Myocardial oxygen demand can be met if there is a balance between supply and oxygen demand. Decrease in myocardial oxygen supply may be harmful to myocardial function. Coronary heart disease caused by an imbalance between myocardial oxygen supply and demand. When myocardial oxygen demand increases, the oxygen supply must also increase. Increased oxygen demand occurs on: tachycardia, increase myocardial contractility, hypertension, hypertrophy, and dilatation of the ventricles. To increase the supply of oxygen in a sufficient amount of coronary artery flow should be improved.
Four factors that affect cardiac oxygen demand:
* The frequency of heart rate
* Power contraction
* Muscle Mass
* Voltage ventricular wall
The imbalance between supply and oxygen demand can be caused:
* Narrowing of coronary arteries (atherosclerosis), which is the most common cause.
* Decrease in blood flow (cardiac output).
* Increased myocardial oxygen demand
* Coronary artery spasm.
Suply demand
Suply demand
Suply demand
Pathogenesis
Coronary artery atherosclerosis is a cause of coronary artery disease are most commonly found. In coronary atherosclerosis, there is accumulation of lipids and fibrous tissue in the coronary artery so that narrow the coronary artery lumen.
Mechanisms of atherosclerosis:
* In the tunica intima containing lipid deposits occur much cholesterol.
* Occur complex atherosclerotic plaque consists of fat, fibrous tissue, collagen, calcium, cellular debris and capillaries.
* Changes degenerative artery wall.
* Coronary artery luminal narrowing.
CHD RISK FACTORS
Risk factors irreversible:
* Age
* Gender
* Family history / genetic
* Race
Reversible risk factors:
* Hyperlipidemia, hypercholesterolemia
* Hypertension
* Smoking
* Diabetes mellitus
* Obesity
* Stress psychologic
* Type of personality
* Lack of sports activities
Clinical manifestations
* Without symptoms
* Angina pectoris
* Acute Myocardial Infarction
* Arrhythmias
* Suck heart
* Sudden deaths
PATOFISOLOGI
Ischemia
Ischaemia is a condition of oxygen shortage is temporary and reversible. Decrease in oxygen supply will improve the mechanism of anaerobic metabolism. Long ischemia can cause muscle death or necrosis. State that continued necrosis can cause death of heart muscle (myocardial infarction). Ventriekel left is the living heart of the most susceptible to ischemia and infarction, due to left ventricular oxygen demand greater for contraction. Anaerobic metabolism is not very effective addition to the energy produced is not large enough also enhances the formation of lactic acid that may reduce the PH cell (lactic). Ischaemia is typically marked changes in ECG: T inversion, and ST segment depression.
Combined effects of hypoxia, decrease in energy supply, as well as acidosis can quickly disrupt the function of the left ventricle. Strength of contraction in the affected areas susceptible to interference, muscle fibers shorten, as well as its velocity decreases. Changes in these contractions can be caused decrease in cardiac output. Ischemia can cause pain as the result of excessive accumulation of lactic acid. Angina pectoris is chest pain that accompanies myocardial ischemia.
Angina pectoris can be divided: of angina pectoris stable (stable of angina), angina pectoris unstable (unstable wind), a variant of angina (angina prinzmetal).
Stable angina pectoris: chest pain belonging to stable angina is the pain that arises when performing activities. The pain of not more than 15 minutes and lost the rest.
Unstable angina pectoris (UAP): The chest pain arising UAP at rest, the pain lasts for more than 15 minutes and an increase in pain.
Variant angina: Unstable angina is caused by coronary artery spasm.
Infarction
Ischemia lasting more than 30 minutes can cause irreversible cell damage and muscle death (necrosis). Part of experiencing myocardial necrosis or infarction will cease to contract permanently.
Nursing care
* Review: a complaint of pain, disease history, risk factors.
* Physical examination: TTV, peripheral perfusion, capillary reffil, arterial pulsation, heart sounds: S3, S4, murmurs, lung sounds: Ronchi, whezing.
* Response psychological: depression, anxiety, worry.
* ECG: T inversion, ST depression
* Laboratory: Routine blood, cardiac enzymes, lipid profile.
* Echocardiogram
* Kateterisasi heart
* Photo thoracic
Nursing Diagnosis
* Decrease in cardiac tissue perfusion
* Changes in breathing pattern
* Changes in comfort; pain
* Intolerance activity
* Anxiety
Management of
* The most effective management is to detect and mitigate risk factors.
* Reducing cardiac oxygen demand by decreasing heart work
* Increase the oxygen supply of heart
* Coronary revascularization
Coronary revascularization
Coronary revascularization is a way to improve vascularities blood vessels to the heart. Three mechanisms revaskkularisasi
Coronary were: PTCA (Percutaneous Transluminal Coronary Angioplasty), revascularization with CABG surgery, therapy Thrombolytics.
PFS REHABILITATION PROGRAM
Rehabilitation of heart disease is a series of efforts to help cure the patient in order to return quickly to normal life. Rehabilitation aims to restore the PFS physical condition, mental and social one as optimal as possible so that achieved self ability to run activities at home or occupation.
Phase I Program
Courses are given in all patients who are still in care at the hospital. Program implemented as soon as possible in patients with stable hemodynamics since the ICCU, inpatient unit, until the patient home. Length of training: 7-14 days. Types of exercise: 5 minute warm-up that includes exercises arm muscles, legs, hips in a rhythmic and repetitive. Components of core exercises is the road / bike with a load that can be gradually increased according to response to exercise. The exercise ended with cooling for 5 minutes.
Phase II Program
Is an advanced program whose implementation as soon as possible after the patient's home. Length of training: 6-8 weeks 3x/minggu held for one hour. Types of exercise: warm-up for 5-10 minutes of stretching, followed by riding a stationary bike and walking for 30-45 minutes. The exercise ended with cooling for 10 minutes.
Phase III Program
Is a long term program with a community base. Conducted after the patients completed the Phase II program through the heart exercise test and achieve aerobic capacity. Length of training: 1-3 months
Pathophysiology
Risk Factors
Atherosclerosis
PSS Myocardial Blood Supply
Myocardial ischemia
Necrosis / infarction
PSS myocardial contractility
PSS Bulk Heart
Heart Failure
Death
Thursday, May 27, 2010
Emergency Acute Respiratory Syndrome
DEFINITIONS
Emergency Acute Respiratory Syndrome (Adult Respiratory Intensive Care Syndrome) is a type of lung failure with a variety of different abnormalities, which resulted in the collection of fluid in the lungs (pulmonary edema).
Severe acute respiratory syndrome is a medical emergency that can occur in people who previously had normal lungs. Although often called acute respiratory syndrome, acute adult, this condition can also occur in children.
CAUSE
Could cause any disease, directly or indirectly injure the lung:
Severe and widespread infection (sepsis)
Pneumonia
* Very low blood pressure (shock)
* Terhirupnya food into the lungs (inhaling vomit from the stomach)
* Multiple blood transfusions
* Damage to the lungs by inhaling a high concentration of oxygen
* Pulmonary embolism
* Injury to the chest
* Severe burns
* Drowning
* Operation cardiopulmonary bypass
* Inflammation of the pancreas (pancreatitis)
* Overdose of drug such as heroin, methadone, or aspirin propoksifen
* Severe trauma
* Blood transfusion (especially in very large quantity).
Symptoms usually appear within 24-48 hours after the occurrence of disease or injury.
SGPA often coincided with failure of other organs, like liver or kidneys. is one risk factor is cigarette smoking than SGPA. SGPA incidence is about 14 among 100 000 persons per year.
SYMPTOMS
Severe acute respiratory syndrome occurred within 24-48 hours of the basic abnormalities.
At first the patient will experience shortness of breath, usually in the form of rapid and shallow breathing.
Due to low oxygen levels in the blood, the skin looks pale or blue, and other organs like the heart and brain function disorders. The loss of oxygen because this syndrome can cause complications from other organ syndrome occurs immediately after or several days / weeks later when the patient does not improve the situation. Loss of oxygen that lasts a long time can cause serious complications such as kidney failure. Without proper treatment, 90% of cases ended with death. When given appropriate treatment, 50% of patients will survive. Because the patient is less able to fight infection, they usually suffer from bacterial pneumonia in the history of the disease. Other symptoms that may be found:
- Anxiety, feeling his end approaching
- Low blood pressure or shock (low blood pressure accompanied by other organ failure)
- Patients are often unable to complain because it looks very painful symptoms.
DIAGNOSIS
On physical examination using a stethoscope, abnormal respiratory sounds (like ronki or wheezing). Blood pressure is often low and the skin, lips and nails sufferer looks bluish (cyanosis, due to lack of oxygen).
Examinations are usually done to diagnose SGPA:
* X-ray chest (indicating the accumulation of fluid in a place that should be filled with air)
* Arterial blood gases
* Calculate the blood type and blood chemistry
* Bronchoscopy.
TREATMENT
Patients with severe acute respiratory syndrome treated in intensive care units.
Oxygen therapy is very important to correct the blood oxygen level, oxygen is often given in high concentrations (100% oxygen may be required). When oxygen delivery to the front lid not managed to overcome the problem, it is necessary to use tools respirator (ventilator). Ventilator delivering oxygen by using the pressure through a pipe inserted into the nose, mouth or trachea; pressure helps put oxygen into the blood. The applied pressure can be adjusted to help keep the opening small airways and alveoli, and to ensure the lungs do not receive excessive concentration due to excessive concentrations can damage the lungs and aggravate the syndrome. Other supportive treatment such as giving intravenous fluids or food (via infusion) is also important because dehydration or malnutrition may occur that could cause the cessation of organ function (a state known as multiple organ failure). Specific drugs given to treat infection, reduce inflammation and remove fluid from the lungs. For example, in infection are given antibiotics.
Emergency Acute Respiratory Syndrome (Adult Respiratory Intensive Care Syndrome) is a type of lung failure with a variety of different abnormalities, which resulted in the collection of fluid in the lungs (pulmonary edema).
Severe acute respiratory syndrome is a medical emergency that can occur in people who previously had normal lungs. Although often called acute respiratory syndrome, acute adult, this condition can also occur in children.
CAUSE
Could cause any disease, directly or indirectly injure the lung:
Severe and widespread infection (sepsis)
Pneumonia
* Very low blood pressure (shock)
* Terhirupnya food into the lungs (inhaling vomit from the stomach)
* Multiple blood transfusions
* Damage to the lungs by inhaling a high concentration of oxygen
* Pulmonary embolism
* Injury to the chest
* Severe burns
* Drowning
* Operation cardiopulmonary bypass
* Inflammation of the pancreas (pancreatitis)
* Overdose of drug such as heroin, methadone, or aspirin propoksifen
* Severe trauma
* Blood transfusion (especially in very large quantity).
Symptoms usually appear within 24-48 hours after the occurrence of disease or injury.
SGPA often coincided with failure of other organs, like liver or kidneys. is one risk factor is cigarette smoking than SGPA. SGPA incidence is about 14 among 100 000 persons per year.
SYMPTOMS
Severe acute respiratory syndrome occurred within 24-48 hours of the basic abnormalities.
At first the patient will experience shortness of breath, usually in the form of rapid and shallow breathing.
Due to low oxygen levels in the blood, the skin looks pale or blue, and other organs like the heart and brain function disorders. The loss of oxygen because this syndrome can cause complications from other organ syndrome occurs immediately after or several days / weeks later when the patient does not improve the situation. Loss of oxygen that lasts a long time can cause serious complications such as kidney failure. Without proper treatment, 90% of cases ended with death. When given appropriate treatment, 50% of patients will survive. Because the patient is less able to fight infection, they usually suffer from bacterial pneumonia in the history of the disease. Other symptoms that may be found:
- Anxiety, feeling his end approaching
- Low blood pressure or shock (low blood pressure accompanied by other organ failure)
- Patients are often unable to complain because it looks very painful symptoms.
DIAGNOSIS
On physical examination using a stethoscope, abnormal respiratory sounds (like ronki or wheezing). Blood pressure is often low and the skin, lips and nails sufferer looks bluish (cyanosis, due to lack of oxygen).
Examinations are usually done to diagnose SGPA:
* X-ray chest (indicating the accumulation of fluid in a place that should be filled with air)
* Arterial blood gases
* Calculate the blood type and blood chemistry
* Bronchoscopy.
TREATMENT
Patients with severe acute respiratory syndrome treated in intensive care units.
Oxygen therapy is very important to correct the blood oxygen level, oxygen is often given in high concentrations (100% oxygen may be required). When oxygen delivery to the front lid not managed to overcome the problem, it is necessary to use tools respirator (ventilator). Ventilator delivering oxygen by using the pressure through a pipe inserted into the nose, mouth or trachea; pressure helps put oxygen into the blood. The applied pressure can be adjusted to help keep the opening small airways and alveoli, and to ensure the lungs do not receive excessive concentration due to excessive concentrations can damage the lungs and aggravate the syndrome. Other supportive treatment such as giving intravenous fluids or food (via infusion) is also important because dehydration or malnutrition may occur that could cause the cessation of organ function (a state known as multiple organ failure). Specific drugs given to treat infection, reduce inflammation and remove fluid from the lungs. For example, in infection are given antibiotics.
Management of abdominal TRAUMA
INTRODUCTION
Abdominal cavity is a cavity with the support of the rear of the structure of the spine, lumbo-sacral torako entire cavity is filled with muscle and connective tissue which is relatively vulnerable to trauma, when compared with the framework of the chest.
On the top is below the diaphragm and pelvic diaphragm constituted by a skeleton propped up by the pelvis. The side of the face entirely in the form of the muscle, whose strength is relative depending on the degree of burden that are routinely given to the muscles.
As a result of protective construction abdominal cavity, the organs contained within the abdominal cavity becomes very susceptible to trauma either sharp or blunt trauma injury, trauma is a relatively "lightweight" is enough to cause organ damage, intra-torakal, but without handled quickly and appropriately, will be able to cause a fatal condition.
Three things that cause medical emergencies Intra-Abdomen, Namely:
th hemorrhage due to trauma that damage the liver, lymph, abdominal aortic or venous blood vessels of the mesentery, mesocolon and omentum, and retroperitoneal organ damage.
Peritonitis due to th difusa tercecernya intestinal contents into the peritoneal cavity due to intestinal leakage.
Dissemination th kidney damage and urinary bladder.
Pathophysiology
Abdominal Trauma divides the sharp trauma, trauma and blunt trauma bullets.
Trauma sharp or sharps puncture gave lesion on kutis and subcutis, when more deeply involve the abdominal muscles, and the puncture will penetrate deeper into the peritoneum and intraperitoneal organs capable of injuring or may directly injure when traumatic retroperitoneal organs come from behind. Very rarely encountered sharp penetrating trauma from the face to the rear wall of the abdomen or vice versa.
Sharp trauma of the abdominal wall will cause bleeding in situ, when the trauma through the peritoneum, there may be polas omentum.
Sharp trauma can easily injure the liver, mesentery and mesocolon, gastric, pancreatic or jar, but due to the nature of mobility, rarely injure the small intestine, colon, spleen and kidney.
Resulting from sharp trauma on the bleeding that usually is observed, or if the injury is affected by gastric, gastric acid will be found to spread within the peritoneal cavity, which will give a great enough stimulus, such as signs of peritonitis.
The situation somewhat different on the bullet penetrating trauma, in which organ damage rather "Complicated", because it made possible the emergence of multi-organ damage. Due to the rotation speed and bullet penetration which occurred, in the form of laceration injuries that occurred greater than the diameter of the bullet. In the event of perforation diameter of the abdomen, possible occurrence of intraperitoneal and retroperitoneal organ damage at once. In these circumstances, other than bleeding, frequent intestinal perforation was also found that multiple, and extensive retroperitoneal hemorrhage.
Blunt trauma from the direction of advance, the damage generally occurs due to trauma by pinching between the lumbar spine. The situation that often occurs is perforated gastric or hepatic rupture. Liver and spleen rupture was found in a state of hepatomegaly and / or splenomegali. Ruptured jar found, if at the appropriate trauma advance jars - jars in a state full of urine.
ENFORCEMENT DIAGNOSIS
Sharp trauma and penetrating trauma of the bullet is very easily diagnosed, which needs to be established with certainty is whether the trauma is through the abdominal wall. Blunt abdominal trauma requires a careful physical examination, to determine whether there is damage to intraperitoneal organs. Necessary to distinguish the existence of peritonitis or peritonitis due to reaction tertumpahnya intestinal contents or blood in the peritoneal cavity freely, or signs of bleeding peritonismus due to stimulation of the abdominal wall or retroperitoneal bleeding. When clinical diagnosis is not obtained by physical-certainty, abdominal x-rays need to be made in an upright position or semi-sitting and lateral decubitus position, with the hope of finding of free air or free intraperitoneal fluid.
Intraperitoneal hemorrhage allegations are supported by the location of trauma, general condition of patients, specifically the state of hemoglobin and hematocrit levels in blood, and when necessary with kanula puncture the abdominal wall.
Suspicion of renal trauma, which is supported by the diantarannya hematuria, can be assessed by making nefrografi with intra venous contrast (IVP) and rupture mug, can be detected with sistografi, which is found when blunt trauma is accompanied suprasimfisis signs of peritonitis, haematuria with a diuresis relatively small.
ACTION RESPONSE
Evaluation th state of the heart-lung
Overcome th state of shock as well as improving the condition of fluid and electrolyte balance
Place the catheter in dauer th
Exploration th injury / trauma laparotomy in all cases, sharp and penetrating trauma rounds, held in an operating room, in general narcotics, with a preparatory tool for laparotomy.
Exploration th wound to ensure, whether the wound through the peritoneum or not, if the wound through the peritoneum, exploratory laparotomy forwarded action.
th laparotomy exploration has been conducted to blunt abdominal trauma, when the lesion for signs of bleeding and / or intra-peritoneal free air.
Preparation th blood transfusion Hb level sufficient to at least 10 benchmarks.
Special Policy:
th arterial haemorrhage: controlled by ligation
th intestinal perforation / Gastric: closed perforations. When there are multiple intestinal perforation, or extensive laceration of the intestines / colon, should be simple to hemikolektomi resection, in order to minimize trauma and operation time shortened.
th liver rupture: a simple sewing done until lobektomia liver taste.
th Ruptured spleen: splenectomy performed, suturing the spleen to be unsatisfactory, because kerapukan network and the high level of bleeding.
Damage th pancreas: attempted reconstruction, when the trauma of the head of the pancreas which, if damaged section toward the caudal pancreatic body, pancreatic resection should be performed.
Ruptured th jar: usually just a simple suturing
th Ruptured kidney: tends to conservative therapy, antibiotics and hemostatikum. In a state of "Shattered Kidney" or the hilum progressive renal bleeding, considered nefrektomi action.
th prolapsed omentum: can not ever put omentum is not in the operating room in conjunction with exploratory laparotomy
CLOSING
yr, good observation, followed by quick action and adequate treatment, patients do not have to die as a result of abdominal trauma, except in the state of the abdominal aorta rupture.
Although th state of the process toward medical emergencies in abdominal trauma going pretty slow, does not mean we can put the triage victims of abdominal trauma at a low level.
th Need to exercise, education, adequate or extensive experience, so that someone who engaged in the field of medical emergencies can quickly, accurately and precisely, to determine the definitive diagnostics of abdominal trauma, especially in blunt trauma, so that therapy is fast, accurate and adequate can be applied.
th physical examination, clinical diagnostics is very important with or without medical support.
Abdominal cavity is a cavity with the support of the rear of the structure of the spine, lumbo-sacral torako entire cavity is filled with muscle and connective tissue which is relatively vulnerable to trauma, when compared with the framework of the chest.
On the top is below the diaphragm and pelvic diaphragm constituted by a skeleton propped up by the pelvis. The side of the face entirely in the form of the muscle, whose strength is relative depending on the degree of burden that are routinely given to the muscles.
As a result of protective construction abdominal cavity, the organs contained within the abdominal cavity becomes very susceptible to trauma either sharp or blunt trauma injury, trauma is a relatively "lightweight" is enough to cause organ damage, intra-torakal, but without handled quickly and appropriately, will be able to cause a fatal condition.
Three things that cause medical emergencies Intra-Abdomen, Namely:
th hemorrhage due to trauma that damage the liver, lymph, abdominal aortic or venous blood vessels of the mesentery, mesocolon and omentum, and retroperitoneal organ damage.
Peritonitis due to th difusa tercecernya intestinal contents into the peritoneal cavity due to intestinal leakage.
Dissemination th kidney damage and urinary bladder.
Pathophysiology
Abdominal Trauma divides the sharp trauma, trauma and blunt trauma bullets.
Trauma sharp or sharps puncture gave lesion on kutis and subcutis, when more deeply involve the abdominal muscles, and the puncture will penetrate deeper into the peritoneum and intraperitoneal organs capable of injuring or may directly injure when traumatic retroperitoneal organs come from behind. Very rarely encountered sharp penetrating trauma from the face to the rear wall of the abdomen or vice versa.
Sharp trauma of the abdominal wall will cause bleeding in situ, when the trauma through the peritoneum, there may be polas omentum.
Sharp trauma can easily injure the liver, mesentery and mesocolon, gastric, pancreatic or jar, but due to the nature of mobility, rarely injure the small intestine, colon, spleen and kidney.
Resulting from sharp trauma on the bleeding that usually is observed, or if the injury is affected by gastric, gastric acid will be found to spread within the peritoneal cavity, which will give a great enough stimulus, such as signs of peritonitis.
The situation somewhat different on the bullet penetrating trauma, in which organ damage rather "Complicated", because it made possible the emergence of multi-organ damage. Due to the rotation speed and bullet penetration which occurred, in the form of laceration injuries that occurred greater than the diameter of the bullet. In the event of perforation diameter of the abdomen, possible occurrence of intraperitoneal and retroperitoneal organ damage at once. In these circumstances, other than bleeding, frequent intestinal perforation was also found that multiple, and extensive retroperitoneal hemorrhage.
Blunt trauma from the direction of advance, the damage generally occurs due to trauma by pinching between the lumbar spine. The situation that often occurs is perforated gastric or hepatic rupture. Liver and spleen rupture was found in a state of hepatomegaly and / or splenomegali. Ruptured jar found, if at the appropriate trauma advance jars - jars in a state full of urine.
ENFORCEMENT DIAGNOSIS
Sharp trauma and penetrating trauma of the bullet is very easily diagnosed, which needs to be established with certainty is whether the trauma is through the abdominal wall. Blunt abdominal trauma requires a careful physical examination, to determine whether there is damage to intraperitoneal organs. Necessary to distinguish the existence of peritonitis or peritonitis due to reaction tertumpahnya intestinal contents or blood in the peritoneal cavity freely, or signs of bleeding peritonismus due to stimulation of the abdominal wall or retroperitoneal bleeding. When clinical diagnosis is not obtained by physical-certainty, abdominal x-rays need to be made in an upright position or semi-sitting and lateral decubitus position, with the hope of finding of free air or free intraperitoneal fluid.
Intraperitoneal hemorrhage allegations are supported by the location of trauma, general condition of patients, specifically the state of hemoglobin and hematocrit levels in blood, and when necessary with kanula puncture the abdominal wall.
Suspicion of renal trauma, which is supported by the diantarannya hematuria, can be assessed by making nefrografi with intra venous contrast (IVP) and rupture mug, can be detected with sistografi, which is found when blunt trauma is accompanied suprasimfisis signs of peritonitis, haematuria with a diuresis relatively small.
ACTION RESPONSE
Evaluation th state of the heart-lung
Overcome th state of shock as well as improving the condition of fluid and electrolyte balance
Place the catheter in dauer th
Exploration th injury / trauma laparotomy in all cases, sharp and penetrating trauma rounds, held in an operating room, in general narcotics, with a preparatory tool for laparotomy.
Exploration th wound to ensure, whether the wound through the peritoneum or not, if the wound through the peritoneum, exploratory laparotomy forwarded action.
th laparotomy exploration has been conducted to blunt abdominal trauma, when the lesion for signs of bleeding and / or intra-peritoneal free air.
Preparation th blood transfusion Hb level sufficient to at least 10 benchmarks.
Special Policy:
th arterial haemorrhage: controlled by ligation
th intestinal perforation / Gastric: closed perforations. When there are multiple intestinal perforation, or extensive laceration of the intestines / colon, should be simple to hemikolektomi resection, in order to minimize trauma and operation time shortened.
th liver rupture: a simple sewing done until lobektomia liver taste.
th Ruptured spleen: splenectomy performed, suturing the spleen to be unsatisfactory, because kerapukan network and the high level of bleeding.
Damage th pancreas: attempted reconstruction, when the trauma of the head of the pancreas which, if damaged section toward the caudal pancreatic body, pancreatic resection should be performed.
Ruptured th jar: usually just a simple suturing
th Ruptured kidney: tends to conservative therapy, antibiotics and hemostatikum. In a state of "Shattered Kidney" or the hilum progressive renal bleeding, considered nefrektomi action.
th prolapsed omentum: can not ever put omentum is not in the operating room in conjunction with exploratory laparotomy
CLOSING
yr, good observation, followed by quick action and adequate treatment, patients do not have to die as a result of abdominal trauma, except in the state of the abdominal aorta rupture.
Although th state of the process toward medical emergencies in abdominal trauma going pretty slow, does not mean we can put the triage victims of abdominal trauma at a low level.
th Need to exercise, education, adequate or extensive experience, so that someone who engaged in the field of medical emergencies can quickly, accurately and precisely, to determine the definitive diagnostics of abdominal trauma, especially in blunt trauma, so that therapy is fast, accurate and adequate can be applied.
th physical examination, clinical diagnostics is very important with or without medical support.
The dangers of AIDS or HIV
AIDS (Acquired Immune Deficiency Syndrome) is a disease that's how it works to destroy the human immune system. AIDS is caused by a virus called HIV (Human Immunodeficiency Virus), entered into the human body. HIV is rapidly paralyze the human immune system. After the crippled immune system, a person with AIDS usually will die of a disease (called secondary disease) which usually will be eradicated by the body's immune system if it is still good. AIDS is the disease most feared at this time. HIV virus that causes this disease, damage the body's defense system (immune system), so people who suffer from this disease the ability to defend itself from disease attack reduced. Someone who is HIV positive, do not necessarily have AIDS. Many cases in which HIV-positive person but do not become ill in the long term. However, existing HIV in a person's body will continue to damage the immune system. As a result, viruses, fungi and bacteria are usually harmless to extremely dangerous because they damage the body's immune system. From a survey of people in the last 20 years more than 60 million infected with HIV virus. Of that amount, 20 million people died of Acquired Immune Deficiency Syndrome (AIDS). In 2001, UNAIDS (Joint United Nations Programme on HIV or AIDS) estimates, the number of People Living With HIV or AIDS (PLWHA) 40 million. AIDS cases were first discovered in the United States, in 1981, but the case did little to provide information about the source of this disease. Now there is clear evidence that AIDS is caused by a virus known as HIV. HIV is part of a group of viruses called Lentivirus nonmanusia found in primates. Collectively, the Lentivirus is known as a monkey virus called Simian immunodeficiency virus (SIV). HIV is a descendant of SIV. Specific SIV types similar to the two types of HIV, the HIV-1 and HIV-2, which had attacked one of the white blood cells are lymphocytes. In Indonesia, the first AIDS case was discovered in 1987. A 44-year-old tourist from the Netherlands died in Sanglah Hospital, Bali. Stranger's death was caused by AIDS. By the end of 1987, there were six people who were diagnosed HIV positive two of them have AIDS. Since 1987 until December 2001, out of 671 people with AIDS, as many as 280 people died. HIV spread so rapidly throughout the world. Phenomena is like an iceberg in the sea, people with HIV or AIDS just looks a little on the surface. Infection with HIV or AIDS AIDS is one of infectious diseases. But not as easily transmitted as influenza virus or other virus. HIV virus can live in all human body fluids, but who has the ability to infect others with HIV only located in: blood, vaginal fluid and sperm. HIV infection or AIDS, which is known by: * Transfusion of blood from HIV. * Having sex with HIV. * A small portion (25-30%) pregnant women with HIV to the fetus. * Syringes or needles / tattoo equipment / stud that is used in conjunction with HIV or AIDS patients; and * milk of mothers with AIDS to children susuannya. Measures to prevent HIV or AIDS How to prevent the entry of a disease generally familiarize them with healthy living, ie eating healthy food, exercise, and healthy relationships. Several measures to avoid HIV or AIDS, among others: * Avoid sexual relations outside marriage and keep in touch with only one sexual partner. * Always Use a condom, especially for high risk behavior groups. * A mother whose blood was examined and found positive for HIV should not become pregnant, because it can transfer the virus to the fetus. Will wish to become pregnant when should always consult a doctor. * The people who belong to groups of high risk behaviors should not be a blood donor. * The use of puncture needles and other tools such as the acupuncture, tattoo needles, piercing needles, disposable and should only be guaranteed sterilitasnya. * Stay away from drugs, because it has been proved that the spread of HIV or AIDS among panasun (IDUs), 3-5 times faster than other risk behaviors. At Kampung Bali, Jakarta, nine of 10 HIV-positive IDUs. Wrong Perceptions About HIV or AIDS AIDS is a disease caused by the HIV virus which until now has not found drugs and a vaccine that would be truly beneficial to overcome AIDS. That is why AIDS is one of the most dreaded disease today. The emergence of the wrong assumption on the actions and attitudes relating to HIV or AIDS continues to establish the disease to be feared. Therefore, please be aware that HIV or AIDS is not transmitted through: * Working with people affected by HIV infection. * Bites of mosquitoes or other insects. * Touch of hands or hug each other. * Sex by using condoms. * Use of a meal together. * Use the toilet together. * Sprays sneezing or coughing.
ANEMIA IN INDIVIDUAL
A. Basic Concept of Disease 1. Understanding Anemia Anemia is a reduction in the quantity or quality of red blood cells in circulation. Anemia can be caused by impaired formation of red blood cells, increased loss of red blood cells through chronic or sudden bleeding, or lysis (destruction) of red blood cells redundant. (Corwin, 2001: 119) Anaemia is a condition due to decreased hemoglobin production, increased destruction of blood cells meah and / or due to blood loss. (Potter & Perry, 2006: 1559) Anemia is a term that indicates a low red blood cell count and hemoglobin and hematocrit below normal. (Brunner & Suddarth, 2002: 935) From the above understanding of the anemia, it can be concluded that anemia is a decrease in quality or quantity of red blood cells in the circulation due to decreased hemoglobin production, increased destruction of red blood cells and / or loss of red blood cells. 2. Anatomy of Blood Red Blood Cell Physiology consists of shaped elements and the plasma in the number of equivalent. The elements are shaped red blood cells (erythrocytes), white blood cells (leukocytes), and blood-chip (thrombocyte). Plasma consists of water 90%, and 10% of electrolytes, dissolved gases, various waste products of metabolism and nutrients such as sugars, amino acids, fat, cholesterol, and vitamins. Protein in the blood such as albumin, imunoglobin, and component levels of coagulation and is co-author of the plasma component. Other proteins in the plasma serves to transport a variety of hormones and fat soluble which is actually difficult. Examples of materials transported bound to plasma proteins is low and high density of thyroid hormone, iron, phospholipids, and cholesterol. a. Formation Blood Cells Red blood cells, white blood cells, and thrombocyte formed in the liver and spleen in the fetus, and bone disumsum after birth. The process of formation of blood cells called hematepoiesis. Originated from the bone marrow hematopoiesis of cells would pluripotensial (meaning having a lot of potential / likely). Cells would be the source of all blood cells. These cells have reproductive cells through DNA replication and mitosis, and differentiation of cells when they begin to split and develop into red blood cells, white blood cells, or thrombocyte. The process of formation of red blood cells can be seen in chart 2.1 below. Chart 5.1 simple diagram of blood cell differentiation in bone marrow. Whole blood cells derived from the cell would b. The control of cell growth would be Tues, stimulated to form blood cells receive the mark by in utero and after birth. These signs include the release of local product molecules, which is an indication of the state density in the hematopoietic tissue. Sign also includes the circulation of hormones, (hematopoietic growth factors) that stimulate plorifelari many or all cells. Hemaopoietik growth factor specific for cells which they called factor stimulation penstimulasi colony (colony-stimulating factor). c. Red Blood Cells Red blood cells (erythrocytes) did not have a cell nucleus, mitochondria, or ribosomes. These cells can not perform mitosis, cell oxidative phosphorylation, or formation of proteins. Red blood cells contain the protein hemoglobin carries most of the oxygen yag taken in the lungs to cells throughout the body. Hemoglobin occupying most of the intracellular space of erythrocytes. Mature blood cells are removed from the bone marrow and lived about 120 days to then experience the disintegration and death. Red blood cells that died was replaced by new cells produced by bone marrow. Red blood cell structure is shown in the figure below: Figure 2.1 Structure of Red Blood Cells Source: tinkling bells Hati.htm (accessed on March 27, 2008) d. Nature-Nature of Red Blood Cells Red blood cells are usually described by size and amount of hemoglobin contained in the cells: 1) Normositik: Cells of normal size 2) Normokromik: Tue with a normal amount of hemoglobin 3) microcytic: Cells that are too small in size 4 ) Makrositik: Cells that are too large in size 5) Hipokromik: Cells that amount is too little hemoglobin 6) Hiperkromik: Cells that amount of hemoglobin is too much Under normal circumstances, shape of blood cells can be fickle. This property allows these cells to enter or pass without causing damage and capillary microcirculation. If the red blood cells is difficult to change shape (rigid), then those cells can not survive during its circulation in the circulation. e. Red Blood Cell Antigen red blood cells have a variety of specific antigens located on cell membranes and not found in other cells. Antigen-antigen is named A and B and Rh. ABO antigens A person has two alleles (genes) that encode each of antigens A or B, or do not have both, which is named O. One allele is received from each parent. Antigens A and B are codominant. People who have antigens A and B (AB) will have blood (groups) AB. Those who have two antigen A (AA) or one A and one O (AO), will have the blood of A. Those who have two antigen B (BB), or one B and one O (BO), will have the blood B. People who do not have a second antigen (OO) will have the blood of O. People who have blood type AB blood will receive an A, B or O However, people who do not have the antigens A and B will form an immune response when exposed to the antigen-antigen during blood transfusions. Rh antigens are the other main group antigens on red blood cells as well as the genes inherited from each parent. Major Rh antigen called Rh factor. People who have Rh antigens are considered Rh positive (Rh +). People do not have Rh antigens are considered Rh negative (Rh-). Rh positive gene is dominant. Thus, one should have two negative factors to be Rh negative. Rh positive person who will receive Rh negative blood, but those who do not have Rh antigens to form immune response if exposed to Rh positive blood. f. Universal Blood Donor and recipient blood recipients are those who have the universal blood-AB positive blood because their immune system will regard A or B antigen positive and Rh antigens as part of themselves (not foreign objects). Thus, they can receive all the profiles of ABO and Rh. Universal blood donors are those who have O negative blood Despite their negative immune system will attack the blood that contain antigens A or B and Rh factor, they can be given blood transfusions to all the recipients. g. Hemoglobin Hemoglobin consists of iron containing materials called hem (heme) and globulin proteins. There are about 300 molecules hemogobin in each red blood cell. Each hemoglobin molecule has a binding site for oxygen. Called hemoglobin that binds oxygen-globin oksihemo. Hemoglobin in the blood can bind oxygen partial or total in the fourth place. Hemoglobin that binds oxygen fully saturated / total, while that of saturated hemoglobin deoksigenasi will experience a partial saturation of less than 100%. Systemic arterial blood from the lungs is saturated with oxygen. Hemoglobin to release oxygen to the cells so that the saturation of hemoglobin in the blood of the pen is about 60%. Hemoglobin final task is to absorb carbon dioxide and hydrogen ions and bringing them into the lungs where these substances are released from hemoglobin. There are at least 100 types of abnormal hemoglobin molecules which are known in humans, which is formed from a variety of mutations. Most part types are less capable of transporting oxygen than normal hemoglobin. h. Split Red Blood Cell When red blood cells begin berdisintegrasi at the end of its life, these cells release hemoglobin into the circulation. Hemoglobin described in the liver and the spleen. Globulin molecules converted into amino acids which are used again by the body. Iron is stored in the liver and the spleen to be reused. Time changed to another molecule bilirubin, which then dieksresikan through feces as bile or urine. 3. A. Etiology Aplastic anemia aplastic anemia is anemia normokromik normositik caused by bone marrow dysfunction such that the blood cells that die are not replaced. Caused aplastic anemia by many things including bone marrow cancer, bone marrow destruction by autoimmune processes, vitamin deficiency, various drugs and radiation or chemotherapy. (Corwin, 2001: 122-123) b. Hemolytic anemia hemolytic anemia is a decrease in the number of red blood cells caused by excessive destruction of red blood cells. Hemolytic anemia may occur due to genetic defects in red blood cells, autoimmune disease or may be obtained due to pejanan certain drugs or toxins. (Corwin, 2001: 124) c. Sickle cell anemia Sickle cell anemia is a recessive disorder caused by inheritance otosom two copies defiktif hemoglobin genes, one from each parent. The defective hemoglobin, called hemoglobin S (HbS), become stiff and shaped like a crescent due to low-oxygen exposure. Stimuli that often lead to the formation of sickle cells is physical stress, fever or trauma. d. Anemia Anemia, Post-post-bleeding Bleeding is normositik normokromik anemia caused by sudden blood loss in healthy people. Bleeding can be unclear or vague. (Corwin, 2001: 128) e. Pernicious anemia pernicious anemia is anemia due makrositik normokromik vitamin B12 deficiency. Vitamin B12 is absorbed by the intrinsic factor produced by gastric hormones. Most of the causes of pernicious anemia is caused by deficiency of intrinsic factor, but can also occur in food vitamin B12 deficiency. Intrinsic factor deficiency can occur in congenital or due to atrophy or destruction of gastric mucosa due to chronic gastric inflammation or autoimmune disease. Appointment of part or all of the stomach in surgery will also cause deficiency of intrinsic factor. (Corwin, 2001: 129) f. Folate Deficiency Anemia of folate deficiency anemia is anemia due to deficiency normokromik makrositik-vitamin folate. Deficiency occurs relatively frequently in young women and all people suffering from malnutrition or alcohol abuse. (Corwin, 2001: 130) g. Iron Deficiency Anemia Iron deficiency anemia is a microcytic anemia hipokromik caused by iron deficiency in nutrition or blood loss is slow and chronic. (Corwin, 2001: 131) h. Sideroblastik Anemia Anemia is sideroblastik-hipokromik microcytic anemia characterized by the presence of red blood cells are immature (sideroblas) in the circulation and bone marrow. Sideroblastik Anemia can occur due to primary genetic effect on chromosome X that is rarely found (mainly found in the male) or can arise spontaneously, especially in older people. Secondary causes of anemia sideroblastik are certain drugs, such as some chemotherapy drugs and the ingestion of lead. (Corwin, 2001: 131-132) 4. A. Pathophysiology Anemia due to decrease in Red Blood Cell Anemia caused by disturbances in the quality of the formation of red blood cells arise if the red blood cell size is too small (microcytic) or too big (makrositik). Anemia associated with the quality of red blood cells also occur if an interruption occurs the formation of hemoglobin. This will cause excessive high concentration of hemoglobin (hiperkromik) or low excess (hipokronik). b. Anemia due to lysis or anemia caused by sudden haemorrhage or bleeding lysis associated with sudden decrease in the total number of red blood cells in the circulation. Red blood cells normally live about 120 days. Destruction or loss of red blood cells that occurs before 100 days is abnormal 5. Clinical manifestation of anemia characterized by hemoglobin levels below normal. Clinical manifestations of this condition include fatigue, decreased activity tolerance, increased shortness of breath, looking pale and increased heart rate. (Potter & Perry, 2006: 1559) a. Systemic signs of anemia that is classic: 1) Increased heart rate because the body tries to give more oxygen to the network 2) Increased respiration rate as the body attempts to provide more oxygen to the blood 3) Headache caused by decreased blood flow to the brain 4) Pain tired due to the increased oxygenation of the various organs including the heart and skeletal muscles 5) Skin pale due to reduced oxygenation six) Nausea from a decrease in gastrointestinal blood flow and central nervous system 7) Impairment of quality hair and skin b. If the thrombocyte and white blood cells are also affected, the symptoms increased with: 1) Bleeding and bruising easily arise 2) recurrent infections 3) The wound skin and mucous membranes are difficult to recover c. In sickle cell anemia, the symptoms increased with: 1) severe pain caused by vascular obstruction at the second disease attacks), recurrent bacterial infections 3) Splenomegali because spleen cells clean up the dead d. Ataxia (motor coordination disorder suggest dysfunction and reduced sensory and central nervous system myelin degeneration and mental activity can be affected for the client with pernicious anemia. E. Landfill iron causes hepatomegaly and splenomegali in clients with iron deficiency anemia. 6. Impact on the Body Structure and Function Other Increased heart rate because the body tries to give more oxygen to the network. It can occur with heart failure due to severe anemia. Increased respiration rate as the body attempts to provide more oxygen to the blood. Nausea caused by decreased blood flow of the gastrointestinal tract and central nervous system, splenomegali because cleaning spleen cells die, causing iron accumulation hepatomegaly. Clients are at risk of anemia occurs decubitus. Decrease in hemoglobin level reduced blood oxygen-carrying capacity and reduce the amount of oxygen available to the network. Anemia also interfere with cell metabolism and interfere with wound healing. (Potter & Perry , 2006: 1260), and decreased quality of hair and skin, bleeding and bruising easily arise. feeling tired due to the increased oxygenation of the various organs including the heart and skeletal muscle. ataxia (motor coordination problems and reduced sensory dysfunction suggest and degeneration of the central nervous system myelin and activities can be affected mentally, dizziness caused by reduced blood flow to the brain, severe pain caused by vascular obstruction in the attacks of diseases. 7. Management of Medical Investigations of anemia include: a. The bone marrow biopsy in aplastic anemia b. Examination decreased hematocrit, hemoglobin and calculate c. Examination of red blood cells to identify the status of prenatal fetal homozygous at (sickle cell anemia) d. blood analysis will show cells makrositik-normokromik (pernicious anemia and folate deficiency). e. Analysis of blood cells will show microcytic-hipokromik and a decrease in serum iron (iron deficiency anemia) f. Fecal examination to look for faint blood may be positive, suggesting bleeding or gastrointestinal carcinoma (iron deficiency anemia) g. The bone marrow examination showed accumulation of iron, sideroblas and phagocytic macrophages (sideroblastik anemia). The treatment will depend on the type of anemia experienced. Here are some codes of conduct on anemia: a. Treat the underlying disease, if known, or avoid causing ingredients. b. transfusions to alleviate the symptoms. c. d. Immunosupresi bone marrow transplantation when caused by autoimmune disease . e. medicine to stimulate bone marrow function may be effective. profilaktif f. Antibiotics can be given to prevent infection. g. Supplementation of folic acid can stimulate the formation of red blood cells h. Good hydration can reduce the occlusion. i. Avoid situations or activities of oxygen deficiency requiring oxygen. j. injection of vitamin B12. k. The oral folate. l. The iron-rich diet containing meat and green vegetables such as spinach. m. oral iron supplements. n. Treat the cause of abnormal bleeding if any. o. The cause of the disease when associated with the drug should be removed. p. piridoksin Drugs may cure disease. Doenges B. Nursing Process (1999: 6) states that nursing care is an important factor in patient survival and the maintenance aspect, rehabilitative and preventive health care. Implementation nursing care to clients with anemia using the nursing process which consists of four stages, as proposed by Yura And Walls (1967), namely the assessment, planning, execution or implementation and evaluation, in which nursing diagnoses included in the assessment stage (Gaffar, 1999: 54) . 1. The assessment In the assessment phase of efforts to obtain data and or information will be grouped and analyzed so that it can be formulated nursing diagnoses that will be overcome at the planning stage. The process of assessment through several stages, including: a. Data Collection 1) The identity of a ) Identity Client Data obtained includes name, age, gender, ethnicity / nation, religion, address, medical diagnosis of anemia, No.RM / CM, entry date and the date of the Hospital was doing the assessment. w) The identity of the responsible Data obtained by the responsible person's name, age, education, occupation, address and relationship with the client. 2) Medical history a) The main complaint with anemia Clients generally will experience fatigue and shortness of breath. b) Medical history now includes descriptions of the main complaints are kronolgis. Description answer questions relating to where (location), what (quality, factors that aggravate or relieve the symptoms), when (attack, duration, frequency), and how much (intensity, severity), was also asked about the related manifestations . (Engel, 1999: 12). Fatigue and shortness of anemia is felt when the activity and decreases with rest or administration of oxygen. c) a past medical history should be studied mainly to know the client's experience in undergoing treatment and care, history of drug use causes anemia, underwent experience kemotherapi, vitamin habits, alcohol abuse, history of trauma or exposure to radiation serta history of allergy who owned clients. d) Medical history family medical history should be studied anemia in her family and the family experience in dealing with family members who suffered from anemia. 3) Patterns Patterns habits Habits include such things as follows: a) Pattern Assessment Nutrition nutrition is an important first step in nursing care and preventive health services. Assessment of nutritional help in identifying eating habits, misunderstandings and symptoms that can give an indication of nutritional problems. (Engel, 1999: 38). Review of nausea and other eating disorders. b) Assess the Pattern Elimination of gastrointestinal bleeding (melena or blood in the stool content) and hematuri if any. c) Rest and Sleep Patterns Determine the side effects of treatment on sleep patterns. Monitor the client's sleep patterns and note the relationship of physical factors (such as sleep apnea, airway obstruction, pain / discomfort and frequent urination) or psychological factors (such as fear or anxiety) that can disrupt sleep patterns. (Wilkinson, 2007: 478) d) Assess the Activity Pattern of the client's ability in performing activities using the endurance level (Gordon in Wilkinson, 2007: 3) as follows: Level 1: Walk in the regular speed on a plane, but the breathing became more shorter than normal when one or more stairs to climb. Level 2: Walking a city block or climb 1500 meter horizontal one or climbing stairs slowly without stopping. Level 3: Walk horizontally no more than 150 meters without stopping and no one is able to climb stairs without stopping. Level 4: dyspnea and fatigue when resting. e) The pattern of the Personal Hygiene Perform ability to conduct compliance assessments of personal hygiene to the following indicators (value 1-5: dependence [not able to participate], require another person or a hearing aid, requiring the assistance of others, independently with the aid of tools, fully independent). (Wilkinson, 2007: 420). 4) Physical Examination a) General Appearance Clients with anemia would appear weak and congested. b) Inspection Persistem a) Assess Cardiovascular System throbbing wall of the thorax, heart frequency count for one minute, percussion heart, examine the state of the conjunctiva, blood pressure, CRT, calculate the JVP pressure, auscultation of heart sounds of rhythm, whether there is any abnormal heart sounds, rank , high-low tone, quality, assess whether there is cyanosis, finger clubber. In the client with anemia found rapid heart rate, conjunctival anemis, and complications of heart failure can occur due to severe anemia. b) Digestive System Check oral cavity, lip mucosa review, assess whether there is any tartar, teeth, observe the shape of the abdomen, observe whether there is any swelling, peristaltic intestinal auscultation, examine whether there is pain with palpation or without palpation, check the belly skin turgor , MC Burney check point area, region epigastric, do the liver and spleen palpation. In the client with anemia found nausea, splenomegali and hepatomegaly. c) Breathing System Review whether there is any nasal secretions, observe form the thorax, auscultation of breath, count the frequency of breathing, respiratory rhythm examine, observe whether or not there is also dyspnea, intercostal retraction, nostril breathing, palpation of chest wall vibration, review of cyanosis. In the client with anemia found increased respiration rate and feeling crowded. d) Assess the situation Integumentary System Hair, color, growth, and dissemination of, easy to fall off or not, review head hygiene, examine the skin moisture, warmth, body temperature. In the client with anemia found in the data slowing wound healing, decreased quality of hair and skin, easy bleeding and bruising occur until decubitus. e) System Review Muskulo skeletal form upper and lower extremities, assessing range of motion (Range of Motion), muscle strength test, there tidaknnya examine fracture. In the client with anemia was found exhausted and feeling weak. f) Assess Persyarafan System client awareness, assess the quantitative assessment of consciousness, cranial nerve examination test. In the client with anemia found ataxia and distractions of mental activity, dizziness and severe pain. g) Assess the Endocrine System with palpation of the lymph glands, thyroid gland check by inspection, review forms, symmetry, thyroid auscultation. In the client with anemia did not crash the endocrine system h) System of a supra pubic area urinal Palpation, percussion kidney at Angel costovertebrata area (CVA), presence or absence of bladder distension. In the client with anemia not find abnormalities in urination system. 5) Psychological Data a) Emotional Status Review the status of client emotions. Emotion client with anemia usually unstable, the client is worried because they do not know about his illness. b) Self-concept (1) Body image perception Ask clients about their bodies. Parts of the body's likes and dislikes. (2) Assess the status of self-identity and position of the client prior to treatment, client satisfaction of the status and position (schools, workplaces, groups). (3) Role Ask a task or role that carries the family, and group or community. Assess client's ability in carrying out the task or role. (4) Ask Yourself Ideal client expectations to the body, position, status, tasks or role, assess the ability of clients to the environment and expectations of clients against the disease. (5) Self-Esteem Ask client relationships with others, ask the assessment or appreciation of other people to himself and his life. c) Long Term and Short stressor Kaji about issues facing clients in the last six months, review is also about new problems experienced. d) Mechanism Koping Assess client's ability to solve problems. e) Hope and Understanding Client Review of Current Condition on client expectations and assess current knowledge about the client's current condition. Six), Social and Cultural Data Kaji client communication patterns and interpersonal interactions, review of lifestyle, sociocultural factors, family support systems and economic status. 7) Data should be reviewed Spiritual beliefs of clients, sources of power, and the views of the disease that was suffered. 8) Data Supporting a) The bone marrow biopsy in aplastic anemia b) Examination decreased hematocrit, hemoglobin and red blood cell count c) prenatal examination to identify the status of a fetus homozygous at (sickle cell anemia), d) blood analysis will show selsel makrositik-normokromik ( pernicious anemia and folate deficiency). e) blood analysis will show microcytic cells-hipokromik and decrease serum iron (iron deficiency anemia), f) Inspection of the stool to look for faint blood may be positive, suggesting bleeding or gastrointestinal carcinoma (iron deficiency anemia) g) of bone marrow examination showed iron accumulation, and macrophage phagocytic sideroblas (anemia sideroblastik) b. Analysis of the data analysis process is to connect the data obtained with the concepts, theories, principles of nursing care that are relevant to the client. Data analysis through data validation, data grouping, comparing the data, determines the gaps / data gaps, interpret the existence of inequality / disparity of data and make conclusions about the gaps / problems. (Gaffar, 1999: 60) c. Nursing diagnosis nursing diagnosis is a statement which describes the status or the actual or potential health problems. (Gaffar, 1999: 61). Nursing diagnosis on the client with anemia by Engram (1999: 423-433) are: a. Pain associated with factors: Damage to tissue perfusion secondary to vaso-Occlusive crisis. b. Impaired self-concept associated with factors: the rejection of others secondary to chronic pain. c. Activity intolerance related to factors: Anemia d. High risk of damage to the management of maintenance in the home associated with factors: Lack of knowledge about the condition and plan of action. 2. A. Planning Pain-related factors: Damage to tissue perfusion secondary to vaso-Occlusive crisis. Limitation characteristics: Expressing pain, facial grimacing, moaning, crying, to protect the side of pain, has a lesion on the foot. Results of patients (collaborative): Demonstrating missing from chronic pain evaluation criteria: Denying pain, facial expression relaxed. Rational intervention first. During a sickle cell crisis, monitor: Results of laboratory reports (GDA, JDL, serum electrolytes, chemistry profile) vital signs every four hours and haluaran Enter each eight hours of general status (Appendix F) every eight hours to identify indications of progress or deviations from expected results 2. Maintain head of bed elevated to allow maximum lung expansion 3. Tirah Keep lying to the limitations of activity until pain and dyspnea is reduced to conserve energy 4. when fever exists; give antipyretics and antibiotics prescribed and recommend at least 2-3 liters of fluid intake daily and complex carbohydrate foods (bread, cereal, potatoes, pasta) Antipyretics help adjust the thermostat to lower body temperature. Fever to increase metabolic rate. Complex carbohydrates provide calories needed to meet rising energy basal metabolic rate (BMR). Loss of fluid is increased when rate increases mentabolisme. Fluids also help to wash the collected cells and stop the formation of sickle cells. 5. Give a narcotic analgesic, if necessary, the muscle relaxants, and tranquilizer. Kefektifannya evaluation. To control severe pain. Many doctors find that the tranquilizer and muscle relaxants when used with analgesics provides more effective removal of pain for a longer period. 6. Give oxygen through nasal kanula at 6 L / min. Encourage use of fingers or ear oximetry to monitor oxygen saturation continuously when there is severe dyspnea. Supplemental oxygen to help increase oxygen tension and increase oxygen saturation approached normal limits, 90-100mmHg. 7. Give transfusion packaging facility determined in accordance with protocols and procedures. Monitor trasnfusi reactions (Table 6-2). Follow the facility procedure when a reaction occurs trasnfusi. Most aimed to maintain hemoglobin at approximately 10g/dl. This takrealistis to expect a normal hemoglobin level in patients with cell anemia crescent. HR packaging is given to replace blood cell components without adding volume. 8. consult with your doctor if the urine becomes turbid These findings indicate excessive hemolysis of human resources and the need for evaluation of renal function b. Self-concept disturbance associated with factors: Rejection of others secondary to chronic pain. Limitation characteristic: Reveal experience rejection, reported a low price, despair, or takbermakna, can be reported withdrawing from social activities. Results of patients (collaborative): Demonstrate effective coping with chronic illness. Criteria of evaluation: Revealing the acceptance of self on the scene, revealing the work plan realistic. Interventions Rationale 1. Evaluation of the use of social relationships in the community. Refer patients with sickle cell disease on the foundation of local (if any). These agencies provide information on all aspects of sickle cell disease and its nature. Can also provide information about support groups. 2. Refer patients in vocational counseling when necessary. When the election of a job, considering the strength and physical endurance of individuals. Work requires heavy physical exertion is a career takrealistis for individuals with sickle cell anemia. 3. Encourage families to treat individuals with sickle cell disease, such as other household members, not as people with disabilities. Emphasize the need for patients to avoid distinguish themselves with others. Self-esteem is enhanced when the patient feel valued as individuals with meaning and dignity. c. Intoleransi Aktivitas berhubungan dengan faktor : Anemia Batasan karakteristik : Melaporkan kelelahan menetap, dispnea pada pengerahan tenaga, dapat melaporkan palpitasi; dapat menunjukkan takikardia dan takipnea pada istitahat. Hasil pasien (kolaboratif) : Mendemonstrasikan peningkatan toleransi pada aktivitas. Kriteria evaluasi : Melaporkan berkurangnya kelelahan dan dispnea bila melakukan rutin, frekuensi nadi 60-100 nadi per menit, dan frekuensi pernapasan 12-24 per menit istirahat. Intervensi Rasional 1. Pantau: Hasil JDL dan gas darah arteri (GDA) Tanda vital setiap 4 jam Toleransi pada aktivitas fisik Untuk mengidentifikasi indikasi-indikasi kemajuan atau penyimpangan dari hasil yang diharapkan. 2. Konsul dokter bila pasien mengalami denyut jantung tak teratur, takikardia menetap, rales disertai oleh penurunan haluaran urine dan peningkatan tekanan darah. Abnormalitas jantung dapat terjadi pada anemia berat karena hipoksemia miokard. Sebagai respons kompensasi pada hemoglobin rendah, frekuensi jantung meningkat untuk memenuhi kebutuhan tubuh terhadap oksigen pada adanya saturasi oksigen darah rendah. Suhu tubuh mungkin lebih rendah daripada normal karena vasokonstriksi perifer dan pirau darah ke organ sentral. 3. Bila pasien menunjukkan hipoksia ekstrem, lakukan tindakan yang ditentukan seperti oksigen suplemen, trasnfusi darah, dan tira baring pada posisi semi-Fowler. Bila transfusi darah dilakukan, pantau terhadap reaksi transfusi (Tabel 6-2) per prosedur fasilitas. Implementasikan protokol fasilitas bila terjadi reaksi. Oksigen suplemen meningkatkan jumlah ketersediaan oksigen pada SDM. Tirah baring menurunkan kebutuhan jaringan terhadap oksigen. Transfusi darah lengkap atau SDM kemasan memberikan cara cepat meningkatkan jumlah SDM dan hemoglobin dan nilai hematokrit. Posisi tegak memungkinkan ekspansi paru penuh. 4. Instruksikan pasien untuk melakukan aktivitas sesuai toleransi dan menghindari pengerahan tenaga berlebihan. Berikan bantuan sesuai kebutuha dengan AKS. Bantu pasien dengan memprioritaskan aktivitas dan merencanakan periode istirahat selama sehari. Periksa ferkuensi nadi sebelum dan setelah aktivitas fisik. Aktivitas fisik meningkatkan konsumsi oksigen. Istirahat meningkatkan kebutuhan energi tubuh. Ketahanan fisik ditingkatkan bila pengerahan tenaga fisik diimbangi dengan istirahat. 5. Anjurkan pasien menggunakan anti-emetik sesuai pesanan, dimana dapat meliputi suplemen besi, vitamin B12, dan asam folat. Jelaskan tujuan suplemen yang diresepkan Nutrien ini esensial untuk eritropoeisis dan sintesis hemoglobin. 6. Bila tak mampu menggunakan preparat besi per oral dan impferon yang diresepkan, gunakan langkah yang tepat untuk meminimalkan ketidaknyamanan dari injeksi intramuskular dari obat ini: Ganti jarum setelah menghentikan larutan dari vial. Gunakan metoda injeksi Z-track. Berikan intramuskular dalam (IM) dengan menggunakan otot gluteal. Tambahkan 0,2mL udara pada spuit yang berisi obat-obatan. Imferin sangat mengiritasi pada jaringan subkutan dan dapat menyebabkan pewarnaan permanen. Tindakan ini menjamin bahwa obat-obatan disimpan hanya di dalam otot. 7. Anjurkan pasien untuk meningkatkan masukan diet daging jeroan (khususnya hati) kuning telur, kacang-kacangan, makanan laut sayuran berdaun hijau, roti gandum dan sereal. Makanan ini sumber terbaik dari besi, vitamin B12, dan asam folat. d. Risiko Tinggi Terhadap Kerusakan Penatalaksanaan Pemeliharaan Di Rumah berhubungan dengan faktor : Kurang pengetahuan tentang kondisi dan rencana tindakan Batasan karakteristik : Mengungkapkan kurang pemahaman. meminta informasi, melaporkan riwayat ketidakpatuhan.. Hasil pasien(kolaboratif) : Mendemonstrasikan keinginan memenuhi rencana perawatan. Kriteria evaluasi : Mengungkapkan pemahaman tentang kondisi dan rencana tindakan, solusi terhadap anemia. Intervensi Rasional 1. Hindari penggunaan botol air panas atau bantalan pemanas untuk mengatasi sensitivitas dingin. Berikan instruksi tentang tindakan untuk menghemat panas tubuh untuk menghilangkan sensitivitas dingin : Meningkatkan suhu ruangan Menggunakan selimut ekstra Menggunakan pakaian ekstra Penggunaan sumber pemanas secara langsung pada tubuh dapat mengakibatkan luka bakar. Sensitivitas dingin adalah refleksi dari upaya tubuh untuk mengkompensasi hipoksemia kronis dengan menurunkan laju metabolisme dan pirau darah ke organ vital. Tindakan penghematan panas ini membantu mencegah kehilangan panas tambahan dari tubuh. 2. Berikan informasi tentang kondisi primer yang menyebabkan anemia. Jelaskan bagaimana ini menimbulkan anemia. Artikan anemia dan tanda-tandanya serta gejala-gejalanya. Jelaskan tujuan therapi yang ditentukan. Penyuluhan kesehatan meningkatkan kerja sama pasien dan kepatuhan dengan rencana therapeutik 3. Bila terapi besi dilanjutkan di rumah, berikan instruksi berikut : Obat-obatan menjadikan feses hijau gelap. Bila konstipasi atau diare terjadi, beri tahu dokter. Perubahan pada dosis atau interval dapat mengatasi masalah usus. Gunakan suplemen besi dengan jus sitrus karena vitamin C dan asam sedang meningkatkan absorpsi besi. Penyuluhan kesehatan penting untuk meningkatkan keamanan dalam perawatan mandiri di rumah. Gunakan setelah makan untuk meminimalkan ketidaknyamanan gaster. Bila preparat cair digunakan, larutkan dengan jus sitrus minum dengan sedotan untuk mencegah pewarnaan gigi. Pertahankan perjanjian evaluasi untuk mendapatkan pemeriksaan hemoglobin dan hematokrit. Laporkan tanda-tanda toksisitas besi pada dokter: sakit kepala, rasa besi, kekakuan sendi. 4. Jelaskan bahwa ini dapat memerlukan waktu beberapa minggu sebelum hasil ditunjukkan dari suplemen besi oral. Kekurangan simpanan besi harus diperbaiki sebelum ada bukti dalam pemeriksaan serum, biasanya kira-kira dua bulan. 3. Implementasi Implementasi merupakan perencanaan keperawatan oleh perawat dan klien. Hal-hal yang harus diperhatikan ketika melakukan implementasi adalah intervensi dilaksanakan sesuai rencana setelah dilakukan validasi, penguasaan keterampilan interpensional, intelektual, dan teknikal, intervensi harus dilakukan dengan cermat dan efisien pada situasi yang tepat, keamanan fisik, dan psikologi dilindungi dan dokumentasi keperawatan berupa pencatat dan pelaporan (Gaffar, 1999 : 65). Perawatan pada klien dengan anemia mencakup manajemen nyeri, observasi tanda-tanda vital, pemeriksaan laboratorium darah, observasi tingkat toleransi pada aktivitas fisik, pemberian transfusi darah dan kebutuhan oksigenasi, pemenuhan kebutuhan nutrisi serta pemberian pendidikan kesehatan tentang kondisi, program pengobatan dan kebutuhan perawatan pada klien dengan anemia. Salah satu tindakan fokus pada anemia adalah pemberian transfusi darah. Potter (2000 : 634-641) menyatakan langkah-langkah pemberian transfusi seperti yang terlihat pada tabel berikut ini. Tabel 2.1 Prosedur Pemberian Transfusi Peralatan : a. Selain alat-alat yang digunakan untuk memberikan infus intra vena b. Larutan normal salin 0,9% c. Set infus dengan filter dalam d. Kateter besar (diameter 18-G atau 19-G) e. Produk darah yang benar f. Sarung tangan sekali pakai Langkah-Langkah Rasional a. Cuci tangan b. Kenakan sarung tangan sekali pakai c. Jelaskan prosedur pada klien. Tentukan apakah klien pernah mendapatkan transfusi sebelumnya dan catatan reaksi jika ada. d. Pastikan bahwa klien telah menandatangani format persetujuan. e. Buat jalur intra vena dengan kateter besar (diameter 18-G atau 19-G) f. Gunakan selang infus yang memiliki filter. g. Gantungkan wadah larutan 0,9% NaCl untuk diberikan setelah menginfuskan darah. a. Mengurangi transmisi mikroorganisme. b. Mengurangi transmisi patogen darah. c. Klien yang pernah mendapatkan transfusi darah pada masa lalu dapat merasakan ketakutan yang lebih besar terhadap transfusi. d. Beberapa institusi memerlukan klien untuk menandatangani surat persetujuan sebelum menerima transfusi komponen darah. e. Memungkinkan infus darah lengkap dan mencegah hemolisis. f. Filter mengangkat debris dan bekuan darah kecil. g. Mencegah hemolisis sel-sel darah merah. h. Ikuti protokol institusi dalam mendapatkan produk darah dari bank darah. Minta darah bila anda telah siap menggunakannya. i. Dapatkan data dasar tanda-tanda vital 30 menit sebelum pemberian transfusi darah. Laporkan adanya peningkatan suhu pada dokter. j. Tusuk unit darah, pencet bilik drip dan biarkan filter terisi darah, buka klem pengatur dan biarkan selang infus terisi darah. k. Hubungkan selang transfusi darah ke kateter intra vena dengan mempertahankan kesterilan. Buka klem bagian bawah. l. Tetap bersama klien selama 15 menit sampai 30 menit masa transfusi. Kecepatan aliran awal selama waktu ini harus 2 sampai 5 ml/ menit. m. Pantau tanda-tanda vital klien tiap 5 menit selama 15 menit pertama, tiap 15 menit selama satu jam berikutnya, tiap jam sampai unit darah terinfuskan dan selama satu jam setelah infus selesai. h. Darah lengkap atau kemasan sel-sel darah merah harus tetap dalam lingkungan dingin (1-6 oC). i. Memastikan suhu, nadi, tekanan darah, dan pernapasan pra transfusi klien dan memungkinkan deteksi reaksi transfusi dengan mempertahankan perubahan pada tanda-tanda vital. j. Menyiapkan filter dan selang terisi darah. Membantu mempercepat hubungan dari selang infus yang telah disiapkan ke kateter intra vena. k. Memulai infus produk darah ke dalam vena klien. l. Kebanyakan reaksi transfusi terjadi selama 15 sampai 30 menit transfusi. m. Waspadalah terhadap setiap perubahan tanda-tanda vital yang dapat merupakan tanda awal reaksi transfusi. n. Atur infus sesuai pesanan dokter. Kemasan darah biasanya diberikan 1 sampai 2 jam sementara darah lengkap diberikan selama 2-3 jam. o. Setelah darah diberikan, bersihkan selang infus dengan normal salin 0,9% dan letakkan kantung darah pada kantung plastik untuk dikembalikan ke bank darah. p. Buang semua bahan yang telah digunakan di tempat yang telah disediakan. Lepaskan sarung tangan dan cuci tangan. q. Catat tipe dan komponen darah yang diberikan dan respon klien terhadap therapi darah. Biasanya digunakan catatan transfusi darah. n. Kondisi klien menentukan kecepatan darah yang harus diberikan. Faktor tetesan untuk selang darah adalah 10 tetes/menit. o. Menginfus sisa darah di dalam selang intra vena, normal salin 0,9% mencegah hemolisis sel-sel darah merah. p. Mengurangi transmisi mikroorganisme. q. Mencatat pemberian komponen darah dan reaksi klien. 4. Evaluasi dan Catatan Perkembangan Fase akhir dari proses keperawatan adalah evaluasi terhadap asuhan keperawatan yang diberikan. Hal yang dievaluasi adalah keakuratan, kelengkapan, dan kualitas data, teratasi dan tidaknya masalah klien, serta pencapaian tujuan serta ketepatan intervensi keperawatan. (Gaffar 1999:67). Sesuai dengan rencana evaluasi maka sasaran evaluasi adalah sebagai berikut: 1) Proses asuhan keperawatan, berdasarkan kriteria atau rencana yang telah disusun. 2) Hasil keperawatan, berdasarkan kriteria keberhasilan yang telah dirumuskan dalam rencana evaluasi. Catatan ini berorientasi pada masalah dan disusun oleh anggota tim kesehatan. Setiap anggota menuliskan perkembangan yang terjadi pada lembaran yang sama, yaitu lembaran SOAP (subjective and Objective data, Analysis, Planning). 1) S (Data Subjektif) Data subjektif adalah data yang didapat dari klien secara langsung, misalnya dari keluhan atau perkataan klien. 2) O (Data Objektif) Data yang didapat melalui pengamatan dan pemeriksaan, seperti hasil pemeriksaan hasil fisik, hasil pemeriksaan laboratorium, hasil observasi, dan hasil pemeriksaan radiologi. 3) A (Analisis) Berdasarkan data subjektif dan objektif maka perawat melakukan analisis terhadap data tersebut. Analisis berfungsi untuk merumuskan kesimpulan mengenai perkembangan kondisi klien, menetapkan diagnosis baru (jika ada perubahan), dan mengevaluasi keefektifan tindakan yang telah dilakukan. 4) P (Perencanaan) Pada lembar ini perawat menuliskan rencana asuhan. Rencana asuhan dapat mencakup instruksi khusus untuk mengatasi masalah, mencari data tambahan, dan pendidikan bagi pasien dan keluarga. Rencana asuhan ini biasanya mengacu pada rencana sebelumnya, namun disertai beberapa perbaikan dan modifikasi. Evaluasi serta kriteria hasil yang diharapkan pada klien dengan anemia adalah mendemonstrasikan hilang dari nyeri dengan kriteria klien menyangkal nyeri, ekspresi wajah rileks; mendemonstrasikan koping efektif dengan penyakit kronis dengan kriteria mengungkapkan penerimaan terhadap diri pada situasi saat itu, mengungkapkan rencana pekerjaan realistis; mendemonstrasikan peningkatan toleransi pada aktivitas dengan kriteria melaporkan berkurangnya kelelahan dan dispnea bila melakukan rutin, frekuensi nadi 60-100 nadi per menit, dan frekuensi pernapasan 12-24 per menit istirahat serta mendemonstrasikan keinginan memenuhi rencana perawatan dengan kriteria mengungkapkan pemahaman tentang kondisi dan rencana tindakan, solusi terhadap anemia.
All About Cervical Cancer
Cervical cancer or cervical cancer (also called cervical cancer) is one of the diseases the most common cancer for women. Every one hour, one woman killed in Indonesia because of cervical cancer or cervical cancer this. Facts show that millions of women in the world infected with HPV, which is considered the disease through sexual intercourse most common in the world.
In Indonesia, every one hour, one woman died of cervical cancer
According to World Health Organization (WHO), this infection is a major risk factor for cervical cancer. Every year, hundreds of thousands of undiagnosed cases of HPV in the world and thousands of women died of cervical cancer, caused by the infection. Given the fact that this horrible, then the various preventive measures and treatment have been made to address cervical cancer or cervical cancer.
Cervical cancer or cervical cancer occur in the reproductive organs of a woman. The cervix is the narrow section at the bottom between the vagina and uterus of a woman. In part this is happening and where the growth of cervical cancer. What causes cervical cancer or cervical cancer? How do I prevent it? And how to handle it if it is infected with HPV?
HPV
Cervical cancer is caused by a viral infection HPV (human papillomavirus) or human papilloma virus. HPV causes warts in both men and women, including genital warts in, called condyloma akuminatum. Only some of the hundreds of variants of HPV that can cause cancer. Cervical cancer or cervical cancer can occur if there is an infection that does not heal for a long time. Conversely, most HPV infections will go away, overcome by the immune system.
Causes and Symptoms of Cervical Cancer
Cervical cancer attacks the cervical region or the cervix caused by HPV infection (human papillomavirus) that did not recover in time. If the immune system decreases, the HPV infection will mengganas and can lead to cervical cancer. The symptoms are not too visible at an early stage, that's why the beginning of cervical cancer HPV infection is considered as "The Silent Killer".
Some symptoms can be observed although not always an indication of HPV infection. Whitish or spend a bit of blood after intercourse is little sign of symptoms of this cancer. In addition, the foul-smelling yellowish fluid in the genital area can also be an indication of HPV infection. This virus can be transmitted from one patient to another and infect the person. Can be transmitted through direct contact and by sexual intercourse.
When there is this virus in a person's hand, then touching the genitals, the virus will move and can infect the cervix or neck of your womb. Other modes of transmission is in the closet in a public restroom that has been contaminated by the virus. A cancer patient may use a closet, the HPV virus in patients who have moved into the closet. If you use it without cleaning it, it could be a virus and then switch to your genital area.
Poor lifestyle one can be supports increasing the number of patients with this cancer. Smoking habits, consuming less vitamin C, vitamin E and folic acid may be the cause. If the consume nutritious foods will make the immune system can ward off increases and the HPV virus.
The risk of cervical cancer is an active woman who had sex very early age, which often change sex partners, or who have sex with men who like to switch pairs. Another factor is the use of oral contraceptives for long periods or were from families who have a history of cancer.
Often, men who showed no symptoms of HPV infection that is spread to their partners. A man who had sex with a woman who suffered from cervical cancer, will be the media of this virus carriers. Furthermore, when this man to have sex with his wife, the virus was able to move to his wife and menginfeksinya.
Detection of Cervical Cancer
How do I detect that a woman infected with HPV that cause cervical cancers? Symptoms of a person infected with HPV are not visible and not easily observed. The easiest way to find out by cytological examination of the cervix. This check is now popularly known as a Pap smear or Papanicolaou smear taken from a Greek doctor who discovered this method of George N. Papanicolaou. However, there are also various other methods for early detection of HPV infection and cervical cancer as follows:
*
IVA
IVA is the abbreviation of Visual Inspection with Acetic Acid. Method of examination with cervical smear or cervix with acetic acid. Then observed if there are abnormalities such as white areas. If no change in color, it can be considered no infection of the cervix. You can do at the health center with a relatively cheap price. This can be done only for early detection. If you detect any suspicious signs, the other detection methods should be done further.
*
Pap smear
Pap smear test methods in common use a scraper or brush your doctor to take a little sample of cervical cells or cervical. Then these cells will be analyzed in the laboratory. The test can reveal whether there is infection, inflammation, or abnormal cells. According to reports the world, with regular Pap smear tests have reduced the number of deaths from cervical cancer.
*
Thin prep
Thin prep method is more accurate than Pap smears. If the Pap smear is just take some of the cells in the cervix, or neck of the womb, then the Thin prep will inspect all parts of the cervix or neck of the womb. Of course the result will be far more accurate and precise.
*
Colposcopy
If all the test results on the previous method showed an infection or a gaffe, colposcopy procedure will be performed using instruments equipped with a magnifying lens to observe the infected part. The goal was to determine whether there are lesions or abnormal tissue in the uterine cervix, or neck. If there is abnormal, taking a small biopsy of tissue from the body done and treatment for cervical cancer begin.
Treating Cervical Cancer
If infected with HPV, do not worry, because currently available a variety of treatments which can control HPV infection. Some of the deadly aim of treatment of cells that contain the HPV virus. Another is to remove the damaged or infected with electrical surgery, laser surgery, or cryosurgery (remove the abnormal tissue by freezing).
If cervical cancer has reached an advanced stage, it will be done chemo therapy. At some severe cases a hysterectomy may also be that the uterus or womb removal operations in total. The aim is to remove cervical cancer cells that have been developed in the body.
However, prevention is better than cure. Therefore, how to prevent infection with HPV and cervical cancer? Here are some ways you can do to prevent cervical cancer.
Preventing cervical cancer
Although cervical cancer scary, but we can all be prevented. You can do a lot of precautionary measures before ultimately infected with HPV and cervical cancer. Some practical ways you can do in daily life, among others:
* Have a healthy diet, rich in vegetables, fruit and cereal to stimulate the immune system. For example consume various karotena, vitamins A, C and E, and folic acid can reduce the risk of cervical cancer.
* Avoid smoking. Much evidence suggests the use of tobacco can increase your risk of cervical cancer.
* Avoid sex before marriage or at the very young or teenage years.
* Avoid having sex during menstrual period proved to be effective to prevent and inhibit the formation and development of cervical cancer.
* Avoid having sex with more partners.
Regularly * A Pap smear tests regularly. Currently Pap smears can be done even at the level of health centers with affordable prices.
* Alternative Pap smear is a test IVA with a cheaper cost of Pap smears. The goal for the early detection of HPV infection.
* Giving the HPV vaccine or vaccination to prevent infection with HPV.
* Perform cleaning of intimate organs or vagina is known as a toilet. This can be done alone or can be also with the help of expert doctors. The goal was to clean the female sex organs from dirt and disease.
Healthy Living No Cervical Cancer
Cervical cancer is preventable and treatable. Early detection and routine Pap smears will minimize the risk of cervical cancer. Change your lifestyle and your eating patterns to avoid the disease that killed many women in this world. Thus, the health of the cervix or the cervix is more assured. With proper treatment, cervical cancer is not something frightening.
In Indonesia, every one hour, one woman died of cervical cancer
According to World Health Organization (WHO), this infection is a major risk factor for cervical cancer. Every year, hundreds of thousands of undiagnosed cases of HPV in the world and thousands of women died of cervical cancer, caused by the infection. Given the fact that this horrible, then the various preventive measures and treatment have been made to address cervical cancer or cervical cancer.
Cervical cancer or cervical cancer occur in the reproductive organs of a woman. The cervix is the narrow section at the bottom between the vagina and uterus of a woman. In part this is happening and where the growth of cervical cancer. What causes cervical cancer or cervical cancer? How do I prevent it? And how to handle it if it is infected with HPV?
HPV
Cervical cancer is caused by a viral infection HPV (human papillomavirus) or human papilloma virus. HPV causes warts in both men and women, including genital warts in, called condyloma akuminatum. Only some of the hundreds of variants of HPV that can cause cancer. Cervical cancer or cervical cancer can occur if there is an infection that does not heal for a long time. Conversely, most HPV infections will go away, overcome by the immune system.
Causes and Symptoms of Cervical Cancer
Cervical cancer attacks the cervical region or the cervix caused by HPV infection (human papillomavirus) that did not recover in time. If the immune system decreases, the HPV infection will mengganas and can lead to cervical cancer. The symptoms are not too visible at an early stage, that's why the beginning of cervical cancer HPV infection is considered as "The Silent Killer".
Some symptoms can be observed although not always an indication of HPV infection. Whitish or spend a bit of blood after intercourse is little sign of symptoms of this cancer. In addition, the foul-smelling yellowish fluid in the genital area can also be an indication of HPV infection. This virus can be transmitted from one patient to another and infect the person. Can be transmitted through direct contact and by sexual intercourse.
When there is this virus in a person's hand, then touching the genitals, the virus will move and can infect the cervix or neck of your womb. Other modes of transmission is in the closet in a public restroom that has been contaminated by the virus. A cancer patient may use a closet, the HPV virus in patients who have moved into the closet. If you use it without cleaning it, it could be a virus and then switch to your genital area.
Poor lifestyle one can be supports increasing the number of patients with this cancer. Smoking habits, consuming less vitamin C, vitamin E and folic acid may be the cause. If the consume nutritious foods will make the immune system can ward off increases and the HPV virus.
The risk of cervical cancer is an active woman who had sex very early age, which often change sex partners, or who have sex with men who like to switch pairs. Another factor is the use of oral contraceptives for long periods or were from families who have a history of cancer.
Often, men who showed no symptoms of HPV infection that is spread to their partners. A man who had sex with a woman who suffered from cervical cancer, will be the media of this virus carriers. Furthermore, when this man to have sex with his wife, the virus was able to move to his wife and menginfeksinya.
Detection of Cervical Cancer
How do I detect that a woman infected with HPV that cause cervical cancers? Symptoms of a person infected with HPV are not visible and not easily observed. The easiest way to find out by cytological examination of the cervix. This check is now popularly known as a Pap smear or Papanicolaou smear taken from a Greek doctor who discovered this method of George N. Papanicolaou. However, there are also various other methods for early detection of HPV infection and cervical cancer as follows:
*
IVA
IVA is the abbreviation of Visual Inspection with Acetic Acid. Method of examination with cervical smear or cervix with acetic acid. Then observed if there are abnormalities such as white areas. If no change in color, it can be considered no infection of the cervix. You can do at the health center with a relatively cheap price. This can be done only for early detection. If you detect any suspicious signs, the other detection methods should be done further.
*
Pap smear
Pap smear test methods in common use a scraper or brush your doctor to take a little sample of cervical cells or cervical. Then these cells will be analyzed in the laboratory. The test can reveal whether there is infection, inflammation, or abnormal cells. According to reports the world, with regular Pap smear tests have reduced the number of deaths from cervical cancer.
*
Thin prep
Thin prep method is more accurate than Pap smears. If the Pap smear is just take some of the cells in the cervix, or neck of the womb, then the Thin prep will inspect all parts of the cervix or neck of the womb. Of course the result will be far more accurate and precise.
*
Colposcopy
If all the test results on the previous method showed an infection or a gaffe, colposcopy procedure will be performed using instruments equipped with a magnifying lens to observe the infected part. The goal was to determine whether there are lesions or abnormal tissue in the uterine cervix, or neck. If there is abnormal, taking a small biopsy of tissue from the body done and treatment for cervical cancer begin.
Treating Cervical Cancer
If infected with HPV, do not worry, because currently available a variety of treatments which can control HPV infection. Some of the deadly aim of treatment of cells that contain the HPV virus. Another is to remove the damaged or infected with electrical surgery, laser surgery, or cryosurgery (remove the abnormal tissue by freezing).
If cervical cancer has reached an advanced stage, it will be done chemo therapy. At some severe cases a hysterectomy may also be that the uterus or womb removal operations in total. The aim is to remove cervical cancer cells that have been developed in the body.
However, prevention is better than cure. Therefore, how to prevent infection with HPV and cervical cancer? Here are some ways you can do to prevent cervical cancer.
Preventing cervical cancer
Although cervical cancer scary, but we can all be prevented. You can do a lot of precautionary measures before ultimately infected with HPV and cervical cancer. Some practical ways you can do in daily life, among others:
* Have a healthy diet, rich in vegetables, fruit and cereal to stimulate the immune system. For example consume various karotena, vitamins A, C and E, and folic acid can reduce the risk of cervical cancer.
* Avoid smoking. Much evidence suggests the use of tobacco can increase your risk of cervical cancer.
* Avoid sex before marriage or at the very young or teenage years.
* Avoid having sex during menstrual period proved to be effective to prevent and inhibit the formation and development of cervical cancer.
* Avoid having sex with more partners.
Regularly * A Pap smear tests regularly. Currently Pap smears can be done even at the level of health centers with affordable prices.
* Alternative Pap smear is a test IVA with a cheaper cost of Pap smears. The goal for the early detection of HPV infection.
* Giving the HPV vaccine or vaccination to prevent infection with HPV.
* Perform cleaning of intimate organs or vagina is known as a toilet. This can be done alone or can be also with the help of expert doctors. The goal was to clean the female sex organs from dirt and disease.
Healthy Living No Cervical Cancer
Cervical cancer is preventable and treatable. Early detection and routine Pap smears will minimize the risk of cervical cancer. Change your lifestyle and your eating patterns to avoid the disease that killed many women in this world. Thus, the health of the cervix or the cervix is more assured. With proper treatment, cervical cancer is not something frightening.
Prevent Cervical Cancer
Moms I'd take this article from a site www.cegahkankerserviks.org because this info is very important. Because you know that each year approximately 500 000 women diagnosed with cervical cancer and more than 250,000 died. Total of 2.2 million women in the world suffer from cervical cancer. Cervical cancer tend to appear in women aged 35-55 years, but can also appear in women with a younger age.
In Indonesia, estimated to occur every day, 41 new cases of cervical cancer and 20 women meningal world because of the disease.
What is cervical cancer?
Cervical cancer (cervical cancer) is cancer that occurs in the cervix or cervical area. Uterine cervix is the part that connects the upper uterus with the vagina. Cervical cancer is cancer no. Two of the most frequent and deadly attacks of women worldwide.
What are the symptoms of cervical cancer?
The early symptoms of pre-cancerous condition generally marked by the discovery of the abnormal cervical cells that can be found through a Pap smear test. Cervical cancer often causes no symptoms. But if these abnormal cells develop into cervical cancer, before symptoms appear as follows:
1. Abnormal vaginal bleeding such as:
* Bleeding between regular menstrual periods
Menstrual * period longer and more than usual
* Bleeding after sexual intercourse or pelvic examination
2. Pain during intercourse
When you experience one of the above symptoms, immediately contact your doctor! The above conditions are not always caused by cervical cancer, but can be a sign of vaginal infection that needs to be treated immediately.
What causes cervical cancer?
More than 95 percent of cervical cancers caused by a virus known as Human Papilloma Virus (HPV). HPV or Human Papilloma Virus is a virus that attacks humans. There are more than 100 types of HPV which most are harmless, causing no visible symptoms and goes away by itself. HPV infection is most common in young adults (18-28 years).
How can HPV spread?
HPV can infect all people, because HPV can be spread through sexual contact. Those who have intercourse at a very young age (under 20 years) and frequent change of sexual partners are at high risk for infection with HPV. But keep in mind that every woman at risk for HPV infection, although faithful to one partner. An infected partner will be a source of HPV infection for other women.
HPV Infection and Cervical Cancer
After the first HPV infection, the development of cervical cancer depend on the direction of high risk HPV types or low, usually called pre-cancerous lesions. Low-risk HPV types (types 6 and 11) almost no risk of becoming cervical cancer, but can cause genital warts. Most HPV infections will recover by themselves within 1-2 years because of the natural immune system. However settle infections caused by the types of high risk HPV such as type 16 or 18 will lead to cervical cancer. Cervical cancer began to develop when abnormal cells in cervical wall began to multiply out of control and form a lump called a tumor.
After the first HPV infection, the development of cervical cancer depend on the direction of high risk HPV types or low, usually called pre-cancerous lesions. Low-risk HPV types (types 6 and 11) almost no risk of becoming cervical cancer, but it may cause. Most HPV infections will recover by themselves within 1-2 years because of the natural immune system. However settle infections caused by the types of high risk HPV such as type 16 or 18 will lead to cervical cancer. Cervical cancer began to develop when abnormal cells in cervical wall began to multiply out of control and form a lump called a tumor.
Pap Smear Test
Pap smear test (Pap smear) can detect abnormal cells in the cervix early as possible.
How to prevent cervical cancer?
Current cervical cancer can be prevented with a vaccine help that can provide protection against HPV infection. An anti-HPV vaccine is quadrivalent provide protection against HPV types 16 and 18, which is the cause of 70% of cervical cancer cases and HPV types 6 and 11, which cause 90% of cases of genital warts. Consult your doctor to how to help prevent cervical cancer.
Doctor Consultation
It is important to remember that after vaccination does not mean that Pap smear tests are not needed. Pap smear tests should be carried out regularly in accordance with the advice of doctors to detect early presence of abnormal cells in the cervix before they become pre-cancerous conditions or cervical cancer. Do consult with your doctor regularly!
In Indonesia, estimated to occur every day, 41 new cases of cervical cancer and 20 women meningal world because of the disease.
What is cervical cancer?
Cervical cancer (cervical cancer) is cancer that occurs in the cervix or cervical area. Uterine cervix is the part that connects the upper uterus with the vagina. Cervical cancer is cancer no. Two of the most frequent and deadly attacks of women worldwide.
What are the symptoms of cervical cancer?
The early symptoms of pre-cancerous condition generally marked by the discovery of the abnormal cervical cells that can be found through a Pap smear test. Cervical cancer often causes no symptoms. But if these abnormal cells develop into cervical cancer, before symptoms appear as follows:
1. Abnormal vaginal bleeding such as:
* Bleeding between regular menstrual periods
Menstrual * period longer and more than usual
* Bleeding after sexual intercourse or pelvic examination
2. Pain during intercourse
When you experience one of the above symptoms, immediately contact your doctor! The above conditions are not always caused by cervical cancer, but can be a sign of vaginal infection that needs to be treated immediately.
What causes cervical cancer?
More than 95 percent of cervical cancers caused by a virus known as Human Papilloma Virus (HPV). HPV or Human Papilloma Virus is a virus that attacks humans. There are more than 100 types of HPV which most are harmless, causing no visible symptoms and goes away by itself. HPV infection is most common in young adults (18-28 years).
How can HPV spread?
HPV can infect all people, because HPV can be spread through sexual contact. Those who have intercourse at a very young age (under 20 years) and frequent change of sexual partners are at high risk for infection with HPV. But keep in mind that every woman at risk for HPV infection, although faithful to one partner. An infected partner will be a source of HPV infection for other women.
HPV Infection and Cervical Cancer
After the first HPV infection, the development of cervical cancer depend on the direction of high risk HPV types or low, usually called pre-cancerous lesions. Low-risk HPV types (types 6 and 11) almost no risk of becoming cervical cancer, but can cause genital warts. Most HPV infections will recover by themselves within 1-2 years because of the natural immune system. However settle infections caused by the types of high risk HPV such as type 16 or 18 will lead to cervical cancer. Cervical cancer began to develop when abnormal cells in cervical wall began to multiply out of control and form a lump called a tumor.
After the first HPV infection, the development of cervical cancer depend on the direction of high risk HPV types or low, usually called pre-cancerous lesions. Low-risk HPV types (types 6 and 11) almost no risk of becoming cervical cancer, but it may cause. Most HPV infections will recover by themselves within 1-2 years because of the natural immune system. However settle infections caused by the types of high risk HPV such as type 16 or 18 will lead to cervical cancer. Cervical cancer began to develop when abnormal cells in cervical wall began to multiply out of control and form a lump called a tumor.
Pap Smear Test
Pap smear test (Pap smear) can detect abnormal cells in the cervix early as possible.
How to prevent cervical cancer?
Current cervical cancer can be prevented with a vaccine help that can provide protection against HPV infection. An anti-HPV vaccine is quadrivalent provide protection against HPV types 16 and 18, which is the cause of 70% of cervical cancer cases and HPV types 6 and 11, which cause 90% of cases of genital warts. Consult your doctor to how to help prevent cervical cancer.
Doctor Consultation
It is important to remember that after vaccination does not mean that Pap smear tests are not needed. Pap smear tests should be carried out regularly in accordance with the advice of doctors to detect early presence of abnormal cells in the cervix before they become pre-cancerous conditions or cervical cancer. Do consult with your doctor regularly!
Subscribe to:
Posts (Atom)
