Minggu, 17 April 2011

NITA NEWBORN


1.       Remove NN from case by unlatching the Velcro strap
2.       Remove bottle with simulated blood concentrate and add 380cc of destilled water, mix and set aside
3.       Place NN on a level surface and remove the white caps on the end of the tubing exiting the head and the right leg
4.       Remove the fluid bag with attached tubing, making sure the roller clamp is closed and fill with simulation blood.
5.       Hang the fluid bag approximately 16 inches above the model.
6.       Attach the fluid bag tubing to the tubing axiting the head. See figure
7.       Open the white snap clamps on both of the tubes exiting the model.
8.       Slightly elevate the feet above the head
9.       Position the leg tubing over a sink or container and gradually prime the veins with simulated blood by slowly opening the roller clamp. Permit simulated blood to flow through the system until no air bubbles are visible in the clear leg tubing. Close the snap clamp on the leg tubing and re-attach the white cap. Fully open the roller clamp on the fluid bag.
10.   The legs can now be lowered.
11.   Attach a 16g or 18g. IV catheter(metal needle removed) to a syringe. Insert chateter into umbilical vein approximately one inch. Aspirate slowly while withdrawing catheter from umbilical vein. It may be necessary to repeat this procedure to remove allair and prime the umbilical vein with simulated blood.

CAUTION : ACCESING THE UMBILICAL VALVE WITH A METAL NEEDLE WILL DAMAGE VALVE.
12.   NN is now primed and ready for use.
Additional features
1.       Measurement of proper feeding tube length using anatomical reference points.
2.       Practice of placing and securing nasal cannulas
3.       Suctioning of nasal passages and the ability to verify patency of nasal passages.
4.       Suctioning of upper airway
5.       Fluid can be introduced into the nasal and oral passageways but should be aspirated or drained when practice session is over.


Care and cleaning of NN
1.       After each use close the roller clamp on the fluid bag tubing and the snap clamp on the tubing axiting the head.
2.       Disconnect and drain the fluid bag. Flush fluid bag and tubing with water.
3.       Refill fluid bag with clean water and re-attach to tubing axiting the head.
4.       Position leg tubing over sink or container and remove white cap. Open snap clamps, followed by roller clamp, and flush the model until clean water is visible in leg tubing.
5.       Disconnect and drain fluid bag.
6.       It is recommended that a 12cc syringe or larger be used to blow out any remaining water. To do this pull back on plunger and then insert syringe into the fitting on tubing exiting the head. Push plunger in and repeat until water is no longer visible coming out of the tubing at the foot.
7.       Ordinary stains can be removed by washing with soap and warm water.
8.       Return model to case and store with white end caps removed and snap clamps open to allow tubing to dry.
NN body is stain resistant and betadine/iodine can be used on it. While betedine will gradually stain the skins with repeated use, some clinicians feel this is a minor consideration when teaching and assessing proper tachniques in site preparation. If this is concern, water can be used to eliminate the staining. The life of the vein and skins will be maximized by the use of small gauge needles (20g or semaller) and proper care and storage.
Over time and use it may become necessary to replace the vein and skins. See REPLACEMENT PARTS FOR NITA NEWBORN.
PROBLEM SOLVING
PROBLEM: unable to prime model
Solution: verify that both snap clamps are opened and the white caps have been removed. Check roller clamp. Visually inspect vein tube for any twisting or kinking.
Problem: unable to infuse fluid
Solution: check steps above. Check that fluid bag does not contain more than 500cc
Problem: air is present when withdrawing from veins
Solution: model is not properly primed. Reprime and flush trapped air until no air is present in leg tubing.
Problem: unable to insert umbilical chateter
Solution: check back side of the model to make sure that the white umbilical valve housing is pushed all the way in. place a small amount of Vaseline on the chateter and re-insert.
Problem: air is present when withdrawing from the umbilical vein
Solution: umbilical vein not properly primed. Reprime with syringe perinstructions.

Jumat, 15 April 2011

VITAMIN

Vitamin pada umumnya dapat dikelompokkan menjadi 2 kelompok,yaitu vitamin yang larut dalam lemak yakni vitamin A,D,E,K : serta vitamin yang larut dalam air yakni vitamin B dan vitamin C

Vitamin A
vitamin A memiliki beberapa bentuk,diantaranya adalah vitamin A,vitamin A asetat, vitamin A palmitat.
Vitamin A alkohol atau akseroftol mudah dioksidasi oleh udara atau oleh senyawa oksidator lainnya dan peka terhadap sinar,sedangkan ester vitamin A relatif lebih stabil terhadap oksidasi.

Vitamin D
Dari beberapa vitamin D, dua diantaranya dianggap paling penting yaitu D2(ergo kalsiferol) dan vitamin D3 (kole kalsiferol). Struktur kedua vitamin ini sangat mirip. vitamin D2 banyak terdapat dalam bahan nabati, sementara D3 banyak terdapat dalam minyak ikan hati.

Vitamin E
Vitamin E merupakan salah satu vitamin yang larut dalam lemak. keaktifan vitamin E dalam beberapa senyawa tokoferol berbeda. Dikenal alfa;beta;gamma;dan delta-tokoferol. alfa-tokoferol menunjukkan keaktifan vitamin E yang paling tinggi.vitamin E banyak terkandung di dalam kedelai,telur,bayam,tomat,brokoli dan dark chocholate.

Vitamin K
 K=koagulation,yang artinya pembekuan. Vitamin K berperan dalam proses pembekuan darah apabila terjadi trauma pada tubuh. Vitamin K bersifat tahan panas, tetapi akan segera rusak apabila terpapar senyawa asam, basa, dan cahaya matahari. Pada manusia vitamin K didapat dari nutrisi asupan makanan dan mikroflora pada saluran pencernaan. Di dalam hati, vitamin K dibutuhkan untuk mengaktivasi protrombin dengan reaksi karboksilasi gugus Glu pada residu protein prekursornya. Asam glutamat yang mengalami reaksi karboksilasi akan berubah menjadi asam karboksiglutamat gamma.
 vitamin ini ditemukan dalam sayuran hijau seperti bayam,brokoli,katuk,kol,slada,dll.

Vitamin B
Vitamin B adalah 8 vitamin yang larut dalam air dan memainkan peran penting dalam metabolisme sel. Dalam sejarahnya, vitamin pernah diduga hanya mempunyai satu tipe, yaitu vitamin B (seperti orang mengenal vitamin C atau vitamin D). Penelitian lebih lanjut menunjukkan bahwa komposisi kimia didalamnya membedakan vitamin ini satu sama lain dan terlihat dalam contohnya dalam beberapa makanan. Suplemen yang mengandung ke-8 tipe ini disebut sebagai vitamin B kompleks. Masing-masing tipe vitamin B suplemen mempunyai nama masing-masing (contoh; B1, B2, B3).
daftar vitamin B
  • Vitamin B1 (tiamin)
  • Vitamin B2 (ribloflavin)
  • Vitamin B3,(niasin, termasuk asam nikotianat dan nikotinamida)
  • Vitamin B5 (asam pantotenat)
  • Vitamin B6 (piridoksin)
  • Vitamin B7, juga dikenal sebagai vitamin H (biotin)
  • Vitamin B9, juga dikenal sebagai vitamin M dan vitamin B-c (asam folat)
  • Vitamin B12 (kobalamin)

Vitamin C
Vitamin C adalah salah satu jenis vitamin yang larut dalam air dan memiliki peranan penting dalam menangkal berbagai penyakit.
Vitamin ini juga dikenal dengan namakimia dari bentuk utamanya yaitu asam askorbat. Vitamin C termasuk golongan vitamin antioksidan yang mampu menangkal berbagai radikal bebas ekstraselular. Beberapa karakteristiknya antara lain sangat mudah teroksidasi oleh panas, cahaya, dan logam. Buah-buahan, seperti jeruk, merupakan sumber utama vitamin ini.