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Cleansweep RN

“Sometimes those things that attract the most attention to us are the things which afford us the greatest privacy." - Tom Robbins

The Right to Privacy refers to your right to be left alone. When something is private to a person, it usually means there is something within them that is considered inherently special or personally sensitive. The degree to which private information is exposed therefore depends on how the public will receive this information, which differs between places and over time. In contrast, invasion of privacy refers primarily to a public figure's right to be left alone by the media, not necessarily a physical intrusion into one's private property or personal space. Invasion of privacy charges are typically presented in a civil lawsuit against media that have crossed a perceived line into an individual’s private life, or have used his or her resemblance in an unauthorized public manner. There are several ways a person's right to privacy can be invaded. The most common privacy invasions recognized by law are as follows: False Light, this type of invasion of privacy occurs when an individual is falsely portrayed in a highly offensive manner. Disclosure of Private Facts, this type of invasion occurs when private or embarrassing facts are revealed about an individual without relation to a legitimate public concern. Intrusion, this is where someone intrudes upon a person in a situation in which that person has a reasonable expectation of privacy.

The most controversial video of invasion of privacy in the Philippines these days is on YouTube. The video was first aired last April 15 on the said website. It is a video of an operating room procedure conducted at Vicente Sotto Memorial Medical Center in Cebu City, wherein the medical practitioners removed a foreign object lodged in a patient’s rectum. The operation was for the removal of a perfume container that got stuck in the patient’s rectum after the patient admitted that he had a sexual encounter with a male partner. Issues of violation of patient confidentiality, hospital protocol and unprofessional conduct of medical staff are confronting the said hospital, which has so far withheld of the doctors and health care team involved. The hospital released its findings and recommendations even as its head was summed on to Manila for investigation. The said findings were, three doctors and one nurse in the medical team involved in the operation will face administrative case for possible violation of conduct and ethical standards; A clinical instructor alluded to by the staff who misbehaved was banned from the hospital and a student allegedly responsible for uploading the video to YouTube should be endorsed to his or her school for disciplinary action. According to the Philippine Medical Association (PMA) & Philippine Nurses Association (PNA), if the medical team who conducted the operation was found violating the code of ethics, the doctors and nurses could be expelled from the association. Basing on the SOP in each hospital, no one is allowed to take pictures or videos while the operation is going on unless it is with the consent of the patient and for educational purposes. We should follow and implement the policies of the hospital and respect the privacy of each individual undergoing an operation. It was stated in the code of ethics that we must protect the records and information of our clients. This is a lesson not only for nurses, doctors and other allied health team but for everybody.

jacko the great

Gastrointestinal Reflux Disease or GERD is a common term utilized today to describe the return of gastric (stomach) content into the esophagus. GERD is characterized by a cough, burning sensation in the stomach, chest, red, sore throat, and pain in the gastric region. Often patients with GERD will experience the presence of gastric content returning into the oral cavity (mouth) upon lying down at night. Common causes of GERD include caffeine, consuming large meals before bed, over eating, spicy or fatty foods, binding clothing, acidic drinks, lack of mastication with meal consumption, and constipation. Emesis (vomiting) is another common GI problem as well as a protective mechanism of the body. Emesis is the opposite action of normal peristalsis; food is not moved downward in the GI tract, instead it is propelled upward via the esophagus into the oral cavity and exits the mouth. The most common causes of emesis production include altered equilibrium, gluttony, viral or bacterial illness, and purposeful production for weight control as with bulimia or anorexia nervosa. Flatulence (intestinal gas) or flatus is a natural occurrence in the gastrointestinal tract. Intestinal gas is formed by bacteria and/or carbohydrates that have been ingested without proper mastication and have fermented in the GI tract. Individuals who are unable to tolerate or alter the mechanical structure of lactose have an increased production of gas in the intestinal tract as well.

Cleansweep RN

Case Study of the Week : Waardenburg Syndrome

Many of us are not familiar of with the word Waardenburg Syndrome; even we nurses are not quite familiar with this kind of disease. As I explore my medical dictionary, I found out what’s Waardenburg syndrome is. Waardenburg is an inherited deafness. Some experts called it as Klein-Waardenburg syndrome or Shah-Waardenburg syndrome. But I’m not contented with that explanation, so I decided to investigate more about this ailment and here are my findings. Waardenburg syndrome is a rare disease characterized by deafness in association with pigmentary anomalies and defects of neural crest-derived tissues. It is an inherited form of deafness accompanied by a characteristic white forelock of hair and multiple colors with in the irises of the eyes. It was considered a inherited disease as an autosomal dominant disease, when we say Autosomal dominant- it is a gene or corresponding characteristics whose effect is shown in the individual whether its allele (one or two alternative forms of gene) is the same or different. This disease was named after a Dutch ophthalmologist in the person of Dr. P. J. Waardenburg.

As I dig up the details of this ailment, I found out that it has six (6) main features. The following are the features of Waardenburg syndrome; first there is a lateral displacement of the medial canthi combined with dystopia (weakness of wasting) of the lacrimal puncta and blepharophimosis (small aperture between the eyelids); second, a prominent broad nasal root; third, a hypertrichosis (excessive growth of hair) of the medial part of the eyebrows; fourth, white forelock; fifth, heterochromia iridis (color difference in iris of eye) and last, deafmutism. Some experts have formulated hypothesis regarding this syndrome, they explained that there was a deficient neural crest theory, suggesting a developmental abnormality of the neural crest as a cause of the disease. Others believed that Waardenburg is a part of the first arch syndrome and the intrauterine necrosis theory. But some experts alleged none of these possibilities explains all features of this disease. They believed that inherited causes account for approximately 50% of individuals seen for childhood hearing loss, of which 70% are due to mutations in numerous single genes that impair auditory function alone. But one thing I’m really sure of, genes are the ones who is responsible for syndromic forms of hearing loss in Waardenburg syndrome which includes PAX3 on band 2q37, observed in types I and III, and MITF mapped on 3p12-p 14.1 for type II. This syndrome is autosomal dominant for most persons with types I, II, or III. Waardenburg type IV is autosomal recessive with variable penetrance.

According to studies children with Waardenburg syndrome have a usual life expectancy. Morbidity is related to deafness and to deficiency of neural crest-derived tissues, including mental retardation, seizures and eye disorders. Waardenburg syndrome affects people of the same sex in all races worldwide and can be recognized immediately or soon after birth. Histologic findings revealed that melanocytes are absent, or that only a few dihydroxyphenylalanine-positive cells are present. In other word the number of melanocytes on the edge of the leukodermas is reduced or missing who’s responsible for the pigmentation. So, how can we manage this? Is there a treatment on this disease? Early diagnosis and improvement of the hearing defect are most important for the psychological development of children with this disease. The depressing part of this is that there is no effective treatment available for persons with Waardenburg syndrome. Tolerance and understanding of persons with Waardenburg syndrome may help to support their integration into society. Other experts suggest that genetic counselling is a good idea for patients with this ailment.

Cleansweep RN
Case Study of the Week: Peptic Ulcer

When a physician verbalize about GI bleeding, he is usually not talking about an external wound that results in visible bleeding from one or more GI organs, but rather means something more specific. Bleeding in the gastrointestinal tract means that some part of the body represented in the diagram above is bleeding internally, either slightly which may or may not be very serious or heavily which may have serious health consequences. GI bleeding is not a disease, but a symptom of a disease. There are many possible causes of GI bleeding, including hemorrhoids, peptic ulcers, diverticulitis, ulcerative colitis and Crohn’s disease. The test used most often to look for the cause of GI bleeding is called endoscopy. It uses a flexible instrument inserted through the mouth or rectum to view the inside of the GI tract.

Peptic Ulcer is the most common GI disturbances nowadays. So, first we should know what is Peptic Ulcer? What are the signs and symptoms pertaining to this disturbance, and how can we prevent and manage this? Well, we will be acquainted with the answer as we deepen our discussion about this ailment. A Peptic Ulcer is a sore in the lining of your stomach or your duodenum, the first part of your small intestine. A burning stomach pain is the most common symptom. Most of patients manifest pain which may come and go for a few days or weeks. The pain is usually dull, gnawing ache which comes and goes for several days or weeks and occurs 2 to 3 hours after a meal. Most client complaint that they experienced pain during the middle of the night—when there stomach is empty and was relieved by eating or antacid medications.

But many people especially those who are not in medical field don't know the reason behind peptic ulcers. It happens when the acids that help you digest food damage the walls of the stomach or duodenum. The most common cause is infection with a bacterium called Helicobacter pylori, a type of bacteria that is responsible for the majority of peptic ulcers. They weaken the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause a sore, or ulcer. Another cause is the long-term use of non-steroidal anti-inflammatory medicines (NSAIDs) such as aspirin and ibuprofen. Stress and spicy foods do not cause ulcers, but it can worsen them. Management includes medicines to block stomach acids or antibiotics to kill ulcer-causing bacteria. Not smoking and avoiding alcohol can also help. Surgery may help for ulcers that don't heal.

How can we treat Peptic Ulcer Disease? Peptic ulcers are treated with drugs that kill the bacteria, reduce stomach acid, and protect the stomach lining. Antibiotics are used to kill the bacteria. Two types of acid-suppressing drugs might be used: H2 blockers and proton pump inhibitors. H2 blockers work by blocking histamine, which stimulates acid secretion in other hand proton pump inhibitors suppress acid production by halting the mechanism that pumps the acid into the stomach. Metrodinazole (antibiotic), Ranitidine (H2 Blocker), and Omeprazole (Proton-pump) are most common drugs used to treat ulcers. GI bleeding can be an emergency condition requiring immediate medical attention. Intravenous fluids and medications, blood transfusions, drainage of the stomach contents through a nasogastric (NG) tube, and other measures may be required. Once the condition is stable, a physical, including a detailed abdominal examination, will be performed.

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