Parkinson's disease is a progressive disorder of the nervous system that affects movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while a tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes stiffness or slowing of movement. In the early stages of Parkinson's disease, your face may show little or no expression, or your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time. Although Parkinson's disease can't be cured, medications may markedly improve your symptoms. In occasional cases, your doctor may suggest surgery to regulate certain regions of your brain and improve your symptoms.

Four-Step Guide to ABG Analysis Is the pH normal, acidotic or alkalotic? Are the pCO2 or HCO3 abnormal? Which one appears to influence the pH? If both the pCO2 and HCO3 are abnormal, the one which deviates most from the norm is most likely causing an abnormal pH. Check the pO2. Is the patient hypoxic?

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Spine Examination

Physical assessment is taking an educated, systematic look at all aspects of an individual’s health status utilizing knowledge, skills and tools of health history and physical exam. To collect data- information about the client’s health, including physiological, psychological, sociocultural and spiritual aspects To establish actual and potential problems To establish the nurse-client relationship Method: The history is done first, then the physical examination focuses on finding data associated with the history. Health History- obtained through interview and record review. Physical exam- accomplished by tools and techniques ** A complete assessment is not necessarily carried out each time. A comprehensive assessment is part of a health screening examination. On admission, you will do an admission assessment (not necessarily including everything presented here) and document it on the admission form. You will do a daily shift assessment (patient systems review). And, if client has a specific problem, you may assess only that part of the body (focused). Data Collection: Information is organized into objective and subjective data: Subjective: Apparent only to person affected; includes client’s perceptions, feelings, thoughts, and expectations. It cannot be directly observed and can be discovered only asking questions. Objective: Detectable by an observer or can be tested against an acceptable standard; tangible, observable facts; includes observation of client behavior, medical records, lab and diagnostic tests, data collected by physical exam. ** To obtain data for the nursing health history, you must utilize good interview techniques and communications skills. Record accurately. DO NOT ASSUME. D. Frameworks for Health Assessment There are two main frameworks utilized in health assessment: Head to Toe- systematic collection of data starting with the head and working downward. Functional Health Assessment- Gordon’s 11 functional health patterns that address the behaviors a person uses to maintain health. PERSON is the ACC-ADN framework for assessment. It is similar to Gordon's functional health patterns.

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Dialysis patients need to choose their heart medicine carefully, as Canadian researchers say that some beta blockers are easily removed from the blood during treatment. Also, people who eat a Mediterranean diet may decrease their risk of developing kidney problems. Eboni Williams reports on the day's top health news.

#dialysis #uvahealth
If your kidney function is declining and medications and other treatments aren’t working, dialysis can offer life-saving care. UVA has one of the largest dialysis programs in the country. Nephrologist Daphne Knicely, MD, explains the types of home dialysis and how they can work to fit your life.

Find out more at: https://uvahealth.com/services/dialysis

Transcript

Dialysis is just a way to replace the kidneys when they're not working anymore. So when the kidneys stop working, they stop getting rid of water, stop balancing the chemistry, stop getting rid of the toxins. Then dialysis does its job by balancing the chemistries, getting rid of the toxins, and help remove fluid. It doesn't fix the kidneys. It just replaces them.

I usually think of dialysis as two components. There's hemodialysis and peritoneal dialysis. So peritoneal dialysis can only be done at home. Hemodialysis can be done in a center, or it can be done at home.

Hemodialysis is where you have some sort of access to the blood. Either some sort of shunt in the arm that connects an artery and vein, or a catheter. And it allows for blood to leave you, go through a machine, get cleaned, chemistries balanced, and then comes back to you.

For home hemodialysis, the patient actually learns how to do that treatment. It's a very simple machine, very user-friendly. Training is usually about anywhere from four weeks up to eight weeks, and you work one-on-one with a nurse. You still see the physician. You come in about once a month, maybe twice a month, to get labs. You'll see a social worker, and a nutritionist at the same time.

Peritoneal dialysis takes place by putting a tube into your abdomen. And we take dialysis fluid that's chemically balanced. When we put it into the abdomen, it uses those little blood vessels to pull toxins out, to balance chemistries, kind of like little filters. Now, after it sits in there for several hours, we drain it out.

Anyone that needs dialysis is a candidate for home dialysis. There's not one type of dialysis that's going to make you live longer. They're all equal. The goal is to pick the type of dialysis that fits with your life.

Cushing's disease is a serious condition of an excess of the steroid hormone cortisol in the blood level caused by a pituitary tumor secreting adrenocorticotropic hormone (ACTH). ACTH is a hormone produced by the normal pituitary gland. ACTH stimulates the adrenal glands (located on top of the kidneys) to produce cortisol, commonly referred to as the stress hormone.

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In this instructional video, Director of Critical Care Nephrology, Sevag Demirjian, MD goes over the steps for in-hospital production of ultra-pure continuous hemodialysis fluid.

By using the information in this video and/or any other materials made available by Cleveland Clinic related to the dialysate solution, you agree to comply with and be bound by the terms of the Permissive Use Agreement, a copy of which is available at https://bit.ly/3f9lN4j

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General Examination - Clinical Skills OSCE - Dr Gill

The general examination is one of those early exams, which is essentially used to start medical students off with their clinical skills studies.

In the real world, it's mainly used with regard to gaining an overview of a patient, such as for a medical check up, or a baseline examination, for example, a health report.

They have been a couple of comments about the pulse monitor used in the video. For those who are interested. I’ve reached out to the manufacturer, and they’ve requested that the following code is provided to viewers, in order to get 20% off, if they decide on themselves.

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Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.

Some people watching this video may experience an ASMR effect

#DrGill #Asmr #Clinicalskills

#drgill #clinicalskills #asmr

Shoulder Clinical Examination - Medical School Clinical Skills - Dr Gill

Personally, I find the shoulder examination the most complex examination possibly as there are so many variations and special tests. Some of which overlap and some will relate specifically to a patients presentation.

Often in a medical school syllabus, only select special tests will be used. In this shoulder exam demonstration, we include the Hawkins-Kennedy Test looking for impingement. This is dovetailed with examination for bicipital tendonitis as this is another possible cause of impingement type symptoms.

This shoulder upper limb exam follows the standard "Look, Feel, Move" orthopaedic exam approach, and overall order as set out in MacLeods Clinical Examination

Watch further orthopaedic examinations for your OSCE revision:

The Spine Examination:
https://youtu.be/pJxMHa6SCgU

Knee Examination
https://youtu.be/oyKH4EYfJDM

Hip Joint Clinical Examination
https://youtu.be/JC9GKq5nSdQ
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.

However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.

The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.


#ShoulderExamination #ClinicalSkills #DrGill

Extracorporeal shock wave lithotripsy (ESWL) uses shock waves to break a kidney stone into small pieces that can more easily travel through the urinary tract camera.gif and pass from the body. See a picture of ESWL camera.gif. You lie on a water-filled cushion, and the surgeon uses X-rays or ultrasound tests to precisely locate the stone. High-energy sound waves pass through your body without injuring it and break the stone into small pieces. These small pieces move through the urinary tract and out of the body more easily than a large stone. The process takes about an hour. You may receive sedatives or local anesthesia. Your surgeon may use a stent if you have a large stone. A stent is a small, short tube of flexible plastic mesh that holds the ureter open. This helps the small stone pieces to pass without blocking the ureter.

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