Pediculosis features

· presence of nits (louse eggs which she attaches to hairs or fabric)

· skin itch

· scratches and impetiginous (pustule) crusts on the skin

Patient's personal regimen

The personal regimen is assigned by the doctor; the particular type depends on the patient's condition (severity of the desease) and character of the desease.

· Strict bed rest – the patient mustn't get out of or even move in his bed; the patient is aided by ward nurse and paramedical personnel (feeding, personal hygiene, using bedpan, etc.)

· Bed rest – patient isn't allowed to get out of bed, but may turn around and sit in it; the patient is aided by ward nurse and paramedical personnel (feeding, personal hygiene, using bedpan, etc.)

· Semi-bed rest – patient is forbidden to leave the ward; may sit in bed and on a chair to take food, make morning toilet. It is allowed to eat in a sitting position.

· Ambulation (ambulant regimen) – the patient is allowed to move freely around his ward and keep his personal hygiene himself inside the ward. Half of the daytime the patient may spend in sitting position.

· Open-ward ("free") regimen – the patient is allowed to move around the department and the hospital (corridors, stairways, hospital territory).

Determination of patient's condition

To do it the nurse should check:

· patient's general condition

· patient's position in bed

· patient's consciousness

· anthropometric data

Some variants of patient’s forced position

States of consciousness

Types of constitution

· Asthenic (Greek asthenes – weak, a – negation, sthenos - strength). Asthenic constitution is presented by the predominance of longitudinal body measurements over the cross ones. Such people are usually thin, limbs and chest are prolonged, epigastric angle is sharp; they have a tendency to intestine and duodenum ulcer, pulmonary tuberculosis.

· Hypersthenic type of constitution is characterized by the predominance of cross over longitudinal body proportions, chest is broad, epigastric angle is blunt. Such people have a tendency for metabolism disorders (fatty, carbohydrates), suffer from obesity, gout, atherosclerosis, coronary heart disease, arterial hypertension.

· Normosthenic type of constitution is characterized with proportionate ratio of longitudinal and cross parts, epigastric angle is even.

Main types of medical nurse documentation

· Logbook of patient rotation: registration of admission and discharge of patients

· Procedure list: list of doctor’s prescriptions for medicine and injections

· Temperature list: general data describing the patient’s condition: body temperature, pulse, blood pressure, respiratory rate, diuresis, body weight

· Journal of prescriptions: procedures prescribed by the doctor – laboratory diagnostics, medical procedures, visits to subspecialists

· Journal of control of drugs, drastic remedies and poisonous substances

· Journal of safe keys control

· Requirements for food: includes number of patients and their personal diets

· Journal of duties registration: number of all patients, their “rotation” during the day; number of patients with fever and severe forms of disease; violation of rules in the department, etc.

Inside-hospital (nosocomial, hospital) infection – infectious disease, which patients get during their stay at the hospital (medico-profilactic institution) after 48 hours from the admission or soon after the discharge (also after 48 hours), as well as medical workers, who take care and treat sick persons.

Risk groups

· hospital patients (infected inside the hospital)

· sick person, who come for help to medical institutions (day ward, dispensary, polyclinic) as well as call for emergency at home

· medical personnel (infected helping sick patients in hospitals or other medical institutions)

Inside hospitals there can be the following types of infection:

· purulent-septical infections (pyodermatitis)

· child diseases: measles, scarlet fever, German measles, diphtheria, epidemic parotitis, etc.

· virus infections: flu, virus hepatitis, HIV, etc.

· intestine infection, salmonellosis, amebiasis, shigellosis, etc.

· extremely dangerous infections: anthrax, plague, typhoid fever, etc.

Main causative agents of nosocomial infections are the following pathogens:

· obligate pathogenic microflora: microorganisms, that cause child infections – measles, diphtheria, scarlet fever, etc., intestine infections – salmonellosis, etc., hepatitis B, C and others

· opportunisticmicroflora: aurococcus, streptococcus,, blue pus rod, Escherichia coli, etc.

· Cytomegaloviruses, protozoa

Main risk groups for nosocomial infections:

· patients who are prescribed to do a lot of medical-diagnostical procedures

· patients with the chronical forms of the disease

· aged (old) patients

· patients with decreased immunity

Main rules of nosocomial infection prophylaxis:

· proper use and storage of protective clothes

· proper processing of personnel’s hands

· keepingof sanitary-epidemiological regime in the admission department: sanitary-hygienic processing, detection of pediculosis, thermometry, etc.

· sanitary-hygienic processing and control of patients in the departments

· disinfection of any medical tools

· sanitary regime of eating: cleaning food-storing, food-preparing rooms, removal of food wastes and control of food release dates. Active detection of patients who have contacted infected persons and may have got the infection

Disinfection (Lat. de - prefix, meaning “removal”, inficio – root, meaning “contaminate”) – complex of measures to eliminate vagetant forms of pathogenic and opportunistic microorganisms. There are two main types of disinfection:

· prophylactic disinfection – prevention of nosocomial infections

· nidal disinfection – disinfection in the detected nidus of the infection