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Touch For God hath not given us the Spatial orientation)

II Timothy 1:7

spirit of fear, but of power, and love, and a sound mind.

NURSING FACTS IN BRIEF Bio Physical Concept in Nursing and Rehabilitation/laboratory tests
NEUROLOGY CT SCAN • A structural imaging study using a computer-basedx-ray to provide a cross sectional image of the brain. Advantages: • 100% sensitivity • When MRI is contraindicated ,CT is the procedure of choice. To Do’s: • Ask if (+) allergy to Iodine • Tell the patient to expect a sensation of feeling flushed if contrast is injected through IV catheter • Procedure may last for 10 to 30 min • Maintain immobility on the entire process • Instruct clients to remove metallic items MRI • Noninvasive structural imaging procedure that uses powerful magnetic field and radiofrequency waves to create an image • The imaging procedure of choice for most neurololgic disorders. Types: • Closed-tunnel-like • Open MRI-NO close chamber.The patient can comfortably see all views while the scan is in progress. Advantages: • NO radiation / exposure to contrast medium • Sensitivity to blood flow • Ability to distinguish water, iron, fat and blood. Disadvantages: • NO to patients with pacemakers, aneurysm clips/implants To DO’s: • Use of bathroom prior to procedure-( may last 40 to 90minutes.) • Instruct patients to remove metal items • Encourage patient to remain still as possible during the procedure • Inform that the scanner will make a dull , thumping noise throughout the procedure PET (Positron Emission Tomography) • A computer based functional imaging that permits study of the brain’s metabolism , blood flow and chemical processes. • Provides information on patterns of glucose and O2 metabolism. To Do’s: • Procedure requires injection or inhalation of a radioactive substance that emits protons. • Reassure patient that radiation exposure is minimal • Advise patient to void prior to procedure since it may take several hours Cerebral Angiography Following local anesthesia , radiopaque dye is injected through catheter in brachial or femoral artery and passed through cervical blood vessels to assess cerebral circulation. Cerebral Hemisphere Frontal lobe ¾ Thought ¾ Memories ¾ Emotions ¾ Moral behavior Parietal lobe ¾ Taste Temporal lobe ¾ Smell ¾ Hearing ¾ Memory ¾ Emotional expression Occipital lobe ¾ Language ¾ Visual interpretation Cranial nerves:
CN I II DYSFUNCTION Decreased sense of smell Decreased visual acuity and visual fields INTERVENTIONS Is often accompanied by impaired taste and weight loss Frequent reorientation to environment. Position objects around client in deference to visual impairment Intermittent eye patching Lubricate eyes to protect against corneal abrasions Caution in shaving and mouth care. Choose easy to chew foods with high caloric content. Protect corneas from abrasion by using lubricant Oral hygiene. Account for decreased food intake. Cosmetic approach to hiding facial weakness. SAFETY! Move slowly to prevent nausea and emesis. Assist ambulation

III Double vision IV,VI (diplopia) V Decreased facial sensation Inability to chew Decreased corneal reflexes

VII Facial weakness and decreased taste(ant. tongue) VIII Hearing loss, imbalance, vertigo, tinnitus IX X XI

Dysarthria, Dysphagia, Maintain airway. Prevent aspiration. cardiac and respiratory Swallow therapy instability Inability to turn Mobility aids. Physical therapy shoulders or turn head from side to side Maintain airway. Prevent aspiration. Swallow therapy

XII Dysarthria, dysphagia

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Brainstem (Midbrain , Pons , Medulla) Medulla Oblongata - Apneustic center. Potent stimulus is hypoxia. Cerebellum- Coordination of movement Pituitary Gland - the master gland Neurons-the functional unit of the Nervous system wrapped by myelin sheath.

¾ Choroid plexus-Responsible for the production of CSF. EENT: „ Ophthalmoscopic Test „ Examination of the eye that combines an ophthalmoscope and a lens for observing minute structures in the cornea , iris and fundus. Tonometer applied to cornea-measures IOP „ Normal: 12 – 21 mmHg

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/410-0250

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Avoid : Iron preparations Iodides Bromides Aspirin NSAIDs Vitamin C supplements greater than 250 mg/day Hydrogen Breathe Test Pneumocytes: Type I – responsible for the lining of the lungs and alveoli Type II-responsible for the secretion of surfactants Type III –resposible for the natural defense of the lungs. Lecithin –Spingomyelin ( Normal ratio .Mutans and S. CARL E. for 3 days before the test and during the stool collection period: High fiber content. Mucociliary escalator-group of fine cells called cilia continuously moving bringing the minute dirt and mucus accessible for expectoration.2 - . allowing change of gases in the alveoli and contributing to the elasticity of the pulmonary tissue. Laboratory Tests: Creatinine Phosphokinase (CPK-MB) ¾ A blood test used to detect damage to the heart muscle. BALITA REVIEW CENTER TEL. • Q-T interval-contraction of the ventricles lasts almost from the beginning of the Q wave to the end of the T wave.ventricular repolarization. skeletal muscle and brain. Purposes: 9 9 9 9 Evaluating patients with unstable angina Detecting reperfusion after coronary recanalization Estimating MI size Detecting MI perioeperatively Gastrointestinal System GUAIAC TESTS (Occult Blood Test) Common practices are the following. the poorer the vision GENERAL NURSING CARE FOR EYE SURGERY „ PRE-OPERATIVE: -Explain procedures -Allow verbalization of feeling and expectations -Teach post-op care POST-OPERATIVE NURSING CARE „ Lie on unoperated side „ Avoid constipation „ Avoid sneezing and coughing „ Neck Hyperextension „ Report any sudden sharp pain „ Avoid sensory deprivation „ Nutrition Innervation: ALL Extraocular muscle-innervated by CN III EXCEPT: ¾ Superior Oblique-Trochlear nerve ¾ Lateral Rectus-Abducens nerve Larynx-the voice box 9 Phonation (Voice formation)-the most complicated function of the larynx.26 mEq/L “ O2 Sat 95-99% Vibraessae-group of hair in the nostrils use to filter the inspired air .potentials generated when the ventricles depolarize prior to contraction • T wave.„ IOP increased in glaucoma Snellen’s Chart „ Normal: 20/20 „ Assesses visual acuity „ The higher the denominator. Epiglottis-The structure that overhangs the larynx that prevents the foods from entering the larynx and the trachea while swallowing. • P wave.Atrial depolarization • QRS complex. Depolarization . Alveoli Small outpouching of walls of alveolar space through which gas exchange takes place. Respiratory: Chest X ray A radiograph made by projecting xrays through organs or structures of the body onto the photographic film.reversal of the resting potential in excitable cell membranes when stimulated Repolarization . Mantoux Test (Tuberculin Test) Administration of Intradermal injection of a purified protein derivative of the tubercle bacilli.raised . RESULT READ AFTER 48 TO 72 HOURS-a hardened . DR. 735-4098/410-0250 . red area of 8 to 10 mm is a positive reaction.the return to resting potential. Avoid food with a high peroxide content: Turnips Cauliflower Broccoli Horseradish Melon. Sputum Exam Sputum coughed out first thing in the morning and specimen sent to the laboratory. • PR interval –the duration between the beginning of the P wave and the beginning of the QRS complex. „ TURBINATE BONES ( CONCHAE) „ INCREASE THE MUCOUS MEMBRANE SURFACE OF THE NASAL PASSAGES AND SLIGHTLY OBSTRUCT THE AIR FLOWING THROUGH THEM.7.Viridans-two of the normal flora of the oral cavity implicated in the causation of bacterial endocarditis. „ TRAPS DUST „ WARMS INSPIRED AIR Surfactants Certain lipoproteins that reduce the surface tension of pulmonary fluids . Lactate Dehydrogenase (LDH) ¾ Measures anaerobic carbohydrate metabolism and as one of the several serum indicators of MI and muscular dystrophies. Avoid red meat in the diet. ABG This test helps to evaluate gas exchange in the lungs by measuring the gas pressures and pH of an arterial sample ABG normal values “ PaO2 80-100 mmHg “ PaCO2 35-45 mmHg “ pH 7.35.45 “ HCO3 22. NO.. 9 S. Troponin Test ¾ Measures level of cardiac troponins to differentiate cardiac from non-cardiac chest pain. Done for three consecutive mornings.2:1). Cardiology ECG Measurement of the electrical current spread into the tissues surrounding the heart.

and vascular abnormalities.LH and FSH 4. such as tumors.milk and molasses. ADH/Vasopressin Growth Hormone (Somatotrophic Hormone) Causes growth of almost all cells and tissues of the body. Ultrasound can detect small abdominal masses. Stimulating hormones and trophic hormones ACTH TSH MSH Stores and releases 1. UPPER GASTROINTESTINAL SERIES AND SMALL BOWEL SERIES Upper GI series and small-bowel series are fluoroscopic x-ray examinations of the esophagus. NURSING AND PATIENT CARE CONSIDERATIONS Abdominal ultrasound usually requires the patient to be NPO for at least 6 hours before the procedure. 3. for better visualization of certain organs ENDOSCOPIC PROCEDURES Endoscopy is the use of a flexible fiberoptic tube to visualize the GI tract Endoscopes contain multipurpose channels that allow for air insufflation. BARIUM ENEMA Fluoroscopic x-ray examination visualizing the entire large intestine. Kayexalate enema to decrease the serum potassium level) To soften the stool ( oil-retention enemas) To relieve gas( tidal. Gonadotrophins. Use of Enemas containing neomycin to decrease the bowel’s bacteria count . The patient should not smoke after midnight before the test. 2. FSH Causes growth of follicles in the ovaries prior to ovulation Promotes sperm formation in the testes. Prolactin 3. obstructions. ascites. Promotes mitosis and cell size an specific differentiation of certain types of cells.INSULIN DELTA .SOMATOSTATIN F – Pancreatic polpeptide The Ovaries contains Granulosa and Theca cells which secrete ESTROGEN and Progesterone The testes contains Leydig cells that secrete Testosterone Radio-Active iodine uptake (RAI) Measures the absorption of the injected iodine isotope by the thyroid tissue Increased uptake may indicate HYPERfunctioning gland DR. Important: 9 An IV sedative will be administered. and sigmoid colon through a fiberoptic sigmoidoscope. Can visualize structural changes. Air is inserted during the procedure to permit better visualization of the GI tract. Instruct the patient that stool will be light in color for the next 2 to 3 days from the barium. Keep patient NPO until patient is alert and gag reflex has returned. and the passage of special instruments. polyps. Emphasize NPO after midnight before the test. gallstones. OXYTOCIN 2. May resume regular diet after gag reflex returns and tolerating fluids.or fleet enemas) Endocrine Growth hormone 2. NO Antibiotics and laxative / enemas 1 week before the test. fluid-filled cysts. Explain to the patient: What the x-ray procedure involves. The patient must be NPO after midnight. A noninvasive test focuses high-frequency sound waves to obtain an image of the structure. and ulcerative colitis. Adrenals:CORTEX Secretes three types of STEROID hormones 1. That proper preparation provides a more accurate view of the tract and that preparations may vary.3 - . Double-contrast studies administer barium first followed by a radio lucent substance. BALITA REVIEW CENTER TEL. to produce a thin layer of barium to coat the mucusa. 735-4098/410-0250 . Change position of patient.Measures the amount of hydrogen produced in the colon. 9 9 9 9 The patient may be asked to swallow once in a while as the endoscope is being advanced. Instruct patient to maintain low-residue diet for 2 to 3 days before test and a clear liquid dinner the night before the procedure. diverticula. as indicated. NO. such as air. fistulas. rectum. cortisone and corticosterone 2.and then exhaled in the breath. Important: Explain procedure to patient. fluoroscopy outlines the GI mucus and organs. ULTRASONOGRAPHY 1. NPO 12 hours before the procedure.GLUCAGON BETA . dilated bile ducts. Sex hormones Estrogen and testosterone ADRENAL MEDULLA Secretes Adrenergic Hormones: Epinephrine Nor-epinephrine Pancreas (Endocrine) ALPHA . irrigation. and small intestine after the patient ingests barium sulfate. PROCTOSIGMOIDOSCOPY AND COLONOSCOPY Visualization of the anal canal. Ultrasound with Doppler for vascular assessment. Mineralocorticoids Aldosterone 3. fluid aspiration. 9 A plastic mouthpiece will be used to help relax the jaw and protect the endoscope. Air may be introduced to provide a double-contrast study. stomach. Other functions include: Biopsy or cytology of lesions Removal of foreign objects or polyps Control of internal bleeding Opening of strictures. Glucocorticoids Cortisol. Prolactin Promotes development of the breasts and secretion of milk Gonadothrophs LH Plays important role in ovulation Secretion of female sex hormones by the ovaries and testosterone by the testes. As the barium passes through the GI tract. Patient will be instructed at various times throughout the procedure to drink the barium (480 to 600 mL).absorbed in the blood. CARL E.

25-dihydroxycholecalciferol Calcitonin Facilitates Ca reabsorption in the kidneys Increases Ca absorption in the GIT Synthesized and secreted by parafollicular cells of the thyroid Secretion is stimulated by an increase in serum Ca Inhibits bone resorption 9 Urine testing for glucose Benedict’s test Ketones 9 ONLY Regular insulin can be used INTRAVENOUSLY IMPORTANT: Insulin is administered at home subcutaneously Cloudy insulin should be thoroughly mixed by gently inverting the vial or ROLLING between the hands Select syringes that match the insulin concentration. laryngospasms. o Increases renal Ca reabsorption o Increases intestinal absorption of Ca Parathyroid hormone regulates serum calcium levels HYperparathyroidism Increased serum Ca level Decreased serum PO4 Increase bone resorption Hypoparathyroidism Numbness and tingling sensation on the face (+) Trosseau’s and Chvostek’s signs Bronchospasms. LOW cholesterol and LOW fat diet Manage constipation appropriately Provide a WARM environment Avoid sedatives and narcotics Instruct patient to report chest pain promptly Hyperthyroidism Exophthalmos-The least seen yet he most pathognomonic in hyperthyroidism Goiter-the most common manifestation PTH Actions: o Increases bone resorption o Inhibits renal PO4 reabsoprtion (Phosphaturic effect).glucagon. Hypothyroidism DOC-Levothyroxin( Synthroid) -should be taken on an empty stomach LOW calorie. immunodeficiencies. WBC Colorless. stress Eosin: allergies Baso: polycythemias. some leukemias Lympho: infection. lymphoproliferative disordes. BALITA REVIEW CENTER TEL. inflammation.9% and above Thyroid Growth CNS maturation and development BMR regulation Stroke volume increased Circulation Fat Metabolism CHO metabolism VIT D: Advise client to eat Vitamin D rich foods Place a tracheostomy set. O2 tank and suction at the bedside Prepare CALCIUM gluconate Provide a HIGH-calcium and LOW phosphate diet DR.4-7% Good control.5 % to 8. CARL E. NO. O2 & suction machine at bed side Active form is 1. leukemia Hemoglobin Heme-the O2 carrying component of Hemoglobin Globin-bound to Iron Sites of Blood components formation Liver .Decreased uptake my indicate HYPOfunctioning gland Thyroid Scan Performed to identify nodules or growth in the thyroid gland Pretest Check for pregnancy Thyroid medication may be withheld temporarily NPO Post-test Ensure proper disposal of body wastes FASTING BLOOD GLUCOSE Aids in the diagnosis of Diabetes (Screening) Pre-test: NPO for 8 hours Normal FBS. allergic reactions Monos: Lymphoproliferative disorders.4 - .hormones • O2 to tissues • Collect and dispose wastes from the cellular metabolism • RBC • Responsible for carrying O2 and CO2 between the lungs and tissues via the hemoglobin • Biconcave. dysphagia Cardiac dysrhythmias Hypotension TO DO’s: Place a tracheostomy set. cortisol and epinephrine Hematology • Delivers nutrients.5%or less Fair control. nucleated .primary function is for protection against invading microorganism Functions: Phagocytocis Immunocytes B and T lymphocytes Plasma Cells (BM) Life Span of 1 week. WBC Differential: Neuts: infection.7.active fro 5 to 6 weeks to 6 months AOG Spleen -active 4 to 8 months AOG BM -active at 5 moths AOG and becomes the primary site from 7 month AOG and thereafter. 735-4098/410-0250 .7. U-100 means 100 units per mL Instruct the client to draw up the REGULAR (clear) Insulin FIRST before drawing the intermediate acting (cloudy) insulin SOMOGYI EFFECT Nocturnal hypoglycemia followed by rebound hyperglycemia Due to the production of counter regulatory hormones.80-109 mg/dL Glycosylated Hemoglobin A 1-C Blood glucose bound to RBC hemoglobin Reflects how well blood glucose is controlled for the past 3 months FASTING is NOT required! N.9% Poor control. disc-shaped NO nucleus.

Cancer ¾ cells into another „Anaplasia-Marked morphologic „Rate of Growth „Local Invasion ƒPleomorphism-variation in size and function „Pleomorphism-variation in size and function Normal mechanism and proliferation of cells are disturbed which results in distinctive morphologic alterations of the cell and aberrations in tissue patterns. „Undifferentiated „Erratic and Uncontrolled Growth „Expansive and Invasive „Secretes abnormal proteins „METASTATIC „Suffix “SARCOMA / CARCINOMA” Processes Involved Point mutation .Iliac bones. CARL E. ƒHypertrophy. and destruction of the surrounding tissue. 735-4098/410-0250 . CHEMICAL AGENTS • Smoking • Dietary ingredients • Drugs • Benzene 3. Papilloma Virus • RNA Viruses.Change in a gene occurring spontaneously affecting the expression of the gene. hyperchromic anemia A progressive megaloblastic macrocytic anemia that results from the lack of intrinsic factor resulting to disorder in RBC maturation. BALITA REVIEW CENTER TEL.Loss of a piece of a chromosome. CMV. ` The Spread of Primary Cancer in Another Organ Made Possible: BENIGN „Well-differentiated „Slow growth „Encapsulated „Non-invasive „Does NOT metastasize ƒDirect seeding into body cavities or surfaces ƒLymphatics ƒHematogenous Diagnostic Evaluation • Complete medical history • PE • Biopsy • Estrogen and Progesterone levels • CBC • Platelet count • Blood Chem –Suffix.5 - .“OMA” –Adipose tissue. -Needs nutrients as Vitamins ACE Iron and Protein. Deletion . Dietary Habits • Low-Fiber • High-fat • Processed foods • Alcohol 5. replacement after injury or ƒRegeneration . ƒFibroplasia .A characteristic of a tumor cell. ƒThe growth of Cancer cells are accompanied by progressive infiltration . EBV.Loss of normal cell differentiation .Programmed cell death to balance cell proliferation. STEPS: INITIATION • Carcinogens alter the DNA of the cell • Cell will either die or repair PROMOTION • Repeated exposure to carcinogens • Abnormal gene will express • Latent period PROGRESSION • Irreversible period • Cells undergo NEOPLASTIC transformation then malignancy Etiology of Cancer 1. Skull. Viruses and Bacteria • DNA viruses.Metaplasia-the reversible conversion of normal tissue „Anaplasia .H.fibrOMA MALIGNANT Iron Deficiency Anemia Folate Deficiency Anemia Aplastic Anemia Pernicious Anemia Duodenum and Upper Jejunum-site of Iron Absorption Fe Deficiency Anemia(Microcytic.LipOMA DR. „Metaplasia .Compensatory mechanism as a result of increased „Differentiation extent to which the parenchymal cells resemble comparable normal cells both morphologically and functionally.Replacement by connective tissue.Same cell type workload as exemplified by Ventricular hypertrophy in CHF.angiOMA –Fibrous tissue. hypochromic anemia) Most common Anemia Causes: Chronic Blood Loss Bleeding FOLATE DEFICIENCY ANEMIA (MEGALOBLASTIC ANEMIA) Causes Poor dietary intake Alcoholism Anorexia nervosa Malignancy Pernicious Macrocytic.HIV • Bacterium. and long bones . Genetics and Family History • Colon Cancer • Breast cancer 4.myOMA –Blood vessels. PHYSICAL AGENTS • Radiation • Exposure to irritants • Exposure to sunlight 2. Sternum. ANEMIA Kinds: –Bone. Hormonal agents • DES • OCP especially estrogen 7. „Apoptosis . pylori 6.Hepa B. Immune Disease • AIDS Tumor Characteristics To Do: Vitamin B12 IM Iron therapy Blood transfusion as needed Physical examination every six months *At risk for Gastric Cancer Aplastic anemia Hypoplasia of the bone marrow resulting to PANCYTOPENIA Anemia Leukopenia Thrombocytopenia Causes Congenital Acquired Idiopathic Infections Medications Heavy metals Cellular Growth and Differentiation „Repair of Tissues Apoptosis.Vertebrae. invasion . May be caused by certain drugs as: Colchicine Neomycin Cimetidine Hormonal contraceptives Schilling’s Test Most definitive diagnostic test to note absorption of Vit B12. and functional changes.osteOMA –Muscle. Herpes. NO.

735-4098/410-0250 .Administration of several courses of chemotherapy before definitive surgical intervention.In addition to the treatment rendered. Therapeutic Strategies „Adjuvant therapy „Neoadjuvant therapy . capillary refill ƒPresence of Dyspnea.Unusual bleeding • T. ƒColor.gums „Thrombocytopenia<20thou Respiratory and Cardiovascular System Assess: „An induction for advanced disease with no alternative treatment „Adjunct therapy Cell Cycle „Lung sounds „Pulmonary fibrosis (Age>60. refractory to chemotherapy. ƒExcisional – Biopsy of tissue removed by surgical cutting.Presence of distant metastases Management malignancy histologic cell type.N2.weakness.T4.Increasing involvement of regional lymph nodes „M . CXR. CARL E.fatigue.liver function tests and total bilirubin Hematopoietic Disorder MAINTAIN TISSUE INTEGRITY • Handle skin gently • Do NOT rub affected area • Lotion may be applied • Wash skin only with SOAP and Water Nursing Intervention MANAGEMENT OF ALOPECIA Alopecia begins within 2 weeks of therapy „Depends on type of „Primary treatment – Removal of tumor ƒLocal excision. and DRE • Female.Indigestion • O. presence of metastasis and condition of the patient. „High dose /Intensive therapy – Administered in the BM „Preoperative Chemotherapy –Done prior to surgery Adverse • • • • • • • Effects of Chemotherapy Alopecia Anorexia Renal /hepatic d/o Mucositis Anemia Neutropenia Thrombocytopenia „T-Primary tumor „Tx-Primary tumor unable to assess „TO-NO evidence or Primary tumor „Tis-Carcinoma in Situ „T1.N3 .Increasing size and or local extent of primary tumor „N .Highly accurate and done in OPD ƒIncisional – Biopsy of a selected portion of a lesion.urine.Change in bowel/bladder habits • A.Resting. Mammography and Pap’s Smear • Male.Breast Examination.DNA component doubles in preparation for cell division „G2 (Gap 2 Phase ) .A sore that does not heal • U. Testicular self-exam Nursing Assessment 9 Utilize the ACS 7 Warning Signals CAUTION • C.Bleomycin or with preexisting lung disease) „Cardiac studies before administering Doxorubicin and „G1 (Gap 1 )-RNA and CHON synthesis DR. stage. Treatment and Types of Surgical Procedures „Regrowth within 8 weeks of termination „Encourage to acquire wig before hair loss occurs „Encourage use of attractive scarves and hats „Provide information that hair loss is temporary BUT anticipate change in texture and color Chemotherapy General Effects: Assessment : Integumentary ƒPain ƒSwelling ƒRashes ƒSkin pigmentation ƒTaste changes ƒStomatitis if present Gastrointestinal „DHN „Nausea and vomiting „Electrolyte Imbalance „Anorexia „Jaundice „Liver enzymes. ƒCore needle biopsy – Needle biopsy with a large hollow needle.T3.Absence of distant metastasis „M1 . BALITA REVIEW CENTER TEL.Has had pulmonary Cyclophosphamide (Cardiotoxic) Neuromuscular ™ Paresthesia DTR GUT radiation.Absence or presence of distant metastases „Mx .A control NOT a treatment „Reconstructive or Rehabilitative „Preventive or Prophylactic „Intent is to destroy as many tumor cells as possible with minimal effect on healthy cells exists Chemotherapy ƒAssess signs of infection ƒAdventitious breath sounds ƒFever ƒAssess skin ƒStool.Presence or absence or regional lymph node involvement „Nx .CHON and RNA synthesis occurs „M (mitosis) phase . Turgor.6 - . mass size and bleeding tendency.Obvious change in warts • N.Occult Blood.• Imaging Procedures Screening • Male and female.T2.No regional lymph node involvement „N1.for small-sized mass ƒWide excision -For bigger sized mass ƒAdjuvant treatment. NO.Regional lymph nodes are unable to assess „NO .DRE for prostate.Nagging cough and hoarseness Nursing Assessment • Weight loss • Frequent infection • Skin problems • Pain • Hair Loss • Fatigue • Disturbance in body image/ depression • Presence of mass • Non-healing wounds • Presence of discharge The American Joint Committee of Cancer (The TNM Classification) „S (Synthesis).vertigo ƒProvide frequent Rest Periods Neutropenia „Palliative Treatment . with margin „Anemia „Debulking Therapy – may be bone prior to surgery to lessen the „Salvage treatment -The use of an extensive surgical approach to treat a local recurrence after implementing a less extensive primary approach.Thickening or lump in the breast • I.Divides in 2 identical daughter cells „GO . BIOPSY ƒFine Needle Aspiration Biopsy-Tissue is obtained by application of suction through a needle attached to a syringe.Unable to assess „Mo .

735-4098/410-0250 .” DR.„Monitor UO „BUN Crea “We make our world significant by the courage of our questions and by the depth of our answers. BALITA REVIEW CENTER TEL. CARL E.7 - . NO.