Makoi Makuei

ROLES OF A NURSE

By Chipo James Mainda

Nurses serve their communities in many ways and have essential roles in healthcare. Nurses promote healthy lifestyles, advocate for patients, provide health education, and directly care for many patients. The exact functions of nurses have changed somewhat over the years; however, their importance in healthcare remains evident.

✓ Patient care

The primary role of a nurse is to be a caregiver for patients by managing physical needs, preventing illness, and treating health conditions. To do this, nurses must observe and monitor the patient and record any relevant information to aid in treatment decision-making processes.

✓Advocator

A nurse often serves as a patient advocate in protecting a patient's medical, legal, and human rights. Since many sick patients may be unable to comprehend medical situations and act accordingly, it is often the nurse's role to support the patient. In order to be a client advocate, listening, and placing yourself in the shoes of the patient will enable you to know what it feels like and react with the situation.

This may involve representing the patient's best interests, especially when treatment decisions are being made. Furthermore, nurses will often inform and support patients when they have questions or are apprehensive about treatments, procedures, or any other aspect of their care. Nurses may also make suggestions for patients' treatment plans in collaboration with the patient, their families, and other health professionals.

✓ Planning of care

A nurse is directly involved in the decision-making process of treating patients. Thus, it is essential that nurses think critically when asses sing patient signs and identify potential problems to make the appropriate recommendations.

✓ Educator

Nurses are also responsible for ensuring that patients can understand their health, illnesses, medications, and treatments to the best of their ability. This is particularly important when patients are discharged from the hospital and are responsible for continuing their treatments at home.

A nurse should take the time to explain to the patient and their family or caregiver what to do and expect when they leave the hospital or medical clinic. Nurses should also ensure that the patient feels supported and knows where to seek additional information if needed.

✓Counselor

Being a counselor means that the nurse helps the client to develop coping mechanisms that are healthy enough. Since each client faces different degrees of stress, the nurse must be able to facilitate the recognition of the patient to cope with the challenge of certain alterations in the daily living brought about by health-related problems. The role encompasses emotional, intellectual, and psychological support.

✓ Change Agent

The nurse catalyzes the change that is needed for the patient’s improvement. Using the nursing process, the nurse will identify first the problem areas and develop a plan of action in order for the patient to change his mind and eventually change his behavior. Being a change agent means that the nurse will help the patient to get out of the usual scenario, identify the need for the change and implement the changes, and getting accustomed to these changes.

✓ Leader

As a nurse, he or she must be able to be an inch or a foot farther than other personnel. It means that he or she must have a wider view of the situation and create goals and objectives that were attainable for the group. Leading as a nurse means that you can influence others to be together in the same goal or objective.

✓ Researcher

The work of a nurse involves changes in nursing care. This change can only be known for using research. Scientifically, a nurse can function as a researcher in order to improve their practice as well as give patient outcomes a better picture.

For more join our daily online lessons on WhatsApp 0977353901.

THE IMMUNIZATION SCHEDULE

1. BCG (Bacilli-Calmette guerien)
Dose
✓0.05mls
Age
✓At birth or first contact
Route
✓ Intradermal
Site
✓ Upper outer aspect of the left arm.
Protection against
✓Tuberculosis

2. OPV (Oral polio vaccine)
Dose
✓ 2-3 drops (0.5mls)
( Doses 0,1,2,3 )
Age
✓ 0-13 days ( OPV-0). At 6 weeks (OPV-1) .10 weeks (OPV-2) and 14 weeks (OPV-3)
✓If child missed between 0 -13 days, It should be given at 9months as OPV-4.
Route
✓ Orally
Site
✓ By mouth
Protection
✓ Poliomyelitis

3.Dip + Hib+ Hep B(Doses 1,2,3)
Dose
✓ 0.5mls
Age
✓ At 6 weeks, 10 weeks, and 14 weeks
Route
✓ Intramuscular
Site
✓ The outer aspect of the left thigh .
Protection against
✓ Diphtheria, tetanus, pertussis, Haemophilus influenza type B, Hepatitis B.

4. Measles
Dose
✓ 0.5mls
Age
✓ At 9 months and 18 months
Route
✓ Subcutaneous
Site
✓ Upper arm on the deltoid muscle
Protection against
✓ Measles

5. Rotavaccine
Dose
✓0.5mls
Age
✓ At 6 weeks and 10 weeks
Route
✓ Oral
site
✓ Mouth
Protection against
✓ Diarrhoea

6. Vitamin A
Dose
✓ 100,000iu
Age
✓6-11 months
Site
✓ Mouth
Route
✓ Oral
Protection against
✓ Night blindness

7. Pcv (Pneumococcal conjugate vaccines)
Dose
✓ 0.5mls
Age
✓ At 6 weeks. 10 weeks. 14 weeks
Route
✓ Intramuscular
Site
✓ Anterolateral thigh or deltoid muscle
Protection against
✓ Protection against Infections causes by the bacterim streptococcus pneumoniae.

8. Inactive polio vaccine (IPV)
✓Also known as the Salk vaccine.
Dose
✓ 0.5mls
Age
✓ Given at 14 weeks as a single dose
Site
✓On the thigh
Route
✓ Intramuscular
Protection against
✓ Poliomyelitis type 1,2, and 3.

ADMIN IS SAYING GOOD MORNING TO YOU FAMILY PILLARS

If you were patient trusties.
What could u prefer as your treatment opinion
Injections or orals.
No medical rational need

ARTESUNATE (ARTESUN) INJECTION
By NTS MUTALE FREDRICK CHILESHE MWINE
Available Strength:
✓60mg/6mls
✓30mg/3mls
✓120mg/12mls

Route: IM/IV use

INDICATION FOR USE 👨‍⚕️🧑‍⚕️🏥
✓Artesunate is used as 1st line treatment in management of severe Malaria.
✓It is an Anti-malarial drug.

RECONSTITUTION 👨‍⚕️🧑‍⚕️🏥👩‍⚕️
✓Artesunate injection comes with 1(one)vial containing the powder to be reconstituted and 2 (two) ampoules.
✓1 ampoule contains sodium bicarbonate (1ml) and the other contains sodium chloride (5mls).
✓When starting to reconstitute, start by adding the sodium bicarbonate (1ml) into the vial which contains the powder and start to swirl gently until it is clear(Do not shake).
✓When it is clear, add the sodium chloride (5mls) into the vial.
✓At this moment, the vial now contains 6mls(1mls sodium bicarbonate and 5mls sodium bicarbonate) making the strength 60mg/6mls.
✓Artesunate is at this moment ready for administration.

DOSAGE💊
✓Artesunate is given 3mg/kg to patients weighing less than 20kgs
✓And 2.4mg/kg to patients weighing above 20kgs.
E.g
✓If patient is weighing 17kg. It will be 17kg×3=51mg of Artesunate.
✓If patient is weighing 24kg. It will be 24kgs×2.4=57.6mg of Artesunate.

✓The patient receives 3(three) doses of Artesunate given 12hours apart.
E.g
If the first dose is given .
2nd dose will be at 00:00hrs.
3rd dose will be at 12:00hrs.

✓Artesunate should not be given as an infusion but as a Bolus slowly within 1-2minutes.

DIRECTION FOR USE📜
✓After patient receives the three doses of Artesunate and responds positively, the blood slide now shows no malaria parasites,the patient should still receive the full course for Artemether lumefantrine (Coartem)×3days after receiving Artesunate.
✓ If patient is unable to tolerate oral drugs (Coartem), then Artesunate should be continued but ordered "Once daily until patient is able to tolerate oral drugs but to a maximum of 7 days".
✓But if patient does not respond to Artesunate(the 3 doses) meaning after the three doses of Artesunate patient is still sick and the blood slide still shows malaria parasites, switch to the 2nd line treatment for severe Malaria which is Quinine injection.

Note📝
✓Children weighing

TOOTH DECAY/CAVITIES

By Chipo James Mainda

Cavities are permanently damaged areas in the hard surface of your teeth that develop into tiny openings or holes. Cavities, also called tooth decay or caries, are caused by a combination of factors, including bacteria in your mouth, frequent snacking, sipping sugary drinks and not cleaning your teeth well.

Cavities and tooth decay are among the world's most common health problems. They're especially common in children, teenagers and older adults. But anyone who has teeth can get cavities, including infants.

If cavities aren't treated, they get larger and affect deeper layers of your teeth. They can lead to a severe toothache, infection and tooth loss. Regular dental visits and good brushing and flossing habits are your best protection against cavities and tooth decay.

Cavities are caused by tooth decay (a process that occurs over time). Here's how tooth decay develops:

* Plaque forms. Dental plaque is a clear sticky film that coats your teeth. It's due to eating a lot of sugars and starches and not cleaning your teeth well. When sugars and starches aren't cleaned off your teeth, bacteria quickly begin feeding on them and form plaque. Plaque that stays on your teeth can harden under or above your gum line into tartar (calculus). Tartar makes plaque more difficult to remove and creates a shield for bacteria.

* Plaque attacks. The acids in plaque remove minerals in your tooth's hard, outer enamel. This erosion causes tiny openings or holes in the enamel (the first stage of cavities). Once areas of enamel are worn away, the bacteria and acid can reach the next layer of your teeth, called dentin. This layer is softer than enamel and less resistant to acid. Dentin has tiny tubes that directly communicate with the nerve of the tooth causing sensitivity.

Everyone who has teeth is at risk of getting cavities, but the following factors can increase risk:
* Decay most often occurs in your back teeth (molars and premolars), certain foods and drinks, frequent snacking or sipping, inadequate brushing, not getting enough fluoride, etc

For more join our daily online lessons on Whatsapp 0977353901

❤️ Happy Valentine’s Day!

💐 Have a wonderful day, and most importantly, take care and love yourself.

💡 Remember, you have the right to make informed choices about your sexual and reproductive health, including whether or not to have children, how to space pregnancies, and how to prevent unintended pregnancies.

☔ Contraception can be used for both pregnancy prevention and planning, allowing individuals and couples to decide when and if they want to have children.

Most people can use contraceptive methods safely, regardless of age or marital status.

👩🏽‍⚕️ If you have any health issues, a healthcare provider can help you choose the safest and most suitable option.

Emergency contraception, such as the copper IUD and emergency contraception pill, can be used immediately after unprotected in*******se. Make sure to seek a pharmacy or healthcare provider as soon as possible within 72 hours.

Highly effective contraceptive methods include:

➡️ Implants
➡️ IUDs

🛡️ Condoms (male and female) are the ONLY contraceptive methods that provide protection against both pregnancy and STIs/HIV. Using condoms correctly and consistently along with other methods enhances protection and peace of mind.

Choosing the right contraceptive method depends on your health, lifestyle, and personal preferences. Explore your options and speak to a healthcare provider to find the best fit for you.

NURSING CARE FOR SICKLE CELL ANAEMIA (CRISIS)
NURSING CARE

 AIMS:
 To relieve pain
 To prevent complications
 To promote comfort
 To offer IEC to the patient and mother about the condition
 To relieve anxiety
ENVIRONMENT
 The patient will be nursed in a general ward, however reverse barrier nursing
will be used to prevent noso-comial infection.
 Patient will be nursed at the acute bay for close observation
 The room should be warm because the patient has cold to prevent a crises.
 The room should be well ventilated to promote air circulation and prevent
R.T.I.
 Oxygen apparatus will be made available for use when in time of dyspnoea
 The room should be well lit for easy observation

PAIN RELIEF

 Offer prescribed analgesics to for pain relief and comfort
 I will do warm compresses on the painful areas to relieve pain
 I will provide a bed cradle to relieve the weight of the linen their by prevent
pain due to pressure
POSITION
 The patient will be propped up to relieve dyspnoea.

 As the condition improves I will allow the patient to adopt any position of
comfort

PSYCHOLOGICAL SUPPORT

 I will explain the disease process in order to raise the knowledge levels and
thereby alley anxiety
 I will encourage the patient to ask question and I will answer accordingly
those I cannot answer I will refer to the physician
 I will explain all procedures to my patient in order to allay anxiety
 I will involve a successfully managed case to come and talk to my patient in
order to allow the patient ask pressing question and get answer this will
improve the patients outlook on his condition
 I will explain to him that as the health care team we are doing everything
possible to ensure that he get better in order to promote co-operation.
 I will provide diversional therapy in order to shift the patient’s mind from
the hospital routine and his condition
 I will involve him in planning his own care in order for him not to feel left
out
 I will involve a successfully managed case to come and talk to my patient in
order to allow the patient ask pressing question and get answer this will
improve the patients outlook on his condition
 I will involve the loved ones in his care in order for him not to feel
neglected.
OBSERVATIONS
 I will do vital sign and BP to act as the base line data in order to know if the
condition is improving or deteriorating
 I will observe for cyanosis if improving or getting worse and give oxygen
therapy when necessary

 I will observe dyspnoea if present will prop up the patient to promote lung
expansion and there by relieve dyspnoea
 I will observe the patient’s facial expressions to detect pain and administer
prescribed analgesics like panadol
 I will observe the feeding pattern of my patient and take measures like
giving small frequent meals to promote appetite
 I will observe the respirations to detect dyspnoea and report accordingly
 I will observe the pressure area to detect on set of pressure sore development
 I will observe the IV fluids to prevent fluid over load
 I will observe the feeding pattern of my patient and take measures like
giving small frequent meals to promote appetite
 If on BT I will observe the transfusion to detect transfusion reaction
REST AND ACTIVITY
 The patient will be on bed rest in the acute phase in order to reduce the
demand for oxygen.
 During a crisis the patient will be on complete in order to promote recovery.
 I will plan my nursing care in such a way that periods of rest are allowed in
order to conserve patient’s energy.
 I will provide a quiet environment to promote rest.
 I will nurse the patient in a quiet room to promote rest
 I will do related procedures in blocks to promote rest
 I will administer prescribed analgesics to relieve headache there by promote
rest
 I will ensure that squeaking trolleys a oiled to prevent noise and there by
promote restNUTRITION
 I will provide energy giving foods like Nshima to provide the energy needed
for the metabolic processes
 I will provide protein foods like fish and beans to promote replacement of
worn out tissues
 Vegetables and fruits will be provided to raise the immunity and promote
skin and mucous membrane
 I will provide a lot of oral fluids to prevent dehydration due to excessive
sweating and promote bringing up of phlegm
 I will serve small frequent meals to promote appetite
 I will provide Iron rich food such as liver, meat, green leafy vegetables to
promote blood formation
 I will allow visitors to bring food preferred by the patient in order to
promote appetite
 I will do regular mouth washes in order to promote appetite
HYGIENE
 I will encourage the patient to take plunge baths in order to remove dead
epithelium and promote comfort
 I will do hair care to promote self esteem and also prevent pediculosis
 I will do nail care to prevent auto infection and bruising self which can lead
to bleeding
 I will do mouth care with a soft brush to prevent halitosis and causing
bleeding because patient has bleeding tendencies
 Any soiled linen and clothes will be changed to promote comfort
MEDICATION
 I will administer prescribed analgesic like Pethidine or morphine at the right
time to promote rest
 I will give prescribed antibiotics like X-pen to promote quick recovery
 I will ensure that I offer my patient folic acid and folic acid to promote blood
formation
 I will ensure that the drugs are swallowed in my presence to promote
recovery.
 I will ensure that I sign for the drug to prevent over dosing the patient
 I will give the drug at the right time and frequency to ensure required plasma
level are maintained thereby promoting recovery
ELIMINATION
 I will provide a lot of fluids and roughage to prevent constipation
 I will prove copious fluids in order to promote renal wash out and there by
prevent renal problems
 I will offer a bed pan if he is confined to bed to ensure bowel movement
PATIENT TEACHING
 I will educate the patient about his condition in order to create awareness
and prevent recurrence of the condition
 I will explain the need for taking the medication in order to promote
compliance and recovery.
 I will educate the patient about the predisposing factors in order to prevent
crises
 I will talk to the patient about the need to take a balanced diet using locally
available foods in order to boost the immunity and blood formation.
 I will educate the patient about the need keep the review dates so that his
progress is monitored to ensure full recovery

Nursing lecture Zone -NLZ
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