tag:blogger.com,1999:blog-87298137140715789392024-02-19T09:59:44.871+08:00Medical and meAnonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.comBlogger13125tag:blogger.com,1999:blog-8729813714071578939.post-33734543642241390982013-05-04T10:18:00.001+08:002013-05-04T10:18:18.203+08:00Accident and Emergency Questions<br />
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-MY" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin;">EMERGENCY QUESTION FROM NCLEX<o:p></o:p></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span lang="EN-MY" style="font-size: 16.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-weight: bold; mso-bidi-theme-font: minor-latin;"><br /></span></div>
<div class="MsoListParagraphCxSpFirst" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">11. </span><b><span lang="EN-MY">A patient arrives at the emergency
department complaining of mid-sternal chest pain. Which of the following
nursing action should take priority?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">A complete history with emphasis on
preceding events. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">An electrocardiogram.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Careful assessment of vital signs.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Chest exam with auscultation.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">22.<span style="font-size: 7pt;"> </span></span><!--[endif]--><b><span lang="EN-MY">Patient has been hospitalized with
pneumonia and is about to be discharged. A nurse provides discharge
instructions to a patient and his family. Which misunderstanding by the family
indicates the need for more detailed information?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">The patient may resume normal home
activities as tolerated but should avoid physical exertion and get adequate
rest.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">The patient should resume a normal
diet with emphasis on nutritious, healthy foods. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">The patient may discontinue the
prescribed course of oral antibiotics once the symptoms have completely
resolved.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">The patient should continue use of the
incentive spirometer to keep airways open and free of secretions.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">33.<span style="font-size: 7pt;"> </span></span><b><span lang="EN-MY">A nurse is caring for an elderly
Vietnamese patient in the terminal stages of lung cancer. Many family members
are in the room around the clock performing unusual rituals and bringing ethnic
foods. Which of the following actions should the nurse take?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">Restrict visiting hours and ask the
family to limit visitors to two at a time. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">Notify visitors with a sign on the
door that the patient is limited to clear fluids only with no solid food
allowed. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">If possible, keep the other bed in the room
unassigned to provide privacy and comfort to the family.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">Contact the physician to report the unusual
rituals and activities.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">44.<span style="font-size: 7pt;"> </span></span><b><span lang="EN-MY">The charge nurse on the cardiac unit
is planning assignments for the day. Which of the following is the most
appropriate assignment for the float nurse that has been reassigned from labor
and delivery?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">A one-week postoperative coronary
bypass patient, who is being evaluated for placement of a pacemaker prior to
discharge. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B. </span><span lang="EN-MY">A suspected myocardial infarction
patient on telemetry, just admitted from the Emergency Department and scheduled
for an angiogram. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">A patient with unstable angina being
closely monitored for pain and medication titration.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">A post-operative valve replacement patient who
was recently admitted to the unit because all surgical beds were filled.<o:p></o:p></span></div>
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<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">55.<span style="font-size: 7pt;"> </span></span><b><span lang="EN-MY">A newly diagnosed 8-year-old child
with type I diabetes mellitus and his mother are receiving diabetes education
prior to discharge. The physician has prescribed Glucagon for emergency use.
The mother asks the purpose of this medication. Which of the following
statements by the nurse is correct?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">Glucagon enhances the effect of insulin in
case the blood sugar remains high one hour after injection.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">Glucagon treats hypoglycemia resulting from
insulin overdose.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">Glucagon treats lipoatrophy from insulin
injections.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">Glucagon prolongs the effect of insulin,
allowing fewer injections.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">66.<span style="font-size: 7pt;"> </span></span><b><span lang="EN-MY">A patient on the cardiac telemetry
unit unexpectedly goes into ventricular fibrillation. The advanced cardiac life
support team prepares to defibrillate. Which of the following choices indicates
the correct placement of the conductive gel pads?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The left clavicle and right lower
sternum.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY"> Right of midline below the bottom rib and the
left shoulder. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY"> The upper and lower halves of the
sternum. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY"> The right side of the sternum just below the
clavicle and left of the precordium.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">77.<span style="font-size: 9.090909004211426px;"> </span></span><b><span lang="EN-MY">The nurse performs an initial
abdominal assessment on a patient newly admitted for abdominal pain. The nurse
hears what she describes as "clicks and gurgles in all four
quadrants" as well as "swishing or buzzing sound heard in one or two
quadrants." Which of the following statements is correct?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">The frequency and intensity of bowel
sounds varies depending on the phase of digestion. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">In the presence of intestinal obstruction,
bowel sounds will be louder and higher pitched.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">A swishing or buzzing sound may represent the
turbulent blood flow of a bruit and is not normal.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;"> </span></span><span lang="EN-MY">All of the above.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">78.<span style="font-size: 7pt;"> </span></span><b><span lang="EN-MY">A patient arrives in the emergency
department and reports splashing concentrated household cleaner in his eye.
Which of the following nursing actions is a priority?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Irrigate the eye repeatedly with
normal saline solution. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Place fluorescein drops in the eye.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Patch the eye.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Test visual acuity.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">99.<span style="font-size: 7pt;"> </span></span><b><span lang="EN-MY">A nurse is caring for a patient who
has had hip replacement. The nurse should be most concerned about which of the
following findings?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Complaints of pain during
repositioning.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Scant bloody discharge on the surgical
dressing. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Complaints of pain following physical
therapy. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Temperature of 101.8 F (38.7 C).<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<span lang="EN-MY">10.<span style="font-size: 7pt;"> </span></span><b><span lang="EN-MY">A child is admitted to the hospital
with an uncontrolled seizure disorder. The admitting physician writes orders
for actions to be taken in the event of a seizure. Which of the following
actions would NOT be included?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Notify the physician.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Restrain the patient's limbs.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Position the patient on his/her side
with the head flexed forward.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Administer rectal diazepam.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">11.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">Emergency department triage is an
important nursing function. A nurse working the evening shift is presented with
four patients at the same time. Which of the following patients should be
assigned the highest priority?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">A patient with low-grade fever,
headache, and myalgias for the past 72 hours.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY"> A patient who is unable to bear weight on the
left foot, with swelling and bruising following a running accident.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY"> A patient with abdominal and chest pain following
a large, spicy meal.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">A child with a one-inch bleeding
laceration on the chin but otherwise well after falling while jumping on his
bed.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">12.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">A patient is admitted to the hospital
with a calcium level of 6.0 mg/dL. Which of the following symptoms would you
NOT expect to see in this patient?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Numbness in hands and feet.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Muscle cramping.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Hypoactive bowel sounds.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Positive Chvostek's sign.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">13.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">A nurse cares for a patient who has a
nasogastric tube attached to low suction because of a suspected bowel
obstruction. Which of the following arterial blood gas results might be
expected in this patient?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">pH 7.52, PCO2 54 mm Hg.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">pH 7.42, PCO2 40 mm Hg.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">pH 7.25, PCO2 25 mm Hg.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">pH 7.38, PCO2 36 mm Hg.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">14.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">A patient is admitted to the hospital
for routine elective surgery. Included in the list of current medications is
Coumadin (warfarin) at a high dose. Concerned about the possible effects of the
drug, particularly in a patient scheduled for surgery, the nurse anticipates
which of the following actions?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Draw a blood sample for prothrombin
(PT) and international normalized ratio (INR) level.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Administer vitamin K. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Draw a blood sample for type and
crossmatch and request blood from the blood bank.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Cancel the surgery after the patient
reports stopping the Coumadin one week previously.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">15.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">The follow lab results are received
for a patient. Which of the following results are abnormal? Note: More than one
answer may be correct.</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Hemoglobin 10.4 g/dL.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Total cholesterol 340 mg/dL.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Total serum protein 7.0 g/dL.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Glycosylated hemoglobin A1C 5.4%.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">16.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">A nurse is performing routine
assessment of an IV site in a patient receiving both IV fluids and medications
through the line. Which of the following would indicate the need for
discontinuation of the IV line as the next nursing action?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The patient complains of pain on
movement.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The area proximal to the insertion
site is reddened, warm, and painful.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The IV solution is infusing too
slowly, particularly when the limb is elevated.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">A hematoma is visible in the area of
the IV insertion site.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">17.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">A hospitalized patient has received
transfusions of 2 units of blood over the past few hours. A nurse enters the
room to find the patient sitting up in bed, dyspneic and uncomfortable. On
assessment, crackles are heard in the bases of both lungs, probably indicating
that the patient is experiencing a complication of transfusion. Which of the
following complications is most likely the cause of the patient's symptoms?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Febrile non-hemolytic reaction.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Allergic transfusion reaction.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Acute hemolytic reaction.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Fluid overload.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">18.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">A patient in labor and delivery has
just received an amniotomy. Which of the following is correct? Note: More than
one answer may be correct.</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Frequent checks for cervical dilation
will be needed after the procedure.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Contractions may rapidly become
stronger and closer together after the procedure.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The FHR (fetal heart rate) will be
followed closely after the procedure due to the possibility of cord
compression.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The procedure is usually painless and
is followed by a gush of amniotic fluid.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">19.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">A nurse is counseling the mother of a
newborn infant with hyperbilirubinemia. Which of the following instructions by
the nurse is NOT correct?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Continue to breastfeed frequently, at
least every 2-4 hours.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Follow up with the infant's physician
within 72 hours of discharge for a recheck of the serum bilirubin and exam.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Watch for signs of dehydration,
including decreased urinary output and changes in skin turgor.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Keep the baby quiet and swaddled, and
place the bassinet in a dimly lit area.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">20.<span style="font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY">A nurse is giving discharge instructions
to the parents of a healthy newborn. Which of the following instructions should
the nurse provide regarding car safety and the trip home from the hospital?</span></b><span lang="EN-MY"><o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The infant should be restrained in an
infant car seat, properly secured in the back seat in a rear-facing position.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The infant should be restrained in an
infant car seat, properly secured in the front passenger seat.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The infant should be restrained in an
infant car seat facing forward or rearward in the back seat.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">For the trip home from the hospital, the
parent may sit in the back seat and hold the newborn.<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 36pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">21.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Rhea, confused and short breath,
is brought to the emergency department by a family member. The medical history
reveals chronic bronchitis and hypertension. To learn more about the current
respiratory problem, the doctor orders a chest x-ray and arterial blood gas
(ABG) analysis. When reviewing the ABG report, the nurses sees many
abbreviations. What does a lowercase “a” in ABG value present?<o:p></o:p></span></b></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Acid-base balance<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">B.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Arterial Blood<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">C.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Arterial oxygen saturation<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">D.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Alveoli<o:p></o:p></span></div>
<div style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div style="margin-left: 36pt; text-align: justify;">
<br /></div>
<div style="margin: 0cm 0cm 0.0001pt 36pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">22.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">An emergency room nurse is assessing a male client who has
sustained a blunt injury to the chest wall. Which of these signs would indicate
the presence of a pneumothorax in this client?</span></b><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A low respiratory rate<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">B.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Diminished breath sounds<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">C.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The presence of a barrel chest<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">D.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A sucking sound at the site of
injury<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify;">
<br /></div>
<div style="margin: 0cm 0cm 0.0001pt 36pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">23.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A black client with asthma seeks <span class="ilad">emergency care</span>
for acute respiratory distress. Because of this client’s dark skin, the nurse
should assess for cyanosis by inspecting the:</span></b><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Lips.<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">B.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Mucous membranes.<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">C.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Nail beds.<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">D.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Earlobes.<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify;">
<br /></div>
<div style="margin: 0cm 0cm 0.0001pt 36pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">24.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><b><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">At 11 p.m., a male client is admitted to the emergency department.
He has a respiratory rate of 44 breaths/minute. He’s anxious, and wheezes are
audible. The client is immediately given oxygen by face mask and methylprednisolone
(Depo-medrol) I.V. At 11:30 p.m., the client’s arterial blood oxygen saturation
is 86% and he’s still wheezing. The nurse should plan to administer:</span></b><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Alprazolam (Xanax).<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">B.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Propranolol (Inderal)<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">C.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Morphine.<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">D.<span style="font-family: 'Times New Roman'; font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY" style="font-family: "Calibri","sans-serif"; font-size: 11.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Albuterol (Proventil).<o:p></o:p></span></div>
<div style="margin: 0cm 0cm 0.0001pt 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY">25.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY">A client is admitted to the emergency
department following an overdose of barbiturates. What should the nurse do
first?<o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Assess and assist ventilation.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Monitor the BP.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Prepare to administer blood products.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Place the client in the trendelenburg
position.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY">26.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY">A male client who is 76 years of age
comes to the emergency department with sudden onset of severe pain in his back,
flank and abdomen. He reports feeling weak and his BP is 68/31 mmhg. Urine
output is absent. Bilateral leg pulses are weak, although bruit and pulsation are
noted at the umbilicus. The nurse should first:<o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Obtain consent for emergency surgery.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Assess leg pulses with a Doppler test.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Palpate the abdomen for presence of a
mass.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Start an IV infusion.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY">27.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY">An alert client is admitted to the
emergency department with a severe laceration of his arm with heavy bleeding.
What action should the nurse take first?<o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Apply a tourniquet above the wound.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Assess pulse and nerve functioning of
the arm.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Cover the wound with a dressing and
apply firm pressure.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Start an IV infusion.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY">28.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY">A small airplane has crashed in a
neighbourhood of 10 houses. One of the victims appears to have a cervical spine
injury. First aid for this victim includes which of the following?<o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Establish an airway with head tilt.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Immobilize the spine.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Logroll the victim to a side-lying
position.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Elevate the feet 6 inches.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY">29.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY">Several clients come to the emergency
department suspected contamination by the Ebola virus. The nurse should do
which of the following? Select all that apply.<o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY"> Call in extra staff to assist with the
possibility more clients with the same condition. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Isolate all the suspected clients in
the emergency department in one area.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Obtain diluted household bleach from
housekeeping services.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Restrict visitors from the emergency
department.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">E.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Request that the emergency department
be closed to other client.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY">30.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY">The nurse in the immediate care clinic
is assessing a client who is 80 years of age and lives with his son’s family.
The client is scald burns on his hands and both foramens (10% first-degree
burns). The nurse should do first:<o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Cleanse the wounds with warm water.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Apply antibiotic cream.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Call for transport to a burn centre.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Cover all the burns with sterile
dressing.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY">31.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY">A client who is 16 years of age is
seen in an emergency department following the rape. The management of a rape
victim should primarily be directed toward:<o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Relieving physical discomfort.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Maintain self-esteem.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Assessing for sources of infection
resulting from the rape.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Teaching the victim how to prevent
future attacks.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18pt; text-align: justify;">
<i><span lang="EN-MY">A nurse who witnesses a motor vehicle
accident stops to provide emergency assistance to the injured motorists.<o:p></o:p></span></i></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY">32.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY">When the nurses assess a victim who
has been thrown from the vehicle, which assessment finding is most suggestive
of the serious head injury?<o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The victim has a bad head injury.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The victim asks the nurse, “What
happened?”<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The victim is hesitant to move.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">The client has clear fluid draining
from the ears.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<i><span lang="EN-MY">The
accidents victim is taken to the emergency department for evaluation.<o:p></o:p></span></i></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpMiddle" style="text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><b><span lang="EN-MY">33.<span style="font-size: 7pt; font-weight: normal;"> </span></span></b><!--[endif]--><b><span lang="EN-MY">While waiting for the physician to
examine the client, how should the nurse position the client?<o:p></o:p></span></b></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">A.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Dorsal recumbent with the legs
elevated.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">B.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Supine with head slightly elevated.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">C.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Flat with neck immobilizer in place.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="margin-left: 72pt; text-align: justify; text-indent: -18pt;">
<!--[if !supportLists]--><span lang="EN-MY">D.<span style="font-size: 7pt;">
</span></span><!--[endif]--><span lang="EN-MY">Right lateral with the neck flexed.<o:p></o:p></span></div>
Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com1tag:blogger.com,1999:blog-8729813714071578939.post-77161655856289808402013-05-04T10:15:00.001+08:002013-05-31T01:56:07.862+08:00Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com0tag:blogger.com,1999:blog-8729813714071578939.post-44291145818373522402013-04-25T23:40:00.001+08:002013-04-25T23:40:20.079+08:00Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com0tag:blogger.com,1999:blog-8729813714071578939.post-41988123186563802812013-03-10T21:11:00.000+08:002015-09-02T10:48:29.411+08:00I am looking for a scholarship on Bachelor of Nursing. Anyone has information about that...???<br />
please contact me ( +6282176543765 ) or comment this post.. Thanks<br />
I appreciate it. =)Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com0tag:blogger.com,1999:blog-8729813714071578939.post-65929796006329565222013-03-06T15:27:00.000+08:002013-03-06T17:02:02.095+08:00TRANSFUSI DARAH <b><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">ISTILAH DALAM TRANSFUSI DARAH:</span></b><br />
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span>
<ol>
<li><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Transfusi =</span></b><span style="line-height: 115%;"> proses pemindahan darah</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Donor = </span></b><span style="line-height: 115%;">orang yang memberikan
sejumlah darah ke orang lain yang membutuhkan</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Resipien = </span></b><span style="line-height: 115%;">orang yang menerima sejumlah
darah dari orang lain</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Donor Universal = </span></b><span style="line-height: 115%;">golongan darah yang bisa memberikan
sejumlah darahnya ke semua golongan darah lain. Golongan darah yang
dimaksud adalah O</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Resipien Universal = </span></b><span style="line-height: 115%;">Golongan darah yang dapat menerima
sejumlah darah dari semua golongan darah lain. Golongan darah yang dimaksud
adalah AB</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Serum = </span></b><span style="line-height: 115%;">plasma tanpa fibrinogen</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Antigen = </span></b><span style="line-height: 115%;">aglutinogen merupakan protein asing
yang akan digumpalkan oleh antibodi / aglutinin</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Antibodi = </span></b><span style="line-height: 115%;">protein plasma yang dapat menggumpalkan
antigen / aglutinin</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Aglutinasi = </span></b><span style="line-height: 115%;">penggumpalan darah akibat
ketidakcocokan antara jenis aglutinogen donor dengan aglutinin resipien</span></span></li>
</ol>
<!--[if !supportLists]--></div>
<div class="MsoNormal" style="text-align: justify;">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
</div>
<div class="MsoNormal" style="text-align: justify;">
<div style="text-align: left;">
<b><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Pengertian Transfusi Darah</span></b></div>
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<ul>
<li style="text-align: left;"><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Transfusi</span></b><span style="line-height: 115%;"> <b>Darah</b> adalah proses
pemindahan <b>darah</b> dari <b>donor</b> yang sehat kepada
penderita (recipient).</span></span></li>
</ul>
</div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--></div>
<div class="MsoNormal" style="text-align: justify;">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
</div>
<div class="MsoNormal" style="text-align: justify;">
<div style="text-align: left;">
<b><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">TUJUAN TRANSFUSI DARAH<o:p></o:p></span></b></div>
</div>
<ol start="1" style="margin-top: 0cm;" type="1">
<li class="MsoNormal" style="mso-list: l3 level1 lfo3; tab-stops: list 36.0pt; text-align: justify;"><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Meningkatkan
volume sirkulasi darah setelah pembedahan, trauma atau perdarahan<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l3 level1 lfo3; tab-stops: list 36.0pt; text-align: justify;"><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Meningkatkan
jumlah sel darah merah dan untuk mempertahankan kadar hemoglobin pada
klien yang mengalami anemia berat.<o:p></o:p></span></li>
<li class="MsoNormal" style="mso-list: l3 level1 lfo3; tab-stops: list 36.0pt; text-align: justify;"><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Memberikan
komponen seluler yang terpilih sebagai terapi pengganti (misal : faktor
pembekuan plasma untuk membantu mengontrol perdarahan pada klien yang
menderita hemofilia)<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="text-align: justify;">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
</div>
<div class="MsoNormal" style="text-align: justify;">
<div style="text-align: left;">
<b><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">INDIKASI TRANSFUSI DARAH<o:p></o:p></span></b></div>
</div>
<div class="MsoNormal" style="margin-left: 36.0pt; mso-list: l2 level1 lfo4; tab-stops: list 36.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span>
<ul>
<li><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Pasien dengan kehilangan darah dalam
jumlah besar (operasi besar, perdarahan postpartum, kecelakaan, luka bakar
hebat, penyakit kekurangan kadar Hb)</span></li>
<li><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Pasien anemia berat,</span></li>
<li><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Kelaian darah bawaan,
pasien yang mengalami penyakit liver ataupun penyakit lainnya yang
mengakibatkan tubuh pasien tidak dapat memproduksi darah atau komponen
darah sebagaimana mestinya.</span></li>
</ul>
<!--[if !supportLists]--></div>
<div class="MsoNormal" style="text-align: justify;">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<div class="MsoNormal">
<div style="text-align: left;">
<b><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Jenis Donor Darah<o:p></o:p></span></b></div>
</div>
<div class="MsoNormal" style="margin-left: 36pt; text-indent: -18pt;">
<div style="text-align: left;">
<!--[if !supportLists]--><span style="font-family: Georgia, Times New Roman, serif;"><span style="font-family: "Wingdings 3"; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: "Wingdings 3"; mso-fareast-font-family: "Wingdings 3";">}<span style="line-height: normal;"> </span></span><!--[endif]--><span style="line-height: 115%;">Ada dua macam <b>donor</b> <b>darah</b> yaitu
:<o:p></o:p></span></span></div>
</div>
<div class="MsoNormal">
</div>
<ol>
<li style="text-align: left;"><span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Donor</span><span style="line-height: 115%;"> keluarga atau </span><span style="line-height: 115%;">Donor</span></b><span style="line-height: 115%;"><b> Pengganti
</b>adalah </span><span style="line-height: 115%;">darah</span><span style="line-height: 115%;"> yang dibutuhkan pasien dicukupi oleh </span><span style="line-height: 115%;">donor</span><span style="line-height: 115%;"> dari
keluarga atau kerabat pasien.</span></span></li>
<li style="text-align: left;"><span style="font-family: Georgia, Times New Roman, serif;"><span style="line-height: 115%;"><b>Donor</b></span><span style="line-height: 115%;"><b> Sukarela</b> adalah </span><span style="line-height: 115%;">orang</span><span style="line-height: 115%;"> yang
memberikan </span><span style="line-height: 115%;">darah</span><span style="line-height: 115%;">, plasma atau komponen </span><span style="line-height: 115%;">darah</span><span style="line-height: 115%;"> lainnya
atas kerelaan mereka sendiri </span><span style="line-height: 115%;">dan</span><span style="line-height: 115%;"> tidak menerima uang atau
bentuk pembayaran lainnya. Motivasi utama mereka adalah membantu penerima </span><span style="line-height: 115%;">darah</span><span style="line-height: 115%;"> yang
tidak mereka kenal </span><span style="line-height: 115%;">dan</span><span style="line-height: 115%;"> tidak untuk menerima sesuatu
keuntungan.</span></span></li>
</ol>
</div>
<div class="MsoNormal" style="text-align: justify;">
<div style="text-align: center;">
<div style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
</div>
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 6.75pt; margin-right: 6.75pt; text-align: center; width: 416px;">
<tbody>
<tr style="height: 30.55pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="background: yellow; border-bottom: solid #DA1F28 2.25pt; border: solid #DA1F28 1.0pt; height: 30.55pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 74.1pt;" valign="top" width="99"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">GOLONGAN</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
<td style="background: yellow; border-bottom: solid #DA1F28 2.25pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: solid #DA1F28 1.0pt; height: 30.55pt; mso-border-left-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 117.4pt;" valign="top" width="157"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">SEL DARAH MERAH</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
<td style="background: yellow; border-bottom: solid #DA1F28 2.25pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: solid #DA1F28 1.0pt; height: 30.55pt; mso-border-left-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 120.5pt;" valign="top" width="161"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">PLASMA</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
</tr>
<tr style="height: 19.2pt; mso-yfti-irow: 1;">
<td style="background: #92D050; border-top: none; border: solid #DA1F28 1.0pt; height: 19.2pt; mso-border-top-alt: solid #DA1F28 2.25pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 74.1pt;" valign="top" width="99"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A<o:p></o:p></span></div>
</td>
<td style="background: #F8E7E8; border-bottom: solid #DA1F28 1.0pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: none; height: 19.2pt; mso-border-left-alt: solid #DA1F28 1.0pt; mso-border-top-alt: solid #DA1F28 2.25pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 117.4pt;" valign="top" width="157"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Antigen A<o:p></o:p></span></div>
</td>
<td style="background: #F8E7E8; border-bottom: solid #DA1F28 1.0pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: none; height: 19.2pt; mso-border-left-alt: solid #DA1F28 1.0pt; mso-border-top-alt: solid #DA1F28 2.25pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 120.5pt;" valign="top" width="161"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Antibodi A<o:p></o:p></span></div>
</td>
</tr>
<tr style="height: 26.7pt; mso-yfti-irow: 2;">
<td style="background: #92D050; border-top: none; border: solid #DA1F28 1.0pt; height: 26.7pt; mso-border-top-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 74.1pt;" valign="top" width="99"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">B<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DA1F28 1.0pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: none; height: 26.7pt; mso-border-left-alt: solid #DA1F28 1.0pt; mso-border-top-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 117.4pt;" valign="top" width="157"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Antigen B<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DA1F28 1.0pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: none; height: 26.7pt; mso-border-left-alt: solid #DA1F28 1.0pt; mso-border-top-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 120.5pt;" valign="top" width="161"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Antibodi B<o:p></o:p></span></div>
</td>
</tr>
<tr style="height: 27.2pt; mso-yfti-irow: 3;">
<td style="background: #92D050; border-top: none; border: solid #DA1F28 1.0pt; height: 27.2pt; mso-border-top-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 74.1pt;" valign="top" width="99"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">AB<o:p></o:p></span></div>
</td>
<td style="background: #F8E7E8; border-bottom: solid #DA1F28 1.0pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: none; height: 27.2pt; mso-border-left-alt: solid #DA1F28 1.0pt; mso-border-top-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 117.4pt;" valign="top" width="157"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Antigen A & B<o:p></o:p></span></div>
</td>
<td style="background: #F8E7E8; border-bottom: solid #DA1F28 1.0pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: none; height: 27.2pt; mso-border-left-alt: solid #DA1F28 1.0pt; mso-border-top-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 120.5pt;" valign="top" width="161"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Tidak ada Antibodi<o:p></o:p></span></div>
</td>
</tr>
<tr style="height: 48.25pt; mso-yfti-irow: 4; mso-yfti-lastrow: yes;">
<td style="background: #92D050; border-top: none; border: solid #DA1F28 1.0pt; height: 48.25pt; mso-border-top-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 74.1pt;" valign="top" width="99"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">O<o:p></o:p></span></div>
</td>
<td style="border-bottom: solid #DA1F28 1.0pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: none; height: 48.25pt; mso-border-left-alt: solid #DA1F28 1.0pt; mso-border-top-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 117.4pt;" valign="top" width="157"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><span lang="IT" style="font-size: 12.0pt; line-height: 115%; mso-ansi-language: IT;">Tidak ada
antigen</span><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
<td style="border-bottom: solid #DA1F28 1.0pt; border-left: none; border-right: solid #DA1F28 1.0pt; border-top: none; height: 48.25pt; mso-border-left-alt: solid #DA1F28 1.0pt; mso-border-top-alt: solid #DA1F28 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 120.5pt;" valign="top" width="161"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><span lang="IT" style="font-size: 12.0pt; line-height: 115%; mso-ansi-language: IT;">Antibodi Anti
A &</span><span style="line-height: 115%;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><span lang="IT" style="font-size: 12.0pt; line-height: 115%; mso-ansi-language: IT;">Anti B</span><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
</tr>
</tbody></table>
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<div class="MsoNormal">
<div style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Dua jenis penggolongan darah yang paling penting, yaitu
penggolongan ABO dan Rhesus (faktor Rh).<o:p></o:p></span></div>
</div>
<div class="MsoNormal">
<div style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;"><br /></span></div>
</div>
<div class="MsoNormal" style="text-align: center;">
</div>
<div class="MsoNormal" style="text-align: center;">
<div style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Tabel Kecocokan Plasma</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</div>
<div class="MsoNormal" style="text-align: center;">
<div style="text-align: center;">
<b><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;"><br /></span></b></div>
</div>
<div style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<div class="MsoNormal">
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 47.2pt; mso-padding-alt: 0cm 0cm 0cm 0cm; mso-table-layout-alt: fixed; mso-yfti-tbllook: 1056; width: 448px;">
<tbody>
<tr style="height: 27.05pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td rowspan="2" style="background: #E8EAF0; border: solid #39639D 1.0pt; height: 27.05pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 62.4pt;" valign="top" width="83"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Golongan</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Darah</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
<td rowspan="2" style="background: #E8EAF0; border-left: none; border: solid #39639D 1.0pt; height: 27.05pt; mso-border-left-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 58.65pt;" valign="top" width="78"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Antigen pada</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Eritrosit</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
<td rowspan="2" style="background: #E8EAF0; border-left: none; border: solid #39639D 1.0pt; height: 27.05pt; mso-border-left-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 72.85pt;" valign="top" width="97"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Antibodi dalam</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Plasma</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
<td colspan="2" style="background: #E8EAF0; border-left: none; border: solid #39639D 1.0pt; height: 27.05pt; mso-border-left-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 5.0cm;" valign="top" width="189"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Aman Ditransfusi</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
</tr>
<tr style="height: 9.35pt; mso-yfti-irow: 1;">
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 9.35pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.9pt;" valign="top" width="95"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Recipient<o:p></o:p></span></div>
</td>
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 9.35pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.85pt;" valign="top" width="94"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Donor<o:p></o:p></span></div>
</td>
</tr>
<tr style="height: 29.2pt; mso-yfti-irow: 2;">
<td style="background: #E8EAF0; border-top: none; border: solid #39639D 1.0pt; height: 29.2pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 62.4pt;" valign="top" width="83"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A<o:p></o:p></span></div>
</td>
<td style="background: #E8EAF0; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 58.65pt;" valign="top" width="78"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A<o:p></o:p></span></div>
</td>
<td style="background: #E8EAF0; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 72.85pt;" valign="top" width="97"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">B<o:p></o:p></span></div>
</td>
<td style="background: #E8EAF0; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.9pt;" valign="top" width="95"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A, AB<o:p></o:p></span></div>
</td>
<td style="background: #E8EAF0; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.85pt;" valign="top" width="94"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A, O<o:p></o:p></span></div>
</td>
</tr>
<tr style="height: 29.2pt; mso-yfti-irow: 3;">
<td style="background: #CED3DF; border-top: none; border: solid #39639D 1.0pt; height: 29.2pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 62.4pt;" valign="top" width="83"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">B<o:p></o:p></span></div>
</td>
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 58.65pt;" valign="top" width="78"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">B<o:p></o:p></span></div>
</td>
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 72.85pt;" valign="top" width="97"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A<o:p></o:p></span></div>
</td>
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.9pt;" valign="top" width="95"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">B, AB<o:p></o:p></span></div>
</td>
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.85pt;" valign="top" width="94"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">B, O<o:p></o:p></span></div>
</td>
</tr>
<tr style="height: 29.2pt; mso-yfti-irow: 4;">
<td style="background: #E8EAF0; border-top: none; border: solid #39639D 1.0pt; height: 29.2pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 62.4pt;" valign="top" width="83"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">AB<o:p></o:p></span></div>
</td>
<td style="background: #E8EAF0; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 58.65pt;" valign="top" width="78"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A + B<o:p></o:p></span></div>
</td>
<td style="background: #E8EAF0; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 72.85pt;" valign="top" width="97"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">-<o:p></o:p></span></div>
</td>
<td style="background: #E8EAF0; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.9pt;" valign="top" width="95"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">AB<o:p></o:p></span></div>
</td>
<td style="background: #E8EAF0; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.85pt;" valign="top" width="94"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A, B, AB, O<o:p></o:p></span></div>
</td>
</tr>
<tr style="height: 29.2pt; mso-yfti-irow: 5; mso-yfti-lastrow: yes;">
<td style="background: #CED3DF; border-top: none; border: solid #39639D 1.0pt; height: 29.2pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 62.4pt;" valign="top" width="83"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">O<o:p></o:p></span></div>
</td>
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 58.65pt;" valign="top" width="78"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">-<o:p></o:p></span></div>
</td>
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 72.85pt;" valign="top" width="97"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A + B<o:p></o:p></span></div>
</td>
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.9pt;" valign="top" width="95"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">A, B, AB, O<o:p></o:p></span></div>
</td>
<td style="background: #CED3DF; border-bottom: solid #39639D 1.0pt; border-left: none; border-right: solid #39639D 1.0pt; border-top: none; height: 29.2pt; mso-border-left-alt: solid #39639D 1.0pt; mso-border-top-alt: solid #39639D 1.0pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 70.85pt;" valign="top" width="94"><div class="MsoNormal" style="text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">O<o:p></o:p></span></div>
</td>
</tr>
</tbody></table>
</div>
<div class="MsoNormal">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
</div>
<div class="MsoNormal">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Pada</span></b><span style="line-height: 115%;"> <b>tahun</b> 1900 Dr. Loustiner menemukan 4 macam <b>golongan</b> <b>darah</b> :<o:p></o:p></span></span></div>
</div>
<div class="MsoNormal">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;"> 1. <b>Golongan</b> <b>darah</b> A<o:p></o:p></span></div>
</div>
<div class="MsoNormal">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;"> 2. <b>Golongan</b> <b>darah</b> B<o:p></o:p></span></div>
</div>
<div class="MsoNormal">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;"> 3. <b>Golongan</b> <b>darah</b> AB<o:p></o:p></span></div>
</div>
<div class="MsoNormal">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;"> 4. <b>Golongan</b> <b>darah</b> O</span></div>
</div>
<div class="MsoNormal">
<div style="text-align: left;">
<span style="font-family: Georgia, Times New Roman, serif;"><b style="text-indent: -18pt;"><span style="line-height: 115%;">Sel</span></b><span style="line-height: 115%; text-indent: -18pt;">ain itu <b>tahun</b> 1940 </span><span style="line-height: 115%;">ditemukan golongan </span><b style="line-height: 115%;">darah</b><span style="line-height: 115%;"> baru
yaitu Rhesus Faktor </span><b style="line-height: 115%;">positif</b><span style="line-height: 115%;"> </span><b style="line-height: 115%;">dan</b><span style="line-height: 115%;"> </span><b style="line-height: 115%;">rhesus</b><span style="line-height: 115%;"> </span><b style="line-height: 115%;">faktor</b><span style="line-height: 115%;"> </span><b style="line-height: 115%;">negatif
pada sel darah merah (erythrocyte).</b></span></div>
</div>
<div class="MsoNormal">
<div style="text-align: left;">
<b style="line-height: 115%;"><span style="font-family: Georgia, Times New Roman, serif;"><br /></span></b></div>
</div>
<div class="MsoNormal">
</div>
<div class="MsoNormal">
</div>
<ul>
<li style="text-align: left;"><span lang="IN" style="font-family: Georgia, Times New Roman, serif; line-height: 115%; text-indent: -18pt;">Apabila
seseorang memiliki protein di permukaan sel darahnya, maka orang tersebut
diidentifikasikan <b>rhesus positif (+).</b></span></li>
<li style="text-align: left;"><span lang="IN" style="font-family: Georgia, Times New Roman, serif; line-height: 115%; text-indent: -18pt;">Apabila
seseorang <b>tidak</b> memiliki protein di permukaan sel darahnya,
maka orang tersebut diidentifikasikan <b>rhesus negatif (-).</b></span></li>
<li style="text-align: left;"><span style="font-family: Georgia, Times New Roman, serif;"><b style="text-indent: -18pt;"><span style="line-height: 115%;">Rhesus</span></b><span style="line-height: 115%; text-indent: -18pt;"> <b>Faktor</b> <b>positif</b> <b>banyak</b> terdapat <b>pada</b> <b>orang</b> <b>Asia</b> <b>dan</b> <b>Negatif</b> Pada
orang Eropa, Am</span><span style="line-height: 115%;">erica</span><span style="line-height: 115%;">, Australia.</span></span></li>
<li style="text-align: left;"><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%; text-indent: -18pt;">Bila rhesus darah beda dengan suami,
dokter bisa memberikan tindakan pencegahan terbentuknya zat antirheus dengan
obat anti-Rhogama globulin (RhoGAM)/ anti D atau Rh Immunuglobulin. RhoGAM
disuntikkan pada usia kehamilan 28 minggu dan saat persalinan. </span></li>
<li style="text-align: center;"><span style="font-family: Georgia, Times New Roman, serif; line-height: 115%; text-indent: -18pt;">Bila ibu mempunyai rheusus negatif,
atau ketidakcocokan golongan darah antara janin dan ibu baru diketahui usia
persalinan, suntikan RhoGAM untuk ibu sebaiknya diberikan dalam waktu maksimal
72 jam setelah persalinan. rhoGAM efektif hanya berlangsung 12 minggu, sehingga
setelah lewat masa tersebut harus mendapat suntikan kembali agar kehamilan
berikutnya tidak bermasalah.</span></li>
</ul>
<div style="text-indent: -24px;">
<table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; margin-left: 6.75pt; margin-right: 6.75pt; mso-padding-alt: 0cm 0cm 0cm 0cm; mso-table-anchor-horizontal: margin; mso-table-anchor-vertical: paragraph; mso-table-left: center; mso-table-lspace: 9.0pt; mso-table-rspace: 9.0pt; mso-table-top: 44.2pt; mso-yfti-tbllook: 1056; width: 558px;">
<tbody>
<tr style="height: 30.85pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">
<td style="background: #FBEAE7; border: solid #EB641B 1.0pt; height: 30.85pt; padding: 3.6pt 7.2pt 3.6pt 7.2pt; width: 134.7pt;" valign="top" width="180"></td>
<td style="background: yellow; border-left: none; border: solid #EB641B 1.0pt; height: 30.85pt; mso-border-left-alt: solid #EB641B 1.0pt; padding: .75pt 5.4pt 0cm 5.4pt; width: 148.95pt;" valign="top" width="199"><div class="MsoNormal" style="mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: 44.2pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Ayah Rh +</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
<td style="background: yellow; border-left: none; border: solid #EB641B 1.0pt; height: 30.85pt; mso-border-left-alt: solid #EB641B 1.0pt; padding: .75pt 5.4pt 0cm 5.4pt; width: 134.65pt;" valign="top" width="180"><div class="MsoNormal" style="mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: 44.2pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Ayah Rh -</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
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<td style="background: yellow; border-top: none; border: solid #EB641B 1.0pt; height: 56.85pt; mso-border-top-alt: solid #EB641B 1.0pt; padding: .75pt 5.4pt 0cm 5.4pt; width: 134.7pt;" valign="top" width="180"><div class="MsoNormal" style="mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: 44.2pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Ibu Rh +</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
</td>
<td style="background: #F7D3CC; border-bottom: solid #EB641B 1.0pt; border-left: none; border-right: solid #EB641B 1.0pt; border-top: none; height: 56.85pt; mso-border-left-alt: solid #EB641B 1.0pt; mso-border-top-alt: solid #EB641B 1.0pt; padding: .75pt 5.4pt 0cm 5.4pt; width: 148.95pt;" valign="top" width="199"><div class="MsoNormal" style="mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: 44.2pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Janin Rh +<o:p></o:p></span></div>
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<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Tidak bermasalah<o:p></o:p></span></div>
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<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Janin Rh +<o:p></o:p></span></div>
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<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Tidak bermasalah.<o:p></o:p></span></div>
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<td style="background: yellow; border-top: none; border: solid #EB641B 1.0pt; height: 81.3pt; mso-border-top-alt: solid #EB641B 1.0pt; padding: .75pt 5.4pt 0cm 5.4pt; width: 134.7pt;" valign="top" width="180"><div class="MsoNormal" style="mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: 44.2pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><b><span style="line-height: 115%;">Ibu Rh -</span></b><span style="line-height: 115%;"><o:p></o:p></span></span></div>
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<td style="background: #FBEAE7; border-bottom: solid #EB641B 1.0pt; border-left: none; border-right: solid #EB641B 1.0pt; border-top: none; height: 81.3pt; mso-border-left-alt: solid #EB641B 1.0pt; mso-border-top-alt: solid #EB641B 1.0pt; padding: .75pt 5.4pt 0cm 5.4pt; width: 148.95pt;" valign="top" width="199"><div class="MsoNormal" style="mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: 44.2pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif;"><span lang="SV" style="font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">Janin Rh +</span><span style="line-height: 115%;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: 44.2pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;">
<span lang="SV" style="font-family: Georgia, Times New Roman, serif; font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;">Akan timbul
masalah <o:p></o:p></span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><span lang="SV" style="font-size: 12.0pt; line-height: 115%; mso-ansi-language: SV;"> karena beda
dengan ibu.</span><span style="line-height: 115%;"><o:p></o:p></span></span></div>
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<td style="background: #FBEAE7; border-bottom: solid #EB641B 1.0pt; border-left: none; border-right: solid #EB641B 1.0pt; border-top: none; height: 81.3pt; mso-border-left-alt: solid #EB641B 1.0pt; mso-border-top-alt: solid #EB641B 1.0pt; padding: .75pt 5.4pt 0cm 5.4pt; width: 134.65pt;" valign="top" width="180"><div class="MsoNormal" style="mso-element-anchor-horizontal: margin; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: center; mso-element-top: 44.2pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;">
<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Janin Rh –<o:p></o:p></span></div>
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<span style="font-family: Georgia, Times New Roman, serif; line-height: 115%;">Tidak bermasalah.<o:p></o:p></span></div>
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<b><span style="line-height: 115%;"><span style="font-family: Georgia, Times New Roman, serif;">KOMPONEN DARAH<o:p></o:p></span></span></b></div>
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<b><span style="line-height: 115%;"><span style="font-family: Georgia, Times New Roman, serif;"><br /></span></span></b></div>
<div class="MsoNormal" style="text-align: left;">
<b><span style="line-height: 115%;"><span style="font-family: Georgia, Times New Roman, serif;">1. Darah lengkap
(whole blood) </span></span></b></div>
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<b style="line-height: 18px; text-indent: -18pt;"><span style="line-height: 115%;"><span style="font-family: Georgia, Times New Roman, serif;"><br /></span></span></b></div>
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</div>
<ul>
<li style="text-align: left;"><span style="line-height: 18px; text-indent: -18pt;"><span style="line-height: 115%;"><span style="font-family: Georgia, Times New Roman, serif;">Untuk mengatasi perdarahan akut dan
masif, meningkatkan dan mempertahankan proses pembekuan. </span></span></span></li>
<li style="text-align: left;"><span style="font-family: Georgia, Times New Roman, serif;"><span style="line-height: 18px; text-indent: -18pt;"><span style="line-height: 115%;">Darah lengkap yang </span></span><span style="line-height: 18px; text-indent: -24px;">diberikan dengan golongan ABO dan Rh yang diketahui.</span></span></li>
<li style="text-align: left;"><span style="line-height: 18px; text-indent: -24px;"><span style="font-family: Georgia, Times New Roman, serif;">Bisanya tersedia dalam volume 400-500 ml dengan masa hidup 21 hari. </span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><span style="font-weight: bold; line-height: 18px; text-align: left; text-indent: 0in;">Indikasi</span><span style="font-weight: bold; line-height: 18px; text-align: left; text-indent: 0in;">: </span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><span style="color: #2da2bf; line-height: 18px; text-align: left; text-indent: -0.56in;">a) </span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">Penggantian</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">
</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">volume </span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">pada</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">
</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">pasien</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;"> </span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">dengan</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">
</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">syok</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">
hemorrhagic, </span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">trauma </span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">atau</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">
</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">luka</span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;"> </span><span style="line-height: 18px; text-align: left; text-indent: -0.56in;">bakar</span></span></li>
<li style="text-align: left;"><span style="line-height: 18px; text-indent: -24px;"><span style="font-family: Georgia, Times New Roman, serif;">
b) Klien
dengan perdarahan
masif dan
telah kehilangan
lebih dari
25 persen dari
volume darah
total</span></span></li>
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<span style="font-family: Georgia, Times New Roman, serif;"><span style="font-weight: bold;">2.
Packed </span><span style="font-weight: bold;">Red Blood cells (RBCs)</span></span></div>
<span style="text-indent: 0in;"><ul><span style="font-family: Georgia, Times New Roman, serif;">
<li><span style="text-align: left; text-indent: -0.28in;">Komponen</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">ini</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">mengandung</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">sel</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">darah</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">merah</span><span style="text-align: left; text-indent: -0.28in;">,
SDP, </span><span style="text-align: left; text-indent: -0.28in;">dan</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">trombosit</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">karena</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">sebagian</span><span style="text-align: left; text-indent: -0.28in;">
plasma </span><span style="text-align: left; text-indent: -0.28in;">telah</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">dihilangkan</span><span style="text-align: left; text-indent: -0.28in;">
(80 %).</span></li>
<li><span style="text-align: left; text-indent: -0.28in;">Tersedia</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">volume 250 ml. </span><span style="text-align: left; text-indent: -0.28in;">Diberikan</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">selama</span><span style="text-align: left; text-indent: -0.28in;"> 2 </span><span style="text-align: left; text-indent: -0.28in;">sampai</span><span style="text-align: left; text-indent: -0.28in;">
4 jam, </span><span style="text-align: left; text-indent: -0.28in;">dengan</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">golongan</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">darah</span><span style="text-align: left; text-indent: -0.28in;"> ABO </span><span style="text-align: left; text-indent: -0.28in;">dan</span><span style="text-align: left; text-indent: -0.28in;">
Rh yang </span><span style="text-align: left; text-indent: -0.28in;">diketahui</span><span style="text-align: left; text-indent: -0.28in;">.</span></li>
<li><span style="text-align: left; text-indent: -0.28in;">Masa
hidup komponen
ini 21 hari.</span></li>
<li><span style="font-weight: bold; text-align: left; text-indent: -0.28in;">Indikasi</span><span style="font-weight: bold; text-align: left; text-indent: -0.28in;"> </span><span style="font-weight: bold; text-align: left; text-indent: -0.28in;">:</span></li>
<li><span style="text-align: left; text-indent: -0.28in;">a) </span><span style="text-align: left; text-indent: -0.28in;">Pasien</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">dengan</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">kadar</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">Hb</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">rendah</span></li>
<li><span style="text-align: left; text-indent: -0.28in;">b) </span><span style="text-align: left; text-indent: -0.28in;">Pasien</span><span style="text-align: left; text-indent: -0.28in;">
anemia </span><span style="text-align: left; text-indent: -0.28in;">karena</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">kehilangan</span><span style="text-align: left; text-indent: -0.28in;">
</span><span style="text-align: left; text-indent: -0.28in;">darah</span><span style="text-align: left; text-indent: -0.28in;"> </span><span style="text-align: left; text-indent: -0.28in;">saat </span><span style="text-align: left; text-indent: 0in;">pembedahan</span></li>
<li><span style="text-align: left; text-indent: 0in;">c</span><span style="text-align: left; text-indent: 0in;">) </span><span style="text-align: left; text-indent: 0in;">Pasien</span><span style="text-align: left; text-indent: 0in;">
</span><span style="text-align: left; text-indent: 0in;">dengan</span><span style="text-align: left; text-indent: 0in;"> </span><span style="text-align: left; text-indent: 0in;">massa</span><span style="text-align: left; text-indent: 0in;">
</span><span style="text-align: left; text-indent: 0in;">sel</span><span style="text-align: left; text-indent: 0in;"> </span><span style="text-align: left; text-indent: 0in;">darah</span><span style="text-align: left; text-indent: 0in;">
</span><span style="text-align: left; text-indent: 0in;">merah</span><span style="text-align: left; text-indent: 0in;"> </span><span style="text-align: left; text-indent: 0in;">rendah</span></li>
</span></ul>
</span></div>
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<span style="font-family: Georgia, Times New Roman, serif;"><span style="font-weight: bold;">3.
White Blood Cells (WBC </span><span style="font-weight: bold;">atau</span><span style="font-weight: bold;">
</span><span style="font-weight: bold;">leukocyte)</span></span></div>
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</div>
<ul>
<li><span style="font-family: Georgia, Times New Roman, serif;"><span style="text-indent: -0.28in;">Komponen</span><span style="text-indent: -0.28in;">
</span><span style="text-indent: -0.28in;">ini</span><span style="text-indent: -0.28in;"> </span><span style="text-indent: -0.28in;">terdiri</span><span style="text-indent: -0.28in;">
</span><span style="text-indent: -0.28in;">dari</span><span style="text-indent: -0.28in;"> </span><span style="text-indent: -0.28in;">darah</span><span style="text-indent: -0.28in;">
</span><span style="text-indent: -0.28in;">lengkap</span><span style="text-indent: -0.28in;"> </span><span style="text-indent: -0.28in;">dengan</span><span style="text-indent: -0.28in;">
</span><span style="text-indent: -0.28in;">isi</span><span style="text-indent: -0.28in;"> </span><span style="text-indent: -0.28in;">seperti</span><span style="text-indent: -0.28in;">
R</span><span style="text-indent: -0.28in;">BCs</span><span style="text-indent: -0.28in;">,
plasma </span><span style="text-indent: -0.28in;">dihilangkan</span><span style="text-indent: -0.28in;"> 80 </span><span style="text-indent: -0.28in;">%</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><span style="text-indent: -0.28in;">Biasanya</span><span style="text-indent: -0.28in;">
</span><span style="text-indent: -0.28in;">tersedia</span><span style="text-indent: -0.28in;"> </span><span style="text-indent: -0.28in;">dalam</span><span style="text-indent: -0.28in;">
volume 150 ml.</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><span style="font-weight: bold; text-indent: -0.28in;">Indikasi</span><span style="font-weight: bold; text-indent: -0.28in;"> </span><span style="font-weight: bold; text-indent: -0.28in;">:</span></span></li>
<li><span style="font-family: Georgia, Times New Roman, serif;"><span style="text-indent: -0.28in;">a) Pasien
sepsis yang tidak </span><span style="text-indent: 0in;">berespon
dengan antibiotik </span><span style="text-indent: 0in;">(khususnya
untuk pasien </span><span style="text-indent: 0in;">dengan
kultur darah
positif, </span><span style="text-indent: 0in;">demam
persisten
/38,3° C dan </span><span style="text-indent: 0in;">granulositopenia)</span></span></li>
</ul>
<div>
<div style="direction: ltr; language: en-US; margin-bottom: 0pt; margin-left: .12in; margin-top: 4.0pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;">
<span style="font-family: Georgia, Times New Roman, serif;"><span style="font-weight: bold;">4.
</span><span style="font-weight: bold;">Leukocyte </span><span style="font-weight: bold;">–poor </span><span style="font-weight: bold;">RBCs</span></span></div>
<div style="direction: ltr; language: en-US; margin-bottom: 0pt; margin-left: .12in; margin-top: 4.0pt; mso-line-break-override: none; punctuation-wrap: hanging; text-align: left; text-indent: 0in; unicode-bidi: embed; word-break: normal;">
</div>
<ul>
<li><span style="font-family: Georgia, 'Times New Roman', serif; text-indent: -0.28in;">Komponen
ini sama
dengan
RBCs, tapi leukosit
dihilangkan sampai
95 %, digunakan bila
kelebihan
plasma dan
antibody tidak dibutuhkan.</span></li>
<li><span style="font-family: Georgia, 'Times New Roman', serif; text-indent: -0.28in;">Komponen
ini tersedia
dalam
volume 200 ml, waktu pemberian
1 ½ sampai 4
jam.</span></li>
<li><span style="font-family: Georgia, 'Times New Roman', serif; font-weight: bold; text-indent: -0.28in;">Indikasi</span><span style="font-family: Georgia, 'Times New Roman', serif; font-weight: bold; text-indent: -0.28in;">: </span><span style="font-family: Georgia, 'Times New Roman', serif; text-indent: -0.28in;">Pasien dengan
penekanan
system imun (imunokompromise)</span></li>
</ul>
<span style="font-family: Lucida Sans Unicode;"><b><br /></b></span><span style="font-family: 'Lucida Sans Unicode'; font-weight: bold; text-indent: 0in;">5.
</span><span style="font-family: 'Lucida Sans Unicode'; font-weight: bold; text-indent: 0in;">Platelet/ </span><span style="font-family: 'Lucida Sans Unicode'; font-weight: bold; text-indent: 0in;">Trombosit</span><br /><ul>
<li><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">Komponen</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">ini</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">biasanya</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">digunakan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">untuk</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">mengobati</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">kelainan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">perdarahan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">atau</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">jumlah</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">trombosit</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
yang </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">rendah</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">.</span></li>
<li><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">Volume
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">bervariasi</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">biasanya</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
35-50 ml/unit, </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">untuk</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">pemberian</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">biasanya</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">memerlukan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">beberapa</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">kantong</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">.</span></li>
<li><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">Periksa</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">hitung</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">trombosit</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">pada</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> 1 </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">dan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">
24 jam </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">setelah</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">pemberian</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.28in;">.</span></li>
<li><span style="font-family: 'Lucida Sans Unicode'; font-weight: bold; text-indent: -0.28in;">Indikasi </span></li>
<li><span style="color: #2da2bf; text-indent: -0.56in;">a) </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">Pasien</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">dengan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">trombositopenia</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">
(</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">karena</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">penurunan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">trombosit</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">, </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">peningkatan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">pemecahan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;"> </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">trombosit</span></li>
<li><span style="color: #2da2bf; text-indent: -0.56in;">b) </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">Pasien</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">
</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">dengan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">
leukemia </span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">dan</span><span style="font-family: 'Lucida Sans Unicode'; text-indent: -0.56in;">
marrow aplasia</span></li>
</ul>
</div>
<br />
<br />
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<b><span style="font-size: 12.0pt; line-height: 115%;"><br /></span></b></div>
</div>
Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com0tag:blogger.com,1999:blog-8729813714071578939.post-37374907968710840272013-03-04T17:09:00.000+08:002013-03-04T18:36:24.074+08:00TRIAGE:<br />
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<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">TRIAGE:</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; vertical-align: baseline;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Is a process used to determine severity of illness or injury for
each patient who enters the emergency department <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; vertical-align: baseline;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Putting the patient in
the right place at the right time to receive the right level of care
facilitates allocation of appropriate resources to meet the patient’s medical
need.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">The registered nurse as
the appropriate person to perform patient assessment, which is essential for
the triage process.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">INTRODUCTION</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<br />
<ul>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">The
use of advanced triage may become necessary when medical professionals decide
that the medical resources available are not sufficient to treat all the people
who need help.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">This
has happened in disasters such as volcanoes, thunderstorms, and rail accidents.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">In
these cases some percentage of patients will die regardless of medical care
because of the severity of their injuries. Others would live if given immediate
medical care, but would die without it. </span></li>
</ul>
</div>
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<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">TRIAGE</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<br />
<ul>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">is
a system of sorting patients according to need when resources are insufficient
for all to be treated. The term comes from the French </span><i style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">tri</i><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> (meaning </span><i style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">sort</i><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">).</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">is
process of assessing patients to determine management priorities.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">is
used to sort patients into groups based on the severity of their health
problems and the immediacy with which these problems must be treated.</span></li>
</ul>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">TRIAGE CATEGORIES:</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Patients are triaged into 4 categories: <b>Red, yellow, green
and Black</b>.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: 'Times New Roman', serif;"><span style="font-size: small;"><span style="line-height: 150%;">These </span></span><span style="line-height: 24px;">colours</span><span style="font-size: small;"><span style="line-height: 150%;"> are typically intended to delineate injury
severity. <o:p></o:p></span></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<br />
<ul>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Patients
categorized as </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">RED</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> will die soon without intervention. They
need </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">immediate care</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Patients
categorized as </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">YELLOW</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> are seriously injured but can wait.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Patients
categorized as </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">GREEN</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> are typically the “walking wounded”.
These patients have minor injuries.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Patients
categorized as </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">BLACK</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> are either dead or their injuries are not
compatible with life and must be left.</span></li>
</ul>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">The JumpSTART System</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<br />
<ul>
<li><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">R</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">-Respirations:
15-45 is considered good. If not breathing, reposition, check</span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> P</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">-pulse.
If pulse, 5 rescue breaths. If continued apnea tag </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">BLACK</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">A
respiratory rate <15 or >45 is tagged </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">RED</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">With
a rate of 15-45, assess circulation. Assess a distal pulse for quality. If the
distal pulse is weak or absent, tag </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">RED</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">.</span></li>
<li><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">M</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">-Mental
status is based on AVPU. If the child is Alert, responds to Verbal or Pain, tag </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">YELLOW</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">.
If unresponsive, tag </span><b style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">RED</b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">.</span></li>
</ul>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><u><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">URGENCY CATEGORIES</span></u></b><u><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></u></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">EDs use various triage systems with differing terminology, but all
share this characteristic of a hierarchy based on the potential for loss of
life.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Emergent</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> patients have the highest priority– their condition are
life-threatening and they must be seen immediately.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Urgent</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> patients have serious health problems but not immediately
life-threatening ones; they must be seen within 1 hour.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Non-urgent</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> patients have episodic illnesses threat can be addressed
within 24 hours without increased morbidity.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><u><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">LANGKAH-LANGKAH PERANCANGAN TRIAGE</span></u></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">The goal of the triage process are to gather sufficient data for
determining acuity, identify immediate needs, and establish rapport with the
patient and family.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Use of the nursing process provides the necessary framework for a
consistent approach for every patient.<o:p></o:p></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Assessment<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Diagnosis<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Planning<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Implementation<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Evaluation<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><u><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Assessment</span></u></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">This is defined as a rapid systematic collection of data relevant
to each patient.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Subjective data</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"> provide information disclose by the
patient or family whereas <b>objective data</b> are observable,
measurable information.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">The triage nurse must focus his or her investigation on history of
the complaint and related symptoms and signs.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">The “PQRST” mnemonic is one example of a systematic approach to
patient assessment. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable">
<tbody>
<tr>
<td style="padding: 0cm 0cm 0cm 0cm; width: 105.0pt;" valign="top" width="140"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">COMPONENT</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div>
</td>
<td style="padding: 0cm 0cm 0cm 0cm; width: 354.0pt;" valign="top" width="472"><div align="center" class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: center;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">SAMPLE QUESTIONS</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"><o:p></o:p></span></div>
</td>
</tr>
<tr>
<td style="padding: 0cm 0cm 0cm 0cm; width: 105.0pt;" valign="top" width="140"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<div style="text-align: left;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> P</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> (provokes)<o:p></o:p></span></div>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<div style="text-align: left;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> Q</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> (quality)<o:p></o:p></span></div>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<div style="text-align: left;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> R</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> (radiant)<o:p></o:p></span></div>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<div style="text-align: left;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> S</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> (severity)<o:p></o:p></span></div>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<div style="text-align: left;">
<br /></div>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm;">
<div style="text-align: left;">
<b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> T</span></b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";"> (time)<o:p></o:p></span></div>
</div>
</td>
<td style="padding: 0cm 0cm 0cm 0cm; width: 354.0pt;" valign="top" width="472"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 22.6pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -14.2pt;">
<ul>
<li>What
provokes the symptoms?</li>
<li>What
makes it better? What makes it worse? What does it feel like?</li>
<li>Where
is it? Where does it go? Is it in one or more spots?</li>
<li>If
we gave it a number from 0 to 10, with 0 being none and 10 being the worst you
can imagine, what is your rating?</li>
<li>How
long have you had the symptom? When did it start? When id it end? How long
did it last? Does it come and go?</li>
</ul>
</div>
</td>
</tr>
</tbody></table>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><u><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">DIAGNOSIS</span></u></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<br />
<ul>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Diagnosis
is defined as analyzing information collected in the assessment phase to
determine acuity needs.</span></li>
</ul>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><u><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">PLANNING</span></u></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<br />
<ul>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Planning
is defined as determining a course of action for identified needs to meet the
expected outcome</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">The
triage nurse differentiates urgency of problems and prioritizes care by
assigning acuity level, designating an appropriate treatment area,
communicating to other team members, and identifying interventions to meet the
expected outcome</span></li>
</ul>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><u><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">IMPLEMENTATION</span></u></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<br />
<ul>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">is
defined as carrying out the plan of care</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Nursing
interventions, performs diagnostic procedures and treatments defined in
established protocols, communicates to the patient and family, mobilizes
necessary additional resources and documents all activities in the patient’s
medical record.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Examples
of these activities include splinting, ice application, dressing, etc.</span></li>
</ul>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><u><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">EVALUATION</span></u></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<br />
<ul>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Evaluation
is defined as interpreting the patient’s response to interventions.</span></li>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">The
triage nurse reassesses the patient; evaluates effectiveness of interventions;
and revises the plan of care, expected outcomes, and acuity based on new or
changing patient data.</span></li>
</ul>
</div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><u><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">THE EMERGENCY TEAM</span></u></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify; text-indent: 36.0pt;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">The <b>emergency department (ED)</b>, <b>emergency
room (ER)</b>, <b>emergency ward (EW)</b>, <b>accident &
emergency (A&E)</b> department or <b>casualty</b> department
is a hospital or primary care department that provides initial treatment to
patients with a broad spectrum of illness and injuries, some of which may be
life-threatening and requiring immediate attention.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;"><a href="http://www.blogger.com/blogger.g?blogID=8729813714071578939"><span style="color: blue;"><br />
</span></a>The staff in emergency departments:<o:p></o:p></span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Doctors,<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Physician
assistants (PAs)<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Nurses
with specialized training in emergency medicine<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Paramedics <o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Emergency
medical technicians<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Respiratory
therapists<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Radiology
technicians<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Healthcare
Assistants (HCAs)<o:p></o:p></span></li>
<li class="MsoNormal" style="line-height: 150%; text-align: justify;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman";">Volunteers<o:p></o:p></span></li>
</ol>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 14.2pt; margin-right: 0cm; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo3; text-align: justify; text-indent: -14.2pt;">
<br />
<ul>
<li><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 150%;">Other support staff who
all work as a team to treat emergency patients and provide support to anxious
family members.</span></li>
<li><span style="font-family: Times New Roman, serif; font-size: small; text-align: justify; text-indent: -14.2pt;"><span style="line-height: 150%;">Other </span></span><span style="font-family: Times New Roman, serif; text-align: justify; text-indent: -14.2pt;"><span style="line-height: 24px;">specialities</span></span><span style="font-family: Times New Roman, serif; font-size: small; text-align: justify; text-indent: -14.2pt;"><span style="line-height: 150%;"> can
be added depending on the nature of the injury, for example a neurological
surgeon will attend if there is a serious head injury.</span></span></li>
</ul>
<!--[if !supportLists]--></div>
Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com0tag:blogger.com,1999:blog-8729813714071578939.post-62901217327491225512012-05-11T09:39:00.002+08:002012-05-11T09:41:21.532+08:00PERANCANG KELUARGA<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b>DEFINISI</b></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Perancang keluarga adalah satu kaedah yang dilakukan oleh pasangan suami isteri untuk menjarakkan kehamilan.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">JENIS-JENIS PERANCANG KELUARGA</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Perancang keluarga dibahagi kepada beberapa jenis iaitu :</div>
<br />
<ul>
<li style="text-align: justify;">Hormon Kontraseptif</li>
<li style="text-align: justify;">Kedah Halangan</li>
<li style="text-align: justify;">Alat Dalam Rahim (ADR)/Intra Uterine Contraceptive Device (IUCD)</li>
<li style="text-align: justify;">Kaedah Semulajadi</li>
<li style="text-align: justify;">Sterilisasi</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">HORMON KONTRASEPTIF</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>DEFINISI</b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah satu kaedah kontraseptif yang mengandung hormon iaitu estrogen sahaja atau progesteron sahaja atau kombinasi (gabungan) kedua-dua hormon iaitu estrogen dan progesteron.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>JENIS-JENIS HORMON KONTRASEPTIF</b></div>
<div style="text-align: justify;">
<br /></div>
<br />
<ul>
<li style="text-align: justify;">Pil Perancang Keluarga</li>
<li style="text-align: justify;">Suntikan </li>
<li style="text-align: justify;">Penanaman</li>
</ul>
<br />
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">A.<span class="Apple-tab-span" style="white-space: pre;"> </span>Pil Perancang Keluarga</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah sejenis ubat dimakan oleh wanita untuk mencegah kehamilan. Ia mengandungi hormon wanita iaitu estrogen, progesterone atau kombinasi kedua-duanya.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Cara utama menghalang kehamilan ialah dengan menghalang pengeluaran telur dari kilang ovari seseorang wanita.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Di samping itu, ia juga menyebabkan lendir dari pintu rahim menjadi lebih pekat dan ini juga menghalang kenaikan sperma masuk ke dalam rahim. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Perancang Keluarga boleh diambil oleh:</div>
<br />
<ul>
<li style="text-align: justify;">Semua wanita yang ingin menjarakkan kehamilan yang berumur 35 tahun kebawah</li>
<li style="text-align: justify;">Wanita yang 4 minggu selepas bersalin</li>
<li style="text-align: justify;">Serta merta selepas keguguran</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Cara Pengambilan Pil Perancang Keluarga</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Bagi wanita yang pertama kali makan perancang caranya ialah :</div>
<br />
<ul>
<li style="text-align: justify;">Makan pil pada hari ke 5 haid</li>
<li style="text-align: justify;">Makan pil setiap malam sehingga habis</li>
<li style="text-align: justify;">Rehat selama 7 hari</li>
<li style="text-align: justify;">Pada hari ke 8 malam mulakan pusingan pil yang baru</li>
<li style="text-align: justify;">Jika terlupa 1 biji pil maka makan pil sebaik sahaja teringat dan teruskan pengambilan pil berikut seperti dijadualakan</li>
<li style="text-align: justify;">Jika terlupa 2 biji pil atau lebih, berhenti makan pil dan makan pil pusingan yang baru (pek baru) pada hari ke 5 haid</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Wanita yang tidak boleh mengambil pil perancang keluarga, adalah:</div>
<br />
<ul>
<li style="text-align: justify;">Wanita yang disyaki mengandung</li>
<li style="text-align: justify;">Mengidap penyakit hati</li>
<li style="text-align: justify;">Penyakit jantung</li>
<li style="text-align: justify;">Terlampau gemuk</li>
<li style="text-align: justify;">Urat bersimpul (Varicose vein) yang teruk</li>
<li style="text-align: justify;">Sawan</li>
<li style="text-align: justify;">Bengkak pada leher (Thyrotoxicosis).</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Jika diikuti dengan betul, keberkesanan menggunakan kaedah ini untuk mengelakkan kelahiran amat tinggi iaitu 99.9% kerana :</div>
<br />
<ul>
<li style="text-align: justify;">Pil jenis ini mengelakkan kandungan dengan menyebabkan dinding rahim nipis dan lendir yang pekat.</li>
<li style="text-align: justify;">Ia boleh juga mengelakkan pengeluaran telur dari kilang telur (ovary) tetapi ia tidak konsisten dan memerlukan dos yang tinggi. Hampir 50% wanita menggunakan kaedah ini boleh mengeluarkan telur dari kilang telur </li>
<li style="text-align: justify;">Ia perlu dimakan dengan betul dan mengikut masa yang ditetapkan. Jika masa makan berubah-ubah melebihi tiga jam, ia boleh menyebabkan wanita itu hamil. </li>
<li style="text-align: justify;">Boleh mengelakkan kandungan, pil perancang keluarga mempunyai kesan sampingan yang positif seperti mengurangkan kadar perdarahan haid serta mengurangkan penyakit anemia atau kurang darah dan mengurangkan kesakitan sewaktu haid.</li>
<li style="text-align: justify;">Ia juga boleh mengurangkan risiko mendapat kanser kilang telur dan lapisan Rahim melebihi 50% apabila digunakan melebihi satu tahun.</li>
</ul>
<br />
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">B.<span class="Apple-tab-span" style="white-space: pre;"> </span>Suntikan</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Mengandungi hormone estrogen sahaja. Suntikan menggunakan hormon progestogen, disuntik di otot punggung (otot gluteus) setiap dua bulan bergantung kepada hormon yang digunakan.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Wanita yang boleh mengambil suntikan, adalah</div>
<br />
<ul>
<li style="text-align: justify;">Pesakit mental </li>
<li style="text-align: justify;">Ibu yang menyusukan bayi</li>
<li style="text-align: justify;">Pesakit dengan masalah pada darah (darah berbentuk bulan sabit)</li>
<li style="text-align: justify;">Wanita yang mempunyai kesan sampingan terhadap kaedah hormon yang lain</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Wanita yang tidak boleh mengambil suntikan, adalah:</div>
<br />
<ul>
<li style="text-align: justify;">Hamil</li>
<li style="text-align: justify;">Peradangan di hati </li>
<li style="text-align: justify;">Kanser</li>
<li style="text-align: justify;">Gangguan pada pembekuan darah</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Disebabkan dosnya yang tinggi, ia mengelakkan pengeluaran telur dari kilang telur (ovary) di samping mengakibatkan lendir yang pekat. Wanita yang menggunakan kaedah ini boleh mengalami perdarahan yang tidak menentu.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">C.<span class="Apple-tab-span" style="white-space: pre;"> </span>Penanaman (Implant)</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah kontraseptif hormone dimana hormone progesterone dipasang dibawah kulit. Ia memberi kesan perlindungan jangka masa yang panjang iaitu selama beberapa tahun.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Indikasi Penanaman (implant)</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Kaedah ini boleh digunakan oleh :-</div>
<br />
<ul>
<li style="text-align: justify;">Semua wanita yang ingin menjarakkan kehamilan yang berumur 35 tahun kebawah</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Kontraindikasi Penanaman (implant)</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Kaedah ini tidak dibenarkan kepada wanita yang mempunyai masalah kesihatan seperti berikut :-</div>
<br />
<ul>
<li style="text-align: justify;">Mengandung</li>
<li style="text-align: justify;">Penyakit hepar</li>
<li style="text-align: justify;">Penyakit jantung</li>
<li style="text-align: justify;">Kanser payudara</li>
<li style="text-align: justify;">Gangguan sistem saraf</li>
<li style="text-align: justify;">Sakit kepala sebelah</li>
<li style="text-align: justify;">Urat bersimpul </li>
<li style="text-align: justify;">Tekanan darah tinggi</li>
<li style="text-align: justify;">Asthma</li>
<li style="text-align: justify;">Sawan </li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">KAEDAH HALANGAN</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
DEFINISI</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah perancang keluarga dengan menggunakan kaedah halangan yang mengahalang sperma keluar memasuki rahim.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
JENIS-JENIS KAEDAH HALANGAN</div>
<div style="text-align: justify;">
<br /></div>
<br />
<ul>
<li style="text-align: justify;">Kaedah halangan mekanikal </li>
<li style="text-align: justify;">Kondom</li>
<li style="text-align: justify;">Diaphragm </li>
<li style="text-align: justify;">Cervical cap</li>
<li style="text-align: justify;">Kaedah halangan kimia </li>
<li style="text-align: justify;">Krim</li>
<li style="text-align: justify;">Jeli</li>
<li style="text-align: justify;">Foam</li>
<li style="text-align: justify;">Sponge</li>
</ul>
<br />
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">A.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kaedah halangan mekanikal</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>Kondom</b></div>
<div style="text-align: justify;">
Adalah satu alat yang menghalang pelepasan sperma kedalam rahim.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Teknik penggunaan kondom :</div>
<br />
<ul>
<li style="text-align: justify;">Buka sampul kondom dengan teliti</li>
<li style="text-align: justify;">Pasangkan kondom pada penis yang tegang sebelum melakukan hubungan seks</li>
<li style="text-align: justify;">Pastikan kondom dipasang sehingga ke pangkal penis</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Teknik menanggalakan kondom :</div>
<br />
<ul>
<li style="text-align: justify;">Keluarkan penis dari rahim ketika penis masih tegang sembil memegang kondom</li>
<li style="text-align: justify;">Bungkus dan buangkan kondom yang telah digunakan didalam bekas yang sesuai</li>
</ul>
<br />
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>Diaphragm/servikal kap</b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah sejenis pelapik yang diperbuat daripada getah dan berbentuk bulat. Dipasang ke dalam pangkal rahim diatas serviks untuk mengahalang kemasukan sperma ke rahim semasa persetubuhan.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Teknik penggunaan diaphragm/servikal kap</div>
<br />
<ul>
<li style="text-align: justify;">Klien perlu berada dalam posisi sesuai</li>
<li style="text-align: justify;">Sapukan krim spermisid dikedua-dua permukaan alat untuk membunuh sperma</li>
<li style="text-align: justify;">Diaphragm / servikal kap dilipat dengan jari sambil mencangkung masukkan diaphragm jauh ke dalam vagina dengan bahagian convex menghala kebawah</li>
<li style="text-align: justify;">Pakai 2 jam sebelum persetubuhan</li>
<li style="text-align: justify;">Tetapkan kedudukan alat dengan menggunakan jari</li>
<li style="text-align: justify;">Selepas persetubuhan diaphragm dibiarkan selama 6-8 jam supaya sperma dilemahkan oleh spermisid</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Teknik penjagaan diaphragm/servikal kap</div>
<br />
<ul>
<li style="text-align: justify;">Basuh alat selepas ianya dikeleluarkan dari vagina</li>
<li style="text-align: justify;">Lap kering</li>
<li style="text-align: justify;">Periksa untuk kekoyakan</li>
</ul>
<br />
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">B.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kaedah Kimia</span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
Adalah dengan menggunakan krim, jeli ataupun foam iaitu bahan yang menggunakan kimia yang bertindak melemahkan sperma.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Contoh bahan kimia</div>
<br />
<ul>
<li style="text-align: justify;">Spermidic krim/jeli</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Teknik memakai krim atau jeli</div>
<br />
<ul>
<li style="text-align: justify;">Bahan ini dimasukkan kedalam vagina sebelum persetubuhan dengan menggunakan alat pemasang.</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Teknik memakai foam</div>
<br />
<ul>
<li style="text-align: justify;">Foam ini berbentuk pil dan dimasukkan ke vagina sebelum persetubuhan</li>
<li style="text-align: justify;">5-10 minit selepas ianya diamsukkan ia akan hancur dan akan menjadi buih</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">ALATAN DALAM RAHIM</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<i><b><br /></b></i></div>
<div style="text-align: justify;">
<i><b>INTRA UTERINE CONTRACEPTIVE (IUCD)</b></i></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah sejenis alat kecil yang diperbuat dari bahan plastic yang dimasukkan kedalam Rahim wanita.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Kaedah memasukkan alat dalam Rahim</div>
<br />
<ul>
<li style="text-align: justify;">Ia perlu dimasukkan ke dalam rahim oleh doktor terlatih dan tidak mendatangkan banyak masalah kepada pengguna.</li>
<li style="text-align: justify;">Setelah dimasukkan, alat ini boleh disimpan selama tiga hingga lima tahun bergantung kepada jenis yang digunakan. </li>
<li style="text-align: justify;">Efikasinya untuk mengelakkan kandungan adalah lebih kurang 98%.</li>
<li style="text-align: justify;">Di samping itu, ia boleh mengurangkan perdarahan haid dan hampir 80 peratus wanita tidak mengalami perdarahan selepas tiga bulan penggunaannya.</li>
</ul>
<br />
<div style="text-align: justify;">
*** Walau bagaimanapun, wanita tidak harus bimbang kerana walaupun tidak datang haid, telur masih dikeluarkan dari kilang telur seperti biasa. Ini juga boleh mengurangkan masalah anemia dari perdarahan haid yang berlebihan.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Wanita yang boleh mengambil alat dalam rahim adalah:</div>
<br />
<ul>
<li style="text-align: justify;">Wanita yang pernah melahirkan anak</li>
<li style="text-align: justify;">Apabila lain-lain kaedah yang digunakan tidak sesuai</li>
<li style="text-align: justify;">Bercadang untuk hamil pada jangka masa yang panjang tetapi tidak mahu menerima kaedah yang kekal</li>
<li style="text-align: justify;">Wanita yang gemarkan kaedah yang tidak memerlukan tindakan tiap-tiap hari</li>
<li style="text-align: justify;">Apabila wanita sukar untuk mendapatkan bekalan dalam jangkamasa yang tetap pada tiap-tiap bulan</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Kontraindikasi IUCD</div>
<br />
<ul>
<li style="text-align: justify;">Wanita hamil</li>
<li style="text-align: justify;">Mengalami jangkitan pelvis (e.g :- cervicitis,gonorrhea)</li>
<li style="text-align: justify;">Baru mengalami keguguran septik sehingga ianya bebas dari jangkitan</li>
<li style="text-align: justify;">Kanser pada system reproduktif</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Masa yang sesuai untuk pemasangan IUCD</div>
<br />
<ul>
<li style="text-align: justify;">IUCD boleh dipasang pada bila-bila masa tetapi lebih mudah lebih mudah jika dipasang pada :</li>
<li style="text-align: justify;">Kedatangan haid</li>
<li style="text-align: justify;">6-8 minggu selepas bersalin</li>
<li style="text-align: justify;">Selepas keguguran yang tidak septik</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Kesan Sampingan IUCD</div>
<br />
<ul>
<li style="text-align: justify;">Haid yang banyak</li>
<li style="text-align: justify;">Pengeluaran amaun darah haid agak bertambah dari biasa terutama 2-3 bulan selepas pemasangan IUCD</li>
<li style="text-align: justify;">Mengalami kejang di perut</li>
<li style="text-align: justify;">Akibat tindak balas dari pemasangan IUCD. Mungkin berlaku beberapa hari atau 2-3 bulan pertama selepas pemasangan. Dapatkan nasihat dari dokter atau jika IUCD boleh untuk dikeluarkan</li>
<li style="text-align: justify;">Mengalami haid irregular dalam beberapa bulan pertama. Contohnya :- intermenstrual atau premenstrual spoting 2-3 hari dan akan berkurangan</li>
<li style="text-align: justify;">Klian akan mengalami vaginal discharge yang cair atau mucoid. Ini adalah keadaan yang biasa</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Komplikasi IUCD</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Jangkitan atau inflamasi pelvis</li>
<li>Mengandung luar Rahim (Ectopic pregnancy)</li>
<li>Perpindahan IUCD dapat dicirikan dengan : <span style="text-align: justify;">Sakit/kekejangan dibahagian bawah abdomen, t</span><span style="text-align: justify;">erdapat perbezaan kepanjangan tali IUCD dan ini dikesan dekat dengan serviks, </span><span style="text-align: justify;">Hujung tali IUCD dapat dirasai.</span></li>
</ul>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Pendidikan Kesihatan</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Penjagaan keberihan intuk elak Pelvic Inflammatory Diseases</li>
<li>Mengesan tali IUCD dengan cara memasukkan jari kedalam vagina setiap kali selepas haid. Jika tali tidak dapat dikesan segera jumpa dokter untuk dikesan pemeriksaan</li>
<li>To come again untuk pemantauan keadaan lokasi IUCD</li>
</ul>
<br />
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">KAEDAH SEMULA JADI</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
DEFINISI</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah berasaskan keadaan dimana wanita boleh mengenali masa subur bermula dan waktu subur berakhir. Waktu subur ialah semasa wanita itu boleh hamil sekiranya ada hubungan seks. Masa subur adalah masa ovulasi. Dan jika wanita tidak mahu hamil,hindarkan hubungan seks pada masa ini.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Kelebihan Kaedah Semulajadi</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Tidak memerlukan penggunaan alat, hormone atau melibatkan prosedur pembedahan</li>
<li>Meningkatkan komunikasi oleh kebanyakan pasangan</li>
<li>Lebih mudah diterima oleh kebanyakan pasangan</li>
<li>Boleh dipraktiskan oleh pasangan yang bimbang kepada kaedah yang bukan semulajadi</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
JENIS-JENIS KAEDAH SEMULAJADI<span class="Apple-tab-span" style="white-space: pre;"> </span></div>
<div style="text-align: justify;">
</div>
<ul>
<li>Kaedah masa selamat ( kaedah kalender)</li>
<li>Kaedah suhu badan</li>
<li>Kaedah lendir di serviks</li>
<li>Kaedah campuran</li>
<li>Lain-lain : <span class="Apple-tab-span" style="white-space: pre;"> </span>Kaedah azal dan Kaedah laktasi</li>
</ul>
<br />
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>A.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kaedah Masa Selamat (kaedah kalender)</b></div>
<div style="text-align: justify;">
Iaitu mencegah kehamilan dengan menghindari hubungan seks semasa waktu subur melalui pengiraan kitaran haid.</div>
<div style="text-align: justify;">
Caranya ialah :</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Rekodkan kitaran haid selama 6-12</li>
<li>Dapatkan kitaran haid terpendik dan terpanjang</li>
</ul>
<br />
<div style="text-align: justify;">
Contoh pengiraan haid :</div>
<div style="text-align: justify;">
I.<span class="Apple-tab-span" style="white-space: pre;"> </span>Jun 30</div>
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II.<span class="Apple-tab-span" style="white-space: pre;"> </span>Julai 28</div>
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III.<span class="Apple-tab-span" style="white-space: pre;"> </span>Ogos 32 ( terpanjang)</div>
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IV.<span class="Apple-tab-span" style="white-space: pre;"> </span>Sept 25 (terpendik)</div>
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V.<span class="Apple-tab-span" style="white-space: pre;"> </span>Oct 26</div>
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VI.<span class="Apple-tab-span" style="white-space: pre;"> </span>Nov 29</div>
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VII.<span class="Apple-tab-span" style="white-space: pre;"> </span>Dec 30</div>
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<br /></div>
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Formula</div>
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</div>
<ul>
<li>Kitaran terpendik ditolak 18 (-18) hari pertama subur</li>
<li>Kitaran terpanjang ditolak 11 (-11) hari terakhir subur</li>
</ul>
<br />
<div style="text-align: justify;">
Contoh :</div>
<div style="text-align: justify;">
25 - 18 = 7 (hari ke 7 ialah hari pertama subur )</div>
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32 - 11 = 21 ( hari ke 21 ialah hari terakhir subur )</div>
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<br /></div>
<div style="text-align: justify;">
*** Jadi mereka harus mengelakkan perhubungan kelamin pada lebih kurang hari kelapan hingga ke-24 jika kiraan haid mereka 28 ke 35 hari. Ia agak rumit untuk dikira dan boleh mendatangkan masalah bagi pasangan itu kerana waktu mereka tidak boleh bersama agak panjang.</div>
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<b><br /></b></div>
<div style="text-align: justify;">
<b><br /></b></div>
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<b>B.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kaedah Suhu Badan</b></div>
<div style="text-align: justify;">
Adalah mencegah kehamilan dengan menghindari hubungan seks dari hari pertama haid sehingga suhu badan meningkat 0.2 C hingga 0.4 C dan 3 hari selepasnya. Peningkatan dari aras rendah ke aras tinggi pertanda ovulasi telah berlaku. Jangka hayat ovum ialah 3 hari</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Cara penggunaan kaedah suhu ialah :-</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Ambil suhu badan sebaik terjaga dari tidur setiap pagi menggunakan jangka suhu khas</li>
<li>Letak jangka suhu dibawah lidah selama 5 minit</li>
<li>Catat dan cantumkan bacaan suhu badan diatas geraf dalam tempoh sebulan</li>
<li>Hubungan seks adalah selamat selepas kenaikan suhu badan 3 hari berturut-turut</li>
</ul>
<br />
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>C.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kaedah Lendir di Serviks</b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah mencegah kehamilan dengan menghindari hubungan seks semasa waktu subur dengan mengenal pasti perbezaan cecair yang keluar daripada faraj. Sewaktu subur, cecair yang keluar bertukar dari warna putih yang pekat kepada lendir yang jernih dan cair. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Cara penggunaanya ialah :-</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Perhatikan penukaran pada lendir yang keluar dari vagina pada setiap hari</li>
<li>Masa subur ialah sewaktu lendir yang keluar jernih, melekit yang berupa seperti telur mentah</li>
<li>Hubungan seks ialah selamat selepas lendir serviks menjadi pekat dan keputihan</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b>D.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kaedah Kombinasi</b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah kaedah kombinasi antara kaedah masa selamat (kalender), kaedah pengambilan suhu badan dan kaedah lender serviks. Kombinasi kaedah ini boleh meningkatkan keberkesanan mencegah kehamilan. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>E.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kaedah Lain-Lain</b></div>
<div style="text-align: justify;">
</div>
<ul>
<li>Kaedah Azal iaitu mengeluarkan zakar sebelum ejakulasi supaya air mani dilepaskan diluar faraj.</li>
<li>Kaedah Laktasi. Penyusuan ibu sebagai satu kaedah perancang keluarga sementara.</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Keberkesanan Kaedah Laktasi hanya berlaku sekiranya :-</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Ibu belum datang haid selepas bersalin</li>
<li>Penyusuan susu ibu yang eksklusif</li>
<li>Usia bayi kurang dari 6 bulan</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">STERILISASI</span></b></div>
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<br /></div>
<div style="text-align: justify;">
DEFINISI</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah satu proses pembedahan pemandulan yang dilakukan keatas wanita atau lelaki. </div>
<div style="text-align: justify;">
Sterilisasi boleh dilakukan kepada wanita dan juga kaum lelaki. Kaedah ini adalah kekal. Saluran di rahim wanita diikat atau dipotong bagi mengelakkan perjalanan telur ataupun sperma dan seterusnya menghindarkan persenyawaan.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
JENIS-JENIS STRERILISASI</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Tubal Ligation (ikat Rahim)</li>
<li>Vasectomy (Ikat Rahim)</li>
</ul>
<br />
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>A.<span class="Apple-tab-span" style="white-space: pre;"> </span>Tubal Ligation (ikat Rahim)</b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah satu cara mencegah hamil yang kekal dimana tiub fallopian kiri dan kanan diikat atau dipotong atau diklip. Dengan ini ia menghalang perjalanan ovum bercantum dengan sperma.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Indikasi tubal ligation</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Grandmultipara dengan bad obstetric history semasa mengandung. (e.g:- pregnancy induced hypertension,sakit jantung dll)</li>
<li>Ibu yang sentiasa mendapat komplikasi selepas bersalin seperti postpartum hemorrhage,retained placenta dan lain-lain</li>
<li>Pasangan yang telah lengkap keluarganya terutama ibu berusia 35 tahun ke atas dan mempunyai sekurang-kurangnya 2 anak.</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Komplikasi Tubal Ligation</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Kecederaan pada organ berdekatan</li>
<li>Kesan sampingan ubat bius</li>
<li>Pendarahan yang berlebihan</li>
<li>Perlekatan rahim (Abdominal adhesion)</li>
<li>Mengandung luar Rahim (Ectopic pregnancy)</li>
</ul>
<br />
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>B.<span class="Apple-tab-span" style="white-space: pre;"> </span>Vasectomy</b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Adalah kaedah sterilisasi kekal untuk lelaki. Ia memerlukan pembedahan kecil di mana saluran vas deferens dipotong sedikit dan diikat untuk menghalang perjalanan sperma ke penis.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Komplikasi Vasectomy</div>
<div style="text-align: justify;">
</div>
<ul>
<li>Pendarahan semasa pembedahan</li>
<li>Haematoma</li>
<li>Infeksi</li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com6tag:blogger.com,1999:blog-8729813714071578939.post-73915210594639580632012-05-11T00:53:00.002+08:002012-07-24T09:56:49.938+08:00MELANOMA<br />
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">DEFINISI</span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
Melanoma adalah kanser kulit (tumor malignant) yang berasal di dalam sel-sel dalam kulit iaitu Melanosit (sel yang menghasilkan pigmen melanin pada warna kulit dan rambut. Melanoma biasa berlaku di kulit, selain itu melanoma juga berlaku dalam mata (melanoma intraocular), meninges, digestive tract, atau nodus limfa. </div>
<div style="text-align: justify;">
<span style="font-size: large;"><b><br /></b></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b>INSIDEN</b></span></div>
<div style="text-align: justify;">
Tanda pertama melanoma adalah perubahan dalam saiz, bentuk atau warna tahi lalat. Tetapi melanoma boleh muncul pada badan sebagai mole. </div>
<br />
<ul>
<li style="text-align: justify;">Pada lelaki, melanoma yang paling sering adalah pada badan, antara bahu dan pinggul serta pada kepala dan leher</li>
<li style="text-align: justify;">Pada wanita, melanoma sering terjadi pada bahagian bawah kaki</li>
<li style="text-align: justify;">Melanoma lebih kerap berlaku pada orang yang mempunyai kulit cerah kerana kulit putih lebih mudah dirosakkan oleh cahaya matahari berbanding orang yang mempunyai kulit gelap. </li>
<li style="text-align: justify;">Bagi mereka yang berkulit gelap, melanoma sering muncul: di bawah kuku di tangan dan kaki, pada tapak tangan dan tapak kaki</li>
</ul>
<br />
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">PROGNOSIS</span></b></div>
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<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
Dengan diagnosis dan rawatan awal, peluang untuk pulih adalah besar. Peluang mendapat melanoma meningkat pada orang tua. Melanoma adalah kanser kulit yang serius dan dapat mengancam nyawa jika tidak dirawat pada peringkat awal. Jika ia tidak dikesan awal, melanoma boleh berkembang ke dalam kulit dan merebak ke bahagian badan yang lain (metastasis). Ia sukar untuk dirawat. </div>
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<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">ETIOLOGI</span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b>1.<span class="Apple-tab-span" style="white-space: pre;"> </span>Pendedahan kepada ultaviolet radiasi (UVA dan UVB)</b></div>
<div style="text-align: justify;">
Adalah penyebab utama penyakit melanoma. Sinaran UV menyebabkan kerosakkan sel-sel DNA, iaitu thymine dimerization yang boleh bermutasi dalam gen sel. Apabila sel membahagi, mutasi tersebut direbakkan kepada generasi sel baru dan boleh menjadi tidak terkawal. Normalnya sel kulit berkembang secara terkendali –normalnya pada permukaan kulit sel kulit baru akan mendorong sel kulit mati sehingga terbuang. Tetapi ketika terjadi kerosakkan DNA, sel baru dapat tumbuh diluar kendali dan dapat membentuk sel kanser.</div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>2.<span class="Apple-tab-span" style="white-space: pre;"> </span>Jenis pekerjaan</b></div>
<div style="text-align: justify;">
Outdoor workers yang tidak menggunakan pelindung (seperti cream, sunblock) lebih mudah mendapatkan melanoma berbanding dengan indoor workers. Pada laki-laki, biasanya berlaku di bahagian belakang badan, dan perempuan pada kaki.</div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>3.<span class="Apple-tab-span" style="white-space: pre;"> </span>Radiasi dari lampu (radiasi UV tiruan)</b></div>
<div style="text-align: justify;">
Penggunaan sunbeds (with deeply UVA rays) sangat meningkatkan risiko mendapatkan melanoma</div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>4.<span class="Apple-tab-span" style="white-space: pre;"> </span>Bahan Kimia</b></div>
<div style="text-align: justify;">
Terdedah bahan kimia dalam jangka masa lama seperti arsenic, nikotin, tar dan minyak </div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>5.<span class="Apple-tab-span" style="white-space: pre;"> </span>Genetik/Faktor Keturunan</b></div>
<div style="text-align: justify;">
Jika ada salah satu anggota keluarga yang mempunyai sejarah melanoma maka ahli keluarga yang lain berkemungkinan mendapatkan penyakit yang sama kerana mutasi di CDKN2A dan CDK4.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">FAKTOR RISIKO</span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b>1.<span class="Apple-tab-span" style="white-space: pre;"> </span>Pendedahan kepada cahaya matahari</b></div>
<div style="text-align: justify;">
Sinaran UVA dan UVB adalah merbahaya kepada kulit dan boleh mencetuskan kanser kulit, termasuk melanoma. Orang yang tinggal di lokasi yang mendapat lebih banyak cahaya matahari seperti Florida, Hawaii, dan Australia senang mendapat kanser kulit.</div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>2.<span class="Apple-tab-span" style="white-space: pre;"> </span>Moles</b></div>
<div style="text-align: justify;">
Terdapat 2 jenis moles:</div>
<br />
<ul>
<li style="text-align: justify;">Normal moles: kecil, “beauty marks”</li>
<li style="text-align: justify;">Atypical moles: atau “displastik Nevi”. </li>
</ul>
<br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Tanda-tanda terbentuknya melanoma adalah:</div>
<br />
<ul>
<li style="text-align: justify;">Bintik atau tahi lalat (mole) semakin membesar</li>
<li style="text-align: justify;">Perubahan warna pada tahi lalat, terutama pigmentasi merah, putih dan biru di kulit sekelilingnya</li>
<li style="text-align: justify;">Perubahan pada kulit diatas bintik yang berpigmen, misalnya perubahan konsistensi atau bentuk</li>
</ul>
<br />
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>3.<span class="Apple-tab-span" style="white-space: pre;"> </span>Jenis kulit</b></div>
<div style="text-align: justify;">
Melanoma lebih kerap berlaku pada orang yang mempunyai kulit cerah yang mudah terbakar atau jeragat (orang ini biasanya mempunyai rambut merah atau perang dan bermata biru) kerana kulit putih lebih mudah dirosakkan oleh cahaya matahari berbanding orang yang mempunyai kulit gelap. </div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>4.<span class="Apple-tab-span" style="white-space: pre;"> </span>Sejarah Keluarga (genetic) </b></div>
<div style="text-align: justify;">
1:10 pesakit disahkan dengan penyakit melanoma mempunyai ahli keluarga dengan sejarah melanoma. </div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>5.<span class="Apple-tab-span" style="white-space: pre;"> </span>Immunosuppressive</b></div>
<div style="text-align: justify;">
Compromised immune systems akibat kemoterapi, pemindahan organ, terdedah kepada cahaya matahari dan penyakit seperti HIV/AIDS atau limfoma</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">PATOPHYSIOLOGY </span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
Melanoma adalah berasal dari melanosit yang berada di kulit dan menghasilkan melanin pelindung yang terkandung dalam lapisan basal epidermis diantara dermis dan epidermis. Melanoma boleh berlaku sebagai pertumbuhan kulit baru yang kecil (mole) dan berpigmen pada kulit yang normal. Kulit yang terdedah sinar matahari terlalu lama dan juga pigmented mole adalah faktor yang sering menyebabkan berlakunya melanoma. Melanoma merebak ke bahagian tubuh yang lain (metastasis), yang mana akan terus membiak dan merosakkan tisu-tisu kulit. Apabila pertumbuhan melanoma ke dalam kulit sedikit, maka kemungkinan untuk sembuh adalah besar. Tetapi apabila melanoma telah membiak ke dalam kulit dan merebak melalui aliran darah boleh menyebabkan kematian.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">MANIFESTASI KLINIKAL</span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
Biasanya, tanda pertama melanoma adalah perubahan dalam saiz, bentuk, warna pada tahi lalat (mole). Melanoma mungkin menjadi hitam, tidak normal, gatal, burning sign, atau sakit.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
A = Asimetri </div>
<div style="text-align: justify;">
Satu/sebahagian daripada tumor berbeza dari bahagian-bahagian lain, tidak sepadan </div>
<div style="text-align: justify;">
B = Border </div>
<div style="text-align: justify;">
Sempadan tumor tak menentu. Pinggir sering bergerigis, bertakuk, kabur atau tidak teratur, pigmen boleh merebak ke dalam sekeliling kulit</div>
<div style="text-align: justify;">
C = Colour (warna) </div>
<div style="text-align: justify;">
Tumor mungkin mempunyai warna yang berbeza. Warna tidak sekata. Warna hitam, coklat, dan tan may be present. Kawasan putih, kelabu, merah, pink atau biru boleh dilihat.</div>
<div style="text-align: justify;">
D = Diameter</div>
<div style="text-align: justify;">
Terdapat perubahan dari segi saiz, 1/4 inci or 6 milimeter</div>
<div style="text-align: justify;">
E = Evolving : pertumbuhan lesi dan berubah warna serta rupa </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">JENIS-JENIS MELANOMA</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
1.<span class="Apple-tab-span" style="white-space: pre;"> </span>Superficial spreading melanoma (about 70% of diagnosed cases)</div>
<div style="text-align: justify;">
2.<span class="Apple-tab-span" style="white-space: pre;"> </span>Melanoma nodular (about 15% of diagnosed cases) </div>
<div style="text-align: justify;">
3.<span class="Apple-tab-span" style="white-space: pre;"> </span>Lentigo maligna melanoma (about 10% of diagnosed cases)</div>
<div style="text-align: justify;">
4.<span class="Apple-tab-span" style="white-space: pre;"> </span>Acral lentiginous melanoma (about 5% of diagnosed cases)</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">KOMPLIKASI</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Komplikasi melanoma adalah</div>
<div style="text-align: justify;">
a)<span class="Apple-tab-span" style="white-space: pre;"> </span>Perebakan ke organ lain: otak, paru-paru, tulang, liver dan kulit</div>
<div style="text-align: justify;">
b)<span class="Apple-tab-span" style="white-space: pre;"> </span>Kerosakkan tissue bahagian dalam </div>
<div style="text-align: justify;">
c)<span class="Apple-tab-span" style="white-space: pre;"> </span>Kesan sampingan treatment:</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Sakit</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Loya</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Hair loss</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Fatigue</div>
<div style="text-align: justify;">
d)<span class="Apple-tab-span" style="white-space: pre;"> </span>Kematian mungkin berlaku: berlaku pada peringkat lewat, melanoma akan merebak</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">PENYIASATAN DIAGNOSTIK</span></b></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Ambil sejarah keluarga </div>
<div style="text-align: justify;">
Termasuk sejarah mana-mana kanser kulit dalam ahli keluarga</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Ambil sejarah perubatan </div>
<div style="text-align: justify;">
Ubatan yang pernah diambil, cream atau losyen</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Biopsi </div>
<div style="text-align: justify;">
adalah satu-satunya cara untuk membuat diagnosis yang tepat. Dalam prosedur ini,</div>
<div style="text-align: justify;">
doktor cuba untuk melakukan excisional biopsy. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Shave off</div>
<div style="text-align: justify;">
Lakukan cukuran dibawah kulit untuk elak mikroorganisma. Biasanya dilakukan di Operating theatre dengan pemberian bius setempat untuk memeriksa sel-sel kanser.</div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>Penyiasatan diagnostik yang lain, iaitu:</b></div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Blood test</div>
<div style="text-align: justify;">
Seperti FBC, TWBC untuk kesan infeksi dan inflamasi </div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Chest X-Ray</div>
<div style="text-align: justify;">
Untuk periksa keadaan paru-paru dan mengesan jika berlaku metastasis di paru-paru.</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>CT (Computed Tomography) scan </div>
<div style="text-align: justify;">
Untuk memeriksa perubahan pada kulit dan tahap perebakan kanser.</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>MRI (magnetic resonance imaging) </div>
<div style="text-align: justify;">
Untuk mengesan rebakan kanser ke organ lain</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>PET scan (positron emission tomography scan) </div>
<div style="text-align: justify;">
Untuk mengesan kemungkinan berlakunya metastasis kanser </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">RAWATAN MELANOMA</span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
Pesakit melanoma boleh dirawat dengan cara menjalani pembedahan, kemoterapi, terapi biologi, terapi radiasi atau gabungan rawatan.</div>
<div style="text-align: justify;">
1. <span class="Apple-tab-span" style="white-space: pre;"> </span>Pembedahan</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Kebanyakan kanser kulit boleh dipotong daripada kulit dengan cepat dan mudah. Kadangkala kanser tersebut dibuang sepenuhnya semasa biopsy dijalankan dan rawatan susulan tidak diperlukan. </div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Surgeon mungkin akan melakukan skin graft iaitu menggunakan kulit dari bahagian badan pesakit untuk menggantikan kulit yang telah dibuang. Nodus limfa berhampiran dibuang kerana kanser boleh merebak melalui system limfa.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
2. <span class="Apple-tab-span" style="white-space: pre;"> </span>Kemoterapi</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Kemoterapi digunakan untuk membunuh sel-sel kanser. Ubat yang diberikan adalah melalui cycle dan tempoh rawatan diikuti dengan tempoh pemulihan.</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Cara pemberian kemoterapi, adalah:</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Oral atau suntikan: ubatan memasuki aliran darah dan menuju ke seluruh badan</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Isolated limb/arterial perfusion </div>
<div style="text-align: justify;">
Untuk melanoma pada lengan atau kaki, ubat kemoterapi akan dimasukkan ke dalam aliran darah. Ini membenarkan ubatan mencapai tumor secara langsung. </div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span> </div>
<div style="text-align: justify;">
3.<span class="Apple-tab-span" style="white-space: pre;"> </span>Terapi Biologi (Imunoterapi)</div>
<div style="text-align: justify;">
Adalah satu bentuk rawatan yang menggunakan system imun badan, sama ada secara langsung atau tidak langsung untuk melawan kanser atau mengurangkan kesan-kesan sampingan rawatan. Terapi biologi ini menggunakan bahan cytokines. Badan manusia menghasilkan sitokinin dalam jumlah kecil sebagai tindak balas kepada jangkitan. Dalam sesetengah kes, terapi biologi yang diberikan selepas pembedahan boleh membantu mencegah melanomadari berulang. Interferon alfa dan interleukin-2 (IL2 atau aldesleukin) boleh disyorkan selepas pembedahan.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
4.<span class="Apple-tab-span" style="white-space: pre;"> </span>Radiasi</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Kanser kulit bertindak balas dengan baik terhadap terapi radiasi (juga dipanggil radioterapi), yang menggunakan sinaran tenaga-tinggi untuk merosakkan sel-sel kanser dan menghentikan pertumbuhannya. Para doktor sering menggunakan kaedah rawatan ini bagi kanser-kanser yang timbul di kawasan-kawasan yang sukar dirawat dengan pembedahan seperti kelopak mata, hujung hidung, atau telinga. Beberapa rawatan mungkin diperlukan untuk menghapuskan semua sel-sel kanser. Terapi radiasi mungkin menyebabkan ruam atau menjadikan kulit di kawasan tersebut kering atau merah. Perubahan warna kulit dan/atau tekstur mungkin terbentuk selepas rawatan selesai dan mungkin menjadi lebih kelihatan beberapa tahun kemudian.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
5.<span class="Apple-tab-span" style="white-space: pre;"> </span>Curettage and Elektrodesikasi</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Pihak doktor selalunya menggunakan jenis pembedahan yang dipanggil kuretage. Selepas ubat bius mengebaskan kawasan yang berkenaan, kanser tersebut dikaut dengan kurette, satu alat yang berbentuk sudu tajam. Kawasan tersebut juga dirawat dengan elektrodesikasi. Arus elektrik dari mesin khas digunakan untuk mengawal pendarahan dan membunuh apa juga sel kanser yang tinggal disekitar luka tersebut.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
6.<span class="Apple-tab-span" style="white-space: pre;"> </span>Cryosurgery</div>
<div style="text-align: justify;">
Kesejukan yang ekstrem mungkin digunakan untuk merawat keadaan kulit pada awal permbentukan kanser, seperti aktinik keratosis, begitu juga kanser kulit tertentu. Dalam cryosurgery, cecair nitrogen dibubuh ke ketumbuhan untuk membeku dan membunuh sel-sel yang tidak normal. Selepas kawasan tersebut cair, tisu-tisu mati akan terkupas. Lebih dari satu pembekuan mungkin diperlukan untuk membuang keseluruhan ketumbuhan tersebut. Cryosurgery selalunya tidak menyakitkan, tetapi pesakit-pesakit mungkin mengalami kesakitan dan pembengkakkan selepas kawasan tersebut cair.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
7.<span class="Apple-tab-span" style="white-space: pre;"> </span>Terapi Laser</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Terapi laser menggunakan sinaran cahaya yang halus untuk membuang atau menghapuskan sel-sel kanser. Pendekatan ini kadangkala digunakan bagi kanser yang melibatkan hanya lapisan luar kulit.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b><br /></b></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b>MEDICATIONS</b></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
a)<span class="Apple-tab-span" style="white-space: pre;"> </span>Kemoterapi Topikal</div>
<div style="text-align: justify;">
Kemoterapi topical adalah penggunaan dadah anti kanser dalam bentuk krim atau losen yang dibubuh kepada kulit. Aktinic keratosis boleh dirawat secara efektif dengan dadah anti kanser fluorourasil (juga dipanggil 5-FU). Kaedah rawatan ini juga berguna bagi kanser-kanser yang terhad kepada lapisan kulit teratas. 5-FU tersebut dibubuh setiap hari untuk beberapa minggu. Keradangan yang teruk adalah biasa semasa rawatan, tetapi selalunya tidak meninggalkan parut.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
b)<span class="Apple-tab-span" style="white-space: pre;"> </span>Antibiotik therapy </div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>untuk elak infeksi dan inflamasi jika penyakit disebabkan oleh immunosuppressive </div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Topikal antibiotic: muporicin cream, fucidin cream</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Sistemik antibiotic: erythromycin, dicloxacillin, Metronidazole </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
c)<span class="Apple-tab-span" style="white-space: pre;"> </span>Corticosteroid</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>untuk kurangkan inflamasi, itching and scaling </div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Topikal steroid: hydrocortisone ointment 1%</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Sistemik steroid: Prednisolone 1mg/kg, Dexamethason.</div>
<div style="text-align: justify;">
Kesan anti inflammatory: Mengurangkan vascular permeability</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Kesan sampingan corticosteroid: moon face, osteoporosis.</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
d)<span class="Apple-tab-span" style="white-space: pre;"> </span>Emolient </div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>seperti cream aqueous, emulsifying</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>untuk melembapkan kulit dan mengurangkan gatal</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
e) <span class="Apple-tab-span" style="white-space: pre;"> </span>Analgesic</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>untuk melegakan kesakitan. Seperti Paracetamol, Tramal, Voltaren, Ponstan</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b>NURSING ASSESMENT</b></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Aduan pesakit:</div>
<div style="text-align: justify;">
Itching, sakit, lessions.</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Sejarah penyakit kulit pada ahli keluarga:</div>
<div style="text-align: justify;">
Penyakit kanser kulit pernah dialami oleh ahli keluarga/tidak.</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Jenis pekerjaan:</div>
<div style="text-align: justify;">
Bekerja di outdoor, indoor yang mempengaruhi pendedahan pada cahaya matahari</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Periksa kulit (terutama pada mole/tahi lalat):</div>
<div style="text-align: justify;">
-<span class="Apple-tab-span" style="white-space: pre;"> </span>Bentuk: tidak simetri, tidak sempadan</div>
<div style="text-align: justify;">
-<span class="Apple-tab-span" style="white-space: pre;"> </span>Sempadan: irregular</div>
<div style="text-align: justify;">
-<span class="Apple-tab-span" style="white-space: pre;"> </span>Warna: perubahan warna, dark brown, hitam</div>
<div style="text-align: justify;">
-<span class="Apple-tab-span" style="white-space: pre;"> </span>Diameter: pada amnya tidak lebih besar daripada 6mm</div>
<div style="text-align: justify;">
-<span class="Apple-tab-span" style="white-space: pre;"> </span>Location: berlaku di belakang, dada, abdomen, hujung kaki dan kulit kepala, punggung, peha atau payudara</div>
<div style="text-align: justify;">
-<span class="Apple-tab-span" style="white-space: pre;"> </span>Kelembapan: bersisik, cracked</div>
<div style="text-align: justify;">
-<span class="Apple-tab-span" style="white-space: pre;"> </span>Bilangan: lebih dari 100 moles.</div>
<div style="text-align: justify;">
•<span class="Apple-tab-span" style="white-space: pre;"> </span>Maklumat mengenai onset, tanda dan gejala, lokasi mole/tahi lalat, masa gatal dan kekerapan, pesakit rasa tidak selesa pada mole yang abnormal.</div>
<div style="text-align: justify;">
<span style="font-size: large;"><b><br /></b></span></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">NURSING DIAGNOSIS:</span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
1. <span class="Apple-tab-span" style="white-space: pre;"> </span>Sakit berkaitan dengan gangguan fisiologikal dan proses penyakit</div>
<div style="text-align: justify;">
2.<span class="Apple-tab-span" style="white-space: pre;"> </span>Takut dan bimbang berkaitan dengan pembedahan</div>
<div style="text-align: justify;">
3.<span class="Apple-tab-span" style="white-space: pre;"> </span>Gangguan imej diri berkaitan dengan perubahan pada mole, warna dan adanya lesi di kulit</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;">INTERVENSI KEJURURAWATAN</span></b></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><br /></span></b></div>
<div style="text-align: justify;">
<b>1. <span class="Apple-tab-span" style="white-space: pre;"> </span>Sakit berkaitan dengan gangguan fisiologikal dan proses penyakit</b></div>
<div style="text-align: justify;">
Matlamat: </div>
<div style="text-align: justify;">
sakit dapat dikurangkan, pesakit dapat rehat secukupnya</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Intervensi Kejururawatan:</div>
<div style="text-align: justify;">
a.<span class="Apple-tab-span" style="white-space: pre;"> </span>Pemerhatian</div>
<div style="text-align: justify;">
Lakukan pemerhatian kepada pesakit, seperti aduan, reaksi air muka, dengar aduannya dan tahap kesakitan untuk mengetahui tahap kesakitan dan merancang tindakan jururawat seterusnya</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
b.<span class="Apple-tab-span" style="white-space: pre;"> </span>Rehat</div>
<div style="text-align: justify;">
Beri rehat secukupnya untuk kurangkan sakit</div>
<div style="text-align: justify;">
- rancang aktiviti yang akan dilakukan. Lakukan procedure dalam satu masa untuk memberikan rehat yang secukupnya dan dapat kurangkan sakit.</div>
<div style="text-align: justify;">
- <span class="Apple-tab-span" style="white-space: pre;"> </span>persekitaran yang selesa, ventilasi yang baik, jauh dari bising, untuk memberikan masa rehat kepada pesakit</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
c.<span class="Apple-tab-span" style="white-space: pre;"> </span>Bantu aktiviti harian pesakit</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>bantu pesakit memenuhi keperluan asas pesakit seperti meletakkan barang keperluan berhampiran dengan loker, kebersihan diri pesakit, sponging. Untuk kurangkan pergerakkan yang dapat menyebabkan kesakitan</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
d.<span class="Apple-tab-span" style="white-space: pre;"> </span>Tanda Vital</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>monitor tanda vital setiap 4jam sekali untuk mengesan tanda-tanda kesakitan dan untuk melakukan tindakan seterusnya. Tekanan darah tinggi, tachycardia, tachypnea menandakan bahwa pesakit mengalami kesakitan </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
e.<span class="Apple-tab-span" style="white-space: pre;"> </span>Collaboration pemberian ubatan</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>beri ubatan atas preskripsi doctor iaitu analgesic untuk kurangkan sakit seperti Paracetamol, Tramal, Voltaren, Ponstan.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
f.<span class="Apple-tab-span" style="white-space: pre;"> </span>Sokongan emosi</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>beri sokongan emosi kepada pesakit dengan berbual-bual dengan pesakit, dengar aduan pesakit untuk memberi semangat, sokongan emosi dan kurangkan sakit.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
g. <span class="Apple-tab-span" style="white-space: pre;"> </span>Divertional therapy</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>lakukan aktiviti yang ia sukai seperti mendengarkan muzik, menonton televisyen untuk alihkan perhatian pesakit dari kesakitan.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Penilaian: pesakit mengadu sakit telah berkurangan dan pesakit boleh rehat dengan secukupnya. </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>2.<span class="Apple-tab-span" style="white-space: pre;"> </span>Takut dan bimbang berkaitan dengan pembedahan</b></div>
<div style="text-align: justify;">
Matlamat: </div>
<div style="text-align: justify;">
kebimbangan (anxiety) berkurangan, pesakit lebih yakin dan sedia menjalani pembedahan</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Intervensi Kejururawatan:</div>
<div style="text-align: justify;">
a.<span class="Apple-tab-span" style="white-space: pre;"> </span>Nilai tahap takut dan bimbang dari segi </div>
<div style="text-align: justify;">
- Non-verbal iaitu mimik muka atau senyap. </div>
<div style="text-align: justify;">
- Verbal iaitu melalui aduan/luahan pesakit</div>
<div style="text-align: justify;">
Untuk mengetahui tahap kebimbangan dan dapat merancang tindakan jururawat selanjutnya.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
b.<span class="Apple-tab-span" style="white-space: pre;"> </span>Jelaskan kepada pesakit dan keluarganya mengenai proses persediaan sebelum pembedahan untuk memberikan keyakinan sebelum pembedahan dilakukan</div>
<div style="text-align: justify;">
- mengapa pembedahan perlu dilakukan</div>
<div style="text-align: justify;">
- ujian darah akan dilakukan oleh doctor</div>
<div style="text-align: justify;">
- keizinan pembedahan </div>
<div style="text-align: justify;">
- persediaan bowel</div>
<div style="text-align: justify;">
- penjagaan selepas pembedahan</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
c.<span class="Apple-tab-span" style="white-space: pre;"> </span>Rujuk kepada doctor untuk penerangan yang lebih jelas mengenai pembedahan. Reinvorce pesakit untuk mengetahui bahawa pesakit faham mengenai tujuan dilakukan pembedahan dan kurankan anxiety</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
d.<span class="Apple-tab-span" style="white-space: pre;"> </span>Collaboration ubatan iaitu pemberian sedative sebelum pembedahan, seperti valium untuk mengurangkan kebimbangan dan menggalakkan pesakit rehat.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
e.<span class="Apple-tab-span" style="white-space: pre;"> </span>Galak ahli keluarga beri sokongan kepada pesakit untuk kurangkan kebimbangan</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
f.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kenalkan kepada pesakit yang telah berjaya menjalani pembedahan yang sama untuk menambahkan keyakinan kepada pesakit.</div>
<div style="text-align: justify;">
Penilaian: pesakit faham mengenai pembedahan yang akan ia jalani.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><br /></b></div>
<div style="text-align: justify;">
<b>3.<span class="Apple-tab-span" style="white-space: pre;"> </span>Gangguan imej diri berkaitan dengan perubahan pada mole, warna dan adanya lesi di kulit</b></div>
<div style="text-align: justify;">
Matlamat: </div>
<div style="text-align: justify;">
pesakit dapat mengekalkan hubungan dengan ahli keluarga dan orang di sekelilingnya serta tidak merasa rendah diri</div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span></div>
<div style="text-align: justify;">
Intervensi kejururawatan:</div>
<div style="text-align: justify;">
1.<span class="Apple-tab-span" style="white-space: pre;"> </span>Beri penerangan kepada pesakit mengenai penyakit dan rawatan yang perlu diikutinya untuk kekalkan imej diri dan keyakinan </div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
2.<span class="Apple-tab-span" style="white-space: pre;"> </span>Pakai pakaian yang menutupi kulit pesakit, baju lengan panjang, seluar panjang, longgar dan tidak terdedah untuk elak pesakit merasa rendah diri terhadap penyakitnya.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
3.<span class="Apple-tab-span" style="white-space: pre;"> </span>Galakkan pesakit untuk bertanya dan meluahkan perasaannya serta memberikan pendapat mengenai penyakitnya untuk elak rasa malu terhadap penyakitnya</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
4.<span class="Apple-tab-span" style="white-space: pre;"> </span>Galakkan pesakit untuk melibatkan diri dalam aktiviti yang dilakukan untuk elak pesakit menyendiri dan merasa tersisih.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
5.<span class="Apple-tab-span" style="white-space: pre;"> </span>Nasihatkan pesakit supaya menjaga kebersihan diri untuk mengekalkan imej dirinya. Sapukan losyen/cream yang telah diarahkan doctor.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
6.<span class="Apple-tab-span" style="white-space: pre;"> </span>Galakkan ahli keluarga sentiasa berada di sisi pesakit untuk meningkatkan keyakinan diri.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
7.<span class="Apple-tab-span" style="white-space: pre;"> </span>Kenalkan dengan pesakit yang telah berjaya menjalani rawatan penyakit yang sama untuk memberikan keyakinan diri.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
Penilaian: pesakit tidak merasa rendah diri dan dapat mengikuti rawatan yang diberikan semasa berada di hospital</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b><br /></b></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b>PENDIDIKAN KESIHATAN</b></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b><br /></b></span></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Early detection</div>
<div style="text-align: justify;">
Periksalah kulit apabila memiliki faktor resiko melanoma secara teratur. Screening sangat penting untuk dilakukan intervensi apabila lesi kulit berkembang menjadi melanoma dan untuk kenalpasti perubahan pada kulit.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Nasihatkan untuk tidak terdedah pada cahaya matahari secara langsung</div>
<div style="text-align: justify;">
Elak exposure kulit pada tengah hari terutama pada musim panas (10am-2pm) kerana mengandungi UVA dan UVB yang dapat mencetuskan kanser kulit.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Gunakan sunscreen</div>
<div style="text-align: justify;">
Sapukan sunblock, losyen atau cream dengan SPF 15 (15-30 minit) sebelum keluar rumah untuk melindungi kulit dan elak kulit terbakar.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Pakai pakaian yang melindungi kulit </div>
<div style="text-align: justify;">
Seperti baju lengan panjang, seluar panjang, pakai topi atau cermin mata hitam bila perlu untuk melindungi kulit dan elak terdedah pada cahaya matahari secara langsung.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Elak berjemur atau terdedah cahaya matahari terlalu lama</div>
<div style="text-align: justify;">
Kerana akan merosakkan sel-sel kulit, dan mencetuskan kanser kulit.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Elak kulit kering</div>
<div style="text-align: justify;">
Kulit kering dapat menyebabkan ketidakselesaan. Nasihatkan pesakit untuk kerap mandi, gunakan krim pelembap serta merta selepas drying-off.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Perenang harus reapplied waterproof sunscreen setiap 30 minit kerana waterproof sunscreen bertahan 30 minit sahaja untuk elak kulit terbakar.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Diet seimbang</div>
<div style="text-align: justify;">
Nasihatkan pesakit ambil makanan seimbang, tinggi Vitamin D untuk kesihatan kulit seperti suplemen vitamin D, susu, fish liver oil, soy, greentea, nuts. Ambil cecair yang mencukupi 2-3 liter sehari untuk elak kulit kering.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Lakukan Pemeriksaan kulit </div>
<div style="text-align: justify;">
Masa terbaik untuk menjalankan pemeriksaan ini adalah selepas mandi. Periksa kulit di dalam bilik yang terang menggunakan cermin panjang dan cermin tangan. Cara terbaik adalah dengan mengenal pasti tahi lalat, blemish dan pertukaran dalam saiz, bentuk, atau warna tahi lalat. Periksa semua kawasan termasuk kawasan belakang, kulit kepala, di celah-celah punggung, dan kawasan genital.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span>Tarikh susulan</div>
<div style="text-align: justify;">
Patuhi tarikh susulan mengikut jadual yang ditetapkan untuk progress penyakit dan datang dengan segera apabila berlaku keabnormalan pada kulit atau mole seperti sakit, gatal atau perubahan warna serta bentuk.</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span class="Apple-tab-span" style="white-space: pre;"> </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
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<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
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<br /></div>
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<br /></div>Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com0tag:blogger.com,1999:blog-8729813714071578939.post-80462115867536489832012-05-11T00:34:00.003+08:002012-05-11T00:41:52.381+08:00KOMA<br />
<span style="font-size: large;"><b><br /></b></span><br />
<span style="font-size: large;"><b>DEFINISI:</b></span><br />
Koma adalah suatu keadaan tidak sedar yang tidak dapat dikejutkan ketenatannya.<br />
<br />
Ketiadaan tindak balas terhadap rangsangan yang boleh menimbulkan kesakitan dan refleks pupil serta kornea.<br />
<span style="font-size: large;"><b><br /></b></span><br />
<span style="font-size: large;"><b>Keadaan semasa berlaku Kecemasan pada Pesakit Koma:</b></span><br />
<ol>
<li>Siapkan Katil</li>
<li>Posisi</li>
<li>Pemberian Oksigen</li>
<li>Siapkan Suction</li>
<li>Cardiac Monitoring</li>
<li>Insertion IVD</li>
<li>Pemasangan CBD </li>
</ol>
<div>
<b><span style="font-size: large;"><br /></span></b></div>
<div>
<b><span style="font-size: large;">NURSING DIAGNOSIS:</span></b></div>
<div>
<ol>
<li>Perubahan corak nutrisi iaitu kurang dari keperluan badan b/d tidak boleh mengambil makanan secara normal</li>
<li>Risiko aspirasi pneumonia b/d ketiadaan refleks menelan (refleks gag)</li>
<li>Risiko perubahan integriti kulit berkaitan dengan kurang pergerakan</li>
<li>Risiko kecederaan berkaitan dengan ketidaksedaran diri akibat koma.</li>
<li>Potensi infeksi berkaitan dengan penjagaan CBD (Continuous Bladder Drainage).</li>
</ol>
</div>
<br />
<div>
<b><span style="font-size: large;"><br /></span></b></div>
<div>
<b><span style="font-size: large;">NURSING INTERVENTION:</span></b></div>
<div>
<b><br /></b></div>
<div>
<b>1. Perubahan corak nutrisi iaitu kurang dari keperluan badan b/d tidak boleh mengambil makanan secara normal</b></div>
<div>
<div>
<div>
<b><br /></b></div>
</div>
<div>
Objektif : </div>
<div>
Untuk memenuhi keperluan nutrisi pesakit dan mempercepat proses penyembuhan</div>
<div>
<br /></div>
<div>
Intervensi :</div>
<div>
<ol>
<li>Pemasangan R/T feeding untuk pemberian makanan dan minuman untuk memberikan nutrisi yang mencukupi kerana tiada keupayaan untuk menelan</li>
<li>Rekod pengambilan dan pengeluaran (I/O Chart) secara tepat dan betul untuk maklumat asas dalam menentukan rawatan</li>
<li>Mulakan Intra Venous Infusion jika diarahkan ( e.g TPN ) untuk cegah dehidrasi, ketidakseimbangan elektrolit dan kurang nutrisi</li>
<li>Catit dan lapor abnormaliti dengan segera untuk lain-lain intervensi.</li>
</ol>
<div>
<br /></div>
</div>
</div>
<div>
<div>
Penilaian : </div>
<div>
Pesakit mendapat nutrisi yang mencukupi</div>
</div>
<div>
<br /></div>
<div>
<b><br /></b></div>
<div>
<b>2. Risiko aspirasi pneumonia b/d ketiadaan refleks menelan (refleks gag)</b></div>
<div>
<div>
<br /></div>
<div>
Objektif :</div>
<div>
Pesakit tidak mendapat aspirasi pneumonia</div>
<div>
<br /></div>
<div>
Intervensi :</div>
<div>
<ol>
<li>Monitor TPR dan Blood Pressure (Demam, Takikardia, Takipnea) untuk kesan tanda-tanda aspirasi pneumonia</li>
<li>Suction apparatus sentiasa berada di sebelah katil pesakit dan sedut sekresi dalam mulut dengan segera untuk cegah berlakunya aspirated</li>
<li>Letakkan pesakit dalam posisi lateral untuk sekresi dapat mengalir keluar dari mulut</li>
<li>Elak memasukkan ubatan, makanan atau minuman melalui oral untuk mengelakkan berlakunya aspirated </li>
<li>Beri dan monitor IVI jika diarahkan untuk cegah dehidrasi</li>
</ol>
</div>
</div>
<div>
<br /></div>
<div>
<div>
Penilaian :</div>
<div>
Pesakit tidak menunjukkan tanda-tanda aspirasi pneumonia</div>
</div>
<div>
<br /></div>
<div>
<b><br /></b></div>
<div>
<b>3. Risiko perubahan integriti kulit berkaitan dengan kurang pergerakan</b></div>
<div>
<b><br /></b></div>
<div>
<div>
Objektif :</div>
<div>
Integriti kulit pesakit dapat dikekalkan</div>
<div>
<br /></div>
<div>
Intervensi :</div>
<div>
<ol>
<li>Letakkan pesakit atas permukaan yang kurang memberi tekanan (e.g ripple mattress, soft mattress) untuk cegah tekanan pada kulit pesakit</li>
<li>Tukar posisi dengan kerap setiap 2 jam sekali untuk cegah dari berlaku kudis tekanan</li>
<li>Beri penjagaan pada kawasan yang memberi tekanan (e.g oksiput, scapula, siku) untuk cegah dari mendapat kudis tekanan dan infeksi</li>
<li>Periksa permukaan kulit dengan tanda-tanda : Iritasi, Kemerahan untuk cegah kulit daripada pecah </li>
<li>Bersihkan kulit setiap hari ( sponging ) untuk kurangkan mikroorganisma</li>
<li>Beri jagaan pada bahagian lipatan dan permukaan kulit (e.g groin, axilla) untuk cegah ekskorasi (kepecahan kulit)</li>
<li>Memastikan cadar tidak berkedut dan pakaian pesakit bersih dan kering untuk cegah ekskoriasi pada kulit </li>
<li>Lakukan jagaan perineal (eg: perineal swabbing) untuk mengekalkan kebersihan dan elak jangkitan pada bahagian perineal</li>
<li>Lakukan urutan lembut dengan menggunakan losyen atau bahan pelicin pada bahagian tekanan untuk menggalakkan peredaran darah, dan elak kudis tekanan </li>
<li>Lindungi kulit pada bahagian tertekan dengan krim atau ointment untuk mengekalkan integriti kulit dan mengelakkan mendapat kudis tekanan.</li>
</ol>
</div>
<div style="font-weight: bold;">
<br /></div>
</div>
<div>
<div>
Penilaian :</div>
<div>
Kulit pesakit kekal bersih dan bebas dari kudis tekanan</div>
<div>
<br /></div>
<div>
<b><br /></b></div>
<div>
<b>4. Risiko kecederaan berkaitan dengan ketidaksedaran diri akibat koma </b><br />
<b><br /></b><br />
<br />
Objektif :<br />
Kecederaan dapat dielakkan dan pesakit selamat selama menjalani rawatan di hospital<br />
<br />
Intervensi :<br />
<br />
<ol>
<li>Letakkan pesakit berdekatan dengan kaunter jururawat untuk pemantauan yang rapi terhadap pesakit </li>
<li>Letakkan pesakit di katil yang rendah dan berpagar untuk elak daripada pesakit terjatuh </li>
<li>Galakkan ahli keluarga selalu bersama pesakit untuk memberikan sokongan emosi</li>
<li>Lakukan rawatan dengan lemah lembut ( e.g sponging, tukar baringan ) untuk elak dari kecederaan </li>
<li>Tukar baringan setiap 2 jam sekali untuk elak melecet (ekskorasi)</li>
</ol>
<br />
<div>
<div>
<br /></div>
<div>
Penilaian :</div>
<div>
Pesakit dalam keadaan selamat selama menjalani rawatan di hospital</div>
</div>
<div>
<br /></div>
<div>
<b><br /></b></div>
<div>
<div>
<b>5. Potensi infeksi berkaitan dengan penjagaan CBD</b></div>
<div>
<br /></div>
<div>
Objektif : Infeksi dapat dielakkan</div>
<div>
<br /></div>
<div>
Intervensi :</div>
<div>
<ol>
<li>Asses pengeluaran urin dalam CBD dari segi : Warna, Amaun, Bau untuk mengenal pasti tanda-tanda jangkitan</li>
<li>Monitor tanda vital 4 jam sekali untuk memperhatikan tanda-tanda jangkitan yang ditunjukkan dengan peningkatan suhu badan </li>
<li>Kosongkan urin bag sebelum penuh untuk mengelakkan dari penakungan urin yang boleh menyebabkan infeksi</li>
<li>Letakkan urin bag berada dibawah paras pinggang pesakit untuk mengelakkan urin back flow dari urin bag ke bladder. Elak ascending infection. </li>
<li>Gunakan aseptik teknik semasa menukar tiub dan bag CBD untuk elak infeksi</li>
<li>Penjagaan perineum setiap hari untuk mengelakkan komplikasi UTI</li>
</ol>
</div>
</div>
<div>
<div>
<br /></div>
<div>
Penilaian :</div>
<div>
Pesakit tidak mendapatkan jangkitan sistem urinary semasa berada di hospital </div>
</div>
<br />
<div style="font-weight: bold;">
<br /></div>
</div>
<div>
<br /></div>
<div style="font-weight: bold;">
<br /></div>
</div>Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com2tag:blogger.com,1999:blog-8729813714071578939.post-80169097084452776392012-05-10T22:52:00.000+08:002012-07-24T09:58:13.791+08:00LUMBAR PUNCTURE<span style="font-size: large;"><b><br /></b></span><br />
<span style="font-size: large;"><b>DEFINITION:</b></span><br />
<div>
Lumbar Puncture is the insertion of sterile needle into the sub-arachnoid space of the spinal canal, usually between the third and fourth vertebra, to reach the cerebral spinal fluid.<br />
<div>
This procedure requires sterile technique and careful client positioning. It is performed therapeutically to administer drugs or anaesthetics and to relieve intra-cranial pressure.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgu4O7YCd007nyGnyQkXbiAULKhfQQilbzsNtf1sXPLcTKP0kysuxe3H8hwAIeau_FMkmG8_eIAGTcbpTPITCww9gkQ1AEILR6VNdeP5kVqVvProqR_DttyPtkG8-mjFO5U78C9aBn9kno/s1600/ans7_lumbar_puncture.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="color: black;"><img border="0" height="234" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgu4O7YCd007nyGnyQkXbiAULKhfQQilbzsNtf1sXPLcTKP0kysuxe3H8hwAIeau_FMkmG8_eIAGTcbpTPITCww9gkQ1AEILR6VNdeP5kVqVvProqR_DttyPtkG8-mjFO5U78C9aBn9kno/s320/ans7_lumbar_puncture.jpg" width="320" /></span></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzeACiJlE5jthrzAHHefVgpgdKYtBAVhd9hLKK4NMNdp6eYvR4YViquZs6DQdUqpsvQ2giDakndLWrue3ts1F-i4gcqyuKxNUJMdZf5nYQVdwNts4LvKAbBun05Mkeejfw85lrZU7QVV8/s1600/coursePreviewImage1.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="color: black;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzeACiJlE5jthrzAHHefVgpgdKYtBAVhd9hLKK4NMNdp6eYvR4YViquZs6DQdUqpsvQ2giDakndLWrue3ts1F-i4gcqyuKxNUJMdZf5nYQVdwNts4LvKAbBun05Mkeejfw85lrZU7QVV8/s1600/coursePreviewImage1.png" /></span></a></div>
<span style="font-size: large;"><br /></span></div>
<div>
<span style="font-size: large;"><b>PURPOSE:</b></span></div>
<div>
<ol>
<li>To determine the pressure of the cerebral spinal fluid (CSF)</li>
<li>To detect increased intra-cranial pressure (ICP)</li>
<li>To detect presence of blood in the cerebral spinal fluid, this indicates cerebral haemorrhage</li>
<li>To obtain cerebral spinal fluid specimen for laboratory analysis</li>
</ol>
</div>
<div>
<span style="font-size: large;"><b><br /></b></span></div>
<div>
<span style="font-size: large;"><b>PRE PROCEDURE CARE:</b></span></div>
<div>
<ol>
<li>Reinforce doctor's explanation to client and significant others to the get cooperation from the client</li>
<li>Check if consent has been properly secured and attached to chart to prevent legal implications</li>
<li>Verify from doctor place for performing the procedure to facilitate the procedure</li>
<li>Prepare equipment needed to get the requirement ready</li>
<li>Screen the client properly to provide privacy for the client</li>
<li>Ask the client to empty the bladder to prevent complications</li>
</ol>
</div>
<div>
<span style="font-size: large;"><b><br /></b></span></div>
<div>
<span style="font-size: large;"><b>POST CARE:</b></span></div>
<div>
<ol>
<li>Instruct the patient to lie flat for at least 6 hours to reduce chance of headache </li>
<li>Monitor the patient carefully following the procedure. Adverse reactions including headache, vertigo, syncope, nausea, tinnitus, respiratory distress, change in vital signs and fever should be reported to the professional nurse or doctor to detect the abnormalities if any</li>
<li>Give the patient increased fluids for at least 24 hours after the procedure to prevent dehydration</li>
<li>Ensure the comfort and safety of the patient to promote comfort of the patient</li>
<li>Record the procedure in the client's chart to provide baseline data</li>
</ol>
<div>
<span style="font-size: large;"><br /></span></div>
</div>
<div>
<span style="font-size: large;">THE NORMAL RESULTS OF CSF:</span></div>
<div>
<ul>
<li>Protein: 15-45 mg/dL</li>
<li>Glucose: 50-80 mg/dL</li>
<li>White Blood Cell: < 5 mm3</li>
<li>Red Blood Cell: 0-5</li>
<li>Opening Pressure: 5-20 cm</li>
<li>Clarity, Colour: Clear and colourless.</li>
</ul>
</div>
<div>
<br /></div>
<div>
<br /></div>
<div>
<br /></div>
</div>Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com0tag:blogger.com,1999:blog-8729813714071578939.post-20772111030977720972011-11-15T11:43:00.000+08:002012-07-24T09:58:31.677+08:00JODOH ♥♥ USAH MENCARI YANG "TERLALU SEMPURNA"<div class="separator" style="clear: both; text-align: center;">
<span class="Apple-style-span" style="margin-left: 1em; margin-right: 1em;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9IHp6Nj-Kj57yBwPD1a9vTD_qX3NIi-0vlcm40vth5RxyTpE5Bhj_Z9TQ3lGR9YTSNnUO2jT5CqkFpbUYdBR2H4BjVRILvoTIWXWvy-zAsk3DBdnodCSLKqlg8RTxctwhR1xLwPwoM1E/s1600/298826_294349400589310_192242767466641_1043366_889784_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="272" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9IHp6Nj-Kj57yBwPD1a9vTD_qX3NIi-0vlcm40vth5RxyTpE5Bhj_Z9TQ3lGR9YTSNnUO2jT5CqkFpbUYdBR2H4BjVRILvoTIWXWvy-zAsk3DBdnodCSLKqlg8RTxctwhR1xLwPwoM1E/s320/298826_294349400589310_192242767466641_1043366_889784_n.jpg" width="320" /></a></span></div>
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<span class="Apple-style-span" style="border-collapse: collapse; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 11px; line-height: 14px;">Jika kamu memancing ikan... Setelah ikan itu terlekat di mata kail, hendaklah kamu mengambil ikan itu... Janganlah sesekali kamu LEPASKAN ia semula ke dalam air begitu saja.. Kerana ia akan SAKIT oleh kerana bisanya ketajaman mata kailmu & mungkin ia akan MENDERITA selagi ia masih hidup. </span></div>
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<span class="Apple-style-span" style="border-collapse: collapse; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 11px; line-height: 14px;">Begitulah juga...setelah kamu memberi banyak PENGHARAPAN kepada seseorang... Setelah ia mulai MENYAYANGIMU, hendaklah kamu MENJAGA hatinya... Janganlah sesekali kamu meninggalkannya begitu saja... Kerana dia akan TERLUKA oleh kenangan bersamamu, & mungkin TIDAK dapat MELUPAKAN segalanya selagi dia mengingatmu... </span></div>
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<span class="Apple-style-span" style="border-collapse: collapse; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 11px; line-height: 14px;">Jika kamu menadah air biarlah berpada, jangan terlalu mengharap pada takungannya & janganlah menganggap ia begitu teguh...cukuplah sekadar keperluanmu... Apabila sekali ia retak...tentu sukar untuk kamu menambalnya semula... Akhirnya ia dibuang... Sedangkan jika kamu cuba memperbaikinya, mungkin ia masih dapat dipergunakan lagi... </span></div>
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<span class="Apple-style-span" style="border-collapse: collapse; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 11px; line-height: 14px;">Begitu juga jika kamu memiliki seseorang, TERIMALAH seadanya... Janganlah kamu terlalu mengaguminya & janganlah kamu menganggapnya begitu istimewa... Anggaplah dia manusia biasa. Apabila sekali dia melakukan KESILAPAN, bukan mudah bagi kamu untuk menerimanya... Akhirnya kamu KECEWA & meninggalkannya. Sedangkan, jika kamu MEMAAFKANNYA boleh jadi hubungan kamu akan TERUS hingga ke akhirnya.... </span></div>
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<span class="Apple-style-span" style="border-collapse: collapse; font-family: 'lucida grande', tahoma, verdana, arial, sans-serif; font-size: 11px; line-height: 14px;">Jika kamu telah memiliki sepinggan nasi, yang kamu pasti baik untuk dirimu... Mengenyangkan - Berkhasiat. Mengapa kamu berlengah, cuba mencari makanan yang lain..?? Terlalu ingin mengejar kelazatan... KELAK.. Nasi itu akan basi & kamu tidak boleh memakannya... Lalu kamu akan menyesal. </span></div>
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Begitu juga jika kamu telah bertemu dengan seorang insan, yang pasti membawa KEBAIKAN kepada dirimu. MENYAYANGIMU.. MENGASIHIMU... Mengapa kamu berlengah, cuba MEMBANDINGKANNYA dengan yang lain..?? Terlalu mengejar kesempurnaan... KELAK.. Kamu akan KEHILANGANNYA apabila dia menjadi milik orang lain... Lalu kamu juga yang akan MENYESAL...!!</div>
</div>Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com0tag:blogger.com,1999:blog-8729813714071578939.post-82522352670432273832011-11-15T01:26:00.000+08:002012-07-24T09:59:02.329+08:00Video Klip dan Lirik Lagu Cinta Dalam Hati by UNGU<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/9w3SSIMIPBg?feature=player_embedded' frameborder='0'></iframe></div>
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<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: 14px; line-height: 24px;"></span></div>
mungkin ini memang jalan takdirku<br />
mengagumi tanpa dicintai<br />
tak mengapa bagiku asal kau pun bahagia<br />
dalam hidupmu, dalam hidupmu<br />
<br />
telah lama kupendam perasaan itu<br />
menunggu hatimu menyambut diriku<br />
tak mengapa bagiku mencintaimu pun adalah<br />
bahagia untukku, bahagia untukku<br />
<br />
<i>reff:</i><br />
<br />
ku ingin kau tahu diriku di sini menanti dirimu<br />
meski ku tunggu hingga ujung waktuku<br />
dan berharap rasa ini kan abadi untuk selamanya<br />
dan ijinkan aku memeluk dirimu kali ini saja<br />
tuk ucapkan selamat tinggal untuk selamanya<br />
dan biarkan rasa ini bahagia untuk sekejab saja<br />
<i><br />
</i><br />
<i>repeat reff</i>Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com1tag:blogger.com,1999:blog-8729813714071578939.post-11529011084288676042011-11-14T01:36:00.000+08:002012-07-24T10:01:02.014+08:00Acute Appendicitis<div class="MsoNormal" style="line-height: 200%; text-align: justify;">
<span class="apple-style-span"><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; line-height: 200%;"><span style="font-size: large;">DEFINITION</span><span style="font-size: small;"><o:p></o:p></span></span></b></span></div>
<div style="line-height: 200%; margin-bottom: 15.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif;">Acute Appendicitis is a sudden condition in which appendix becomes inflamed and fills with pus at vermiform appendix (Right Iliac Fossa). <o:p></o:p></span></div>
<div style="line-height: 200%; margin-bottom: 15.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif;">Appendix is a finger-shaped pouch that projects out from colon on the lower right side of abdomen.</span></div>
<div style="line-height: 200%; margin-bottom: 15.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: large;"><br />
</span></div>
<div style="line-height: 200%; margin-bottom: 15.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif;"><span style="font-size: large;">PROGNOSIS</span><o:p></o:p></span></b></div>
<div style="line-height: 200%; margin-bottom: 15.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif;">Perforation: In patients under age 10 or over age 30 (50%), Other (10%)<o:p></o:p></span></div>
<div class="mmpara" style="line-height: 200%; margin-bottom: .2in; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif;">Without surgery or antibiotics, mortality is<span class="apple-converted-space"> </span><span class="symbol">></span><span class="apple-converted-space"> </span>50%.<o:p></o:p></span></div>
<div class="mmpara" style="line-height: 200%; margin-bottom: .2in; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="color: black;"><a href="http://www.blogger.com/post-edit.g?blogID=8729813714071578939&postID=1152901108428867604&from=pencil" name="v890745"></a></span></div>
<div style="line-height: 200%; margin-bottom: 15.0pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif;">With early surgery, the mortality rate is<span class="apple-converted-space"> </span><span class="symbol"><</span><span class="apple-converted-space"> </span>1%, and convalescence is normally rapid and complete. With complications (rupture and development of an abscess or peritonitis), the prognosis is worse: Repeat operations and a long convalescence may follow. <o:p></o:p></span></div>
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</div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: large;"><br /></span></b><br />
<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif;"><span style="font-size: large;">ETIOLOGY</span><o:p></o:p></span></b></div>
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<span style="font-family: Arial, sans-serif;">The cause of appendicitis isn't always clear. Sometimes acute appendicitis can occur as a result of:<o:p></o:p></span></div>
<div class="MsoNormal" style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 7.5pt; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -22.5pt;">
<span class="apple-converted-space"><span style="font-family: Symbol; font-size: 10pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><strong><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">An obstruction.</span></strong><span class="apple-converted-space"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 7.5pt; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Food waste or a hard piece of stool (fecal stone, hardened stool), calculus, worm, neoplasm can block the opening of the cavity that runs the length of appendix. <o:p></o:p></span></div>
<div class="MsoNormal" style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 7.5pt; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -22.5pt;">
<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Adhesion</span></b><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"><o:p></o:p></span></div>
<div class="MsoNormal" style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 7.5pt; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Adhesion at appendix walls or nearby structure because of disease or fibrosis.<span class="hps"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 7.5pt; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -22.5pt;">
<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">“Kinking” appendix<o:p></o:p></span></b></div>
<div class="MsoNormal" style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 7.5pt; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">The appendix becomes inflamed and edematous as a result of becoming kinked.<o:p></o:p></span></div>
<div class="MsoNormal" style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 7.5pt; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -22.5pt;">
<span class="apple-converted-space"><span style="font-family: Symbol; font-size: 10pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><strong><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">An infection.</span></strong><span class="apple-converted-space"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 7.5pt; margin-left: 22.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;">
<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Appendicitis may also follow an infection, such as a gastrointestinal viral infection, or it may result from other types of inflammation. The most common bacteria in the appendix are Bacteroides fragilis and Escherichia Coli.<o:p></o:p></span></div>
<div class="MsoNormal" style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 7.5pt; text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 15pt; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: large;">PATOPHYSIOLOGY</span></b></div>
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<span style="font-family: Arial, sans-serif;"> Acute appendicitis seems to be the end result of a primary obstruction of the appendix lumen. Once this obstruction occurs the appendix subsequently becomes filled with mucus and swell, increasing pressures within the lumen and the walls of the appendix, resulting in thrombosis and occlusion of the small vessels, and stasis of the lymphatic flow. As the former progresses, the appendix becomes ischemic and then necrotic. As bacteria begin to leak out through the dying walls, it inflamed. Pus forms within and around the appendix. The end result of this is appendicle rupture causing gangrene, peritonitis, which may lead to septicemia and eventually death.<o:p></o:p></span></div>
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<span style="font-size: large;"><br /></span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif;"><span style="font-size: large;">CLINICAL MANIFESTATION</span><o:p></o:p></span></b></div>
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<span style="font-family: Arial, sans-serif;">1. <u>Pain</u><o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Acute pain suddenly in the right iliac fossa. Characterized by Colicy<o:p></o:p></span></div>
<div style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 15pt; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -13.5pt;">
<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Pain usually begins in the center of the abdomen, around the navel area. Later, the pain may move downward and to the right, to an area called <i style="mso-bidi-font-style: normal;">McBurney's point</i> and pain when pressure is released (<i style="mso-bidi-font-style: normal;">Rebound Tenderness</i>)<o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif;">Rovsing’s sign </span></i><span style="font-family: Arial, sans-serif;">– deep palpation will cause pain in the right iliac fossa<i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div>
<div style="font-family: Arial, sans-serif; line-height: 200%; margin-bottom: 15pt; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: -13.5pt;">
<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Pain increased when moving/coughing. <i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div>
<div style="text-align: center; text-indent: -18px;">
<span class="Apple-style-span" style="font-family: Arial, sans-serif;"><span class="Apple-style-span" style="line-height: 32px;"><br />
</span></span></div>
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<span style="font-family: Arial, sans-serif;">2. <u>Nausea and Vomiting<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> Due to pain in the abdomen<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">3. <u>Anorexia<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> Due to prolonged pain<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">4. <u>Fever (37.8<sup>o</sup>C – 38.3<sup>o</sup>C), Tachypnea, Tachycardia<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> Due to inflammatory process and dehydration <o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">5. <u>Constipation/Diarrhea<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> Inflammatory process disrupt peristalsis movement<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">6. <u>Dehydration<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> Coated tongue/halitosis <o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">7. <u>Lethargic, Malaise</u><o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> Due to fever<o:p></o:p></span></div>
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<span style="font-size: large;"><br /></span></div>
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<span class="apple-style-span"><span style="font-family: Arial, sans-serif; line-height: 200%;"><span style="font-size: large;">TEST AND DIAGNOSIS</span><span style="font-size: small;"><o:p></o:p></span></span></span></h1>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%; text-indent: -22.5pt;">1)<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><u style="line-height: 200%; text-indent: -22.5pt;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Physical Examination</span></u></div>
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<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Rebound Tenderness at Right Iliac Fossa.<o:p></o:p></span></div>
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<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Gentle pressure on the painful area. When the pressure is suddenly released, appendicitis pain will often feel worse, signaling that the adjacent peritoneum is inflamed. Other signs, watch for include abdominal rigidity and a tendency to stiffen abdominal muscles in response to pressure over the inflamed appendix.<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">2) <u>Rectal Examination<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"> If pain means inflammation at rectocecal <o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">3) <u>Blood Test</u><o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">To check for a high White Blood Cell Count, which may indicate an infection. (Leukocytosis = >12.000 – 20.000)<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">4) <u>Urine F.E.M.E (Full Examination Microscopic Examination)</u><o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Urinalysis to make sure that a urinary tract infection or a kidney stone isn’t causing pain. <o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">5) <u>Imaging Test</u><o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">An abdominal X-ray (feacalith), an Ultrasound scan or a computerized tomography (CT) scan to help confirm appendicitis. <o:p></o:p></span><br />
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<span style="font-size: large;"><span style="font-family: Arial, sans-serif; line-height: 200%;"> </span><span style="font-family: Arial, sans-serif; line-height: 200%;"> </span></span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; line-height: 200%;"><span style="font-size: large;">TREATMENT</span><span style="font-size: small;"><o:p></o:p></span></span></b></div>
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<b style="line-height: 200%;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">1. CONSERVATIVE</span></b></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">a)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><u><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Reduce Pain<o:p></o:p></span></u></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Complete Rest In Bed, comfort position<o:p></o:p></span></div>
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<span class="hps"><span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">No analgesic before diagnosis of appendicitis because it will lose sign<o:p></o:p></span></span></div>
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<span class="hps"><span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">No hot water bag. It will cause rupture<o:p></o:p></span></span></div>
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<span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">b)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span class="hps"><u><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Nil By Mouth (6-8hours)<o:p></o:p></span></u></span></div>
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<span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">To avoid aspiration pneumonia<o:p></o:p></span></span></div>
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<span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">c)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span class="hps"><u><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Treat Fever</span></u></span><span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"><o:p></o:p></span></span></div>
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<span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">>37.5<sup> o</sup>C = cold compress, >38<sup>o</sup>C = tepid sponging<o:p></o:p></span></span></div>
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<span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">d)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span class="hps"><u><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Observation<o:p></o:p></span></u></span></div>
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<span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Vital Sign, general condition (vomit- amount and content, record and do mouth toilet<o:p></o:p></span></span></div>
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<span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">e)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span class="hps"><u><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Antibiotic to kill microorganism<o:p></o:p></span></u></span></div>
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<span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">f)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span class="hps"><u><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Intake output chart<o:p></o:p></span></u></span></div>
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<span class="hps"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Due to lost of appetite and weight (LOA & LOW)<o:p></o:p></span></span></div>
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<span class="hps" style="line-height: 200%;"><b><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">2. SURGICAL (</span></b></span><b style="line-height: 200%;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">APPENDICECTOMY)</span></b></div>
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<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Appendicectomy is the surgical procedure for removal of the appendix.<o:p></o:p></span></div>
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<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">The operation can be performed via a laparoscopic approach or via 3 small incision with camera to visualize the area of interest in abdomen.<o:p></o:p></span></div>
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<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span class="apple-style-span"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Open <a href="http://en.wikipedia.org/wiki/Laparotomy" title="Laparotomy">laparotomy</a></span></span><span class="apple-converted-space"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"> </span></span><span class="apple-style-span"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">may be necessary of findings reveal suppurative appendicitis with complications such as rupture, abscess, adhesions. </span></span><a href="http://www.blogger.com/post-edit.g?blogID=8729813714071578939&postID=1152901108428867604&from=pencil" name="Hospitals"></a><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"><o:p></o:p></span><br />
<span class="apple-style-span"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"><br /></span></span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif;"><span style="font-size: large;">PREOPERATIVE CARE</span><o:p></o:p></span></b></div>
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<span style="font-family: Arial, sans-serif;">1. <u>Consent form<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> As a medico legal from patient<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">2. <u>Skin Prep<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> From nipple line to mid thigh to avoid microorganism from skin<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">3. <u>Electrocardiogram </u>if more 40 years old<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">4. <u>Investigation<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> - Hb, TWBC, Urine FEME<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> - BUSE, RBS if more 40 years old<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">5. <u>Anesthetist <o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> Under general anesthesia to give pre medication and reduce anxiety such as valium, morphine<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">6. <u>Weight</u> for calculate the dose of medication<o:p></o:p></span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif;"><span style="font-size: large;">POST OP CARE</span><o:p></o:p></span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif;">(1) <i style="mso-bidi-font-style: normal;">IMMEDIATE CARE</i><u><o:p></o:p></u></span></b></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif;"> </span></b><span style="font-family: Arial, sans-serif;">a. <u>Keep Nil By Mouth </u>to avoid aspiration pneumonia<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> Give IV Drip cause of KNBM<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> b. <u>Observation<o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Vital Sign</span></div>
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<li><span style="font-family: Symbol; line-height: 200%; text-indent: -0.25in;"><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; line-height: 200%; text-indent: -0.25in;">Hyperpyrexia, tachycardia (sign of infection)</span></li>
<li><span style="font-family: Symbol; text-indent: -0.25in;"><span style="line-height: 32px;"> </span><span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; line-height: 200%; text-indent: -0.25in;">Hypotension (sign of hypovolemic shock)</span></li>
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<span style="font-family: Symbol; line-height: 200%; text-indent: -0.25in;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; line-height: 200%; text-indent: -0.25in;">General condition = pale, weak, pain</span></div>
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<span style="font-family: Symbol; line-height: 200%; text-indent: -0.25in;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif; line-height: 200%; text-indent: -0.25in;">Inspection of Surgical Wound to prevent infection and hypovolemic shock</span></div>
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<span style="font-family: Arial, sans-serif;"> c. <u>Medication</u><o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Analgesic to reduce pain, example: IM Voltaren 50mg sta<o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Antibiotic to kill microorganism (E.coli), example: IV Cloxacillin 1g<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> d. <u>Ryle’s Tube</u> <o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Aspiration/free flow, measure and record<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> e. <u>Drainage Tube</u> (for perforated appendix)<o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Hang the drainage bottle safely<o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Monitor amount, color and record<o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Avoid tangled/twisted<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> f. <u>Position<o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Supine first and lateral position to secretion out <u><o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Give a pillow when patient conscious<u><o:p></o:p></u></span></div>
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<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif;">(2) SUBSEQUENT CARE<o:p></o:p></span></i></b></div>
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<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-family: Arial, sans-serif;"> </span></i></b><span style="font-family: Arial, sans-serif;">a. <u>Nutrition<o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Clear fluid if there’s bowel sound<o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Continue with nourishing fluid, then Soft diet and Normal diet<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> b. <u>Continued observation<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> c. <u>Continued Medication,</u> such as antibiotic, analgesic<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> d. <u>Early ambulation<o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Seated after 24hour to avoid hypostatic pneumonia<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> e. <u>Breath and coughing exercise</u> to expanse lungs and decrease of pain<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> f. <u>Wound care <o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Dressing under aseptic technique<u><o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Avoid contact wound with dirty hand<u><o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">STO for 5<sup>th</sup>-7<sup>th</sup> day after op<u><o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> g. <u>Activity daily Living</u><o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;"> Personal hygiene, elimination and avoid injury<o:p></o:p></span><br />
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<b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif;"><span style="font-size: large;">HEALTH EDUCATION BEFORE DISCHARGE</span><o:p></o:p></span></b></div>
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<span style="font-family: Arial, sans-serif;">1) <u>Wound care<o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Avoid wet wound, not to touch wound with dirty hand<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">2) <u>Taking Medication<o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Consume antibiotic, vitamin for healing process of the wound<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">3) <u>Nutrition<o:p></o:p></u></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">High protein (fish, meat, egg)<o:p></o:p></span></div>
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<span style="font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><span style="font-family: Arial, sans-serif;">Vitamin (orange, grape)<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">4) <u>Personal hygiene<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> Clothes clean, not wet<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">5) <u>Activity<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> Can carry the heavy thing after 6weeks<o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif;">6) <u>TCA</u>/ <u>FOLLOW UP<o:p></o:p></u></span></div>
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<span style="font-family: Arial, sans-serif;"> STO for 5<sup>th</sup>-7<sup>th</sup> day, monitor of healing process of the wound<o:p></o:p></span></div>
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<span style="line-height: 200%; text-align: justify;"><span style="font-size: large;"><b>COMPLICATIONS</b></span></span></div>
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<span class="apple-converted-space" style="line-height: 200%; text-align: justify; text-indent: -22.5pt;"><span style="font-family: Symbol; font-size: 10pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span></span><strong style="line-height: 200%; text-align: justify; text-indent: -22.5pt;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">A ruptured appendix.</span></strong><span class="apple-converted-space" style="line-height: 200%; text-align: justify; text-indent: -22.5pt;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"> </span></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">If appendix ruptures, the contents of intestines and infectious organisms can leak into abdominal cavity. <o:p></o:p></span></div>
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<span class="apple-converted-space"><span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><strong><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">A pocket of pus that forms in the abdomen.</span></strong><span class="apple-converted-space"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"> <o:p></o:p></span></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">If appendix has burst, infection and the seepage of intestinal contents may form an abscess-a pocket of infection around the appendix. Causing a more widespread infection of the abdominal cavity<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div>
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<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Appendicular Mass<o:p></o:p></span></b></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Chronic inflammatory will form fibrosis and structural hardening.<o:p></o:p></span></div>
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<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Peritonitis</span></b><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"><o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Will happen if the inflammation spreads to peritoneum cavity.<o:p></o:p></span></div>
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<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Infected Wound</span></b><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;"><o:p></o:p></span></div>
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<span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Will occur when patient do not take care of appendicectomy wound.<o:p></o:p></span></div>
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<span style="font-family: Symbol; font-size: 12pt; line-height: 200%;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span><b style="mso-bidi-font-weight: normal;"><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">Adhesion </span></b><span style="font-family: Arial, sans-serif; font-size: 12pt; line-height: 200%;">may cause intestinal obstruction but this is not common.<o:p></o:p></span></div>Anonymoushttp://www.blogger.com/profile/03013316556653110609noreply@blogger.com3