CASTS AND MOLDS

hanging cast -  for the fx of the shaft of the humerus
functional arm cast - for the fracture of the shaft of the humerus withe callus formation; flexion and extension is allowed
shoulder spica - fx of the humerus and shoulder joints
airplane - fx of the humerus and shoulder joints
short arm circular cast - fx of wrist and fingers
short arm posterior mold - fx of the wrist and fingers with open wound
long arm circular cast -  fx of radius and ulna
munster or fuenster's cast - fx of radius and ulna with callus formation
long arm posterior mold -  fx of radius and ulna with open wound
rizzer's jacket - for scoliosis; fx of thoraco-lumbar spine
minerva - hanging blouse; for scoliosis but specifically in the upper dorsal cervical spine
1 1/2 hip spica - fx of 2 hips and 1 femur
double dip spica - fx of 2 hips and 2 femur
long leg circular cats - fx of tibia and fibula
long leg posterior mold - fx of tibia and fibula with open wound
basket cast - with sever leg trauma with open wound and ventilation
cylindrical leg cast - fx of the patella
quadrilateral/ischial weight bearing cast - fx of the shaft of femur with callus formation
cast brace - fx of teh distal 3rd of the femur and proximal 3rd of tibia and fibula with callus formation
boot leg cast - for fx of the hips and femur, for post polio with knee contracture
patellar-tendon bearing - fx of tibia and fibula with callus formation
delvit cast - fx of distal 3rd of tibia and fibula with callus formation
boot leg posterior mold - fx of hip and femur with open wound
boot cast - fx of the hip and femur
internal rotator splint - for post hip operation
collar cast - fx of the cevical spine
single hip spica - fx of 1 hip and 1 femur
pantalon cast - fx of the pelvic bone
1 1/2 hip spica posterior mold - fx of 2 hips and 1 femur with open wound
double hip spica posterior mold - fx of 2 hips and 2 femurswith open wound
body cast - fx of lower torso-lumbar spine
frog cast - for congenital hip dislocation
single hip sipca postreior mold - fx of pelvic bone with open wound
night splint for - post polio

1. Coma- a clinical state of unarousability or unresponsiveness to any internal or external stimuli.
2. increased intracranial pressure- an increased in the normal value of 5-15mmHg
3. Epilepsy- chronic disorder characterized by recurrent and unprovoked seizure (seizure is an abnormal muscular contraction due to an abnormal electrical activity of the brain
4. stroke- sudden loss of brain function resulting from disruption of blood supply
5. Parkinson's Disease- a progressive neurologic disorder that affects movement resulting from degeneration of substantia nigra
6. Huntington's Disease-  a progressive autosomal dominant hereditary resulting from degeneration of certain nerve cells
7. Alzheimers' Disease- a progressive degenerative neurologic disorder characterized by memory loss, impared judgment, and personality changes.
8. Guillian Barre Syndrome- acute autoimmune disorder that destroys the myelin sheath of the peripheral nerves.

Altered level of consciousness

altered level of consciousness is not a disorder but a symptom of a particular disorder

Coma-a clinical state of unarousability and unresponsiveness to any internal or external stimuli, it can last for days, weeks, months or years

CAUSES include neurologic (brain injury, stroke), metabolic (DKA, renal failure), toxicologic (drug overdose, alcohol intoxication)

PATHOPHYSIOLOGY:
because of causes there will be a disruption of the cells of the nervous system that will cause a faulty impulse transmission that will result to ALOC

SIGNS AND SYMPTOMS
-there will be an alteration in pupillary response (negative PERLA- pupils are equal, regular, round in shape, and reactive to light and accommodation). the pupils will be fixed and dilated.
-alteration in eye opening response, verbal response, motor response, and behavioral response.

DIAGNOSIS
It can be diagnosis by using glascow coma scale and by complete assesssment of the nervous system

*if the comatose patient has an abnormal pupillary response the cause is neurologic
visualization procedures include x-ray, CT scan and MRI

*if the comatose patient has a normal pupillary response the cause metabolic or toxicologic
Liver function test include:
SGPT- SERUM GLUTAMIC PYRUVIC TRANSAMINASE
ALT-ALANINE AMINO TRANSFERASE
SGOT - SERUM GLUTAMIC OXALOACETIC TRANSAMINASE
AST - ASPARTASE AMINO TRANSFERASE
RENAL FUNCTION TESTS: BUN AND CREA
BLOOD TEST
DRUG TEST
ABG - ARTERIAL BLOOD GAS

MANAGEMENT
-maintain patent airway
level 2 and 3 - position the patient semi fowlers
level 4 - mechanical ventilation and intubation
-protect the patient- raise the padded side rails
-maintain fluid and nutritional balance- hydration, IV therapy, ngt, ogt, tpn, ppn
-provide oral and skin care - wet cottonballs, turn patient side to side and stretch the linen
-maintain normal body temperature
-maintain corneal integrity - administer artificial tears as prescribed, aplly eye patches
-maintain bowel and bladder integrity
-manage complications (pneumonia, aspiration, pressure ulcer, respiratory difficulties)

There's noting you can achieve if you don't move and experience some mistakes. Remember that you can learn from your mistakes and make it as a motivation for you to succeed.

11 Key Areas of Responsibility / Core Competency / Indicators

11 Key Areas of Responsibility

1. Safe and  Quality  Nursing Care

Core Competency 1:

 Demonstrates knowledge base on the health /illness status of individual / groups

Indicators

• Identifies the health needs of the clients (individuals, families, population groups and/or communities)

•  Explains the health status of the clients/ groups

 Core Competency 2.

Provides sound decision making in the care of individuals / families/groups considering their beliefs and values

Indicators

• Identifies clients’ wellness potential and/or health problem

• Gathers data related to the health condition

• Analyzes the data gathered

• Selects appropriate action to support/enhance wellness response; manage the health problem

• Monitors the progress of the action taken

Core Competency 3:

Promotes safety and comfort and privacy of clients

Indicators

• Performs age-specific safety measures in all aspects of client care

• Performs age-specific comfort measures in all aspects of client care

• Performs age-specific measures to ensure privacy in all aspects of client care

 Core Competency 4:

Sets priorities in nursing care based on clients’ needs

Indicators

• Identifies the priority needs of clients

• Analyzes the needs of clients

• Determines appropriate nursing care to address priority needs/problems

 Core Competency 5:

Ensures continuity of care

Indicators

• Refers identified problem to appropriate individuals / agencies

• Establishes means of providing continuous client care

 Core Competency 6:

Administers medications and other health therapeutics

Indicators

• Conforms to the 10 golden rules in medication administration and health therapeutics

 Core Competency 7:

Utilizes the nursing process as framework for nursing

 

 7.1 Performs comprehensive and systematic nursing assessment

• Obtains informed consent

• Completes appropriate assessment forms

• Performs appropriate assessment techniques

• Obtains comprehensive client information

• Maintains privacy and confidentiality

• Identifies health needs 

 7.2   Formulates a plan of care in collaboration with clients and other members of the health team

• Includes client and his family in care planning

• Collaborates with other members of the health team

• States expected outcomes of nursing intervention maximizing clients’ competence

• Develops comprehensive client care plan maximizing opportunities for prevention of problems and/or enhancing wellness response

• Accomplishes client-centered discharge plan

7.3   Implements planned nursing care to achieve identified outcomes

• Explains interventions to clients and family before carrying them out to achieve identified outcomes

• Implements nursing intervention that is safe and comfortable

• Acts to improve clients’ health condition or human response

• Performs nursing activities effectively and in a timely manner

• Uses the participatory approach to enhance client-partners empowering potential for healthy life style/wellness

 7.4   Evaluates progress toward expected outcomes

• Monitors effectiveness of nursing interventions

• Revises care plan based on expected outcomes

2.  Management of Resources and Environment

Core Competency 1:

Organizes work load to facilitate client care

Indicators

• Identifies tasks or activities that need to be accomplished

• Plans the performance of tasks or activities based on priorities

• Verifies the competency of the staff prior to delegating tasks

• Determines tasks and procedures that can be safely assigned to other members of the  team

• Finishes work assignment on time 6

 Core Competency 2:

Utilizes financial resources to support client care

Indicators

• Identifies the cost-effectiveness in the utilization of resources 

• Develops budget considering existing resources for nursing care

Core Competency 3:

Establishes mechanism to ensure proper functioning of equipment

Indicators

• Plans for preventive maintenance program

• Checks proper functioning of equipment considering the:

- intended use

- cost benefits

- infection control

- safety

- waste creation and disposal storage

• Refers malfunctioning equipment to appropriate unit

  

Core Competency 4: 

Maintains a safe environment

Indicators

• Complies with standards and safety codes prescribed by laws

• Adheres to policies, procedures and protocols on prevention and control of infection

• Observes protocols on pollution-control (water, air and noise)

• Observes proper disposal of wastes

• Defines steps to follow in case of fire, earthquake and other emergency situations.

3. Health Education

Core Competency 1:

Assesses the learning needs of the clientpartner/s

Indicators

• Obtains learning information through interview, observation and validation

• Analyzes relevant information

• Completes assessment records appropriately

• Identifies priority needs

 Core Competency 2: 

Develops health education plan based on assessed and anticipated needs

Indicators

• Considers nature of learner in relation to: social, cultural, political, economic, educational and religious factors.

• Involves the client, family, significant others and other resources in identifying learning needs on behavior change for wellness, healthy lifestyle or management of health problems

• Formulates a comprehensive health education plan with the following components: objectives, content, time allotment, teachinglearning resources and evaluation parameters

• Provides for feedback to finalize the plan

 Core Competency 3:

Develops learning materials for health

Indicators

• Develops information education materials appropriate to the level of the client

• Applies health education principles in the education  development of information education materials

Core Competency 4: 

Implements the health education plan

Indicators

• Provides for a conducive learning situation in terms of time and place

• Considers client and family’s preparedness

• Utilizes appropriate strategies that  maximize opportunities for behavior change for wellness/healthy life style

• Provides reassuring presence through active listening, touch, facial expression and gestures

• Monitors client and family’s responses to health education

 Core Competency 5: 

Evaluates the outcome of health education

Indicators

• Utilizes evaluation parameters

• Documents outcome of care

• Revises health education plan based on client response/outcome/s

4. Legal Responsibility

Core Competency 1:

Adheres to practices in accordance with the nursing law and other relevant legislation including contracts, informed consent.

Indicators

• Fulfills legal requirements in nursing practice

• Holds current professional license

• Acts in accordance with the terms of contract of employment and other rules and regulations

• Complies with required continuing professional education

• Confirms information given by the doctor for informed consent

• Secures waiver of responsibility for refusal to undergo treatment or procedure

• Checks the completeness of informed consent and other legal forms

 Core Competency 2:

Adheres to organizational policies and procedures, local and national  

Indicators

• Articulates the vision, mission of the institution where one belongs

• Acts in accordance with the established norms of conduct of the institution / organization/legal and regulatory requirements 

Core Competency 3: 

Documents care rendered to clients

Indicators

• Utilizes appropriate client care records and reports.

• Accomplishes accurate documentation in all matters concerning client care in accordance to the standards of nursing practice.

5. Ethico-moral Responsibility

Core Competency 1:

Respects the rights of individual / groups

Indicators

• Renders nursing care consistent with the client’s bill of rights: (i.e. confidentiality of information, privacy, etc.)

 Core Competency 2:

Accepts responsibility

Indicators

• Meets nursing accountability requirements as embodied in the job description and accountability for

own decision and actions

• Justifies basis for nursing actions and judgment

• Projects a positive image of the profession

 Core Competency 3:

Adheres to the national and international code of ethics for nurses

Indicators

• Adheres to the Code of Ethics for Nurses and abides by its provision

• Reports unethical and immoral incidents to proper authorities

 6. Personal and Professional Development

Core Competency 1:

Identifies own learning needs

Indicators

• Identifies one’s strengths, weaknesses/ limitations

• Determines personal and professional goals and aspirations 

 Core Competency 2: 

Pursues continuing education

Indicators

• Participates in formal and non-formal education

• Applies learned information for the improvement of care 

 Core Competency 3:

Gets involved in professional organizations and civic activities

Indicators

• Participates actively in professional, social, civic, and religious activities

• Maintains membership to professional organizations

• Support activities related to nursing and health issues

 Core Competency 4:

Projects a professional image of the nurse

Indicators

• Demonstrates good manners and right conduct at all times

• Dresses appropriately

• Demonstrates congruence of words and action

• Behaves appropriately at all times

 Core Competency 5:

Possesses positive attitude towards change and criticism

Indicators

• Listens to suggestions and recommendations

• Tries new strategies or approaches 

• Adapts to changes willingly

 Core Competency 6:

Performs function according to professional standards 

Indicators

• Assesses own performance against standards of practice

• Sets attainable objectives to enhance nursing knowledge and skills

• Explains current nursing practices, when situations call for it

7. Quality Improvement

Core Competency 1: 

Gathers data for quality improvement

Indicators

• Identifies appropriate quality improvement methodologies for the clinical problems

• Detects variation in specific parameters i.e vital signs of the client from day to day

• Reports significant changes in clients’ condition/environment to improve stay  in the hospital 9

• Solicits feedback from client and significant others regarding care rendered

 Core Competency 2:

Participates in nursing audits and rounds

Indicators

• Shares with the team relevant information regarding  clients’ condition and significant changes in clients’ environment

• Encourages the client to verbalize relevant changes in his/her condition

• Performs daily check of clients’ records / condition 

• Documents and records all nursing care and actions implemented

 Core Competency 3:

Identifies and reports variances

Indicators

• Reports to appropriate person/s significant variances/changes/occurrences immediately

•  Documents and reports observed variances regarding client care 

Core Competency 4:

Recommends solutions to identified problems

Indicators

• Gives an objective and accurate report on what was observed rather than an interpretation of the event 

• Provides appropriate suggestions on corrective and preventive measures

• Communicates solutions with appropriate groups

8. Research

Core Competency 1:

Gather data using different methodologies

Indicators

• Specifies researchable problems regarding client care and community health

• Identifies appropriate methods of research for a particular client / community problem

• Combines quantitative and qualitative nursing design through simple explanation on the phenomena observed

 Core Competency 2: 

Analyzes and interprets data gathered 

Indicators

• Analyzes data gathered using appropriate statistical tool

• Interprets data gathered based on significant findings

 Core Competency 3: 

Recommends actions for implementation 

Indicators

•  Recommends practical solutions appropriate to the problem based on the interpretation of significant findings

 Core Competency 4:

Disseminates results of research findings

Indicators

• Shares/presents results of findings to colleagues / clients/ family and to others

• Endeavors to publish research

• Submits research findings to own agencies and others as appropriate

 Core Competency 5:

Applies research findings in nursing practice 

Indicators

• Utilizes findings in research in the provision of nursing care to individuals / groups / communities

• Makes use of evidence-based nursing to enhance nursing practice 10

9. Records Management

Core Competency 1:

Maintains accurate and updated documentation   of client care 

Indicators

• Completes updated documentation of client  care

• Applies principles of record management

• Monitors and improves accuracy, completeness and reliability of relevant data

• Makes record readily accessible to facilitate client care

 Core Competency 2:

Records outcome of client care 

Indicators

• Utilizes a records system ex. Kardex or Hospital Information System (HIS)

• Uses data in their decision and policy making activities

 Core Competency 3:

Observes legal imperatives in record keeping 

Indicators

• Maintains integrity, safety, access and security of records

• Documents/monitors proper record storage, retention and disposal

• Observes confidentially and privacy of the clients’ records

• Maintains an organized system of filing and keeping clients’ records in a designated area

• Follows protocol in releasing records and other information

 

10. Communication

 Core Competency 1:

Establishes rapport with client, significant others and members of the health team

Indicators

• Creates trust and confidence

• Spends time with the client/significant others and members of the health team to facilitate interaction 

• Listens actively to client’s concerns/significant others and members of the health team

 Core Competency 2:

Identifies verbal and non-verbal cues 

Indicators

• Interprets and validates client’s body language and facial expressions

 Core Competency 3:

Utilizes formal and informal channels

Indicators

• Makes use of available visual aids 

• Utilizes effective channels of communication relevant to client care management

 Core Competency 4:

Responds to needs of individuals, family, group and community

Indicators

• Provides reassurance through therapeutic touch, warmth and comforting words of encouragement 

• Provides therapeutic bio-behavioral  interventions to meet the needs of clients

 Core Competency 5: 

Uses appropriate information technology to facilitate communication

Indicators

• Utilizes telephone, mobile phone, electronic media 

• Utilizes informatics to support the delivery of healthcare

11. Collaboration and Teamwork

Core Competency 1:

Establishes collaborative relationship with colleagues and other members of the health team

Indicators

• Contributes to decision making regarding clients’ needs and concerns

• Participates actively in client care management including audit

• Recommends appropriate intervention to improve client care

• Respect the role of other members of the health team

• Maintains good interpersonal relationship with clients , colleagues and other members of the health team

 Core Competency 2:

Collaborates plan of care with other members of the health team

Indicators

• Refers clients to allied health team partners

• Acts as liaison / advocate of the client

• Prepares accurate documentation for efficient communication of services 

Medical Devices Every Hospital Uses

Stress System for Practicing Cardiology

The Quinton Q4500 Stress System is ideal for practicing cardiology. The device features a dedicated keyboard, large CRT screen, 7 user-definable treadmill and 3 user-definable ergometer protocols, which each include a resting stage and up to 99 exercise stages to measure the patient’s capabilities. Other features of the Quinton Q4500 include a menu/entry/control functions that are easily accessible and an oversized soft-touch exercise device control, which allows the treadmill or bicycle ergometer operation.

Autoclave for Sterilizing Objects

The Pelton & Crane Delta 10 Autoclave is specifically used for sterilizing objects and can be found in every hospital. The autoclave includes a sterile dry cycle and a 10 inch chamber and features filtered close door drying, electronic temperature and time controls and preprogrammed sterilization. Another important feature is the automatic chamber, which preheats to maximize productivity by shortening the cycle times. A digital function display is also a key component because it allows for accurate and easy monitoring of the sterilization cycle. 

Patient Monitor for Recording Blood Pressure

The Datascope Passport Patient Monitor includes ECG, SPO2 and non-invasive blood pressure and recorder. The monitor features a large screen for viewing at any angle of the operating room, adult finger sensor, ECG cable, blood pressure hose, standard adult cuff and recorder paper.

Surgical Lights for a Precision Work

The Skytron Stellar ST2323 is a popular brand of surgical lights that feature dual center-mounted light heads with focusable control and wall-mounted intensity control box. The surgical lights also feature advanced multi-lamp optics with vertically segmented reflector designs, light maneuverability, 360 degree movement of all points of rotation, intensity of up to 24,000 footcandles, 90 degree downward travel for low angle lighting and cool beam temperature.

Popular Defibrillators

The Philips Headstart XL is a popular brand for defibrillators and combines the technology of biphasic defibrillation, pacing, ECG and AED. The device uses voice prompts and text messages to guide the user through the process of defibrillation. The manual mode is also available and operates with 1-2-3 operation and can be easily switched from AED to manual mode. The defibrillator also features child and adult paddles in one, portability and synchronized cardioversion.

MRI

A Magnetic Resonance Imaging machine uses a powerful magnetic field, radio frequency pulses and a computer to obtain pictures of your soft tissues, organs, bones and other parts of your body. According to radiologyinfo.org, this machine gives a better picture than the X-ray and can determine whether or not certain conditions such as cancer, heart problems and liver disease are present.

Electrocardiogram

The electrocardiogram will provide your physician with a history of your heart rate. This information is used to determine whether or not the heart is functioning properly. It can also determine what effects certain medications have on your heart rate and detect any problems with the rhythm of your heart rate.

Urine Analyzer

A urine analyzer is used in most hospitals to assist in diagnosing any number of diseases and conditions. Conditions such as pregnancy, drug use, kidney/bladder infections, and urinary tract infections are some that can be detected with the urine analyzer

Automated external defibrillator

An automated external defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient, and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm. With simple audio and visual commands, AEDs are designed to be simple to use for the layman, and the use of AEDs is taught in many first aid, first responder, and basic life support (BLS) level CPR classes.

X-ray

Your doctor may order an X-ray to determine whether or not a bone is broken or there may be something lodged in your body after an accident. The X-ray machine is found in the radiology department and can determine any number of ailments. Patients are covered with a lead vest to protect against radiation while pictures of the affected area are being taken.