PORTFOLIO

ADULT
HEALTH
NURSIN
BSN (Generic) 2nd
Session 2021-2024
Prepared & Composed By:
1
RUBAB MOHSIN
 COLLEGE OF NURSING,
KHAWAJA MUHAMMAD SAFDAR
MEDICAL COLLEGE
DISCIPLINE: (BSN GENERIC) 2nd PROF.
SESSION: 2021-2024

PORTFOLIO
(ADULT HEALTH NURSING)

Student name:
RUBAB MOHSIN
Roll no:

Subject:
ADULT HEALTH NURSING
Instructor:
Ma'am EMMA
Class:
BSN (Generic) 2nd Prof.

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STUDENT’S COVER LETTER

Name of student: RUBAB MOHSIN

Class: BSN (Generic) 2nd Prof.

Respected Madam,
I would like to submit my portfolio for your kind
guidelines. I included a variety of pieces in order to
display a wide breadth of my duties and interests. The
second piece I added, is to include in the portfolio, is
written in response to the events.
Thank you for paying special attention.

Dated: ___________ Yours Sincerely,

RUBAB MOHSIN
BSN (Generic) 2nd Prof.
Roll No.________

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First and foremost, I thank to ALLAH ALMIGHTY &
‫ّٰل‬
Prophet Muhammad ‫َص َّلى ٱل ُه َع َل ْي ِه َو آ ِل ِه َو َس َّل َم‬ to provide me a
chance for this education. I would like to thanks
Respected Principal . She gave us a good healthy
environment for study.
I would like to express my special thanks of gratitude to
my teacher of Adult Health Nursing . I really appreciate
the efforts of the honorable teachers for taking their
time to arrange the educational and informational field
visits & clinical visits in hospital. Their restless efforts
are undeniable and unforgettable as well.
I express my gratitude to all faculty members for
helping us to enhance our knowledge.

BSN (Generic) 2nd Prof.

Teacher Signature:___________

4
 TABLE OF CONTENTS
Serial Topic .Page No
No.

1. What is ADULT HEALTH 8

NURSING?

2. PROCEDURES IN ADULT 9
HEALTH NURSING

 Pathological Lab Test

3.  Biopsy 12
4.  Ultra Sound 14
5.  X-Ray 17
6.  INTRAVENOUS 22
PYELOGRAM (IVP)

7.  GESTRO-INTESTINAL 28
ENDOSCOPY

8.  CYSTOSCOPY 32
9.  CT SCAN 36
10. DISEASES 42

11. SUMMARY 55

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 ADULT HEALTH NURSING

Definition:

A program that prepares registered nurses to

provide general care for adult patients.
Includes instruction in adult primary care,
adult pathophysiology, clinical management of
medication and treatments, patient assessment
and education, patient referral, and planning

ADULT HEALTH NURSING 6

 PATHOLOGICAL LAB TEST

A pathology test is a test that examines samples of your

body's tissues, including your blood, urine, feces
samples obtained by biopsy. Doctors use this
information for diagnosis and treatment of diseases and
other conditions.
Types of Laboratory Test

 Sexually transmitted disease tests

 Lipid panel
 Complete blood count

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  Thyroid panel
 Urinalysis
 Lipid panel
 lipid panel help to find two type of cholesterol one
of them is high density lipoprotein, which is good
cholesterol for us and 2ND one is low density

Sexually Transmitted Disease Tests

Sexually transmitted diseases

may be diagnosed by
taking sample of blood and
sometime by urine, so
there is no surety that you
will get report
immediately. Sometime it
may take at detect the virus.
Complete blood count
This test is very important to find out the wide range of
disorder. This test may help you to measure different
feature of your blood like red blood cell, white blood
cell, platelets, hemoglobin.

Thyroid Panel Test

With the help of thyroid panel you can find out that

8
how your thyroid is producing. A thyroid is a tiny gland
in neck who regulate function like breathing.

Urine Analysis

Urinalysis is a test of your

urine. It's used to detect and
manage a wide range of
disorders, such as urinary
tract infections, kidney

disease and diabetes. A urinalysis involves checking the

appearance, concentration and content of urine.

9
 BIOPSY
Liver Biopsy

Liver biopsy is the biopsy from the liver. It is a medical

test that is done to aid diagnosis of liver disease, to
assess the severity of known liver disease, and to
monitor the progress of treatment.

Equipment
 Core biopsy

needle,
preferably 16
gauge, 11.5 cm.
 Povidone-iodine

solution.
 Formalin bottle (specimen container)

 Injection needle, 21 gauge, 3.75 cm.

 Injection needle, 25 gauge, 2.5 cm.

 Sterile drape(s)

 Saline solution (0.9%), 10-mL ampule.

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Procedure

Just before the procedure, you’ll change into a hospital

gown. Your doctor will give you a sedative through an
intravenous (IV) line to help you relax.

There are three basic types of liver biopsies:

Percutaneous. Also called a needle biopsy, this

biopsy involves putting a thin needle through the
abdomen and into the liver.
 Transjugular. This procedure involves making a

small incision at the neck. A thin, flexible tube is

inserted through the neck’s jugular vein and into
the liver. This method is used for people who have
bleeding disorders.
 Laparoscopic. This technique uses tube-like

instruments that collect the sample through a small

incision in the abdomen.
Nursing Management for Biopsy:

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 ULTRASOUND
An ultrasound scan is a medical test that uses high-
frequency sound waves to capture live images from the
inside of your body. It’s also known as sonography.
The technology is similar to that used by sonar and
radar, which help the military detect planes and ships.
An ultrasound allows your doctor to see problems with
organs, vessels, and tissues without needing to make an
incision.

Equipments
Ultrasound machines consist of:
 a computer console,
 video monitor and
 An attached transducer.
The transducer is a small hand-held device that
resembles a microphone. Some exams may use different

12
transducers (with
different capabilities)
during a single exam.

Procedure
 You will lie on a table,
exposing the area
that’s being viewed.
 A health care provider will spread a special gel on the

skin over that area.

 The provider will move a wand-like device, called a

transducer, over the area.

 The device sends sound waves into your body. The

waves are so high pitched that you can’t hear them.

 The waves are recorded and turned into images on a

monitor.
 You may be able to view the images as they are being

made. This often happens during a pregnancy

ultrasound, allowing you to look at your unborn baby.
 After the test is over, the provider will wipe the gel

off your body.

 The test takes about 30 to 60 minutes to complete.

In some cases, a pregnancy ultrasound may be done by

inserting the transducer into the vagina. This is most
often done early in pregnancy.

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Nursing Interventions
 Preparing patients for exams and treatment.
 Administering medications and treatments, then
monitoring patients for side effects and reactions.
 Creating, implementing, and evaluating patient care
plans with the medical team.
 Performing wound care, such as cleaning and
bandaging them.
 During the procedure the nurse must help the
endoscopist and, when indicated, the anesthetist.
 After the completion of the procedure, the nurse must
carry-on with the reprocessing of the endoscopic
instrument and of the devices.

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 X-RAY
Diagnostic X-ray, or radiography, is a special method
for taking pictures of areas inside the body. A machine
focuses a small amount of radiation on the area of the
body to be examined. The X-rays pass through the
body, creating an image on film or a computer display.

X-Ray Equipments
 The components of an X-ray diagnostic system are:
 the X-ray tube,
 X-ray generator,
 tube stand (support),
 examination table (patient support), and
 control unit; - accessories such as

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 cassettes,
 intensifying screens,
 and film;
 darkroom equipment and
 other supplies for processing the exposed film

How Are X-rays Performed?

 X-rays can be performed on an outpatient basis, or as
part of inpatient care.
 Although
each
hospital
may have
specific
protocols in
place,
generally,
an X-ray
procedure
follows this
process:
 The patient will be asked to remove any clothing or
jewelry which might interfere with the exposure of
the body area to be examined. The patient will be
given a gown to wear if clothing must be removed.
 The patient is positioned on an X-ray table that
carefully positions the part of the body that is to be x-

16
 rayed – between the X-ray machine and a cassette
containing the X-ray film. Some examinations may
be performed with the patient in a sitting or standing
position.
 Body parts not being imaged may be covered with a
lead apron (shield) to avoid exposure to the X-rays.
 The X-ray beam is then focused on the area to be
photographed.
 The patient must be very still or the image will be
blurred.
 The technician steps behind a protective window and
the image is taken.
 Sometimes,
various X-
rays may
have to be
taken at
different
angles, such
as the front
and side
view during
a chest X-
ray.
Nursing Interventions
 Before Chest X-ray

17
The following are the nursing interventions before chest
x-ray:
 Remove all metallic objects. Items such as jewelry,
pins, buttons etc can hinder the visualization of the
chest.
 No preparation is required. Fasting or medication
restriction is not needed unless directed by the health
care provider.
 Ensure the patient is not pregnant or suspected to
be pregnant. X-rays are usually not recommended for
pregnant women unless the benefit outweighs the risk
of damage to the mother and fetus.
 Assess the patient’s ability to hold his or her
breath. Holding one’s breath after inhaling enables
the lungs and heart to be seen more clearly in the x-
ray.
 Provide appropriate clothing. Patients are
instructed to remove clothing from the waist up and
put on an X-ray gown to wear during the procedure.
 Instruct patient to cooperate during the procedure.
The patient is asked to remain still because any
movement will affect the clarity of the image.

After Chest X-ray

The nurse should note the following nursing
interventions after chest x-ray:

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 No special care. Note that no special care is required
following the procedure
 Provide comfort. If the test is facilitated at the
bedside, reposition the patient properly.

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 INTRAVENOUS PYELOGRAM
(IVP)

Intravenous pyelogram (IVP) is an x-ray exam that uses

an injection of contrast
material to evaluate
your kidneys, ureters
and bladder and help
diagnose blood in the
urine or pain in your
side or lower back. An
IVP may provide
enough information to
allow your doctor to
treat you with
medication and avoid
surgery.

What is an Intravenous Pyelogram (IVP)?

An intravenous pyelogram (IVP) is an x-ray
examination of the kidneys, ureters and urinary bladder
that uses iodinated contrast material injected into veins.
An x-ray exam helps doctors diagnose and treat medical
conditions. It exposes you to a small dose of ionizing
radiation to produce pictures of the inside of the body.

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X-rays are the oldest and most often used form of
medical imaging.

When contrast material

is injected into a vein
in the patient's arm, it
travels through the
blood stream and
collects in the kidneys
and urinary tract,
turning these areas
bright white on the x-
ray images. An IVP
allows the radiologist
to view and assess the
anatomy and function of the kidneys, ureters and the
bladder.

What are some common uses of the procedure?

An intravenous pyelogram examination helps the
radiologist assess abnormalities in the urinary system,
as well as how quickly and efficiently the patient's
system is able to handle fluid waste.
The exam is used to help diagnose symptoms such as
blood in the urine or pain in the side or lower back.

21
The IVP exam can enable the radiologist to detect
problems within the urinary tract resulting from:

 Kidney stones
 Enlarged prostate
 Tumors in the kidney,
ureters or urinary
bladder
 Scarring from urinary
tract infection
 Surgery on the urinary
tract
 Congenital anomalies
of the urinary tract

How should I prepare?

How should I prepare?

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1. Your doctor will give you
detailed instructions on how
to prepare for your IVP
study.

2. You will likely be

instructed not to eat or drink
after midnight on the night
before your exam. You may
also be asked to take a mild
laxative (in either pill or
liquid form) the evening
before the procedure.

3. You may need to remove some clothing and/or

change into a gown for the exam. Remove jewelry,
removable dental appliances, eyeglasses, and any metal
objects or clothing that might interfere with the x-ray
images.

4. Women should always tell their doctor and

technologist if they are pregnant. Doctors will not
perform many tests during pregnancy to avoid exposing
the fetus to radiation. If an x-ray is necessary, the doctor
will take precautions to minimize radiation exposure to
the baby. See the Safety in X-ray, Interventional

23
Radiology and Nuclear Medicine Procedures page for
more information about pregnancy and x-rays.
What does the equipment look like?
This exam typically uses a radiographic table, one or
two x-ray tubes, and a video monitor. Fluoroscopy
converts x-rays into video images. Doctors use it to
watch and guide procedures. The x-ray machine and a
detector suspended over the exam table produce the
video.
How does the procedure work?
X-rays are a form of
radiation like light or radio
waves. X-rays pass
through most objects,
including the body. The
technologist carefully
aims the x-ray beam at the
area of interest. The
machine produces a small
burst of radiation that passes through your body. The
radiation records an image on photographic film or a
special detector.

In an IVP exam, an iodine-containing contrast material

is injected through a vein in the arm. The contrast
material then collects in the kidneys, ureters and

24
bladder, sharply defining their appearance in bright
white on the x-ray images.
How is the procedure performed?

You will lie on the table

and still x-ray images are
taken. The contrast
material is then injected,
usually in a vein in your
arm, followed by
additional still images.
The number of images
taken depends on the
reason for the
examination and your
anatomy.

You must hold very still and may need to hold your
breath for a few seconds while the technologist takes
the x-ray. This helps reduce the possibility of a blurred
image. The technologist will walk behind a wall or into
the next room to activate the x-ray machine.

GESTRO-INTESTINAL
ENDOSCOPY

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Introduction
An endoscopy procedure involves inserting a thin,
flexible tube called an endoscope down your throat and
into your esophagus. A tiny camera on the end of the
endoscope lets your provider examine your esophagus,

stomach and the beginning of your small intestine, also

called the duodenum.
Equipments
Endoscopy is a nonsurgical procedure used to examine
a person’s digestive tract. Using an endoscope, a
flexible tube with a light and camera attached to it, your
doctor can view pictures of your digestive tract on a
color TV monitor.
Endoscopy System
 Camera
processor

26
  Monitor
 Light source
 Video recorder
 Video printer
 Suction system
 E.S.U
 Trolley with hanger
 Endoscope
 Endo-accessories

Procedure
 Explain the procedure to the patient. Allay any fears
and allow the patient to verbalize any concerns.
 Obtain informed consent for this procedure.
 Keep the patient on nothing by mouth (NPO) status
for 4 to 8 hours before the test to reduce the risk of
aspiration.
 Instruct the patient to perform good mouth care to
minimize the risk of Introducing bacteria into the
lungs during the procedure.
 Remove and safely store the patient’s dentures,
glasses, or contact lenses Before administering the
pre-procedural medications.
 Administer the pre-procedural medications as
ordered. Atropine may be used to prevent vagal-
induced bradycardia and to minimize secretions.

27
 Meperidine may be used to sedate the patient and
relieve anxiety.
 Reassure the patient that he or she will be able to
breathe during this procedure. Instruct the patient not
to swallow the local anesthetic sprayed into the

Throat. Provide a basin for expectoration of the

lidocaine.
Nursing Interventions

 Answering patient questions and addressing their

concerns.
 Observing patient vital signs.
 Sedating patients before procedures.
 Recovering patients after procedures.
 Administering the necessary medication to patients.

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 Keeping the patient informed throughout the
duration of the procedure.
 Completing all necessary documentation including
patient notes and discharge documents.
 Preparing the instruments, equipment, and supplies

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 CYSTOSCOPY
Cystoscopy is a procedure that allows your doctor to
examine the lining of your bladder and the tube that
carries urine out of your body (urethra). A hollow tube

(cystoscope) equipped with a lens is inserted into your

urethra and slowly advanced into your bladder.
Urologists use cystoscopies to diagnose and treat urinary
tract problems. A cystoscopy can diagnose:
 Bladder cancer or urethral cancer.
 Bladder stones.
 Bladder control problems.
 Enlarged prostate (benign prostatic hyperplasia).
 Urethral strictures and urinary fistulas.
 And UTIs.

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Equipments
Basic setup for rigid cystoscopy requires an endoscope,
light source andirrigation fluid.Irrigation fluid includes
normal saline,
glycine or
sterile water.
In the
absence of an
endoscopic
camera the
surgeons
views the image directly through the optical eyepiece at
the proximal end of the instrument.
Cystoscopes are manufactured in a variety of sizes
expressed in French (Fr) gauge. One French gauge
denotes an instrument circumference of 1/3 mm. Rigid
cystoscopes are manufactured in sets consisting of an
optical lens, bridge, sheath, and visual obturator. The
typical scope sizes used in adults are 20 and 22 Fr. The
optical lenses come with tip angles ranging from 0° to
120°. The bridge connects the optical lens to the sheath,
and usually has one or two working channels.

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Procedure
A cystoscopy
may feel
uncomfortable,
but anesthesia
keeps you from
feeling pain. A
diagnostic
cystoscopy
usually only
takes about five
minutes, but may
take a little
longer. If you’re
having a biopsy
or treatment, the procedure may take longer.
During a cystoscopy, your doctor:
 Slides a lubricated cystoscope through the urethra to
the bladder.
 Injects sterile salt water through the cystoscope into
the bladder. A stretched, full bladder makes it easier to
see the bladder lining. You may feel like you need to
pee.
 Looks at the inside of the bladder and urethra.
 Inserts small instruments through the cystoscope. Your
provider uses these tools to remove tissue samples or
tumors, if needed.

32
 Drains the injected liquid from the bladder or asks you
to empty your bladder in the restroom.
Nursing Interventions
Before and During Cystoscopy
 Obtain valid
consent for the
procedure
 Blood and urine
studies
 x-rays of the
kidneys, ureters,
and bladder, may
be performed
before cystoscopy.
 The nurse describe the examination to patient and his
family with doctor:
 A cystoscope typically lasts from 10-40 minutes
Expect any blood in the urine to clear up in one to two
days.

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 CT SCAN
 How Do CT Scans Work?
 How Are CT Scans Done?
 What Is It Used For?
 What Is a CT Scan with Contrast?
 Are There Any Risks?
A computed
tomography (CT
or CAT) scan
allows doctors to
see inside your
body. It uses a
combination of X-
rays and a
computer to create
pictures of your
organs, bones, and
other tissues. It
shows more detail
than a regular X-
ray.
You can get a CT scan on any part of your body. The
procedure doesn't take very long, and it's painless.
How Do CT Scans Work?
They use a narrow X-ray beam that circles around one
part of your body. This provides a series of images from
many different angles. A computer uses this information

34
to create a cross-sectional picture. Like one piece in a
loaf of bread, this two-dimensional (2D) scan shows a
“slice” of the inside of your body.
This process is repeated to produce a number of slices.
The computer stacks these scans one on top of the other
to create a detailed image of your organs, bones,
or blood vessels. For example, a surgeon may use this
type of scan to look at all sides of a tumor to prepare for
an operation.
How Are CT Scans Done?
You'd probably get a scan at a hospital or radiology
clinic. Your doctor might tell you not to eat or drink for a
few hours before the procedure. You may also need to
wear a hospital gown and remove any metal objects, such
as jewelry.
A radiology technologist will perform the CT scan.
During the test, you’ll lie on a table inside a large,
doughnut-shaped CT machine. As the table slowly
moves through the scanner,
the X-rays rotate around your
body. It’s normal to hear a
whirring or buzzing noise.
Movement can blur the image,
so you’ll be asked to stay very
still. You may need to hold
your breath at times.
How long the scan
takes will depend on

35
what parts of your body are being scanned. It can take
anywhere from a few minutes to a half-hour. In most
cases, you’ll go home the same day.
What Is It Used For?
Doctors order CT scans for a long list of reasons:
 CT scans can detect bone and joint problems, like
complex bone fractures and tumors.
 If you have a condition like cancer, heart
disease, emphysema, or liver masses, CT scans can
spot it or help doctors see any changes.
 They show internal injuries and bleeding, such as
those caused by a car accident.
 They can help locate a tumor, blood clot, excess
fluid, or infection.
 Doctors use them to guide treatment plans and
procedures, such as biopsies, surgeries, and radiation
therapy.
 Doctors can compare CT scans to find out if certain
treatments are working. For example, scans of a
tumor over time can show whether it’s responding
to chemotherapy or radiation.
What Is a CT Scan with Contrast?
In a CT scan, dense substances like bones are easy to see.
But soft tissues don’t show up as well. They may look
faint in the image. To help them appear clearly, you may
need a special dye called a contrast material. They block

36
the X-rays and appear white on the scan,
highlighting blood vessels, organs, or other structures.
Contrast materials are usually made of iodine or barium
sulfate. You might receive these drugs in one or more of
three ways:
 Injection: The drugs are injected directly into a vein.
This is done to help your blood vessels, urinary
tract, liver, or gallbladder stand out in the image.
 Orally: Drinking a liquid with the contrast material
can enhance scans of your digestive tract, the
pathway of food through your body.
 Enema: If your intestines are being scanned, the
contrast material can be inserted in your rectum.
After the CT scan, you’ll need to drink plenty of fluids to
help your kidneys remove the contrast material from
your body.
Are there any risks?
CT scans use X-rays, which produce ionizing radiation.
Research shows that this kind of radiation may damage
your DNA and lead to cancer. But the risk is still very

37
small -- your chances of developing a
fatal cancer because of a CT scan are about 1 in 2,000.
But radiation’s effect adds up over your lifetime. So your
risk increases with every CT scan you get. Talk to your
doctor about the procedure’s potential dangers and
benefits, and ask why the CT scan is necessary.
Ionizing radiation may be more harmful in children.
That’s because they’re still growing. They also have
more years to get exposed to radiation. Before the
procedure, you may want to ask the doctor or technician
if the CT machine’s settings have been adjusted for a
child.
Tell your physician if you’re pregnant. If you need
imaging for your stomach area, your doctor may
recommend an exam that doesn’t use radiation, such as
an ultrasound.
What are the side effects?
Some people are allergic to the contrast materials. Most
of the time, the reaction is mild. It can lead to itchiness or
a rash. In very few cases, the dye may trigger a life-
threatening reaction. For this reason, your health
care provider may want to monitor you for a short period
after your CT scan. Tell your doctor about
any allergies you have to medications, seafood, or iodine.
Your doctor should know, too, if you have diabetes and
are taking the drug metformin. They’ll let you know if

38
you should stop taking your medication before or after
your procedure.
Although it’s rare, contrast materials can lead
to kidney problems. Let your doctor know if you have
any kidney issues before the CT scan.

39
 ASTHMA
What is ASTHMA?
Asthma is a chronic inflammatory disorder of the airways.
The chronic inflammation causes an increase in the airway
hyper-responsiveness that leads to recurrent episodes of
wheezing, breathlessness, chest tightness and cough,
particularly at night or early in the morning.

ETIOLOGY:
 Family history
 Allergies
 Viral respiratory infections
 Occupational exposures

40
  Smoking
 Air Pollution
 Obesity

Clinical manifestations of asthma:

 Wheezing
 Dyspnea
 Cough
 Chest Tightness
 Expiration may be prolonged
 Secretions may be white, thick, tenacious, gelatinous
mucus.

PATHOPHYSIOLOGY OF
ASTHMA

41
42
DiAGNOSIS OF ASTHMA
 History
 Physical Examination
 PFT (Pulmonary Function Tests)
 Peak Expiratory Flow Rate
 Chest X-ray
 ABG or Oximetry
 Allergy skin testing
 Blood level of eosinophils and IgE

Management & Treatment

Prevention and long-term control are key to stopping asthma
attacks before they start. Treatment usually involves learning
to recognize your triggers, taking steps to avoid triggers and
tracking your breathing to make sure your medications are
keeping symptoms under control. In case of an asthma flare-
up, you may need to use a quick-relief inhaler.

Medications
The right medications for you depend on a number of things
— your age, symptoms, asthma triggers and what works best
to keep your asthma under control.

Preventive, long-term control medications reduce the swelling

(inflammation) in your airways that leads to symptoms.
Quick-relief inhalers (bronchodilators) quickly open swollen
airways that are limiting breathing. In some cases, allergy
medications are necessary.

43
Long-term asthma control medications,

Inhaled corticosteroids.

 Leukotriene modifiers.
 Combination inhalers.
 Theophylline.
 Quick-relief (rescue) medications
 Short-acting beta agonists.
 Anticholinergic agents.
 Oral and intravenous corticosteroids. .

44
NURSING Management

 Check oxygen status

 Listen to lungs
 Assess for respiratory distress
 Position patient upright
 Administer medications as prescribed

45
46
 GLAUCOMA

Definition:
Glaucoma is a group of eye diseases that result in damage to
the optic nerve (or retina) and cause vision loss.

Types of glaucoma:
There Are Two Types of Glaucoma

1-Angle Closure Glaucoma

2-Close Angle Glaucoma

47
Open angle glaucoma:
In open-angle glaucoma, the trabecular meshwork offers
increased resistance to fluid outflow. This causes the pressure
to build up inside your eye.

Close angle glaucoma:

In closed-angle glaucoma, both the uveoscleral drain and the
trabecular meshwork become blocked.

Pathophysiology of glaucoma:
The main problem or pathology in glaucoma is caused by
raised intraocular pressure. It is this raised pressure that
compresses and damages the optic nerve. Once the optic nerve
is damaged, it fails to carry visual information to the brain and
this result in loss of vision.

Causes of increased intraocular pressure

Normally the aqueous humor plays an important role in
nutrient delivery and waste disposal for the cells. It is
produced by the ciliary body epithelium and drains out

48
through the trabecular meshwork at the anterior chamber
angle. When this flow is disrupted the pressure within the eye
builds up. This disruption can occur in two ways:-

Blockage at the drainage at the trabecular meshwork (in open

angle glaucoma)

Narrowing of the angle of drainage (in angle closure)

Clinical manifestations of glaucoma:

 No symptoms in early stages
 Gradually, patchy blind spots in your side vision. Side
vision also is known as peripheral vision
 In later stages, difficulty seeing things in your central
vision
 Severe headache
 Severe eye pain
 Nausea or vomiting
 Blurred vision
 Halos or colored rings around lights
 Eye redness

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Diagnosis
Your provider may perform several tests, including:

 Measuring intraocular pressure, also called tonometry

 Testing for optic nerve damage with a dilated eye
examination and imaging tests
 Checking for areas of vision loss, also known as a
visual field test
 Inspecting the drainage angle, also known as
gonioscopy

Management and treatment :

Eye drops/Medication:
Prescription eye drops decrease fluids and increase
drainage to alleviate eye pressure. There are many types of
eye drop medications that can be used for this condition.
Because glaucoma is a lifelong condition, you may need to
use daily eye drops for life.

Laser treatment:
Your eye doctor uses a laser (strong beam of light) to help
improve fluid drainage from your eye. While the laser can
complement the use of eye drops, it may not replace it
completely. The results from laser treatments vary, but can
last up to five years. Some laser treatments can also be
repeated.

Surgery:
Surgery is another way to help reduce eye pressure. It is
more invasive but can also achieve better eye pressure

50
 control faster than drops or laser. Surgery can help slow
down vision loss, but it can’t restore lost vision or cure
glaucoma.

Nursing intervention:
 Instruct client regarding the type of glaucoma and
treatment plan.
 Emphasize the importance of monitoring vision.
 Instruct client regarding the daily use, timing, and
purpose of eye drop administration.
 Darken the environment.
 Apply cool compresses to the forehead.
 Provide quiet space.
 If surgery is performed, instruct the client to avoid
sudden head movements, coughing, and bending down
because these can increase IOP; wear an eye shield at
night to protect the operative eye; take the stool softeners
and increase fluids to avoid straining at stool.

TEACHING CARE PLAN FOR CLIENT

 Name Fatima begum

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Treatment Nutrition Exercise Lifestyle Follow up

Medications Adequate fluid ADL Hygiene Follow up

 Tab levo floxacin  Fluid intake Activities Have  Prescription
should be of daily life enough
(750mg) should be
adequately should be sleep
 Tab administer moderate Prevention followed to
 Adequate to restrict from
amlodipine(oral) maintain
nutrition the on IOP watching
 2%pilocarpine ed  Fluid should TV or recovery
contain all other
 Diflupredinate period or
essential electronic
eye drop nutrients to devices minimize
fulfill body Keep eye
requirement clean the
 Avoid irritants Wash eye problem
 Avoid food or with warm
fluid irritants water
 Minerals such
as
Ca+,phosphate
should be low
in diet.

 Age 40y  Problem Acute glaucoma

 Gender Female
 Date 09-08-2022
 Registration reference
12105004

52
53
 SUMMARY

During my entire session of BSN (Generic) 2nd year session

(2021-2024) I learnt about the different procedures and
diseases. Not only did I acquire the knowledge about Adult
Health Nursing and different caring techniques of
Adult Health Nursing in my portfolio but also I have included
all above mention objectives. I learnt about the roles and
responsibilities of a professional adult health nurse. I done
case studies and read books along with researches and
references to complete this task. All these efforts elaborated in
this Portfolio.

Yours Obediently,

RUBAB MOHSIN

Roll Number: ____________________

BSN (GENERIC) 2nd Prof.

College of Nursing, GTHS, Lahore

54
 REFERENCES

 Burner and suddarths text book of medical and

surgical nursing ,12th edition.
 Robbins and coria ,pathological basis of disease ,
8th edition
 Health Information Centre Mayo Clinic Org.
 Adult Health Nursing made Incredibly Visual!
Lippincott Williams & Wilkins, 2007.
 Wikipedia , the free encyclopedia
 https://www.brightfocus.org/asthma/article/creating-
asthma-treatment-plan
 https://www.brightfocus.org/glaucoma/article/
creating-glaucoma-treatment-plan

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