Acute Rheumatic Fever

Is a systematic disease characterized by inflammatory lesions of connective tissue and endothelial tissue, primarily affecting the heart and joints. The pathogenesis is thought to be an autoimmune response to group A beta-hemolytic streptococcus. There is cross-reactivity between cardiac tissue antigens and streptococcal cell wall components. The unique pathologic lesions of rheumatic fever is the Aschoff body, a collection of reticuloendothelial cells surrounding a necrotic center on some structure of the heart. Acute Rheumatic Fever is commonly seen in children ages 5 to 15 but may occur in adults. There is a high recurrence rate, and 75% of those with ARF progresses to acute rheumatic heart disease in adulthood. Complications include significant heart failure, pericarditis, pericardial effusions, aortic or mitral valve insufficiency, and permanent cardiac damage. Assessment History of streptococcal pharyngitis or upper respiratory infection 2 to 6 weeks before onset of illness. Jones criteria, presence of two major manifestations, or one major and two minor manifestations, plus evidence of preceding streptococcal infection, are required to establish diagnosis. Major manifestations: Carditis Polyarthritis Chorea Erythema marginatum Subcutaneous nodules Minor manifestations: History of previous rheumatic fever or evidence of pre-existing rheumatic disease. Arthralgia: pain in one or more joints without evidence of inflammation, tenderness to touch, or limitation of motion. Fever: temperature in excess of 100.4 degree Fahrenheit (38 degree Celsius). Erythrocyte sedimentation rate (ESR) – elevated. C – reactive protein – positive. Electrocardiogram (ECG) changes – mainly pulse rate interval prolongation. White blood cell count – elevated (leukocytosis). Diagnostic Evaluation Throat culture for group A beta-hemolytic streptococci and blood sample for titter of streptococcal antibodies ( antistreptolysin O, or ASO titer) to support evidence of recent streptococcal infection. Complete blood count, ESR, and C-reactive protein for changes described above. Baseline ECG and echocardiogram may be done to evaluate valve function. Chest x-ray for cardiomegaly or heart failure. Pharmacologic Interventions Antibiotics to treat streptococcal infection – generally I.M. penicillin or erythromycin in penicillin allergy. Corticosteroids for patients with carditis complicated by heart failure to prevent permanent cardiac damage. Salicylates or nonsteroidals for patients with arthritis (but not while on high-dose corticosteroids because of risk of GI bleeding) and antipyretics to control fever, after diagnosis has been established. Phenobarbital, diazepam if chorea is present. Prophylactic antibiotics for at least 5 years after ARF. Nursing Interventions Monitor temperature frequently, and patient’s response to antipyretics. Monitor the patient’s pulse frequently, especially after activity to determine degree of cardiac compensation. Auscultate the hear periodically for development of new heart murmur or pericardial or pleural friction rub. Observe for adverse effects of salicylate or nonsteroidal anti-inflammatory drug (NSAID) therapy, such as stomach upset, tinnitus, headache, GI bleeding, and altered mental status. Monitor the patient’s response to long-term activity restriction. Restrict sodium and fluids and obtain daily weights as indicated. Administer medications punctually and at regular intervals to achieve constant therapeutic blood levels. Explain the need to rest (usually prescribed for 4 to 12 weeks, depending on the severity of the disease and health care provider’s preference) and assure the patient that bed rest will be imposed no longer than necessary. Assist the patient to resume activity very gradually once asymptomatic at rest and indicators of acute inflammation have become normal. Provide comfort measures. Provide safe, supportive environment for the child with chorea. Observe for the disappearance or any major or minor manifestations of the disease and report signs of increased rheumatic activity as salicylates or steroids are being tampered. Encourage continuous prophylactic antimicrobial therapy to prevent recurrence.

Basic Wound Management and Suturing Training

GSN-International Skills Enhancement and Education Center (ISEEC) invites all Healthcare Providers to attend their workshop entitled:

"Basic Wound Management and Suturing Training "

3 Days Training with PRC- CPE Units and International Standard

(Council for Nursing CPE Provider Accreditation # 2009-023)

principles of wound management as they appl

On completion of this module, students will: 1. Understand th
ey to a simple laceration. 2. Be able to demonstrate the preparation of a simple laceration for closure.

. Be able to demonstrate basic suturing techniques on a model. Date: August 23-35, 2010 Venue: Unit 5

3. Be able to demonstrate sterile technique while preparing and suturing a simple laceration on a model.
402 Pacific Corporate Center 131 West Avenue Quezon City. Ms. Grace S. Navea, RN, BSN, MBA, CPHM, Ph.D (President/CEO of GSN ISEEC, Open Heart OR Nurse, ICU Nurse, PICC Nurse in the USA)

For inquiries and Reservation/Registration Pls. contact the following numbers: * Office: 355-06-15 * Globe - 09153787964 * Smart- 09301832876 * Sun- 09334622474 Look for: Xomai, RN

GSN-International Skills Enhancement and Education Center (ISEEC) invites all nurses to attend their workshop entitled:

"Healthcare Management: Effective Team Dynamics in the Healthcare Setting Workshop" with PRC- CPE Units and International Standards

Effective Team Dynamics

A successful team doesn’t ‘just happen’. It’s rare for a group of individuals to work together without friction, and hoping that everything will simply just click into place when it matters simply isn’t going to work in the longer term. For a team to succeed, they need to continually practice and challenge their collaboration.

Only by constantly improving interactions and looking at the relationships between its members, can real teamwork be achieved. But when it does work, the rewards are significant. In fact, when a team works successfully and efficiently, everyone benefits. When synergy is created between its members, a winning team can truly perform better than the sum of its parts; far more than the individual members are capable of. It shows how to create strong bonds of mutual trust and respect between colleagues.

This will help you to:

* increase the productivity of your team
* establish a common purpose
* assume responsibility and accountability
* improve delegation skills
* develop the potential of people
* improve communication skills
* create mutual trust, support, and collaboration
* develop high-performance teamwork

Date: August 11, 2010 (8am-12pm)

Venue: Unit 502 Pacific Corporate Center 131 West Avenue Quezon City.

Ms. Grace S. Navea, RN, BSN, MBA, CPHM, Ph.D (President/CEO of
GSN ISEEC)



For inquiries and Reservation/Registration Pls. contact the following numbers:

* Globe - 09153787964,
* Smart- 09301832876
* Sun- 09334622474


Look for: Xomai, RN

Issues and Challenges in Pediatric Psychiatry

GSN - International Skills Enhancement and Education Center (ISEEC) proudly present and invite all NURSES on our Workshop entitled:

"Issues and Challenges in Pediatric Psychiatry : Family Management Approaches in dealing with Adolescent Risky Behaviors " Workshop

 

Date: August 5, 2010 (8am-12pm)

Venue: Unit 502 Pacific Corporate Center 131 West Avenue Quezon City.

Ms. Grace S. Navea, RN, BSN, MBA, CPHM, Ph.D (President/CEO of GSN ISEEC)


* Risky Adolescent Behavior

High-risk activities in adolescence—unprotected sex, substance abuse, violence, and other forms of risky behavior—remain a pervasive and costly problem in Western societies, despite extensive efforts to prevent or reduce these activities through intervention programs.

An evolutionary perspective provides a fresh alternative to the mental health model. In particular, risky behaviors might reflect adaptations to harsh environments rather than deviations from optimal development.

The dominant scientific paradigm for explaining these high-risk behaviors can be termed the mental health model, which assumes (implicitly if not explicitly) that harsh social environments adversely affect children’s wellbeing, promoting disturbances in development, even if not clinical disorders per se. This model emphasizes the costs and largely ignores the benefits of risk-taking, making it difficult to explain the motives for risky behavior in adolescents.



For inquiries and Reservation/Registration
Pls. contact the following numbers:

Office number: 355-06-15
Globe - 09153787964,
Smart- 09301832876
Sun- 09334622474

Look for: Xomai, RN

Issues and Challenges in Gerontologic Nursing

GSN - International Skills Enhancement and Education Center (ISEEC) proudly present and invite all NURSES on our Workshop entitled:
"Issues and Challenges in Gerontologic Nursing : Managing Caregiver's fatigue in families with Alzheimer's Disease" Workshop

Caring for someone with Alzheimer’s disease impacts every aspect of daily life. As Alzheimer’s patients lose one ability after another, caregivers face tests of stamina, problem-solving, and resiliency. During this long and difficult journey, communication diminishes, rewards decrease, and without strong support, caretakers face challenges to their own well-being.

Maintaining emotional and physical fitness is crucial. Preparing and protecting yourself, working to understand your loved one’s experience, and embracing help from others can minimize the hazards and enhance the joys of your caregiving experience.

Date: August 5, 2010 (8am-12pm)

Venue: Unit 502 Pacific Corporate Center 131 West Avenue Quezon City.

Ms. Grace S. Navea, RN, BSN, MBA, CPHM, Ph.D (President/CEO of GSN ISEEC)


For inquiries and Reservation/Registration
Pls. contact the following numbers:

Office number: 355-06-15
Globe - 09153787964,
Smart- 09301832876
Sun- 09334622474

Look for: Xomai, RN

"HAND-OFF COMMUNICATION Guidelines in health Care Setting "

GSN - International Skills Enhancement and Education Center (ISEEC) proudly present and invite all NURSES on our Workshop entitled:

"HAND-OFF COMMUNICATION Guidelines in health Care Setting "

Date: July 31, 2010 (9am-5pm)

Venue: Unit 502 Pacific Corporate Center 131 West Avenue Quezon City. Ms. Grace S. Navea, RN, BSN, MBA, CPHM, Ph.D (President/CEO of GSN ISEEC)


Purpose

The purpose of Hand-Off Communication is to provide accurate information about a patient’s care, treatment and services, current condition and any recent or anticipated changes. The information communicated during hand off must be interactive and accurate.

A hand off includes information exchange during:

* Nursing shift change
* Nursing to Physician Communication
* Physician transfer of complete responsibility during vacation coverage
* Physician transfer of on call responsibility
* Nurse temporarily leaving a unit for break
* Nurse and physician hand off from patient registration to the inpatient unit (Admitting physician to attending physician and admission staff to unit RN)
* Nurse and social service clinician hand off before patient goes to off unit group and upon return from group if significant change has taken place
* Physician hand off upon transfer to another hospital setting



Standards for Hand Off Communication:

- Hand off communication is interactive, allowing the opportunity for questioning between the giver and receiver of patient/client/resident information

- Hand off communication includes up to date information regarding the patient care, treatment and service, condition and any recent or anticipated changes

- Interruptions are to be minimized to limit the possibility that information would fail to be conveyed or would be forgotten.

- Hand off communication requires process for verification of the received information including repeat-back or read-back as appropriate.

- The receiver of the hand off information has the opportunity to review relevant patient historical data, which includes previous care, treatment, or services.

- Hand off communication is required for all patients who are deemed to be at risk for elopement, suicide, combative destructive issues, seizures, seclusion or restraint who are currently on precautions as well as those patients who have just been removed from precautions and/or those patients with special care needs.


For inquiries and Reservation/Registration
Pls. contact the following numbers:

Office number: 355-06-15
Globe - 09153787964,
Smart- 09301832876
Sun- 09334622474

Look for: Xomai, RN