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International Journal of

Nursing Critical

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JUL–DEC 2016 IJNCC

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Nursing Critical Care

International Journal of Nursing Critical Care aims to improve the care of critically ill patients by

distributing, and promoting information relevant to intensive care. The Journal is devoted to Nurses and

Other Health Professionals involved in the care of patients with critical needs. Time to time journal will

publish peer- reviewed papers that are research and development oriented and is of interest to the healthcare

providers.

Focus and Scope of the Journal Assessment of critical care patients

Anatomy and physiology of the respiratory, cardiovascular, renal, gastrointestinal and integumentary

systems

Intensive care

Critical care environmental issues.

Critical Care Networks.

End of life care

Ethical and legal issues in critical care

Patient centered care

Inotropic therapy, invasive and non-invasive cardiac output monitoring.

Safety Culture Replacement therapies

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PUBLICATION MANAGEMENT TEAM

INTERNAL MEMBERS

Associate Manager

ChairmanMr. Puneet Mehrotra

Managing Director,JournalsPub,

New Delhi

Hidam Renubala

Ankita Singh

Deepika Bhadauria

Rekha Rani

Commissioning Editors

Dr. Chhavi Goel

Manisha Dhoble

EDITORIAL BOARD MEMBERS

Dr. Mala-ThayumanavanBGS Global Hospital, Bangalore,

India.

Dr. Pratibha SwamyCollege of Nursing, NIMHANS, Bangalore,

India.

Dr. Sukhwinder KaurNational Institute of Nursing Education,

PGIMER, India.

Dr. Usha UkandeChoithram College of Nursing, CH&RC Indore

(M.P.), India.

Dr. C. Kanniammal Meenakshi College of Nursing, Chennai,

India.

Dr. Arnel Banaga SalgadoRAK Medical and Health Sciences University,

United Arab Emirates

Kawaljit KaurMedical surgical Nursing, Mai Bhago College of

Nursing, Tarn Taran (Punjab), India.

Regina D SatvekarBharati Vidyapeeth College of Nursing, Sangli

(Maharashtra), India.

Mr. N.J. Vasudevan Chitra College of Nursing, Kerala,

India.

K. PriscillaMatha College of Nursing, Tamil Nadu,

India.

A Arvin BabuSree Abirami Hospital and College of Nursing,

Coimbatore, India

Mr. Sembian. N.Government Nursing College, U.P. Rural Institute of Medical Sciences & Research,

Saifai, Etawah

Dr. Parimala.K.Samuel Principal, Chitra College of Nursing, Kerala,

India

From the Editor's Desk

Dear Readers,

We would like to present, with great pleasure, the Second Volume of a new scholarly

journal, International Journal of Nursing Critical Care. This journal is part of the

Applied Sciences, and is devoted to the scope of present nursing issues, from theoretical

aspects to application-dependent studies and the validation of emerging technologies.

This new journal was planned and established to represent the growing needs of

Nursing Critical Care as an emerging and increasingly vital field, now widely recognized as an integral part

of scientific and technical investigations. Its mission is to become a voice of the Nursing Science community,

addressing researchers and practitioners in this area.

The core vision of International journal of Nursing Critical Care in JournalsPub is to propagate novel

awareness and know-how for the profit of mankind ranging from the academic and professional research

societies to industry practitioners in a range of topics in Plant Nursing in general. JournalsPub acts as a

pathfinder for the scientific community to published their papers at excellently, well-time & successfully.

International Journal of Nursing Critical Care focuses on original high-quality research in the realm of

Intensive care, Assessment of critical care patients, Anatomy and physiology of the respiratory,

cardiovascular, renal, gastrointestinal and integumentary systems, Critical care environmental issues,

Critical Care Networks, End of life care, Ethical and legal issues in critical care, Patient centered care,

Inotropic therapy, invasive and non-invasive cardiac output monitoring, Safety Culture Replacement

therapies.The Journal is intended as a forum for practitioners and researchers to share the techniques of

Nursing and solutions in the area.

Many scientists and researchers have contributed to the creation and the success of the Nursing community.

We are very thankful to everybody within that community who supported the idea of creating an innovative

platform. We are certain that this issue will be followed by many others, reporting new developments in the

field of Nursing.

This issue would not have been possible without the great support of the Editorial Board members, and we

would like to express our sincere thanks to all of them. We would also like to express our gratitude to the

editorial staff of JournalsPub, who supported us at every stage of the project.

It is our hope that this fine collection of articles will be a valuable resource for Nursing readers and will

stimulate further research into the vibrant area of Nursing.

Puneet Mehrotra

Managing Director

1. A Study to Assess the Self-Concept Among Adolescents T. Kochurani, S.J. Vayalil 1

2. Newer Methods of Cardiac Output Monitoring Neha Sharma 5

3. Use of Inotropes in Critical CareBrinder Bhangal 11

4. Immunosuppressant Drugs and Their Side EffectsArminder Singh 15

5. Are Nurses Aware Regarding Danger Signs of Labor? A Cross-Sectional Screening in a Tertiary Care Centre in North IndiaS. Kumbhakar, V.R. Vijay 19

Contents

IJNCC (2016) 1-4 © JournalsPub 2016. All Rights Reserved Page 1

International Journal of Nursing Critical Care Vol. 2: Issue 2

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A Study to Assess the Self-Concept Among Adolescents

T. Kochurani, S.J. Vayalil* Department of Community Health Nursing, Lourdes College of Nursing, Kerala, India

ABSTRACT The present study was conducted to assess the self-concept among adolescents. The

objectives of the study were; to assess the self-concept among adolescent population using

self-concept inventory and find the association between the self-concepts with selected

demographic variable. Non-experimental quantitative approach was used and research

design adopted for the study is descriptive survey design. The study was carried out in Ward

34 of Thrikkakara municipality. A total of 33 adolescents were selected by convenience

sampling technique. The tools used for the study were demographic proforma to assess the

socio demographic characteristics and self-concept inventory to assess the level of self-

concept among adolescents. The result revealed that among 33 sample, 14 (42.4%) have

good self-concept 19 (57.6%) have excellent self-concept. Among demographic variables

gender had significant association to the self-concept of adolescents ( =0.024, P=0.037)

Keywords: adolescents, assess, self-concept

INTRODUCTION Adolescence is a new birth, for the higher

and more completely human traits are

now born. Stanley Hall

Adolescence is a transitional stage of physical and mental human development.[1] And it is characterized by a number of cognitive, emotional, physical and attitudinal changes, which can be conflict on one hand and positive personality development on the other. In global population one in 5% is an adolescent. In 2012, the world had 721 million were adolescents. In India according to 2010 census 243 million are adolescents and the proportion of adolescent’s is 19%.[2] Total population of Kerala according to 2011 census is 33, 406061(3.34) crores. Adolescent population of Kerala (‘000) was 5, 433, and decadal growth rate is 9%.[3] Adolescence is the bridge between childhood and adult hood. It is a time of rapid development of growing maturity,

discovering one’s real self, defining personal values, etc.[4] Every adolescent have a thrust to success in all fields which they have engaged and adjusted with these changes. Success and failure in life largely depend on the variables like emotions, academic abilities, intellectual capacities, socialization, self-awareness, etc. Self-awareness gained increases feeling of worth, thus enabling them to make healthy self-evaluations, in spite of what others may think of them. Self-understanding further allows showing empathy and understanding others during relational interactions. In sum, biological, cognitive and affective functions affect the development of self-images, worth, esteems efficacies, wills, control and awareness and shape self-conceptions.[5]



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Newer Methods of Cardiac Output Monitoring

Neha Sharma* Department of Nursing, Khalsa College of Nursing, Amritsar, India

ABSTRACT

Vertebrate circulatory frameworks comprise of blood, which transports materials to and from

cells by means of veins, and a heart to pump the blood. One vital part of the circulatory

framework is to give oxygen to cells. When in doubt, little creatures have a higher rate of

oxygen utilization per unit body mass than expansive creatures. In this manner, the heart of a

little creature must supply oxygen at a higher rate than the heart of a huge creature. Since

the oxygen limit of blood is comparable amongst little and huge creatures, little creatures

must have hearts that pump blood at a higher rate, or as it were, have a higher

cardiovascular yield.

Keywords: aortic impedance, aortic pressure, capacitor, cardiac output INTRODUCTION

Cardiovascular output (CO) is the essential compensatory system that reacts to an oxygenation challenge. Despite the fact that Harvey found the flow of blood over 300 years prior, routine estimation of CO is accessible just since 1970's, when Swan, Ganz and associates reported that aspiratory course catheter (PAC) inclusion could be performed at the bedside by the utilization of exceptionally composed inflatable tipped catheter. Preferably, the innovation which gives CO estimation ought to be noninvasive, precise, solid, ceaseless, and good in grown-ups and pediatric patients. At present, no single system meets every one of these criteria. Late advances in innovation have prompted to the improvement of insignificantly obtrusive and non-intrusive strategies. The improvement of impedance cardiography and advances in gadgets and flag preparing has prompted to the improvement of absolutely non-obtrusive screens, which can give constant estimation of

haemodynamic parameters. A few audits distributed in the later past report clinical approval and confinements of the different negligibly obtrusive and absolutely non-intrusive strategies and also their constraints.[1] A late survey by the creators clarifies the utilization of PAC in hemodynamic observing. INVASIVE METHODS Thermodilution Technique Aside from its weight observing capacities, without a doubt the most vital element of PAC is its capacity to quantify CO utilizing the thermodilution strategy. The thermodilution procedure has turned into the defacto clinical standard for CO assurance. This strategy depends on standard like pointer weakening however utilizes warm rather than shading as a marker. Heart yield is figured utilizing the changed Stewart-Hamilton pointer weakening condition. The system has as of late been adjusted to figure the ceaseless CO and also checking of right ventricular

IJNCC (2016) 11-14 © JournalsPub 2016. All Rights Reserved


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Use of Inotropes in Critical Care

Brinder Bhangal Phoenix Institute of Nursing, Punjab, India

BACKGROUND

Inotropes are a social occasion of pharmaceuticals that modify the contractility of the heart. Positive inotropes invigorate the heart's compressions, so it can pump more blood with fewer heartbeats. This solution is for the most part given to patients with congestive heart disillusionment or cardiomyopathy. These pharmaceuticals may similarly be given to patients who have had a late heart ambush. Now and again, inotropes are given to patients whose hearts have been crippled after heart surgery (in examples of cardiogenic daze). Negative inotropes incapacitate the heart's withdrawals and direct the heart rate. These arrangements are used to treat (hypertension), ceaseless heart dissatisfaction, unpredictable heart rhythms (arrhythmias), and midriff torment (angina). They are here and there used as a piece of heart ambush patients to diminishing weight on the heart and foresee future heart strikes. The method of reasoning for inotrope utilize Inotropes are demonstrated in intense conditions where there is low cardiovascular yield (CO, for example, cardiogenic stun taking after myocardial dead tissue, intense decompensated heart disappointment and low CO states after heart surgery. Lessened CO prompts to tissue hypo perfusion and consequent hypoxia. Digestion system changes from oxygen consuming to anaerobic, bringing about the arrangement of lactic corrosive. On the

off chance that left untreated, this can bring about multi-organ disappointment and demise. Mean Arterial Pressure

Tissue perfusion is liable to mean vein circulatory strain (MAP), which is the consequence of CO and systemic vascular resistance (SVR):* Layout CO × SVR Diminishing CO or SVR cuts down the MAP and along these lines reduce tissue perfusion. [* = central venous weight (CVP) can in like manner be joined into the condition (i.e., MAP - CVP = CO × SVR). Since CVP is a far tinier regard than MAP, it has no sober minded impact to fuse CVP in the condition and it is frequently disregarded for simplicity][1] Systemic Vascular Resistance

SVR can be depicted basically as the impenetrability to circulation system (CO). It is frequently called the “afterload.” Heart Yield

CO is dependent on the stroke volume (SV) and heart rate (HR): CO = HR × SV The SV depends on upon the SVR (afterload) and the "preload". Preload (how much ventricles are stretched out before contracting) compares with the end diastolic volume (the volume of blood in a ventricle toward the end of filling). It is basic to streamline preload by amending fluid change before starting inotropes,



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Immunosuppressant Drugs and Their Side Effects

Arminder Singh* Phoenix Nursing Institute, Punjab, India

ABSTRACT

Immunosuppressive medications or immunosuppressive specialists or antirejection

prescriptions are medications that restrain or avoid movement of the insusceptible

framework. They are utilized as a part of immunosuppressive treatment to: Keep the

dismissal of transplanted organs and tissues (e.g., bone marrow, heart, kidney, liver) Treat

immune system infections or ailments that are no doubt of immune system root (e.g.,

rheumatoid joint inflammation, different sclerosis, myasthenia gravis, psoriasis, vitiligo,

systemic lupus erythematosus, sarcoidosis, central segmental glomerulosclerosis, Crohn's

illness, Behcet's Disease, pemphigus, and ulcerative colitis). Treat some other non-immune

system incendiary ailments (e.g., long haul hypersensitive asthma control).

Keywords: drugs, immunosuppressant, side-effect

INTRODUCTION

Immunosuppressant medications are a class of medications that stifle or decrease the quality of the body's insusceptible framework. They are likewise called hostile to dismissal drugs. One of the essential employments of immunosuppressant medications is to bring down the body's capacity to dismiss a transplanted organ, for example, a liver, heart or kidney. There are 2 sorts of Immunosuppressant:

(1) Induction medications: Powerful antirejection drug utilized at the season of transplant.

(2) Maintenance medications: Antirejection medicines utilized for the long haul.

The three primary immunosuppressants medicates as of now utilized as a part of organ transplantations are the accompanying: (a) Cyclosporins (Neoral, Sandimmune,

SangCya). These medications demonstration by repressing T-cell

actuation, therefore keeping T-cells from assaulting the transplanted organ.

(b) Azathioprines (Imuran). These medications upset the union of DNA and RNA and cell division.

(c) Corticosteroids, for example, prednisolone (Deltasone, Orasone). These medications smother the irritation connected with transplant dismissal.

Most patients are recommended a mix of medications after their transplant, one from each of the above principle bunches; for instance cyclosporin, azathioprine and prednisolone. Over a timeframe, the measurements of every medication and the quantity of medications taken might be lessened as the dangers of dismissal abatement. In any case, most patients need to take no less than one immunosuppressive for whatever is left of their lives. Think about a land home loan; the upfront installment resemble the acceptance



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Are Nurses Aware Regarding Danger Signs of Labor? A Cross-

Sectional Screening in a Tertiary Care Centre in North India

S. Kumbhakar*, V.R. Vijay College of Nursing, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, UP, India

ABSTRACT

Awareness of danger signs during labor is one of the essential aspects of maternal well-being

that enhances early diagnosis and treatment as it augments reduction in maternal and infant

mortality. The objective of the study was to assess the knowledge regarding danger signs of

labor among the nurses and to find out the association between the selected demographic

variables and their knowledge score. A cross sectional descriptive research approach was

employed. Three hundred and twenty two subjects are included in the study. Subjects were

prearranged on the basis of purposive sampling. Interview schedule was used to collect socio

demographic and clinical data of the subjects. Knowledge was assessed by a questionnaire

related to danger signs. The result showed that a large group (44%) belongs to moderately

adequate category and 38% were in inadequate group whereas only 18% had adequate

knowledge. Keywords: awareness, danger signs of labor, nurses

INTRODUCTION The labor and childbirth are special proceedings in women life. It is a time of great hope and pleasurable anticipation whereas it can also be a time of panic, distress and even death. UNICEF report reveals India’s maternal mortality rate reduced from 212 deaths per 100,000 live births in 2007 to 178 deaths in 2012.[1] Labor may be linked with certain risks for both women and fetus. Appropriate midwifery care such as adequate fetal and maternal monitoring, judicious medical intervention, reducing prolonged labor and apt referral throughout and immediately after childbirth can help out to avoid intrapartum complications.[2–5] The key obstetric danger signs comprises of early or premature rupture of membrane, profuse vaginal bleeding, prolonged labor (more than 24 hrs of labor

pain or pushing pain more than 2 hours), tearing abdominal pain, hyperpyrexia, oliguria or dysuria , toxemia of pregnancy (frontal or occipital severe headache, blurred or double vision, sudden epigastric pain, overactive reflexes, protein in urine, raised BP), increased pulse rate or reduced BP, convulsions, decreased or absence of fetal movement, diminished or raised or absence FHR, Meconium or blood or golden yellow stained liquor, retained placenta, inversion of uterus(sense of something coming out) , and fruity smell breath.[6–8] A study pointed out that timely and necessary obstetric intervention was delayed by midwives’ due to the lack of proper monitoring of warning signs throughout labor. Several studies noted that midwives’ had critically low knowledge to recollect the danger signs of

Mechanical Engineering

Chemical Engineering

Architecture

Applied Mechanics

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1 more...

2 more...2 more...

5 more...

Computer Science and Engineering

Nanotechnology« International Journal of Solid State Materials« International Journal of Optical Sciences

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Civil Engineering

Electrical Engineering

Material Sciences and Engineering

Chemistry

5 more...4 more...

3 more...

Biotechnology

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Nursing « International Journal of Immunological Nursing« International Journal of Cardiovascular Nursing« International Journal of Neurological Nursing« International Journal of Orthopedic Nursing« International Journal of Oncological Nursing

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Nursing Critical

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JUL–DEC 2016 IJNCC