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Nurses Zone Documentary, Ndola (2025)

29/09/2025

PULMONARY TUBERCULOSIS

By Chipo James Mainda

Pulmonary tuberculosis, is a chronic infectious disease of the respiratory system affecting the lungs, in which there is formation of tubercles/granulomas in the lungs, that is caused by mycobacterium tuberculosis, characterized by night sweats, dry or productive cough and fever.

Normally, during inhalation, air enters the lungs by travelling down the trachea. Then it continues to the bronchi and bronchioles and ends up in the alveoli. The alveoli are tiny air sacs surrounded by small blood vessels called capillaries, and this is where gaseous exchange takes place. Tuberculosis is an airborne disease transmitted by respiratory droplets.

When the mycobacterium gains access in succeptible condition, it'll reach the alveoli in the lungs where it'll multiply invading the lung tissue and trigger an immune response via inflammation. The mycobacterium bacilli will then be ingested by macrophages normally found in the lungs forming the classical tuberculous granuloma, which is a primary lesion. This usually remains small and commonly heals without becoming detectable.

The mycobacterium may further be contained inside the granulomas especially if the immunity is good, the body will wall off the infection. Although the bacilli remain alive for years. This is called primary tuberculosis. Basically, the patient will have no signs, no symptoms of the disease, but will have a calcified spot seen on X-ray, and some immunoglobulins may be isolated.

The lymphocytes will also be sensitized and in response will work together with the macrophages to surround and engulf the bacilli in the lungs. This acquired immunity usually inhibits further growth of the bacilli and further development of active infection.

If the immunity is not strong and can't handle the bacilli, the infection tends to be aggressive. The bacilli may spread from the lungs via the bloodstream or lymphatic system to other parts/organs of the body, including the meninges, bones, liver, kidneys etc. Other than that, necrosis of lung tissue occurs, producing a caseous (cheesy) substance composed of bacteria, pus and mucus. This is coughed up as sputum, leaving a cavity in the lung. If cavities erode the blood vessels, the patient will cough up blood. When healing occurs, there will be much scar tissue.

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28/09/2025

THE FLOW OF CEREBROSPINAL FLUID

By Chipo James Mainda.

Cerebrospinal fluid (CSF) is a clear fluid found within the ventricles (cavities) of the brain, central canal of spinal cord and beneath the cranial and spinal meninges in the subarachnoid space. It protects and nourishes the brain and spinal.

The meninges (dura mater, arachnoid mater, and pia mater) are the three membranes that envelop the brain and spinal cord. Cerebrospinal fluid is located in the subarachnoid space between the arachnoid mater and the pia mater. The primary function of the meninges is to protect the central nervous system.

The whole process begins when cerebral spinal fluid (CSF) is produced by the choroid plexus in the lateral ventricles. Cerebrospinal fluid will flow through an opening called the foramen of monro to enter the third ventricle. From the third ventricle, the cerebral spinal fluid continues to flow downward into the fourth ventricle passing through a passageway called cerebral aqueduct/aqueduct of silvius.

In the fourth ventricle, the cerebrospinal fluid will continue the journey flowing download into the spinal cord. Nevertheless, some fluid will pass through the foramina in the roof of the fourth ventricle called foramen of lushka and foramen of mangendie to enter the subarachnoid space.

The cerebral spinal fluid will circulate through the brain and spinal cord in this space (subarachnoid space) and passes back or be absorbed into the blood through tiny diverticular of arachnoid mater called the villi which project into the venous sinuses.

Balance between production and absorption of cerebrospinal fluid is critical. Because cerebrospinal fluid is made continuously, medical conditions that block it normal flow or absorption results in over accumulation of cerebrospinal fluid. This results in pressure against the brain tissue causing hydrocephalus.

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27/09/2025

TIPS ON HOW TO WRITE A SIMPLE BUT POWERFUL MANAGEMENT OF FIRST STAGE OF LABOUR.

By Chipo James Mainda

Labour is the process by which the fetus, placenta, and membranes are expelled through the va**na. Normal labour occurs at term, and spontaneous in onset with the foetus presenting by vertex, and the process is completed within 18 hours, and no complications arise to both the mother and the baby.

First stage of labour is the longest stage. It begins with regular uterine contractions and ends with full cervical dilatation (10cm). It is further divided into 2 phases:
* Latent phase, which is the onset of uterine contractions, and cervical dilatation from 0-3cm.
* Active phase, which begins from 4cm cervical dilatation to 10cm cervical dilatation. It may be accomplished by moderate to strong uterine contractions.

Use the acronym "AEPREPP-HOIB"
In which;

A- Aims
E- Environment
P- Psychological care
R- Rest
E- Exercises
P- Position
P- Pain relief
H- Hygiene
O- Observations
I- Infection prevention
B- Bowel and bladder care

Then open a partograph and monitor the following;

- Foetal well being
- Progress of labour
- Maternal well being

NOTE: During latent phase use the acronym and during active phase open the partoraph.

For more join our daily online lessons on Whatsapp 0977353901.

26/09/2025

PRAYER BEFORE STARTING WORK

Loving Father,

May I be your hands and feet today,
Bringing comfort, healing and care.
May I speak with your love,
Bringing hope, understanding and kindness.
May I carry your peace in my heart,
Bringing clarity, reassurance and calmness.
May each moment be filled with heavenly truth.
With you I am stronger, kinder and wiser.
Come lead me through each moment
And watch over my working day.

Amen

25/09/2025

GLAUCOMA

By Chipo James Mainda.

Glaucoma is an acute or chronic disorder affecting the eye in which the pressure in the eyeball increases above 21mmHg, due to advanced age, blunt trauma to the eye and other associated predisposing factors leading to damage of the optic nerve characterized by peripheral vision loss.

Normally, light rays enter the eye through the clear cornea, then through the pupil and the lens. This light rays are then focused onto the retina which is a light sensitive tissue lining in the back of the eye. The optic nerve is connected to the retina and is made up of many nerve fibres. Light signals from the retina are then sent through the optic nerve to the brain were there interpreted as images we see.

Other than that, to understand how glaucoma affect the eye, it is also important to know how the fluid in the eye called aqueous humor is produced and maintained to prevent eye damage.

Acqueous fluid is secreted by the ciliary body then this fluid enters the posterior chamber of the eye and passes through the pupil to enter the anterior chamber of the eye where it circulates and fills the anterior chamber. It is then absorbed back in the bloodstream from the angle of the anterior chamber where the iris meets the back of the cornea called the trabecular meshwork.

The normal intraocular pressure in the eye is 12-21mmHg. It is controlled by the balance between the production and drainage of the aqueous humor. So when the rate of production is greater than the drainage or when the acqueous fluid doesn't drain properly, there is a rise in the intraocular pressure and this causes glaucoma.

For more, join our daily online lessons on Whatsapp 0977353901.

24/09/2025

We are offering online critical care nursing lessons

23/09/2025

So iweh ninshi tawakalembepo exam ukwabula ukukopela ai?🤔

23/09/2025

WEBER'S AND RINNE'S TESTS

By Chipo James Mainda

Rinne and Weber tests are exams that test for hearing loss. They help determine whether the patient have conductive or sensorineural hearing loss. This determination allows a doctor to come up with a treatment plan for hearing changes.

A Rinne test evaluates hearing loss by comparing air conduction to bone conduction. Air conduction hearing occurs through air near the ear, and it involves the ear canal and eardrum. Bone conduction hearing occurs through vibrations picked up by the ear’s specialized nervous system.

A Weber test is another way to evaluate conductive and sensorineural hearing losses.

HOW TO DO WEBER'S TEST

To perform Weber’s test strike the fork against your knee or elbow, then place the base of the fork in the midline, high on the patient’s forehead.
It is important to steady the patient’s head with your other hand so that reasonably firm pressure can be applied.

Then ask the patient: “Do you hear the sound louder in one ear than the other?”

• If so, in which ear is it louder?
• If the patient is unclear, you may ask if they hear it “everywhere.” Be careful not to ask the question in a leading manner.

Interpretation of Weber’s test

Weber’s test will ‘lateralise’, i.e. move to one side, with a relatively small amount of hearing loss (5dB).
• If sound is heard equally in both ears (that is normal).
• If a patient has a unilateral conductive hearing loss, the tuning fork sound will be heard louder in the deaf/affected ear.
• If a patient has a unilateral sensorineural hearing loss, the tuning fork sound will be heard louder in the normal ear.

HOW TO DO RINNE'S TEST

This test aims compare air conduction with bone conduction. Explain the test first: “I’m going to put this vibrating tuning fork in two positions, one touching the bone near you ear, one a short distance from the ear. I want you to tell me which position you hear the tuning fork loudest in.”

Begin by striking the tuning fork against your knee or elbow. Hold the tuning fork in one hand and place the base against the patient’s mastoid process.
Allow it to stay there for 2-3 seconds to allow them to appreciate the intensity of the sound. Then promptly lift the fork off the mastoid process and place the vibrating tips about 1cm from their external auditory meatus. Leave it there again for a few seconds before taking the tuning fork away from their ear.
• Ask the patient in which of the positions they were able to hear the note the loudest in.

* A patient who hears the tuning fork loudest when held 1cm from the external auditory meatus has a positive Rinne’s test (and that is normal).
* A patient who hears the fork loudest when it is held against the mastoid process has a negative Rinne’s test.

Interpretations of Rinne’s Test

In a normal ear, sound is conducted to the cochlear most efficiently via air conduction. Sound can also be transmitted to the cochlea, less efficiently, via bone.
✓ So…
• If a patient can hear best when the tuning fork is in the air (positive Rinne’s) then air conduction is better than bone conduction so there is no significant conductive hearing loss.
• If the patient can hear best when the tuning fork is on the mastoid (negative Rinne’s) bone conduction is better than than air conduction, demonstrating a conductive hearing loss.

For more join our daily online lessons on WhatsApp 0977353901.

21/09/2025

SUNBATHING

By Chipo James Mainda

Sunbathing is when you let sunlight touch your skin. It’s often done to get a tan or feel warm. It also applies to leisure time spent outside under the sun, maybe for health benefits or just for the sake of relaxing.

Sunlight has many light waves. The crucial ones for our health are ultraviolet (UV) rays, especially A and B types. These UV rays are behind all the sunbathing effects on us. Our bodies use these rays in different ways, notably vitamin D production and potentially boosting mood through serotonin release.

BENEFITS OF SUNBATHING

From getting more vitamin D to improved mental health, sunbathing has some potential benefits which are described below:

✓ Vitamin D Production

Vitamin D is key to our wellbeing and thanks to sunbathing, our bodies get to produce more of it. Vitamin D supports many body functions from bone strength, immune system control, to muscle health. It helps our bodies absorb calcium, which in turn builds strong bones and keeps muscles functioning.

✓ Mood enhancement and mental health

Sunlight is said to bring a positive change in our mind state and uplifts our mood. Sunlight exposure is said to increase serotonin, that’s a neurotransmitter that makes us feel good. More sunlight means more serotonin, resulting in improve mood. That’s why bright sunny days often make us happier.

✓ Other health benefits

The proposed benefits of sunbathing don’t end at vitamin D and mood upliftment, it may also help in the following:

* Improved sleep via melatonin regulation
Being under the sun helps control natural melatonin production in our bodies. This hormone handles sleep-wake cycles and time spent under the sun is said to power its night-time release, leading to better sleep quality and duration.

* Heavy sunbathing increases skin cancer risks while balanced sunbathing links to lower risks for cancers like those of breast, colon, and prostate.

RISKS ASSOCIATED WITH SUNBATHING

Yes, sunbathing comes with a kind side, but don’t overlook the risks linked to too much sun exposure. By knowing these risks, you may improve your sun protection approaches.

✓ Sunburn and Skin Damage

Too much sunbaring can cause short and long-term skin harm. Like painful sunburns and chances of skin cancer.
Both UVA and UVB rays can hit our skin. UVA enters deeper causing indirect DNA damage and fastens skin aging. Meanwhile, UVB interacts with DNA directly, leading to sunburns and increases skin cancer risk.

✓ Early Aging and Skin Health

Long-term sun exposure can cause early aging and unwanted skin changes. UV radiation breaks up collagen fibers in the skin. It weakens skin structure causing sagging, uneven texture, and thin lines.

✓ Eye Damage From Too Much Sun

Too much sun with no protection can damage our eyes. It increases the chances of cataracts and other vision problems.

For more join our daily online lessons on WhatsApp 0977353901.

19/09/2025

God's time is the best!

18/09/2025

SWIMMER'S EAR

By Chipo James Mainda

Swimmer's ear is an infection in the outer ear canal, which runs from the eardrum to the outside of the head. It's often brought on by water that remains in the ear, creating a moist environment that aids the growth of bacteria. Putting fingers, cotton swabs or other objects in the ears also can lead to swimmer's ear by damaging the thin layer of skin lining the ear canal.

Swimmer's ear is also known as otitis externa. Usually you can treat swimmer's ear with eardrops. Prompt treatment can help prevent complications and more-serious infections.

Swimmer's ear is an infection that's usually caused by bacteria. It's less common for a fungus or virus to cause swimmer's ear. The outer ear canals have natural defenses that help keep them clean and prevent infection. Protective features include:
• A thin, water-repellent, slightly acidic film lines the ear canal and discourages bacterial growth.
• The outer ear, particularly around the opening of the ear canal, helps prevent foreign bodies from entering.

If you have swimmer's ear, your natural defenses have been overwhelmed. The conditions that often play a role in infection include:
* Moisture in the ear canal that creates an ideal environment for bacterial growth
* Exposure to contaminated water
* Damage to the sensitive skin of the ear canal that creates an opening for infection.

Factors that can increase the risk of swimmer's ear include:
* Excess moisture in the ear canal from heavy perspiration, prolonged humid weather or water remaining in the ear after swimming.
* Exposure to high bacteria levels in contaminated water.
* Cleaning the ear canal with cotton swabs, hairpins or fingernails, which can cause scratches or abrasions.
* Ear devices, such as earbuds or hearing aids, which can cause tiny breaks in the skin.

Swimmer's ear symptoms are usually mild at first, but they can worsen if the infection isn't treated or spreads. Doctors often classify swimmer's ear according to mild, moderate and advanced stages of progression.

✓ Mild signs and symptoms

* Itching in the ear canal
* Slight redness inside the ear
* Mild discomfort that's made worse by pulling on the outer ear (pinna or auricle) or pushing on the little "bump" in front of the ear (tragus)
* Some drainage of clear, odorless fluid

✓ Moderate progression

* More-intense itching
* Increasing pain
* More-extensive redness in the ear
* Excessive fluid drainage
* Feeling of fullness inside the ear and partial blockage of the ear canal by swelling, fluid and debris
* Decreased or muffled hearing

✓ Advanced progression

* Severe pain that might radiate to the face, neck or side of the head
* Complete blockage of the ear canal
* Redness or swelling of the outer ear
* Swelling in the lymph nodes in the neck
* Fever

For more join our daily online lessons on WhatsApp 0977353901.

17/09/2025

COR PULMONALE

By Chipo James Mainda

Cor pulmonale is a condition that happens when a respiratory disorder results in high blood pressure in the pulmonary arteries (pulmonary hypertension). The name of the condition is in Latin and means “pulmonary heart.” It’s also known as right-sided heart failure because it occurs within the right ventricle of the heart.

Therefore, cor pulmonale is a loosely defined term that describes the change in structure or function of the right ventricle of the heart. The right ventricle of the heart is responsible for carrying deoxygenated blood to the lungs. Cor pulmonale causes the right ventricle to enlarge and pump blood less effectively than it should. The ventricle is then pushed to its limit and ultimately fails.

It’s possible to prevent this condition by controlling the high pressure of the blood going to the lungs. But untreated pulmonary hypertension can eventually lead to cor pulmonale along with other related, life-threatening complications.

The lungs depend on the heart to transport blood from the body to the lungs. Pulmonary hypertension occurs as a result of increased pressure in the lungs’ arteries. This increased pressure can then cause resistance in the heart’s right ventricle. It’s a result of having to overcome the high pressure in the lungs in order to force blood into them. This increased pressure leads to cor pulmonale, and the result is ineffective transportation of blood to the lungs. This, in turn, will lead to decreased oxygen transport to the rest of the body.

The most common cause of acute cor pulmonale is typically caused by a pulmonary embolism, which is a blood clot in the lungs. Chronic cor pulmonary most commonly results from chronic obstructive pulmonary disease (COPD).

The symptoms of cor pulmonale may not be noticeable at first because they’re similar to the feelings you get after a hard workout. They include:
* Shortness of breath
* Tiredness
* An increased heart rate
* Lightheadedness
Over time, these symptoms will worsen and flare up even during periods of rest. Other symptoms include:
* Chest pain during physical activity
* Excess fluid that leads to swelling in the body and lower extremities
* Swelling in various parts of the body

Usually, treatment for cor pulmonale aims to treat the primary condition that causes it. Often this includes:
* Oxygen therapy
* Diuretics, help decrease the volume around the cavity of the lungs; this allows the whole system to be less clogged.
* Digoxin

For more join our daily online lessons on WhatsApp 0977353901.

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