Nutrition

Hello everyone!
I have to say that the last post about 'Study Skils' was so much fun to write! It reminded me of my very first post! I hope you enjoyed it!
In this post I'll be taking about Nutrition. I'll be talking about the major food groups that we all need to eat from in order to maintain good health. Enjoy!

Keeping a balanced diet is important in keeping up good health and maintaining your bodily systems.

A balanced diet for most people should consist of:

60% Carbohydrates
30% Fat
10% Protein
Vitamins, minerals and water

Here, I'll go on to explain each food group a bit more in detail...

Carbohydates
These are found in starchy and sugary foods. Complex carbohydrates are mainly starchy foods, including potatoes, rice, bread and pasta and have additional nutritional value as they contain many other vitamins, minerals and fibre. Simple carbohydrates are the sugary ones, found in cakes, biscuits and sweets which are sometimes termed empty calories, as they provide no other nutritional benefits. Dr. Richard Marotta, headmaster of the Garden School in Jackson Heights, actually said that, "Eating excessively sweet foods gives you a rush and then you come crashing down. You want to keep your blood sugar at a steady pace." Which could not be more true.
Carbohydrates are our main source of energy, in fact, energy from the breakdown of carbs is the only type of energy the brain can use. Carbohydrates are broken down in the liver and muscles, by a process known as glycogenesis. It is then stored as glycogen until it is needed.

Fats
Fats serve several important purposes. They provide energy and when stored, provide protection to our vital organs.
There are two types of fats, saturated and unsaturated. Saturated fats are 'the bad fats' which are normally solid at room temperature, such as butter and meat fat. Unsaturated fat is more difficult to breakdown and so is mainly stored within the body. Unsaturated fats are generally better for us and are often liquid at room temperature, for example olive oil and sunflower oil, although they can also be found in avacados and nuts.
A healthy diet should not contain more than 30% fat, and a maximum of 10% should be saturated fat. Fat provides a secondary source of energy and once the relatively small carbohydrate stores are exhausted, fat metabolism becomes the primary source of energy.

Proteins
Proteins are large compounds consisting of amino acids. There are 20 amino acids which the body requires. 12 of these can be synthesised within the body, and the other 8 (essential amino acids) must be consumed through our diets.
Proteins are found in abundance in meats, eggs, fish, dairy products, nuts and seeds. Protein is essential for growth, repair and maintenance of our body tissues and for this reason, many athletes (mainly those requiring strength or size) will increase the amount of protein they consume, in order to help their muscles grow and develop strength.

Fluids
Fluids are vital to help prevent dehydration. During the day our bodies sweat to help cool us down. This results in a loss of water which must be replaced. Electrolytes such as sodium are also lost in our sweat. The presence of these electrolytes also helps the water to diffuse through the small intestine, back into the body. Research also shows that those who drink water before an exam actually perform better and score a third higher than those who do not. So, drink lots of water before exams you students!!

Vitamin and Minerals
Vitamins and minerals are vital in the diet for a wide range of functions, but only needed in tiny amounts. Providing you have a balanced diet as shown above, containing lots of fresh foods, there is no need for vitamin or mineral supplementation.

In more detail, Vitamins, one of the most essential nutrients required by the body, can be broadly classified into two broad categories namely, water-soluble vitamins and fat-soluble vitamins. Water-soluble vitamins (B vitamins and vitamin C) get flushed out from the body; therefore there arises a need to consume these vitamins on a daily basis. On the contrary, fat-soluble vitamins (Vitamins A, D, E, and K) get stored in the body's fatty tissues. There are distinctive kinds of vitamins and each vitamin play a unique role in promoting health fitness.

Here is a list of different vitamin types:

Vitamin A: it helps a great deal in improving your eyesight. Also it aids in maintaining healthy skin. Rich sources of vitamin A are: eggs, milk, apricots, carrots, spinach and sweet potatoes etc.

Vitamins B: vitamin B is a list of multiple vitamins like B1, B2, B6, B12, niacin, folic acid, biotin, and pantothenic acid. Vitamin B aids in generating energy that the body utilizes to carry out its activities. Vitamin B also participates actively in making red blood cells that carry oxygen to different parts of your body. Rich sources of vitamin B include whole grains, such as wheat and oats, fish and seafood, leafy green vegetables, dairy products like milk and yogurt, beans and peas etc.

Vitamin C: it helps in strengthening your gums and muscles. Vitamin C found in citrus fruits like oranges, also aids in healing wounds. It enables you to overcome infections. Foods rich in vitamin C, apart from citrus fruits are: tomatoes, broccoli, cabbage and strawberries etc.

Vitamin D: it works towards strengthening your bones and teeth. It also aids in absorbing the calcium required by the body. Foods rich in vitamin D are: fish, egg yolk, milk and other dairy products etc.

Vitamin E: It takes care of your lungs and also aids in formation of red blood cells. Good sources of vitamin E are: whole grains, such as wheat and oats, leafy green vegetables, egg yolks, nuts etc.

Vitamin K: vitamin K helps in the maintenance of normal levels of the blood clotting proteins. Good sources of vitamin K are: leafy green vegetables, dairy products, like milk and yogurt, pork etc.

Just like your body needs vitamins, your body needs minerals for growth and health.

There are two kinds of minerals in food: macrominerals and trace minerals. Macrominerals are minerals your body needs in larger amounts, yet your body needs just small amounts of trace minerals.

Macrominerals


Calcium

Actions:
•Needed for making bones and teeth
•Helps nerves and muscles function

Sources:
•Dairy products, such as milk, cheese, and yogurt
•Canned salmon
•Leafy green vegetables, such as Chinese cabbage, bok choy, kale, collard greens, turnip greens, mustard greens
•Broccoli
•Calcium-fortified foods — from orange juice to cereals and crackers

Chloride

Actions:
•Needed for keeping the right amounts of water in the different parts of your body

Sources:
•Salt
•Rye
•Tomatoes
•Lettuce
•Celery
•Olives
•Beef and pork
•Cheese

Magnesium

Actions:
•Needed for making bones and teeth
•Helps nerves and muscles function

Sources:
•Leafy green vegetables
•Nuts
•Bran cereal
•Seafood
•Dairy products, such as milk, cheese, and yogurt

Phosphorus

Actions:
•Needed for making bones and teeth
•Needed for storing energy from food

Sources:
•Dairy products, such as milk, cheese, and yogurt
•Red meat (beef, pork, and lamb)
•Poultry
•Fish
•Eggs
•Nuts
•Peas

Potassium

Actions:
•Helps nerves and muscles function
•Needed for keeping the right amounts of water in the different parts of your body

Sources:
•Bananas
•Broccoli
•Tomatoes
•Potatoes with skins
•Leafy green vegetables, like spinach, turnip greens, collard greens, and kale
•Citrus fruits, like oranges
•Dried fruits


Sodium

Actions:
•Helps nerves and muscles function
•Needed for keeping the right amounts of water in the different parts of your body

Sources:
•Salt
•Milk and cheese
•Beets
•Celery
•Beef and pork
•Green olives

Note: Many people get too much sodium.


Trace Minerals

Copper

Actions:
•Helps protect cells from damage
•Needed for making bone and red blood cells

Sources:
•Shellfish (especially oysters)
•Chocolate
•Mushrooms
•Nuts
•Beans
•Whole-grain cereals


Fluoride

Actions:
•Needed for making bones and teeth

Sources:
•Saltwater fish
•Tea
•Fluoridated water (water that has had fluoride added to it)


Iodine

Actions:
•Needed for your thyroid gland to function properly

Sources:
•Seafood
•Iodized salt (salt that has had iodine added to it)
•Drinking water (in regions with iodine-rich soil, which are usually near an ocean)


Iron

Actions:
•Helps red blood cells deliver oxygen to body tissues (If you don't get enough iron, you could get iron deficiency anemia.)
•Helps muscles function

Sources:
•Red meat, such as beef
•Tuna and salmon
•Eggs
•Beans
•Baked potato with skins
•Dried fruit, like apricots, prunes, and raisins
•Leafy green vegetables, such as spinach and turnip greens
•Whole grains, like whole wheat or oats
•Breakfast cereals fortified with iron


Selenium

Actions:
•Helps protect cells from damage
•Needed for your thyroid gland to function properly

Sources:
•Brazil nuts
•Fish and shellfish
•Red meat
•Enriched breads
•Eggs
•Chicken
•Wheat germ


Zinc

Actions:
•Needed for healthy skin
•Needed for healing wounds, such as cuts
•Helps your body fight off illnesses and infections

Sources:
•Red meat (beef, pork, and lamb)


So, we've seen what we need to eat in order to maintain a healthy, balanced diet. But how can we do this? By eating the right types of foods, of course! And what better way to do this than by eating your five-a-day!

Why 5 a day?
Fruit and vegetables are part of a balanced diet and can help us stay healthy. That’s why it so important that we get enough of them.
5 A DAY highlights the health benefits of getting five 80g portions of fruit and vegetables every day. That’s five portions of fruit and veg altogether, not five portions of each.
Five reasons to get five portions
• Fruit and vegetables taste delicious and there's so much variety to choose from.
• They're a good source of vitamins and minerals, including folate, vitamin C and potassium.
• They're an excellent source of dietary fibre, which helps maintain a healthy gut and prevent constipation and other digestion problems. A diet high in fibre can also reduce your risk of bowel cancer.
• They can help reduce the risk of heart disease, stroke and some cancers.
• Fruit and vegetables contribute to a healthy and balanced diet.

Fruit and vegetables are also usually low in fat and calories (provided you don’t fry them or roast them in lots of oil). That’s why eating them can help you maintain a healthy weight and keep your heart healthy.
5 A DAY is based on advice from the World Health Organization, which recommends eating a minimum of 400g of fruit and vegetables a day to lower the risk of serious health problems, such as heart disease, stroke, type 2 diabetes and obesity.

To get the most benefit out of your 5 A DAY, your five portions should include a variety of fruit and vegetables. This is because different fruits and vegetables contain different combinations of fibre, vitamins, minerals and other nutrients.
Almost all fruit and vegetables count towards your 5 A DAY. Potatoes and cassava don’t count because they mainly contribute starch to the diet.

So, when you think about it, eating your five a day is pretty easy really!
This motivates me to try to eat more healthily! Some days I just crave McDonalds! Which can be very hard to resist!!!
Hope you enjoyed this one! See you next time!

Emily

Study skills

Good evening!
I know it's been a week but so much has happened! I've been so busy trying to make an effort on my assignment and portfolio that I've (almost) forgotten about this blog! So, i'm sorry about that! Also, I've been trying to get ready for my placement and everything which has been really stressful! The couple hours i get when I return from uni everyday is simply leisure (like lounging around watching The Walking Dead).
So, for this post no theoretical stuff. No A&P, no OBS, no IPL... NONE of that today! I'll be talking about study skills (and hopefully this will motivate me to want to study harder!!) This won't just apply to health and social care students (Nurses, social workers, radiographers, ODPs...) but it'll apply to ANY student - whether you are at GCSE level, Advanced level or degree level.
So, I'll be dividing this post up into sections: Who, what, where, when, why and how? So, lets begin!!

WHO?
Depending on your personality you will either work alone or in groups.

Alone
Personally I prefer to study alone. I actually CANNOT study with others. I'm not unsociable, in fact i'm the very opposite - if i study with others i will end up talking about something else. Like, shopping, gigs, piercings, food, music... stuff like that. Which obviously has NO relevance to the endocrine system whatsoever. Anyway, if you choose to go it alone then by all means do so. Don't think that you can't. Just because you're friends aren't gonna walk you to the library or whatever, you can still be independent and study on your own. Besides, if you study alone you can focus on the areas you specifically need to work on, you can stay as long as you want and take breaks when you want. You'd actually be surprised how many people study alone. Almost everyone! Plus, I always think that study groups are just EXCUSES to be together. To 'study'. Riiiiight. It's like a 'study date'. Dude, you're not going to study... Who would study on a DATE?! Hello?! Moving on, If you are going to study alone, make sure you have everything you need such as your study utensils and plan (we'll get to that bit later) and make sure you have a suitable area for study. Figure out if you work best in silence or with some background music or a little mummering from others in the background. I remember at A level I would always study in the library after four because most of the kids from years seven to eleven had gotten fed up by then and gone home. Therefore, the library was blissfully peaceful! I was friends with the librarian so she'd let me stay until six sometimes! Also, choose a computer or desk that is in a perfect position: either near the stacks in the library for quick referencing, or opposite a window for perfect ventilation; near the water fountain for hydration or in the corner for tranquility. It's up to you so at the beginning of the year seek out these little areas so you aren't squeezed elbow to elbow with other students at 'rush hour'!

In groups
Even though I don't really study in groups that often I still find it quite fun! (IKR! Bet you weren't expecting THAT!) Like they say: 'two heads are better than one' and in the case of studying, sometimes it works better to have a study-buddy or a couple other people to lay the snakes out flat, so to speak. Studying with others can be great because its not only a social thing but it's a peer-support thing. What I mean is, if 'you scratch my back, I'll scratch yours'. If you don't get something, someone else can clarify it for you and help you. If you get something they don't, then you can help them to understand so it works out by helping each other. Also, you can study in different ways, E.G. by presentations, discussion and debates ETC. Not only that, but you'll be improving your communication skills which is very important for any student - it will help you no end in university interviews, job interviews, on your CV, in the workplace, make friends in the future... the list goes on. So, don't dismiss the idea of working with others. it can be great fun. However, beware of digressing conversations and laziness. Some people may also try to get away with doing nothing while the 'smart ones' do it all. Which can be extremely annoying.

WHAT?
This section will talk about WHAT you should study. Again I'll divide this up...

Lecture notes
So many people write a ton of lecture notes in their notebooks but can be fussed to type the notes up and print them out for their folders. WHY?! It literally takes about ten minutes tops. Plus, going over what was covered in classes will motivate you to research more and will clarify to you what was said about a certain topic and what wasn't (I.E. what the lecturer expects you to do extra/individual research on).

Prioritizing
After typing up your lecture notes, try to ascertain what you DID understand and what you didn't. The stuff that you didn't understand is probably the stuff that is more pressing. Its the stuff you should study/cover first.

Resources
So when you've chosen the topic you don't get, you can choose where you'll get the informaion. So, where do you start? In most libraries you won't just have books. There will be internet access, journals, e-books, CDs, DVDs ETC. And you can use any of these (probably not the CDs and DVDs for assignments...) to aid your study. As long as it helps you to understand a topic. Thats the main thing. Also you can normally reserve and renew books online, whether its your local or university library.

Choosing the book/journal
So, lets say you've decided to just look in books for now. You are standing in the aisle for 'Nursing' and you have NO idea what book to pick out. What the heck do you do? Well, first off, scan the book spines for titles. If you are looking up something about ATP, it's no good looking at a book that is entitled 'Guide to clinical placements', is it? So, think logically. Look for an A&P book if you want to know about ATP. Look for student guides if you are looking up clinical placements.
So, now you've picked up a book and it looks kind of relevant. What do you do? Well, open the book and flip through it. Is it set out in a way that you'd easily learn from it. If you are a visual learner, does it have plenty of pictures? If you are a logical learner, does the book go into lots of detail or does it just cover the basics? Also, think about whether you'll be taking the book out or not. If you are, is it of suitable size to carry it around for a few hours (or at least your trip home)?

And once you've got it?
Sometimes I start typing up whats in the book, word for word. But then i just get bored and start watching anime. Which kinda defeats the object. So, perhaps scan through the chapter before writing notes and place post-it notes over the paragraphs that are most relevant? Then, why not leave the computer for a while and draw up a mind up, jotting down key points of important information and colouring it so the key bits stand out? you could also write up notes on it and then type. Sure it may take a bit longer but you'll be going over the information twice which makes the studying actually WORTH it and you'll definately understand it afterwards. You could also make little revision cards on the key info. By-the-way, they don't literally HAVE to be 'cards'. I studied using revision cards and just paper did fine for me.

WHERE?
Determining where to study really makes a difference. But you can either study at home or at your institution / university / school / college.

Home
This covers grandmas house, your student accomodation, your friends house ETC. I alwyas say 'oh, yeah, I'll just do it at home'. And then I don't. haha. But sometimes studying at home isn't that bad. You may be distracted but if you have the house alone you will, hopefully, be free from major distractions. Unless the TV is calling you... Remember that if you study at home you will have distractions like 'dinner time' which you think 'ahh i need a break anyway. You'll have brother and sisters screaming the house down. You'll have mummy popping in to put the washing away or if your bedroom is next to the bathroom like mine is, someone will flush the toilet and you're concentration will diminish rapidly. Oh and if your brothers or sisters call up to you telling you someones on the phone for you or that 'Alcatraz' is on TV and you really CAN'T miss an episode... Anyway, what i mean is, home has so many distractions. If you can take it, sure. But I don't have tonnes of breaks and prefer to study for like an hour or two at a time. But it's up to you.

University/college
Sometimes there will be cafes or studying areas you can just take a book to and read or take notes from quietly. However, obviously there is the library where more resources are available to you. Every institution is different though and some campus unis can get really crowded so the library at three is not the best place to go for peace and seclusion. Why not go slightly off campus so a small bar or cafe and just read for about thirty minutes and wait for the rush hours to die down. That way you can definately get a computer in the library later.

In bed
Okay, i can explain! Read a book before you go to bed. If you don't like reading, tough. Get used to it. You'll need to like reading in order to pass the course. Even if you dont read fiction before bed its always good to read something before you hit the hay. Research shows that reading for 15 minutes reduces your stress by 70%. Others say more. Also, reading just a couple pages a night is better than nothing. I've started doing this and i'm actually learning a lot. A lady in my classes mentioned something that I wouldn't have even known if i hadn't read it in the book i'm currently reading!

When travelling
Not just in bed. Yes, on the bus, in the car (if you're not driving!) and on the train just read a few pages. Not even that. It will help so much towards your knowledge!

Outside
You can actually study in the park, at the beach... anywhere! Outdoors is actually a great place to escape to if the house is too noisy or the library is jam-packed! It's stress relieving and almost fun! Just be careful you don't get sunburn or anything!

WHEN?
It's important to decide what time to study as it determines how much information you retain and how long you will study for.

In the morning
There's a girl in my classes who always says that she studies and prepares for classes in the morning before she goes to uni. Now, I personally wouldn't recommend this. Why? Because in the morning, generally you are probably rushing around to get ready. Therefor you'll have limited time to study. If you procrastinate and just sit at your desk thinking, then you'll have wasted precious sleeping time so theres no point. Some are more alert in the morning (I am, i know) but even so, save your energy for lectures and seminars. Give yourself more time to prepare. Don't get up early in order to do so. The mornings should be to allow for a hearty breakfast and to get your circulation and brain juices flowing! Also, NEVER study for exams in the morning! It only makes you panic. I know plenty of people who've done this in the past and have literally MUCKED UP the exam because of it. Study the night before but leave the books in the morning. Don't be tempted.

In the afternoon
Lunchtimes are actually good times to allow for study time! This may be difficult if you eat with friends because they might call you a geek.. my friends do... But don't let that deter you! If you are THAT worried, just read a couple pages from your book like we said earlier. Later in the afternoon, say three-ish, is probably the time I set out for study. It gives me time alone so I can focus and, even though I am tired, I have time to type and print out notes and print out research for tomorrows classes. I also have time to read around a topic and look for better books. I've even stayed at the library until about nine at night! Plus, if you want a break you can always go for a wander. Our campus shop at UCS is literally just under the library so it's perfect for getting late afternoon snacks! I also believe this is the case with University of Essex as well and a few other unis.

In the evening
The evening is great for study too! This is the time i have at home for myself or for extra study. I can update this blog or read from books or journals or e-books. Or I can do a bit more to my assignment or just watch anime! I try to get at least an hour a day study time in. Even if it's just scanning through internet pages for something. But I would say that past eleven, studying is not good. You'll be too tired to process the information and you do need sleep in order to keep up good grades.

WHY?
whats the point of studying and reading around a topic?

Grades
C'mon! If you don't study then your grades will obviously fail! But I guess many people do actually think that there is no need to read around a topic or do extra research, but there is! If, like me, you are studying to become a HCP, then you need to keep up-to-date with medical research and this entails reading around a topic. Also, to become a competent student you will need to UNDERSTAND a topic. Not just 'know'. I found this to be the case with many of my fellow sixth formers. Most thought they were okay just reading from the textbook a few minutes from the exam. Nope. They weren't. You need to understand what you are learning and make the knowledge your own. Don't just accept what the book says. Use other books and journals, written by different authors. Everyone has a different take on the world. Authors will disagree and maybe you will disagree with what they have written. In fact, in exams by pointing out research flaws you actually get the higher grades. This was certainly the case in psychology.

For your own competency
Kind of touched on this one. But if you study hard and really put in the effort, you will obviously have a better knowledge. This will set you up better for jobs and will aid in your future choices and decision making.

Confidence
No-one likes looking like a fool. So don't walk into a lecture without having some idea (at least) of what the lecture will be about. I don't just mean knowing what the title of the lecture is, I mean knowing what the title suggests.

HOW?
And finally, how can you study?

Written
You can study by writing notes from a textbook or drawing up diagrams or mind maps to help you retain the information. Revision cards or making a quiz for yourself and others.

Orally
You can have a group discussion or debate on a given topic which will allow for new ideas. You can also give presentations or just chat about a topic to someone who isn't on your course or knows nothing about the topic.

Technologically
By this, I mean using technology to learn. So, you can type up your notes. Make a slideshow presentation. Or just record your voice on a tape recorder. My A level PE teacher suggested that we record a fake-radio show once. He even suggested we make up a song! I thought it was a dumb idea at first but, thinking back to it now, it wasn't actually a bad idea in terms of remembering information!

Mnemonics
Just an easier and more fun way to remember stuff.

Reading
You get the idea by now (: read just a few pages a day of any book that relates to your course!

Practise exam questions
Exam questions are great because they are specific to most students needs and very relevant!

Role play
If you are doing a health and social care course like me, you could ask a sibling or family member to be a guinea pig so you can practice things like vital signs for instance.


Well, that is it for now! I hope this has helped! It has motivated me to keep studying hard, actually! Sometimes, i must say, i feel like giving up. Sometimes I think to myself that I'm never gonna improve or I think that others are so much better than I am but I know thats just me being underconfident. It's me undervaluing myself. I know I shouldn't but I just do. If you do this, don't worry! I can totally understand! It can be hard when you feel inexperienced and unworthy and you are not! Just keep trying hard! Enjoy what you are learning! you'll never be a student again! (unless you do post-grad -_-...) So enjoy the experience! But give yourself plenty of breaks and make the most of the time you have to learn!

Emily

Clinical skills: Vital Signs

Hello again!
I'm not in the library anymore. Those Apple Macs drive me up the wall! I hate the mice and I hate the Caps Lock button because it keeps sticking!! Grr...
It's great to be back on my beautiful Dell Inspiron Q15R!
In this post I'll be covering clinical skills. In particular I'll be talking about Vital signs and how to take them! Enjoy!

Vital Signs (TPR)

Respiration Rate
Before taking a patients breathing rate (BR), they must have been relaxed for at least five minutes, not talking. The BR must be taken over one minute to ensure that we do not miss anything out. One breath is counted as one rise and fall of the chest.
It may also help to look at the abdominals as well as observing the depth of breathing.
If both sides of the chest do not rise (both sides moving is known as bi-lateral movement), for instance, the patient could be suffering from a collasped lung.
It is also important to observe and see whether breathing is...
* regular
* through the nose or mouth
* loud/quiet
* Allowing them to speak
* laboured

Pulse
When measuring a persons pulse, we are taking note of the number of times their heart is beating in a minute (BPM). The blood in the artery is at high pressure, this makes it easy to record pulse.
Where we can take pulse...
* Radial artery - Wrist - choosen as the 'easiest' to take because it does not restrict a patient of personal space
* Carotid artery - Neck - Big vessel that is closest so your heart
* Pedal artery - Foot - Choosen if the patient has a compliant that might compromise circulation in the leg or foot
* Femoral artery - Inner thigh
* Popliteal artery - Behind the knee
* Brachial artery - In crook of arm, Other side of the elbow
* Temporal artery - Temples at the side of the head

Small childrens radial arteries are smaller and therefore harder to find so a more accurate way of taking their pulse would be to use a stethoscope on the apex of the heart (just under the breast).

Technique
* When taking pulse, use two fingers (preferably the two middle fingers; not your thumb or index finger as, of course, you have a pulse which can give off inaccurate readings). Using two fingers instead of say, one, widens the surface area meaning you will get a more accurate reading.
* Push down gently for a few moments before counting
* What helps me to remember where to find the radial pulse, is that you will most likely find a pulse on your wrist in line with your thumb.
* Also, what helps me find the brachial pulse is that this pulse will be found on the side of the arm opposite the thumb!
* If you are not sure or get the reading wrong, don't guess. Do it again!
* If you cannot find the pulse, try the other arm or drop the arm so that it is haning down freely. This increases bloodflow.
* Also some people suffer from heightened anxiety before their blood pressure is taken. This is known as White Coat Syndrome (my nana says that she has this!!) which is fear of going to the doctors/to the hospital, basically!
* Bradycardia is a term meaning a HR under 60 BPM
* Tachycardia is a term meaning a HR over 100 (meaning that something has changed in their physiology. For instance, they may be losing a lot of blood so their body is trying to compensate for the lost blood and therefore increases HR).
* A normal HR would be approx. 60-100 BPM.

Temperature
Temperature is a good sign of infection as there are many metabolic functions going on in the body that affect temperature.
Normal body tempertature is approx. 37-36.5 degrees celcius. (Childrens might be slightly different).
It's important to recognise that you should know the internal (core) temperature instead of the external termperature.
A temporal reader can be used to take temperature by running the device from the middle of the head to the hairline at the temple and then to behind the ear.
A digital thermometer can also be used or even a Tympanic Thermometer.
Before taking temperaturecheck whether the patient is wearing a lot of clothes, has just had a hot bath, a hot drink or is covered with a lot of bed sheets as all these factors can contribute to higher temperature.

Terminology
Pyrexia is the term used to describe high temperature. A pyrexial (hyperthermic) patient would have a temperature above 38 degrees celcius. In the same way, hypothermia is low core temperature. A person is apyexial if they have normal core temperature.
Something else I found interesting is that if someone does not show the symptoms of a complaint (and therefore will not be treated) is said to be asymptomatic. Something else a little bit random I found interesting - any term ending in 'itis' such as 'bronchitis' describes an inflammation of something. E.g. bronchitis is an inflammation of the main air passages into the lungs.

Blood Pressure
When measuring blood pressure, it is important to remember that you are actually measuring the pressure of blood coming out of the heart. Also the patients may actually be aware of their own BP as they probably take it themselves at home if they have hypertension.
BP is measured in mmHg, by a sphygmomanometer.
A normal BP is considered to be 100/70. Hypertension is high BP is is said to be pressures similar to 140/80, for instance. However, always remember when taking TPRs that what is considered 'normal' may not be 'normal' for your patient. Everyone is different.
Blood pressures are made up of two different pressures. Systolic and Diastolic. Systolic pressure is pressure when the heart is contracting. Diastolic is pressure of the blood in the arteries when the heart is at rest between beats. So, in a BP of 100/70, a patients systolic pressure would be 100 and their diastolic would be 70. When measuring BP using a sphygmomanometer, you can refer to the little numbered gauge to find the systolic and diastolic pressure.

Technique
* Tell the patient to fully relax
* The rubber bladder inside the sphygmomanometer should cover 80% of their arm circumference.
* As well as a sphygmomanometer you will also need a stethoscope in order to find the systolic and distolic pressures.
* Inflate the cuff, listening carefully using the stethoscope. When you do not hear the pulse, or the pulse has seemingly stopped, record this as the systolic pressure. (Refer to the little gauge to record the number). Then slowly release the air, listening again for the pulse to stop. This is the diastolic pressure.
* Make sure that you document what arm you took the BP from.

Oxygen Saturation
02 saturation is the amount of oxygen carried in the blood.
'Normal' oxygen saturation woud be aprrox. 94-99. 02 saturation can easily be taken from the finger by a oximeter (which also can record your HR).
Oxygen saturation can be improved by regularly changing position.

Another random little note: pain is also seen as a vital sign as it indicates that a patient is conscious enough to recognise pain and that they still have feeling in an area.

Thats all folks!! Hope you liked this post! Thanks for reading!

Emily

Clinical Skills: Mouth Care

Hello again!
I'd like to add mor to clinical skills while I still can! I'm in the UCS library at the minute and I've had, like, a whole day of lectures which as some of you may know can be very tiring even though you are sitting down the whole day!! ^ ^
Someone in this library has KFC... I can smell it... It smells sooo good!!!!! -_-;
Anyway, here is mouth care! Enjoy!

Mouth Care

What you need:
* Towel and/or disposable soft cloths, disposable bowl, waste bag, mouthwash, toothbrush and toothpaste, jug and glass, drinking straw, gloves, goggles and apron, small, free-standing mirror, tongue depressor, pen torch.
* Fill a jug with water, bring it and other equipment to the patients bedside.
Wash hands thoroughly, put on gloves and an apron (you may wish to wear goggles to prevent splashing into your eyes.

Supervising mouth care

* If the patient is bed-ridden but capable of self-care, encourage him to perform his own mouth care
* If allowed, assist the patient into an upright position, place the over-bed table in front of him with the mirror angled to allow the patient to view his face; arrange the rest of equipment on the table, ensuring everything is within reach.
* Drape the towel over the patient’s chest to protect clothing.
* Mix mouthwash in a glass, place a straw in it if needed and position the disposable bowl nearby.
* Instruct him to brush his teeth and gums while looking into the mirror. Encourage him to rise frequently during brushing, and provide facial tissues or soft cloths for him to wipe his mouth.
* Ensure all areas of the mouth are cleaned – teeth, palate, buccal surfaces, gums and tongue.

Performing mouth care
* Perform mouth care on the patient if they are comatose or unable to do it themselves.
* If they wear dentures, clean them thoroughly.
* Raise the bed to a comfortable working height to prevent back strain.
* If a patient is unconscious then lower the head of the bed and position the patient on his side, with his face extended over the edge of the pillow to facilitate drainage and prevent fluid aspiration.
* The conscious patient should be assisted to an upright position.
* Arrange the equipment on the over-bed table or bed locker.
* Place a soft disposable cloth under the patients chin and a disposable kidney bowl near his cheek to absorb and catch drainage.
* Lubricate the patients lips with water or petroleum-free balm to prevent dryness and cracking. Reapply lubricant as needed, during oral care
* If necessary use a tongue depressor to hold the patients tongue flat during the procedure.
* Wet the toothbrush with water. If needed, use hot water to soften the bristles.
* Apply toothpaste and brush the patients lower teeth from the gum line up; the upper teeth, from the gum line down.
* Place the brush at a 45 degree angle to the gum line and press the bristles gently into the gingival sulcus. Using short gentle stroke to prevent gum damage, brush the buccal surfaces (toward the cheek) and the lingual surfaces (toward the tongue) of the bottom teeth. Using the same technique, brush the buccal and lingual surfaces of the top teeth. Brush the biting surfaces of the bottom and top teeth, using a back and forth motion.
* Hold the disposable kidney bowl steady under the patients cheek and wipe his mouth and cheecks with tissues/soft cloth as needed. Use suction as required.
* Follow up with a swab.
* After brushing the patients teeth, dip a cotton-tipped mouth swab into the mouthwash solution or warm water. Press the swab against the side of the glass to remove excess moisture. Gently stroke the gums, buccal surfaces, palate and tongue to clean the mucosa and stimulate circulation.

After mouth care
* Assess the patients mouth for cleanliness and tooth and tissue condition
* Rinse the toothbrush and glass, dispose of the kidney bowl
* Empty and clean the suction bottle, if used, and place a clean yanker suction catheter on the tubing
* Remove your gloves and apron, return reusable equipment to the appropriate storage location, and discard disposable equipment in the clinical waste or household waste as per local policy. Wash your hands.

Documenting mouth care
* In your nursing care plan document the time and date of mouth care and sign. Document the condition such as bleeding, dry, oedema, mouth odour, excessive secretions or plaque on the tongue.
* Document the care that your administered.


And that's it!!
Hope you enjoyed it!! (:

Emily

Clinical Skills: Eye care

hi guys! this is the second clinical skills post that i'm doing!! yey!! Today we had our first lecture on IPL which is 'Inter-professional learning'. I'll get to that stuff a bit later on...
For now though I'm gonna explain Eye care! Enjoy!!

Eye Care

For this you will need:

A sterile galley pot, gloves and apron, sterile towel, sterile normal saline solution, sterile low-linting gauze swabs, artificial tears or eye ointment.

How to do it

* Assemble the equipment at the patients bedside. Open the sterile towel and open all sterile equipment on to this.
* Pour a small amount of saline solution into the galley pot. Open the sterile gauze using an aseptic technique and place on the sterile towel.
* Wash your hands thoroughly, put gloves and an apron on and inform the patient of what you would like to do in order to gain consent, even if the patient is comatose or unresponsive.
* To remove secretions or crusts adhering to the eyelids and eyelashes, first soak gauze in sterile normal saline solution. Then gently wipe the patients eye with the moistened gauze, working from the inner canthus to the outer canthus to prevent debris and fluid from entering the nasolacrimal (tear) duct.
* After cleaning the eyes, instil artificial tears or apply eye ointment, as prescribed, to keep them moist.
* After giving eye care, dispose of the galley pot, apron and gloves. Use new equipment for each care episode.

Documenting eye care
* Record the time and type of eye care in your notes.
* If applicable, record administration of eye drops or ointment in the patient’s medication chart.
* Document unusual crusting or excessive or coloured drainage and report findings as appropriate

Hope you enjoyed it!

Emily

Clinical Skills: Hand Hygiene

I guess this is the very first post I'll be doing on clinical skills!! yey! ^ ^
In this post I'll be explaining Hand hygiene and why it is important in the clinical environment and the best methods for hand washing.
It might sound a bit picky, thinking that we don't know how to wash our hands. But in a clinical environment, bacteria is quickly spread and this can mean outbreaks of MRSA and Clostridium Difficile (C-diff). Not good as both of these infections can be life-threatening. Hospitals are places that should aid patient recovery, not accelerate their death.
So, hand hygiene is very important! Therefore, I'll be discussing this with you in this post!

Hand Hygiene
* You should wash your hands before and after giving patient care or having contact with contaminated objects, even if you have worn gloves.
* You should make sure that you remove rings and jewellery as local policy allows, because they harbour dirt and skin microorganisms. Remove your watch - preferably you can wear a fob watch.
* Clothing should not be worn below the elbow when working in clinical environments.
* Fake nails and nail polish should not be worn as they have the potential to harbour microorganisms. Check your local policy.

Hand washing technique
* Wet your hands and wrists with warm water, and then apply soap from a dispenser. Avoid using bar soap to prevent cross-contamination. Hold your hands below elbow level to prevent water from running up your arms and back down, thus contaminating clean areas.
* Work up a lather by rubbing your hands together for about 10 seconds. Soap and water reduce surface tensions and this, aided by friction, loosens surface mircooragnisms, which wash away in the lather.
* Pay attention to under your fingernails and around the cuticles and also to your thumbs, palms, knuckles, and sides of your fingers and hands. Microorganisms can thrive in these overlooked areas.
* If you do not remove your wedding ring, move it up and down to get underneath it.
* Avoid splashing water on yourself or the floor because microorganisms spread more easily on these surfaces.
* Avoid touching the sink or taps because they are considered contaminated.

Rinsing and drying your hands
* Rinse hands and wrists well because running water flushes soil, soap or detergent, and microorganisms away.
* Pat hands dry with a paper towel.
* Turn off the taps by gripping them with a dry paper towel to avoid contaminating your hands.
* Dispose of the paper towels in the waste bin using a foot pedal to open the bin.

Other tips
* Use alcohol hand gel as well but just remember that they should be used up to 3 times before you should wash again. Also alcohol gels are insufficient to kill Clostridium Difficile, so remember to wash your hands after caring for patients with this infection.
* You must always allow time for the alcohol gel to dry as it is the drying of the alcohol that reduces the bacterial count.
*Ideally you should wash your hands at the beginning of your shift, before and after direct and indirect patient contact, before and after performing any body functions (E.G blowing your nose or using the toilet); beofre preparing or serving food, before administering medications; after removing gloves or personal protective equipment and after completing your shift.


So, that's all there is to it!! Similarly to the A&P bit I'm doing, I'll be continually updating Clinical Skills!

'Clinical Skills Made Incredibly Easy!' By Mhairi Hastings - This is the book that I regularly use to help me with clinical skills and I really do suggest you buy it or at least check your local/university library for it! It's actually getting me through clinical skills lectures!!

Anyway, I hope you have enjoyed this post! It's actually kinda hard to catch up on these blog posts that I've missed! There's so much information in one weeks worth of lectures, it's UNREAL!!
Ttyl,

Emily

A&P Part Two: The Renal System!

Hello!
In this post I'll be chatting about the renal system! I know It's been a while since A&P but I thought I'd give us a break from A&P for a bit because it is a slightly hard to grasp at first!
But the renal system isn't so bad, so here goes...

The Renal System

The renal system (Also known as the Urinary system) is made up of the Kidneys whose main roles are the removal of wastes and the maintenance of the body's water balance.

Here are their other vital functions:

1. Control of the body's water balance. The amount of water in the body must be balanced against the amount of water which we drink and the amount we lose in urine and sweat etc.

2. Regulation of blood pressure via the renin-angiotensin-aldosterone system

3. Regulation of blood electrolyte balance - Na+, Ca2+, K+ etc.

4. Excretion of metabolic wastes such as urea, creatinine and foreign substances such as drugs and the chemicals we ingest with our food

5. Help in the regulation of the body’s acid base balance

6. Regulation of red blood cell production via the hormone erythropoietin

7. Help in the production of vitamin D

Indeed, this long list shows us how important the renal system is to the normal functioning of the body.


Structure of the renal system
The kidneys are large, bean shaped organs which lie on the dorsal side of the visceral cavity, roughly level with the waistline.
Blood is supplied to the kidneys by the renal arteries which branch off the aorta. The kidneys and are drained by the renal veins into the inferior vena cava. From the kidneys, urine passes to the urinary bladder via the ureters.
Urine is passed to the outside environment via the urethra (this is routed differently in males and females)- See Figure 1.


Macrostructure of the kidneys
The kidneys are protected by a tough fibrous coat called the renal capsule. Under the capsule, the arrangement of nephrons and capillaries in the kidney produce the appearance of distinct regions when viewed in longitudinal section.
The outer cortex region surrounds darker triangular structures called pyramids which collectively form the medulla. The inner part of the kidney, the renal pelvis, collects the urine draining from the nephron tubules and channels it into the ureter - (Figure 2 shows a sectioned view of the kidneys)

Microstructure of the kidneys
The basic functional unit of the kidney is the nephron. Each nephron is composed of a glomerular capsule, glomerulus, proximal convoluted tubule, loop of Henle and distal convoluted tubule. The renal corpuscle includes the glomerular capsule and the glomerulus. The renal tubule is the part of the nephron that directs the filtrate away from the glomerular capsule and includes the proximal convoluted tubule, loop of Henle, distal convoluted tubule and the collecting duct. The collecting duct is not considered part of the nephron as many nephrons drain into one collecting duct.
There are over one million nephrons in each human kidney and together they are responsible for the complex water regulation and waste elimination functions of the kidneys. The heads of the nephrons are in the cortical region and the tubular component then descends through the medulla and eventually drains into the renal pelvis - (Figure 3 Shows the arrangement of nephrons in the kidneys)

The key area of interface between the circulatory system and the tubular part of the kidney is the knot of glomerular capillaries in the Bowman's capsule. Those liquid parts of the blood that are able to cross through the filtration membrane of the capillaries pass into the Bowman's capsule and then into the tubular section of the nephron - (Figure 4 shows The Bowman's capsule and glomerulus). The filtration membrane only allows water to pass through it and small molecules that will dissolve in water such as waste (urea, creatinine etc.) glucose, amino acids and ions. Large proteins and blood cells are too large to be filtered and remain in the blood.

The filtered fluid or filtrate enters the proximal tubule and then into the loop of Henle which is the part of the nephron which dips in and out of the medulla. From the loop of Henle, the filtrate travels through the distal tubule and then into a common collecting duct which passes through the medulla and into the renal pelvis - See Figure 5.

Now to consolidate our knownledge of the nephrons components...

Component's, their description and functions

Glomerular (Bowman) capsule
• The start of the nephron.
• It is a double-walled chamber that looks as if the wall of the nephron had been pushed in on itself.
• The walls of the glomerular capsule are thin, but only allow water and small ions to pass through.
• Filtrate (water and small molecules) which is similar to blood plasma passes into the capsular space of the glomerular capsule.
• The glomerular capsule continues as the proximal convoluted tubule (PCT).
• Function: Filtration

Glomerulus
• A tiny capillary network that lies within a glomerular capsule.
• The glomerulus receives blood at high pressure from a tiny branch of the renal artery, called the afferent arteriole.
• The filtered blood (blood cells, proteins and large molecules) leaves the glomerulus via the efferent arteriole which goes on to form a capillary plexus around the PCT, before draining into a tiny branch of the renal vein.
• Function: Filtration

Proximal convoluted tubule (PCT)
• Originating from the glomerular capsule the PCT is a highly twisted and coiled tubule that descends through the cortex.
• It is the part of the nephron responsible for most of the reabsorption of the filtrate.
• Water, glucose, amino acids and salts are reabsorbed from the PCT back into the bood.
• Drugs, toxins and solutes such as bicarbonate, hydrogen and potassium ions and urea are secreted into the PCT.
• It continues as the loop of Henle.
• Function: Reabsorption & Secretion

Loop of Henle
• A tubule with a long hairpin turn, its descending limb enters the medulla, where it makes a 180 degree turn so that its ascending limb enters the cortex.
• Salts are reabsorbed from the loop of Henle into the medulla of the kidney (making the medulla very salty compared to the filtrate).
• It ends in the cortex as the distal convoluted tubule (DCT).
• Function: Reabsorption

Distal convoluted tubule (DCT)
• A highly coiled tubule located in the cortex and surrounded by capillaries.
• Salts such as sodium are actively absorbed from the DCT under the control of a hormone called aldosterone.
• Hydrogen and potassium ions are actively secreted into the DCT to regulate pH.
• The rate of absorption and secretion in the DCT are controlled by hormones.
• It empties into the collecting tubule (CT).
• Function: Active Secretion

Collecting tubule(CT)
• They pass through the medulla forming the pyramids of the kidneys.
• Bicarbonate, potassium and hydrogen ions, are secreted into the CT to regulate pH.
• Water and salts are reabsorbed from the urea in the CT under the control of two hormones (one of them being anti-diuretic hormone that increases the CT permiability to water).
• Each CT opens into a minor calyces at the apex of the renal pyramid.
• From here urine flows via funnel-like calyces into the pelvis of the kidney.
• Function: Reabsorption, Secretion & Transport


Understanding the functions of the components

Filtration

Filtration at the glomerulus is under pressure as the afferent arteriole is so close to the abdominal aorta. The fluid that passes through the wall of the glomerular capsule into the nephron is called the glomerular filtrate and is similar in composition to plasma. Blood and protein cannot pass into the filtrate but small waste molecules can.
Interesting fact I found: 600 ml of blood will pass through the glomerulus each minute, 125 ml of which will be absorbed into the nephron as glomerular filtrate!

Reabsorption

The tubule of the nephron functions to reabsorb most of the glomerular filtrate. The cells of the tubule reabsorb vital nutrients and water back into the blood, while retaining the waste products that the body needs to eliminate. The plexus formed by the efferent arteriole (from the glomerulus) passes closely to the proximal convoluted tubule, allowing direct transfer into the blood. In the loop of Henle the filtrate is further concentrated. Water is absorbed by osmosis, being transported down its concentration gradient.
The amount of water reabsorbed is controlled by an anti-diuretic hormone (OMG Endocrine system, guys!!) secreted by the posterior lobe of the pituitary gland. The amount of salts reabsorbed is controlled by aldosterone secreted by the cortex of the suprarenal glands. These hormones are increased or decreased according to the needs of the body.

Active secretion

During active secretion, wastes that were not initially filtered out of the blood in the glomerular capsule such as ammonia and certain drugs and toxins are removed from the capillaries into the distal convoluted tubule.


I think that's all i'll type about renal for today, guys! There's so much to go through and i'm pretty sure that i've barely scratched the surface!! O_o
So watch out for A&P Part Three: The Respiratory system coming very soon!!

Bye!

Emily

Nursing Practice: Pressure Ulcers

In this post I'm going to talk about what we covered in one of our first nursing practice lectures which was about pressure ulcers.

Nursing Practice

•Guideline – A general rule, principle or piece of advice
•Policy – A proposed or adopted course or principle of action. Something you must follow otherwise you may be disciplined
•Standards – A required or agreed level of quality. Recommended by regulating/professional bodies and must be followed EG The code of practice.

What is stroke?

A stroke occurs when blood flow is interrupted to part of the brain. Without blood to supply oxygen and nutrients and to remove waste products, brain cells quickly begin to die. Depending on the region of the brain affected, a stroke may cause paralysis, speech impairment, loss of memory and reasoning ability, coma, or death. A stroke also is sometimes called a brain attack or a cerebrovascular accident (CVA).

Pressure Ulcers
Pressure ulcers, also sometimes known as bedsores or pressure sores, are a type of injury that affects areas of the skin and underlying tissue. They are caused when the affected area of skin is placed under too much pressure.

Pressure ulcers can range in severity from patches of discoloured skin to open wounds that expose the underlying bone or muscle.

How pressure ulcers develop
Pressure ulcers develop when a large amount of pressure is applied to an area of skin over a short period of time. Or, they can occur when less force is applied but over a longer period of time. They can develop within two hours. So it is important to move a patient at least once every two hours.

The extra pressure disrupts the flow of blood through the skin. Without a blood supply, the affected area of skin becomes starved of oxygen and nutrients. It begins to break down, leading to the formation of an ulcer.

Healthy people do not get pressure ulcers because they are continuously and subconsciously adjusting their posture and position so that no part of their body is subjected to excessive pressure.

However, people with health conditions that make it difficult for them to move their body often develop pressure ulcers. In addition, conditions that can affect the flow of blood through the body, such as type 2 diabetes, can make a person more vulnerable to pressure ulcers.


Preventing pressure Ulcers
•Change a patient’s position at least once every two hours
•Use equipment such as mattresses or pillows to relieve pressure on vulnerable areas

Vulnerable areas for pressure ulcers
If a patient is bedbound (unable to get out of bed) they are at risk of developing pressure ulcers on their:
•shoulders or shoulder blades
•elbows
•back of your head
•rims of your ears
•knees, ankles, heels or toes
•spine
•tail bone (the small bone at the bottom of your spine)

If they are sitting or they are a wheelchair user, they are at risk of developing pressure ulcers on:
•the buttocks
•the back of your arms and legs
•the back of your hip bone

Other reasons for patient discomfort:
•If a patient is incontinent, urine is acidic which may burn their skin
•Hospitals can also become very warm which may cause them to sweat which can in turn cause discomfort

Hygiene needs of a patient

Assessment
•Check the nail beds and the skin to check for capillary refill time and circulation – press on the skin and check how long the skin takes to return to its natural colour
•Skin can be an indication of dehydration – this is obvious if the skin is dry, if, when the skin on the back of the hand is pinched, the skin takes some time to return to its normal state. And also if the tongue is dry.
•Check the patient for ulcers
•Find out if the patient is diabetic – because you must not cut diabetics nails in case you catch the skin because of slow wound healing which could make them more prone to infection
•Is their skin a healthy colour?
•Check health of nails – are they yellow or horn-like?

Nutritional assessment
•Is the patient overweight or underweight?
•Maintain holistic care whilst bathing – involve them in conversations by asking them how they are feeling, asking them what their name is. Make them feel at peace and comfortable.

However…
Allow them independence as much as possible. If they can, allow them to dress themselves or wash themselves without help. This also allows them to maintain dignity and self-respect

Social assessment
•Integrate them into the conversation if with another nurse and use a nice calming tone of voice

Evidence based practice
•Do not wear gloves unnecessarily (each box costs £8!!) and if there is no clinical reason to as this might frighten the patient or put up a psychological barrier between the nurse and the patient
•Do not touch intravenous infusions!!
•Pat a patient dry instead of rubbing – especially if the patient has dry skin as you do not want to aggravate the skin
•Check the skin for sores of ulcers
•You should work with your mentor approximately 40% of placement and you should have three meetings with them. One at the beginning, one two/three weeks in and one at the end.

Emily

Helpful Medical Phrases

I decided to upload a list of medical terms/phrases that might help you to understand them a bit. Hope this helps.

Key Terms - Life Sciences
a-, an- [Without or lacking]: Anaerobic, anemia
ad- [Toward]: Adrenalin
amphi- [both sides of, two]: amphibian
ana- [Up against]: anatomy, anabolic
anti- [Against, opposite, opposed to]: antibiotic, antigen, antibody
arthro- [Joints]: Arthritis
auto- [self, same]: autoimmune
bi- [Two]: bicarbonate
bio- [Life]: Biology
blast- [pertains to embryo]: osteoblast
broncho- [windpipe]: bronchus, bronchi, bronchitis
carb- [coal]: carbon, carbohydrate
cardio- [heart]: cardiac, myocardium, electrocardiogram
cat- [down, download]: catabolic
chloro- [green]: chlorophyll, chlorine
chromo- [colour]: chronosome
com- con- col- co- [with, together]: coenzyme
cranio- [cranium, skull]: cranial
cuti- [Skin]: cuticle
cyto-, cyte [Vessel or container]: cytoplasm, cytokinesis, leukocyte
de- [away, off, removal, separation]: dehydration
derm- [skin]: dermis, epidermis
dia- [passing through, through, thorough]: diaphragm
endo- [within]: endoderm
gastro- [stomach]: gastric
gen- [born, produced]: geneology
gluco-, glyco-[pertaining to sugar]: glucose, glycogen, glycolysis
hemo-, hemato-, hemia, -emia [Blood]: hematology, hemoglobin
hepato- [Liver]: hepatitis
hetero- [Other, different]: heterogeneous
histo- [web of a loom, pertains to biological tissues]: antihistamine
homo-, homeo- [same, similar]: homeostasis
hydro- [water]: dehydration
hyper- [over, above, more than]: hyperthyroid

Emily

Health and Wellbeing

Hi again!
Thought I'd continue to update while I'm still motivated.

Health and wellbeing

Health definition:
•“Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” – World health organisation
•“Health arises from harmony with nature” – ‘Mirage of health’
•“Ill health is precisely located malfunctions of the body” – Greek God Ascelepius
•“Health is equilibrium, illness is an upset” – Hippocrates
•“Health is a combination of factors having a particular effect on an individual” – Ewles and simnett, 1991

Wellness
Definition – An active process of becoming aware of and making choices toward a more successful existence
Process – never arrive at a point where there is no possibility of improving
Aware – we are, by nature, continuously seeking new information so we can improve.
Choices – considered a variety of options and select those that seem to be in our best interest.
Success – determined by each individual to be their personal collection of accomplishments for their life

Health is…
•Achieving optimum function (Seedhouse, D. 1991)
•“I want to be all that I am capable of becoming” (Mansfield, K. 1977)
•A State of optimum capacity for an individual for the effective performance of the role(s) and task(s) for which they have been socialised (parsons, T. 1951)


Social health definition:
•Capability of individuals, families, groups and communities to cope successfully in the face of significant adversity or risk (Social indicators research, 1997)

Mental health definition:
•Feeling good about life and yourself and being able to get on with life in the way you want.
•Not about income but how you feel about your life

Medical model…
•Disease represents a crucial issue facing society
•Diseases are readily diagnosed and counted
•Approach is narrow and implies that people with disabilities are unhealthy and health is only about physical disease and mortality

When you are healthy, you feel…
•Happy
•Motivated
•Feel energetic
•Well

Bodily changes as you get older involve…
•Weight
•Skin/nails
•Hair
•Teeth and bones
•Sleep needs
•Eye sight
•Sexuality (due to physical changes)
•Spirituality and attitudes to life


Popular topics that patients may ask you about…
•Alcohol
•Fitness
•Food/diet
•Healthy eating
•On a budget
•Lose weight
•Military medicine
•Mental health
•Sexual health
•Smoking
•Class of 1948
•Get fit for 2012
•Five a day

Internet sources…
•NHS direct
•Health search engine
•Health direct
•Dh.gov.uk – elect a hospital

What affects your health?

Individual
•Physical health
•Healthy eating
•Motivation to go to the doctors/dentist

Immediate social/physical environment
•Job – is your job physical or sedentary? Is your income enough to afford ‘healthy’ foods?

Wider social/political
•Political – less funding for promoting health? Less funding for equipment or facilities?
•Social acceptance – men in general may not want to admit they are on a diet because of peer pressure or looking stupid (not ‘manly’)
•Petrol prices can influence whether we walk or drive


So there you have it!!
Hope you enjoyed!

Emily

Negotiated Care

Hi everyone!
I'm really sorry for the lack of posts!
I've been juggling quite a few things at the minute (but, hey, my aim is to keep this particular blog 'professional' so...)
Today I'm gonna be talking about negotiated care, so here goes...

Negotiated Care

Pearson, 1989. P.141:

‘The power to heal lies within the patient and not the nurse'

Who are your caring for? What do we call those we care for?
•Service user
•Patient
•Client
•Individuals – nursing is about holistic care
•Customer
•Consumer

Terminology
•Patient – A person receiving or required to receive medical treatment - (concise oxford dictionary, 2010)
•Client – refers to all groups or individuals who have direct or indirect contact with nurses or midwives in professional capacity (used in mental health a lot) – (NMC, 2002)
•Customer – one that buys goods or services
•Consumer – recipient of health care such as a patient in a hospital
•Service user – a person who uses health services

Patient
•Have some form of treatment to improve their own health or wellbeing
•Are expected to co-operate and trust the nurse
•Patients can behave anxious, distress or nervous and tend to have ‘blind faith’ in doctors or nurses. They can become quite passive and may not ask questions as they do not want to make a fuss.
•Department of health, 1996 – patient or carer involvement is essential to help people make informed decisions about their own health care
•NHS plan, 2000 – patients must have more say in their own treatment and more influence over the way the NHS works.
•DH, 2008 – high quality care for all:
•“set new foundation for health services – giving patients more choice and thei healthcare is more personalised and fair”.
•Emphasis is on a partnership between healthcare professional and the patients. Focus is on meeting and exceeding the expectations of patients.
•NHS constitution, 2010: Includes rights to choose both treatment and providers and information on quality so that where relevant patients are able to make informed choices.

High quality care – what does it involve?
•Negotiation
•Patient choice
•Shared decision making
•Active participation in care
•What do we mean by negotiation?
•Working together
•Principles of decision making

For patients to make a decision they must be able to…
•Understand
•Know the risks
•Given enough information to enable them to make the right decision (DH, 2001)

A person is unable to make a decision if they…
•Are unconscious
•Are not active in the decision making process
•Cannot understand the information
•Cannot retain formation
•Cannot communicate the decision

Mental capacity act 2005
•Protect people who cannot make decisions for themselves
•Could have a brain injury, a stroke or a severe learning disability
•A person is presumed to make their own decisions

Children or young people
•16-17 year olds can legally consent to treatment
•Under 16 year olds can consent to treatment is deemed ‘gillick competent’

Children act 1989
•Those with parental responsibility can make decisions for a young person or child
•Children or young people have the right to be involved in decisions, be heard or have their views taken into account

What information do patients need?
•Who you are
•Information about the treatment including the pros and cons and side effects
•After care
•Up to date information
•Nurses to be honest to patients and use limited jargon
•What the treatment involves
•The role of the nurse is to inform and interpret for the patient

Benefits
•Can make quicker decisions
•Feel more in control of decision making
•Prevent further problems and issues in the future
•Confidence
•Helps them to plan their lives
•Makes people feel more respected and valued

Difficulties
•May think we do not have enough knowledge as a student nurse
•May take anger out on HCPs
•Can refuse treatment
•Can be difficult to communicate decisions
•Religious beliefs

Examples of when service users/carer might become active participants in care planning…
•Rehab
•Palliative care
•Support plans
•Medications
•Four levels of involving them in decision making…
•Give information about decision
•Consultation
•Joint decision making
•Giving responsibility for users to decide or act themselves

User involvement
+VE
•Can tell you things you don’t already know
•Aids recovery
•Builds rapor
•Greater sense of control

-VE
•Lack of co-operation
•May not understand or think they are not ill

Empowerment
•“Social process of recognising, promoting and enhancing people abilities to meet their own needs, solve their own problems and mobilise the necessary resources in order to feel in control of their lives.” – Gibson, 1991
•Nurses’ role is to empower and help patients to consider options and consequences in order to make informed decisions. Nurses must allow patients to participate in their own care.

Again, so sorry for the lack of updates. I know i did promise i'd update a lot. It's just a lot is going on for me now. Please bear with me! Keep checking for updates! I love my readers!

'Til next time.

Emily

Holistic Nursing

Hello ^ ^
Long time no see (; LOL!
Tonight I'll be talking about holistic nursing.

What is holistic nursing?
• Relationship-centred care
• Recognising body-mind-emotion-spirit-environment principles in daily life and in clinical practice
• Desire to do good – not performed for the sake of the law or because of duty
• Paying attention to all aspects of an individual – the physical, social, mental and emotional person
• Communicating verbally and non-verbally

The practice process is based on six main principles...
• Assessing
• Diagnosing
• Identifying outcomes
• Planning care
• Implementing plan of care
• Evaluating

The caring process involves...
• Recognising the totality of the human being – the interconnectedness of the body, mind, spirit and emotion
• Focusing on how the individual is cognitively perceiving and emotionally dealing with the illness
• Focusing on effect on persons family, social relationships and economic resources
• Focusing on care interventions that promote healing, peace and comfort

Holistic Assessments
• Include physical, mental, emotional, cultural, sexual, spiritual and transpersonal and energy field assessments
• Energy field assessments are based on the concept that all beings are composed of energy and congestion of this energy will create disharmony and disease
• Spiritual assessments – religious beliefs and a person’s purpose in life. Ask questions about their sense of peace, what brings them joy, strength and hope.
• First ask an individual: “What do you think is happening/going on with you?” And then: “What do you think would help?”
• Help the person to identify risk factors such as lifestyle, habits, beliefs, values, family or personal history
• Focus on individual’s goals rather than the nurses
• Therapeutic plans of care respect person experience and uniqueness of each healing journey
• Holistic nurses respect that outcomes may not be expected as they may evolve differently


I know some of my posts seem quite short and to the point, without much detail but I promise that as the year progresses I will continuously add detail as I go along! You'll pretty much be able to see my knowledge grow over the years, I promise ^^
Oh, also I did a little research earlier. It might sound silly but I actually did not know what the different was between diagnosis and prognosis. If you didn't know here you go:

Diagnosis: what illness or injury a patient has.

Prognosis: the outlook/forecast/decision of how to TREAT the diagnosis. Good prognosis = you are likely to recover. Poor prognosis = you are not likely to recover.

Bye!!

Emily

A&P Part One: The Endocrine System

Hello everyone!
I know it's been about a week since my last post but I thought I'd wait a bit so I could make this post more interesting!!
Good news by-the-way! We've finally moved onto the more exciting stuff - Life Sciences!! xD Yey!! haha!
In this post, as you can probably guess from the title ^^, I will be discussing the all-important and absolutely astonishing endocrine system! (Quick note: I was originally going to be talking about Endocrine, Renal *AND* Respiratory in this one post but... I started writing and realised that there was just *SO* much to write about on each system - why does the human body have to be so complex?!?!? Ahaa - So I've decided to split this post into three A&P parts. So, A&P part two and three will follow soon! Enjoy!!)

The Endocrine System
This vital system in our body consists of widely separated endocrine glands which secrete hormones. Hormones, as you may recall from GCSE biology, are 'messenger' substances produced in one part of the body but regulates the activity of cells in other parts of the body. Most hormones enter interstitial fluid and then the bloodstream. The circulating blood then delivers hormones to cells throughout the body. Hormones exert their effects by binding to receptors on or in their 'target' cells and their levels are greatly influenced by factors such as stress, infection and changes in balance of fluid and minerals in the blood. If, however, a hormone is present in excess, the number of target-cell receptors may decrease. This is called 'down-regulation'. In contrast, when a hormone is deficient, the number of receptors may increase. This is known as 'up-regulation'.
The Endocrine system is vital for regulating mood, growth and development, tissue function and metabolism, sexual function and reproductive processes. Responses of the Endocrine system are also slower than the responses of the nervous system. Although it may take seconds for a hormone to act, most take several minutes or more to cause a response. And while the nervous system acts on specific muscles and glands, the influence of the Endocrine system is much broader as it helps regulate virtually all types of body cells.

Endocrine Glands
Endocrine glands secrete hormones into the interstitial fluid surrounding the secretory cells. The hormones then diffue into the blood capillaries and the blood carries them to target cells throughout the body. Because they depend so much on the cardiovascular system to distribute products, the endocrine glands are some of the most vascular tissues in the body.

The Endocrine Glands & the hormones they produce...

Pituitary Gland
Human Growth Hormone (HGH)
-Chemical Nature: Protein.
-Mode of Action: Cyclic AMP.
-Important Roles: Stimulates protein synthesis and release of energy from fats.

Thyroid Stimulating Hormone (TSH)
-Chemical Nature: glyco-protein.
-Mode of Action: Cyclic AMP.
-Important Roles: Stimulates production and release of thyroid hormones.

Adrenocorticotrophic hormone (ACTH)
-Chemical Nature: Peptide.
-Mode of Action: Cyclic AMP.
-Important Roles: Stimulates production and release of adrenal cortex hormones.

Follicle stimulating hormone (FSH)
-Chemical Nature: glyco-protein.
-Mode of Action: Cyclic AMP.
-Important Roles: Maturation of follicles in females and production of sperm in males.

Luteinizing hormone (LH)
-Chemical Nature: glyco-protein.
-Mode of Action: Cyclic AMP.
-Important Roles: Triggers ovulation and development of corpus luteum.

Prolactin (PR)
-Chemical Nature: Protein.
-Mode of Action: --
-Important Roles: Stimulates milk production by mammary glands.

Melanocyte stimulating hormone (MSH)
-Chemical Nature: Peptide.
-Mode of Action: Cyclic AMP.
-Important Roles: Increases skin pigmentation.

Anti-diuretic hormone (ADH)
-Chemical Nature: Peptide.
-Mode of Action: Cyclic AMP.
-Important Roles: Stimulates reabsorption of water by kidney tubules.

Oxytocin
-Chemical Nature: Peptide.
-Mode of Action: --
-Important Roles: Stimulates contraction of the uterus.

Pineal Gland
Melatonin
-Chemical Nature: Amine.
-Mode of Action: --
-Important Roles: Possible inhibitory action on ovaries.

Thyroid Gland
Thyroxin
-Chemical Nature: Amino Acid.
-Mode of Action: Cyclic AMP.
-Important Roles: Increases metabolic rate, stimulates growth in infants.

Thyrocalcitonin
-Chemical Nature: Peptide.
-Mode of Action: --
-Important Roles: Promotes calcium absorption by bones.

Parathyroid Glands
Parathyroid hormone (PTH)
-Chemical Nature: Protein.
-Mode of Action: Cyclic AMP.
-Important Roles: Promotes calcium absorption from intenstine, stimulates calcium release from bones.

Thymus Gland
Thymosin
-Chemical Nature: Peptide.
-Mode of Action: --
-Important Roles: Possible influence on B-lymphocytes.

Pancreas (Islets of Langerhans)
Insulin
-Chemical Nature: Protein.
-Mode of Action: Cyclic AMP.
-Important Roles: Stimulates absorption of glucose into liver and muscle cells, formation of glycogen.

Glucagon
-Chemical Nature: Peptide.
-Mode of Action: Cyclic AMP.
-Important Roles: Increases blood glucose level, breakdown of glycogen.

Adrenal Glands

The Cortex:
Mineralocorticoids, aldosterone

-Chemical Nature: Steroid.
-Mode of Action: Gene activation.
-Important Roles: Stimulates reabsorption of sodium ions by kidney tubules, reduces reabsorption of potassium ions.

Glycocorticoids: Hydrocortisone, Corticosterone, Cortisone

-Chemical Nature: Steroid.
-Mode of Action: Gene activation.
-Important Roles: Reduce effects of stress responses.

The Medulla:
Adrenalin (80%), Noradrenalin (20%)

-Chemical Nature: Amine.
-Mode of Action: Gene activation.
-Important Roles: Increased heart and breathing rates, other 'fight or flight' responses.

Ovary
Oestrogen

-Chemical Nature: Steroid.
-Mode of Action: Gene activation.
-Important Roles: Development of female sexual characteristics, repair of uterus lining.

Progesterone

-Chemical Nature: Steroid.
-Mode of Action: Gene activation.
-Important Roles: Development o uterus ready for implantation.

Testis
Testosterone

-Chemical Nature: Steroid.
-Mode of Action: Gene activation.
-Important Roles: Development of male sexual characteristics.


The Master Gland
Attached to the hypothalamus in the brain, hangs the pituitary gland. This gland is nicknamed 'the master gland' because it stimulates all other hormone-producing glands to produce their own hormones. And while it is vital in the endocrine system, amazingly it is only the size of a pea!
It is comprised on two parts - the anterior and posterior lobe (see first picture in post). The anterior lobe secretes six hormones (which are named above) and is influenced by the hormones from the hypothalamus. The posterior lobe stores hormones that are from the hypothalamus, they are released when needed. Antidiuretic hormone (ADH) and oxytocin are produced in the hypothalamus and transported by axons to the posterior pituitary.

Feedback Mechanisms
The endocrine system uses cycles and negative feedback to regulate physiological functions. Negative feedback regulates the secretion of almost every hormone. Cycles of secretion maintain physiological and homeostatic control. These cycles can range from hours to months in duration.

This 'feedback' mechanism involves the hypothalamus, the pituitary gland and the target gland to control hormone production. A feedback system promotes to release of another hormone (positive feedback) or can inhibit its release (negative release). This mechanism helps to maintain the body's balanced functioning.

Example of how it works...

1. Responding to levels of the Thyroid hormone, the hypothalamus make TRH (Thyrothropin-releasing hormone). This stimulates the anterior pituitary gland to release TSH (Thyroid-stimulating hormone). The thyroid gland is then triggered to produce hormones.

2. If the Thyroid hormone levels are too high, negative feedback alters the hypothalamus so that it produces less TRH. A lower level of TRH results in a reduced level of TSH. So the Thyroid responds by producing less hormone.

3. If the Thyroid hormone levels fall too low, the feedback mechanism is weakened. In response, the hypothalamus makes more TRH; TSH rises so that the levels of Thyroid hormone also rise.

Chemical classes of hormones
OK, so above you can see that I have (in the description of glands and the hormones they produce) mentioned whether hormones were steroids, amines, peptides or proteins. Well, now I'm going to explain what all this means. So, here goes...

There are two main types of hormones
* Lipid (fatty acids) soluble hormones: i.e. steroid hormones which are derived from cholesterol.
* Water soluble hormones:
Amine hormones: synthesised by removing the CO2 molecule and modifying amino acids. Example: Tyrosine.
Peptides and proteins: Amino acid polymers (large molecules with high melting and boiling points). Smaller peptide hormones consist of 3-49 amino acids while the larger consist of 50-200. Examples of peptides: oxytocin/ADH. Examples of proteins: HGH and insulin.

Adding to this, hormones can either be...
* Circulating hormones: Pass from secretory cells that make them, then into interstitial fluid, then into the bloodstream. Circulating hormones may linger in the bloodstream but are finally excreted by the kidneys.
* Local hormones: Act locally on neighbouring cells (or on the same cell that secreted them) without first entering the bloodstream. In comparison to circulating hormones, local hormones are inactivated quickly. Hormones acting on neighbouring cells are called 'paracrines'. Those acting on the same cell that secreted them are called 'autocrines'.

Hormone Transportation
*Water Soluble: Molecules circulate in blood plasma and are not attached to other molecules.
*Lipid soluble: Bind to transport proteins.

These transport proteins (which are made by cells in the liver) have three functions...
1. Make lipid soluble hormones temporarily water soluble which increases their solubility in the blood.
2. Delay passage of small hormone molecules through the filtering system in the kidneys which slows the rate of hormone loss in the urine.
3. provide ready reserve of hormone already present in the bloodstream.

Actually about 0.1-10% of molecules of lipid soluble hormones don't bind to transport proteins. This is called 'free fraction'. It is the free fraction that diffuses out of capillaries, binds to receptors and triggers responses.

Clinical connection: Peptide/protein hormones such as Insulin need to be taken by injection. Taken orally, the digestive enzymes destroy them by breaking their peptide bonds. Steroid/thyroid hormones both are effective when taken orally as they are not split apart during digestion and easily cross the intestial lining because they are lipid soluble.

Mechanism of hormone action
The endocrine system acts by releasing hormones that in turn trigger actions in specific target cells. Receptors on target cell membranes bind only to one type of hormone. More than fifty human hormones have been identified; all act by binding to receptor molecules. The binding hormone changes the shape of the receptor causing the response to the hormone. There are two mechanisms of hormone action on all target cells.


Water Soluble
Water soluble hormones do not enter the cell but bind to plasma membrane receptors, generating a chemical signal (second messenger) inside the target cell. Five different second messenger chemicals, including cyclic AMP have been identified. Second messengers activate other intracellular chemicals to produce the target cell response.







Lipid soluble
The second mechanism involves steroid hormones, which pass through the plasma membrane and act in a two step process. Steroid hormones bind, once inside the cell, to the nuclear membrane receptors, producing an activated hormone-receptor complex. The activated hormone-receptor complex binds to DNA and activates specific genes, increasing production of proteins.



Phew! I know this was a long one, guys! Probably the longest one yet! And I have to tell ya - we're not even finished yet!! There's so much that I haven't said in this post!! Plus we still have Renal and Respiratory!! O_o IKR! LOL!
Anyway, I hope you are all well and I hope you enjoyed this post!
I find all this fascinating! I love learning about how the human body works. It's truely amazing that it all goes on without us consciously knowing about it!!
Anyway, ttyl!!

Emily