Nursing Assignment Report writing help online: Foot health, knee problems – its symptoms, sound education
Portfolio Task: Module 1
Effective Study Skills are the Sole Foundation of a sound education
Study skills, as defined by Adams and Hamm (1994), are paths which lead to the learning. Ley and Young (1998) have defined Education as a formal process followed deliberately by a society with an aim to transfer the knowledge, skills, customs and values which it has accumulated to the future generations. Effective study skills establish a sound education system as it leads to a positive outcomes across multiple academic content areas and for diverse learners ( Semones 1991).
Raiment of study skills have been developed in order to formulate a process which helps in delivering new information in an organized manner. These arrays include Mnemonics; through which information are recalled, effective reading and concentration techniques, as well as efficient note taking.
Crystal clear understanding of a subject and effective application of study skills are the two main components of a sound education. Students who are capable of getting good grades may find it difficult to score the same not because of the lack of ability but because of the absence of effective study skills (Devine 1987). “Someone who works hard and is well organised but spends all their time on unimportant tasks may be efficient but not effective. To be effective, you need to decide what tasks are urgent and important and to focus on these” (University of Kent). Chances of failure are reduced through effective skills and learners can take advantage of learning opportunities.
Study skills make learners capable of acquiring knowledge in an organized and synthesized manner, retaining the acquired knowledge and finally applying the acquired knowledge in an effective manner. Scope of study skills are not limited to academic knowledge only it prepare learners for lifelong learning experience (Hoover and Patton 1995). Indispensable skills such as organizing, listening, and retaining information are developed through study skills. All these skills are quite important in every phase and situation in life. For example when an individual is applying for a job, crystal clear knowledge is very significant in order to crack the interview.
Study skills can be defined as the techniques which assist an individual in becoming an effectual learner. Some students might posses these study skills naturally while most people do not have them. Cottrell (2008) has explained it in better manner that a skill can be any learned activity, something which can be developed through thorough practice. The study skills have been categorized into various categories like active listening, presentation techniques, critical thinking skills, writing skills, time management, reading comprehension, memory techniques, and research and evaluation. Both natural skills as well as acquired ones need to be developed as well as fine tuned so that they become effectual.
To conclude, in order to attain a sound education, it is very essential to develop effective study skills as in the absence of these study skills, education will not sustain and will crash down. Apart from building a solid base for sound education, study skills also develop skill of thinking in critical manner, command on a language and effective communication skills, skill of listening and not just hearing and skill of asking logical questions which ultimately result in sound education ( Fuchs, Fuchs, Mathes and Simmons 1997).
Portfolio Task: Module 2
Briefly describe the importance of the interaction between the respiratory and cardiovascular systems in maintaining the body’s internal balance
The system of heart and blood vessels of human body is termed as cardiovascular system (Hockenberry, 2003). Two words “Cardio” and “Vascular” on combining make the word “cardiovascular”. The term “cardio” is derived from “cardiac” meaning Heart and the term “vascular” means blood vessels. So the name itself indicates that cardiovascular systems are the system of heart and blood vessels. Cardiovascular system is also known as “Circulatory System”. Cardiovascular system in human body consists of the heart, the blood, lymphatic tissues and blood vessels. In order to maintain life, the cardiovascular system is very vital. Heart, which works constantly to infuse oxygenated blood in the body, is the centre of the cardiovascular system.
The respiratory system is a biological system of introducing respiratory gases to the interior and performs gas exchange (Hockenberry, 2003). In biology, the process in which gases contained in human body and gases present in atmosphere are exchanged with each other in the human lungs and this termed as gas exchange process (International Health Care Worker Safety Center 2002). The nose, pharynx, trachea and lungs constitute the respiratory system in a human body.
Oxygenated blood in provided by the heart to keep all the vital organs live. Help of respiratory system is essential for the heart to perform this job. Two lungs, one trachea and one alveolar constitute the respiratory system (Lillis 2002). The respiratory system supply oxygen to the blood and then blood deliver this oxygen to all other parts of the body. The blood is provided with the oxygen through the process of breathing. In the process of breathing we in take oxygen and leave out carbon dioxide. Oxygen is supplied to the blood during this exchange of gases.
Cardiovascular system leads to homeostasis in human body. Homeostasis means that tissue fluids that surround the cells need oxygen and nutrients present in the blood to function properly (Hurley 2001). Maintaining homeostasis properly in human body largely depends on capability of cardiovascular system to deliver the oxygen and nutrients in such a manner that it reaches every cell in the body through the thousands of miles of capillaries that permeate every tissue. Respiratory system helps in proper maintenance of homeostasis by two ways; they are proper gas exchange and regulation of blood pH.
Thus it has been analyzed that heart is vital organ, however without lungs it becomes impossible for heart to perform its duty. The heart would not be able to operate even if the cardiovascular system is working adequately and is healthy and lungs are unhealthy. The heart will eventually fail devoid of oxygen and vice-versa is also applicable. The human body is crafted to function only when it gets oxygen and the only method to maintain regular supply of oxygen is to keep the respiratory and cardiovascular system healthy ( Chaperon 2008).
To conclude, in order to sustain life, numerous distinguish organs has been put together which also makes it a complex machine. Although the role played by every organ is important but then there are certain organs which holds special position in a body (Stachnik and Wulff , 2002). Various systems that operate in a human body are dependent on these components to function properly and keep body in balance. Interaction between the respiratory and cardiovascular systems in one such example which operates to balance the interactions between organs that is unable to exist or survive without each other.
Portfolio Task: Module 3
“When you ask a patient to plantar flex a foot, what changes occur within the muscles involved?”
According to Maitland (1977), the movement of foot in which ankle is bent is termed as Plantar Flexion. Posture where one stands on his/ her tiptoes or gas pedal of a vehicle is pushed, plantar flexion takes place. Through plantar flexion, ankle muscles and calf are relaxed so that they can properly work. The term “Plantar Flexion” is used to describe the movement of toe in which toe is pointed in the downward direction as a result of extending or straightening of ankle. Plantar flexor muscles, namely, the gastrocnemius, soleus, tibialis posterior, flexor digitorumlongus, flexor hallucislongus, peroneus longus and peroneus brevis are involved in plantar flexion (Kisner and Colby, 1990). More simply, it can be described as “the movement of the foot away from the body by bending the ankle. Plantar flexion occurs when you stand on your tiptoes or when you push down on the gas pedal in your vehicle. Plantar flexion depends on the muscles of the ankle and the calf to work properly” (Kisner and Colby, 1990).
Muscles present in the posterior compartment of the leg are the one which get involved in plantar flexion. The flexor hallucis longus, the flexor digitorum longus and the tibialis posterior are the main three muscles which are used in plantar flexion. Gastrocnemius, the soleus and the plantaris are the superficial posterior compartment muscles which get involved in plantar flexion.
The changes that occur when you ask a patient to plantar flex a foot involve the movement of the muscles and how each one works together to make the motion of the foot to move. “The actions of a muscle are the main movements that occur when the muscle contracts” (Tropp and Norlin, 1995
). The most evident consequence of immobilization is loss of muscle force. The loss of force, similar to the loss of muscle mass, is a time-dependent process. The decrease in force, however, is not strictly proportional to the loss of muscle mass because neural input15, 16 and metabolic energy stores17 also play a role in determining the amount of force output.
If the heel is gently raised by the subject, the contraction of the muscle fibres of gastrocnemius can be felt. After it if the knee is fully flexed and foot is plantar flexed, soleus can be felt contracting while gastrocnemius remains relaxed. This is because the upper (femoral) and lower (calcaneal) attachments of gastrocnemius are bought closer together, shortening the muscle and essentially preventing it from contracting” (Maitland, 1977).
In injury-free subjects the highest loss of 50% strength is seen to occur after the immobilization of knee which occurs in the quadricepos and in the hand muscles too which is followed by 35% value for the flexors and arm extensors along with 20% reduction in the plantarflexors. This indicates that there is no clear relationship between the sizes of the muscles its location and the loss of strength (Duchateau & Hainaut 1990). Thus this indicates that the muscles in the lateral compartment have very weak participation in the plantar flexion (Duzan 2009).It is the joints in the ankle which are highly involved in the plantar flexion.
Portfolio Task: Module 4
“A patient comes in with a hot inflamed toe, how does the circulatory system contribute to this process?”
A person generally get hot inflamed toe when the uric acid level is too high in the blood. Generally, in a human body uric acid is metabolized by liver and kidney throws it out in the form of urine. But sometimes amount of uric acid that is being formed in body can be too high and the level of uric acid that is being eliminated is not sufficient. Thus chemicals and inflammatory mediators released from damaged tissues result in hot inflamed toe. Redness (rubor), heat (calor), swelling (tumor) pain (dolor) and loss of function are some classic and clinical symptoms of hot inflamed toe (Dobson, 1999).
The patient presents with a hot inflamed toe and the circulatory system contributes to this process in the following way. “Inflammation helps to remove the harmful agent and by doing so encourages subsequent healing. The inflammatory response is a collection of overlapping events. These are increased blood flow, accumulation of tissue fluid, migration of leucocytes, increased core temperature, pain and in some cases, suppuration” (Emmerson, 1996).
The circulatory system plays an important part of this process because whenever an injury occurs there is redness and heat which results from large amount of blood which gets accumulated in the severely damaged or injured area (Wu, Muzny, Lee & Casker 1992). Therefore the circulatory system contributes to this process by allowing more blood flow to the area until the process of healing begins.
Hot inflamed toe initiated the inflammatory process by swelling and expanding the toe and they are around it. The process of inflammation activates the circulatory system which is why the white cells and the blood starts collecting around the injured or irritated toe are. This process of inflammation is circulatory systems reaction towards the injury through symptoms like swelling, pain, redness and heat. The tissue reaction of the injury whether it is direct or indirect is seen in the form of hot inflamed toe through the reaction of circulatory system and this is the internal response of the system. That is why it has been noticed that burning and aching in the toes might occur because it has been found that it is due to the response of circulatory system of pour body (Henderson).
“Arterioles supplying the damaged area and the local capillaries dilate which cause an increase in the blood flow to the site. This is because a number of chemical mediators from the damaged are released locally. This increased blood flow to the area of tissue damage provides more oxygen nutrients for increased cellular activity that accompanies inflammation. It is this increased blood flow which causes a rise in temperature and reddening of the inflamed area and also contributes to the swelling and oedema associates with inflammation” (Steele, 1992).
The patient will very likely be suffering pain. This is caused by “pressure on nerve endings from the interstitial fluid and the effect of some inflammatory mediators such as substance P and prostaglandins that cause pain” (Dobson, 1999).
In conclusion, the circulatory system contributes to the hot inflamed toe by releasing an increase in the blood flow to the affected area, by accumulation of tissue fluid and the migration of leucocytes, until the process of healing can begin.
Portfolio Task: Module 5
“Discuss the possible presenting symptoms after a hard knock on the leg in the area behind the knee?”
Possible presenting symptoms that could result from a hard knock on the leg in the area behind the knee are swelling due to the “escape of blood from damaged blood vessels adjacent to the area of the injury, rupture of the anterior cruciate ligament, damage to the synovial membranes, torn menisci, fractures or collateral ligament sprains” (McAlindon et al, 2000).
Stiell et al (1996) have discussed it is likely that the patient will be experiencing acute pain but this could be eased by rest but will resurface once activity is resumed. The patient will describe a feeling of “weakness, aching or stiffness, which at times may be sharp and quite severe. When the case history is taken, the patient will remember a particular episode that contributed to the injury” (Smith and Green, 1995).
Injury resulting from a hard knock on the leg in the area behind the knee could occur in sports such as football and rugby and as well as the possible damage to the areas mentioned in first paragraph, bruising and damage to the gastronomies and soleus muscles may also occur.
Depending on the severity of the hit and the period in which a hard knock took place, a hard knock to the posterior of the knee could cause many symptoms ( Norman, Cacciotti, Sivilitto 1996). There could be bruised or swollen knee. There may be less range of motion or even if it is there it may be very painful. The person may limp or be unable to bear weight. Tendon or the sheath around a tendon becomes inflamed and the sufferer gets an intolerable pain. There is accumulation of excessive fluid in the synovium (membrane in the knee capsule). This may also indicate towards an underlying condition. Such fluid buildup can be blood or increased secretion form the symposium as a reaction to some type of inflammation or overuse.
To conclude, there are number of symptoms in case of hard knock in the leg but some of them are very common. The first and the foremost symptom in case of hard knock on the leg in the area behind the knee is swelling of the knee and the area around it ( Puet and Griffin 1994). There may be a gradual development in this swelling over hours to days after an injury. Another common symptom is limitation in the mobility of the knee. Generally swelling limits the motion. The ligament, which connect the shin bone to the thigh bone provides stability to the knee. In case there is some stretch in the ligament, , the knee may feel as though it is giving way beneath the patient.
The other possible symptoms which are associated with hard knock on the leg in the area behind the knee are effusion which is caused due to intense inflammatory processes occurring within the joint spaces. Rheumatoid arthritis, gout and infection are some of the conditions which can lead to effusion or inflammatory arthritis. The knee might appear swollen because of accumulation of liquids as it happens in the case of effusion which might also include, warmth, redness and pain while making any movement ( Thompson 2009).
Portfolio Task: Module 6
Write a properly referenced essay on the treatment and management of a patient with corns
Laakso et al (2000) have discussed, generally in the high pressure area of the foot, one may find a hard skin in a small area, generally round in shape and pressed inside the skin. These symptoms are together referred as the corns. Corns can be described as a “painful and conical thickening of the stratum corneum of the epidermis found principally over toe joints and between the toes, often caused by friction or pressure. Corns can be hard or soft, depending on their location, although hard corns are usually found over toe joints and soft corns are found between the fourth and fifth toes” (Jagust et al, 2001).
The condition of corns is “associated with excess intermittent mechanical stress (shear, friction, pressure, torsion and tension) which results in abnormal keratinization” (Jagust et al, 2001).
Helomamolle corns occur when the impingement is adjacent to the webspace ( Frontera, Silver, and Rizzo 2008) . The skin is often macerated and may become secondarily infected. Despite their hard texture, these more distal digital corns are sometimes referred to as soft corns.” (The Foot Examination & Diagnosis, 1997) (Fleming et al 2002). The patient must seek medical advice from the podiatrist who will make a “reduction of the overlying callous and enucleation (removal of the deep central core) of the corn. Following this, either an antiseptic agent, protective pad or an acid is applied. The application of a caustic preparation known as silver nitrate can help to shrink the cavity that has been left after the corn has been removed” (Demaerel et al 2003).
Vascular and neurovascular heloma corns have “vascular and neural elements and operating can be extremely painful. Local anaesthesia or progressive electrosurgery may be required with repeated applications of silver nitrate solutions” (Jagust et al, 2001).
However the best way to contribute towards the corn therapy for a physician is to encourage the corn prevention in the patients through proper education. The main essence of corn prevention is to eliminate any stances or chances of pressure or friction in patient (Schalock and Sober 2009). The shoes worn by patient should be well fitted and the pressure over the toes should be distributed in even manner. Shoes or sandals which provide ultimate comfort and are soft should be worn. The stocking should also fit well and provide enough cushioning to the foot.
The patient can be advised to use powder for keeping the feet dry in order to avoid friction due to wetness in the feet. The rational of these measures should be carefully explained to the patient by the physician so that patient compliance can be ensured. Other measures for curing corns are using proprietary plasters or paring down of large lesions (Singh, Bentley, and Trevino 1996).
In conclusion the management plan put into place will include regular maintenance to keep the corn and callus reduced, the use of padding to prevent the pressure, offering advice about the fitting of footwear, the possible use of foot orthotics or supports to relieve the pressure under the foot and in some circumstances surgical correction of the bony prominence that may be causing the high pressure area and the corns to return.
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