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THE THEMATIC PLAN OF THE PRACTICAL TRAINING
ON DISCIPLINE "CLINICAL МЕДСЕСТРИНСТВО IN SURGERY"
FOR STUDENTS І COURSE OF MEDICAL FACULTY №4
WITH UNIT OF YOUNGER MEDICAL AND PHARMACEUTICAL EXPERTS
SPECIALITY “NURSE BUSINESS” (EQL - "BACHELOR")
ON 2010-2011 a.y.
The substantial module 1. The organization of work in surgical hospital. Peculiarities of surgical patient‘s care.
1. Main principles of granting of the surgical help to the population of Ukraine and its legal aspects. Classification of the surgical help. Peculiarities of the organization of work of nurse in general surgical and specialized surgical units (thoracal; the neurosurgical; the urological; the proctologic; endocrine and laparoscopic surgeries; traumatological, etc.). Nurse process in surgical clinics.
2. Main principles of medical ethics and deontology in surgical clinic. Structure of surgical clinic. The organization of work of admitting office in surgical hospital. Peculiarities of a sanitary washing of patients with a surgical pathology in admitting office. Peculiarities of carrying out of anthropometry and thermometry of the patient with an acute surgical pathology.
3. Requirements to personal hygiene and medical staff clothes in a surgical hospital, requirements to linen and clothes of surgical patients. Transportation of a patient with an acute surgical pathology to unit and operating room.
4. Main principles of keeping of a sanitary-hygienic regimen of surgical unit. Rules of cleaning of the basic subunits of a surgical hospital. Peculiarities of keeping of a treatment-protective regimen of surgical unit.
5. Concept about a surgical infection. Pure and purulent dressing rooms. The organization of work in purulent dressing room and peculiarities of care of patients with a purulent pathology. Utilization of dressing material contaminated by purulent discharges. The organization of care of patients with anaerobic gangrene.
6. The basic antiseptic means. Classification of chemical and biological antiseptic means, the mechanism of its action and methods of its using.
7. Structure of a operating block and maintenance of a sanitary-hygienic regimen in operating room. The organization of different kinds of cleaning in the operating room. The main means and methods of processing of hands of the surgeon and a operating field.
8. Definition and classification of methods of sterilization of cutting, optical and general surgical instruments. The basic methods of sterilization of a suture material. A structure, a principle and an operating mode of an autoclave, safety rules during work with an autoclave.
9. Concept about surgical manipulation and surgical operation. Main kinds of surgical operations, concept about stages of their performance. Kinds of surgical instruments. Concept about main kinds of surgical stitches.
10. The basic stages of performing of a pleural puncture, abdominal puncture, diagnostic puncture and duty of the younger medical personnel on preparation of patients for these manipulations.
11. The main tasks of the preoperative period. Concept about preoperative preparation of the patient. Preparation for a planned operation. Preparation for an urgent operation. Main kinds of enemas and peculiarities of their application in surgical patients. Psychological preparation of patient for operation and a role of younger medical personnel in it.
12. Main principles of care of patients in postoperative period and prevention of possible complications.
The substantial module 2. The basic duties and professional actions of nurse of surgical unit.
13. Bleeding: definition, kinds of bleedings according to data of examination. Methods of estimation of a hemorrhage. Methods of a temporal stopping of a bleeding: digital pressing; a technique of applying of a pressing bandage, a torsion tourniquet, a tourniquet. Methods of a final stopping of a bleeding: mechanical, physical, biological. Peculiarities of application of different methods of a stopping bleeding.
14. Concept about blood groups and a rhesus-accessory. Methods of definition of blood group and a Rh factor. The general rules of a haemotransfusion. The necessary list of examination which should be spent before a haemotransfusion. The methods of definition individual, a rhesus and biological compatibility of donor‘s blood with recipient‘s blood. Checking of macroscopic properties of donor‘s blood.
15. Technique of performance of a haemotransfusion, carrying out of observation over the patient during a hemotransfusion. Prevention of complications at a haemotransfusion.
16. The kinds of anesthesia, acquaintance with a performance technique of infiltrative and conductive anesthesia. Epidural anesthesia: acquaintance with technique and sequence of performance. Methods of prevention and treatment of complications at carrying out of different methods of local anesthesia. Acquaintance with technical means for performance of an inhalation narcosis. A technique of carrying out of an endotracheal narcosis. Nurse actions on providing of performance of different kinds of anesthesia and a narcosis. Concept about the elementary resuscitation actions. Technique of performance of an artificial lung ventilation and an indirect cardiac massage.
17. Kinds of wounds. Granting of first aid by the victim with cutting and the bruise wounds. The organization of a primary surgical preparation of a wound. Kinds of primary sutures depending on type and localization of wound. A role of nurse in the organization of a surgical treatment of a purulent wound. Kinds of secondary sutures.
18. Structure of pure and purulent dressing rooms, the organization of a sanitary-hygienic regimen in them. A technique of flushing through drainage tubes, replacement of drainages to the patient with a purulent wound, applying of the ointment bandages. Antiseptic means for a lavage of purulent wounds. Technique of performance of a dressing to the patient with a pure (operational) wound. Technique of flushing through drainages of an abdominal cavity.
19. Concept about injury of soft tissues, skulls and thorax. Measure of the first medical aid by the victim with the closed injuries. Rules of transportation of victims with injury of soft tissues, skulls and thorax. Preventive actions for the prevention of development of a traumatic shock, a pheumothorax, an internal bleeding.
20. The patient with accompanying disturbances of respiratory system. Help strategy at critical respiratory conditions. Inadequate breath, a pheumothorax, dispnoe, an infection of respiratory tract, a respiratory distress-syndrome of adults (ARDS), obstructive diseases of respiratory tracts.
21. The nurse aid and tactics of care by the patient with a surgical pathology and accompanying disturbance of cardiovascular function (an arrhythmia, conductivity disturbance, an ischemia to a myocardium, an infarct, cardiomyopathies, a myocarditis, a malformation of heart and vessels, a hypertensia, a thromboembolism).
22. Concept about an acute abdomen, the causes, the basic clinical signs, bases of nurse diagnostics and treatment. A basic difference in tactics of nurse by granting of an first aid to the patient with acute and chronic surgical diseases of a abdomen. A purulent peritonitis. Preoperative preparation and postoperative care of patients.
23. The general concepts about an abdominal trauma. Kinds of injury of an abdomen and organs of abdominal cavity (penetrating and non-penetrating) - definition, possible etiological factors, the basic characteristic signs. The first aid granting at abdominal trauma. A spleen and liver trauma. A haemoperitoneum. Clinical signs of these diseases. Treatment tactics. Care of patients in the postoperative period.
24. Concept about an acute abdomen, the causes, the basic clinical signs, bases of nurse diagnostics and treatment. A basic difference in tactics of nurse by granting of an first aid to the patient with acute and chronic surgical diseases of a abdomen. Gastrointestinal bleedings, possible etiological factors, the basic clinical signs. Tactics of nurse at case of gastrointestinal bleedings.
25. Perforative ulcer. Complication of a peptic ulcer of a stomach and duodenum. A clinics, a diagnostics, a treatment. The first aid. Preoperative preparation and postoperative care of patients.
26. The signs of the fractures of bones and first aid granting at fractures. Application of means of a transport immobilization. The signs of dislocations, first aid by the patient with various dislocations.
27. Burns and frostbites. Methods of checking of the area of a lesion and severity of a condition of the patient with a burn. The organization of first aid to the victim with a burn. Duties of nurse by providing of infusion therapy for the patient with a burn shock. First aid to the victim with a frostbites. Duties of nurse by providing of the treatment program to the victim with a frostbites.
28. Concept about acute purulent diseases of soft tissues, their kinds and the basic clinical signs. Actions of nurse at conservative and operative treatment of abscesses, phlegmones, furuncles, carbuncles, a hydradenitis, a mastitis, an erysipelas, a lymphadenitis, a lymphangitis, a paraproctitis. The basic clinical signs of a panaris and a phlegmon of a hand, a duty of nurse at carrying out of diagnostics and treatment of a panaris and a hand phlegmon.
29. Concept about an acute specific infection. A role of nurse in treatment programs at a gas anaerobic gangrene, a tetanus, a wound diphtheria, anthrax. Preventive ways of a tetanus, a diphtheria, anthrax, a gas gangrene. Actions of nurse at carrying out of detoxication to the patient with an acute surgical infection.
30. Acquaintance with the basic clinical signs of a necrosis, gangrene, the ulcer, foreign body. Actions of nurse by granting of first aid to the patient with an foreign body. A role of nurse on providing of the intended treatment of patients with different kinds of a necrosis, a gangrene, ulcers, fistulas, foreign bodies.
31. Strategy of nurse help to patients with disturbances of function of kidneys and a bladder. Methods of an examination of function of kidneys and a bladder. Renal insufficiency. A lithiasis and an urolithiasis. Injury of the urogenital apparatus.
32. Trauma and disease of urogenital organs. Purulent diseases of kidneys. An urolithiasis. A bladder inflammation. A bladder stones. A hydrocele and a funiculocele. A prostate inflammation, the clinics. Care of patients, treatment in the specialized hospital.
33. Disease of vessels of the lover extremities. Varicose disease. An acute and chronic thrombophlebitis. Posttromboflebitive disease. An obliterating endarteritis and an atherosclerosis of vessels of the lover extremities. Treatment. Diagnostics. Care of patients.
34. The total module control.
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