C

OMPLICATION OF EACH DISEASE

CONDITION

LETS HAVE AN EXAMPLE FOR THIS

CONCEPT.

A PATIENT WAS DIAGNOSED TO BE SUFFERING

FROM PHENYLKETONURIA . INTERVENTIONS BY THE
NURSE SHOULD BE AIMED AT MONITORING THE
PATIENTS GROWTH AND DEVELOPMENT DUE TO
WHICH POSSIBLE COMPLICATIONS?
A.HYDROCEPHALUS
B.PARALYSIS
RETARDATION

C.MALNUTRITION
D.MENTAL

THE CORRECT ANSWER IS (D)

MENTAL RETARDATION.IT IS A
COMMON
COMPLICATION OF UNTREATED
PHENYLKETONURIA.NOW LETS
IDENTIFY THECOMMON
COMPLICATION OF CERTAIN
DISEASES.

DISEASES AND THEIR

COMMON COMPLICATION

DISEASES

COMMON COMPLICATION

Acute gastroenteritis

Dehydration

Acute lymphocytic leukemia

Bleeding

Addisons disease

Shock

Anemia, pernicious

Peripheral neutritis

Anemia, sickle cell

Cerebrovascular accident

Cardiac valvular disorder

Congestive heart failure

Cystic fibrosis

Male: sterility; female: difficulty

conceiving

Cholelithiasis

Cholecystitus

Complete heart block

Congestive heart failure

Gonorrhea
Herpes

Pelvic inflammatory diseases

(PID)
Cervical cancer

Hypertension

Cerebrovascular accident

Infectious mononucleosis

Splenic rupture

Lymes disease

Paralysis

DISEASES

COMMON COMPLICATION

Lead poisoning

Mental retardation

Meningistis

Hearing impairment

Mitral valve stenosis

Acute glomerulonephritis

Myocardial infarction
Pancreatitis

Premature ventricular
contractions
Hypocalcemia/ hyperglycemia

Phenylketonuria

Mental retardation

Polycythemia vera

Cerebrovascular accident

Pre-eclampsia

Abruptio placenta

Sexually transmitted disease

Pelvic inflammatory diseases

(female)
Rheumatic heart disease
Mitral valve stenosis
Acute glomerulonephritis

Sore throat

IET IS APPROPRIATE TO YOUR

PATIENT!

NOW,LETS MOVE
ON TO THE CONCEPT
ON THERAPEUTIC DIET

LETS HAVE AN EXAMPLE

WHICH OF THE APPROPRIATE DIET FOR A CHILD

WITH FIBROSIS?
A.HIGH PROTEIN,LOW CARBOHYDRATE
B.HIGH CALORIE
C.LOW PROTEIN,HIGH CARBOHYDRATE,MODERATE FAT
D.HIGH RESIDUE,LOW FAT,LOW CALORIE

WHATS YOUR GUESS?...........OK THE ANSWER IS

(B).WHY?
A PATIENT WITH CYSTIC FIBROSIS SHOULD BE ON A
HIGH CALORIE,HIGH SODIUM DIET BECAUSE PATIENTS
WITH CYSTIC FIBROSIS TEND TO LOSE MORE SODIUM
IN THEIR SWEAT AND WOULD NEED ADDITIONAL
CALORIES AS A SOURCE OF ENERGY.ALTHOUGH THRE
IS NO OPTION THAT EXACTLY STATES THIS TYPE OF
DIET, THE OTHER OPTIONS CONTAIN WRONG
INFORMATION, SO THE BEST ANSWER IS (B) HIGH
CALORIE!

REMEMBER: IF A PART OF A POSSIBLE

OPTION IS WRONG THE ENTIRE OPTION IS
CONSIDERED WRONG

THERAPEUTIC DIET
FOR SPECIFIC DISEASE
CONDITIONS

Acne

Low fat

Acute gastroenteritis (diarrhea)

Clear liquid

Acute glomerulonephritis

Low Na, Low protein

Addisons disease

High Na, Low K

Anemia, iron deficiency

High Iron

Anemia, pernicious

High Protein, Vitamin B

Anemia, sickle cell

High fluid

Angina pectoris

Low cholesterol

Arthritis, gout

Purine Restricted

Attention deficit hyperactivity

disorder

Finger foods

Bipolar disorder

Finger foods

Burn

High calorie, High protein

Celiacs disease

Gluten-free

Cholecystitis

High Protein, High carbohydrate,

Congestive heart failure

Low Na, Low Cholesterol

Cretinism

High protein, High calcium

Crohns disease
Cushings disease

High Protein, High carbohydrate,

Low fat
High K, Low Na

Cystic fibrosis

High calorie, High Na

Cystitis

Acid Ash (for alkaline stones)

Alkaline Ash (for acid stones)

Decubitus ulcer (bedsore)

High protein, High Vitamin C

Diabetes mellitus

Well balanced

Diarrhea

High K, High Na

Diverticulitis

Low residue

Diverticulosis

High residue with no seeds

Dumping syndrome

High fat, High protein, dry

Hepatic encephalopathy

Low protein

Hepatitis

High protein, High calorie

Hirschsprungs disease
Hyperparathyroidism

High calorie, Low residue, High

protein
Low calcium

Hypertension

Salt restricted

Hyperthyroidism

High calorie, High protein

Hypoparathyroidism

High calcium, Low phosphorus

Hypothyroidism
Kawasakis disease

Low calorie, Low cholesterol, Low

saturated fat
Clear liquid

Liver cirrhosis

Low protein

Menieres disease

Low Na

Myocardial infarction

Low fat, Low cholesterol, Low Na

Nephrotic syndrome
Osteoporosis

Low Na, High protein, High

calorie
High calcium, High Vitamin D

Pancreatitis

Low fat

Peptic ulcer (duodenal/gastric)

Phenylketonuria

High fat, High carbohydrate, Low

protein
Low protein

Pregnancy induced hypertension

High protein

Renal colic

Low sodium, Low protein

Renal failure (acute)

Renal failure (chronic)

Low protein, High carbohydrate,

Low Na (Oliguric phase)
High protein, High calorie
and Restricted fluid (Diuretic
phase)
Low protein, Low Na, Low K

Tonsilitis

Clear liquid

Nephrotic syndrome
Osteoporosis

Low Na, High protein, High calorie

calorie
High calcium, High Vitamin D

Pancreatitis

Low fat

Peptic ulcer (duodenal/gastric)

Phenylketonuria

High fat, High carbohydrate, Low

protein
Low protein

Pregnancy induced hypertension

High protein

Renal colic

Low sodium, Low protein

Renal failure (acute)

Renal failure (chronic)

Low protein, High carbohydrate,

Low Na (Oliguric phase)
High protein, High calorie
and Restricted fluid (Diuretic
phase)
Low protein, Low Na, Low K

Tonsilitis

Clear liquid

KNOW WHAT

QUIPMENT TO PREPARE
AT THE BEDSIDE

 In foreign nursing exams, some of the most frequently asked questions are those
that require the nurse to anticipate the type of equipment that needs to be at the
patients bedside. Consider the example below
In a patient with Sengstaken Blakemore tube, which of the following equipment
should the nurse keep at the bedside?
A. Wirecutter
B. Torniquet

C. Clamp
D. Scissors

 One of the dangers of having a Senstaken- Blakemore tube in place, is

accumulation of blood above the level of the bleeding esophageal varices. This can
possibly lead to aspiration. When this occurs, the nurse should deflate the
esophageal balloon by cutting the port that leads to the balloon, in order to
promote the drainage of the blood to the stomach. The nurse should therefore have
a pair of SCISSORS ready at the patients bedside. So the answer is (D).

HERES A LIST OF CONDITIONS

THAT REQUIRE AN EQUIPMENT AT
THE BEDSIDE.

Amputation

Torniquet

Autonomic dysreflexia

Catheter

Chest tube drainage

Cerebrovascular accident

Extra bottle
Clamp/forcep
Vaselanized gauze
Sunctioning equipment

Cholinergic crisis

Tracheostomy/endotracheal tube

Deep vein thrombosis

Tape measure

Epiglotitis

Tracheostomy/Endotracheal tube

Hydrocephalus

Tape measure

Laryngotracheobronchitis

Tracheostomy

Myasthenic crisis

Endotracheal tube

Parkinsons disease

Suction apparatus

Pregnancy-induced hypertension

Padded mouth gag

Radium implant

Lead container, forceps

Senstaken-Blakemore tube

Scissors

Spinal cord injury

Tracheostomy

Thyroidectomy

Tracheostomy

Tonsillectomy

Flashlight

Tracheostomy tube

Obturator, hemostat

Wired jaw

Wire cutter

ACILITATE PROPER

POSITIONING OF YOUR
PATIENT!

 In order for you to be able to position your patient appropriately, the first thing that
you should do is to ask yourself: What position will I use? Will it aggravate or
lessen the condition? And what is the purpose of the position? Will it
promote something or will it prevent something?
Lets have an example
Immediately after a supratentorial craniotomy, in what position should the patient be
placed?
A. Side-lying

C. Semi-Fowlers

B. Supine

D. Trendelenburg

After craniotomy, the usual goal of care is to prevent the accumulation of fluid at
the surgical site. It is therefore essential for you to promote venous drainage and
this is best accomplished by placing the patient in the Semi-fowlers position. The
answer therefore is letter (C).

SO HERES A LIST OF
APPROPRIATE POSITIONING
FOR SPECIFIC CONDITIONS

Abdominal aneurysm surgery

Air embolism

Appendicitis

Fowlers, to prevent pressure on the

gaft
Turn the patient on left side and lower
head of the bed, this will cause the air
to rise to the right atrium
If unruptured: any position of comfort;
If ruptured: semi-fowlers, to prevent
the upward spread of infection

Asthma

Sitting position, leaning forward,

to facilitate breathing

Autonomic dysreflexia
Bronchoscopy

High fowlers, to prevent

hypertensive stroke
Semi-fowlers, post procedure, to
prevent aspiration

Bronchiolitis

Tripod position, to facilitate breathing

Cardiac catheterization

Cast
Cataract surgery

Cerebral aneurysm

Cleft lip (post op)

Cleft palate
Congestive heart failure

Keep insertion site extended for 4-6

hours, to prevent arterial occlusion
Elevate extremity, to prevent edema
Semi-fowlers postoperatively, to
prevent edema at the operative site
Semi-fowlers, to prevent pressure in
the aneurysm site
Supine, to prevent pressure on the
suture line
Prone, to prevent aspiration
High fowlers, to improve
oxygenization

Craniotomy

If supratentorial: semifrowlers; If infratentorial: flat,

to facilitate venous drainage from
the head

CVA

Elevate the head, to reduce ICP

Dumping syndrome

Epistaxis

Flail chest

Femoro-popliteal by-pass graft

Hemorroidectomy

Supine after meals, to prevent

rapid emptying of the stomach
Leaning forward, to prevent
aspiration of blood
Keep on the affected side, to
facilitate expansion of the
unaffected lung
Keep the affected extremity
extended, to promote circulation
Side lying, to prevent pain

Hiatal hernia

Upright position after meals, to

prevent reflux of stomach contents

Hip surgery

Keep the legs in abduction, to

prevent dislodge of the head of the
femur from the acetabulum

Hypophysectomy

Elevate the head of the bed, to

prevent increased ICP

Increased ICP

Elevate the head of the bed, to

prevent further increase in ICP

Laminectomy

Keep the back as straight as

possible, to prevent twisting the
spine
Semi-fowlers, to maintain patent
airway and minimize edema

Laryngectomy
Liver biopsy

Right side lying post procedure, to

prevent bleeding

Lobectomy
Lumbar puncture

Semi-fowlers, to promote
breathing
Lateral side lying, during the

Mastectomy

procedure, to facilitate the entry of

the needle between L3-L4; flat
position after the procedure, to
prevent
spinal
headache
Elevate on
pillow
the extremity on

Myelogram

Placenta previa
Postural drainage

the affected side, to prevent

lymphedema
If water based dye (Amipaque) was
used: Elevate the head of the bed,
to prevent upward dispersion of the
dye; If oil based dye (Pantopaque)
was used, keep the patient flat on
bed, to prevent leakage of CSF.
Sitting position, to minimize
bleeding
Lung segment to be drained should
be in the uppermost position, to
facilitate drainage

Prolapsed cord

Knee-chest, to prevent pressure on

the cord

Pulmonary edema

Fowlers, to facilitate breathing

Pyloric stenosis

Right side lying on an infant car

seat after meals, to facilitate entry of
stomach contents into the intestines

Radium implant in the cervix

Flat on bed, to prevent dislodge

Retinal detachment

Keep the affected side towards

the bed, so gravity will help the
detached retina to fall back in place

Seizure

Side lying, to prevent backward

falling of the tongue which may
obstruct the airway

Shock

Modified trendelenburg, to
promote venous return to the heart

Spinal cord injury

Immobilize the patient, to prevent

twisting the spine

Thoracentesis

Thrombophlebitis
Thyroiddectomy

Tonsillectomy

Fowlers (during the procedure), to

facilitate removal of fluid from the chest
wall, after the procedure you may
position the patient in any position of
comfort
Place the patient on bedrest and
elevate the affected leg, to promote
circulation
Semi-fowlers and avoid hyperflexion
and hyper-extension of the neck, to
prevent tension on the suture line
Sidelying or prone, to promote
drainage of secretion

Total parental nutrition

Trendelenburg during tube insertion,

to prevent air embolism

Tracheoesophageal fistula (TEF)

Supine with the head elevated on an

inclined plane of at least 30 degrees, to
minimize the reflux of gastric secretions

Varicose veins

Elevate the legs above the level of the

heart, to facilitate venous return to the
heart
Keep the legs elevated, to prevent

Vein stripping and ligation

venous stasis