Your skin is the first line of defense for the body’s immune system. The average adult’s skin spans 21 square feet, weighs nine pounds, and contains more than 11 miles of blood vessels. So it would make sense to spend a few extra minutes in the morning or evening taking care of your body’s largest organ.
Dr. Marina Peredo, owner of Spatique Medical Spa in Smithtown, N.Y. and clinical professor at Mount Sinai School of Medicine, recommends that everyone should change their daily skin regimen when the weather changes — especially during the winter months. Not only is it cold outside, but the heat inside if your home can tend to dry out your skin. Here are a few recommended and helpful tips that you can implement in your everyday winter beauty routine.
1. Eat More Tomatoes
Since tomatoes are one of the biggest sources of lycopene — a powerful antioxidant — eating them can help protect your skin against sun damage. Even during the winter months, sun damage can still happen. Tomatoes help block UV penetration and prevent damage to vulnerable skin.
2. Use an Ointment Moisturizer
By using something that is oil based rather than water based you will create a protective barrier on your skin. “You can also look for lotions or creams containing humectants, including glycerine, alpha-hydroxy acids that attract moisture to your skin,” Paredo tells Medical Daily. By adding moisture to your skin, you’re preventing it from cracking and drying out which can lead to premature aging.
3. Don’t Forget Your Hands and Feet
Since your hands and feet have fewer oil glands the change of weather will cause them to become even drier. Try to use mild cleansers when washing your hands and avoid using hand sanitizers since the alcohol in many of them can dry skin out. If you’re stepping outside, don’t forget to protect your hands with gloves.
4. Use a Humidifier
A humidifier is a machine that reinfuses moisture into the air that typically evaporates in the winter. The lack of moisture could dry out your skin over time. Use the machine at 30 to 50 percent humidity and use it in rooms that you are most often in.
5. Take Shorter and Cooler Showers
Taking a cold shower can improve the blood circulation between organs and skin considerably. Increased circulation keeps your skin looking younger and will help to keep you warmer.
6. Drink Just As Much Water
One important tip that many doctors and health care professionals recommend is to stay hydrated. Many people feel that since they are not sweating or losing as much water as they would in the summer months that drinking water and staying hydrated is not as important. However, keep drinking your eight glasses of water per day, wear sunscreen, bundle up, and enjoy the winter.
Working the holidays is tough, especially if you’ve never had to do it before. But you will get through it, and you might even find out it’s not as bad as you thought.
5 Tips For the Newbie Nurse: Getting Through the Holidays
1. Focus on the positive
OK, so maybe you don’t get to eat turkey and stuffing this Thanksgiving, topped with some football and followed by a nap. But you’ve made some huge strides this year — you’re a NURSE. Holidays are important, but focusing on your accomplishments and your sense of pride makes just one day seem a little less essential. Keep in mind that your presence is very likely a shining light for patients going through a tough time.
2. But allow yourself to be sad
It’s a bummer. There’s no arguing that. For many of you new grads, it may the first time you’ve spent a holiday without your loved ones. If your family is local, you might be able to squeeze in an after shift dinner (or an after shift breakfast for you night nurses!). But if your family isn’t nearby, you may be missing out altogether. Either way, it’s OK to cry. Acknowledge your feelings — they’re valid and deserve your attention.
3. Do something small for yourself
Choose some way to treat yourself ahead of time and then follow through. It doesn’t have to be expensive or take a lot of time. What about a real bubble bath with candles and champagne? Make it special and celebrate you.
4. Create a fab holiday re-do
Missing out on you favorite holiday? Create your own re-do and out-do the original! Invite your favorite people and have all your traditional rituals, but add something new. Rules are made to be broken.
5. Share the day with a new kind of family — your colleagues
Your nursing (and physician and admin!) colleagues are the only ones who truly understand what you go through every day. And guess what? Everyone else you’re working with is also working the holiday. So no one ‘gets it’ better than they do. Relish in your new work family and celebrate the amazing group of people you work with.
Now that you are a registered nurse, you are ready to face the real world of giving quality nursing care. Aside from acquiring the much coveted duty uniform, shoes and apparel, you might be thinking how you can be protected while at work. Whether you are working with pay or not, it is of essential to be armed with potent protection against the hospital or community setting you will be able to encounter.
Hand washing frequently has been of essential importance. Aside from that, immunization is also important to stress especially for newly hired nurses. Yes, nurses are not exempted to undergo their usual clinical procedure – injections.
Here are some essential immunizations that must be attained.
- Hepatitis B vaccine – Since college days, it was clear that you won’t be able to pursue on clinical duty if you have not undergone such Hepatitis B vaccine. Let’s face it, anytime of the day nurses will be exposed to blood and other body fluids so it is important to protect yourself from any infection that those fluids can bring when in contact with the skin or open wound.
Boosters can also be importance if you have checked your titer. It is still a good practice to observe universal precaution even though you are already immunized. Having an injection might be a little painful but it will pay off, almost all foreign countries may require Hepatitis B vaccination for future applicants or even here in the Philippines. Having Hepatitis B infection can mean a career-ending situation.
- Tetanus Toxoid – Nurses and needle-prick or needle-stick injuries are favorite topics of research. Seminars sprouted left and right with this topic and how to prevent or lower the rate of needle-prick injuries. It is another way to be exposed to infectious agents especially when pricked with used needles. Some patients may have blood borne diseases that can easily be transmitted through needle-prick. Aside from that, needle-prick injuries might also pave way to infected wounds which can lead to tetanus.
Almost all of the hospitals may have protocols regarding needle-prick injuries. Some health care institutions may also shoulder the expenses when it comes to intervening cases of needle-prick injuries.
- Flu Vaccine – Nurses can be exposed to various health care settings and viral agents can be taken up into the respiratory tract. Aside from the stress and shifting hours of work, accumulated stress may exhibit physical symptoms such as flu. Having flu while working is totally uncomfortable and you might even need to take a day off in order to recuperate.
Good thing there are flu vaccines available upon doctor’s prescription and assessment. Complete assessment must be done also because allergic reaction may also occur. Anyway, getting a flu vaccine can ensure you a year round free from acquiring flu together with proper diet and hygiene.
- Pneumonia Vaccine – Specialized areas of clinical nursing may house patients with chronic ailments. Aside from intensive care units, the emergency room may also be another place wherein nurses are prone to various types of pneumonia. Pneumonia may initially pose as flu-like symptoms but may eventually need antibiotic intervention or even hospitalization upon proper diagnostic work-up.
From community-acquired pneumonia to hospital-acquired pneumonia, nurses are at high risk for exposure. Once again, taking time off from work may not only be a waste of money but also an increased working for nurses who will cover you from your duty hours. So it is also important to get an evaluation whether you are entitled to have a pneumonia vaccine.
These are just some of the important vaccines that can be done in order to strengthen acquired immunity against infectious and common diseases that can infect nurses in their workplace. It is still an important thing to note that before having an immunization, you must consult a physician first so that proper medical evaluation can be done in order to prevent allergic reactions and other untoward situations.
Good day fellow medical practitioners (and health conscious people as well). I’ve decided to keep this blog alive again. Message me if you want to request a specific topic. Thank you!
Nerve cells arranged in networks communicate information with one another through neurotransmission which is the conduction of electrical messages from neuron to neuron. The electrochemical messages cross the synapses between neural cells by way of special chemical messengers called neurotransmitters.Neurotransmitters are chemicals found and produced in the brain to allow the transmission of impulses from one nerve cell to the next across synapses. They aid in the conduction of information throughout the body. These chemicals fit into specific receptor cells embedded in the membrane of the dendrite that either fuel up or excite action in the cells (excitatory) or stop or inhibit an action (inhibitory). Presence or absence of these neurotransmitters can directly or indirectly have an effect on neurons in a specific portion of the brain. Thus, the levels of these chemicals in the brain have an effect to a person’s behavior.
Mechanism of Nerve Impulse
Nerve cell conduction or communication is an extremely rapid process which involves the following:
- The impulse moves through the nerve in a long and slender cellular part called the axon.
- As the impulse travels through the axon it travels the presynaptic membrane. It is in this area that neurotransmitters are released in the free space called the synaptic cleft.
- The receptors located in the postsynaptic membrane of another nearby neuron pick up the free flowing neurotransmitters.
- The molecule is adapted in the next nerve cell and the impulse continues to the next nerve cell until the message is relayed throughout the body.
What happens after neurotransmitters sent the information?
After they served their purpose of being released into the synapse and relaying the messages to the receptor cells, they are transported back from the synapse to the axon to be stored for later use which is a process called reuptake. If the neurotransmitters will not undergo reuptake, they will be metabolized and inactivated by enzymes, primarily monoamine oxidase.
This is the first neurotransmitter discovered which is found in the brain, spinal cord and particularly at the neuromuscular junction of the skeletal muscle of the peripheral nervous system. The mechanism of action of acetylcholine could either be excitatory or inhibitory. Acetylcholine is synthesized from dietary choline found in red meat and vegetables. Research and studies have linked the incidence of Alzheimer’s disease with decreased acetylcholine secretion in the neurons.
Physiologic Effects and Functions:
- Muscular stimulation – acetylcholine signals muscles to become active including the muscles of the gastrointestinal system.
- Controls the sleep and wakefulness cycle of a person. It has a part in scheduling the rapid eye movement (REM) sleep or dream.
Surgical removal of the entire uterus through an abdominal incision.
- A hysterectomy is indicated for a variety of conditions, including endometriosis, adnexal disease, postmenopausal bleeding, dysfunctional uterine bleeding, and benign fibromas or malignant tumors.
- For women in their childbearing years, this surgery, as with a vaginal hysterectomy, can be a devastating blow psychologically, since they may feel they have lost their primary sexual characteristic and therefore can no longer function as women.
- Supine, with arms extended on armboards.
- Lower transverse (Pfannenstiel), vertical, midline, or paramedian.
- Laparatomy pack and/ or transverse Lap sheet.
- Four folded towels
- Major Laparotomy tray or abdominal hysterectomy tray
- Self-retraining retractor
- Internal stapling instruments
- Basin set
- Needle counter
- Foley catheter with drainage bag
- Internal stapling
- After incising the skin, the incision is deepened through the subcutaneous tissue with the deep knife or cautery pencil.
- The fascia is nicked with the deep knife and incised using a curved Mayo dissecting scissors.
- Grasping one edge of the fascial margin with two or more Kocher clamps, blunt dissection separates the fascia from the underlying muscle.
- The muscle is divided manually. The peritoneum is then knicked with the deep knife, and the incision is lengthened with Metzenbaum scissors.
- A self-retraining retractor is placed in the wound, with moist lap sponges to protect the wound edges; the surgeon will “pack the bowel” away from the uterus with additional moist warm Lap sponges, and the operating table is placed in slight Trendelenberg position.
- The uterus is isolated by severing it from the uterine ligaments ans adnexa.
- The round ligaments of the uterus are ligated, divided, sutured, and tagged with a hemostat.
- To divide the ligaments, a curved Mayo scissors or scalpel is used. An internal stapling device can be used to free the uterus from the adnexa.
- The surgeon mobilizes the uterus to the level of the bladder.
- Using a Metzenbaum scissors and long tissue forceps, the surgeon separates the two structures by dissecting the peritoneal covering away from the bladder. This is called the bladder flap, and will be reattached (reperitonealized) later.
- Once the bladder has been separated from the uterus, mobilization is continued.
- At the level of the cervix, long Allis or Kocher clamps are placed around the edge of the cervix, and it is divided from the vagina using a long scissors or a long knife.
- If the ovaries are to be preserved, the ovarian ligaments is ligated and divided adjacent to the uterus.
- The uterosacral ligaments are ligated and divided, along with the cardinal ligaments.
- To close the wound, the surgeon begins by suturing the vaginal vault using an absorbable suture.
- The wound is irrigated with warm saline, and hemostasis is achieved.
- To close the peritoneum, the surgeon grasps the edges with several Kelly hemostats and the peritoneum is closed with a running suture.
Perioperative Nursing Considerations
- Foley catheterization is usually performed after the internal vaginal prep is completed but before the abdominal prep is begun.
- A sterilization permit may be required in addition to the operative permit.
- Instruments that have come in contact with the cervix and or vagina must be treated as contaminated and discarded into a basin that can be passed off the yield.
- Once the abdomen is opened, 4 x 4 Raytec sponges should be replaced by Lap sponges.
- If a free sponge has been placed in the vagina prior to closing, it is included in the sponge count and must be removed from the vagina before the count is correct and the patient leaves the room.
- Internal staples are usually contraindicated in severe cases of pelvic inflammatory disease or endometriosis.
This disease is said to be caused by a shortage of dopamine in relation to Ach in the basal ganglia of the brain. This disease is common among the elderly. It is characterized by hand tremors, slowness of movements, limb stiffness and gait/balance disturbances, As health care providers, it is our duty to provide health teachingsfor our patients that they can use once they are outside our care. The goal of the health teaching is to control the patient’s manifestations and lead a normal life.
If patient has slow movements, teach him/her to:
- Rock back and forth to start an activity.
- Count while walking.
- Visualize the intended movement.
- Maintain a wide based gait.
- Imagine stepping into an imaginary line when walking.
- Look up, not down when walking.
If patient experiences tremors, teach him/her to:
- Squeeze a small rubber ball.
- Lie down flat down on the floor and relax the body.
- Sleep on the affected side.
- Use both hands when accomplishing a task.
To avoid stiffness, teach patient to:
- Perform exercises/stretches daily.
- Exercise early in the morning because energy is at its highest level.
- If standing becomes difficult, exercise in bed.
- Avoid soft and low chairs.
To ensure safety, teach patient to:
- Always wear sturdy shoes.
- Use a walker/cane.
- Remove all clutter from the floor.
- Adequate lighting is always needed.
- Organize necessary items within an easy reach distance.
- Have grab bars installed in the bathroom.
For good communication:
- Exaggerate pronunciation of words.
- Finish the first word before saying another one.
- Speak in short but concise phrases.
- Face the listener.
- Pause after every few words.
If patient has trouble getting dressed, teach him/her to:
- Use button fasteners.
- Buy clothes that are easy to wear.
- Dress in front of the mirror.
To prevent aspiration, teach patient to:
- East slowly.
- Take small bites.
- Chew thoroughly and move food around the mouth.
- Swallow one bite before getting another.
- Eat in an upright position.
- Eat food rich in fiber.
- Avoid caffeine.
Parkinson’s disease can strongly affect the client’s activity of daily living but with the proper health teaching, they would be able to manage on their own or with little help.