Follow-through- Diabetic
My name is Arman. I'm on my forties.I have this problem like at times I was having a blurred vision.I am overweight and have a sedentary lifestyle. What could you help me then?
Author:
Arman I don't know how you are feeling today but base on what you have told me the manifestation could lead to something else. Why don't you try to visit hospital and have a check-up. Most probably you could ask for an FBS then you could text me again.
I have my Hgt done by my niece who is a nurse it is about 380. Anyway my niece said that I can work on my sugar by going to the gym and watching my diet.
Author:
I don't know but I guess both of you are denying that you've got a problem. Anyway tell her to repeat Hgt.This time you have to fast for about 8 hours.That is no food intake from 12 midnight until you have your Hgt, alright!
I had my Hgt it is 200. I am afraid 0f medicine especially if I am going to take it for the rest of my life
Author:
That is still high. Try FBS and you have to fast for the next 8 hours once more. You have no choice. You have to take oral medicine otherwise some of your internal organs might be compromise.
Yes I have the result now. It is 10.1 mmol/l but the normal values are 4.2-6.4 mmol/l. Thanks! The doctor told me to drink oral medicine twice. One tablet in the morning and another at night. It is Metformin HCl 500 mg tablet oral hypoglycemic. It does not cost me much unlike before I used to take herbal medicines that have no therapeutic effects. I feel better now. I owe it to you probably I just need someone to talk to. Cheers!
Author:
Not yet! You don't owe me anything. I am just a nurse and I consult also the physician as you did. You owe it to yourself for seeking help. You owe God for enlightening your mind. Hey I guess you should try checking your HbA1c, as well . Go back to the physician after the result so he could adjust the dosage of your medicine accordingly.
I have my HbA1c. It is 10.0 % ; the normal values are 4.50-6.30 %. The doctor told me to take my oral medicine 3 times a day with meals. Meanwhile, I have to take my medicine religiously and probably next month I will get my Hgt once more and the doctor will work from there. Hopefully if it goes down I would reduce my medicine .Thanks, I will keep an update for you!
I have tried my Hgt today and it is about 175. I feel great!
Author:
Cool ! You should maintain it at 90. I suggest you have an FBS after 2 weeks of taking your medicine so the dosage be adjusted.
I just got my Hgt today and it is 112. I am feeling good!
Author:
That is great! Do not forget to have your FBS a week after so dosage of your medicine could be reduced.
I just got my FBS today and it is 6.2 mmol/l. The normal value is 4.2-6.4 mmol/l . The physician told me that I just got the right dose so I have to continue my Metformin HCl 3 x a day.
Author :
Good to hear that I am hoping that you would feel better each day!
I got my Hgt today and it is 151.
Author:
That's a bit high. Continue with your medications and have a check-up . What have you been doing lately?
I have been eating a lot. I always feel hungry lately. I feel too tired at times. I also drink a lot.
Author:
Based on your Hgt you are supposed to add more medicine . You have to watch your carbohydrates and sugar intake. Alcohol may cause an adverse reaction while you are taking the medication. I thought you want to get cured . Why are you doing this?
Sorry . I just feel like am depriving myself of all the things that I love doing.
Author:
I do not know what you are doing. Helping yourself is not deprivation.
Sorry! I am trying to adjust on my present situation. Much as I could I watch my carbohydrates intake, do some daily exercise and limit alcohol . I just cannot update you on my Hgt because I find it hard every now and then to visit hospital for that. Could you recommend any alternative?
Author:
Perfect! I suggest if you have extra money to buy the glucometer,, needles and strips for Hgt, you must purchase now. Checking your Hgt will be a routine to update your blood sugar.
Hello! It's been quite while since I updated you. I was not able to buy the glucometer. I feel like I can't prick on my fingers. I'll just leave the Hgt thing to the physician or nurse. Anyway my latest Hgt reading is 99. I actually feel better lose weight and almost 2 to 3 kg away to having that perfect normal weight. I see things clearer like I've never seen them before. I slim down and I have learned to appreciate the taste of food. Thanks!
Author:
Good to hear that! Well you were able to survive the consequences of having Type II diabetis and that includes lost of vision, amputation of gangrened foot and others. Keep on taking your medication regularly and avoid too much sweets, carbohydrates and alcohol. Keep your body fit by doing exercises regularly. Cheers!
______________________________________________________________
My name is Philip. Like Arman I used to splurge drinking , eating and having fun . Now I feel like I am starting to loose my hearing.
Author:
How did you notice that you can't hear well anymore?
I used to clean my ears and everytime I put this bud in my ear I can hear the usual sound it creates. But now no matter how I roll the bud I could not hear that sound anymore.
Author:
What did you do then to help yourself ?
I bought an expensive hearing aid but when I tried it at home it won't work.
Author:
Please consult a physician and ask for assistance.
Thanks! The physician told me that hearing aids have specialize treatment on an ear problem. It is like eyeglasses that we use for a particular eye defect.
Author:
I suggest you visit an EENT.
Hello I visited an EENT today. He checked my ears and he said it is clogged. He prescribed me antibiotics and eardrops. He asked me to go back after a week. He take a look at the hearing aid I bought and he said it didn't fit my ear. That was too large for me. Byebye now!
Author:
See sometimes we bought things that was really not cool. Anyways update me alright?
Yeah! Just done with antibiotics. I feel great today. The doctor told me to continue on my eardrops. He told me that the clogged was almost gone. Thanks!
Author:
No problem sir. So long as you are concerned with your health you will have a great day ahead of you!
Thank you I can hear things clearer now!
____________________________________________________________________
My name is Martin. I am 26 years old. Alcohol is my cure. Until last night, I got my BP result and it is 140/100. I am afraid because I am still too young to be hypertensive. How could you help me then?
Author:
I suggest you visit a physician at once.
Yes ,I consulted a doctor and he prescribed me Calciblre 5mg. I feel better now.
Author:
Good for you. Maybe you can cut-off or at least decrease your alcohol intake.
Saturday, February 27, 2010
BLOOD TRANSFUSION
Thanks to those who read my post . I don't earn here except that you benefit from whatever I was able to share. Goodluck in all your undertakings!
But if you really insist you can always help through Metrobank S/A No. 2348004756. My account name is : Celso Balonzo. Thank you from Philippines, Mabuhay!
May God bless you always!
Nursing Procedures- are the usual routine in a hospital setting. These include: blood transfusion, NGT, etc.
BLOOD TRANSFUSION
- The introduction of whole blood or components of the blood , plasma , serum, erythrocytes, or platelets into the venous circulation.
Why are blood transfusion performed?
- for anticipated loss of blood during the surgery
- a low blood count before, during or after the surgery
- severe heart failure (COPD , Anemic, CHF, MI)
- Bone marrow failure
- moderate to severe anemia
What is blood made of ?
- Human blood is made of a fluid called plasma that carries red and white blood cells and platelets.
What are red blood cells?
- It carry oxygen from the lungs to to her body organs and carbon dioxide back to the lungs.
What are white blood cells ?
- It fight infections by destroying bacteria, viruses and germs.
What are platelets?
- It helps control bleeding by making clots in the blood vessels opened by surgery or injury.
What is plasma?
- It carries the blood cells throughout the body and contains proteins and minerals. some proteins help the blood to clot.
Is blood tansfusion safe?
- Blood used at most hospitals are from volunteer donors.
- Each blood donor must answer medical history questions and be given a limited physical examination before accepted as donor.
- Donated blood is carefully tested for hepatitis viruses B and C, HIV, human T- lymphotrophic viruses I and II, and syphilis
Transfusion products:
Packed Red Blood Cells
- most commonly transfused blood component
- restores blood oxygen during capacity
- can be refrigerated for up to 42 days
- take oxygen through the bloodstream to every part of the body and bring carbon dioxide back to the lungs
- normally made in the bone marrow, the soft inner part of the bone
- usually given into a vein over 2-4 hours
Whole Blood
- contains red blood cells and plasma
- often used for open heart surgery, for exchange transfusion in newborn babies with hemolytic disease and for massive blood loss
Fresh Frozen Plasma
- plasma which was frozen and stored shortly after it was obtained from the blood donor
- defined as the fluid portion of one unit of human blood that has been centrifuged, separated and frozen solid at 18 degrees Celsius within 6 hours of collection.
- thawed plasma may be transfused up to 5 days after thawing
- one unit is approximately 250ml and must be ABO compatible
Cryoprecipitate
- a frozen blood product prepared from plasma
- indicated for hemophilia A , hypofibrinogenaemia , bleeding from excessive anticoagulation, massive hemorrhage, and disseminated intravascular coagulation.
- compatibility testing is not indicated but it is given as ABO compatible
- AB type is the universal plasma donor; O type is the universal plasma recipient
Platelets
- cell fragments which prevent or stop bleeding or bruising by physically plugging the hole in the blood vessels.
- usually given into a vein over a few minutes to an hour
- indicated for thrombocytopenia, acute leukemia, to restore platelet count preoperatively
- if a patient's bone marrow is not producing platelet, then platelet transfusion is needed once or twice a week
Granulocytes
- type of white blood cells that help the body fight infection
- also called neutrophils
- for severe gram negative infection or severe neutropenia unresponsive to routine forms of therapy in immunosuppressive patients
- usually infused into a vein over 1-2 hours
- given daily for 5 days or until the patient's granulocyte count returns to normal level
BLOOD TYPE IDENTIFICATION
Patient/ (Compatible Transfusion) Plasma/ RBC
Type A / Type A or AB/ Type A or O
Type B/ Type B or AB / Type B or O
Type AB / Type AB / Type A, B, AB or O
Type O / Type A, B, AB or O/ Type O
Rh(-)/ Must receive RH (-) blood
Rh (+)/ Can receive Rh (-) or (+)
O(-)/-/ Universal donor for RBC
AB (+)/ Universal donor for plasma
Purposes
- to increase the circulating blood volume as in shock due to hemorrhage
- to increase red cell volume of hemoglobin content of the blood as in anemia
- to increase WBC content of the blood as in agranulocytosis and leukopenia
- to increase the quantity of protein (malnutrition), excessive loss of protein from burns or vesicular skin diseases
MATERIALS NEEDED
- Intravascular tray
- Plain NSS
- Compatible blood transfusion set
- Tourniquet
- Intravenous catheter/ needle/ gauge 18/19
- Blood product
- Gloves (sterile)
- Micropore
- IV stand / pole
- Cotton balls with alcohol
PROCEDURE
1. Verify doctor's order and make a treatment card.> To avoid mistakes
2. Explain procedure to the patient.> Encourage patient's cooperation and decrease anxiety
3. Check the availability of blood components, blood typing and amount of blood. > To prevent blood transfusion reaction and lethal effect of transfusion
4. Warm the blood at room temperature (30 C) by wrapping the blood bag with towel. Blood should be transfused not more than 20 minutes from the time it arrives from the blood bank. > To prevent untoward blood reaction
5. Have a doctor or a nurse to countercheck the compatible blood to be transfused:
> Name and identification number
> Patient's blood group and Rh type
> Donor's blood group and Rh type
> X-match compatibility
> Blood unit and serial component
> Expiration date of blood product (FWB, PRBC, FFP, Cryoprecipitate)
> To prevent any problem in relation to transfusion
6. Get the baseline vital signs before transfusion. (PR/CR, RR, BP, Temperature). > To compare any change in vital signs before and during BT
7. Get premedication 30 minutes before transfusion (anti-histamine, benadryl, antamin, paracetamol). > To prevent minor allergic reaction
8. Wash hands and don gloves. > To prevent contamination of microorganisms
9. Initiate an intravenous line with appropriate cannula with plain NSS, anchor catheter properly and regulate rate. > To flush out tubing and keep IV open
10. Open compatible blood aseptically and spike blood bag carefully; prime tubing and remove bubbles. > To prevent air embolism
11. Disinfect the Y injection port of IV tubing and insert the needle from the BT administration set and secure with adhesive tapes.
12. Close IV fluid of plain NSS or regulate to KVO while transfusion is going on.
13. Transfuse the blood for 4-6 hours via injection port at 10-15 gtts/min then regulate at ordered time.
14. Observe for any untoward signs and symptoms such as chills, elevated temperature, itchiness, urticaria, flushed skin and dyspnea. > Transfusion reaction occurs during the first 10-15 minutes of transfusion. If any occurs, stop the transfusion and report to the physician.
15. Swirl the bag (FWB) once in a while.> To mix the solid and liquid elements of the blood.
RBC tends to settle at the bottom of the solution while the plasma rises to the top as the blood bag hangs
16. If blood is consumed, close roller clamp of blood transfusion set then disconnect from the intravenous line and regulate the intravenous fluid as ordered.
17. Carry out post BT order such as repeat hgb and hct, bleeding time, serial platelet count , etc.
18. document observations done.
>Time started
>Time ended
>Blood transfusion reactions, if any
ADVERSE REACTIONS:
- Circulatory overload
- Sepsis
- Febrile reaction
- Allergic reaction
- Acute hemolytic reaction
But if you really insist you can always help through Metrobank S/A No. 2348004756. My account name is : Celso Balonzo. Thank you from Philippines, Mabuhay!
May God bless you always!
Nursing Procedures- are the usual routine in a hospital setting. These include: blood transfusion, NGT, etc.
BLOOD TRANSFUSION
- The introduction of whole blood or components of the blood , plasma , serum, erythrocytes, or platelets into the venous circulation.
Why are blood transfusion performed?
- for anticipated loss of blood during the surgery
- a low blood count before, during or after the surgery
- severe heart failure (COPD , Anemic, CHF, MI)
- Bone marrow failure
- moderate to severe anemia
What is blood made of ?
- Human blood is made of a fluid called plasma that carries red and white blood cells and platelets.
What are red blood cells?
- It carry oxygen from the lungs to to her body organs and carbon dioxide back to the lungs.
What are white blood cells ?
- It fight infections by destroying bacteria, viruses and germs.
What are platelets?
- It helps control bleeding by making clots in the blood vessels opened by surgery or injury.
What is plasma?
- It carries the blood cells throughout the body and contains proteins and minerals. some proteins help the blood to clot.
Is blood tansfusion safe?
- Blood used at most hospitals are from volunteer donors.
- Each blood donor must answer medical history questions and be given a limited physical examination before accepted as donor.
- Donated blood is carefully tested for hepatitis viruses B and C, HIV, human T- lymphotrophic viruses I and II, and syphilis
Transfusion products:
Packed Red Blood Cells
- most commonly transfused blood component
- restores blood oxygen during capacity
- can be refrigerated for up to 42 days
- take oxygen through the bloodstream to every part of the body and bring carbon dioxide back to the lungs
- normally made in the bone marrow, the soft inner part of the bone
- usually given into a vein over 2-4 hours
Whole Blood
- contains red blood cells and plasma
- often used for open heart surgery, for exchange transfusion in newborn babies with hemolytic disease and for massive blood loss
Fresh Frozen Plasma
- plasma which was frozen and stored shortly after it was obtained from the blood donor
- defined as the fluid portion of one unit of human blood that has been centrifuged, separated and frozen solid at 18 degrees Celsius within 6 hours of collection.
- thawed plasma may be transfused up to 5 days after thawing
- one unit is approximately 250ml and must be ABO compatible
Cryoprecipitate
- a frozen blood product prepared from plasma
- indicated for hemophilia A , hypofibrinogenaemia , bleeding from excessive anticoagulation, massive hemorrhage, and disseminated intravascular coagulation.
- compatibility testing is not indicated but it is given as ABO compatible
- AB type is the universal plasma donor; O type is the universal plasma recipient
Platelets
- cell fragments which prevent or stop bleeding or bruising by physically plugging the hole in the blood vessels.
- usually given into a vein over a few minutes to an hour
- indicated for thrombocytopenia, acute leukemia, to restore platelet count preoperatively
- if a patient's bone marrow is not producing platelet, then platelet transfusion is needed once or twice a week
Granulocytes
- type of white blood cells that help the body fight infection
- also called neutrophils
- for severe gram negative infection or severe neutropenia unresponsive to routine forms of therapy in immunosuppressive patients
- usually infused into a vein over 1-2 hours
- given daily for 5 days or until the patient's granulocyte count returns to normal level
BLOOD TYPE IDENTIFICATION
Patient/ (Compatible Transfusion) Plasma/ RBC
Type A / Type A or AB/ Type A or O
Type B/ Type B or AB / Type B or O
Type AB / Type AB / Type A, B, AB or O
Type O / Type A, B, AB or O/ Type O
Rh(-)/ Must receive RH (-) blood
Rh (+)/ Can receive Rh (-) or (+)
O(-)/-/ Universal donor for RBC
AB (+)/ Universal donor for plasma
Purposes
- to increase the circulating blood volume as in shock due to hemorrhage
- to increase red cell volume of hemoglobin content of the blood as in anemia
- to increase WBC content of the blood as in agranulocytosis and leukopenia
- to increase the quantity of protein (malnutrition), excessive loss of protein from burns or vesicular skin diseases
MATERIALS NEEDED
- Intravascular tray
- Plain NSS
- Compatible blood transfusion set
- Tourniquet
- Intravenous catheter/ needle/ gauge 18/19
- Blood product
- Gloves (sterile)
- Micropore
- IV stand / pole
- Cotton balls with alcohol
PROCEDURE
1. Verify doctor's order and make a treatment card.> To avoid mistakes
2. Explain procedure to the patient.> Encourage patient's cooperation and decrease anxiety
3. Check the availability of blood components, blood typing and amount of blood. > To prevent blood transfusion reaction and lethal effect of transfusion
4. Warm the blood at room temperature (30 C) by wrapping the blood bag with towel. Blood should be transfused not more than 20 minutes from the time it arrives from the blood bank. > To prevent untoward blood reaction
5. Have a doctor or a nurse to countercheck the compatible blood to be transfused:
> Name and identification number
> Patient's blood group and Rh type
> Donor's blood group and Rh type
> X-match compatibility
> Blood unit and serial component
> Expiration date of blood product (FWB, PRBC, FFP, Cryoprecipitate)
> To prevent any problem in relation to transfusion
6. Get the baseline vital signs before transfusion. (PR/CR, RR, BP, Temperature). > To compare any change in vital signs before and during BT
7. Get premedication 30 minutes before transfusion (anti-histamine, benadryl, antamin, paracetamol). > To prevent minor allergic reaction
8. Wash hands and don gloves. > To prevent contamination of microorganisms
9. Initiate an intravenous line with appropriate cannula with plain NSS, anchor catheter properly and regulate rate. > To flush out tubing and keep IV open
10. Open compatible blood aseptically and spike blood bag carefully; prime tubing and remove bubbles. > To prevent air embolism
11. Disinfect the Y injection port of IV tubing and insert the needle from the BT administration set and secure with adhesive tapes.
12. Close IV fluid of plain NSS or regulate to KVO while transfusion is going on.
13. Transfuse the blood for 4-6 hours via injection port at 10-15 gtts/min then regulate at ordered time.
14. Observe for any untoward signs and symptoms such as chills, elevated temperature, itchiness, urticaria, flushed skin and dyspnea. > Transfusion reaction occurs during the first 10-15 minutes of transfusion. If any occurs, stop the transfusion and report to the physician.
15. Swirl the bag (FWB) once in a while.> To mix the solid and liquid elements of the blood.
RBC tends to settle at the bottom of the solution while the plasma rises to the top as the blood bag hangs
16. If blood is consumed, close roller clamp of blood transfusion set then disconnect from the intravenous line and regulate the intravenous fluid as ordered.
17. Carry out post BT order such as repeat hgb and hct, bleeding time, serial platelet count , etc.
18. document observations done.
>Time started
>Time ended
>Blood transfusion reactions, if any
ADVERSE REACTIONS:
- Circulatory overload
- Sepsis
- Febrile reaction
- Allergic reaction
- Acute hemolytic reaction
Subscribe to:
Posts (Atom)