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ENDOSCOPY AND ITS’ NURSING INTERVENTION

Endoscopy is a process or procedure to visualize the GI tract of a person. It’s a fiberoptic instrument with the attachment of lights and camera for visualization and still pictures. This is modern and less invasive procedure to diagnose and or collect biopsy. Patient would not undergo surgical procedure though they will still have to get sedated using anesthesia for a twilight effect. There are several types of endoscopies such as: Arthroscopy – this is an insertion through the skin into the joint to diagnose arthritis and for rotator tear and repair. Bronchoscopy – an insertion through the mouth unto the bronchial tubes of the lungs for visualization. This is also use to stop bleeding and dilating the tube when bleeding and narrowing of tubes are present. Colonoscopy – this is inserted through rectum and up to the colon. Use to diagnose colon cancer and removing polyps to prevent colon cancer. Colposcopy – this is use to detect cervical cancer. Insertion is through vaginal opening to visualize the cervix. Cystoscopy – is use to for bladder visualization. Inserted through the urethra unto the bladder that will visualize the inside and outside part of the bladder to detect possible problem. ERCP/endoscopic retrograded cholangiopancreatography – use to visualize the stomach, liver, small intestine and the anatomy of pancreas to check problems and or cancerous cells. The insertion starts from the mouth, stomach, small intestine unto the pancreas. EGD / esophagogastroduodenoscopy – this insertion will start from the mouth and down to esophagus, stomach and into the duodenum of small intestine. This procedure will visualize the system and check possible diagnoses and biopsies. Laparoscopy – use to visualize peritoneal cavity. Insertion made through the belly button over the abdomen to diagnose infertility and or the removing of appendix. Laryngoscopy – insertion is done from the mouth unto the larynx to detect any abnormalities or cancer at the larynx. Mediastinoscopy – is an insertion to visualize the lungs to detect cancer cells and even the enlargement of lymph nodes. The scope will be inserted through the chest wall unto the space between the lungs. Proctoscopy- use to evaluate rectal bleeding, which is inserted through the anus for rectum evaluation. Thoracoscopy – this insertion is made through the chest wall unto the lungs for vision and to collect biopsies for cancer diagnoses. This is also considered useful for the removal of cancer cells, although not all lung cancers can be treated in this procedure. Standard procedure When undergoing endoscopy, the patient is required to have six to eight hours fasting, and additionally patient who will have a colonoscopy, laxative for cleaning the colon will be used to remove bowels. On the other hand: The Sigmoidoscopy It is another endoscopic procedure to visualize the rectum and sigmoid colon. When doing the procedure, the patient will be in the knee-chest position on the specialized table. This procedure will detect tumors, polyps, inflammatory and infectious diseases, fissures and or hemorrhoids. Nurse responsibilities before and during procedures Before the procedure nurses must make it sure that paper works such as consent form will be signed by the patient before the procedure to avoid law suit of assault and or battery. Likewise, to educate the patient about endoscopy including on how it is being done, the purpose of the procedure and its side effects. Patient must be guided by the nurse to knee-chest position, and tell the patient to relax and deep breath when feels the urgency to defecate as the scope passing through. After the procedure it is responsibility of the nurse to monitor bleeding especially when doing polypectomy or biopsy. General complication Because insertion of foreign material is done, perforations through the structure is expected as well as bleeding and the sedation effects. References Lewis, et.al. (2017). Medical Surgical Nursing 10th Ed. Elsevier, Inc. St. Louis, Missouri https://www.verywellhealth.com/endoscopy-description-and-preparation-513961 https://brooksidepress.org/giu/lessons/lesson-1-nursing-care-related-to-the-gastrointestinal-system/section-iii-diagnostic-procedures/1-23-endoscopy/?cn-reloaded=1

A PRESENTATION ON HOW TO PREPARE A HEALTHY FRUITS APPITIZERS

Chronic Stress And Why Most Nurses Are Unhealthy

First of all, having a healthy life style is always a choice because even if how much pressure you are as a nurse; a nurse who choose to stay healthy will always find ways to make her choices beneficial to her/him. However, some people get overwhelmed and feel the stressful situation as too much to bear, reason that some of them will eat too much or unhealthy foods. Hence: the elevation of cortisol hormones. In the real world of nursing, it is a stressful world. Imagine you are emphatically caring an ill person, whom you wish in your heart that the patient would not in pain. It totally affects to the nurse emotion. Likewise, the understaffing of nurses even CNA’s will make the nurses to work more days or time with overloaded number of workloads but with insufficient salary. Overwork underpaid. For these reasons, the nurses become physically, emotionally, financially and or socially stress and when you are stressful it literally affecting your body and mind system. Remembering the Anatomy and Physiology that in a stressful situation the sympathetic and parasympathetic nervous systems activated, which started with the senses that send messages to amygdala then hypothalamus and so on. With all this sending and perceiving stress messages it releases all types of hormones in our body that rapidly changes our physiologic and emotion till to the release of cortisol hormones that trigger hungers to us. And if these stressors are keep repeating, it will cause the nurses to experience a chronic stress. We know that in nursing world, stress will never be ended that is why we definitely exper

ience a chronic stress. The tendency to eat more and to have no time to work out are definite and will lead us get sick or unhealthy. So, what will going to do to improve the nurses’ health habits? Well, we need personal conviction and commitment first for a change to have a healthy life style. I said, conviction because once you believe that healthy habits mean healthy physique means free of pain, then you will start right away. Commitment because once you are committed to make a difference, you will never break it. But if you fail, you surely have a room to start all over. WAYS TO IMPORVE THE NURSE’S HEALTHY HABITS Relaxation: you don’t need to travel in order to relax. Deep breathing is one key. To have power nap of 20 minutes (love naps), being near with nature like walking with bare feet and etcetera Physical Activities: a 30 minutes dance won’t hurt, walking with dogs and or yoga, my new found exercise, the Hula Hooping for 20 minutes which accordingly, when doing hula hoops you seems already have swimming exercise, walking and or running. Social Supports and Emotion Supports: from friends, family and co-workers. why? Because human is socially inclined. It improves our mood. Eating healthy foods: eating complete set of go, grow, glow foods. Carbs, protein, vegetables and or fruits with small portion control. It will make your system balanced and fulfill satiety on your brain. Also, train your brain to eat healthy. Taking daily vitamins: we need multivitamins, D3, zinc and of course vitamin C to help absorbs the minerals we are taking. Enjoy your Nurse job! Reference https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response https://www.healthyfood.com/advice/10-ways-to-retrain-your-brain-for-weight-loss/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710609/

The Capitation Structure Is Not Helping The Enrollee But The Provider

What is capitation? In Fundamental Book by Taylor it says, is a fixed amount per enrollee of health plan and with Timby it says, a system with preset fee assign to the member with the aim of getting quality service. Really? If the insurer budget is 5k for instance, for the annual wellness check, mammogram, drug testing and others, then how much the facility would pay for the medical practitioners, such as Physicians, nurses, technicians and even to CNAs handling the care? I am sure that with all of these services the 5k dollars would not be enough, therefore the insurance enrollees would be paying the exist amount charge for the care service provided to the patient. However, the question above was, how might the health care facility cut down its in-hospital health care cost? For what, for the facility to profit more, or to avoid extra payments from the patient/enrollee? The capitation payment strategy is a fixed payment system that the facility can receive, regardless if the enrollees use it or not, the facilities accordingly will still get the money. And if the enrollees will use it, the health care facility will allocate the money as small or lower as possible in order to hold more money than spending the money for equipment and services. Perfect example is the use of IV tubing package. To cut the cost, the facility might be using the cheapest package but is not working properly with the patient. Or the facility might be sending the patient home even the problem is not completely resolve yet, to cut the room service fees, or might be putting the patient in a shared-ward to minimize room expenses. I am sure there are other ways that a facility would cut the cost down for them to earn more rather than providing quality care service for the enrollee, unless the patient is willing to pay the extra charge. SOURCES Taylor, et. Al. (2015). Fundamentals of Nursing 8th Ed. Wolters Kluwer Timby, B. (2017). Fundamentals Nursing Skills And Concepts 11th ed. Wolters Kluwer