerably greater.
  • Ethnicity is another factor that can have an affect on both an individual's likelihood of developing glaucoma and the variety of glaucoma. Those of Asian descent are prone to "closed angle" glaucoma, while those of African or Afro-Caribbean nationality are prone to "open angle" glaucoma.
Risk Groups
  • People known to have a family history of glaucoma
  • People that have suffered from diabetes, anemia and other systemic diseases
  • Men and women of Hispanic or African American origin
One simple way to protect your eyes is by wearing sunglasses, especially with polarized lenses. Wearing protective eyewear like those with polarized lenses is one of the best ways to protect your eyes and sight. Polarized lenses can reduce the stress on your eyes by limiting the entry of excess light and UV rays into your eyes.

Talk to a glaucoma doctor whenever you have any type of symptoms related to this condition or when your primary care physician tells you it is a good idea for you to contact these professionals. If you do have regular eye exams, your optometrist will likely catch this occurring sooner than you will notice symptoms. That is one of the most important reasons for you to have screenings on an annual basis especially as you get older and the risks become larger.

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Knowledge Deficit: Illness Care

Nursing Diagnosis: Knowledge Deficit

After nursing intervention, increased client knowledge.
Knowledge: Illness Care
with criteria:
  • Knowing diet
  • The disease process
  • Energy Conservation
  • Control of infection
  • Treatment
  • Activities recommended
  • Procedure of treatment
  • Regimen
  • Health resources
  • Disease management
Nursing Interventions:
Teaching: Dissease Process
  1. Assess the level of knowledge of the client and family about the disease process.
  2. Describe the pathophysiology of the disease, signs and symptoms and possible causes.
  3. Provide information about the condition of the client.
  4. Prepare the client's family or the people who mean the information about the client's development.
  5. Provide information on the diagnosis of the client
  6. Discuss lifestyle changes that may be needed to prevent complications in the future, and or control the disease process.
  7. Discuss the choice of therapy or treatment.
  8. Explain the reason for the implementation of the action or therapy.
  9. Encourage clients to explore options or obtain alternative.
  10. Describe complications that may occur.
  11. Encourage clients to prevent side effects of the disease.
  12. Dig resources or support available.
  13. Instruct the client to report signs and symptoms to health care workers.
  14. Collaboration with other teams.

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Leadership in Nursing

Management of Nursing

Nursing management essentially focuses on human behavior. To achieve the highest level of productivity in nursing care, patients need a nurse manager who trained in the knowledge and skills of human behavior for nurses manage nursing professional and non-professional workers.

Mc. Gregor states that every human being is an individual's life as a whole is always interaction with the world of other individuals. What happened to these people is a result of the behavior of others. Attitudes and emotions of others influence people. Subordinates depends on the leadership and desire to be treated fairly. A relationship will succeed if desired by both parties.

Subordinates need a sense of security and will fight to protect themselves from the threats that are false or really a threat to the unmet needs in the work situation.

Leaders create the conditions to bring effective leadership to form an atmosphere that can be accepted by subordinates, so that subordinates do not feel threatened and frightened.

To be able to do the things mentioned above, both superiors and subordinates need to understand about the kind of leadership management, which in turn formed the motivation and attitude of professional leadership.

Leadership will come when someone because of the properties and behavior have the ability to encourage others to think, act, and or do something according to what is desired.

Leadership in the context of major organizational emphasis on the function of the direction that includes telling, showing, and motivate subordinates. Management function is closely related to the human factor in an organization, which includes the interaction between humans and focuses on a person's ability to influence others.

In the nursing leadership is a leader's use of skills (nurses) in influencing the other nurses that are under its control for the division of tasks and responsibilities in providing nursing care services so that the goal of nursing is reached. Each nurse has a different potential for leadership, but these skills can be learned so it can always be applied and improved.

It has been mentioned that the leadership style is influenced by the nature and behavior of which is owned by the leader. Because of the nature and behavior of the person with the other person is not exactly the same, the style of leadership that is shown is not the same. Based on the opinion of the relationship between the leadership styles of behavior, then in discussing leadership styles to the field of administration is often associated with a pattern of management, often associated with talk about behavior.

Depending on the nature and behavior encountered in an organization and or owned by the leader, the leadership style exhibited by a leader can differ from one another.

An effective leader is a leader who can influence others to work together to achieve a satisfactory outcome for the beneficial changes.

Leadership tasks:
  1. As decision-makers
  2. As the bearer of responsibility
  3. Mobilize resources to achieve goals as a conceptual thinker
  4. Working with and through others
  5. As a mediator, politician, and diplomat.
The role of the leader of the group:
  • As liaison interpersonal, which is a symbol of a group in performing duties legally and socially, has the responsibility and motivate, manage people and organize the development of connective tissue and is working outside the group.
  • As an innovator or reformer
  • As an information provider, which monitors the information in the organization's environment, disseminate information from the outside to subordinates and represented the group as a speaker.
  • gathering strength
  • Stimulate public debate
  • Creating the position of nurses in the media
  • Choosing a strategy that is most effective, acting at the right time
  • Maintaining activity
  • Maintaining formaf decentralized organization
  • Acquiring and developing the best research data
  • studying the experience
  • Do not give up without trying.
Nursing is a profession that continues to change, more extensive functions, either as executor of care, managers, experts, educators, and researchers in nursing. Seeing a broad functions as described above, then the nurse should be prepared to gain knowledge and skills about leadership. Nursing leaders are needed both as implementing nursing care, educators, managers, experts, and the field of nursing research.

With a model of effective leadership, it is expected in the future of the nursing profession can be accepted with a good image in the community as a profession that was developed based on science and emerging technologies.

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9 Nursing Diagnosis for Colon Cancer

Colon, or colorectal, cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon).

Causing no obvious symptoms especially at the early stages, most cases are diagnosed when lesion cancerous change already occurs. At this point, the disease is already in its advanced state and may already be harder to treat.

The physical signs of this disease arise gradually over time, making it difficult for doctors to diagnose it correctly. Most of these symptoms are felt only when the disease is already about to do significant damage to the colon. Thus, timely, quick, and accurate diagnosis is of extreme importance for sufferers.

Many cases of colon cancer have no symptoms. The following symptoms, however, may indicate colon cancer:
  •     Abdominal pain and tenderness in the lower abdomen
  •     Blood in the stool
  •     Diarrhea, constipation, or other change in bowel habits
  •     Narrow stools
  •     Weight loss with no known reason
The course of therapy varies in different patients regarding the treatment of colon cancer. There are a number of factors that are considered including the state of health of patients and the location and the size of the tumor as well as the severity of colon cancer that are considered by Oncologists (doctors specialized in cancer diagnosis and treatment) in choosing a therapy. The three primary colon cancer treatments include surgery, radiotherapy and chemotherapy. As the case may be, a combination of these treatments may be employed for the patient.

9 Nursing Diagnosis for Colon Cancer
    1. Constipation related to obstructive lesions.
    2. Acute Pain related to tissue compression secondary to obstruction.
    3. Fatigue related to anemia and anorexia.
    4. Imbalanced Nutrition, Less Than Body Requirements related to nausea and anorexia.
    5. Risk for fluid volume deficit related to vomiting and dehydration
    6. Anxiety related to cancer diagnosis and surgery planning
    7. Knowledge Deficit: the diagnosis, surgical procedures, and self-care.
    8. Impaired Skin Integrity related to surgical incision (abdominoperineal), stoma formation, and faecal contamination of the skin periostomal.
   9. Disturbed body image related to colostomy.

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The Risk of Erectile Dysfunction

The risk of erectile dysfunction increases with increasing age. Between 15 to 25% of men over 65 have this problem. In older men, erectile dysfunction is often caused by physical problems such as drug side effects, diseases and injuries. Everything that can damage the nervous system and disrupt blood flow to the penis can cause erectile dysfunction.

Here are some things that can cause erectile dysfunction, diabetes, high blood pressure, atherosclerosis (arterial stiffness), prostate surgery, hormone balance disorders, drug and alcohol abuse.

And certainly erectile dysfunction is also caused by emotional factors. By the time a man having problems with their sexual partners, men are at risk of suffering from erectile dysfunction. Here are some psychological issues that can cause erectile dysfunction, anxiety, stress, depression, was not interested in a sexual partner.

If someone is having problems with erections, immediate medical assistance should be made ​​to prevent the development of severe disorders and problems that disrupt the lives of husband and wife.

Monitoring erections during sleep can do to help with the diagnosis. A healthy man unconscious erections during sleep. If an erection does not occur during sleep the possible causes of erectile disorder is due to a physical problem. This examination can not be sure disturbance and still require further investigation is more complete.

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Preeclampsia - 4 Nursing Diagnosis

Preeclampsia is a serious health disorder that affects the minority of pregnant women. It is a condition where a pregnant woman has high blood pressure and high levels of protein in her urine. Preeclampsia is usually pronounced during second trimester and third trimester in pregnancy.

The main and first symptom of preeclampsia is hypertension, usually a reading of 140/90 mm Hg or an increase of 30 mm Hg systolic (top number) and 15 mm Hg diastolic (bottom number) in your normal blood pressure reading. High increase in the blood pressure imposes is the first symptom of Preeclampsia in pregnant women. Preeclampsia can develop into eclampsia, a condition where the mother would have seizures. While rare, other complications for the mother include stroke, rupture of the liver, bleeding problems, and premature separation of the placenta from the uterus prior to birth. Preeclampsia is more common with first pregnancies, teenage mothers, women over 40 and carrying multiple fetuses, but any pregnant woman can develop it. It usually develops late in the pregnancy (after 37 weeks) but can occur any time from 20 weeks to two weeks after delivery.

Mild preeclampsia usually has no noticeable symptoms and is only found when a pregnant woman goes in for her normal prenatal visit and her doctor discovers elevated protein in the urine and high blood pressure. The difference between mild and severe preeclampsia is only 20 mm Hg systolic and 10 mm Hg diastolic.

The only cure for preeclampsia is to give birth.

It is common that women who are diagnosed with preeclampsia do not feel like anything is wrong. Some preeclampsia symptoms include:
  •     Pains in the abdominal area
  •     Urinating less than normal
  •     Weight gain more than two pounds per week
  •     Rapid weight gain over a few days
  •     Persistent dull, throbbing headaches
  •     Nausea and vomiting
  •     Vision problems
Women with a history of preeclampsia are more at risk for more severe versions of the condition for later pregnancies.

Changes in reflex and nervous system are another factor. The nervous system coordinated the body system and its functionality. The nervous system controls and coordinates all our actions as humans as all the body systems are connected to each other. Preeclampsia affects the central nervous system which results to severe headache, impaired vision, partial and sometimes total blindness.

Abdominal Pains as a result of liver malfunction. The liver being a vital organ in the body plays important role in digestion. This is specifically connected to protein and amino acids stability. Through deamination and detoxication of protein, the liver gets rid of nitrogenous waste products that are not excreted by the kidney from the blood stream.

After the data is collected and then analyzed so that the diagnosis may be found in severe preeclampsia clients are:
1. Fluid Volume Deficit related to plasma protein loss, decreased colloid osmotic pressure. (Marilyn Doenges, 2000)
2. Impaired tissue perfusion related to the occurrence of vasospasm arterioles (prene M Bobak, 1995:835)
3. Risk for Injury: the fetus related to inadequate placental blood perfusion (Prene M Bobak 1989:718)
4. Imbalanced Nutrition, Less Than Body Requirements related to inadequate food intake manifested by nausea and anorexia (Sharon J Reeder, 1987:747)
5. Anxiety: moderate: fear of pregnancy failure related to lack of knowledge (Marilyn Doenges, 2000)

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Anal Atresia Nursing care Plan


Anal atresia is a congenital disorder known as imperforate anus, including the anus, rectum, or both (Betz. Ed 3 in 2002)

Atresia comes from the Greek, "a" means no, "trepis" means nutrition or food. In medical terms "atresia" itself is the absence or closure of a normal body orifice or tubular organ in congenital called Clausura. In other words, the absence of holes in the proper place or a perforated appendix channel or body cavity, it can happen due to a congenital or occur later due to the disease process on the channel. Atresia can occur throughout the body channels, such as anal atresia. Anal atresia is no perforation of the rectum. Anal atresia have another name ie imperforate anus. If atresia occurs it is almost always requires surgery to create a channel like normal state.

According to Ladd and Gross (1966) imperforate anus in 4 categories, namely:
  1. Stenosis of the lower rectum or at the anus.
  2. Persistent anal membrane.
  3. Imperforate anus and rectum ends the impasse lies at various distances from the peritoneum.
  4. Separate anus with the tip.

Atresia can be caused by several factors, among others:
  1. The breakdown of the upper gastrointestinal tract with the anal area so that babies born without anus.
  2. Failure of growth when the baby was 12 weeks / 3 months.
  3. The disruption or cessation of embryological development in the intestine, the distal rectum and urogenital tract, which occurs between the fourth to the sixth week of gestation.
Clinical Manifestations
  1. Meconium did not come out after 24-48 hours.
  2. Neonates vomit green.
  3. The anal membrane.
  4. External fistula in the perineum.

Nursing Care Plan
1. Fluid volume deficit relatd to lose excessive vomiting
Demonstrated by:
  • Skin dry mucous membranes.
  • Decreased skin turgor.
  • Increased pulse and temperature.
  • Decrease in blood pressure.
  • Output more than fluid intake
  • Hemoconcentration.
  • Electrolyte balance disorders.
After implementation, lack of fluid volume can be resolved.
Expected outcomes:
  • Maintaining adequate hydration with moist mucous membranes, skin turgor and capillary refill is good, stable vital signs, adequate urine output.

2. Impaired Skin Integrity related to colostomy
Demonstrated by:
  • There is stitching drain.
  • The existence of the incision.
  • The presence of skin irritation.
  • There is swelling and redness.
  • The skin around the colostomy wet and no drainage.
After implementation impaired skin integrity can be resolved
Expected outcomes:
  • The skin around the stoma area will be colored pink, dry and free from skin damage, incision free of redness, no swelling and drainage.

3. Risk for infection related to surgical procedures
Demonstrated by:
  • The existence of the surgical wound exposure to outside air.
  • Wound care was not using sterile technique.
  • The existence of materials that can contaminate surgical incision.
After implementation, the infection does not occur.
Expected outcomes:
  • Infection does not occur.
  • There are no signs of infection

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Beware of Snacks Made from Formaldehyde (Formalin)

Formaldehyde Formalin
We understand  together that the snack is a diverse kind. The main ingredients and seasonings are very diverse. Of course from a variety of snacks is not derived from formalin ingredients (preservatives).

If there is formaldehyde in the snack product (in this case is not wrapped), it is most likely derived from:
  1. Additional Materials Food or other materials mixed in the process.
  2. Containers problematic process, meaning that it contains formaln.
  3. Formalin deliberately given by the manufacturer.
For the number 3, the chances are rare, there is usually  an accident, if there is a mistake, it  does not know. But the important thing is to recognize the characteristics  of foods containing these  ingredients for safety  formalin.

Know that  formalin also called formol or formaldehyde solution, which is an aqueous solution containing  about 37 percent by weight or 40 percent by volume of the compound  formaldehyde (HCHO)  and 6-13 percent metahnol.

Methanol is used to reduce formaldehyde solution stabilizer and prevents the formation of formaldehyde polymerization into paraformaldehid buildup.

Formalin  Material Characteristics:
  • Not color.
  • Smelling sharp.
  •  Sense of burning.
Formalin Function:
  • Preservatives body.
  • Disinfectant.
  • Sterilize room (fumigation).
Formalin Side Effects:

1. Formalin that enter the body.
  • Poisoning body.
  • Stomach irritation.
  • Vomiting.
  • Central nervous system disorders.
  • Allergies.
  • At high levels can lead to failure of blood circulation.
2. Gas or vapor:
  • Causes eye irritation.
  • Trigger bronchitis.
  • Respiratory Tract disturbed.
3. Exposed Skin:
  •  Allergies.
  •   Taste like burning.
4. Formalin is karsogenik (can cause cancer).
Therefore, if using formalin, need protection so skin contact is not direct.

The food was preserved with formalin, of course banned for dangerous and damaging to human health.

Recognize  the characteristics of foods  containing formalin.

To identify foods that contain formaldehyde include:
  • Looks more springy when pressed.
  • Fish or meat seemed more rigid.
  • It smells stimulate the nose.
  • Flies are not willing to settle on foods containing formalin.

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Hypertension - Medical and Nursing Management

Nursing Management for Hypertension
Hypertension is also called as High blood pressure. Hyper meaning High and Tension meaning Pressure. Pressure is the force generated when the heart contracts and pump blood through the blood vessels that conduct the blood to various parts of the blood. Hypertension, or high blood pressure, is a persistent blood pressure above 90 mm Hg between the heart beats (diastolic) or over 140 mm Hg at the beats (systolic).

Hypertension does not in itself give dramatic symptoms, but it is dangerous because it causes a highly increased risk for heart infarction, stroke and renal failure.

There are two major types of hypertension: Essential or primary hypertension and secondary hypertension. Primary hypertension is the most common condition, found in 95 per cent of the cases. It has no definite cause. There are several factors that may act in combination, causing the blood pressure to increase. Secondary hypertension is found in five to ten per cent the cases. Here, the increase in blood pressure is caused by a specific defect in one of the organs in the body. Treating the affected organ can control or cure the hypertension.

The direct mechanisms causing hypertension is one or more of these factors:
  • An increased tension in the blood vessel walls.
  • An increased blood volume caused by elevated levels of salt and lipids in the blood holding back water.
  • Hardened and inelastic blood vessels caused by arteriosclerosis.

The primary causes behind these mechanisms are not fully understood, but these factors contribute to causing hypertension:
  • A high consume of salt
  • A high fat consume.
  • Stress at work and in the daily life.
  • Smoking.
  • Over-weight
  • Lack of exercise.
  • Kidney failure.

Hypertension Symptoms:
Some of the common symptoms of hypertension are:
  • Giddiness, Dizziness and a Feeling of Instability.
  • Palpitations.
  • Insomnia (inability to sleep well).
  • Digestive problems and Constipation.

Hypertension is only determined through a blood pressure measurement equipment and reads the systolic and diastolic of the blood. There is actually no identified sign of hypertension; rather, it varies from one person to another. Some people report to have experienced headaches, fatigue, dizziness, blurring of vision and facial flushing.

Symptoms only surface when signs of end-organ damage are determined or are possible; otherwise, the condition is still considered accelerated hypertension. Malignant hypertension, on the other hand, is caused by increased intracranial pressure. These could be diagnosed through retinal examination.

Medical Management for Hypertension

When lifestyle measures and supplements are not enough to cure the condition, medical treatment must be applied.

Diuretics, or medicines to increase the urine production, are used to decrease the water content in the blood vessels, and thereby reduce the pressure in the vessels. When the water content is lowered, the heart does not need to pump so hard any more, and this will also reduce the pressure.

Beta-adrenergic blockers are another group of medicines to treat hypertension. This group of medicines block the signals that hormones and neurotransmitters give to the vessel walls, and the vessel walls then relax. They also slow down the heart rate to give a lower pressure exerted by the heart upon the blood.

Nursing Management for Hypertension
  1. Diet
    Diet for Hypertension
    The diet is recommended for patients with hypertension:
    • Moderate salt restriction of 10 g / day to 5 g / day
    • Diets low in cholesterol and low in saturated fatty acids
    • Weight loss
    • Decrease your intake of ethanol
    • Stopping smoking
  2. Physical Exercise
    Physical Exercise for Hypertension
    Physical exercise or regular exercise and directed that recommended for patients with hypertension is a sport that has four principles:
    •  Various forms of exercise that is isotonic and dynamic such as running, jogging, cycling, swimming, etc.
    •  The intensity of exercise is good between 60-80% of aerobic capacity or 72-87% of the maximum pulse-called training zone.
    •  The duration of exercise ranged from 20-25 minutes on the exercise zone
    •  Frequency should exercise 3 times per week and at least a good 5 x per week
  3. Education Psychological
    Provision of psychological education for hypertensive patients include:
    • Biofeedback techniques - Biofeedback is a technique that is used to indicate the subject of the signs of the state of the body that is consciously by the subject is not considered normal. Application of biofeedback is mainly used to treat somatic disorders such as headaches and migraines, as well as for psychological disorders such as anxiety and tension.
    • Relaxation techniques - Relaxation is a procedure or technique that aims to reduce tension or anxiety, a way to train people to be able to learn to make the muscles in the body to relax
  4. Health Education (Extension)
    The purpose of health education is to increase patient knowledge about hypertension and its management so that patients can maintain life and prevent further complications.

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Megacolon - Hirschsprung's Disease Definition, Symptoms and Management

There is some  understanding of megacolon,  but essentially the same, namely a disease caused by a mechanical obstruction caused by inadequate motility of the intestine so that no spontaneous bowel evacuation  and inability spinkter rectum relaxes.

Hirschsprung's  disease or megacolon is the absence of ganglion cells in the rectum or the rectosigmoid colon.  And the lack of these circumstances lead to abnormality or absence of peristalsis and the absence of spontaneous  bowel evacuation (Betz,  Cecily & Sowden: 2000).

Hirschsprung  disease is a congenital anomaly resulting in mechanical obstruction due to lack adekuatan portion of the intestinal motility.  (Donna L. Wong, 2003: 507).

Various Kinds of Hirschsprung Disease

Based on the length of the affected segment, can be distinguished two types, namely:
  1. Short segment Hirschsprung disease. Aganglionosis segments from the anus to the sigmoid; This represents about 70% of cases of Hirschsprung disease and is more common in boys than girls.
  2. Long segment Hirschsprung disease. Abnormalities may exceed the sigmoid, even the entire colon or small intestine. Found as much in boys and girls. (Ngastiyah, 1997: 138)

Signs and  Symptoms

a. The failure of the passage of meconium in the first 24 hours of life.
b. Chronic constipation starting from the first month of life to look like ribbon stool.
c. Intestinal obstruction in the neonatal period.
d. Abdominal pain and distension.
e. Impaired growth.
(Suriadi, 2001: 242)
f. Total obstruction at birth with vomiting, abdominal distension and a lack of evaluation of meconium.
g. Delay followed meconium obstruction periodic evaluation of improved spontaneously or with edema.
h. Mild symptoms of constipation for several weeks or months followed by acute intestinal obstruction.
i. Lightweight construction, enterocolitis with diarrhea, abdominal distension and fever. Fetid diarrhea may be the only symptom.
j. Only mild symptoms of constipation.
(Mansjoer, 2000: 380)

• Neonatal Period:
a. Failed to issue meconium within 48 hours after birth.
b. Vomit contains bile.
c. Reluctant to drink.
d. Abdominal distention.

• The infants and children:
a. constipation
b. recurrent diarrhea
c. Feces such as ribbon, foul-smelling
d. abdominal distention
e. failure to thrive
(Betz, 2002: 197)

Signs and symptoms after birth
1. No expenditure meconium (more than 24 hours of delay)
2. Vomiting green
3. Abdominal distension, constipation.
4. Diarrhea is the most prominent with excessive fecal expenses / spending a lot of gas.

Symptoms in older children because the symptoms are not apparent at birth.
1. A history of constipation at birth
2. Abdominal distention increased
3. Attacks constipation and diarrhea occur alternately
4. Bothered collapsed because of frequent diarrhea.
5. Liquid stool, and grains such as tape.
6. Large and bulging belly.
7. lethargy
8. Problems in the absorption of nutrients, which leads to weight loss, diarrhea or both, and delay or slow growth.
9. Colon infection, especially newborn or very young, which can include enterocolitis, a serious infection with diarrhea, fever and vomiting and sometimes dangerous colonic dilatation.

• In children or older adults, symptoms may include constipation and low values ​​of red blood cells (anemia) due to blood loss in the stool is also accompanied by leukocytosis.


Surgery Hirschsprung conducted in 2 phases, namely conducted colostomy loop or double-barrel so that the tone and size of intestinal dilatation and hypertrophy can be back to normal (takes 3-4 months), followed by one of the three following procedures:
1. Duhamel Procedure: Withdrawal under the direction of normal colon and colon aganglionic menganastomosiskannya behind.
2. Swenson Procedure: Do end-to-end anastomosis of the colon to the anal canal ganglion restricted.

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Bronchial Asthma Diagnosis and Treatment

Nursing Diagnosis Bronchial Asthma
Bronchial asthma is the extra right title for the frequent form of asthma. Bronchial asthma is an illness brought on by increased responsiveness of the tracheobronchial tree to varied stimuli. The results paroxysmal constriction of the bronchial airways. Though the 2 kinds of bronchial asthma have related signs, together with wheezing (a whistling sound within the chest) and shortness of breath, they've fairly completely different causes.

The symptoms of bronchial asthma are tightness of chest, shortness for breath, coughing and wheezing. The causes are mainly hereditary. Allergies, eczema, and irritations that affect the bronchus cause the symptoms to manifest.

Allergic bronchial asthma is a kind of bronchial asthma that is triggered by allergens within the air. Allergens like: Cockroaches, Mud mites, Mould. Bronchial asthma attacks occur when one is exposed to these conditions that are not favorable to the bronchus. We have irritants found around ones working conditions such as strong scents may be through perfumes, colognes or even disinfectants that one inhales. It is therefore to be on the look out as to what triggers yours.

Bronchial Asthma Treatment 

Chest X-Ray: Your doctor might do a chest X-ray to rule out any other illnesses that may be inflicting related symptoms. Peak Expiratory Move (PEF): Utilizing a tool referred to as a peak movement meter, you forcefully exhale into the tube to measure the power of air you'll be able to expend out of your lungs. Peak move monitoring can help you monitor your how well your asthma is doing at home. Spirometry: A lung perform check to measure your respiratory capacity and how properly you breathe. You'll breathe into a device known as a spirometer.

Bronchial Asthma Treatment 

Bronchial asthma treatment now has new treatment protocols that recommend the prevention of asthma medications, such as inhaling corticosteroids or nebulizers. This medication usually helps an asthmatic person to suppress the inflammation of the lungs as well as reduce the swelling of the linings in the airway passages.

Another recommended asthma treatment is alternative therapies. A recent study shows that almost half of the population of asthmatic persons now uses the form of unconventional therapy for their bronchial asthma treatment.

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Allergic Rhinitis - Allergen Avoidance Tips

Allergic rhinitis is the most common cause of rhinitis, which indicates inflammation of the mucous membrane of the nose. Allergic rhinitis usually causes inflammation not only in the nose but also in the surrounding areas which include eyes, eustachian tubes, middle ear, sinuses and throat. People who have allergies are frequently advised to avoid the substances that cause sneezing, wheezing, runny nose, tear-filled eyes, itching, inflammation, and hives.

Allergy sufferers may be asked to give away pets and potted plants. They can be told they have to keep their bedroom windows tightly shut at night. They may be told that they need to avoid food sensitivities, so they can't eat anything made with wheat, meat, citrus, tomatoes, chocolate, cheese, milk, or eggs. And they may be told that they can't stay friends with people who like to use perfume or aftershave.

The signs and symptoms of allergic rhinitis can be mild or severe. You may also experience severe symptoms that will last from 4 days to 4 weeks. Chronic congestion is one of the most common symptoms of this condition. This symptom may cause pain and facial pressure and this may affect your sense of taste and smell. The skin right below your eyes may redden and swell. The symptoms of allergic rhinitis may occur immediately after you are exposed to certain substances that trigger an allergic reaction. Some of the most common allergens include dust, pollen and animal dander. In some cases, exposure to perfume or cigarette smoke can also worsen your condition.

Allergic Rhinitis - Allergen Avoidance Tips
  • Avoid keeping animals that shed fur. Animal dander is a well known trigger for allergic rhinits. If you already own an animal or are keen on keeping one, keep your pet away from your bedding and bathe your pet regularly.
  • Most studies show an association between air pollutants and the exacerbation of allergic conditions. During periods of haze, patients with allergic conditions should avoid unnecessary outdoor activities.
  • Avoid smoking and exposure to second hand smoke.
  • The range of occupational sensitizers is very large and complex, and will require assessment by a specialist.
  • True food allergies are uncommon, and exhaustive testing for food allergies is usually impractical.
  • Encase pillows, mattresses etc with allergen-proof, anti-dust mite covers.
  • Wash all bedding and stuffed toys in hot water (exceeding 60 degrees Celcius) once a week.
  • Avoid carpets, thick curtains and stuffed toys where possible.
  • Use vacuum with integral, HEPA filters.
  • Keep all clothing in drawers/closets to reduce dust collection.
  • Clean all surfaces with a damp cloth regularly.
  • Regularly change and clean air conditioner filters.
  • Keep clutter under control.

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Benefits of Yoga in Menopausal Women

The women who had been dizzy and afraid to face the advent of menopause do not have to wonder anymore. Hot flushes and sweating constantly attack can be overcome or at least reduced. Only with yoga you can do it. Even yoga is said to improve mental function. As stated by the scientists of India.

To investigate whether yoga can help women who are menopausal and experiencing physical and cognitive symptoms, scientists randomly assigned 120 postmenopausal women aged 40 to 55 years. They were asked to do yoga or simple stretching and muscle strengthening exercises five days a week for a period of eight consecutive weeks.

Postures, breathing and meditation in yoga, "Having one common effect, by affecting the mind that makes a person become calm," said the scientists.

The women in the yoga group also listened to lectures on using yoga to manage stress and other yoga-related topics. While those in the control group heard lectures on diet, exercise, the physiology of menopause, and stress.

After eight weeks, women in the yoga group showed a significant reduction in their body. Sense of body heat and sweat at night decreases symptoms. While those in the control group did not experience this. This was stated by Dr R Chattha of Swami Vivekananda Yoga Anusandhana Samsthana in Bangalore, India.

Although both groups showed improvements in a test of attention and concentration, the yoga group showed significant progress. Of the 10 components of memory and intelligence tests, 8 points earned by those in the yoga group, while the control group only six. Improvements were significantly greater in the yoga group compared to the control group on seven subjects.

"This study shows the superiority of yoga. This also means showing that physical activity also improves cognitive function with an emphasis on proper breathing, synchronizing breathing with body movements, relaxation and mindful rest," said the scientists.

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Sinusitis Symptoms and Treatment

Sinusitis is the medical term for inflammation (irritation and swelling) of the sinuses. It's usually caused by infection. Sinusitis can be acute or chronic. Acute sinusitis (going on less than four weeks), is usually precipitated by an earlier upper respiratory tract infection, generally of viral origin. Virally damaged surface tissues are then colonized by bacteria, most commonly haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis and Staphylococcus aureus. Acute sinusitis often starts as a cold, which then turns into a bacterial infection. Allergies, pollutants, nasal problems and certain diseases can also cause sinusitis. Chronic sinusitis are the same as acute sinusitis, but tend to be milder and last longer than 8 weeks.

Sinusitis symptoms are frequent headache, difficulty in breathing and one has pain above the eyes. All these symptoms must not be ignored as these are the main causes of this infection. The doctors say that it is best to cure the disease when it is at the primary stage. One can easily cure it then, but if someone ignores it then it will cause problems for sure. So when someone has a problem with a change of climate and is having frequent headaches, then he or she must surely get a checkup done from the doctor.

Treatments include antibiotics, decongestants and pain relievers. Use an over-the-counter medicine such as acetaminophen (one brand name: Tylenol) for pain. Using heat pads on the inflamed area, saline nasal sprays and vaporizers can also help. Taking ibuprofen or acetaminophen can help to relieve pain and inflammation. A cool-mist humidifier may soothe your sinuses. Warm compresses usually help with facial pain. Nasal corticosteroid sprays may be used to decrease swelling, especially if you have swollen structures (such as nasal polyps) or allergies. Antibiotics are used to cure the particular infection causing sinus inflammation. Surgery to clean and drain the sinuses may also be necessary, especially in patients with recurrent episodes of inflammation despite medical treatment.

There are natural treatment you can take to overcome the problem of sinusitis. First, as much as possible avoid inhaling traffic fumes, cigarette smokes and chemicals at home or at work. Second, exercise regularly. Even walking for thirty minutes three to four times a week can be very effective. Third, avoid foods such as eggs, wheat, fatty foods, pastries, sugar, chocolate and any food that contains food additives. Fourth, eat more fruits and vegetable, fish, hot chicken and salads. Fifth, drink two to three liters of water a day. Keep in mind that water helps in keeping the body clean. Lastly, when suffering from colds, inhalation is a tested way of relieving blocked sinuses.

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Angina Pectoris: Definition, Etiology, Clinical Manifestations and Pathophysiology

Definition of Angina Pectoris

1. Angina pectoris is chest pain caused by myocardial ischemia and temporary or reversible. (Fundamentals of nursing cardiothoracic, 1993)

2. Angina pectoris is a chronic syndrome in which the client had suffered the typical chest pain like pressure, or feel heavy in the chest that often radiating to the left arm that arise at the time of the activity and immediately lost when the activity stops. (Prof. Dr. H.M. Sjaifoellah Noer, 1996)

3. Angina pectoris is a term used to describe the type of discomfort that are usually located in areas retrosternum. (Practical Guidance Cardiovascular).

Etiology of Angina Pectoris
  • Arteriosclerosis
  • Coronary artery spasm
  • Severe anemia
  • Arthritis
  • Aortic insufficiency
Clinical Manifestations of of Angina Pectoris
  • Substernal or retrosternal chest pain radiating to the neck, throat area inter scapula or left arm.
  • Quality of pain, such as distressed heavy objects, such as pressing, hot, sometimes just a bad feeling in the chest (chest discomfort).
  • Duration of pain lasted 1 to 5 minutes, no more than 30 minutes.
  • Pain lost (decreases) when the rest-sleep or administration of nitroglycerin.
  • Accompanying symptoms: shortness of breath, feeling tired, sometimes appearing cold sweat, palpitations, dizzines.
  • EKG: ST segment depression, inverted T waves.
  • EKG: often normal at the time of the attack did not arise.
Pathophysiology of Angina Pectoris

The mechanism of the onset of angina pectoris is based on inadequate oxygen supplied to the cells caused by myocardial arterial rigidity and narrowing of the lumen of the coronary arteries (coronary arteriosclerosis). It is not known exactly what causes arteriosclerosis, it is clear that no single factor was responsible for the development of arteriosclerosis. Arteriosclerosis is a disease of the coronary arteries are most commonly found. When a tissue workload increases, the need for oxygen also increases. If demand increases in the healthy heart dilates the coronary artei and more blood flow and oxygen to the heart muscle. However, if the rigidity or coronary artery had narrowed by arteriosclerosis and can not dilate in response to increased demand for oxygen, then an ischemic (lack of blood supply) myocardium.

Presence of endothelial injury resulting in loss of production of No (nitric oxide), which serves to inhibit a variety of reactive substances. In the absence of this function can cause smooth muscles to contract and arises spasmus aggravate coronary lumen narrowing due to myocardial oxygen supply is reduced. Narrowing or block is not so apparent cause symptoms if not reached 75%. If the narrowing of more than 75% and is triggered by the excessive activity of the coronary blood supply is reduced. Myocardial cells using anaerobic glycogen to meet their energy needs. Metabolism produces lactic acid which lowers the pH of the myocardium and cause pain. When energy demand decreases cardiac cells, the oxygen supply becomes inadequate and back muscle cells oxidative phosphorylation to form energy. This process does not produce lactic acid. With the loss of lactic acid pain will subside.

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Head to Toe Physical Examination for Dyspnea


1) Examination of the chest, beginning from the posterior thorax, the client in a seated position.

2) Chest observed by comparing one side to the other.

3) Actions done from the top (apex) to the bottom.

4) Inspection of the thorax poterior skin color and condition, scars, lesions, masses, spinal problems such as kyphosis, scoliosis and lordosis.

5) Record the number, rhythm, respiratory depth, and symmetry of chest movement.

6) Observation of respiratory type, such as: nasal breathing or diaphragmatic breathing, and the use of auxiliary respiratory muscles.

7) When observing respiration, record the duration of the inspiration phase (I) and expiratory phase (E). This phase normally ratio 1: 2. Prolonged expiratory phase indicate the presence of airway obstruction and is often found on the client Chronic Airflow Limitation (CAL) / COPD

8) Review the configuration of the chest and compare anteroposterior diameter (AP) and lateral diameter / tranversal (T). This ratio normally ranges from 1: 2 to 5: 7, depending on the client's body fluids.

9) Abnormalities in breast shape:
a) Barrel Chest
Arise due to the occurrence of lung overinflation. An increase in AP diameter: T (1:1), often occurs in emphysema clients.

b) Funnel Chest (Pectus Excavatum)
Arise in case of depression of the bottom of the sternum. This will compress the heart and major blood vessels, resulting in murmurs. This condition can occur in rickets, Marfan's syndrome or due to accidents.

c) Pigeon Chest (Pectus Carinatum)
Arise as a result of inaccuracies sternum, where an increase in AP diameter. Arise in clients with severe kyphoscoliosis.

d) kyphoscoliosis
Seen with the elevation of the scapula. This deformity would interfere with the movement of the lungs, can occur in clients with osteoporosis and other musculoskeletal disorders affecting the thorax.

Kiposis: increasing the normal curvature of the thoracic vertebral column causing the client looks bent.

Scoliosis: curved lateral thoracic vertebrae, accompanied by vertebral rotation

10) Observation symmetry of chest movement. Movement disorders or inadequate chest expansion indicates disease in the lung or pleura.

11) Observation of abnormal retractions intercostal spaces during inspiration, which can indicate airway obstruction.


Conducted to assess the symmetry of chest movement and observed abnormality, identified the skin's condition and knowing vocals / premitus tactile (vibration).

Palpate thoracic abnormalities were examined to determine the time of the inspection, such as: mass, lesions, swelling.

Assess also the softness of the skin, especially if the client complains of pain.

Vocal premitus: chest wall vibrations generated when speaking.


Nurses perform percussion to assess pulmonary resonance, the organ that is around and development (excursion) diaphragm.

Types of percussive sounds:

Percussive sound normal:
Resonant (Sonor) :: resonate, low tone. Generated in normal lung tissue.
Dullness: produced on the part of the heart or lungs.
Tympany :: musical, produced in the stomach that contain air.

Sound Percussion Abnormal:
Hyperresonant: resonated lower than the resonant and raised in the abnormal lung filled with air.

Flatness: very dullness and therefore a higher tone. Percussion can be heard on the thigh, which contains all of the area of tissue.


Is a very significant study, listening to breath sounds include normal, additional sounds (abnormal), and sound.

Normal breath sounds generated from the vibration of air passing through the airway from the larynx to the alveoli, the nature of the net.

Normal breath sounds generated from the vibration of air passing through the airway from the larynx to the alveoli, the nature of the net

Normal breath sounds:

a) Bronchial: often called the "Tubular sound" because the sound is produced by air passing through a tube (pipe), his voice loud, loud, with a gentle blowing. Expiratory phase is longer than inspiration, and there is no interruption between the two phases. Normal sounds in the trachea or suprasternal notch area.

b) Bronchovesicular: a combination of bronchial and vesicular breath sounds. His voice was loud and with a moderate intensity. Inspiration as long as the expiration. The sound was heard in the thoracic region where the bronchi covered by the chest wall.

c) Vesicular: sounds soft, smooth, like a breeze. The inspiration is longer than expiration, expiratory sounds like a hoot.

Additional breath sounds:

d) Wheezing: sound during inspiration and expiration, with the character of a loud voice, musical sounds associated with the continuous flow of air through a narrowed airway.

e) Ronchi: heard during inspiration and expiration phases, character voice sounded slow, loud, persistent snoring sound. Dealing with thick secretions and increased sputum production

f) Pleural friction rub: heard during inspiration and expiration. Character voice: rough, squeak, sounds like the friction resulting from inflammation of the pleural region. Often times clients also experience pain when breathing deeply.

g) crackles

Fine crackles: each phase more often heard during inspiration. Characters pop sound, broken due to the humid air passing through the area in the alveoli or bronchioles. Sounds like the hair rubbed.

Coarse crackles: more prominent at expiration. Character voice is weak, rough, scraping sound or truncated due to the presence of fluid secretion in the airway. It will probably change when the client coughs.

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Insomnia - 7 Natural Remedies

7 Natural Remedies for Insomnia
Insomnia is a symptom, not a stand-alone diagnosis or a disease. By definition, insomnia is "difficulty initiating or maintaining sleep, or both" or the perception of poor quality sleep. Among adults, insomnia affects women more often than men. The incidence tends to increase with age.

Causes of Insomnia
  • No Bedtime Routine
  • Having late dinners or heavy snacks before bedtime
  • Stresses at the workplace and at home
  • Over stimulating your mind before bedtime
  • Too much napping
  • Going to bed when you are not tired
  • The bedroom may not conducive for sleeping
  • Lack of exercise during the day
When you are seeking professional treatment for insomnia?
  • When the sleep of chronic, lasting more than 4 weeks began to interfere with normal life activities.
  • The state does not respond well to medication or self-help homes
  • Accompanied by chest pain, difficulty breathing, etc.
  • The condition worsens over time.
Symptoms of Insomnia
  • Sleep problems, but tired
  • Interrupted by frequent awakenings, difficulty falling back to sleep
  • Afternoon drowsiness, irritability, fatigue
  • Excessive dependence on alcohol or sedatives such as sleeping pills to sleep
  • Waking up too early
  • Problems with concentration
Here is 7 Natural Remedies for Insomnia
  1. Bedtime routine
  2. Relaxation
  3. Calm down and clear your mind
  4. Give time again to yourself
  5. A balanced weight loss program helps to make a balanced mind
  6. Don't lie in bed if you can't sleep
  7. Your bedroom is for sleeping solely.

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