Basic information about Fiber

Fiber

Fiber is one of those mysterious nutrients which are known to many to be very important part of our dietary intake.

Fiber is basically referred to as the carbohydrates that cannot be digested. The fiber is always present in all eaten foods from plants.  This includes: fruits, vegetables, grains, nuts and legumes.

It is strictly recommended on both adult and children to consume at least 20 – 35 grams of food dietary fiber every day. If you have more calories intake, you must also consume more fiber.

Fiber is categorized into:

1. Fiber as to its source or origin (example: fiber from grains which is called cereal fiber).

2. Fiber as to its water solubility.  Some fibers are easily dissolved in water but others are not.

Foods with Soluble Fiber

• Oatmeal, oat bran
• Nuts and seeds
• Legumes
• Beans
• Dried peas
• Lentils
• Apples
• Pears
• Strawberries
• Blueberries

 

Foods with Insoluble Fiber

• Whole wheat bread
• Barley
• Couscous
• Brown rice
• Bulgur
• Whole grain breakfast cereals
• Wheat bran
• Seeds
• Carrots
• Cucumbers
• Zucchini
• Celery
• Tomatoes

 

 

Health Effects of Eating Fiber

Fiber is helpful to the body in many ways:

1.  Relieving constipation and hemorrhoids

Fiber can absorb large amount of water in the bowel.  This makes stools softer and easier to pass.

2.  Keeping weight under control

Foods containing plenty of fiber have more bulk than low-fiber foods.  If taken in the right form at the right time and at sufficient quantities, fiber can sometimes slow the onset of hunger.

3.  Preventing Certain Diseases

Fiber intake has been importantly linked with the metabolic syndrome.  This is a constellation of factors that increases the chances of developing diseases: heart disease, diabetes, high blood pressure, high insulin levels, excess weight, high levels of triglycerides, body's main fat-carrying particle and low levels of HDL (good) cholesterol. Getting enough fiber in the diet can lower the risk of developing certain conditions such as:

• Heart Disease
• Diverticular disease
• Gallstones and kidney stones
• Type 2 Diabetes
• Colon Cancer

Fiber vs. Heart Disease

Heart disease is characterized by the building up of cholesterol-filled plaque in the coronary arteries --- arteries that feed the heart. This condition leads these parts to become narrow and stiff (this is commonly known as atherosclerosis). When there is already total blockage of a coronary artery, heart attack occurs.  The high intake of dietary fiber prevents the blockage and helps lower risk of heart disease.

Fiber vs. Diverticular Disease

Eating dietary fiber more particularly insoluble fibers lower risk of diverticular disease. Diverticulitis is painful disease characterized by the inflammation of the intestine, is one of the most common age-related disorders of the colon.

 

Fiber vs. Constipation

High-fiber dietary intake relieves and prevents constipation because gastrointestinal tract is highly sensitive to dietary fiber.  The fiber in wheat bran and oat bran are more effective in same amounts with that fiber in fruits and vegetables.

Fiber vs. Type 2 Diabetes

High-fiber diet and low in high-glycemic-index foods helps maintain healthy weight, being physically active and lower risk of Type 2 diabetes.   Type 2 diabetes is another kind of diabetes which is characterized by sustained high blood sugar levels. This condition happens when the body can no longer produce enough of the hormone insulin to lower blood sugar to normal levels or cannot anymore perform the proper use of the insulin that the body produces.

  

Fiber vs. Colon Cancer

 High-fiber diet lowers the risk of colorectal cancer (colon cancer).

Some Healthy and Importance tips for increasing fiber intake:

·  You must eat whole fruits instead of drinking fruit juices.

· You must patronize if not replace white rice, bread, and pasta with brown rice and whole grain products.

·  You must prefer whole grain cereals for breakfast.

· You must choose for snack raw vegetables instead of chips, crackers, or chocolate bars.

· You must substitute legumes for meat two to three times per week in chili and soups.  

·  You must use in dishes whole grains and legumes as part of the main meal or in salads.

Basic information about Assisting the Patient with a Bedpan or Urinal

Assisting the Patient with a Bedpan or Urinal

The equipment used in assisting patient with bedpan or urinal

1. Bedpan or Urinal with cover

2. Rubber protector and cover

3. Toilet Paper

4. Douche Pitcher with warm water (un-sterile)

5. Basin of warm water

6. Soap

7. Hand Towel (bath towel may also be used)

Procedure in assisting patient with Bedpan or Urinal

1. Prepare all equipment and bring to bedside and them place bedpan or chair.

2. Provide privacy to the patient.

3. Fold diagonally upper flap of top sheet near you.  Ask the patient to flex the legs.  Lift the buttocks slightly and simultaneously slip the rubber protector and cover under the buttocks.

4. Remove bedpan cover, Fold and tuck under mattress at the foot of the bed then place bedpan along side of patient. The patient is placed in a comfortable position to facilitate elimination.

5. Help patient lift under the lower lumbar region.  With the free hand slip bedpan under buttocks.  Make sure the patient the patient is comfortable and is in such a position where she will be able to void and/or defecate, without wetting herself or the bed.

6. Place call bell within patient’s reach with instructions to call when through. Weak patients are not left alone when on the bedpan.

7. Assist patient to clean herself. This is done to insure thorough cleaning of patient.

8. Assists patient to lift herself as you remove the bedpan, rubber protector and cover.  Place bedpan on chair and cover with bedpan cover immediately. Assisting will avoid too much strain on the part of the patient.  Covering the bedpan will eliminate embarrassment.

9. Assist patient to wash her hands and then make her comfortable. Washing of the hands is a good health habit.

10. Take all used equipment to the utility room.

11. Observe contents of bedpan before emptying into the aeroflush. Accurate observation is of utmost importance and helpful in the diagnostic of the patient’s illness.

12. Take back equipment to the bedside. All equipment is kept in the table for neatness and facility for next use.

Important Points to Remember in Giving and Removing Bedpan

1. Insure privacy so that tension is relieved and patient’s sphincters are relaxed.

2. Bedpan should be warmed to help the patient to relax.

3. Bedpan should never be left on the floor and should be emptied and cleaned immediately.

Procedure in Giving Bedpan to the Patient

1. Warm the bedpan in the utility room by pouring warm inside and rotating the water around the sides of the bedpan.

2. Cover the bedpan and bring to the patient’s bedside.  Screen the patient.

3. Place the bedpan on the chair at the side of the bed.

4. Hang cover on the foot of the bed or over the back of the chair.

5. Turn back the top sheet without exposing the patient.

6. Flex the patient’s knees and see that the gown or pajama is out of the way.

7. With the other hand, slide the bedpan under the buttocks.

8. Place one hand under the buttocks and help the patient raise his buttocks.

9. Unless contraindicated, raise the patient to the backrest position.  Put the patient in a favorable position for elimination by either elevating head of bed or by placing a small pillow rolled towel under the lumbar region.

10. Place the toilet paper and the call light within easy reach of the patient.

11. Leave the room or unit unless the patient is too weak to be left alone.

Procedure in Removing Bedpan from the Patient

1. Give the toilet paper to the patient.  If the patient is too ill, the nurse is responsible for cleaning the patient.

2. Flex the patient’s knees.  With one hand, raise the buttocks of the patient and remove the bedpan with the other hand.

3. Place the bedpan cover at once and place on the chair.

4. Straighten the top sheet and adjust the back and knee rest.

5. Wash the patient’s hands with soap and water.  Rinse and dry with hand towel.

6. Carry the covered bedpan to the utility room.

7. Empty contents into toilet bowl.  Rinse thoroughly in cold water with bedpan brush. Scald with hot water afterwards.

8. Place in rack to drain.

9. Wash your hands thoroughly.

Procedure with the Bedpan if the Patient does not need Assistance

1. Cover the urinal with a urinal cover and take to the bedside.

2. Place the urinal on the other side of the bed without removing the cover.  If the patient does not need assistance, leave the unit.

3. Be sure that the light is within easy reach.

4. Return to bedside when the patient turns on the signal light.

5. Take the covered urinal to the utility room.

6. Measure urine if an output order is required.

7. Empty and rinse the urinal.  Wash and return to its proper place.

Procedure with the Bedpan if the Patient needs Assistance

1. Fold back the top sheet and bring down the pajamas taking care not to expose the patient.

2. Separate the legs slightly so that the urinal can be placed between them.

3. With one hand holding the urinal, raise the penis the other hand and direct it to the opening of the urinal.

4. After the patient has finished, slowly remove the urinal by withdrawing it from the patient’s legs.

5. Cover with urinal cover and place on the chair. Make the patient comfortable.

6. Measure the urine if an output record is required.

7. Empty the urinal, rinse and place it in the proper place.

Basic information about Aseptic Technique

ASEPTIC TECHNIQUE

Strict aseptic technique is needed at all times in the operating room.  Freshly cut living tissue can become infected easily.  Therefore, it is essential for the nurse and all members of the operating room team to know the common sources of microorganism in an Operating room and the means by which they reach the sterile field to contaminate it.

The operating team consists of:

1. The surgeon
2. First Assistant
3. Second Assistant
4. Scrub Nurse
5. Circulating Nurse

Source of Contamination:

1. Members of the operating team
2. The patient
3. All articles used in the wound and on the sterile set up
4. Dust in the air
5. Other personnel or visitor in the operating room

Control of Sepsis in OR includes:

1. Covering the mouth and nose
2. Clean OR clothes and shoes, not worn outside the OR suite
3. Meticulous housekeeping practices
4. Proper methods of sterilization of all items used
5. Strict aseptic technique in all details
6. Minimum of activity in the room and of movement in and out.

Basic information about Ascaris

 The Ascaris

Ascaris lumbricoides is the most common human helminth with low pathogenicity. However, in cases of heavy intensity infection, life threatening complications may occur. This chapter deals with the epidemiology, mode of transmission, life cycle, pathology, clinical manifestations, and complications of ascaris.

What are the general characteristics of Ascaris?

·  Largest intestinal roundworm

·  Most common intestinal helminth in man

The Epidemiology of Ascaris

·  Ascaris is endemic in our country, with prevalence rates of 80-90% in some areas

·  It affects the most vulnerable sector of the population, children age 2-14 years

·  Ascariasis thrives in areas where there is lack of sanitation practices, like slum areas in urban centers

·  Transmission takes place predominantly:

1. In yard/compound contaminated with human feces
2. In field that has been fertilized with human feces
3. By consumption of contaminated vegetables

·  When prevalence rate is high in children and low in adults, it means that the household type of transmission prevails, a case in which the area around the house is heavily contaminated through indiscriminate defecation by young children.

·  Seasonal variations in the incidence of ascariasis show the major peaks for infection:

a. The highest infection rate is from July to August

b. The lowest infection rate is in October and January

·  It appears that ascaris re-infection and transmission are highest when rainfall is minimal and lowest when rainfall is heaviest.

What is the usual mode of transmission of ascaris?

Ascaris is transmitted through the oral-fecal route by ingestion of embryonated egg on its 3rd stage larva

The Life Cycle and Stages of Ascaris

The Egg

The 2 types of eggs recoverable from stool are:

         

The fertilized egg, which is broadly oval, golden brown in color and is in the single cell stage when passed in the feces

· It’s laid by female worm after copulation

· It measures 55-75µm by 35-50 µm

· The egg shell consists of 3 layers:  

1. The inner non-permeable, lipoidal vitteline membrane
2. It is thick transparent middle layer or glycogen membrane
3. The outermost coarsely mamillated, albuminoid layer, which may be occasionally absent

· The egg survives in the environment for as long as 2 years sensitive to heat, being easily killed at = 70ºC.

The Unfertilized egg

·         It’s laid by uncopulated female worm

·         It never undergoes further development

·         It is generally larger, narrower, and elongated

·         It measures 88-94 µm

The Larva

Infective stage which contains the 3rd stage larva

  

The Adult worm

· It is white, creamy, or pinkish yellow when freshly expelled elongated and cylindrical?

· It measures 15-30cm x 3mm with curved posterior end

· It is smaller, shorter and more slender than the female

· It measures 20-45cm x 5mm with straight posterior end

· It lays about 240,000 eggs/day

· 1 female produces approximately 65,000,000 eggs in 9 months

· Its life span of the worm is as long as 18 months

What is the Pathology of Ascaris?

The Larvae

The larvae cause the following damage as they migrate from the liver to the lungs:

1. Petechial hemorrhages in the lungs

2. Massive damage to the lung tissues

3. Initiation of granulomatous reactions should the larvae get lodged in the brain, eyeball, kidney, or spinal cord

The Adult worms

Because adult worms habitate the upper and middle parts of the small intestines, they cause the following disorders:

1. Decreased fat and nitrogen absorption

2. Increased nitrogen loss through the feces

3. Malabsorption of or intolerance to lactose

What are the Clinical Manifestations of Ascaris?

1. There is vague abdominal pain

2. There would be enlarged abdomen

3. There would be Diarrhea

4. There would be Weight loss

5. There would be Vomiting

6. There would be presence of live worms in the stool or vomitus if infection is severe

What are the complications of Ascaris?

1. Loefflers's syndrome is an allergic eosinophilic infiltration of the lung usually seen in hypersensitive individuals.

2. Pathology in the liver, brain, or eyeball as larvae, migrating through the bloodstream, may eventually be lodged in these organs.

3. Wanderlust or erratic behavior of the worms results in erratic migration which, in turn, may lead to: Acute appendicitis when a worm blocks the appendix; Acute pancreatitis when a worm blocks the pancreatic duct; Acute cholecystitis when a worm blocks the ampulla of vater; Multiple liver abscess when a worm invades the liver parenchyma

4. Intestinal obstruction results when there is a bolus of worms or when the worms become entangled.    Peritonitis when a worm causes bowel perforation

Basic information about Arthritis

 Arthritis

What is Arthritis?

Arthritis is the condition wherein there’s an inflammation of one or more joints in the body. The involved joints are warm, swollen, tender and painful, especially during movement because the collagen in the cartilage had been diminished for various factors.

What are the known types of Arthritis?

• Osteoarthritis
• Gouty arthritis
• Rheumatoid arthritis
• Lupus arthritis

Osteoporosis (or degenerative joint disease)

The Osteoporosis or degenerative joint disease is the most common which occurs chiefly in older persons characterized by the degeneration of articular cartilage.  There are also eventual changes in the bone and synovial membrane, accompanied by pain and stiffness.

Gouty arthritis

Gouty arthritis is the results from large amount of uric acid deposited in the joints.  It may also appear in the body’s other structures such as the ear cartilage, subcutaneous tissues and kidneys.

Rheumatoid arthritis

Rheumatoid arthritis is an inflammatory connective tissue disease.  This is very common among women (35-45 years old) characterized by bilateral, symmetrical joint disease.  There are also erosive changes and positive test for rheumatoid factor. It also affects other organs and systems of the body.

Lupus arthritis

The lupus arthritis a multi-organ disease affecting young women with butterfly rash in the face and polyarthritis and the involvement of other organs like the kidneys, lungs and the heart.

How does individual develop Osteoarthritis?

Osteoarthritis may result from the following:

• The wear and tear of the joints due to aging
• The family tendency to develop arthritis
• The obesity causing extra stress on the joints
• The joint trauma due to spot injury
• The repetitive overuse of joints
• The joint inflammation secondary to gout or rheumatoid arthritis

What are the main symptoms and signs of Osteoarthritis?

• The arthritic patients will be suffering from pain, stiffness and swelling of the joints (such as hands, knees, ankles and hips).
• The arthritic joints usually may produce deformities most common in the hands and fingers.
• The symptoms and signs arthritis may not be exhibit in some patients even though some arthritic changes are shown in the x-ray findings.

What is the number statistics of Osteoarthritis?

Osteoarthritis is very ordinary and commonly affects people who are already over age of 45 years old. The statistics also increases with age. Over 50% of those 65 years old and above develop sighs of osteoarthritis on x-ray. In the Philippines alone, it is estimated that about 11 million Filipinos suffer from osteoarthritis based on a recent prevailing survey of 16%.

What would results to the joint of an arthritic patient?

The cartilage (which is composed of 50% collagen) that protects the joints and cushions the bones during movement breaks down because of aging and perhaps repetitive abusive use. The cartilage tends to be damaged when the joint is used. Repairing process is only possible and sets in when there’s formation of new cartilage.

The pain is caused by friction when the spurs are formed that hamper the movement of the joints because of the bones growth.

How shall we manage Osteoarthritis?

The main aim why we are treating Osteoarthritis is to reduce and/or relieve pain, decrease the inflammation in order to increase our mobility. These are achieved through:

• Taking enough rest
• Regular Exercise like muscle stretching and strengthening
• Maintain proper weight and weight reduction for overweight or obese
• Drug treatment like using analgesic/anti-inflammatory drugs
• Physical therapy and treatment by way of heat and exercise for weight-bearing joints
• Using joint protection like canes, braces, bandages and walking aids
• Undergoing joint replacement in severe cases

What are the common drugs that physicians prescribe to relieve pain and joint swelling in arthritis?

• Paracetamol
  If your joint pain and inflammation is very minimal, Paracetamol is effective in relieving the pain.
• NSAID
  (Non-steroidal Anti-Inflammatory Drug)

If your joints are painful and swollen and you find it difficult to move, your doctor may prescribe an NSAID (Non-Steroidal Anti-Inflammatory Drug) which reduces inflammation by blocking the release of pain substances known as prostaglandins.

NSAID is tolerated by some patients by taking occasionally. Take caution, if large doses are taken for more thank two weeks, this may caused you stomach upset, nausea, vomiting or diarrhea. There may also allergic reactions in some hypersensitive persons. Furthermore, NSAID may lead to stomach bleeding and kidney failure usually with some elderly people and those with ulcer and kidney disease history.