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  • Acute Respiratory Failure

    Acute Respiratory Failure (ARF): – This disorder occurs when the lungs no longer meet the body’s metabolic
    needs.  It isn’t easily defined because it has many causes and variable
    clinical presentation.

    Cause:  Acute respiratory failure may develop in patients
    with Chronic obstruction pulmonary disease (COPD ) from any condition that
    increases the work of breathing and decreases the respiratory drive. 
    Conditions includes:  respiratory tract infection, bronchospasm, or
    accumulating secretions secondary t cough suppression.   Other
    causes of ARF in COPD include:

    Central nervous system (CNS) depression – head trauma or injudicious
    use of sedatives, narcotics, tranquilizers, or oxygen

    Cardiovascular disorders – myocardial infarction (MI), congestive
    heart failure (CHF), or pulmonary emboli

    Airway irritants – smoke or fumes

    Endocrine and metabolic disorders – myxedema or metabolic alkalosis

    Thoracic abnormalities – chest trauma, pneumothorax, or thoracic
    or abdominal surgery.

    Symptoms:

    In COPD patients with ARF: hypoxemia (deficient oxygenation of
    the blood) and acidemia affect all body organs.

    Altered respirations. Rate may be increased, decreased, or normal;
    respirations may be shallow, deep, or alternate between the two. Cyanosis
    may or may not be present. Auscultation of the chest may reveal crackles,
    rhonchi, wheezes, or diminished breath sounds.

    Altered mentation. The patient show evidence of restlessness,
    confusion, loss of concentration, irritability, tremulousness, diminished
    tendon reflexes, and papilledema.

    Cardiac dysrhythmias. Tachycardia (rapid heart rate), with increased
    cardiac output and mildly elevated blood pressure secondary to adrenal
    release of catecholamine, occurs early in response to low PaO2 (oxygen
    level). With myocardial hypoxia, dysrhythmias may develop. Pulmonary hypertension also occurs.

    Treatment:

    Antibiotic for infection

    Bronchodilators

    Steroids

    In COPD patients, ARF is an emergency that requires cautious
    oxygen therapy

    In significant respiratory acidosis persists, mechanical ventilation
    through an endotracheal or a tracheostomy tube may be necessary

    High – frequency ventilation may be used if the patient doesn’t respond
    to conventional mechanical ventilation

  • Acute Renal Failure

    Acute Renal Failure (ARF): – the sudden interruption of kidney function from obstruction, reduced
    circulation, or renal parenchymal disease. If untreated, it can progress
    to end-stage renal disease, uremic syndrome, and even death. ARF
    is usually reversible with treatment.

    Cause: Perenal failure is
    associated with diminished blood flow to the kidneys. The cause may
    be due to hypovolemia, shock, embolism, blood loss, sepsis, pooling of
    blood in ascites or burns, CHF, dysrhythmias, and tamponade.

    Intrinsic renal failure- cause may include;
    acute poststreptococcal glomerulonephritis, acute tubular necrosis, systemic
    lupus erythematosus, periarteritis nodosa, vasculitis, sickle cell disease,
    bilateral renal vein thrombosis, acute pyelonephritis, ischemia, or renal
    myeloma.

    Postrenal failure – is associated with
    bilateral obstruction of urinary outflow. The causes may include
    renal calculi, blood clots, tumors, benign prostatic hypertrophy, strictures,
    urethral edema from catherterization, and papillae from papillary necrosis.

    Symptoms:

    Oliguria (diminished urine secretion in relation
    to fluid intake)
    Anuria (complete suppression of urine formation
    by the kidney) -Rarely seen
    Anorexia
    Nausea
    Vomiting
    Diarrhea or Constipation
    Stomatitis
    GI bleeding
    Dry mucous membranes
    Uremic breath
    Headache
    Drowsiness
    Irritability
    Confusion
    Peripheral neuropathy
    Convulsion
    Skin dryness
    Pruritus
    Pallor
    Purpura
    Hypertension
    Dysrhythmias
    CHF
    Systemic edema
    Anemia
    Coma

    Treatment:

    Goals: To reestablish effective renal function
    (if possible), and to maintain the constancy of the internal environment
    despite transient renal failure.

    Supportive care: High in calories and low
    in protein, sodium and potassium diet, with supplemental vitamins and restricted
    fluids.

    Electrolyte monitoring is essential to detect
    hyperkalemia.

    Prevention of hyperkalemia: treatment may
    include – dialysis, sodium bicarbonate, and hypertonic glucose and insulin
    infusions.

  • Acne

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    Acne: Acne or pimples, are the terms used to describe
    a most common skin condition of an inflammatory nature. Acne is caused
    by the plugging up of the skin pores. Acne and pimples, are most
    common in adolescent boys, and can occur in both sexes. Acne usually
    begins at the beginning of puberty, or at a time when the hormonal glands
    are active, such as in pregnancy, and before menstruation. Acne is
    cause when the sebaceous glands within the hair follicles, or pores become
    plugged, The plug can cause the follicle to bulge causing what is called
    white heads, and if the top of the bulge becomes dark, it is known as Black
    heads. If the plug grows in size, it can cause the wall of the follicle
    to rupture, and normal bacteria and dead skin cells along with oil, can
    enter The skin and form a small infected area called, pustules, also known
    as pimples or zits. If the infected area lies deep within the skin,
    they may become large enough to form cysts.

    Cysts: Cysts are formed when oil underneath the follicle
    continues to grow and fill the affected area resulting in a soft
    raised area of the skin (a lump). cysts are not usually painful or discolored
    unless they become infected.

    Acne is not contagious, and is not caused by dirt or other external
    factors. Although dirt and oil left on the face can contribute
    to Acne. Acne is considered a hormonal disorder, and is considered
    to be a hereditary disorder. In the severe forms of acne cysts or absecess,
    scars can be produced.

    Acne Vulgaris affects 85% of the population who are between the ages
    of 12 and 25. It occurs primarily on the face, chest, and upper back.
    The cause is unknown, but there is a genetic factor. That is, the
    chance of getting it, and the severity tends to run in some families. Males and females get it at the same rate,
    however males tend to have more severe cases. This is because testosterone
    (male hormone) increases and estrogen (female hormone) decreases the amount
    of sebum (a fatty secretion of glands or sacs into the pore) produced.
    Factors that increase the chance of having acne are, thickening of the
    skin around pores, increased production of sebum and increased number of
    a specific bacteria (Propionibacterium acne’s) on the skin. Acne
    begins in the pores of the affected of skin. Sebum fills the pore.

    Again: There are two major types. In the first type, the
    sebum remains in the pore, and is called noninflamitory acne. If
    it remains open it is referred to as a blackhead. If it is closed
    it is called a white head. The second, referred to as inflammatory, the
    sebum remains in the skin pore, and the walls of the pore begin to thin
    and break down. When the sebum and bacteria enter the surrounding
    tissue it becomes inflamed ( red, swollen, and painful) and infected (bacteria
    growing in the tissue). If this happens close to the surface of
    the skin, it can cause severe scarring. If it occurs deeper in the
    skin, (areas the body has walled off from the surrounding tissue,
    in an effort to stop the the bacteria from spreading) abscess and cysts
    may occur.

    Treatments

    Acne tends to get better during the summer. This may be due to
    exposure to the sun.

    Antibiotics applied directly to the affected area, and over-the-counter
    medications containing benzoyl peroxide, salicylic acid, and/or tretinoin. These are considered the first line of defense, and
    used before moving on to oral (taken by mouth) antibiotics, sex hormones, and others.

    Some severe cases can be helped by surgery.

  • Folliculitis

    Folliculitis:  A bacterial infection of the hair follicle.  The infection may be superficial or deep .  Folliculitis causes pustule formation.  Folliculitis may also lead to the development of furuncles (Furunculosis), commonly called boils, or carbuncles (Carbunculosis), usually caused by Staphylococcus aureus.  It is exacerbated by irritation, pressure, friction, or perspiration.  Prognosis depends on the infection’s severity and on the patient’s conditions and ability to resist infection.

    Cause:  Most common bacteria is staphylococcus aureus.  Risk factors include poor personal hygiene, debilitation, diabetes, an infected wound elsewhere on the body, exposure to chemicals (cutting oils), and management of skin lesions with tar or with occlusive therapy, using steroids.

    Symptoms:

    In folliculitis:  pustules usually appear on the scalp, arms, and legs in children; on the faces of bearded men (sycosis barbae); and on the eyelids (sties).

    Pain

    In furunculosis:  may develop  hard painful nodules (furuncles).  Nodules commonly appear on the neck, face, axillae, and buttocks.  As they become enlarge after several days, they rupture, discharging pus and necrotic material.

    Pain

    Erythema and edema may persist for several weeks.

    In carbunculosis:  the patient develops extremely painful deep abscesses.  These drain through multiple openings onto the skin surface, usually around several hair follicles.

    Fever

    Malaise

    Treatment:

    Make sure the infected area is clean thoroughly with soap and water before applying medication.
    With all medications use as prescribed by your doctor.

    Topical antibiotics such as:  bacitracin and polymyxinb

    For recurrent infection:  systemic antibiotics.

    Furuncles may also require incision and drainage of ripe lesions after application of hot, wet compresses, and topical antibiotics after drainage.  (consult with your doctor)

    Carbunculosis requires systemic antibiotics.

  • Bumbo Baby Chair

    The Bumbo baby chair is the high chair that your little one will love to sit in; it also happens to be the chair that you can trust. Actually, the Bumbo baby sitter is specially designed for the infants who can manage to keep their head up. Infants of six weeks can keep their heads up; so, it will be appropriate to get the Bumbo baby seat for your baby around this time.

    Bumbo Baby Chair – The Design
    This chair is a soft and comfortable one that provides support to the baby’s sides and back. The passive restraints contribute greatly to keeping the baby from sliding forward. The chair can easily hold your little one, if the baby weighs in the range of nine to twenty two pounds.
    The baby should be finding itself quite comfortable in the Bumbo baby chair. The chair is made keeping in mind the posture of the babies. The little ones should be able to sit straight all by themselves in this special Bumbo baby chair. The chair develops the trunk control, which is essential for enabling the baby to sit up.

    The raised leg spaces in the chair enhances the flexibility of the baby’s knee and hip joints, this in turn decreases the strain on the spine of the baby. Orthopedists, pediatricians and physical therapists recommend the Bumbo baby chair for your baby due to its beneficial qualities; so, give your baby this privilege in its growing period.

    The Uses
    There is some good news for the concerned parents: the Bumbo baby seat is comfortable for the baby; at the same time, it is hygienic, safe and non-toxic. This baby seat has already won awards and accolades for sticking to the highest safety standards. The chair is made from low-density foam, which makes it easily portable and lightweight. You can easily clean the outer layer of the material.

    Bumbo baby chair can be used conveniently on any level surface and also keeps your baby occupied. You can make your baby sit in the chair and get engaged into some other activity for sometime, this way your mind will be free and your hands will be free too. This ensures maximum interaction and communication with your little one.

    Straps and fasteners make a baby uncomfortable and the Bumbo baby chair is without any of these discomforts. This chair is made in such a way that the baby’s own body weight is enough to hold the baby in place.

    If you want to give your little one the best of life, start as early as possible with the Bumbo baby seat.

  • California Birth Certificate

    The birth of a baby is always a joyous one and brings with it a whole new chapter in one’s life as well as greater responsibilities. The first thing one would have to do following the arrival of a baby is to obtain a record of birth. Each state has its own procedure and fees for issuing birth certificate. A California birth certificate can only be obtained through the mail and there is no provision to get the same personally through a local office over the counter. The request for the California birth certificate is to be sent to the state’s department of health services.

    The department also offers a rush or priority service, but this is only applicable to the mailing of the California birth certificate and not to the actual processing involved in issuing the certificate. Certified copies of a California birth certificate can also be obtained from the department and these could be of two types – a certified copy or a certified informational copy. All these involve the payment of specified fees and the submission of certain documents. The birth would first have to be recorded at the local level in the county where the birth took place.

    Registering to vote, and applying for a passport, are some of the procedures that require a birth certificate as proof of age and identity. A birth certificate can also be used as proof of identity in various dealings with financial institutions, the labor department, real estate matters and a host of other similar issues. The lower half of a birth certificate also contains other details such as race, occupation, and medical data. This information is not usually included in a certified copy of the birth certificate unless specifically requested by the applicant. When you apply for a California birth certificate or a copy you can also avail the use of a customer service number to look up the status of your application.

  • California Birth Certificates

    Identity theft is a common problem today. If someone obtains your social security number or birth certificate, they can open banking and credit card accounts in your name. You can end up in thousands of dollars of debt, with your credit status ruined. Many states are now making it more difficult to obtain a birth certificate to try to help prevent such identity theft.

    As of July 2003, there are two types of certified copies of California birth certificates. One is a certified copy. This is issued only to certain individuals because it can be used to establish identity. In accordance with California Health and Safety Code 102430, the following may request this certified copy:

    • The person listed on the birth certificate.
    • Anyone entitled to a copy of the birth certificate due to a court order or an attorney or licensed adoption agency that needs the certificate in order to meet the terms of Section 3140 or 7603 of the Family Code.
    • Members of law enforcement or a governmental agencies (as provided by law) who needs the certificate for official business reasons.
    • A child, grandparent, grandchild, brother, sister, spouse, or domestic partner of the person listed on the birth certificate.
    • An attorney representing the estate of the person listed on the birth certificate.
    • Anyone appointed by court to act on the behalf of the person listed on the birth certificate.

    If you have been given a power of attorney, you will need to provide a copy of that when requesting the certified copy. When requesting a certified copy, you must also submit a notarized Sworn Statement. This Sworn Statement includes your signature where you state that under penalty of perjury that you are authorized to receive this certified California birth certificate.

    California birth certificates can also be a certified informational copy. This has the words “Informational, not valid document to establish identity” stamped across it and these California birth certificates cannot be used to establish identity. However, it contains the same information that appears on the certified copy and you are not required to sign a Sworn Statement in order to get it.

    If you have additional questions about obtaining California birth certificates, call your local Department of Health Services.

  • The Earliest Signs of Pregnancy

    There are a few of the earliest signs of pregnancy that can easily be confused with a common sickness at first, especially morning sickness, which some women may start experiencing before they even have a missed period. After a few days of morning sickness many women will realize and start to consider the idea that they may be pregnant, but the first few days you may just think you have a common stomach bug or stomach flu. Another one of the earliest signs of pregnancy is a missed period, and this is usually the first sign that urges a woman to buy a pregnancy test, but the majority of the time a missed period is a good sign of pregnancy for a healthy female. Also if you notice that your breasts are beginning to swell and become very tender, this is another one of the earliest signs of pregnancy.

    END MORNING SICKNESS!!
    For a Happy Pregnancy

    There are many women that will notice different changes that could be another one of the earliest signs of pregnancy, such as the feeling of being wore out and tired all the time and this is due to the strain that a pregnancy puts on your body. Sometimes the woman will also feel bloated which can sometimes cause a woman to feel that she has her period approaching, but it is also one of the earliest signs of pregnancy that some women will experience. After a woman has one child she may remember the symptoms she felt when she first became pregnant, but there are also many times where a woman will have different signs and feelings than she may have had during a previous pregnancy, this is actually quite common. If you are planning and trying to get pregnant then you will probably know many of these early signs of being pregnant.

  • early signs of pregnancy

    END MORNING SICKNESS!!
    For a Happy Pregnancy

    All women experience a wide variety of both physical and emotional symptoms both during and after pregnancy. There are many early signs of pregnancy that can help you determine whether or not you may be pregnant. Of course, the most obvious of these is a missed period. If your period is more than a few days late, you may have a very good chance at being pregnant. Another one of the early signs of pregnancy is a general “feeling” that you are pregnant. We all know our bodies, and when something feels different, odds are it is. Listen to your body and if you suddenly feel more tired than usual, notice slight swelling, headaches, or tenderness in the breasts, you could be pregnant. Frequent urination and nausea in the morning when you awake are also early signs of pregnancy. Some women actually experience very strange, unexplainable cravings for certain foods, while others have sensitivity to aromas and smells all of a sudden. These symptoms are less common but do occur in many pregnant women.

    Since your body is going through humongous changes when you are pregnant, you may experience a great deal of early signs of pregnancy. Some other signs include strong and sometimes painful heartburn as well as constipation. If you don’t normally experience these things, they could also be early signs of pregnancy. Of course, bloating and weight gain, back pains, mood swings, and a higher body temperature than normal are also common signs. Be sure to check with your doctor and find out if you are pregnant for certain, as some of these symptoms may be indicative of other medical conditions. Once you’ve confirmed whether or not you are pregnant, you can begin your plans toward a new baby and a brand new member of the family.

  • Ectopic Pregnancy

    An ectopic pregnancy occurs when the embryo of a child does not completely reach the uterus. Instead, it embeds itself into the lining of the fallopian tube. Eventually in most cases, the embryo can cause bleeding to the mother, which can often expel the embryo, resulting in a miscarriage. In most pregnancies, the embryo is implanted in the uterus, but in an ectopic pregnancy, this is not the case. The cause of this happening is still not known, but there has been some speculation as to what may contribute to it such as smoking or other particular lifestyle choices, but none of them have been scientifically proven. Some other risk factors include age, the use of certain fertility drugs, perious sexually transmitted diseases (which can damage the reproductive organs), and any prior tubal damage. One of the most difficult things about an ectopic pregnancy is that it is hard to diagnose early on, since at the beginning stages there are little to no symptoms. However, as the embryo grows, the symptoms do begin to be more prevalent.

    Some of the most prominent symptoms of an ectopic pregnancy include vaginal bleeding, exceptional back pain, and severe cramping (more than normal). Some women can experience internal bleeding so it is essential that the problem is diagnosed as soon as possible to prevent any harm to the mother. Unfortunately, in cases like this, the embryo cannot and does not survive. At this point it is essential for the doctor to worry about the well being of the mother. If an ectopic pregnancy is treated early, the mother has a better chance of conceiving and having a child successfully the next time around. Since there is no real known cause, most women can usually try to get pregnant again with a fairly high success rate.