NCLEX Review Pediatric Nursing Part 2

11. The nurse is caring for a 10-year-old child during the acute phase of rheumatic fever. Bedrest is part of the child's plan of care. Which of the following diversional activities is developmentally appropriate and meets the health needs of this child in the acute phase of rheumatic fever?

A. Playing basketball with a hoop suspended from the bed.

B. Using hand-held computer video games.

C. Sorting and organizing baseball cards in a notebook.

D. Using art supplies to make drawings about the hospital experience.

12. The nurse is caring for a 13-year-old who has been casted following spinal instrumentation surgery to correct idiopathic scoliosis. The nurse is helping the teen and family plan diversional activities while the teen is in the cast. Which of the following activities would be most appropriate to support adolescent development while the teen is casted?

A. Take the teen shopping at the mall in a wheelchair.

B. Have teen regularly attend special school activities for own class.

C. Encourage siblings to spend time with teen watching television and movies.

D. Plan family evenings playing a variety of board games.

13. A two-month-old infant is in the clinic for a well baby visit. Which of the following immunizations can the nurse expect to administer?

A. TD, Varicella, IPV.

B. DTaP, Hib, OPV, HBV.

C. DTaP, MMR, Menomune.

D. DTaP, Pneumovax.

14. An 18-month-old child with a history of falling out of his crib has been brought to the emergency room by the parents. Examination of the child reveals a skull fracture and multiple bruises on the child's body. Which of the following findings obtained by the nurse is most suggestive of child abuse?

A. Poor personal hygiene of the child.

B. Conflicting explanations about the accident from the parents.

C. Cuts and bruises on the child's lower legs in various stages of healing.

D. Inability of the parents to comfort the child.

15. The nurse is discussing the risk of sudden infant death syndrome (SIDS) in infants with the parents whose second baby died of SIDS six months ago. The parents express fear that other children will die from SIDS since they have already had one baby die. Which of the following statements made by the parents indicate their understanding of the relationship of future children and the risk of SIDS?

A. "There is a 99% chance that we will not have another baby die of SIDS."

B. "There is medicine that can be used to stimulate the heart rate while the baby is sleeping."

C. "Genetic testing is available to determine the likelihood of another baby dying from SIDS."

D. "Any new baby will be on home monitoring for one year to prevent SIDS."

16. A ten-day-old baby is admitted with 5% dehydration. The nurse notes which of the following signs?

A. Tachycardia.

B. Hyperthermia.

C. Hypothermia.

D. Bradycardia.

17. The nurse is asked why infants are more prone to fluid imbalances than adults. The response is

A. infants ingest a lesser amount of fluid per kilogram.

B. infants have functionally immature kidneys.

C. adults have a greater body surface area.

D. adults have a greater metabolic rate.

18. A 10-month-old weighs 10 kg and has voided 100 ml in the past four hours. The nurse determines normal urine output based on the fact that normal urine output is

A. 10 ml/kg/hour.

B. 1–2 ml/kg/hour.

C. 3–5 ml/kg/hour.

D. 7–9 ml/kg/hour.

19. A three-month-old is NPO for surgery. The nurse attempts to comfort him by

A. administering acetaminophen.

B. offering pacifier.

C. encouraging parents to leave so the child can rest.

D. giving 10 cc Pedialyte.

20. An 11-year-old is admitted for treatment of lead poisoning. The nurse includes which of the following in the plan of care?

A. Strict intake and output.

B. Oxygen.

C. Heme-occult stool testing.

D. Calorie counts.

Answers and Rationale:

11. Correct C

Rationale: The middle childhood years are times for collections. The collections of middle to late school-age children become orderly, selective, and neatly organized in scrapbooks. This quiet activity supports the development of industry and concrete operational thought as well as the physical restrictions related to the rheumatic fever.

12. Correct B

Rationale: Early adolescents have a strong need to fit in and be accepted by their peers. Attending school activities helps the teen continue peer relationships and develop a sense of belonging.

13. Correct B

Rationale: Healthy infants at two months of age receive diphtheria, tetanus, and pertussis (DTP); hemophilus influenza (Hib); oral polio vaccine (OPV); and hepatitis B virus (HBV).

14. Correct B

Rationale: Incompatibility between the history and the injury is probably the most important criterion on which to base the decision to report suspected abuse.

15. Correct A

Rationale: Whether subsequent siblings of the SIDS infant are at risk is unclear. Even if the increased risk is correct, families have a 99% chance that their subsequent child will not die of SIDS.

16. Correct A

Rationale: Tachycardia is associated with dehydration.

7. Correct B

Rationale: Infant kidneys are unable to concentrate or dilute urine, to conserve or secrete sodium, or to acidify urine.

8. Correct B

Rationale: Normal urine output is 1–2 ml/kg/hour.

9. Correct B

Rationale: Non-nutritive sucking will help console and pacify him.

10. Correct A

Rationale: CaNaEDTA (treatment for lead poisoning) is nephrotoxic and strict intake and output records need to be kept.

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NCLEX Review Pediatric Nursing Part 1

1. The nurse is testing reflexes in a four-month-old infant as part of the neurologic assessment. Which of the following findings would indicate an abnormal reflex pattern and an area of concern in a four-month-old infant?

A. Closes hand tightly when palm is touched.

B. Begins strong sucking movements when mouth area is stimulated.

C. Hyperextends toes in response to stroking sole of foot upward.

D. Does not extend and abduct extremities in response to loud noise.

2. The mother of a three-month-old infant asks the nurse when she can start feeding her baby solid food. Which of the following should the nurse include in teaching this mother about the nutritional needs of infants?

A. Infant cereal can be introduced by spoon when the extrusion reflex fades.

B. Solid foods should be given as soon as the infant's first tooth erupts.

C. Pureed food can be offered when the infant has tripled his birth weight.

D. Infant formula or breast milk provides adequate nutrients for the first year.

3. The nurse is assessing a six-month-old infant during a well child visit. The nurse makes all of the following observations. Which of the following assessments made by the nurse is an area of concern indicating a need for further evaluation?

A. Moderate head lag when pulled to sitting position.

B. Absence of Moro reflex.

C. Closed posterior fontanel.

D. Three pound weight gain in two months.

4. The nurse is giving anticipatory guidance regarding safety and injury prevention to the parents of an 18-month-old toddler. Which of the following actions by the parents indicates understanding of the safety needs of a toddler?

A. Teach the child swimming and water safety.

B. Use automobile booster seat with lap belt.

C. Allow child to cross the street with four-year-old sibling.

D. Correct Supervise the child in outdoor, fenced play areas.

5. The community health nurse is making a newborn follow-up home visit. During the visit the two-year-old sibling has a temper tantrum. The parent asks the nurse for guidance in dealing with the toddler's temper tantrums. Which of the following is the most appropriate nursing action?

A. Help the child understand the rules.

B. Leave the child alone in his bedroom.

C. Explain that the toddler is jealous of the new baby.

D. Suggest that the parent ignore the child's behavior.

6. The parent of a three-year-old child brings the child to the clinic for a well child checkup. The history and assessment reveals the following findings. Which of these assessment findings made by the nurse is an area of concern and requires further investigation?

A. Uses gestures to indicate wants.

B. Unable to ride a tricycle.

C. Has ability to hop on one foot.

D. Weight gain of four pounds in last year.

7. The parents of a four-year-old child tell the nurse that the child has an invisible friend named "Felix." The child blames "Felix" for any misbehavior and is often heard scolding "Felix," calling him a "bad boy." The nurse understands that the best interpretation of this behavior is which of the following?

A. A way for the child to assume control.

B. A delay in moral development.

C. Impaired parent-child relationship.

D. Inconsistent parental discipline strategies.

8. The nurse is caring for a five-year-old child who is in the terminal stages of acute leukemia. The child refuses to go to sleep and is afraid that his parents will leave. The nurse recognizes that the child suspects he is dying and is afraid. Which of the following questions about death is most likely to be made by a five-year-old child?

A. "Why do children die if they're not old?"

B. "What will my friends do when I die?"

C. "What does it feel like when you die?"

D. "Who will take care of me when I die?"

9. The parents of an eight-year-old child bring the child into the clinic for a school physical. The nurse makes all of the following assessments. Which assessment finding is an area of concern and needs further investigation?

A. Has lost three deciduous teeth and has the central and lateral incisors.

B. Has many evening rituals and resists going to bed at night.

C. Complains of a stomach ache on test days at school.

D. Refers to self as being too dumb and too small during the exam.

10. The nurse is performing a neurologic assessment on an eight-year-old child. As part of this neurologic assessment the nurse is assessing how the child thinks. Which of the following abilities best illustrates that the child is developing concrete operational thought?

A.Tells time in terms of after breakfast and before lunch.

B. Describes a ball as both red and round.

C. Able to make change from a dollar bill.

D. Able to substitute letters for numbers in simple problems.

Answers and Rationale:

1. Correct A

Rationale: The palmar grasp is present at birth. The palmar grasp lessens by age three months and is no longer reflexive. The infant is able to close hand voluntarily.

2. Correct A

Rationale: Infant cereal is generally introduced first because of its high iron content. The infant is able to accept spoon feeding at around four to five months when the tongue thrust or extrusion reflex fades.

3. Correct A

Rationale: By four to six months, head control is well established. There should be no head lag when infant is pulled to a sitting position by the age of six months.

4. Correct D

Rationale: The child has great curiosity and has the mobility to explore. Toddlers need to be supervised in play areas. Play areas with soft ground cover and safe equipment need to be selected.

5. Correct D

Rationale: The best approach toward extinguishing attention-seeking behavior is to ignore it as long as the behavior is not inflicting injury.

6. Correct A

Rationale: This behavior indicates a delay in language and speech development. The child may not be able to hear. The child should have a vocabulary of about 900 words and use complete sentences of three to four words.

7. Correct A

Rationale: Imaginary friends are a normal part of development for many preschool children. These imaginary friends often have many faults. The child plays the role of the parent with the imaginary friend. This becomes a way of assuming control and authority in a safe situation.

8. Correct D

Rationale: The greatest fear of preschool children is being left alone and abandoned. Preschool children still think as though they are alive and need to be taken care of.

9. Correct D

Rationale: The school-age years are very important in the development of a healthy self-esteem. These statements by the eight-year-old child indicate a risk for development of a sense of inferiority and need further assessment.

10. Correct C

Rationale: This ability illustrates the concept of conservation, which is one of the major cognitive tasks of school-age children.

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Respiratory Failure

RESPIRATORY FAILURE

Respiratory failure may be divided into two broad categories: hypoxemic (type 1) and hypercapnic (type 2). Hypoxemic respiratory failure is defined as a partial pressure of oxygen in arterial blood (PaO2) of less than 55 mm Hg when the fraction of inspired oxygen (FIO2) is 0.60 or more. Hypercapnic respiratory failure is defined as a partial pressure of carbon dioxide in arterial blood (PaCO2) of more than 45 mm Hg. Disorders that initially cause hypoxemia may be complicated by respiratory pump failure and hypercapnia . Conversely, diseases that produce respiratory pump failure are frequently complicated by hypoxemia resulting from secondary pulmonary parenchymal processes (e.g., pneumonia) or vascular disorders (e.g., pulmonary embolism).

Hypoxemia

Hypoxemia may be broadly divided into four major categories.

1. Hypoventilation and low FIO2
2. Diffusion limitation
3. Ventilation/Perfusion (V/Qÿ) mismatch
4. Shunt

Common Causes of Hypoxemia and Hypercapnia

1. Hypoxemia

• Pneumonia
• Acute respiratory distress syndrome (ARDS)
• Pulmonary embolism
• Congestive heart failure (CHF)

2. Hypercapnia

• Muscle weakness
• Factors that increase CO2 production (e.g., fever, sepsis, trauma)
• Airway obstruction

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14 Principle of Sterility

1. Only sterile items are used within the sterile field.

2. Gowns are considered sterile only from the waist to shoulder level in front and the sleeves.

3. Tables are sterile only at table level.

4. Persons who are sterile touches only sterile items or areas.

5. Unsterile person avoid reaching over a sterile field; persons avoid leaning over an unsterile area.

6. Edges at anything that encloses sterile contents are considered unsterile.

7. Sterile field created close a possible at time at use.

8. Sterile areas are continuously kept in view.

9. Sterile persons keep well within the sterile area.

10. Sterile persons keep contact with sterile area to minimum.

11. Unsterile persons avoid sterile areas.

12. Destruction at integrity at microbial barrier result in contamination.

13. Microorganism must be kept to an irreducible minimum.

14. There should be no compromises with sterility.

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Effects of Second Hand Smoking

As if the growing number of smoking bans in restaurants, airplanes and other public places isn't sending a strong enough message, researchers now have the first biological data confirming the health hazards of secondhand smoke.

Scientists led by Dr. Ronald Crystal at Weill Cornell Medical College documented changes in genetic activity among nonsmokers triggered by exposure to secondhand cigarette smoke. Public-health bans on smoking have been fueled by strong population-based data that links exposure to secondhand cigarette smoke and a higher incidence of lung diseases such as emphysema and even lung cancer, but do not establish a biological cause for the correlation. Now, for the first time, researchers can point to one possible cause: the passive recipient's genes are actually being affected. (See a new recipe for longevity that says no to smoking.)

Crystal's team devised a study in which 121 volunteers — some of whom smoked and some of whom had never smoked — agreed to have samples of their airway cells studied for genetic activity. The subjects also provided urine so the researchers could measure the amount of nicotine and its metabolites, like cotinine, for an objective record of their exposure to cigarette smoke.

Airway cells that line the bronchus, from the trachea all the way to the tiny alveoli deep in the lungs, are the first cells that confront cigarette smoke, whether it is inhaled directly from a cigarette or secondhand from the environment. Crystal's group hypothesized that any deterioration in lung function associated with cancer or chronic obstructive pulmonary disease, including emphysema and bronchitis, in which the lungs lose their ability to take in air, would begin with these cells. (See TIME's guide for good health at every age.)

And indeed, that's what he and his team found. The researchers removed airway cells from the volunteers using a bronchoscope and tested all 25,000 identified human genes in them to determine which ones were active — either turned on or off — in response to cigarettes. They narrowed the search to 372 genes that were active among the smokers but not in the cells of the nonsmokers. Based on the level of nicotine in the urine, the scientists also divided the volunteers into three groups: smokers, who showed the highest level of the tobacco metabolites; nonsmokers, who showed none of these compounds and a low-exposure group who fell in between. Comparing the 372 genes among these three groups, they found that the low-exposure group shared 34% of the same active genes with nonsmokers and 11% of the same gene activity with smokers. The low-exposure group included both nonsmokers who have never lit up as well as those who admitted to smoking only occasionally.

The results suggest that the genetic changes among the low-exposure volunteers, some of whose exposure is exclusively secondhand, mimicked those of smokers and represent the first molecular steps toward later lung disease. The study did not follow the subjects long enough to document what effect the genetic changes may actually have on the lung tissue, but Crystal says those studies are forthcoming.

"What is interesting to me is how sensitive the lung cells are to any cigarette smoke," he says. "It doesn't matter if you are walking into a cocktail party where other people are smoking or if you smoke one cigarette a week. No matter what level of exposure you have, your lung cells know it and they are responding. It's sort of like canaries in the coal mine — they are crying out and saying, 'I'm changing here, I'm changing the genes that I turn on and off in response to this environmental stress.'" (Read about Bavaria's ban on cigarettes at Oktoberfest.)

It's not clear how permanent these genetic changes are, but previous data suggests that, at least in smokers, some of the alterations may be irreversible. Smokers experience a decline in lung function that is accelerated compared with nonsmokers, and even if they kick the habit, they can never achieve the same level of function as those who never lit up. If the genetic results are confirmed, says Crystal, they may help doctors to identify those whose genetic makeup put them at higher risk of developing lung disease when exposed to cigarettes, and potentially steer them toward drugs that can help them suppress the dangerous effects of nicotine on their cells.

In the meantime, the latest findings should reinforce public-health messages about the dangers of cigarette smoke, even if it is secondhand, says Dr. Norman Edelman, chief medical officer of the American Lung Association. "When you look at the biology, there is no safe level of exposure to tobacco smoke," he says. "This [study] adds an important piece of evidence that inhaling secondhand smoke is deleterious and does things to the airway that are not good."

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SERIES 1: FORENSIC NURSING SEMINAR

GLOBAL LEARNING INNOVATIONS invites all Registered and Student Nurses to:


FORENSIC NURSING SEMINAR SERIES 1

(PRC CPE Provider : Council of Nursing Accreditation Number 2009-026)

A Forensic nurse is a nurse with specialized training in forensic evidence collection, criminal procedures, legal testimony expertise, and more. The Forensic nurse becomes that liason between the medical profession and that of the criminal justice system. When you combine the medical training of a nurse, with the investigative prowess of police detectives and the legal training of a lawyer, you have created a formidable enemy for criminals.


When: JANUARY 16, 2011
Where: SM Cinema, NORTH EDSA Quezon City
Time: 10:00 AM- 2:00 PM

Plenary Discussion:

- Death Examination and Autopsy
- Investigation and Documentation
- Care of the Sexually abused patients


Resource Speaker:
PCI Jericho Angelito Q. Cordero, DPSP, MD, RN

- Pathologist/Medico Legal Officer/DNA Analyst/Forensic Nursing Advocate
- Deputy Chief,DNA Laboratory-PNP Crime Laboratory
- Camp Rafael Crame,Quezon City
- Pathologist,East Avenue Medical Center
- Professor-Legal Medicine, University of the East

Reg Fee: 600php only

Inclusive of 3 Certificates with CPE Units, CD ROM hand out, breaktime refreshment


Note: If you can invite 15 persons (Nurse, BSN Graduates or Students), you are FREE on the Seminar Please refer them to me accordingly so I could note that they are your friends or classmates.

* You need to text me if you want reservations to include you on our headcount for seats, food and certificates. This is on site payment just look for me on the seminar day (Xomai)

For reservations/registrations and inquiries:

Globe - 09278490507/ 09051657926
Smart - 09301832876
Sun - 09334622474

Look for Xomai, RN

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PNA Convention 2011 goes to CEBU

PNA 2011 Convention in CEBU!!!

The PNA 2011 National Convention will be held in CEBU CITY on October 25-28, 2011 at Water Front hotel and casino, Lahug Cebu City!

Book your tickets early!

Registration Fee:
P2,800.00 paid before November 30, 2010
P3,300.00 paid before December 31, 2010
P3,800.00 paid before January 31, 2011

Payments can be made thru bank account (BDO Fuente Branch SA:2310220937) and immediately fax the deposit slip to (032) 254-7454 before the specified deadline.

There is a reservation fee of P200.00 (non-refundable and non-deductible), you will have the chance to win Major! Major! Prizes!!

One Grand Prize Winner
Totally FREE with a side trip to Bohol (Including 3-day accommodation, round-trip tickets, and 100% reimbursement of Registration Fee)

4 Major Prizes
1. Free 1 day tour to Bohol Island Tourist Spots
2. Free Round Trip Airfare courtesy of Cebu pacific (Direct Flights only)
3. Free-3 day Hotel Room Accommodations
4. 100% Registration Fee Reimbursement

3 Minor prizes of 50% Registration Reimbursement

The raffle draw will be on the Valentine’s day (Feb. 14, 2011)


For more info please call the:

PNA-cebu chapter, Inc.
Telefax no. (032) 254-7454
Cell No. 09328479479
Email: PNACEBU@ymail.com
Facebook: http://www.facebook.com/profile.php?id=100001588963953&v=wall

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2011 PNA Regular Membership Renewal, Life Members and Other Services. [Zamboang City Chapter]

The Philippine Nurses Association Zamboanga City Chapter is now accepting payments for 2011 PNA Regular Membership Renewal. The regular membership costs PhP 400.00. The breakdowns are as follows:

Chapter Share P 103.50
National Share P 103.50
Regional Share P 23.00
Mutual Fund P 10.00
ICN Annual Dues P 70.00
PJN Magazine P 70.00
Building Fund P 10.00
TOTAL P 400.00

Benefits of being an Active PNA- Zamboanga City Chapter Member:
1. Access to organizational meetings, continuing professional education (CPE) and other PNA-sponsored activities and enjoy great discounts ;
2. Professional advice or assistance on matters related to practice of the nursing profession;
3. Subscription to Philippine Journal of Nursing and the Official Regional Publication- the Innervations!
4. Mutual Aid in case of member’s death and financial assistance in case when members are seriously ill;
5. Legal advice on ethico-moral concerns related to nursing practice
6. Opportunity (If qualified) for local and international scholarship, nursing award or travel grants;
7. Access to PNA auditorium, library and dormitory facilities (if you are in manila)
8. Professional guidance on matters related to overseas work.



Payment starts on Tuesday, November 30, 2010 on the following Payment Centers and Officers.

Ateneo de Zamboanga University, just look for Ms. Grace Ann Lagura and Lucibelle Enriquez from 3:00 pm to 5:00 pm (Mon to Sat)

Zamboanga City Medical Center, Just look for Angelo C. Cawasa, Operating Room Theatres.

Western Mindanao State University, and Look for Gov. Florence Alcazar, 3/F Research building, Side of College of Law.

RN International Review Center, Blanco Building, In front City Hall.



For Life membership:

You need to be a Regular member for three (3) consecutive years and payment is based on the following age schemes.

AGE PAYMENT
70 = 5,600
69 = 5,800
68 = 6,000
67 = 6,200
66 = 6,400
65 = 6,600
64 = 6,800
63 = 7,000
62 = 7,200
61 = 7,400
60 = 7,600
59 = 7,800
58 = 8,000
57 = 8,200
56 = 8,400
55 = 8,600
54 = 8,800
53 = 9,000
52 = 9,200
51 = 9,400
50 = 9,600
49 = 9,800
48 = 10,000
47 = 10,200
46 = 10,400
45 = 10,600
44 = 10,800
43 = 11,000
42 = 11,200
41 = 11,400
40 = 11,600
39 = 11,800
38 = 12,000
37 = 12,200
36 = 12,400
35 = 12,600
34 = 12,800
33 = 13,000
32 = 13,200
31 = 13,400
30 = 13,600
29 = 13,800
28 = 14,000
27 = 14,200
26 = 14,400
25 = 14,600
24 = 14,800
23 = 15,000

For those interested to become a life member of the PNA, you may contact the PNA-ZC President, Mr. Angelo C. Cawasa for the life membership forms.



OTHER SERVICES: PNA Membership Certification

This certificate serves as an important requirement for international opportunities like SRO, immigration and other legal purposes. In order to secure this document, a member should request it thru the PNA-Secretary and pay PhP100.00. An official receipt will be given and should be presented by the member in order to claim the certificate after 3 working days.

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NLEX December 2010 Tragedy

I was affected emotionally by what was happened especially i'm also a nursing graduate who took the board exam... it was very tragic, especially on their families. Right now, the best that i can do that i will know will help is to pray for their souls and for the good of their families. Rest in Peace.

SOURCE: http://http://www.youtube.com/user/ramver

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AIDS Is A Chronic, Life-Threatening Condition Caused By The Human Immunodeficiency Virus (HIV). By Damaging Your Immune System, HIV Interferes With Your Body's Ability To Fight Off Viruses, Bacteria And Fungi That Cause Disease. HIV Makes You More Susceptible To Certain Types Of Cancers And To Infections Your Body Would Normally Resist, Such As Pneumonia And Meningitis. The Virus And The Infection Itself Are Known As HIV. "Acquired Immunodeficiency Syndrome (AIDS)" Is The Name Given To The Later Stages Of An HIV Infection.

An Estimated 39.5 Million People Have HIV Worldwide. And Though The Spread Of The Virus Has Slowed In Some Countries, It Has Escalated Or Remained Unchanged In Others. The Best Hope For Stemming The Spread Of HIV Lies In Prevention, Treatment And Education.

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Crime Scene Investigation (CSI) For Health Care Providers

GSN-INTERNATIONAL SKILLS ENHANCEMENT AND EDUCATION CENTER (GSN-ISEEC):


Crime Scene Investigation (CSI) For Health Care Providers
* Emergency Global Trends in Forensics
...* The Forensic Nurses Obligation to Society:
* Ethical, Legal and Sociocultural Concepts.

*PRC Accredited CPE provider with no. 2009-023‌

Time and Location:

Saturday, January 15, 2011 · 1:00pm - 5:00pm @ GSN ISEEC Office: West Avenue, QC

Topics:

>Forensic nursing is a relatively new medical practice that combines elements of law enforcement with health care.

>Forensic nurse examiners are gaining recognition in the court system as reliable sources of evidence, which in-turn leads to higher conviction rates and fewer crime scene errors.

Inclusive of handouts, snacks and 2 certificates with cpe units.

LIMITED SLOTS ONLY!!

Note: If you can invite 15 persons (Nurse, BSN Graduates or Students), you are FREE on the Seminar Please refer them to me accordingly so i could note that they are your friends or classmates.

* You need to text me if you want reservations to include you on our headcount for seats, food and certificates (Limited Slots only).

*We also offer Basic Life Support with Automated External Defibrillator (AED) Training, Standard First Aid, Comprehensive ECG Training, Comprehensive Wound Management and Advanced Cardiac life Support Training

For more details/reservation contact: 09994386376/09335218158/09158382870 look for Ms. Lethz

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1st NURSE FUN RUN Para sa Kinabukasan

STOP MAKING NEW NURSES PAY HOSPITAL FEES!

Join the FIRST and BIGGESTNURSE FUN RUN Para sa Kinabukasan ng mga NARS! December 5, 2010, CCP Complex, Manila

The event aims to:

1. Promote good health and wellness through a fun activity among nurses (students, graduates, licensed nurses)

2. Foster camaraderie and the spirit of helping each other in the quest for good opportunities in the nursing career

3. Raise awareness on the “challenges” facing nurses in the country:

- Not enough jobs for thousands of registered nurses (approximately 300,000 unemployed licensed nurses)

- The volunteering and unpaid on-the-job training for nurses where instead of being paid for work, they instead pay hospitals to gain experience

- Low salaries of nurses.

Created By
Rachell Allen Reviewers USA, Ez Ielts, Nursefun Run

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PSYCHIATRIC NURSING SEMINAR SERIES 1: EVIDENCED - BASED ASSESSMENT PERSONALITY AND PERSONALITY DISORDERS

GSN-INTERNATIONAL SKILLS ENHANCEMENT AND EDUCATION CENTER (GSN-ISEEC):

PSYCHIATRIC NURSING SEMINAR SERIES 1: EVIDENCED - BASED ASSESSMENT PERSONALITY AND PERSONALITY DISORDERS.

*PRC Accredited CPE provider with no. 2009-023‌
...

When: December 5, 2010 (1pm-5pm)

Topics:

*Psychiatric nursing or mental health nursing is the specialty of nursing that cares for people of all ages with mental illness or mental distress, such as schizophrenia, bipolar disorder, psychosis, depression or dementia.

*A personality disorder is basically a set of traits that combine to negatively affect your life. They have a wide range of causes and some are easier to treat than others.

Fee: inclusive of handouts, snacks and certificate with cpe units.

LIMITED SLOTS ONLY!!

Note: If you can invite 15 persons (Nurse, BSN Graduates or Students), you are FREE on the Seminar Please refer them to me accordingly so i could note that they are your friends or classmates.

* You need to text me if you want reservations to include you on our headcount for seats, handouts, snacks and certificate
(Limited Slots only).

For reservations/registrations and inquiries: 09994386376/09335218158/09158382870 look for MS. Lethz

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EMERGENCY NURSING SEMINAR

EMERGENCY NURSING SEMINAR

(PRC CPE Provider : Council of Nursing Accreditation #2009-026)

When: NOVEMBER 28, 2010
Where: SM Cinema, MEGAMALL , Ortigas, Pasig City
Time: 10:00 AM - 2:00 PM

Resource Speaker: Mr. Melvin D. Miranda, RN
- Reviewer and Lecturer - Local Board Exam (SRG)
- Taking up Masters Degree in Nursing (MAN)
- Clinical Coordinator
- Have Mastery in Critical Care and Emergency and Medical Surgical Nursing

Reg Fee: 600php only
Inclusive of 3 Certificates , CD ROM hand out, breaktime refreshment

LIMITED SLOTS ONLY!

Note: If you can invite 15 persons (Nurses, BSN Graduates or Students), you are FREE on the Seminar Please refer them to me accordingly so i could note that they are your friends or classmates.

* You need to text me if you want reservations to include you on our headcount for seats, food and certificates. This is on site payment just look for me on the seminar day (Xomai)

For reservations/registrations and inquiries:
Globe - 09051657926/ 09278490507
Smart - 09301832876
Sun - 09334622474

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7 Worst food declared by the "World Health Organization" are in Philippines

To all Filipinos you should be aware of this food which contributes to a high dose of calories!

1. French Fries - Yeah like fries? Guess what this is the number one cause of heart diseases.

2. Ice Cream - Its hot I like to eat lots of ice cream, Oh my I got fat.

3. Doughnuts! - I love those sugar filled, cream bursting, mouth watering doughnuts + with a hot choco. Sweet!

4. Burgers - I'm on a diet I think I'll just eat burger in every meal time. (This is so wrong)

5. Iced Tea - I will pair my food with ice tea. I don't believe it can harm my kidney? could it?

6. Instant Noodles/Canton - Oh I really like eating every morning, snack, afternoon and dinner.

7. Sweetened Pork - I so like sweets why not get the pork sweeten.


Now you know. Try to limit consumption!

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TUBERCULOSIS NURSING SEMINAR

(PRC CPE Provider : Council of Nursing Accreditation # 2009-026)

When: OCTOBER 17 - Sunday
Where: SM MEGAMALL
Time: 10:00 AM- 2:00 PM

Plenary Discussion:

- TUBERCULOSIS: A GLOBAL PERSPECTIVE
- TREATMENT AND MANAGEMENT UPDATES
- NURSING IN TUBERCULOSIS CONTROL SPECIAL CONCERNS


Resource Speaker: Mr. WINSTON A. PALASI, MD, MPH, RN

- Director Field Operations Division Philippine Tuberculosis Society, Inc.
- Operations Manager, PTSI-TB LINC (USAID Project).


Reg Fee: 600php only
Inclusive of 3 Certificates with CPE Units, CD ROM hand out, breaktime refreshment

LIMITED SLOTS ONLY

Note: If you can invite 15 persons (Nurse, BSN Graduates or Students), you are FREE on the Seminar Please refer them to me accordingly so i could note that they are your friends or classmates.

* You need to text me if you want reservations to include you on our headcount for seats, food and certificates (Limited Slots only). This is on site payment just look for me on the seminar day (Xomai)


For reservations/registrations and inquiries:
Globe - 09153787964
Smart - 09301832876
Sun - 09334622474

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JULY 2010 NLEX RESULTS

TOP 10 July 2010 Nursing Board Exam Result

1.RAYAN ABOGADO OLIVA (ATENEO DE NAGA)- 86.80

2.AILEEN ANCANAN AUSTRIA DE LOS SANTOS(STI COLLEGE, INC.)- 86.40

3. ALLYCE JOANA TOLEDO DE LEON (UNIVERSITY OF SANTO TOMAS)- 86.00

ANNA VANESSA ANG GAN (UNIVERSITY OF SANTO TOMAS)- 86.00

4. ALYSSA LEONILA DELA SILVA GUIAM (CENTRO ESCOLAR UNIVERSITY-MANILA 85.80

5.CHARMAINE CAMACHO GAUIRAN (REMEDIOS TRINIDAD ROMUALDEZ MEMORIAL SCHOOL)- 85.60

VIDA THERESA SIBAYAN GUMANGAN (SAINT LOUIS UNIVERSITY)- 85.60

ABIGAIL DIAZ ICASIANO (ARELLANO UNIVERSITY-MANILA)- 85.60

WEENA MARIE BORDEOS LIM (UNIVERSITY OF SANTO TOMAS)- 85.60

JOHN JOSEPH MAYO MONTALBO (FAR EASTERN UNIVERSITY-MANILA)- 85.60

JAN MICHAEL GABIONZA ONG (OUR LADY OF FATIMA UNIVERSITY-VALENZUELA)- 85.60

JOAN DIOQUINO TEJADA (REMEDIOS TRINIDAD ROMUALDEZ MEMORIAL SCHOOL)- 85.60

6. ZYRUS RONN SAMSON BERNASOR (OUR LADY OF FATIMA UNIVERSITY)-VALENZUELA 85.40

ROUCHEL ANNE MAÑEZ BRIONES (UNIVERSITY OF THE PHILIPPINES-MANILA)- 85.40

7. PETER JAMES BONGOLAN ABAD (UNIVERSITY OF THE PHILIPPINES-MANILA)- 85.20

MERJORIE MAY MALICAY ADOLFO CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE)- 85.20

CLARENCE JOY LOZADA CUSTODIO (SAINT JOSEPH COLLEGE-CAVITE CITY)- 85.20

NICO PAULO MANIAGO DIMAL (ANGELES UNIVERSITY FOUNDATION)- 85.20

KRIS RAY ARCELO (DUMAGUIN VELEZ COLLEGE)- 85.20

STELA JOY RAMIREZ ENGADA (WEST VISAYAS STATE UNIVERSITY-LA PAZ)- 85.20

JAN CHRISTIAN GOMEZ FELICIANO (UNIVERSITY OF SANTO TOMAS)- 85.20

JOSE PAOLO JULIAN GALEON TARLAC STATE UNIVERSITY (TARLAC COLLEGE OF TECH.)- 85.20

PAULO KRISTOFFER LUMBA (MACASINAG DE LA SALLE UNIVERSITY-HEALTH SCIENCES INSTITUTE)- 85.20

JOY ANN ACIERTO TAN (NOTRE DAME OF DADIANGAS COLLEGE) 85.20

EMER JOY TAPIC VALE (UNIVERSITY OF BOHOL)- 85.20

8. HANA KIRSTIE SAN MIGUEL ABELLO (UNIVERSITY OF THE PHILIPPINES-MANILA)- 85.00

KEA TENA CAPIO (UNIVERSITY OF SANTO TOMAS)- 85.00

ANA FRANCESCA CABALLERO CENTENO (UNIVERSITY OF SANTO TOMAS)- 85.00

GRACE CECILE WE CO (UNIVERSITY OF THE PHILIPPINES-MANILA)- 85.00

MICHAEL PRINCE NOTORIO DEL ROSARIO (LORMA COLLEGE)- 85.00

ROUELLA CHRISTINA MARTIN FAJARDO (UNIVERSITY OF SANTO TOMAS)- 85.00

JOE MARI ABELLA FLORES CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE)- 85.00

DONNA MAY SISON FRONDA (SAINT JOSEPH COLLEGE-CAVITE CITY)- 85.00

RENAN JAMES SACE LIM (UNIVERSITY OF SANTO TOMAS)- 85.00

ROMINA TAN MANALOTO (OUR LADY OF FATIMA UNIVERSITY-QC)- 85.00

MARIAN SHERYL FLORES MILO (SAINT LOUIS UNIVERSITY)- 85.00

MARIA KRISELDA PEREZ ROSALES (LYCEUM OF THE PHILIPPINES UNIVERSITY-BATANGAS,INC) 85.00

CRISTINA GAN SATIADA (CHINESE GENERAL HOSPITAL COLLEGE OF NURSING & LIBERAL ARTS) 85.00

LAURENCE LESTER GAMBOA TAN (UNIVERSITY OF SANTO TOMAS)- 85.00

ELISE CARA KAW TENG TRINITY UNIVERSITY OF ASIA (TRINITY-QC)- 85.00

MARIE KATHRINA TORRALBA TOJONG (UNIVERSITY OF THE VISAYAS-MANDAUE CITY)- 85.00

JAYLYN GABRILLO VILLAFANIA (SAINT LOUIS UNIVERSITY)- 85.00

9. JAMELA MONTOYA ARCILLA (FAR EASTERN UNIVERSITY-MANILA)- 84.80

CZARINA MYRNELLI MAMORE BUENAFE (NORTHWESTERN UNIVERSITY)- 84.80

ARCEL TIATCO CABIGTING (ANGELES UNIVERSITY FOUNDATION)- 84.80

ELAINE KATRINA SIGALAT CALA (UNIVERSITY OF SANTO TOMAS)- 84.80

JULIE ANN DEL ROSARIO CLARIN (UNIVERSITY OF SANTO TOMAS)- 84.80

ANCEL RIVERA DE GUZMAN (HOLY ANGEL UNIVERSITY)- 84.80

ELEANOR DELOEG DELA PAZ (SAINT LOUIS UNIVERSITY)- 84.80

RIA LEAH OROPESA ESPORLAS (UNIVERSITY OF PERPETUAL HELP SYSTEM DALTA-LAS PIÑAS)- 84.80

ELAINE MEDINA LAPAAN (SAINT LOUIS UNIVERSITY)- 84.80

A NICO NAHAR IDRIS PAJES (ATENEO DE ZAMBOANGA)- 84.80

ANA JESKA SANA PEÑARANDA (WEST VISAYAS STATE UNIVERSITY-LA PAZ)- 84.80

JAN ROLAND CASINTO POMUCENO (NOTRE DAME OF DADIANGAS COLLEGE)- 84.80

ANGELINE VILLAREY REMPILLO (OUR LADY OF GUADALUPE COLLEGES)- 84.80

NICAEL DELA CRUZ SALAZAR (PAMANTASAN NG LUNGSOD NG PASIG)- 84.80

FERIE ANGELICA YVAN SORIANO SILVINO (FAR EASTERN UNIVERSITY-MANILA)- 84.80

IVY BARRETE SUSVILLA CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE)- 84.80

KARA DENEICE SANTOS TUERES (OUR LADY OF FATIMA UNIVERSITY-VALENZUELA)- 84.80

ACE BRIAN SAMANIEGO VERALLO (OUR LADY OF FATIMA UNIVERSITY-VALENZUELA)- 84.80

10. ABEGAEL PANCILES BACOL (MANILA DOCTORS COLLEGE)- 84.60

RAMON CARLO ARPON BARING (CENTRO ESCOLAR UNIVERSITY-MANILA)- 84.60

ROBERT IBEN BARIT (MEDICAL COLLEGE OF NORTHERN PHILIPPINES)- 84.60

LIVIA DEDOROY BARRIESES (RIVERSIDE COLLEGE)- 84.60

MARIA VIRGINIA CINCO CUAYZON (OUR LADY OF FATIMA UNIVERSITY-VALENZUELA)- 84.60

KATHLEEN ANNE PALANCA DE LEON (CHINESE GENERAL HOSPITAL COLLEGE OF NURSING & LIBERAL ARTS)- 84.60

MARK ANTHONY SANTOS DE LUNA (OUR LADY OF FATIMA UNIVERSITY-VALENZUELA)- 84.60

EDWIN SUAREZ DEL ROSARIO II (UNIVERSITY OF SANTO TOMAS)- 84.60

EUNICE PABLICO EMPEÑO (UNIVERSITY OF SANTO TOMAS)- 84.60

GREG ELY CAMBAYA FLORES (OUR LADY OF FATIMA UNIVERSITY-QC)- 84.60

MARCIUS ANTONIUS BALCITA ( GACAYAN UNION CHRISTIAN COLLEGE)- 84.60

APRIL JOY DIANE GARING GALICIA (WESLEYAN UNIVERSITY-PHILIPPINES-CABANATUAN CITY)- 84.60

MARY JOY SARROSA GARBANZOS (UNIVERSITY OF SAINT LA SALLE)- 84.60

ANGELI PALISOC GARCIA TRINITY UNIVERSITY OF ASIA (TRINITY-QC)- 84.60

SARA JANE JAIDE LABBAY (ATENEO DE ZAMBOANGA)- 84.60

MICCA FLORES LAGLEVA (UNIVERSITY OF SANTO TOMAS)- 84.60

RAZEL MAE NACUA LIBOT CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE)- 84.60

ALEXANDRA BASAÑEZ MACALINTAL (ATENEO DE ZAMBOANGA)- 84.60

KRISTINE DE LA CRUZ MACASERO CEBU NORMAL UNIVERSITY (CEBU STATE COLLEGE)- 84.60

CELESTE IMPERIAL MADUEÑO (MANILA DOCTORS COLLEGE)- 84.60

SALLIE RIA DELOS SANTOS (MALAYAN LYCEUM OF THE PHILIPPINES UNIVERSITY)-MANILA 84.60

JAN PAULA ESPIRITU MARTINEZ UNIVERSIDAD DE MANILA (CITY COLL. OF MANILA)- 84.60

KIMBERLY CHAN MENDOZA (SAINT LOUIS UNIVERSITY)- 84.60

MARIE PAZ LACANLALAY NOLASCO (MEDICAL COLLEGE OF NORTHERN PHILIPPINES)- 84.60

ROBELOU LIZANO ONG (FAR EASTERN UNIVERSITY-MANILA)- 84.60

JODELLENE FERNANDEZ PEROCHO (CENTRO ESCOLAR UNIVERSITY-MANILA)- 84.60

CLINTON ROSITA RABADON (BICOL UNIVERSITY-POLANGUI)- 84.60

ERIKA GENINA DAVID RONQUILLO (HOLY ANGEL UNIVERSITY)- 84.60

DIOLIZA MONTENEGRO SACIL UNIVERSIDAD DE SANTA ISABEL (COL DE STA ISABEL)- 84.60

KATHERINE MEJIA VIACRUSIS TRINITY UNIVERSITY OF ASIA (TRINITY-QC)- 84.60

and others...
NURS0710se225.

July 2010 NLE Top Performing Schools

July 2010 NLE Top Performing Schools Cool Buster

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SENSORY FUNCTION, TESTING STRETCH OR DEEP TENDON REFLEXES

Sensory Function

>>Sensation is tested by evaluating the patient’s ability to perceive a light touch, superficial pain (pin-prick), differences in temperature, vibration, position sense and motion. If any abnormality is found, it is important to identify the area of deficit clearly and find the point where the abnormal sensation becomes normal again. This point is referred to as a sensory level.

>>Touch the patient in various areas with cotton (light touch) and with the tip of a pin (pin-prick)

>>Typically begin with the face and move down the body, noting any asymmetry between the right and left sides.


Sensory Function: Stereognosis
-Test the person’s ability to recognize objects by feeling their forms, sizes and weights.
-With eyes closed, placed a familiar object (paper clip, key, coin, cotton ball, or pencil) in the person’s hand and ask the person to identify it.
-Normally, a person will explore it with the fingers and correctly name it.
-Testing the left hand assesses right parietal lobe functioning.
-Astereognosis – inability to identify object correctly. Occurs in sensory cortex lesions e.g. stroke

Sensory Function: Graphestesia

-The ability to “read” a number by having it traced on the skin.
-With the person’s eyes closed, use a blunt instrument to trace a single digit number or a letter on the palm.
-Ask the person to tell you what it is.
-

Inability to distinguish number occurs with lesions of the sensory cortex

Testing Stretch or deep Tendon reflexes

-Evaluation of deep tendon reflexes (DTRs) reveals the intactness of the spinal reflex arc at specific spinal levels as well as the normal override on the reflex of the higher cortical levels.
-DTRs are usually tested by tapping on a tendon with fingers or a reflex hammer. This causes a stretching of certain muscles and results in contraction. When damage occurs to higher centers (upper motor neurons), the spinal reflex arc is uninhibited and the DTRs are hyperactive.

Grading Scale – Reflex (4 Point Scale)-Reflexes are graded on a scale of 0 to 4.

-4+ Very brisk, hyperactive with clonus, indicative of disease
-3+ Brisker than average, may indicate disease
-2+ Average, normal-1+ Diminished, low normal
-0 No response

Definition of terms:

Clonus – is a set of short jerking contractions of the same muscle, is a repeated reflex muscular movements. A hyperactive reflex with sustained clonus (lasting as long as the stretch is held) occurs with upper motor neuron disease.
Hyperreflexia – is the exaggerated reflex seen when the monosynaptic reflex arc is released from the influence of higher cortical levels. This occurs with upper motor neuron lesions. e.g. stroke
Hyporeflexia – which is the absence of a reflex, is a lower motor neuron problem. It occurs with interruption of sensory afferents or destruction of motor efferents and anterior horn cells e.g. spinal cord injury

Dermatomes
-A circumscribed skin area that is supplied mainly from one spinal cord segment through a particular spinal nerve.
-The dermatomes overlap, which is a form of biologic insurance. That is, if one nerve is severed, most of the sensations can be transmitted by one above and the one below.

Dermatomes Landmarks
-The thumb, middle finger and fifth finger are each in the dermatomes of C6, C7 and C8.
-The nipple is at the level of T4.
-The umbilicus is at the level of T10.
-The groin is in the region of L1.

Biceps Reflex (C5 to C6)

-Support the person’s

forearm on yours; this position relaxes, as well as partially flexes, the person’s arm.
-Place your thumb

on the biceps tendon and strike a blow on your thumb.
-You can feel as well as see the normal response, which is contraction of the biceps muscle and flexion of the forearm.

Triceps reflex (C7 to C8)


-Tell the person to let the arm “just go dead” as you suspend it by holding the upper arm. Strike the triceps tendon directly just above the elbow.
-The normal response is extension of the forearm.
-Alternately, hold the person’s wrist across the chest to flex the arm at the elbow, and tap the tendon.

Brachioradialis reflex (C5 to C6)


-Hold the person’s thumbs to suspend the forearms in relaxation.
-Strike the forearm directly, about 2 to 3 cm above the radial styloid process.
-The normal response is flexion and supination of the forearm.

Quadriceps reflex “Knee jerk” (L2 to L4)


-Let the lower legs dangle freely the knee and stretch the tendons.
-Strike the tendon directly just below the patella.
-Extension of the lower leg is the expected response.
-For the person in the supine position, use your own arm as a lever to support the weight of one leg against the other leg.
-This maneuver also flexes the knee.

Achilles reflex “Ankle jerk” (L5 to S2)

-Position the person with the kn

ee flexed and the hip externally rotated.
-Hold the foot in dorsiflexio

n, and strike the Achilles tendon directly.
-Feel the normal response as the foot plantar flexes against your hand.
-For the person in the supine position, flex one knee and support that lower leg against the other leg so that it falls “open.”
-Dorsiflex the foot and tap the tendon.

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Somatoform Disorders

Disorders that involve physical symptoms

Conversion Disorders - anxiety converted into a physical symptom (a là Freud)
Hypochondriasis - normal sensations interpretedas symptoms of scary sicknesses

Somatization is the transference of mental experiences and states into bodily symptoms.
Somatoform disorders are the presence of physical symptoms that suggest a medical condition without a demonstrable organic basis to account fully for them.

☺The three central features of somatoform disorders:

>Physical complaints suggest major medical illness but have no demonstrable organic basis
>Psychological factors and conflicts seem important in initiating, exacerbating, and maintaining the symptoms
> Symptoms or magnified health concerns are not under the client’s conscious control

☺Five specific somatoform disorders:

>Somatization disorder: multiple physical symptoms; combination of pain, GI, sexual, and pseudoneurologic symptoms
>Conversion disorder: unexplained deficits in sensory or motor function associated with psychological factors; attitude of la belle indifference (lack of concern or distress)
>Pain disorder: has primary physical symptoms, pain unrelieved by analgesics; psychological factors influence onset, severity, exacerbation, and maintenance
>Hypochondriasis: preoccupation with the fear that one has a serious disease (disease conviction) or will get a serious disease (disease phobia)
>Body dysmorphic disorder: preoccupation with imagined or exaggerated defect in physical appearance

Ω Onset and Clinical Course
* Symptoms usually onset in adolescence or early adulthood
* All the somatoform disorders are either chronic or recurrent
* Clients will go from one physician or clinic to another, or they may see multiple providers at once in an effort to obtain relief of symptoms

Related Disorders
>> Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms; it is motivated by external incentives such as avoiding work, evading criminal prosecution, obtaining financial compensation, or obtaining drugs

>> Factitious disorder occurs when a person intentionally produces or feigns physical or psychological symptoms solely to gain attention
(In malingering and factitious disorders, people willfully control the symptoms. In somatoform disorders, clients do not voluntarily control their physical symptoms.)
>> Munchausen by proxy occurs when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or to be a “hero” for saving the victim

ΩCultural Considerations
>> Somatization disorder is rare in men in the U.S. but more common in Greece and Puerto Rico
>> Men in India often have that, which is a hypochondriacal concern about loss of semen
>> Koro occurs in Southeast Asia and may be related to body dysmorphic disorder
>> Falling-out episodes, found in the southern U.S. and the Caribbean islands, are characterized by a sudden collapse
>> Hwa-byung is a Korean folk syndrome attributed to the suppression of anger and includes insomnia, fatigue, panic, indigestion, and generalized aches and pains
>> Shenjing shuariuo occurs in China and includes multiple symptoms

☺Etiology
1. Psychosocial theories:
* Unconsciously expressing internalized stress through physical symptoms (somatization)
* Primary gains are achieved when the direct external benefits of being sick provide relief of anxiety, conflict, or distress
* Secondary gains are obtained when the person receives internal or personal benefits from others because one is sick

2. Biologic theories:
* Familial tendencies
* Differences in the way body stimuli are regulated and interpreted

∞Treatment∞
 Treatment is focused on managing symptoms, improving quality of life, and improving coping skills
 Antidepressants are sometimes used for accompanying depression
 Referral to a pain clinic is helpful in pain disorder
 Involvement in therapy groups to improve coping and express emotions verbally has shown some benefit

Application of the Nursing Process

Assessment
 Investigate the client’s physical health status to thoroughly rule out underlying pathology requiring treatment
 History: client likely provides a detailed medical history; quite distressed about his or her health status (except the client with conversion disorder, who displays la belle indifference)
 General appearance and motor behavior: normal
 Mood and affect: may be labile, shifting from sad and depressed (describing physical ailments) to bright and excited (describing trips to health care providers)
 Thought processes and content: intact; content is about physical symptoms; vague in their description but use colorful, exaggerated terms
 Sensorium and intellectual processes: alert and oriented
 Judgment and insight: little or no insight; judgment may be affected by exaggerated responses to physical health concerns
 Self-concept: low self-esteem, lack of confidence, difficulty coping
 Roles and relationships: difficulty fulfilling family roles; few friends or social activities; may report lack of family support
 Physiologic and self-care concerns: legitimate health concerns may include disturbed sleep patterns, poor nutrition, lack of exercise, overuse of prescription medications

Data Analysis
Nursing diagnoses include:
 Ineffective Coping
 Ineffective Denial
 Impaired Social Interaction
 Anxiety
 Disturbed Sleep Pattern
 Fatigue
 Pain

Outcomes
The client will:
 Identify the relationship between stress and physical symptoms
 Verbally express emotional feelings
 Follow an established daily routine
 Demonstrate alternative ways to deal with stress, anxiety, and other feelings
 Demonstrate healthier behavior regarding rest, activity, and nutrition

Intervention
 Providing health teaching
 Assisting client to express emotions
 Teaching coping strategies
 Emotion-focused coping strategies (progressive relaxation, deep breathing, guided imagery, and distractions)
 Problem-focused coping strategies (learning problem-solving methods, applying the process to identified problems, and role-playing interactions with others)
Evaluation
 Is the client making fewer visits to physicians with physical complaints?
 Is the client using less medication and more positive coping techniques?
 Are the client’s functional abilities increased?
 Does the client have improved family and social relationships?

Community-Based Care

 Make appropriate referrals, such as a pain clinic for clients with pain disorder
 Provide information about support groups in the community
 Encourage clients to find pleasurable activities or hobbies

Mental Health Promotion

 Assist clients to deal with emotional issues directly
 Assist clients to continue gaining knowledge about themselves and their emotional needs

Self-Awareness Issues

 Deal with feelings of frustration
 Be realistic about small successes
 Validate client’s feelings
 Deal with feeling that client “could do better if he tried”

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Apply Now and GET a chance to WIN an Apple iPAD

*Convergys Philippines*, the BIGGEST & the BEST call center in the country today, is currently hiring candidates for a leading worldwide communications provider in the US. These Customer Service Experts will be housed in the lifestyle & fashion center of Makati, Glorietta 5.

There is an on-going online job fair which started August 13 and will last until September 11. These candidates will have a chance to win an *16gb Apple iPad* by registering

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