Prevention and Nursing Management for Skin Cancer

Skin protects the body from injury and is a bulwark against bacterial infections, viruses, and fungi. Heat loss and heat storage arranged through vasodilation of skin blood vessels or sweat glands secretion. If skin surface is damaged then, an important body fluid will evaporate and electrolytes will be lost within a few hours.

There are several types of skin cancer. Skin cancer that forms in melanocytes (skin cells that make pigment) is called melanoma. Skin cancer that forms in squamous cells (flat cells that form the surface of the skin) is called squamous cell carcinoma. Skin cancer that forms in the lower part of the epidermis (the outer layer of the skin) is called basal cell carcinoma. Skin cancer that forms in neuroendocrine cells (cells that release hormones in response to signals from the nervous system) is called neuroendocrine carcinoma of the skin.

Sunlight is a major cause of skin cancer. Changes in the ozone layer caused by pollutants such as chlorofluorocarbon pollution, for those who got the ith therapy uses x-rays also cause skin cancer.

Increase in skin cancers are caused by changes in lifestyle, habits of people to sunbathe and do activities in the sun.

Another cause could be found, from skin cancer include:
  • Due to genetic factors.
  • Deficiency in the production of melanin pigment in the skin.
  • Coming into contact with certain chemicals, such as arsenic compounds, nitrate, coal, asphalt and paraffin.
  • Exposure X-ray and medical industries.
Skin tumors can be formed from different types of cells in the skin like epidermal cells and melanocytes. These tumors can be benign or malignant and can be localized in the epidermis or penetrate into the dermis and subcutaneous tissue.

Wet cell carcinoma incidence, based on the amount of melanin pigment in the epidermis and the old total direct exposure to the sun, the sailors and farmers for example, and are often exposed to the sun such as the face, head and neck.

Spectrum of sunlight, which are carcinogenic, are light wavelength range between 280-320 nm and other causes irradiation with light - x, facto genetic but such rare albino and xeroderma pigmentosum.
Spectrum of the sun is what makes skin burn and become damaged (skin color changes to brown).

Clinical Manifestations
  1. The form of skin disorders like moles, the shape is not symmetrical or the shape has no edges that are not equal to each other.
  2. Moles, who has more than one color color. Moles usually have a dark brown color. When seen have a dark brown color and looks to have some red, white, black or dice should be more vigilant.
  3. Moles uneven or faded.
  4. The mole with a diameter more than 6 mm should be checked.
  5. When the changes as painful inflamed bleed easily should consult a physician.

Skin Cancer Prevention
  1. Do not try to make the sun quickly yellowish brown skin, if your skin burn easily.
  2. Avoid unnecessary sun, especially when UV radiation occurs.
  3. Do not let sunburn because UV rays.
  4. Apply sunscreen skin protection preparations if you have to bask under the hot sun. This preparation will prevent the sun's harmful rays.
  5. Apply sunscreen preparations exposed to the sun again after a long time.
  6. Use a lip moisturizer containing ata ligloss reparat sunscreen with a high SPF number.
  7. Wear appropriate protective clothing (eg, hat, long-sleeved shirt).
  8. Do not use a heating lamp to make the skin a yellowish brown.

Skin Cancer Nursing Management

Because many skin cancers removed with excision of action, ran nurses are:
  1. Relieves pain and discomfort.
  2. Provision of appropriate analgesics.
  3. Relieves anxiety.
  4. Patient education and home care considerations.
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Nursing Diagnosis related to Endocarditis

Endocarditis is an infection of the heart valves or the inner membrane of the heart (endocardium). Most people who develop this condition already have heart problems and are over 50 years old, but it can occur at any age, including in children. Symptoms can include fever and chills, lethargy, loss of appetite, slow or rapid heart rate, increased breathing and a persistent cough. There are two types of endocarditis: infective and non-infective.

Some of the general symptoms of endocarditis can include:
  • Fever and chills
  •  Loss of appetite
  • Lethargy
  • Generalised aching throughout the body
  • Abnormal heart rhythms such as a slow heart rate or tachycardia (rapid heart rate)
  • Heart murmur
  • Increased breathing
  • Persistent cough.

The following conditions increase the risk:
  • a history of rheumatic fever or rheumatic heart disease
  •  prosthetic (artificial) heart valves
  • a congenital (present at birth) heart defect
  • a history of intravenous drug use
  • mitral valve prolapse (MVP)
  • diabetes
  • pregnancy

Nursing Diagnosis related to Endocarditis

1. Acute Pain related to
  • Inflammation of the myocardium or pericardium
  • Systemic effects of infection
  • Ischemic tissue (myocardium)

Possibility is evidenced by:
  • Chest pain, spreading to neck / back
  • Joint pain
  • Increased pain with deep inspiration, movement activities, position.
  • Fever, chills.


2. Activity Intolerance related to:
  • Inflammation and degeneration of myocardial muscle cells.
  • Restriction of cardiac filling / ventricular contraction, reduced cardiac output.
  • Toxin from the organism.
Possibility evidenced by:
  • Complaints weakness / fatigue / dyspnea with activity.
  • Changes in signs for activity.
  • Signs of chronic heart failure.

3. Risk for Decreased cardiac output related to:
  • Accumulation of fluid, in Pericardial sac (pericarditis)
  • Stenosis / valve insufficiency
  • Decrease in ventricular function or constricting
  • Degeneration of the heart muscle

Possibility evidenced by:
  • Not applicable for signs and symptoms make the actual diagnosis

4. Risk for Ineffective Tissue Perfusion related to:
  • Thrombus embolism / vegetation valve endocarditis secondary to

Possibility evidenced by:
  • Not applicable for signs and symptoms to make the diagnosis of actual

5. Knowledge Deficit: about condition / treatment can be related to:
  • Lack of information about the disease, how to prevent recurrence or complications

Possibility evidenced by:
  • Request for information
  • Failure to improve
  • Recurrence / complications that can be prevented
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Physical Examination and Examination Support for Rabies

Rabies is an acute infectious disease of the central nervous system in humans and mammals which have been fatal.

In humans theoretically, clinical symptoms consisted of 4 stages in a real situation is difficult to separate one from the other, namely:
  1. Nonspecific prodromal symptoms
  2. Acute encephalitis
  3. Brainstem dysfunction
  4. Coma and death

A variety of complications can occur in patients with rabies and usually occur in comatose. Neurologic complications can include increased intra-cranial pressure: abnormalities in the hypothalamus in the form of diabetes insipidus, syndrome of anti diuretic hormone abnormalities; autonomic dysfunction that causes hypertension, hypotension, hyperthermia, hypothermia, arrhythmias and cardiac arrest. Can be local or generalized seizures, and often in conjunction with arrhythmias and respiratory disorders. In the prodromal stage, common complications of hyperventilation and respiratory depression occurred in the neurological phase. Hypotension occurs due to congestive heart failure, dehydration and autonomic nervous breakdown.


Physical Examination of Rabies :

1. Respiratory Status
  • Increased respiratory rate
  • Tachycardia
  • Temperatures generally increased (37.9 ยบ C)
  • shiver

2. Nutritional Status
  • Difficulty in swallowing food
  • What is the patient's weight
  • Nausea and vomiting
  • Servings the meal was spent
  • Ntritional status

3. Status Neuro-sensory
  • Signs of inflammation

4. security
  • Convulsions
  • Weakness

5. Ego integrity
  • Clients feel anxious
  • Clients do not understand about the disease


Neurologic Physical Assessment:

1. Vital signs:
  • Temperature
  • Breathing
  • Heartbeat
  • Blood pressure
  • Pulse pressure

2. Fontanel head examination results:
  • Prominent, flat, concave
  • Common form of head

3. Pupillary Reaction
  • Size
  • Reaction to light
  • The similarity of response
4. Level of vigilance awareness:
  • The response to the call
  • Irritability
  • Lethargy and drowsiness
  • Orientation to self and others

5. Affect
  • Natural feeling
  • Lability

6. Seizure Activity
  • Type
  • Length

7. Sensory Function
  • Reaction to pain
  • Reaction to temperature
8. Reflex
  • Superficial tendon reflexes
  • Pathological reflexes


Examination Support of Rabies

There are few checks on rabies are:

1. Electroencephalogram (EEG): fatherly used to help define the type and focus of the seizures.

2. CT scan: using X-ray studies are more sensitive than normal to detect differences in tissue density.

3. Magnetic resonance imaging (MRI): generating shadows using a magnetic field and radio waves, useful to show areas of the brain that are not clearly visible when using a CT scan.

4. Positron emission tomography (PET): to evaluate persistent seizures and helped establish the location of the lesion, metabolic changes in the brain or blood alirann.

5. Laboratory Test
  • Lumbar puncture: fluid analyzed cerebrovascular
  • Complete blood count: evaluate platelet and hematocrit
  • electrolyte panel
  • Toxic screening of serum and urine
  • GDA
  • Blood Glucose: Hypoglycemia is a predisposition seizure less than 200 mq / dl
  • BUN: Increased BUN, has the potential for seizures and an indication of the nephrotoxic effect of drug administration.
  • Electrolytes: K, Na
  • Electrolyte imbalance predisposes to seizure
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