Nica Andres

nursing4n00bs:

WOMEN’S HEALTH WEDNESDAY

Uterine Fibroids. What the heck are those, right?

They are benign tumors that grow in and around the uterine walls. In extremely rare cases (less than .1%) they lead to cancer. They come in all sizes (from the size of a pea to the size of an orange) and grow in all areas of the uterus - so their symptoms and treatments are dependent on size/location. 

Smaller fibroids are usually asymptomatic. They may never have to be treated. In other cases, the fibroid may place pressure on the bladder/bowel causing urinary retention/frequency or painful defecation and constipation. They may cause other symptoms such as back pain or painful/heavy menstruation. Rarely, they can interfere with ovulation which can lead to infertility. 

Fibroids are fairly common, especially in the African-American population and women in their later reproductive years. There is a correlation between patients with fibroids and patients with hypertension. They can be diagnosed by use of ultrasound or MRI and may even be palpated during a gynecological exam. Like with reproductive cancers, there’s no surefire prevention. 

As stated before, treatment varies on severity. Tumor-shrinking medications may be prescribed. One method of treatment is cutting off the blood circulation to the fibroids. Radiation can be used. Unfortunately, hysterectomies are typically the go-to treatment and may even be suggested for patients with asymptomatic fibroids - although I hope that in coming years this trend dies down and alternative, less invasive treatments take over. 

nursing4n00bs:

WOMEN’S HEALTH WEDNESDAY

Uterine Fibroids. What the heck are those, right?

They are benign tumors that grow in and around the uterine walls. In extremely rare cases (less than .1%) they lead to cancer. They come in all sizes (from the size of a pea to the size of an orange) and grow in all areas of the uterus - so their symptoms and treatments are dependent on size/location. 

Smaller fibroids are usually asymptomatic. They may never have to be treated. In other cases, the fibroid may place pressure on the bladder/bowel causing urinary retention/frequency or painful defecation and constipation. They may cause other symptoms such as back pain or painful/heavy menstruation. Rarely, they can interfere with ovulation which can lead to infertility. 

Fibroids are fairly common, especially in the African-American population and women in their later reproductive years. There is a correlation between patients with fibroids and patients with hypertension. They can be diagnosed by use of ultrasound or MRI and may even be palpated during a gynecological exam. Like with reproductive cancers, there’s no surefire prevention. 

As stated before, treatment varies on severity. Tumor-shrinking medications may be prescribed. One method of treatment is cutting off the blood circulation to the fibroids. Radiation can be used. Unfortunately, hysterectomies are typically the go-to treatment and may even be suggested for patients with asymptomatic fibroids - although I hope that in coming years this trend dies down and alternative, less invasive treatments take over. 

nursing4n00bs:

TRICKY THURSDAY

The ABCD side effects of Barbituates

• A - Ataxia
• B - Behavioral disturbances
• C - decrease in Concentration, Coma
• D - Depression, Drowsiness, Diplopia

nursing4n00bs:

YOUR WEEKEND NCLEX TIP

After hip replacement surgery, the patient should avoid these three positions until fully recovered:

• Bending more than 90 degrees at the waist (for example, bending over to pick something up)
• Internally rotating the leg
• Adducting the legs (including crossing one’s legs)

The device seen above helps to prevent the latter two positions from occurring during sleep

nursing4n00bs:

MED REVIEW MONDAY

Diocytl sodium sulfosuccinate aka Docusate is a widely used stool softener. It is also known by brand names Colace or Ex-Lax. The drug has emulsifying/surfactant properties, allowing it to break up fats. It also works by inhibiting absorption and increasing secretion in the small intestine. It is prescribed to treat acute constipation. I have seen this as a standard order for all recently delivered maternity patients. It is also given to patients receiving opioids, as constipation is a side effect. When taken in oral form, it may take 1-3 days to see results as opposed to the suppository or enema forms which may take 5-20 minutes. Side effects include diarrhea or stomach cramps, and rarely rectal bleeding.

Alternatively, the drug is used as a pesticide and to irrigate earwax. 

In the movie Girl, Interrupted Brittany Murphy’s character has an eating disorder and trades her meds with other patients for Colace in order to increase her intestine motility. 

nursing4n00bs:

MED REVIEW MONDAY

Zolpidem aka Ambien is hypnotic that works by potentiating the GABA neurotransmitter. It is used for the short term treatment of insomnia, however it is also prescribed as a muscle relaxant and anticonvulsant. The pill works quickly (within 15 minutes) so it should be taken shortly before going to bed. There have been many adverse cognitive reactions reported such as hallucinations (“Ambien dreams”), amnesia, and extreme cases of sleep walking (including sleep-eating and even sleep-driving). These side effects are worse in the elderly. Long term use of the drug may create a dependence, and abrupt discontinuation of use may cause delusions. Ambien is on its way to becoming the most popular drug used in date rape because of its quick action time and tasteless quality. New research reports that the drug evidently improves the reversal rate of aphasia in stroke victims. 

nursing4n00bs:

TRICKY THURSDAY

“One Heart and Two Lungs”

This saying serves as a reminder of Beta receptor activity. Beta-1 receptors are cardiac and Beta-2 receptors are airway. 

nursing4n00bs:

FACTOID FRIDAY

People of the Jehovah’s Witness denomination of Christianity don’t believe in receiving blood transfusions, even in life-or-death emergencies. This includes stores of their own blood taken in preparation for major surgery. They believe the act of ingesting blood is a violation of God’s law according to the Bible, and those who receive a transfusion may face expulsion from the religion. Blood products such as albumin or immunoglobulins are not absolutely prohibited and may be left to personal discretion. 

doctorswithoutborders:

Access to Essential Medicines: Ten Stories That Mattered in 2011

8. Stuck in The Middle: Drug Companies Push Up Prices for Patients in Middle-Income Countries

People living with HIV in middle-income countries like India, Brazil or Thailand are facing huge hikes in the costs of AIDS medicines—at a time when the pharmaceutical industry sees these countries as potentially lucrative markets for high-priced drugs, and “blockbuster” drugs go off-patent in wealthy countries.

This year, a number of drug companies confirmed an ongoing trend by refusing to extend standardized price discounts to middle-income countries—something which was previously routine practice. ViiV, Merck, Johnson & Johnson, and Abbott all now specifically exclude middle-income countries from standardized price discounts for some or all of their drugs. Countries are thus forced to negotiate on a case-by-case basis, which is likely to lead to higher prices.

This move ignores the fact that the majority of people in middle-income countries can’t afford to pay high prices for medicines. To add to the problem, these countries are now losing the support from global health mechanisms like the Global Fund.

Photo: India 2009 © Sami Siva

nursing4n00bs:

CELEBRITY SATURDAY

Impetigo is a skin infection usually seen in pre-schoolers and athletes who participate in skin-to-skin contact such as wrestlers. Symptoms include red sores that erupt and ooze, resulting in honey-colored crusts. The infection is very contagious, so patients should cover their sores with gauze or bandages and avoid allowing the infected area to come into contact with others, especially those with pre-existing skin conditions such as eczema. They should wash their hands often and linens should be washed separately. Itching will spread the infection. There are two types of impetigo: less-severe Bullous impetigo which is caused by the Staph bacteria, and Ecthyma, caused by the Strep bacteria with sores penetrating into the dermis layer of the skin. Mild cases of impetigo can be treated with bactericidal ointment such as neosporin, more serious cases should be treated with an oral antibiotic such as erythromycin. Children should be kept home from school until deemed non-contagious, usually after 24 hours of starting antibiotics. 

In Spring 2008, the late Amy Winehouse was diagnosed with an Impetigo infection.