BAG TECHNIQUE - it is a tool that makes use of a public health bag through which the nurse, during his/her

visit, can perform nursing procedures with case and deftness, saving time and effort with the end in view of rendering effective nursing care.

Public Health Bag - it is an essential and indispensable equipment of the public health nurse which she has to carry along when he/she goes out home visiting. It contains basic medications and articles which are necessary for giving care. Principles of Bag Technique 1. It should minimize if not totally prevent the spread of infection from individuals to families, hence, to the community. 2. Bag technique should save time and effort on the part of the nurse in the performance of nursing procedures 3. Bag technique should not overshadow concern for the patient rather should show the effectiveness of total care given to an individual or family 4. Bag technique can be performed in a variety of ways depending upon agency policies, actual home situation, as long as principles of avoiding transfer of infection are carried out.

Special Considerations in the Use of the Registered Nurse or Public Health Nurse Bag 1. It should contain all necessary articles, supplies and equipment which may be used to answer emergency needs 2. Public health nurse bag and its contents should be cleaned as often as possible. Supplies replaced and ready for use at any time 3. The bag and its contents should be well protected from contact with any article in the home of the patients. Consider the bag and its contents clean and/or sterile while any article belonging to the patient are dirty and contaminated 4. The arrangement of the contents of the bag should be the one most convenient to the user to facilitate efficiency and avoid confusion 5. Hand washing is done as frequently as the situation calls for. It helps in minimizing or avoiding contamination of the bag and its contents 6. The bag when used for a communicable case should be thoroughly cleaned and disinfected before keeping and re-using. Contents of the Registered Nurse or PHN Bag Paper lining Extra paper for making bag for waste materials (paper bag) Plastic/linen lining Apron Hand towel in plastic bag Soap in soap dish Thermometers in case (one oral and one rectal) 2 pairs of scissors (1 surgical and 1 bandage) 2 pairs of forceps (curved and straight) Syringes (5ml and 2ml) Hypodermic needles (g. 19, 22, 23, 25) Sterile dressings (OS, C.B) Sterile cord tie Adhesive plaster Dressing (OS, cotton ball) Alcohol lamp Tape measure Babys scale 1 pair of rubber gloves

 2 test tubes Test tube holder Medicines 1. betadine 2. 70% alcohol 3. ophthalmic ointment (antibiotic) 4. zephiran solution 5. hydrogen peroxide 6. spirit of ammonia 7. acetic acid 8. benedicts solution Note: Blood pressure apparatus and Stethoscope are carried separately. Fat Embolism - Complications of Fracture Care of client in traction Firm matters, foot drops ROM- for unaffected extremities Alignment Complications Trapeze Urinary retention Respiratory complications Evaluate circulatory impairments The Different Complications of Fractures 1. Fat Embolism Embolism that originates from the bone marrow Occurs within 48 hours Restlessness Mental status changes Tachycardia, apnea, and hypotension Petechial rash 2. Compartment Syndrome Decrease perfusion and hypoxia of tissues Within 4 to 6 hours after the onset, neuromuscular damage is irreversible Increased pain and swelling Pain with passive motion Paresthesia pulselessness 3. Osteomyelitis Fever Pain Erythema in the surrounding area Tachycardia Elevated WBC 4. Avascular necrosis

 An interruption of blood supply to the bony tissue, which results in the death of the bone Pain Decreased sensation 5. Pulmonary Embolism Caused by immobility precipitated by a fracture Restlessness Apprehension Dyspnea Diaphoresis Arterial blood gas changes Overview and Osteoarthritis Symptoms Signs and Symptoms of ACute Gouty Arthritis including the Treatment

Osteoarthritis Due to wear and tear of the cartilage caused by overused joints Mostly affected are the weight-bearing joints (knees, hip, and lower spine). This joints are inflamed Formation of bony buildup and loss of articular cartilage causing crepitus degenerative joint disease (hips and knees).

Chronic and Acute Gouty Arthritis - it is SYSTEMIC - it is due to increased uric acid serum level (causes gout) or deposition of urate crystals in joints and other body tissues - Due to a disorder of purine metabolism, excess uric acid in blood (Uric acid is the end product of purine diet). - Gouty Arthritis is also caused by hyperuricemia (increase uric acid in the blood).

Causes of Osteoarthritis Idiopathic excessive use of a specific joints repeated joint injury old age and obesity

Nursing Goal of Gouty Arthritis to relieve pain to protect affected part

Osteoarthritis Symptoms and Signs limited ROM pain in motion compression of the spine as manifested by pain pain increases with activity joint stiffness and immobility muscle spasms skeletal muscle atrophy Heberdens Nodes - bony nodules on distal finger joints, are the size of peas and develop on the end joints of the fingers. Bouchard's Node develop on the middle joints of the fingers. The bones are also become enlarged. The result is pain, redness, and swelling.

Diagnosis of Osteoarthritis - X-ray

Treatment of Osteoarthritis Analgesics rest (best management) hot moist pack Paraffin wax (brushing technique)

Nursing Goals of Osteoarthritis to relieve pain to prevent further stress of joints (plan ADL or activity of daily living) to maintain regular exercise