ADHERENCE AND ASSOCIATED FACTORS TO TYPE 1 DIABETES MELLITUS CARE AMONG ADOLESCENTS AT KISII COUNTY- NURSING RESEARCH PROJECT

Institution Kenya Medical Training College
Course Nursing
Year 3rd Year
Semester Unknown
Posted By MAKORI KERECHA
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ADHERENCE AND ASSOCIATED FACTORS TO TYPE 1 DIABETES MELLITUS CARE AMONG ADOLESCENTS AT KISII COUNTY the recommendations management is associated with better clinical outcomes. In Kisii County, the adherence of adolescents living with T1DM to diabetic care is not well known. The study had the purpose to assess the adherence of children suffering from T1DM to Diabetic care and its associated factors. The quantitative cross-section study was conducted in Kisii County Diabetic Association Centre in Nyamache Sub- County, Kisii County among a convenient sample of 108. The study was conducted from February to April (precise date). A structured questionnaire was used to collect data. Ethical approval was sought and obtained from UR-CMHS-IRB (number of ethics). Participation was voluntary and other ethical principles were observed throughout the study. Descriptive data were entered into the Statistical Package of Social Sciences (SPSS) version 21, and then analyzed using Pearson Chi-square, to determine association between variables. The significance level was set at p-value of < 0.05 A total of 106 (98%) participants who consisted of 40.6% male and 59.4% female completed the survey. The majority of participants were aged between 15-19 (79.2%) years while 22(20.8%) were between 10-14 years old. 79.2% were adherent to diabetic care while 20.8% were not adherent. (72.6%) had schooling while (27.4%) did not attend school. The majority of the participants (79.2%) were in boarding school and (20.8%) were living out of school. Moreover (63.2%) children were living with both parents and (61.3%) of parents were married. There is no association between adherence and Age, gender , Child in boding school, Duration of medication, or if there are causes delayed respect of nurse‘ instructions but the others factors are associated with adherence: schooling child( p:0.001) , Relationship with guardian p:0.001) Parent status(p:<001) ,Guardian‘ occupation(p:<001), education level of guardian( p:0.017) (p:),Ubudehe category(p:<001), Health insurance(p:0.025) Complication (p:0.001) and Co-morbidities
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Junctional Rhythms ( Electrophysiology)
The (AVN) Atrial Ventricular Node is a group of specialized cells located in the lower part of the right atrium above the tricuspid valve base. Its function is to Delay, Relay and Filter impulses as they pass through the Ventricles. The nodal cells have pacemaker properties and can pace the heart at a rate of 40-60b/min. Rhythms coming from the AV junction are called .Junctional dysrhythmias. The electrical impulse must travel backward ( Retrograde) to activate the atria.
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Sinus Mechanisms
A normal heartbeat results from an electrical impulse that originates from the hearts primary pace maker-(SA node) • The Normal sinus rhythm records the hearts electrical impulse that starts in the SAN spreading through the normal conduction pathway. • The SAN dominates other areas that may pace the heart slower and abnormally. All other rhythms will be compared to the Normal Sinus Rhythm
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Ventricular Rhythms
The ventricles (purkinje fibres) may assume the function of pacing the heart, they pace at a slower rate 20-40b/min which cannot sustain the body's perfusion requirements. Rhythms originating from the ventricles are called ventricular arrhythmias because they originate in the ventricles. Ventricular arrhythmias occur when:- a) The SAN fails to initiate an impulse b) The AVN does not pick to pace c) There is an irritable foci in the ventricular muscle
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Sickle cell Crisis
Sickle cell disease (SCD) • A group of hereditary disorders in which the normal adult hemoglobin (hemoglobin A) is partly or completely replaced by abnormal sickle hemoglobin (HgbS). • The most common genetic hematologic condition in children • Transmitted by autosomal recessive pattern of inheritance. • Patient with this condition is homozygous for the sickle cell gene, i.e. both genes are abnormal. • The basic defect responsible for the sickling of erythrocytes is contained in the globin fraction of hemoglobin • The mode of transmission is hereditary • The gene that determines the production of HgbS is situated on an autosome.
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Treatment modalities for hematological disorders
These are therapies aimed at preventing, alleviating the underlying cause or treating the hematological disorder • They include 1. Nutritional therapy: meal management to ensure rich sources of iron, vitamin K, vitamin B9. 2. Supplements: administration of folate, iron sulfate. 3. Treatment of underlying cause: antimalarial, deworming, ulcer treatment
21 Pages 994 Views 0 Downloads 318.84 KB
Valvular heart disease
Outline 1. Review the role of valves in cardiac cycle 2. Define valvular heart disease 3. Identify types of VHD 4. Explain the assessment and diagnostic tests 5. Describe the management of patient with VHD
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Assessment and diagnostic evaluation of patient with haematological disorder
History taking 1. Nutrition: feeding habits; typical meal – to determine deficiencies 2. use of prescription and over-the-counter medications: most hematological conditions can result from herbs, or certain medications. 3. Prior chemotherapy or radiotherapy
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Disseminated intravascular coagulation (DIC)
It is a condition of combine platelet and coagulation factor disorder. • It is characterized by widespread coagulation and bleeding in the vascular compartment. • DIC occurs secondary to inappropriate systemic activation of normal clotting mechanisms. • It is associated with underlying disease manifested as uncontrolled activation of coagulation and fibrinolysis.
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Circulatory Shock
3 elements ensures adequate tissue perfusion 1. Functioning pump (myocardial contractility) 2. Rate of Myocardial contraction 3. Adequate volume of blood (preload) 4. Normal vascular tone, SVR (Afterload) • In order for adequate tissue perfusion to occur, cardiac output must be sufficient to deliver nutrient- and oxygen rich blood to the tissues.
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Hematologic emergencies (Disorders of haemostasis)
Disorders of hemostasis – hypercoagulability states Disorders occurring due to imbalance between procoagulants and anticoagulants. Pro-coagulant factors: Platelets clotting factors Ca2 PLUS molecules released by damaged tissues Anticoagulant factors Protein C Plasmin Antithrombin III
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