INTUSSUSCEPTION Assessment:

An intussusception is a medical condition in which a part of the
intestine has invaginated into another section of intestine, similar to
the way in which the parts of a collapsible telescope slide into one
another.[1] This can often result in an obstruction. The part that
prolapses into the other is called the intussusceptum, and the part that
receives it is called the intussuscipiens.
Symptoms
Early symptoms can include nausea, vomiting - sometimes bile stained
(green color), pulling legs to the chest area, and intermittent moderate
to severe crampingabdominal pain. Pain is intermittent not because the
intussusception temporarily resolves, but because the intussuscepted
bowel segment transiently stops contracting. Later signs include rectal
bleeding, often with 'red currant jelly' stool (stool mixed with blood and
mucus), and lethargy. Physical examination may reveal a 'sausage-
shaped' mass felt upon palpation of the abdomen.
In children or those too young to communicate their symptoms
verbally, they may cry, draw their knees up to their chest or
experience dyspnea (difficult or painful breathing) with paroxysms of
pain.
Fever is not a symptom of intussusception. However, intussusception
can cause a loop of bowel to become necrotic. This leads to perforation
and sepsis, which causes fever.
[edit]Diagnosis
Intussusception is often suspected based on history and physical exam,
including observation of Dance's sign. Per rectal examination is
particularly helpful in children as part of the intussusceptum may be
felt by the finger. A definite diagnosis often requires confirmation by
diagnostic imaging modalities. Ultrasound is today considered the
imaging modality of choice for diagnosis and exclusion of
intussusception due to its high accuracy and lack of radiation. A target-
like mass, usually around 3 cm in diameter, confirms the diagnosis.
An x-ray of the abdomen may be indicated for evaluation of intestinal
obstruction or the presence of free intraperitoneal gas; the latter
finding would imply that bowel perforation has already occurred. In
some institutions, air enema is used for diagnosis as the same
procedure can be used for treatment.[citation needed]
[edit]Treatment
The condition is not usually immediately life-threatening. The
intussusception can be treated with either a barium or water-soluble
contrast enema or an air-contrast enema, which both confirms the
diagnosis of intussusception, and in most cases successfully reduces it.
The success rate is over 80%. However, approximately 5-10% of these
recur within 24 hours.[citation needed]
If it cannot be reduced by an enema or if the intestine is damaged, then
a surgical reduction is necessary. In a surgical reduction, the abdomen
is opened and the part that has telescoped in is squeezed out (rather
than pulled out) manually by the surgeon or if the surgeon is unable to
successfully reduce it or the bowel is damaged, the affected section will
be resected. More often, the intussusception can be reduced by
laparoscopy, whereby the segments of intestine are pulled apart by
forceps.[citation needed]
1. Paroxysmal abdominal pain; legs drawn up, child
is inconsolable; may be comfortable between episodes.
2. Blood in stool, or later “currant jelly” stools containing
sloughed mucosa, blood, and mucus.
3. Vomiting.
4. Increasing absence of stools.
5. Abdominal distention, bowel sound diminished, absent or
high pitch.
6. Sausage like mass palpable in abdomen (Dance’s sign).
7. Unusual looking anus; may look like rectal prolapse.
8. Dehydration and fever
9. Shock like state with rapid pulse, pallor, and marked
sweating.
Diagnostic Evaluation:
1. X-ray of abdomen may show absence of gas or mass in right
upper quadrant.
2. Barium enema is done if there is no appearance
of peritonitis; shows a concave filling defect (will help reduce
the invagination).
3. Ultrasonogram may be done to locate area of telescoped
bowel.
4. Color Doppler sonography determines whether reducible.
Absence of blood flow indicates ischemia and, therefore,
enema reduction should be avoided.
Surgical Intervention:
1. Intussusception can be surgically reduced, resection may be
necessary if bowel is nonviable.
Nursing Intervention:
1. Monitor I.V. fluids and intake and output to guide in fluid
balance.
2. Be alert for respiratory distress due to abdominal distention.
3. Monitor vital signs, urine output, pain, distention, and
general behavior preoperatively and postoperatively.
4. Observe infant’s behavior as indicator of pain; may be
irritable and very sensitive to handling or lethargic or
unresponsive. Handle the infant gently.
5. Explain cause of pain to parents, and reassure them about
purpose of diagnostic tests and treatments.
6. Administer analgesic as prescribed.
7. Maintain NPO status as ordered.
8. Insert nasogastric tube if ordered to decompress stomach.
9. Continually reasses condition because increased pain and
bloody stools may indicate perforation.
10. After reduction by hydrostatic enema, monitor vital signs
and general condition – especially abdominal tenderness,
bowel sounds, lethargy, and tolerance to fluids – to watch
recurrence.
11. Encourage follow up care.
12. Provide anticipatory guidance for developmental age of
child.
http://nursingcrib.com/nursing-notes-reviewer/intussusception/

[edit]Prognosis
Intussusception may become a medical emergency if not treated early,
as it will eventually cause death if not reduced. In developing countries
where medical hospitals are not easily accessible, especially when the
occurrence of intussusception is complicated with other problems,
death becomes almost inevitable. When intussusception or any other
severe medical problem is suspected, the person must be taken to a
hospital immediately.[citation needed]
The outlook for intussusception is excellent when treated quickly, but
when untreated it can lead to death within 2–5 days. Fast treatment is
a necessity, because the longer the intestine segment is prolapsed the
longer it goes without bloodflow, and the less effective a non-surgical
reduction will be. Prolonged intussusception also increases the
likelihood of bowel ischemia and necrosis, requiring surgical resection.
[citation needed]

http://en.wikipedia.org/wiki/Intussusception_(medical_disorder)

 Is the invagination or telescoping of a portion of

the intestine into a adjacent, more distal section of
theintestine causing mechanical obstruction.
 The cause may be idiopathic (unknown but following a viral
infection); lead point (change in the mucosa from another
condition such as cystic fibrosis, Meckel’sdiverticulum, or
hematoma); or post operative.
 It occurs in children younger than age 3, most commonly
ages 5 to 10 months.
 Without prompt treatment, necrosis of the involved
segment leads to shock, perforation, andperitonitis.
LIFE IS A BOAT
Rie Fu
Nobody knows who I really am.
I never felt this empty before.
And if I ever need someone to come along,
Whos going to comfort me and keep me strong?
We are all rowing the boat of fate.
The waves keep on coming and we cant escape.
But if we ever get lost on our way,
The waves would guide you through another day.
Dooku de iki o shiteru toomei ni natta mitai (Far away, Im
breathing, as if I were transparent)
Kudayami ni omoe dakedo mekaku shisarete tadake (It would seem
I was in the dark, but I was only blindfolded)
Inori o sasagete atarashii hi o matsu (I give a prayer as I wait for the
new day)
Asayaka ni hikaru unmi sono hate made (Shining vividly up to the
edge of that sea)
Nobody knows who I really am.
Maybe they just dont give a damn.
But if I ever need someone to come along,
I know you would follow me and keep me strong.
Hito no kokoro wa utsuriyuku mukedashiteku naru (Peoples hearts
change and sneak away from them)
Tsuki wa mada atarashii shuuki de mune o tsureteku (The moon in
its new cycle leads the boats again)
And everytime I see your face,
The oceans heave up to my heart.
You make me wanna strain at the oars,
And soon I can see the shore.
Ohh, I can see the shore
When will I see the shore?
I want you to know who I really am
I never thought Id feel this way towards you
And if you ever need someone to come along,
I will follow you and keep you strong.
Tabi wa mada tsuzuiteku odayakana hi mo (and still the journey
continues on quiet days as well)
Tsuki wa mata atarashii shuuki de ume o terashidasu (The moon in
its new cycle shines on the boats again)
Inori o sasagete atarashii hi o matsu (I give a prayer as I wait for the
new day)
Asayaka ni hikaru umi sono hate made (Shining vividly up to the
edge of that sea)
And every time I see your face,
The oceans heave up to my heart.
You make me wanna strain at the oars,
And soon, I can see the shore.
Unmei no huneoko gi nami wa tsugi kara tsuki e to watashi-tachi o
sou kedo (we are rowing the boat of fate, but the waves keep
attacking us)
Sore mo suteki na tabi ne (But isnt that still a wonderful journey?)
Dore mo suteki na tabi ne (Arent any of them a wonderful
journey?)
FEELS LIKE HOME
Chantal Kreviazuk
Somethin’ in your eyes, makes me wanna lose myself
Makes me wanna lose myself, in your arms
There’s somethin’ in your voice, makes my heart beat fast
Hope this feeling lasts, the rest of my life
If you knew how lonely my life has been
And how long I’ve been so alone
And if you knew how I wanted someone to come along
And change my life the way you’ve done
It feels like home to me, it feels like home to me
It feels like I’m all the way back where I come from
It feels like home to me, it feels like home to me
It feels like I’m all the way back where I belong
A window breaks, down a long, dark street
And a siren wails in the night
But I’m alright, ‘cause I have you here with me
And I can almost see, through the dark there is light
Well, if you knew how much this moment means to me
And how long I’ve waited for your touch
And if you knew how happy you are making me
I never thought that I’d love anyone so much
It feels like home to me, it feels like home to me
It feels like I’m all the way the back where I come from
It feels like home to me, it feels like home to me
It feels like I’m all the way back where I belong
It feels like I’m all the way back where I belong 
OMG
Usher
oh my
oh my gosh
i did it again, so im gone let the beat drop
oh my gosh
[usher]:
baby let me..
baby let me..
baby let me..
[chorus]:
baby let me love you down
theres so many ways to love ya
baby i can break you down
theres so many ways to love ya
i mean like, ooh my gosh im so in love
i found you finally, it make me want to say
oh, oh , oh, oh, oh, oh, oh, oh, oh, oh, oh, oh, oh, oh, oh, oh,
ohh my gosh
it make me want to say
oh, oh, oh, oh, oh, oh, oh, oh, oh
[verse 1]:
i fell in love with shawty when i seen her on the dance floor
she was dancing sexy, pop, pop, popping, dropping, dropping low
never ever has a lady hit me on the first sight
this was something special ; this was just like dynamite
honey got a booty like pow, pow, pow
honey got some boobies like wow, oh wow
girl you know im loving your, loving your style
check, check, check, check, check, checking you out like,
ooh (oooh) she got it all
sexy from her head to the toes
& i want it all, it all, it all
[chorus]:
baby let me love you down
theres so many ways to love ya
baby i can break you down
theres so many ways to love ya
got me like, ooh my gosh im so in love
i found you finally, it make me want to say
oh, oh , oh, oh, oh, oh, oh, oh, oh, oh, oh, oh, oh, oh, oh, oh,
ohh my gosh
you make me want to say(repeat 2x)
oh, oh, oh, oh, oh, oh, oh, oh, oh, oh
[verse 2]:
feel so ? for honey out of all the girls up in this club
this one got me whipped, just off one look, yep i fell in love
girl you something special, you just like dynamite
youre, youre, youre, youre, youre, youre, youre out of sight
fell in love with honey like my, oh my
honey looking wonderful; fly, so fly
honey like a supermodel; my, oh my
baby how you do that, make a grown man cry?
ooh (ooh) baby, you got it all
sexy from her head to the toes
& i want it all, it all, it all
Before the politics that we call the rap game
And back when ain’t nobody listened to my mix tape
And back before I tried to cover up my slang
But this is for the decatur, what’s up Bobby Ray
So can I get a wish to end the politics
And get back to the music that started this shit
So here I stand and then again I say
I’m hopin’ we can make some wishes outta airplanes?

[chorus]:
so, honey let me love you down
theres so many ways to love ya
baby i can break it down
theres so many ways to love ya
got me like, ooh my gosh im so in love i found you finally,
you make me want to say..

oh my gosh
oh my
oh, oh my gosh

[will.i.am]:
oh my gosh
i did it again
so im gone let the beat drop

[usher]:
oh, oh, oh my
oh, oh, oh my, my, my, my, my, my
ooh my gosh

AIRPLANES
B.o.b.

[Chorus Hayley Williams]

Can we pretend that airplanes
In the night sky
Are like shooting stars
I could really use a wish right now (wish right now) (wish right now)
Can we pretend that airplanes
In the night sky
Are like shooting stars
I could really use a wish right now (wish right now) (wish right now)

[Verse 1 B.o.B]
Yeah
I could use a dream or a genie or a wish
To go back to a place much simpler than this
Cause after all the partyin’ and smashin’ and crashin’
And all the glitz and the glam and the fashion
And all the pandemonium and all the madness
There comes a time where you fade to the blackness
And when you’re staring at that phone in your lap
And you hoping but them people never call you back
But that’s just how the story unfolds
You get another hand soon after you fold
And when your plans unravel
And they sayin’ what would you wish for
If you had one chance
So airplane airplane sorry I’m late
I’m on my way so don’t close that gate
If I don’t make that then I’ll switch my flight
And I’ll be right back at it by the end of the night

[Chorus Hayley Williams]

[Verse 2 B.o.B]
Somebody take me back to the days
http://www.elyricsworld.com/airplanes_lyrics_b.o.b..html
Before this was a job, before I got paid
Before it ever mattered what I had in my bank
Yeah back when I was tryin’ to get a tip at subway
And back when I was rappin’ for the hell of it
But now a days we rappin’ to stay relevant
I’m guessin that if we can make some wishes outta airplanes
Then maybe yo maybe I’ll go back to the days