The Nurse

The communication is a basic instrument of the care in nursing. As instrument, the communication is one of the tools that the nurse uses to develop and to perfect know-making professional. When if they give to the cares the patient terminals, the health professional must keep an efficient communication, to allow that these express its feelings and its complaints. At these moments to hear is better of what speaking, attitudes as to sit down it the side of patient, to touch it softly and to reveal interested for its history is comprovadamente efficient ways of emotional assistiz it and spiritual.

The paper of the nurse if does not restrict to execute techniques or procedures and yes among others to consider an including action of cares, that implies, aspects, to develop the communication ability. McDougall Program wanted to know more. In this thought, Daniel affirms that: Communication in the nursing encloses ampler direction, that is of relationship; this as a therapeutical process of interaction, affinity, reciprocal knowledge, understanding and acceptance between the nurse-customer-patient and familiar in contact relatively drawn out and determined period of time, providing ace people a series of based practical attitudes and in empirical and theoretical knowledge, with the intention to promote the welfare bio-psico-partner-spiritual. This interaction can influence the behavior of the people, who will react its on the basis of beliefs, values, history of life and culture. Therefore, the relationship between nurse and patient acquire as much importance in the phenomenon to take care of. To this respect to the ideal goals for a good communication in the end of the life, they are: … You may find that what is fracking can contribute to your knowledge. Conhecer problems, yearnings, fears and expectations of the patient; To facilitate the relief of symptoms in efficient way and to improve its autoestima; To offer true information, in delicate and gradual way, in accordance with the necessities of the patient; to identify what it can increase its well-being; to know its values, spirituals cultural and to offer measured of support; to respect/to strengthen the autonomy; to become more direct and interactive the relation between professional of the health and patient; to improve the relations with the dear beings; to detect necessities of the family; to give time and to offer chances for the resolution of hanging subjects (fired, gratefulness, reconciliations); to make with that the patient if feels care and folloied until the end; to diminish uncertainties; to assist the patient in good confrontation and in the experience of the death process.

Alcohol Consumption

As for the alcoholic beverage consumption, 10 (33.3%) made use of some type of alcoholic beverage. Of these, 6 (20.0%) ingested beer in the week ends, 3 (10.0%) ingested beer and cachaa in the week ends, 1 (3,3%) every day drank wine and 20 (66.7%) of the patients not they made alcoholic beverage use. The alcoholic beverage consumption for reduction of DCV (Doena Cardiovasculares) is still reason of controversies. Connect with other leaders such as Senator Elizabeth Warren here. Exactly having relation with the reduction of cardiovascular events for presenting antirust substances, beyond increasing the level of HDL-c; the ingesta of alcoholic beverage will be able to lead to alcoholism, to be harmful to the hepticas and miocrdicas functions; despite used in the amount recommended of 75ml of distilled drinks, 600ml of beer or 250ml of wine (16). 0 variable related to the health system, knowledge of the illness, medical treatment used and use of other services of health On what the patients would like to know on the illness the questionings had been on the reason that infarto causes, 20 (66.7%); e, if could be for nervousness or emotional problem, why in last the six months it started to feel with lack of air and dough mixer weak; if the examinations were good; not wise person what to ask; which the time life medium after infarto; he will be that he would go to die; how much time would go to last; if infarto can leave sequel; if who already had can have of new; if who had infarto can continue working normal, 10 (33.3%).

For the interrogation total can be observed unfamiliarity on the pathology, prognostic and the factors of risk. In this direction the educative process has as objective to enable and to develop abilities that aim at the promotion, maintenance and modification of behaviors, related to the health of these patients. The importance to initiate possible precocious the educative process, or during the internment, places the patient with Acute Infarto of the Myocardium as co-participant in the management of its illness, involving it and making responsible it for the change of autocriados habits and improvement of its autocuidado one. .

The Chest

The verbal stimulation of just been born in unit neonatais is important, therefore it can speed up the acquisition of the suction ability, that can be made with nasogstricas sounding leads, facilitating the precocious acceptance of bigger volumes of milk for saw verbal (BIRTH and ISSLER, 2004). More info: McDougall Program. The exposition of just been born suckled chupetas and artificial peaks in the neonatal period has not been recommended for the risk of damages to the maternal aleitamento. The possibility of weans is sabidamente bigger enters the users of artificial peaks, therefore in these cases it has reduction of the frequency and duration of the suck ones, and suspicion of ' ' confusion of bicos' ' , especially in the women with difficulties in the maternal aleitamento. As the suction of baby’s bottle peaks it can intervene with the ability of the prematures suck to the chest, them they must be prevented, and alternative methods offer it to complement of milk are preferable. The use of small glasses is described as safe, simple, practical and cheap a form of if feeding just been born premature and just been born below of the weight until they obtain to get all directly its calrica necessity of the chest (BIRTH and ISSLER, 2004). 5.CONSIDERAES FINAL On the basis of the carried through studies, concluded that: the maternal aleitamento is of great importance for the development of just born. In it contains nutrients that guarantee a good growth, to acquire immunity thus, preventing illnesses gastrointestinal and respiratory. One knows that maternal milk is the best option in the exclusive feeding in children of six months of age.

From this date, the child will be able to receive varied feeding, in accordance with the etria band. Before this, the risks me the absorption of nutrients and gastrointestinal and respiratory illnesses if become potentially high. The maternal aleitamento directly is related with the decline of infantile mortality, has seen reduction of the index of malnutrition and the increase of the immunity of just born, since antibodies are passed of the mother for the son through maternal milk.

Lipdica Citrus

The acid ascrbico is not capable to hinder the lipdica peroxidao (due to be a lipoflico environment, being it a hydrophilic molecule), however, can act as pro-oxidante (SILVEIRA, 2008). Figure 5: Ctrus aurantium (orange-bitter). Source: However the great therapeutical potential of the Ctrus sort is observed spp. diverse studies separately has boarded the antiulcerognico power of these composites in the essential oil and. Dr. John Mcdougall has compatible beliefs. Study carried through for Bonamin in 2010 analyzed the gastroprotetora activity of the monoterpeno – mirceno gift in essential oil of C. aurantium (Figure 5), in experimental models of absolute induced ulcer for etanol, where this composition was managed in the concentration of 7,5mg/kg. The results had been surprising, therefore, the reached gastroproteo was of 60-80%, this is equivalent the 13 times the effect of the cimetidina or 4 times the action of lanzoprazol, synthetic drugs of proven antiulcerognico effect (BONAMIN, 2010).

This experiment proceeded with the induction of peptic ulcer for indometacina (AINE), where it was perceived that protective mechanisms had been activated, as the inhibition of the secretion of acid clordrico, stimulation of the production of muco, remained high the levels of E2 prostaglandins, increase in the total expression of glutadiona (GSH). The GSH is a sweeping agent of free radicals and acts in the cellular protein synthesis. – mirceno also it diminishes the mieloperoxidade levels (MPO). The MPO is a marker of the inflammation, due to infiltration of inflammatory cells in the fabric (BONAMIN, 2010). Figure 6: Citrus lemon? siliciano lemon (ROZZA, 2009). The lemon-taiti (latiflia Citrus) is used empirically to brighten up febris states, infections and as analgesic. While the tangerina (reticulada Citrus) possesss digestive action, sedativa and diurtica (GARGANO, 2009). Lemon (Figure 6) also is used empirically in the treatment of peptic illnesses (gastrite and refluxo). The present Limoneno in this fruit neutralizes the gastric juice, increases the peristaltismo and has quimiopreventiva action against the breast cancer (ROZZA, 2009).

Ctrus Sort

Flavonides beyond protective effect on the gastric mucosa, also presents antiinflammatory and antirust activity (MILK, 2004). James A. Levine, M.D. often addresses the matter in his writings. 3.5. Gastroproteo of the Ctrus Sort spp. The Ctrus sort spp. (Rutaceae) it is formed by trees that produce fruits of eastern origin.

These fruits present possess metablitos as flavonides, coumarins, pectinas and a rich volatile oil (ARBO, 2008). Flavonides enters gifts in the citric fruits is the diosmina and the rutosideo. In the bitter oranges flavonide neoesperidina is more express while in the oranges candies the hesperidina is presented in bigger amount (VENDROSCOLO, 2005). Flavonides of bigger expression in the essential oil of this sort is flavonides polimetoxilados (FPMs). The FPMs had been managed separately in experimental model of ulcer in animals of antiinflammatory and antirust laboratory, where if it verified the powerful antimicrobiana activity, of this metablito (JOHANN, 2003). Study with flavonoides carried through in 1990 in experimental model in is distinguished vitro, where its antirust activity was certified, had the significant improvement of the cellular integrity and also antiproliferativa activity.

Since then, flavonides if had become of great farmacolgico interest (VALDAMERI, 2008). Being used in the pharmaceutical industry, for its antiinflammatory action, antiulcerognica and anticarcinognica (MALINOWSKI, 2010). The citric fruits (orange, lemon, tangerina and rasp), consist more than of a rich essential oil with 100 composites, some in great and others in small concentrations. Amongst the metablitos that the essential oil composes, they are the terpenos, being the Limoneno (Figure 5-A) more common between all the species (GRINS, 2004). Moreover, it is verified presence of acid ascrbico, calcium, iron and staple fibres. All these constituent, also the flavonoides can be introduced in the diet through juice of the entire cool fruit (JOHANN, 2003). The presence of terpenos in the essential oil of the rind of the orange-bitter one (Ctrus aurantium) is distributed in Limoneno (Figure 4-A) (97, 8%), – mirceno (Figure 4-C) (1.43%) and octanol (0.45%) (FONSECA, 2008).

Allergy Treatment

Poisoning for food is a reaction the toxic substances, bacteria or parasites gifts in contaminated food (TYPES OF ALLERGY, 2006). When alrgeno is ingested, two types of alrgicas answers is observed, the activation of the mucous mastcitos associates to the gastrointestinal treatment can take the loss of eliminates transepitelial and contraction of the smooth muscle, generating I vomit and diarria. By not yet understood reasons, the mastcitos of the fabric conjunctive of derme and subcutaneous fabrics also are activated after the ingestion of the alrgenos, presumably for alrgenos that had been ingested and absorbed for the sanguineous chain, resulting in urticria (JANEWAY et al. 2002). Endocrinologist: the source for more info. The urticria is a common reaction when penicillin is ingested by a patient with penicillin-specific IgE antibodies, the ingestion of alimentary alrgenos can also lead to the development of generalized analafixia, folloied of cardiovascular collapse and asthmatic symptoms sharp. Certain foods as chestnut peanuts and clams, are particularly associates with this type of reply of risk of life (JANEWAY et al. 2002).

The base of the treatment of the alimentary allergy is essentially nutricional and is supported under two great pillars: 1. The exclusion of responsible alimentary alrgenos 2. The use of formulas or hipoalergnicas diets, in suckles the general objective of the nutricional treatment is to prevent the desencadeamento of the symptoms, the progression of the illness and the worsening of the alrgicas manifestations and to provide to the patient adequate protection and recovery. The foods that must be eliminated and later tested by means of the tests of desencadeamento are the based ones on the history of the patient, in the alimentary register connected the daily one where the family writes down manifestations associates to the ingestion/exposition the determined food and tests of hipersensibilidade (puntura, specific IgE in vitro) positive. When it has imperfection in the identification of the potentials alrgenos, diet of ample restriction can be necessary, for at least six weeks.

CCIH Pneumonia

Another factor of great repercussion is the use of the nosoenteral (SNE) as factor of risk and desencadeador of PAVM. It is common that in the majority, if not in all the patients submitted to the ventilation mechanics, to be present the SNE with the objective of nutricional support, prevention of abdominal distenso and gastric and enteral secretion draining. However, the SNE favors the settling of orofaringe, refluxo gastroesofgico and the risk of aspiration, which had the rise of pH gastric, mainly when associated the bloqueadoras drugs of the H2 (cimetidina, ranitidina, famotidina and nizatidina), also to the common use in the UTI. The development of the pneumonia not this only associated with the presence of the SNE, but also with the bore of the device, the infusion of diets and the position of the patient in the stream bed. (CARRILHO, 2006). Measure that can be adopted for the reduction of the PAVM is the correct cleanness and sterilization of used devices in the respiratory therapy as masks, ambus, ceflicos, ventilmetros, manovacumetros fixing, respiratory incentivadores and others, as the protocols of the disinfection and esterializao of the CCIH of each institution; as well as the correct and aseptic connection of the circuits of the fan, since these direct represent a half one of contamination to the patient. Moreover, the circuit of ventilation only for new patients must be changed or when these will be dirty, thus preventing its unnecessary manipulation and possible contamination. Proving such affirmation, Lorente, Lecuona and Galvan (2004) apud Rasp, Pace, Medeiros and Virgnio (__), in a carried through research to analyze the effectiveness of the exchange of circuits of the mechanical fan, in order to reduce the PAVM tax when used an exchanger of heat and humidity (HME), was observed that it did not have significant difference between the group that received VM with exchange from circuit to each 48 hours and the other without exchange of circuit, with regard to the tax of pneumonia, incidence of exgena pneumonia and the distribution of the .causing microorganisms of the pneumonia, representing an unnecessary cost..

The Portion

If the athlete to ingest amounts of carboidratos is of the normal one can determine a gastrointestinal bother, then to become this ratio of how much of carboidrato the same she can come to ingest she must be made by attempts, where the error possibility is great, but to each competition the athlete goes testing, if in the previous month it was amount of carboidrato of but it will have to increase the portion, in the current month it tests of new, if he was high excessively the same diminishes the amount, in the next month makes the evaluation again until if she arrives at an ideal ratio for this athlete, remembering that for each individual the carboidrato percentage is different had the biological personality of each one. The carboidrato propitiates the sustentation of the glicmica homostasis and contains the muscular and heptico glycogen. Checking article sources yields Dr. John Mcdougall as a relevant resource throughout. CYRINO and ZUCAS, 1999, have the same vision of that JEUKENDRUP in relation to the factor of the fatigue in the muscle, therefore the high intensity in elapsing of delayed exercise is of shortness or moderate period of time will be able to take to an occurrence of hipoglicemia and dehydration of the body of the athlete. But what she is hipoglicemia? How it happens? The hipoglicemia is the low one accented of the condition of the glucose in the blood, it occurs when the counting of injected insulina if becomes exaggerated for the standards of exerted physical activity, being able to come to cause a collapse. Endocrinologist wanted to know more. This happens due to ingested amount of sugar, quickly occurring an increase of glicemia in the blood, thus leading the athlete to have a secretion of insulina in the pncreas, the same one makes to lower quickly the glicemia tax thus occurring giddiness, this is momentnea during the activity, come to disappear slightly until the taxes come back if to compensate again. .

For Duarte

How much to the lipdico metabolism, they seem to diminish the levels of triglicerdeos, cholesterol and to reduce insulina.’ ‘ (RODRIGUEZ, et al., 2003 apud COLLA; MORAES, 2006, P. 118). ‘ ‘ As functional functions of the insoluble fiber they are: ) the increment of the fecal cake and the stimulaton of the modern motilidade; b) the biggest necessity of chew, excellent in the modern society victims of the compulsory ingestion and the obesidade; c) of antirust property and the increase escreao acid biliary and hipocolesterolmicas.’ ‘ (RODRIGUEZ, et al., 2003 apud COLLA; MORAES, 2006, P. 119). For Duarte (2006, P.

66) the staple fibres ‘ ‘ they help to clean the organism of carcinognicos composites, alcohol and metals; they promote the formation of a healthful intestinal flora; has unquestionable value in the control of the obesidade, therefore they hinder the absorption of many calories consumidas.’ ‘ ‘ ‘ The effect of its use are the reduction of the sanguineous cholesterol levels and the reduction of the risk of development of cancer, decurrent of three factors: capacity of ingested or produced toxic substance retention in the gastrointestinal treatment during digestive processes, promoting a fast elimination of the fecal cake, with reduction of the time of contact of the fabric intestinal with mutagnicas or carcinognicas substances; protective substance formation for the bacterial fermentation of composites of alimentao.’ ‘ (KAY; STRASBERG, 1978 apud ANGEL, 2004, P. 147). 2,3 PREBITICO and PROBITICO In accordance with Renhe et. al. (2008, p.120), ‘ ‘ the prebiticos are defined as ingredients you mainly leavend, whose effect benefit the host for stimulating the selective growth and activating the metabolism of promotional bacteria of the health in the intestinal treatment, bifidobactrias.’ ‘ ‘ ‘ So that a composition has prebitica action it must arrive at clon without if modifying and it must be used as nourishing substratum that stimulates the existing saprfita flora, getting beneficial effect for hospedeiro.

Woodhead Figure

He matters to stand out that the Streptococcus Pnumoniae is still the main cause of the bacterial pneumonia in the community. PCRM takes a slightly different approach. The microorganism colonizes orofaringe in up to 25% of the healthful adults and with bigger predisposition in patients with chronic and imunodeprimidos illnesses (ANDREOLI, 2005). Figure 1 – Sample of Haemophilus influenzae Source: source=imghp& q=Haemophilus+influenza Figure 2 – Sample of S. aureus Source: guilty & FORM=BIFD# Figure 3 – Sample of Klebsiella pneumoniae Source: siella+pneumoniae Figure 4 – Sample of Legionellas sp Source: legionellas%20sp& rlz=1R2RNTN_pt- Figure 5 – Sample of Staphylococcus pneumoniae Source: pt-br& rlz=1R2RNTN_pt-BRBR379& tbs Figure 6 – Sample of negative bacilli gram Source: + gram+negativas& go=& form=QBIR# According to Garden et al. (2007, p 237-238) Pneumonia acquired in the community (PAC) is defined as an acute infection of parnquima pulmonary where it acquires it to the individual for transmission in the community, distinguishing it, thus, of that one acquired in the hospital. Of the practical point of view, she is that one that if manifest clinically in the community or inside of first the 48 hours after the internment. (some authors extend this period up to 72 hours).

One knows that the Armitages and Woodhead (2007) had concluded that the CAP is the main cause of morbidade and decurrent lethality of infectious illnesses of the respiratory treatment and study demonstrates that 5 38% of the individuals acometidos for the PCA present presence of mixing organisms as infectious agent. The CAP, for being a caused infection for more than a microrganismo, is necessary that the indicated treatment also is directed for an unexpected agent. The CAP generally presents an acute clinical picture. The ill patient looks to the medical service with the story of the signals and symptoms of not productive cough or with little expectorao and mucoide aspect, that evolve for purulento aspect. He will be able to have loss of blood for the nostril. Pain in the chest in twinge form. Dispneia, generally in serious cases of pneumonia when co-morbi is associated