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By X. Khabir. Franciscan University of Steubenville.

The alcohol abuse is 7 Basic Concepts in Drug Addiction often associated with abuse discount 10mg atorlip-10 with mastercard, domestic violence and couple breakup (Carvalho et al discount atorlip-10 10mg. In the long run order atorlip-10 10 mg fast delivery, individuals addicted to alcohol often lose their jobs (Moreno, Portús and Arias, 1995). It has also been observed that the intensity of alcohol consumption is one of the variables related to the use of other illegal drugs, such that the earlier the consumption of alcoholic beverages begins, the more substances will be used later (Secades, 1996). Adverse effects of alcohol in the juvenile population The negative repercussions of alcohol poisoning are numerous. Among the negative consequences that young people may specifically suffer the following stand out: − School problems: alcohol consumption among boy and girl students has consequences that directly impact on their academic performance. Among the students who have never repeated a course there is a higher proportion of abstainers than among repeaters. Jacobson, Aldalna and Beaty (1994) affirm that 25% of teens had been drinking before their last sexual experience. However, intoxication may act as a barrier to 8 José Pedro Espada and Daniel Lloret Irles implementing the knowledge and attitudes about health behaviors (Cooper et al. Graña and Munoz (2000) found that among adolescent consumers there was a higher probability of carrying out pre-delinquent activities. Other studies, such the one by Basabe and Páez (1992) confirm the co-morbidity between alcohol consumption and antisocial behavior, finding that 11% of adolescents have relationship problems caused by alcohol in the form of fights and quarrels with friends, and 12% with other people. Opiates Opium is a narcotic drug obtained from a type of poppy originating in Asia Minor and known as white opium. The psychoactive effects are produced by the alkaloids contained in opium, which can be classified into two types depending on the action they produce and their chemical composition: − Morphine, codeine, thebaine, which act on the nervous system. It is a psychodysleptic, a substance that disrupts mental activity and acts as a powerful painkilling sedative and anxiolytic. The mechanism of action of morphine is based on the presence of opioid receptors in the Central Nervous System of the human body. When 9 Basic Concepts in Drug Addiction morphine enters the body, it accumulates in the tissues through the blood, acting on said opiate receptors and affecting the Central Nervous System, smooth muscles of the abdominal organs and skin. Among the most noted effects of morphine are analgesia, drowsiness, mood changes and mental confusion. It is capable of producing tolerance after a few doses and causing significant psychological and physical addiction. Barbiturates and Tranquilizers These two broad groups of substances are capable of diminishing Central Nervous System activity. Depending on the dose and formula it may have sedative, hypnotic, anticonvulsant, or anesthetic effects. Tranquilizers or benzodiazepines are a group of substances used in the treatment of sleeping problems and anxiety. Both barbiturates and tranquilizers produce a very high dependency, and in the case of an interruption of their administration withdrawal syndrome appears. Amphetamines Amphetamine is a synthetic compound chemically derived from ephedrine, a natural alkaloid with euphoretic properties. Amphetamines cause variable psychological dependence and low physical dependence and generate tolerance rapidly. The effects of low or moderate doses are: a state of euphoria, sleep loss, decreased appetite, perception of an apparent improvement of overall fitness, increased breathing rate, and bronchial dilation, dry mouth and increased blood pressure and body temperature. Prolonged use or high doses cause irritability and paranoia, hallucinations and delirium, respiratory and cardiac abnormalities and seizures. Cocaine 10 José Pedro Espada and Daniel Lloret Irles Cocaine is hydrochloride of cocaine, the result of a chemical process using coca plant leaves. The main physical effects include tachycardia, hypertension, tremors, increased body temperature and sweating. The psychological effects are related to states of euphoria, a sense of energy, more intense sensations of the senses and increased self-esteem. The major psychological problems resulting from cocaine use are reactive depression when consumption is suppressed or the cocaine psychosis that can spontaneously occur. Minor stimulants of the Central Nervous System Nicotine Nicotine stimulates the Central Nervous System and has a vasoconstrictor effect on some internal organs such as the heart. Principal among the physical effects are increased heart and respiratory rates, arrhythmia and hypertension. While the major immediate psychological effects include increased alertness, concentration and memory, and stress reduction. The prolonged use of tobacco is associated with the onset of cardiovascular diseases, circulatory failure and cancers of the lung, oral cavity, larynx, esophagus and duodenum. Xanthines (caffeine, tine, etc) Chemical elements that are derived from purine, present in the nucleic acid of living cells. This group includes caffeine, theophylline and theobromine, which is found in various plants, such as coffee, tea, or cocoa. Caffeine intake by sporadic consumers or by people not accustomed to it has physical and psychological effects that manifest in better physical performance, stimulation of the psychic functions, facilitation of intellectual effort, and improved attention and concentration; however, it can also produce negative effects such as nervousness, excitement, tremors and restlessness.

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A trachestomy is performed to by pass an upper airway obstruction proven atorlip-10 10 mg, to remove tracheoborncheal secretions atorlip-10 10mg with visa, to prevent aspiration of oral or gastric secretions in the unconscious or paralyzed patient and to replace an endotracheal tube order 10mg atorlip-10 mastercard. There are many disease processes and emergency conditions that make a tracheostomy necessary. After the trachea is (opened) exposed a tracheostomy tube of appropriate size is inserted. The tracheostomy tube is held in place by tapes fastened around the patients neck usually, a square of sterile gauze is placed between the tube and the skin to absorb drainage and prevent infection. Complications: Early complications immediately after the trachestomy is performed include: • bleeding • pneumothorax • air embolism • aspiration • subcutaneous or mediastinal emphysema • recurrent laryngeal nerve damage or • posterior tracheal wall penetration. Immediate Postoperative Nursing care: • The patient requires continuous monitoring and assessment. Nutrition status of the mother 44 Pediatric Nursing and child health care A) Management of low birth weight: ƒ Clean air way ƒ Initiate breathing ƒ Establish circulation ƒ Keep Warm ƒ Administer Vit. Due to maternal origin • Amniotic fluid infection • Obstructed labor • Congenital syphilis Placenta previa • Causeless • Toxemia of pregnancy • Recurrent and the bleeding is painless Gestational Hepatitis B. Due to fetal and maternal origin ƒ Premature separation of placenta ƒ Trauma Abruption placenta 48 Pediatric Nursing and child health care ƒ Causeless ƒ Accidental ƒ Painful(rigid) C. Congenital pneumonia It is caused by aspiration of amniotic fluid or ascending infection. Route of infection: • Transplacental • Amniotic fluid infection • Environment • Instrument Other Neonatal problems: • Congenital abnormalities • Prematurity and related problems • Jaundice • Birth Trauma 4. Neonatal resuscitation: During the initial resuscitation efforts, a 100 % oxygen concentration is administered to the neonate. This adjustment is essential, since elevated pao2 levels can cause irreparable damage to retinal vessels. Furthermore, high oxygen concentrations can directly injure lung tissue premature infants with immature lungs and eye vessels are at particular risk for two conditions that are a direct result of oxygen toxicity: retrolental fibroplasia and bronchopulmonary dysplasia. This may be true, but such a diagnosis is difficult to prove and should never be made without taking a careful history and performing a proper examination in any child with fever. Malaria: one negative blood film report does not exclude malaria B Early measles: look for koplik’s spots C Pneumonia: look at the child for flaring of nostrils, rate of breathing, Lower chest in drawing D Otitis media: check eardrums E Meningitis: neck stiffness, irritability F Urinary tract infection: check urine G Tonsillitis: look at the throat H Relapsing fever: take blood film for haemo parasite 4. This is not only due to congenital malformation or perinatal injury to the central nervous system but also the frequency of “febrile “convulsions in response to a rapid rise of temperature at the onset of acute infective illnesses 55 Pediatric Nursing and child health care Causes: 1. In the neonatal period the major causes of convulsions are • Congenital defect of the brain • Cerebral damage occurring during the process of birth from hypoxia or trauma both account for 90 % of the cases. The remaining 10 % includes: • infection of the brain ( meningitis ) • hypoglycaemia • hyperbillirubinaemia with kernicterus etc 2. Feeding Recommendations during sickness and health: Up to 4 months of age • Breast feed as often as the child wants, day and night, at least 8 times in 24 hours. Shiro, kik, merek fitfit, mashed potatoes and carot, gommen,undiluted milk and egg and fruits 57 Pediatric Nursing and child health care • Add some extra butter or oil to child’s food • Give these foods:-3 times per day if breastfed 5 times per day if not breastfed • Expose child to sunshine 12 months up to 2 years: • Breast feed as often as the child wants, Give these foods 5 times per day • Give adequate serving of: porridge made of cereal and legume mixes. Shiro, kik, merek fitifit mashed potatos and carrot, gommen, undiluted milk and fruits • Add some extera butter or oil to child food • Give these foods 5 times per day 2 years and older: Give family food at least 3 times each day. Also twice daily, give nutrious food between meals, such as: egg, milk, fruits, kita, dabo 58 Pediatric Nursing and child health care Study Questions 1. They may be obvious on examination of the newborn or they may be detected by histological structures. One reason why more deaths occur in the first than during the remaining months of the first year of life is that many 60 Pediatric Nursing and child health care congenital abnormalities are compatible with intrauterine life, but not with extra-uterine life approximately 15 % of death in the neonatal period care caused by such gross malformations. Cleft lip and palate Cleft lip and palate are congenital deformities due to the failure of various parts of the upper lip and palate to fuse in the normal manner. Cleft lip is operated on about the age of three months, cleft palate about the age of one year before speech detects have developed. After care: The arms must be splinted with card board so that the child can not touch the wound. Crying must be prevented by good nursing care and lifting the mother to spend much of her time with the child. Soft feeds are given by spoon well back on the tongue and followed by sterile water. Cleft palate: is treated similarly by paring the adages and suturing after cutting on either side. Preparation The child should be admitted well before operation to be accustomed with the environment. The two most common types of club foot are: Talipes equinovarus Talipes calcaneovalgal Both types are usually bilateral. In Talipes equinovarus, the foot is fixed in palantar fixation and deviates medially i.

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Laboratory diagnosis- Identification of eggs or proglottids in the stool buy generic atorlip-10 10mg on line; use of scotch-tape may be helpful as in pinworm infection as the eggs are sometimes present in the perianal area buy atorlip-10 10 mg visa. All patients suspected of having cysticercosis should be referred to higher centers for better diagnosis and management discount 10 mg atorlip-10 with visa. The spores are able to survive cooking, and if the cooked food (meat and poultry) is not cooled enough, they will germinate. General After completing this module the learner will be able to assess and manage cases of food borne disease. Specific After reading this module you will be able to: ¾ Assess the patient with food borne disease ¾ Make the Nursing diagnosis ¾ Plan the Nursing intervention ¾ Implement the planned intervention ¾ Evaluate the outcomes of the intervention 3. Subjective Data • Onset and duration of the disease (14) • History of ingestion of contaminated food (food with unusual odor or taste, uncooked vegetables, raw meat etc. Nursing Diagnosis Based on the classification of the food borne diseases and findings of the nursing assessment the following actual and potential nursing diagnosis can be made: i. Poisoning related to the ingestion of contaminated food with chemical poisons, poisonous plants and toxins. Knowledge deficit about possible causes of the disease and preventive measures related to lack of information. Risk for fluid volume deficit related to vomiting and increased loss of fluids and electrolytes from gastro-intestinal tract. Establish goals for the nursing intervention • To remove or inactivate the poison before it is absorbed. Establish expected outcomes The patient: • Reveals reduced/ no effects of the poisoning chemical, poisonous plant or toxins • Reports less pain • Reports a decrease in the frequency of diarrheal stools • Tolerates small frequent feeding • Verbalizes concerns and fears • Reports the different causes and preventive measures of food borne disease 78 • Has no observable signs and symptoms of fluid balance • Prevents spread of the infection to others D. Reducing / eliminating the effects of the poisonous chemical, poisonous plant or toxins ¾ Attain control of the air way, ventilation, and oxygenation • Prepare for mechanical ventilation if respirations are depressed. Use gastric emptying procedures as; the following may be used: • Syrup of ipecac to induce vomiting in the alert patient. Administer the specific chemical antagonist or physiologic antagonist as early as possible to reverse or diminish effects of the toxin. Poisons may excite the central nervous system or the patient may have seizures from oxygen deprivation. Measures to Relief Pain To ease anal irritation (pains) caused by diarrhea, clean the area carefully and apply a repellent cream, such as petroleum jelly, warm sitz baths and application of witch hazel compresses can also soothe irritation. Establishing a Regular Pattern of Bowel Elimination and Maintaining Nutritional Balance ¾ Administer medications, as ordered, correlate dosages and routes with the patient’s meals and activities. If the patient is receiving a potassium supplement, be especially alert for the development of hyperkalemia (14,28,29). Reducing Anxiety ¾ An opportunity is provided for the patient to express fears and worry about being embarrassed by lack of control over bowel elimination. The patient is encouraged to be sensitive to body clues that warn of impending urgency (abdominal cramping, hyperactive bowel sounds). Special absorbent underwear, which will protect clothes if there is accidental fecal discharge, may be helpful. Teaching about Possible Causes of the Disease and Preventive Measures ¾ Teach the patient about his or her specific disease and therapeutic regimens. She or he is instructed about personal hygiene and the maintenance of the home environment to prevent the disease. Teach also about proper storage of the food items, chemicals, insecticides/ pesticides, detergents and petroleum products brought to home for household purposes. Instruct the patient to thoroughly cook foods, to properly preserve perishable foods, to always wash his hands with water and soap before handling food, especially after using the bath room toilet, to clean utensils thoroughly, and to eliminate flies and roaches in the home. But fluid balance is difficult to maintain during an acute episode of the disease because the feces are propelled through the intestines too quickly to allow for water absorption; and vomiting that leads to water loss; output exceeds intake. When a patient experiences such a condition the nurse assesses for dehydration (decreased skin turgor, achycardia, weak pulse, decreased serum sodium, thirst) and keeps an accurate record of intake and output. Preventing the Spread of the Disease to Others ¾ To prevent the spread of the infection wash your hands thoroughly after giving care (see figure 3. In general all patients with such disease should be treated as potentially infectious until they are proven to be otherwise. Gloves must be changed between patient care activities and hands must be washed after gloves are removed. Ensure that patients with highly transmissible organisms are physically separated from other patients if hygiene or institutional policy dictates. Potential Complications Based on the assessment data, a potential complication is cardiac dysrhythmia related to electrolyte depletion. Vitals signs, including apical pulse and changes in tendon reflexes and muscle strength, are monitored frequently. Treatment of Specific Food-Borne Diseases Food-borne diseases for which their specific chemotherapy is not indicated in this section please refer annex-v i. Food-borne infections Apart from the chemotherapy management of food-borne infections include fluid and electrolyte replacement.