LVN to ADN: Innovative, Non-Traditional Learning Project. INSTITUTION Austin Community Coll., Tex

Total Page:16

File Type:pdf, Size:1020Kb

LVN to ADN: Innovative, Non-Traditional Learning Project. INSTITUTION Austin Community Coll., Tex DOCUMENT RESUME E!) 299 41F CE 051 042 TITLE LVN to ADN: Innovative, Non-Traditional Learning Project. INSTITUTION Austin Community Coll., Tex. SPONS AGENCY Texas Higher Education Coordinating Board, Austin. PUB DATE 88 NOTE 356p. PUB TYPE Guides - Classroom Use - Guides (For Teachers) (052) EDRS PRICE MF01/PC15 Pius Postage. DESCRIPTORS *Associate Degrees; Behavioral Objectives; Community Colleges; *Course Content; Course Organization; Health; Learning Activities; *Medical Services; Nurses; *Nurses Aides; *Nursing Education; Test Items; Two Year Colleges ABSTRACT This document contains the curriculum for the first nursing course in the Licensed Vocational Nurse Mobility Track Project. The project is designed to provide selected Licensed Vocational Nurses (LVNs) the opportunity to complete the nursing course requirements for an Associate of Applied Science Degree in Nursing (ADN) in three semesters of part-time course work. This course assesses and evaluates nursing knowledge, skills, and attitudes in relationship to the transition to associate degree nursing practice. The content focuses on review of concepts basic to nursing practice and presents content to expand the student's nursing knowledge, skills, and attitudes as they develop in the ADN role of provider of patient care. Laboratory experiences provide the student the opportunity to demonstrate the application of prior learning and new knowledge to clinical situations. The six modules of the course cover the following topics: nursing--profession and process; the psychosocial need; the safety need; the rest, comfort, activity, and regulatory need; the nutrition and elimination needs; and the oxygen need. Each module contains an introduction, module objectives, learning activities, content information, learning resources, and a pretest/posttest. Appendices provide entry-level objectives and materials for the last four modules. (KC) *********************************************************************** * Reproductions supplied by EDRS are the best that can be made * * from the original document. * *********************************************************************** LVN TO ADN: INNOVATIVE, NON-TRADITIONAL LEARNING PROJECT "PERMISSION TO REPRODUCE THIS iU.S. DEPARTMENT of common of Educational Research andImprOwment MATERIAL HAS BEEN GRANTED BY E UCATIONAL RESOURCES INFORMATION CENTER (ERIC) The document hes been reproducedas received from the person ororganization originating it. (3 Minor changes have been madeto mprovs reproduction quality TO THE EDUCATION Points of need opinions slatedin the docu- RESOURCES ment do not necessarily representofficial INFORMATION CENTER (ERIC)" OERI position or policy This project was funded by the Texas Higher Education Coordinating Board through a grant utilizing funds from the Carl B. Perkins Vocational Edu- cation Act. AUSTIN 'N11121 P 0 Box 2285 Austin, Texas 78768 BEST COPYAVAILAB 2 TABLE OF CONTENTS PAGES Course Information and Requirements 3-10 MODULE I NURSING: PROFESSION AND PROCESS 11-12 I The Nursing Profession 13-23 II Austin Community College Associate Degree Nursing Program 24-30 III Nursing Process 31-38 MODULE II THE PSYCHOSOCIAL NEED 39-40 I Overview 41-:7 II Nursing Process 48-67 III Mental Health 68-70 IV Loss/Grief 71-73 V Death and Dying 74-82 VI Psychosocial Dysfunction 83-86 MODULE III THE SAFETY NEED 87-88 I Surgery 89-95 II Infection 96-101 III Disorders of the Skin 102-104 IV Intravenous Therapy 105-109 V Fluid and Electrolytes 110-114 MODULE IV THE REST, COMFORT, ACTIVITY AND REGULATORY NEED 115-116 I Pain 117-123 II Cancer 124-132 III Cancer Treatment 133-136 IV Organic Mental Disease (Aging) 137-140 V Diabetes 141-145 3 PAGES MODULE V THE NUTRITION AND ELIMINATION NEEDS 146-148 I Overview 149-153 II Mouth and Esophagus 154-158 III Oral and Esophageal Cancer 159-162 IV Stomach and Duodenum 163-168 V Malabsorption, Infection, Inflammation, and Obstruction of the Intestines 169-174 VI Cancer of Stomach and Intestines 175-178 VII Eating Disorders 179-181 VIII Overview 182-185 IX Urinary System 186-190 X Male Reproductive Systems 191-194 XI Pancreas (Exocrine) 195-197 XII Gallbladder 198-200 MODULE VI THE OXYGEN NEED 201-203 I Overview 204-210 II Arteriosclerosis/Atherosclerosis 211-214 III Hypertension 215-218 IV Peripheral Vascular Circulation 219-224 V Coronary Artery Disease/Angina Pectoris 225-228 VI Overview 229-237 VII Upper Respiratory System 238-241 VIII Lower Respiratory System 242-247 APPENDIX I SAFETY NEED 248-297 APPENDIX II REST, COMFORT, ACTIVITY, AND REGULATORY NEED 298-308 APPENDIX III NUTRITION AND ELIMINATION NEED 309-334 APPENDIX IV OXYGEN NEED 335-347 4 AUSTIN COMMUNITY COLLEGE ASSOCIATE DEGREE NURSING PROGRAM LVN MOBILITY TRACK PROJECT The purpose of the Licensed Vocational Nurse Mobility Track Project is to provide selected Licensed Vocational Nurses (L.V.N.'s) the opportunity to complete the nursing course requirements for an Associate of Applied Science Degree in nursing in three semesters of part-time course work. The Mobility Track decreases the number of classroom and laboratory hours required to complete nursing courses and additionally, grants college credit for previous work and educational experience. The curriculum for the LVN Mobility Track has been developed from the ACC-ADN program philosophy and conceptual framework. Students in this Mobility Track will be required to meet the existing program objectives. All general education course requirements remain the same as the generic curriculum: however, most of these courses most be completed prior to entry into the LVN Mbbility Track. (SEE DIAGRAM I). The purpose of this project is the development, implementation and evaluation of the first nursing course in the LVN Mobility Tra?k, KS(', 1805: Transition to Associate Degree Nursing. Upon approval of the project, a project director and Advisory Committee will be selected.The Project Director will be responsible for coordination of all project activities. The Advisory Committee will provide consultation and guidance in all aspects of the project. During the fall 1987 semester, all course materials will be developed for NW 1805 and students will be selected for admission. The course materials will include independent learning modules for each unit of study.These modules will incorporate a variety of learning resources and activities which may include required readings, computer-assisted instruction packages, films/videotapes and/or faculty developed materials. Through the use of these modules, students will be accountable for assessment and fulfillment of their own learning needs within a flexible time frame. In addition, seminars will be held weekly to clarify content and support the learning process. The combined use of learning modules and faculty-directed seminars will provide structure for individualized learning. Learning laboratory and clinical learning activities will be designed to provide the student the opportunity to apply their knowledge and skills to actual and simulated patient situations. The focus of the laboratory learning experiences will be the utilization of knowledge to develop the identified competencies of the Associate Degree graduate. During the Spring 1988 semester; the nursing course will be implemented. Additionally, appropriate data will be collected and analyzed to evaluate all aspects of the course. 5 COMPARISON KNEENLVN MDIILITYTRACK DIAGRAM AND GENERIC AONCURRICULUM GENERIC CREDIT NOUNS LYN MOBILITY TRACK CREDIT HOURS !rerleuifila Praraqulsites RIO 1714 Basic Anatomy and 110 1714'ask Anatomy and Physiology I 4 Physiology 4 110 1703Introduction to 110 1703Introduction to Microbiology 3 PS! 1613 Microbiology 3 Introduction to PSY 1613Introduction to Psychology 3 Psychology 3 110 1726Basic Nastily and Physiology 11 4 ANS 1403Pharmacology for Naelth Professionals 3 PSY 1653Human Growth and Development 3 SOC 1713Social Psychology 3 FALL SEMESTER/FIRST YEAR FALL SEMESTER /FIRST YEAR KG 1309Nursing NS6 1805 Transition to AD nursing 110 1724Stoic Amatomy and 5 Physiology II 4 ANS 1403Pharmacology for Heath Professionals 3 SPRING SEMESTER/FIRST YEAR SPRING SDIESTERLFIRSTYEAR NS6 1310 Nursing II 10 PSY 1653 1136 2806 Nobility Course I 6 Human Growth and Irk 4 Development 3 ENG 1613 Inolish.tompoiition SOC 2713Social Psychology 3 3 FALL SENESTERASECCNO YEAR FALL SEMESTER /SECOND YEAR NS6 2110 Nursing III 10 OR NW 2906 %bill ty Course II 6 NS62210 *4 Elective (approved) ENG 1613English Composition 3 3 SPRING SEMESTER /SECOND YEAR NS6 2310 Nursing IV 10 OR NS6 2410 Elective (approved) 3 Upon successful completion of this course. 14 credit hours will be awarded for previous educational/ experiential learning. Upon successful completion of this course, 4 credit hours will be awarded for previous educational/ experiential learning. 6 comma OF NNILITT OPTIONS L1111 MLITT TICK 1110.1 oiM.LENiE UM ftweigia Prorsom111tso 010 1714 keit Antal, sad KO 1714ksic Way $10 1714 look Amami sod Physielegt I g Physiology P1011410C IN 1703Introdoct onto 010 1703 Introdoctiom to IVO 1703 Introduction to Microbiology Microbiology Merolotolog PST 1613 Introdectiem to PST 1613Introduction to PST 1613Introduction to Psychology Psychology Psydelegy 0121724 Omsk Antony and 1110,1724 bsteAmato', and Physiology II PAysielogy II ANS 1403 Pharmacology for ANS 1403 Pharmacology for Neelth Professionals Neelth Professionals PST 1653 Nelms Growth and A/PKY 1653 Nunn growth and Development Prerequisite to NSG III Development SOC 2713Social Psychology SOC 2713Social Psychology SINNER Nome
Recommended publications
  • Musculoskeletal Clinical Vignettes a Case Based Text
    Leading the world to better health MUSCULOSKELETAL CLINICAL VIGNETTES A CASE BASED TEXT Department of Orthopaedic Surgery, RCSI Department of General Practice, RCSI Department of Rheumatology, Beaumont Hospital O’Byrne J, Downey R, Feeley R, Kelly M, Tiedt L, O’Byrne J, Murphy M, Stuart E, Kearns G. (2019) Musculoskeletal clinical vignettes: a case based text. Dublin, Ireland: RCSI. ISBN: 978-0-9926911-8-9 Image attribution: istock.com/mashuk CC Licence by NC-SA MUSCULOSKELETAL CLINICAL VIGNETTES Incorporating history, examination, investigations and management of commonly presenting musculoskeletal conditions 1131 Department of Orthopaedic Surgery, RCSI Prof. John O'Byrne Department of Orthopaedic Surgery, RCSI Dr. Richie Downey Prof. John O'Byrne Mr. Iain Feeley Dr. Richie Downey Dr. Martin Kelly Mr. Iain Feeley Dr. Lauren Tiedt Dr. Martin Kelly Department of General Practice, RCSI Dr. Lauren Tiedt Dr. Mark Murphy Department of General Practice, RCSI Dr Ellen Stuart Dr. Mark Murphy Department of Rheumatology, Beaumont Hospital Dr Ellen Stuart Dr Grainne Kearns Department of Rheumatology, Beaumont Hospital Dr Grainne Kearns 2 2 Department of Orthopaedic Surgery, RCSI Prof. John O'Byrne Department of Orthopaedic Surgery, RCSI Dr. Richie Downey TABLE OF CONTENTS Prof. John O'Byrne Mr. Iain Feeley Introduction ............................................................. 5 Dr. Richie Downey Dr. Martin Kelly General guidelines for musculoskeletal physical Mr. Iain Feeley examination of all joints .................................................. 6 Dr. Lauren Tiedt Dr. Martin Kelly Upper limb ............................................................. 10 Department of General Practice, RCSI Example of an upper limb joint examination ................. 11 Dr. Lauren Tiedt Shoulder osteoarthritis ................................................. 13 Dr. Mark Murphy Adhesive capsulitis (frozen shoulder) ............................ 16 Department of General Practice, RCSI Dr Ellen Stuart Shoulder rotator cuff pathology ...................................
    [Show full text]
  • Cardiac Valvular Disease
    CARDIOLOGY II: Cardiac Valvular Disease Ischemic Heart Disease Congenital Heart Disease (Adult presentations) Vascular Disease Rutgers PANCE/PANRE Review Course Cardiac Valvular Disease Aortic – Stenosis and Regurgitation Pulmonic Mitral Tricuspid Rutgers PANCE/PANRE Review Course Cardiac Valvular Disease Historically in US – Rheumatic in origin Still true in developing countries Now, atherosclerosis involved ? Genetic markers with AS ? Many patients are s/p surgical intervention ECHO remains best diagnostic tool Rutgers PANCE/PANRE Review Course Valvular Dz Practice Case A 22 y/o waitress presents c/o generalized, sub-sternal chest pain that is worsened with exertion. She appears anxious; she denies ETOH, tobacco, and illicit drug use. You auscultate her heart and diagnose MVP. What did you hear to make this diagnosis? Rutgers PANCE/PANRE Review Course Choices: A. A diastolic rumble B. A holo-systolic murmur C. A midsystolic click D. An opening snap Rutgers PANCE/PANRE Review Course Answer: A. A diastolic rumble B. A holo-systolic murmur C. A midsystolic click D. An opening snap Rutgers PANCE/PANRE Review Course Valvular Disease Basics Four Valves: Two main conditions: Aortic Stenosis Mitral Regurgitation or Tricuspid insufficiency Pulmonic Rutgers PANCE/PANRE Review Course Valvular Disease - localization nd Aortic area: 2 R interspace nd Pulmonic area: 2 L interspace Tricuspid area: LLSB Mitral area: Apex (Think APT. Ment — going from right to left along patient’s chest) Rutgers PANCE/PANRE Review Course The Aortic Valve www.healcentral.org UMDNJ PANCE/PANRERutgers Review CoursePANCE/PANRE (becoming Rutgers Review July 1, 2013) Course Aortic Stenosis (AS) 2 ‘routes of entry’/causes possible: Uni/bicuspid aortic valve (congenital) often presents at 50-65 y/o Degenerative or calcific aortic valve o Results from calcium deposits 2 to atherosclerosis (Genetic markers associated: “Notch 1”) So .
    [Show full text]
  • Peripheral Vascular System Examination
    06/11/1431 Ra'eda Almashaqba 1 Arteries: in the arms there are 3 arterial pulses: 1. Brachial pulse 2. Radial pulse 3. Ulnar pulse Ra'eda Almashaqba 2 1 06/11/1431 In the legs: 4 pulses 1. Femoral 2. Popliteal 3. Dorsalis pedis 4. Posterior tibialis Ra'eda Almashaqba 3 Veins Superficial veins:- - Great saphenous - Small saphenous Deep Vein: Femoral Ra'eda Almashaqba 4 2 06/11/1431 In the arms epitrochlear node: on the medial surface of the arm, 3cm above the elbow In the legs superficial inguinal node: 2 group 1. Horizontal group : lies in a chain in the anterior thigh below the inguinal ligament 2. Vertical group: cluster near the upper part of the saphenous vein. Ra'eda Almashaqba 5 Ask pt about pain In the arms or legs to assess for peripheral vascular diseases Ask if there is an intermittent claudication - Have you ever had any pain or cramping in your leg when you walk or exercise? - how far can you walk without stopping to rest? - dose the pain get better with rest? coldness, numbness, pallor in leg or feet Hair loss over the anterior tibial surface Ra'eda Almashaqba 6 3 06/11/1431 Assess pt risk factors ( HTN, Diabetes, tobacco use, hyperlipedemia, MI, CVA) Elicit symptoms of arterial spasm: - Do your fingertips ever change color in cold weather or when you handle cold objects - what color changes do you notice? ask for symptoms of venous peripheral vascular diseases: swelling of feet and leg, ulcer on lower leg near the ankle Ask if there is swelling with redness or tenderness unilateral or bilateral Ra'eda Almashaqba 7 Arms Inspect both arms from the fingertips to the shoulder.
    [Show full text]
  • Common Station
    COMMON STATION SPECIALIST IN PLAB 2 PREPARATION EXAMINATIONS In PLAB 2 Dr Elmira Yaghmaei Dr Hamed Salehi 1 Copyrights © 2017 Common Stations PLAB Academy – Dr Hamed Salehi. All Rights Reserved Table of Contents 1. Abdominal Examination (GI Examination) ............................................................................. 3 2. Thyroid Examination ................................................................................................................... 16 3. Unconscious Patient Examination .......................................................................................... 26 4. Meningitis Examination (Headache) ....................................................................................... 33 5. Alcoholic/Diabetic foot Examination ...................................................................................... 39 6. Hip Examination ........................................................................................................................... 51 7. Knee Examination ....................................................................................................................... 60 8. Elbow Examination ..................................................................................................................... 71 9. Whiplash Injury (Cervical Examination) ................................................................................ 80 10. Primary Survey..........................................................................................................................
    [Show full text]
  • Chronic Venous Insufficiency and Varicose Veins of the Lower Extremities
    REVIEW Korean J Intern Med 2019;34:269-283 https://doi.org/10.3904/kjim.2018.230 Chronic venous insufficiency and varicose veins of the lower extremities Young Jin Youn1,2 and Juyong Lee2 1Division of Cardiology, Department Chronic venous insufficiency (CVI) of the lower extremities manifests itself in of Internal Medicine, Yonsei various clinical spectrums, ranging from asymptomatic but cosmetic problems University Wonju College of Medicine, Wonju, Korea; 2Division of to severe symptoms, such as venous ulcer. CVI is a relatively common medical Interventional Cardiology, Calhoun problem but is often overlooked by healthcare providers because of an underap- Cardiology Center, UConn Health, preciation of the magnitude and impact of the problem, as well as incomplete University of Connecticut School of Medicine, Farmington, CT, USA recognition of the various presenting manifestations of primary and secondary venous disorders. The prevalence of CVI in South Korea is expected to increase, Received : June 27, 2018 given the possible underdiagnoses of CVI, the increase in obesity and an aging Accepted : September 8, 2018 population. This article reviews the pathophysiology of CVI of the lower extrem- Correspondence to ities and highlights the role of duplex ultrasound in its diagnosis and radiofre- Juyong Lee, M.D. quency ablation, and iliac vein stenting in its management. Division of Interventional Cardiology, Calhoun Cardiology Keywords: Diagnosis; Review; Therapeutics; Venous insufficiency Center, UConn Health, University of Connecticut School of Medicine, 263 Farmington Av, Farmington, CT 06030, USA Tel: +1-860-679-2058 Fax: +1 860 679 3346. E-mail: [email protected] INTRODUCTION dividuals, albeit the estimated prevalence of CVI varies depending on the population studies [5-7].
    [Show full text]
  • NCLEX Study Guide (Pdf)
    DO NOT delegate what you can EAT! E - evaluate A - assess T - teach addisons= down, down down up down cushings= up up up down up addisons= hyponatremia, hypotension, decreased blood vol, hyperkalemia, hypoglycemia cushings= hypernatremia, hypertension, incrased blood vol, hypokalemia, hyperglycemia No Pee, no K (do not give potassium without adequate urine output) EleVate Veins; dAngle Arteries for better perfusion A= appearance (color all pink, pink and blue, blue [pale]) P= pulse (>100, < 100, absent) G= grimace (cough, grimace, no response) A= activity (flexed, flaccid, limp) R= respirations (strong cry, weak cry, absent) TRANSMISSION-BASED PRECAUTIONS: AIRBORNE My - Measles Chicken - Chicken Pox/Varicella Hez - Herpez Zoster/Shingles TB or remember... MTV=Airborne Measles TB Varicella-Chicken Pox/Herpes Zoster-Shingles Private Room - negative pressure with 6-12 air exchanges/hr Mask, N95 for TB DROPLET think of SPIDERMAN! S - sepsis S - scarlet fever S - streptococcal pharyngitis P - parvovirus B19 P - pneumonia P - pertussis I - influenza D - diptheria (pharyngeal) E - epiglottitis R - rubella M - mumps M - meningitis M - mycoplasma or meningeal pneumonia An - Adenovirus Private Room or cohort Mask 1 CONTACT PRECAUTION MRS.WEE M - multidrug resistant organism R - respiratory infection S - skin infections * W - wound infxn E - enteric infxn - clostridium difficile E - eye infxn - conjunctivitis SKIN INFECTIONS VCHIPS V - varicella zoster C - cutaneous diphtheria H - herpez simplex I - impetigo P - pediculosis S - scabies 1. Air/Pulmonary Embolism (S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom) --> turn pt to left side and lower the head of the bed. 2. Woman in Labor w/ Un-reassuring FHR (late decels, decreased variability, fetal bradycardia, etc) --> turn on left side (and give O2, stop Pitocin, increase IV fluids) 3.
    [Show full text]
  • COMLEX-USA MASTER BLUEPRINT EFFECTIVE BEGINNING SEPTEMBER 20 18 Contents
    COMLEX-USA MASTER BLUEPRINT EFFECTIVE BEGINNING SEPTEMBER 20 18 Contents Introduction 2 ­Foundation­for­COMLEX-USA 3 Two­Distinct­Dimensions 4 Master­Blueprint­Schematic 5 Licensure­Assessment­Aligned­with­Medical­Education­Pathway 6 Content­Across­the­Examination­Series 7 EFFECTIVE BEGINNI NG SEPTEMBER 20 18 Test­Specifications­for­each­Examination 8 Dimension­1:­Competency­Domains 9 ­Osteopathic­Principles,­Practice,­and­Manipulative­Treatment 10 Osteopathic­Patient­Care­and­Procedural­Skills 13 Application­of­Knowledge­for­Osteopathic­Medical­Practice 16 Practice-Based­Learning­and­Improvement­in­Osteopathic­Medical­Practice 18 Interpersonal­and­Communication­Skills­in­the­Practice­of­Osteopathic­Medicine 21 Professionalism­in­the­Practice­of­Osteopathic­Medicine 24 Systems-Based­Practice­in­Osteopathic­Medicine 27 Dimension­2:­Clinical­Presentations 29 Community­Health­and­Patient­Presentations­Related­to­Wellness 30 Patient­Presentations­Related­to:­Human­Development,­Reproduction,­and­Sexuality 32 Patient­Presentations­Related­to:­Endocrine­System­and­Metabolism 36 Patient­Presentations­Related­to:­Nervous­System­and­Mental­Health 39 Patient­Presentations­Related­to:­Musculoskeletal­System 45 Patient­Presentations­Related­to:­Genitourinary/Renal­System­and­Breasts 50 Patient­Presentations­Related­to:­Gastrointestinal­System­and­Nutritional­Health 53 Patient­Presentations­Related­to:­Circulatory­and­Hematologic­Systems 57 Patient­Presentations­Related­to:­Respiratory­System 60 Patient­Presentations­Related­to:­Integumentary­System 63 References 66 COMLEX-USA INTRODUCTION MASTER BLUEPRINT The­COMLEX-USA­examination­series­is­designed­to­assess­osteopathic­medical­knowledge,­fundamental Introduction clinical­skills,­and­other­foundational­competencies­considered­essential­for­the­practice­of­osteopathic medicine.­The­primary­and­intended­purpose­of­COMLEX-USA­is­for­licensure­of­osteopathic­physicians,­and The­Comprehensive­Osteopathic­Medical COMLEX-USA­is­accepted­for­medical­licensure­in­all­US­states­and­jurisdictions.
    [Show full text]
  • Clinical Study of Varicose Veins of Lower Limb
    CLINICAL STUDY OF VARICOSE VEINS OF LOWER LIMB DISSERTATION SUBMITTED FOR BRANCH – I M.S. (GENERAL SURGERY) THE TAMILNADU DR. M.G.R. MEDICAL UNIVERSITY CHENNAI MARCH - 2007 CERTIFICATE This is certify that this dissertation entitled “CLINICAL STUDY OF VARICOSE VEINS OF LOWER LIMB” submitted by Dr.N.DEEPA to the TamilNadu Dr.M.G.R Medical University, Chennai, is in partial fulfillment of the requirement for the award of M.S Degree Branch – I (General Surgery) and is a bonafide research work carried out by her under direct supervision and guidance. Dr. M.Kalyana Sundaram M.S., FICS Professor and Head of the Department of Surgery, Govt. Rajaji Hospital, Madurai Medical College, Madurai. DECLARATION This is a consolidated report on “CLINICAL STUDY OF VARICOSE VEINS OF LOWER LIMB” based on 75 cases treated at Govt. Rajaji Hospital, Madurai, during the period of July 2004 to September 2006. This is submitted to the Tamilnadu Dr.M.G.R. Medical University, Chennai in partial fulfillment of the rules and regulations for the M.S. Degree Examination in General Surgery. It was not submitted to the award of any degree/diploma to any university either part or in full form previously. Govt. Rajaji Hospital, Madurai Medical College, DR. N.DEEPA Madurai. ACKNOWLEDGEMENT I am very much grateful and indebted to my unit chief and HOD Department of Surgery Professors Dr.M.Kalyanasundaram M.S., FICS., for allowing me to take up the study on varicose veins and for the encouragement given to me in this study by him. At the outset, I wish to thank our Dean Dr.S.M.
    [Show full text]
  • 9Th EDITION CLINICIAN’S POCKET REFERENCE
    9th EDITION CLINICIAN’S POCKET REFERENCE EDITED BY LEONARD G. GOMELLA, MD, FACS The Bernard W. Godwin, Jr., Associate Professor Department of Urology Jefferson Medical College Thomas Jefferson University Philadelphia, Pennsylvania WITH Steven A. Haist, MD, MS, FACP Professor of Medicine Division of General Internal Medicine Department of Internal Medicine University of Kentucky Medical Center Lexington, Kentucky Based on a program originally developed at the University of Kentucky College of Medicine Lexington, Kentucky McGraw-Hill MEDICAL PUBLISHING DIVISION New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto McGraw-Hill abc Copyright © 2002 by Leonard G.Gomella. All rights reserved. Manufactured in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. 0-07-139444-3 The material in this eBook also appears in the print version of this title: 0-8385-1552-5. All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fash- ion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps. McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs.
    [Show full text]
  • Cardiovascular Examination 3/02/2013
    Version 2.0 Cardiovascular Examination 3/02/2013 Prepare patient • Introduction • Position semi-recumbent at 45º • Whole chest exposed General Inspection General signs: • Cachexia, dyspnoea, cyanosis Syndromes: • Down (AVSD), Marfan’s (Ao), Turner’s (PS) Other relevant diseases: • Acromegaly, ankylosing spondylitis (AR) Hands Peripheral cyanosis Clubbing (many causes including): • Cyanotic congenital heart disease • Infective endocarditis • Atrial myxoma • Lung Ca • Chronic lung suppuration o Lung abscess or empyema o Bronchiectasis or CF • Idiopathic pulmonary fibrosis • Pleural mesothelioma • Asbestosis • IBD • Cirrhosis • Coeliac disease • SB lymphoma • Thyrotoxicosis (acropachy) • Idiopathic/familial • Rarely: o Pregnancy o 2º Hyperparathyroidism Stigmata of endocarditis • Splinter haemorrhages • Osler (painful) nodes & Janeway (painless) lesions Xanthomata Arm Radial Pulse • Rate & rhythm. Compare left with right. Also feel for radio-femoral delay (coarctation). Brachial BP • Pulsus paradoxus – exaggerated drop ( ≤≤≤10mmHg) in sysBP (& ↑HR) on inspiration. Measured as BP diff between return of first intermittent sounds (K1 expiration ‘thuds’) & regular K1 ‘thuds’ (expiration & inspiration). E.g. asthma, pericarditis, pericardial effusion. Face Malar flush (MS, PS) Eyes • Sclerae/Conjunctivae – comparative pallor (anaemia), jaundice • Xanthelasma • Argyll Robertson pupils (AR - small accommodating but not light reactive pupils, syphilis.) Mouth • Cyanosis • High arched palate (Marfan’s) • Dentition (risk of endocarditis) Neck JVP •
    [Show full text]
  • Orthopedic Special Tests: Lower Extremity 4 Ce Hours
    CONTINUING EDUCATION for Physical Therapists ORTHOPEDIC SPECIAL TESTS: LOWER EXTREMITY 4 CE HOURS Course Abstract This course provides learners with state-of-the-art literature on orthopedic special tests for the lower extremity, with attention to the statistics that support and/or dispute the continued relevance of each. It begins with an overview of relevant statistical terminology; touches on medical screening, toolbox questionnaires, and clearing the lumbosacral spine; and examines special tests and related statistics for the hip, knee, and ankle. NOTE: Links provided within the course material are for informational purposes only. No endorsement of processes or products is intended or implied. Approvals To view the states that approve and accept our courses, CLICK HERE. Target Audience & Prerequisites PT, PTA, ATC – no prerequisites Learning Objectives By the end of this course, learners will: ❏ Distinguish between the statistical concepts of sensitivity and specificity ❏ Recall elements of medical screening ❏ Identify toolbox questionnaires pertaining to the lower extremity ❏ Recall elements of clearing the lumbosacral spine ❏ Recognize special tests and related statistics for the hip, knee, and ankle ❏ Recognize the significance of statistics as they apply to special test scenarios PHYSICAL THERAPISTS Orthopedic Special Tests: Lower Extremity | 1 Welcome to lower extremity examination tests, an evidence-based Timed Topic Outline course designed to provide you with I. Statistics: Sensitivity and Specificity (20 minutes) state of the art literature on how to II. Medical Screening, Toolbox Questionnaires, perform and interpret orthopedic Lumbosacral Spine and Deep Tendon Reflexes (40 minutes) examination techniques for the lower extremity. III. Special Tests: Hip (60 minutes) The physical examination is made up of IV.
    [Show full text]
  • OSCE Checklist: Varicose Vein Examination
    OSCE Checklist: Varicose Vein Examination Introduction 1 Wash your hands and don PPE if appropriate 2 Introduce yourself to the patient including your name and role 3 Confirm the patient's name and date of birth 4 Briefly explain what the examination will involve using patient-friendly language 5 Explain the need for a chaperone 6 Gain consent to proceed with the examination 7 Adequately expose the patient's lower limbs 8 Position the patient standing 9 Ask the patient if they have any pain before proceeding with the clinical examination General inspection 10 Inspect for clinical signs suggestive of underlying pathology (e.g. scars, ulcers) Leg inspection 11 With the patient standing (if able) look for signs of venous disease from the front, side and back of the legs Assess varicosities 12 Assess the temperature of any varicosities 13 Palpate any visible varicosities Further assessment of the lower limbs 14 Assess for pitting oedema in the lower limbs 15 Palpate the femoral pulse 16 Palpate the popliteal pulse 17 Palpate the posterior tibial and dorsalis pedis pulse Tap test 18 Place one finger, with a small amount of pressure, onto the saphenofemoral junction (SFJ) which is located 4cm inferior-lateral to the pubic tubercle 19 Tap the varicose vein you are assessing, which should be located lower down the leg and feel for a thrill at the SFJ Auscultation 20 Place the bell of the stethoscope over the identified varicosity and listen for a bruit Other special tests 21 Handheld doppler assessment 22 Trendelenburg test (tourniquet test) 23 Cough impulse test 24 Perthe's test To complete the examination… 25 Explain to the patient that the examination is now finished 26 Thank the patient for their time 27 Dispose of PPE appropriately and wash your hands 28 Summarise your findings 29 Suggest further assessments and investigations (e.g.
    [Show full text]