Rose Water Recipe

Rose Water Recipe Rose water is one of several products your can buy or make that retains the fragrance of rose petals. It is used in perfumes and cosmetics, plus it has slightly astringent properties, so it makes an excellent facial toner. Because the commercial process used to make rose water is labor intensive and requires a lot of roses, its an expensive product to buy. However, if you have roses, you can make your own rose water quite easily. Its an easy example of distillation, an important chemical separation and purification process. Rose Water Materials rose petalswatersmall pancotton balls Experiment with different types of roses, since each rose has its own characteristic scent. Damask rose has the classic rose scent, but some roses smell like citrus fruit, spices, or licorice.The resulting rose water wont smell exactly the same as the original flowers because distillation only captures some of the volatile compounds present in the petals. There are other methods used to capture other essences, such as solvent extraction and more complex distillations. Directions Place the rose petals in a small pan.Add enough water to just barely cover the petals.Gently boil the water.Collect the steam that boils off using a cotton ball. You may wish to place the cotton ball on a fork or hold it with tongs, to avoid getting burned. Once the cotton ball is wet, remove it from the steam and squeeze it out over a small jar. This is the rose water.You can repeat the process to collect more steam.Store your rose water in a sealed container, away from direct sunlight or heat. You can refrigerate it to keep it fresh longer. Large Scale Rose Water Recipe Are you ready for a more advanced version of the project? If you have a few quarts of rose petals, you can collect much more rose water using a slightly more complex home steam distillation apparatus: 2-3 quarts rose petalswaterice cubespot with rounded lidbrickbowl that fits inside pot Place the brick in the center of the pot. There is nothing magical about the brick. Its purpose is simply to hold the collection bowl above the surface of the roses.Put the rose petals in the pot (around the brick) and add enough water to barely cover the petals.Set the bowl on top of the brick. The bowl will collect the rose water.Invert the lid of the pot (turn it upside down), so the rounded part of the lid dips into the pot.Heat the roses and water to a gentle boil. Place ice cubes on the top of the lid. The ice will cool the steam, condensing the rose water inside the pot and making it run down the lid and drip into the bowl.Continue gently boiling the roses and adding ice as needed until you have collected the rose water. Dont boil off all the water. Youll collect the most concentrated rose water in the first few minutes. After that, it will become more and more dilute. Turn off the heat when you notice the condensation isnt as rose-scented as you would like. You can collect be tween a pint and quart of rose water in 20-40 minutes using 2-3 quarts of rose petals. Other Floral Scents This process works with other floral essences, too. Other flower petals that work well include: honeysucklelilacvioletshyacinthirislavender You can experiment with mixing the scents to make custom fragrances. While rose water, violet water, and lavender water are edible and safe for use in cosmetics, some other types of flowers are only good as fragrances and shouldnt be applied directly to the skin or ingested. Safety Notes This is a fun project for kids, but adult supervision is required because boiling water and steam are involved. Kids can collect flowers and squeeze liquid from cooled cotton balls.If you are using the rose water (or violet or lavender water) for cooking or cosmetics, be sure to use flowers that are free of pesticides. Many gardeners spray flowers with chemicals or feed them with systemic pesticides. For a simple fragrance project, its fine to simply rinse off the flower petals to remove any residue, but avoid using chemically treated flowers for food projects or cosmetics. Learn More Design Your Own PerfumeSolid Perfume RecipeSafety Tips for Making Perfume

Learn How to Use Lo in Spanish

Learn How to Use Lo in Spanish Lo is one of those words that doesnt always have a clear definition - and it can function in at least three different ways, as a subject pronoun, object pronoun, or definite article. When you run across the word in a sentence and dont know what it means, you often need to figure out first how it is being used. Here, in rough order of how common they are, are the ways that lo can be used: Using Lo as a Masculine Direct-Object Pronoun As a direct object, lo can be translated as either him or it. The feminine equivalent is la.  ¿Pablo? No lo vi. (Pablo? I didnt see him.)El coche es muy caro. Quiero comprarlo. (The car is very expensive. I want to buy it.)Dmelo. (Give it to me.)No creo que lo hayas conocido. (I dont think youve met him.) Note that in the above sentences where lo means him, referring to a person, it would be very common in some areas, particularly in Spain, to use le instead of lo. The use of le as a direct object pronoun is known as leà ­smo. Using Lo as a Neuter Definite Article The definite articles in Spanish, typically el and la when singular, are the equivalent of the English the. Lo can be used as a neuter definite article before an adjective to make an abstract noun. For example, lo importante can be translated as the important thing, that which is important, or what is important. Lo bueno es que hemos sido ms listos. (The good thing is that we have been more clever.)Lo barato sale caro. (What seems cheap ends up expensive.)Lo mejor es que me voy a casa. (The best thing is that Im going home.)Lo mà ­o es tuyo. (What is mine is yours.)El entrenador se especializa en lo imposible. (The coach specializes in the impossible.) Lo as a Neuter Direct-Object Pronoun Lo can be used as an object pronoun to refer to something abstract, to an unnamed activity or situation, or to a previous statement. Used in this way, lo is usually translated as it, sometimes as that: No podemos hacerlo. (We cant do it.)No lo comprendo. (I dont understand that.)Mi religià ³n no lo prohibe, pero cada vez que lo hago, le doy las gracias al animal por darme vida. (My religion doesnt prohibit it, but every time I do it, I give thanks to the animal for giving me life.) Using Lo With Ser and Estar It is common when answering questions to use lo  before  the verbs for to be to refer to a preceding noun or adjective. When used in this way, lo has neither number nor gender. -  ¿Es nueva tu computadora?. - No lo es. (Is your computer new? It isnt.)-  ¿Estaban felices?  - Sà ­, lo estaban. (Were they happy? Yes, they were.) Using Lo Que and Lo Cual The phrases lo que and lo cual serve as relative pronouns usually meaning that, what, or that which: La marihuana: Lo que los padres deben saber. (Marijuana: What parents ought to know.)Mis padres me daban todo lo que yo necesitaba. (My parents gave me everything that I needed.)No puedo decidir lo que es mejor. (I cant decide what is better.)No todo lo que brilla es oro. (Not everything that shines is gold.) Using Lo De The phrase lo de can be translated differently depending on the context, but generally means something like the matter concerning: Los senadores republicanos fueron informados sobre lo de la CIA. (The Republican senators were informed about the CIA matter.)Lo de que las nià ±as japonesas se perdieron no era una mentira. (The story about the Japanese girls getting lost wasnt a lie.)Lo de Castro es todo pretextos y mentiras segà ºn sus enemigos. (Castros way of doing things is all pretexts and lies, according to his enemies.) Using Lo in Phrases Phrases using lo, not necessarily in a way that seems intuitive, include: a lo largo de, throughouta lo lejos, in the distancea lo loco, like crazya lo mejor, probablylo sabe todo, he/she knows it allpor lo general, generallypor lo menos, at leastpor lo pronto, for nowpor lo tanto, as a resultpor lo visto, apparently Using Lo as an Indirect Object In some regions, you may occasionally hear the use of lo as an indirect object instead of le. However, this practice, known as loà ­smo, is considered substandard and should be avoided by those learning the language.

Workplace code of conduct Essay Example | Topics and Well Written Essays - 500 words

Workplace code of conduct - Essay Example It is assessed that having ethical framework is, performing the right or moral thing when no one is looking. The implementation and fulfillment of the ethics are a personal preference and consequently, how workplace ethics are managed depend on the personal ethics of those who are in power over that place of work as well as those who work in that operational atmosphere (Ghillyer) and (Workplace-Ethics). It is significant to keep in mind that workplace codes of conduct are shaped through two significant factors. Workplace policy is the initial factor that has to be in agreement via entire laws as well as regulations that are at present in the authority where the business functions. This helps to make sure that essential workplace ethics prevent some pressure or compulsion to employ in actions that are measured to be against the law, encourage favoritism in the workplace, maintaining unfair hiring plus firing carry out or permit salary to be set that are beneath the smallest legal amou nt or the established standards for the area (Tatum). Nowadays the workplace code of conduct /ethics emerges according to the workplace environment. At the present, organizations have better code of conducts for handling all the type of situations. In company code of conduct we see all the aspects from the ethical point of view. The list of ethical conducts is developed through the analysis of the business situation and operational practice. In company we can have code of conduct regarding lot of different aspects, for examples Forced Labor, Child Labor, Harassment or Abuse, Nondiscrimination, Health and Safety, Freedom of Association and Collective Bargaining, Wages and Benefits, Hours of Work and Overtime Compensation (Fairlabor). . For instance, code of conduct for Ubunto available at: http://www.ubuntu.com/community/conduct The above given aspects and codes of conduct seem to fulfill all the areas of

Generic and specific skills Assignment Example | Topics and Well Written Essays - 750 words

Generic and specific skills - Assignment Example Skill defines the ability to execute an undertaking to a predefined level of competency. A range of generic skills is important in the construction industry. Generic skills, which include but are not limited to computing skills, communication, ICT skills, problem solving skills, and team working skills are essential qualifications valued by employers (UK Commission for Employment and Skills, 2014, 1). They supplement the special and technical skills of employees. The varieties of generic and special skills are available in the construction market, which also includes service delivery and supply of materials. Most companies often offer training in generic skills, but specific skills are normally acquired in learning institutions. In China, the construction market constitutes a large percentage of the country’s GDP. The Chinese construction market is growing at a significantly rapid rate. Specific skills such as technological skills are in demand in the construction industry. Design engineers and architects, for instance, require special skills to come up with designs of houses and roads, and examine the structural components of construction. Despite the high unemployment levels, employers still complain of skill deficits (Klosters, 2014, 9). Staffs with generic skills are often subcontracted to work on contractual basis. Unfortunately, development of managerial skills has not been efficient because systems of management largely remain the same (Ahmad and Ryan, n.d., 1). The country’s type of economy creates several jobs in the construction industry, hence the increase of several construction companies. Even so, construction enterprises and design institutes have shown little interest in develop ing skills required in the construction industry. Even so, the competition between Beijing, Hong Kong and Shanghai means that the industry has potential. Both India and China have shown interest in investing in their

Family and friends Essay Example for Free

Family and friends Essay Katherine had done exercise which was more than necessary. She went to the gym about 5 times a week, which had really been a waste of time, as she was underweight and there was no need for her to exercise. This is because she did not have many calories which needed to be burnt off by exercising. Her diet was mainly made up of; unnourished foods and she did not eat as much as she did not either have the time, or did not enjoy eating at all. She was anorexic and also had the eating disorder of being bulimic. Although, my client is a very clean and hygienic person; she likes working in areas which are clean, and thought this was very important. However, my client was a very heavy smoker and alcoholic. Intellectually:  My client worked 6 days a week and only gets Sundays off to spend with her family and friends. Although, the Sunday Katherine sort off she did not make any use of it as she slept most of the day as she was very tired. My client was a very independent person, and did not at all try to be dependents he did not think she was self-worth and she had a low self esteem. Katherine was often stressing about either work or her family this made her become a very paranoid and anxious person. However she was a very hard working person. Emotionally:  Katherine was always depressed because, she is always being caught up in her work. My client does have the ability to go out and socialize; but feels that she does not have the confidence to go out and make new friends. By doing this she thinks bad of herself, which makes her feel disappointed about herself. Katherine was always sad and unhappy, most of the day which did not improve her motherly skills with her children. Socially:  My client had some friends but didnt have a close nor good relationship with both her family and friends. And had a problem against talking to other people and making new friends, as she did not feel self-worth and didnt have the self-esteem to boost her confidence. She wouldnt organize day trips to enjoy her holidays, and whenever she tried something would go wrong.  AFTER:  My client- Katherine Lewis  But now my client is doing more of this. Physically: Katherine now does a regular amount of exercise. My client takes part in more exercise activities; she has also widened her variety in activities, which has been really good for her physical status. She takes part in things like: swimming, aerobics, dance- for about an hour each session, and jogging, walking for about- 30 minutes each day. Katherine has improved her diet dramatically as, she now eats more than usual and has a very spread out and balanced diet plan. Her diet is mainly made up of now, more nutritious and healthy foods; she also replaced her diet of made up of mostly liquids, to fruits and nuts. On the whole Katherine has a stable weight which is really good for her body, and is slowing becoming a much healthier person from before. Intellectually:  My client now gets up earlier and goes to bed quicker, as this refreshes her for the morning activities which lay ahead of her. This also gives her the opportunity to think straight, and get ready for the challenges which may come ahead of her. She has begun thinking more about the positive things in life, rather than always thinking about the negative sides of things. She has stopped stressing so much about her work and home life, so this gives her a better view upon things, such as how to go solve a problem, or how to spend more time with the family. Her intellectual thinking skills, has improved massively, as she feels more confident about herself. Emotionally:  Katherine goes out more, and opens up her feelings much more than she used to. She feels that she has become a more self-assured person, so this encourages her more to go out and spend some time with her family and friends. My client, who used to feel that she had no one to discuss problems with, has now realised that her family and friends are always there to talk to and to confide with. She used to always be depressed, but now has found resolutions to that, and is happier than before. She emotionally is aware that she has many people around her, who will support and provide her with company if she ever needs it. Overall, my client is a supplementary joyful person, than before.  Socially:  Katherine has now started socializing more than she used to. She invites family and friends over to her house, to get to know them better. This has assisted her a lot, in her socializing skills; she goes out more and has meet many new friends; which are all from different backgrounds. She has the confidence, and the assurance to create a relationship with new people.

HUMAN BEINGS AND NATURE DURING THE REVOLUTION OF THE MIND Essay

HUMAN BEINGS AND NATURE DURING THE REVOLUTION OF THE MIND "Enlightenment is man's release from his self-incurred tutelage. Tutelage is man's inability to make use of his understanding without direction from another. Self-incurred is this tutelage when its cause lies not in lack of reason but in lack of resolution and courage to use it without direction from another. Dare to Know! Have courage to use your own reason!- that is the motto of enlightenment." -Immanuel Kant, 1784 (1) From the sixteenth through the eighteenth centuries, a drastically new way of thinking developed in Western Civilization, a way of thinking that has shaped and defined the modern world. This new mode of thought evolved within two movements, the Scientific Revolution and the Enlightenment. These movements led Western Civilization to a departure from reverence for traditional authority, from a fatalistic view of the world, and from a blending of the spiritual and the secular, allowing the emergence of the individualistic, scientific, progress-oriented attitude that fuels the Western world today. The thinking of the leaders of the Scientific Revolution and the Enlightenment built upon and revolutionized that of Medieval and classical intellectuals. It introduced a belief that human beings could learn to control and conquer nature, defining their lives in new ways and leaving a fear of the supernatural behind. Departure from Traditional Authority The most obvious form in which this new way of thinking deviated from the norm was its rebellion against traditional authority, particularly the powerful authority of the Church. The rebellion against traditional authority, particularly the powerful authority of the Church. The astronomer Nicolaus Co... ...vilization, ed. Perry M. Rogers (Upper Saddle River, NJ: Prentice Hall, 1997): p. 23-24. 19. Marquis de Condorcet, "The Progress of the Human Mind," in Aspects of Western Civilization, ed. Perry M. Rogers (Upper Saddle River, NJ: Prentice Hall, 1997): p. 25-26. 20. William Harvey, "I Learn and Teach From the Fabric of Nature," from On the Circulation of the Blood, in Aspects of Western Civilization, ed. Perry M. Rogers (Upper Saddle River, NJ: Prentice Hall, 1997): p. 20-21. 21. Voltaire, "If God Did Not Exist, He Would Have To Be Invented," in Aspects of Western Civilization, ed. Perry M. Rogers (Upper Saddle River, NJ: Prentice Hall, 1997): p. 35-36. 22. Immanuel Kant, "What Is Enlightenment?" in Aspects of Western Civilization, ed. Perry M. Rogers (Upper Saddle River, NJ: Prentice Hall, 1997): p. 32.

Kawasaki Disease

Acknowledgement This case study would not be possible without the guidance and the help of several individuals who are in one way or another contributed and extended their valuable assistance in the preparation and completion of this study. My outmost gratitude to Ms. Maria Donna Duron, the school directress of St. Augustine School of Nursing Espana for her genuine sincerity and encouragement. To my adviser Ms. Cecilia J. Sarte for her patiently supervising and assisting us with their knowledge, as we gradually go through the process of doing the case study itself, sincerest thanks. To my clinical instructor Mr.Joey M. Cadano for all the help and valuable insight he had shared To my instructor Mr. Paolo M. Zabat and all the faculty staff for their moral support and untiring effort in encouraging us to finish our study. To my classmates and friends who gave their moral support and help all the way despite the busy schedules in preparing their own case study. To my family for supportin g me all the way, providing me with everything I need financially and emotionally. Last but not the least, to our Almighty Father for his unceasing guidance and blessings, for constantly giving me hope, courage and patience.Truly none of this is possible without you. ii Table of Contents TitlePage Number I. Acknowledgementii II. Objectiveiv III. Introduction a. Definition1 b. Incidence1 c. Etiology2 d. Manifestations and Complications2 IV. Anatomy and Physiology3 V. Pathophysiology6 VI. Patient’s Profile a. Biographical Data7 b. Chief Complaint7 c. History of Present Illness7 d. Medical History8 e. Family History8 VII. Laboratory Findings9 VIII. Physical Assessment11 IX. Nursing Care Plan15 X. Drug Study20 XI. Discharge Plan23 iii II. Objectives General:The objective of my case study is to develop and acquire understanding, skills, and knowledge about the disease, and health promotion to prevent further complication on the condition of the patient. Specific: Nurse Centered ? Assess the patient’s overall health status ? Impart necessary health teachings to the patient ? Perform appropriate nursing care in conjunction with the condition of the patient ? Widen and enhance the student nurses’ knowledge and skills through additional research about the nature of the disease, its signs and symptoms, its pathophysiology, its diagnosis and treatment.Patient Centered ? Know when to seek help from the health care providers whenever the signs and symptoms may appear ? Understand the occurrence of Kawasaki Disease ? Know what other complications may arise, if left untreated ? Gather information about the therapeutic regimen iv III. Introduction Definition Kawasaki Disease (mucocutaneous lymph node syndrome) is a form of vasculitis identified by an acute febrile illness with multiple systems affected. The cause is unknown, but autoimmunity, infection, and genetic predisposition are believed to be involved.It affects mostly children between ages 3 months and 8 years; 80% are younger than age 5. It occurs more commonly in Japanese children or those of Japanese decent. It has seasonal epidemics, usually in late winter and early spring. It was first described in 1967 by Dr. Tomisaku Kawasaki in Japan. Kawasaki Disease mainly affects the blood vessels, including coronary arteries. Blood vessels throughout the body get inflamed, and the most serious that could happen is on the heart. If left untreated after 10 days, children may have a higher risk to develop heart problems.Kawasaki Disease manifests in three phases: acute, subacute, and convalescent. The acute phase begins with the abrupt onset of high fever that is unresponsive to antibiotics and antipyretics. The child then develops the remaining diagnostic symptoms. During this stage the child is typically very irritable. The subacute phase begins with the resolution of the fever and lasts until all clinical signs of KD have disappeared. During this phase the child is at greatest ris k for the development of coronary artery aneurysms. Echocardiograms are used to monitor myocardial and coronary artery status.In the convalescent phase, all the clinical signs of KD have resolved, but the laboratory values have not returned to normal (6 to 8 weeks after onset). At the end of this stage the child has regained his or her usual temperament, energy and appetite. The cause of Kawasaki Disease is unknown, but it is thought to be immunologic abnormalities that include increased activation of helper T-cells and increased level of immune mediators and anti-bodies that destroy endothelial cells have been detected during the acute phase of the disease.It has been hypothesized that some unknown antigen, possibly a common infectious agent, triggers the immune response in a genetically predisposed child. Incidence Epidemics of Kawasaki disease primarily occur in the late winter and spring, at 2- to 3-year intervals. Approximately 3000 children with Kawasaki disease are hospitaliz ed annually in the United States. The approximate annual race-specific incidence per 100,000 children younger than 5 years is 32. 5 cases for Americans of Asian and Pacific Island descent, 16. 9 cases for non-Hispanic African Americans, 11. cases for Hispanics, and 9. 1 cases for whites. Although Kawasaki disease has been reported in children of all ethnic origins, it occurs most commonly in Asian children, especially those of Japanese descent. Rates are intermediate among blacks, Polynesians, and Filipinos and are lowest among whites. Manifestations and Complications Manifestations: ? Fever for at least 5 days ? Polymorphous rash ? Strawberry tongue ? Cervical lymphadenopathy Complications: ? Changes in the extremities ? Conjunctival infection ? Vasculitis IV. Anatomy and Physiology [pic]Cardiovascular System Knowing the functions of the cardiovascular system and the parts of the body that are part of it is critical in understanding the physiology of the human body. With its comple x pathways of veins, arteries, and capillaries, the cardiovascular system keeps life pumping through you. The heart, blood vessels, and blood help to transport vital nutrients throughout the body as well as remove metabolic waste. They also help to protect the body and regulate body temperature. The cardiovascular system consists of the heart, blood vessels, and blood.This system has three main functions: ? Transport  of nutrients, oxygen, and hormones to cells throughout the body and removal of metabolic wastes (carbon dioxide, nitrogenous wastes). ? Protection  of the body by white blood cells, antibodies, and complement proteins that circulate in the blood and defend the body against foreign microbes and toxins. Clotting mechanisms are also present that protect the body from blood loss after injuries. ? Regulation  of body temperature, fluid pH, and water content of cells. [pic] Lymphatic SystemAn important supplement to the cardiovascular system in helping to remove toxins from the body, the lymphatic system is also a crucial support of the immune system. Unlike blood, lymph only moves one way through your body, propelled by the action of nearby skeletal muscles. The lymph is pushed into the bloodstream for elimination. Appreciating the importance of the lymphatic system in filtering, recycling, and producing blood as well as filtering lymph, collecting excess fluids, and absorbing fat-soluble materials is necessary to the understanding of human physiology.The lymphatic system consists of lymphatic vessels, a fluid called  lymph,  lymph nodes, the thymus, and the spleen. This system supplements and extends the cardiovascular system in the following ways: ? The lymphatic system collects excess fluids and plasma proteins from surrounding tissues (interstitial fluids) and returns them to the blood circulation. Because lymphatic capillaries are more porous than blood capillaries, they are able to collect fluids, plasma proteins, and blood cells that have escaped from the blood.Within lymphatic vessels, this collected material forms a usually colorless fluid called lymph, which is transported to the right and left subclavian veins of the circulatory system. ? The lymphatic system absorbs lipids and fat-soluble materials from the digestive tract. ? The lymphatic system filters the lymph by destroying pathogens, inactivating toxins, and removing particulate matter. Lymph nodes, small bodies interspersed along lymphatic vessels, act as cleaning filters and as immune response centers that defend against infection. V.Pathophysiology VI. Patient’s Profile Biographical Data Name: S. T. Age: 3 years old Gender:Male Address:Quezon City Birth date: January 14, 2010 Religion: Catholic Nationality:Filipino Informant: â€Å"Mother† Date of Admission:February 17, 2013 Admission Data Chief Complaint: â€Å"High Fever† Initial Diagnosis: Urinary Tract Infection Final Diagnosis: Kawasaki Disease Attending Physician: Dr. K. D . History of Present illness Patient’s present condition started 5 days prior to admission when patient have fever at 38. 5 °C associated with rash from face to neck.The patient was brought to Capitol Medical Center and diagnosed with UTI due to bacteria present in his urine. He was given paracetamol and antibiotics for the treatment. They allowed to go home. 4 days PTA, still with fever documented at 39. 5 °C and rash. Swelling of face and lips are cracked. The mother noticed short, quick breathing. The patient was brought again to the hospital, strawberry tongue is noted upon physical examination. The patient was referred to Infectious Disease (ID) Specialist and confirmed having Kawasaki Disease upon conformatory and other laboratory finding.Past Health History Patient’s mother verbalized that all needed immunizations since birth has been done to the patient. The patient has only experience stomach pain and minor health problems such as occasional cough, cold, a nd mild fever. Family History | |Mother |Father | |Hypertension |- |+ | |PTB – |- | |Cancer |- |- | |Allergies |- |- | VII. Laboratory Findings Urinalysis Report |Normal |Actual |Interpretations |Implication | |Color |Light or Pale yellow |Light Yellow |Normal |indicates good hydration and | | | | | |urine concen | | | | | |tration | |Character |Clear |Slightly Turbid |Abnormal |increase fluid intake | |Glucose |(-) |(-) |Normal |well hydrated | |Reaction |4. 6-8ph |6. ph |Normal |there is normal hydrogen ion | | | | | |concentration and extracellular| | | | | |fluid | | | | | | | | | | | | | | | | | | | |Specific Gravity |1. 010-1. 025 |1. 010 |Normal |the concentrating ability of | | | | |the kidney is normal | | | | | | | | | | | | | | | | | | | |PUS cell |0 |5-8 |Abnormal |indicates possible urinary | | | | | |tract infection | | | | | |Administer antibiotic as | | | | | |ordered | | | | | | | | | | | | | | | | | | | |Squamous |(-) |Few |Abnormal |increase fluid intake | | | | | | | |Bacteria |(-) |Few |Abnormal |increase fluid intake | | | | | |increase intake of Vitamin C | | | | | | | | | | | | | | | | | | | Hematology Report Laboratory/ Diagnostic |Results |Normal Values |Interpretation |Implication | |Procedures | | | | | |Hemoglobin |106 g/L |130-180 |decrease |Decresed hemoglobin leads | | | | | |to symptoms of anemia | |Hematocrit |0. 32 % |0. 40-0. 54 |decrease |Decreased hematocrit leads| | | | | |to symptoms of anemia | |WBC Count |20. 07 |5. 0-10. |increase |Increased WBC was due to | | | | | |presence of infection | |Coagulation Profile | | | | | |Platelet Count |605 |150-450 |increase |Increased PLT points to | | | | | |abnormal conditions of | | | | | |excess clotting | |Differential Count | | | | | |Neutrophil |65 % |50-70 % |normal |Within normal condition | |Lymphocytes |45 % |25-35 % |increase |Will lead to signs of | | | | | |viral infection | |Eosinophil |1 % |1-5 % |normal |Within normal condition | VIII. Physical Assessment |A REA/ REGION |METHOD USED |NORMAL FINDINGS |ACTUAL |INTERPRETATION/ ANALYSIS | | | | |FINDINGS | | | | | | | | |General Appearance | |>Temp: 36. 5-37. 2 °C |> Temp: 39. 5 °C |Not normal.All this symptoms are | | | | | |present due to hyperthermia with | | | |>Resp. Rate: 20-30 cpm | |manifestations of increased respiratory| | |Inspection | |> Resp. Rate: 35cpm |rate and cardiac rate. Fundamentals of | | | |>Pulse Rate: 80-130 cpm | |Nursing, Kozier & Erbs 8th Edition, | | | | |> Pulse Rate: |pp. 529. | |Auscultation |> No Pallor |140bpm | | | | | | | | | | |> Without signs of fatigue |> Pallor | | | |Inspection | | | | | | |> No edema |> Fatigue | | | | | | |Accumulation of fluid in the | | | | | |extremities because of prolong staying | | | | |> Bipedal non- pitting edema |in bed, and excessive accumulation of | | |Palpation | | |fluid in the third spaces, edema | | | | | |developed. Fundamentals of Nursing, | | | | | |Kozier & Erbs 8th Edition, pp. 579. | | | | | | | | | | | | | | | | |Not normal due to excessive | | | | | |accumulation of fluid in the third | | | | | |spaces, edema developed.Fundamentals | | | |> No edema | |of Nursing, Kozier & Erbs 8th Edition, | | | | | |pp. 579. | | | | |> With non- pitting edema | | |Skin | | | | | | |Palpation | | | | | | | | |Not normal.Temperature exceeds the | | | | | |normal temperature because of the | | | | | |presence of infection that causes the | | | | | |skin to be warm. | | | | | | | | | | | |Not normal.A skin lesion is an | | | |> Skin is mildly warm to | |alteration in a client’s normal skin | | | |touch |> Warm to touch |appearance. Fundamentals of Nursing, | | | | | |Kozier & Erbs 8th Edition, pp. 576. | | | | | | | | | | | |Not normal. Poor capillary refill | | | | | |results in poor oxygenation. | | | | | | | | |> Without peeling, must be | | | | | |soft and smooth |> Peeling (desquamation) palms |Not normal because there is increase | | | | |and soles |inflammation of the blood vessels | | | | | |causing it to be red in color. | |Inspection | | | | | | | | | | | | | | | | | | |> Capillary refill is less | | | | | |than 3 seconds |> With a capillary refill of 5 | | | | | seconds | | | | | | |Normal | | | |> No infection, swelling and| | | | |Palpation |moist lips | | | | | | |> Red mucous membranes in the | | | | | |mouth |Normal | | | | | | | |Mouth | | |> Dry lips | | | |Inspection | | | | | | | |> Cracked lips |Not normal due to infection. | | | | | |Fundamentals of Nursing, Kozier & Erbs | | | | |> Strawberry tongue noted |8th Edition, pp. 607 | | | |> Reactive/ responsive to | | | | | |noises |> Reacts to loud noises |Not normal.Use of accessory muscle | | | | | |(abdominal muscle, trapezius muscle, | | | |> Symmetrical and patent | |and sternocleidomastoid muscle) and | | | | |> Symmetrical and patent |increased RR signifies fatigue and | | | | | |hyperthermia. | |Ears | |> Not palpable | |Fundamentals of Nursing, Kozier & Erbs | | | | |> Enlarged, palpable |8th Edition, pp. 548. | | | | | | | | | | | | |Nose | | | | | | |Inspection |> Breath sounds are resonant|>Breath sounds are resonant | | | | | | | | | | | |> Thorax is rounded | | |Lymph Nodes | |> thorax is rounded | | | | |Inspection | | | | | |Palpation |>normal RR 20-30cpm, |> RR 35cpm |> Not normal due to inflammation of the| | | | | |skin lesions | | | |> normal PR 80-130bpm | | | |Chest, Thorax and Lungs | | |>HR 140bpm | | | |Percussion |> no use of accessory | | | | | |muscles in breathing. | | | | | | |> Use of accessory muscle | | | |Inspection | |(abdominal muscle, trapezius | | | | | |muscle, and sternocleidomastoid |> Not normal due to process of the | | | |> Unblemished skin |muscle) |disease and infection.Weakness is due | | |Palpation | | |to lack of energy needed to do normal | | | |> No tenderness; relaxed |> Presence of rash |activities. | | | |abdomen with smooth, | | | | | |consistent tension | |Not normal. Pain was caused by the | | | | |> Tenderness and |presenc e of bacteria in the urine. | | |> No restriction in |hypersensitivity | | | |Inspection |activities, no weakness and | | | | |Auscultation |alert | | | | | | | | | | | | | | | | | | |> Inability to tolerate | | |Abdomen | |> There should no pain felt |activities, weak in appearance, | | | | |when voiding |irritable and lethargic | | | |Inspection | | | | | |> Protein is not evident in | | | | | |the urine | | | | |Palpation | |> With difficulty in urination. | | | | | |Color of the urine is yellow | | | | |> Normal urine output is | |Not normal.This is also caused by | | | |500-1000cc/day or equivalent| |accumulation of excessive fluid in the | |Musculoskeletal and | |to 20-25cc hr | |body | |neurolo- | | | | | |gical status |Inspection | | | | | | |> There should no edema, | | | | | |tenderness, or swelling | | | | | |present | | | | | | | |. |Genitourinary | | | | | | | | | | | | |Inspection | | | | | | | | | | | | | > Non-pitting edema on both feet| | | | | |noted | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |Lower Extremities | | | | | | | | | | | | |Inspection Palpation | | | | IX. Nursing Care Plan X. Drug Study XI. Discharge Plan Medication Patient is given discharge maintenance drug for 2 weeks of 120 mg of aspirin every day or 30 mg QID. Exercise/ Activity The patient can resume his usual activities as soon his condition become normal. There is no restriction with regard to physical activities as long as it is tolerable to the patient’s health status. Treatment Allow the child to rest for faster recovery. Since the patient is taking anti-platelet medications, precautionary measures are discussed to avoid bleeding tendency.The patient is instructed to return to his attending physician within one week after date discharge for a follow up consultation. He is also required to have CBC, platelet count and ESR during that visit. Health Teaching Good hygiene is encouraged. Soft toothbrush are recommended. Petroleum jelly can be applied to dry cracked lips. Use mild soap in cleaning the skin and a mild lotion can be applied to protect skin from drying and peeling. Instill artificial tears to sooth conjunctiva as instructed. Outpatient Orders Remind the family on their follow-up check-up with their physician. Maintain good and safe environment to evaluate the progress of the treatment.Diet Soft or pureed diet is advised when the child’s oral mucosa is still inflamed. Cool liquids like ice chips and ice pops can also be offered. Diet will return to usual when the child is able to tolerate it. Provide high protein diet to promote faster recover. Increase fluid intake to prevent dehydration. A Case Presentation of Kawasaki Disease In Partial Fulfilment of the requirement in Maternal and Child Nursing II A Compilation Presented to: St. Augustine School of Nursing Espana, Manila Presented By: Julie Anne G. Lumbera PN-4A Ms. Cecilia J. Sarte MCN II In structor and Adviser Mr. Joey M. Cadano Clinical Instructor KAWASAKI DISEASE [pic]