Adult Health Nursing-I Solved past paper 2016-LUMHS

Q1) define first line defence /immune system

The ​first line​of ​defence​is your innate ​immune system​. Level one of this ​system consists of physical barriers like your skin and the mucosal lining in your respiratory tract. The tears, sweat, saliva and mucous produced by the skin and mucosal lining are part of that physical barrier.

The bodys first line of defense against pathogens uses mostly physical and chemical barriers such as

  1. Skin ​– acts as a barrier to invasion
  2. Sweat​– has chemicals which can kill different pathogens.
  3. Tears​- have lysozyme which has powerful digestive abilities that render antigens harmless.

Q2) define infertility and requirement for conception

In general, ​infertility​is ​defined​as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. Because fertility in women is known to decline steadily with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex.

The necessary requirements for conception to occur are the following:

  • The fallopian tubes must be unobstructed and functional to receive the egg from the ovary and allow it to meet with the sperm.
  • The sperm must have normal parameters of concentration, forward motility and viability to be able to reach the egg overcoming all the natural hurdles they meet in the way.
  • The passing of the sperm from the vagina to the fallopian tubes must be smooth with a friendly environment from the cervical mucus.ed from the follicle.
  • Ovulation must occur so that a mature egg is release
  • Sexual intercourse must take place during the fertile days.

Q3) describe types of metabolic acidosis

Metabolic acidosis​is a serious electrolyte disorder characterized by an imbalance in the body’s acid-base balance. ​Metabolic acidosis​has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids.

Metabolic acidosis is classified into two types: Metabolic acidosis is classified into two types:

(a)metabolic acidosis with normal AG​ (with increased Cl ¯ ) and (a)metabolic acidosis with normal AG ( with increased Cl ¯ ) and (b) metabolic acidosis with high AG (with normal Cl ¯).

  1. metabolic acidosis with high AG​ (with normal Cl ¯). An increased AG means the accumulation of non-volatile acids in the body. An increased AG means the accumulation of non-volatile acids in the body.

Q4) define abortion and types of abortion


Interruption of pregnancy or expulsion of the product of conception before the fetus is viable is called abortion. The fetus is generally considered to be viable any time after the fifth to sixth month of gestation.

Types of abortion

1)Threatened abortion:-

The term threatened abortion is used when a pregnancy is complicated by vaginal bleeding before the 20th week. Pain may not be a prominent feature of threatened abortion, although a lower abdominal dull ache sometimes accompanies the bleeding. Vaginal examination at this stage usually reveals a closed cervix. 25% to 50% of threatened abortion eventually result in loss of the pregnancy.


The patient is kept at rest in bed until 2 days after blood loss has ceased. Intercourse is forbidden. As soon as the initial bleeding has stopped an ultrasound scan is performed. This will reveal whether or not the pregnancy is intact. The prognosis is good when all

abnormal signs and symptoms disappear and when the resumption of the progress of pregnancy is apparent.

2)Inevitable abortion:-

In case of inevitable abortion, a clinical pregnancy is complicated by both vaginal bleeding and cramp-like lower abdominal pain . The cervix is frequently partially dilated, attesting to the inevitability of the process.


The uterus usually expels its contents unaided , and examination must be made with strict aseptic technique. If the abortion is not quickly completed, or if hemorrhage becomes severe, the contents of the uterus are removed with a suction curettege.

3)Incomplete Abortion:-

In addition to vaginal bleeding, cramp-like pain, and cervical dilatation , an incomplete abortion involves the passage of products of conception , often described by the women as looking like pieces of skin or liver.


Patients require admission to the hospital. Treatment is aimed at preventing infection, controlling bleeding and obtaining an empty and involuting uterus. The chief risks associated with retained products are hemorrhage and sepsis .

4)Missed Abortion:-

The term missed abortion is used when the fetus has died but is retained in the uterus, usually for some weeks. After 16 weeks ’ gestation, dilatation and curettage may become a problem. Fibrinogen levels should be checked weekly until the fetus and placenta are expelled.


Once the diagnosis has been made the uterus should be emptied. Early in gestation evacuation of the uterus is usually accomplished by suction curettage. The prognosis for the mother is good. Serious complications are uncommon .

5)Recurrent Abortion:-

Recurrent abortion refers to any case in which there have been three consecutive spontaneous abortions. Possible causes are known to be genetic error, anatomic

abnormalities of the genital tract, hormonal abnormalities, infection, immunologic factors, or systemic disease .


Paternal and maternal chromosomes should be evaluated. The mother should be ruled out the presence of systemic disorders such as DM,SLE, and thyroid disease. It should rule out the presence of Mycoplasma, Listeria, Toxoplasma etc. infectious disease.Pelvic examination

Q5) define nursing intervention for patient with acute pancreatitis

Nursing Interventions

  1. relieving pain and discomfort
  2. restoring adequate fluid balance
  3. improving breathing pattern
  4. improving nutritional status
  5. improving skin integrity
  6. monitoring and managing potential complications
  7. Change in position
  8. Monitor pulse oximetry

Q6) describe stomatitis and its nursing management

Stomatitis Definition ​: Stomatitis is an inflammation of the mucous lining of the mouth , which may involve the cheeks, gums ,tongue ,lips , and roof or floor of the mouth. The word“ stomatitis “ literally means inflammation of the mouth.

Nursing Management

  1. Instruct the client to brush and floss his teeth and massage his gums several times daily.
  2. Advise the client to use gauze or a sponge toothette to clean the oral mucosa when pain prevents the use of a toothbrush.
  3. Recommend the use of water, saline, or a dilute solution of hydrogen peroxide instead of toothpaste or mouthwash.
  4. Advise the client to eat a bland diet.
  5. Suggest that the client consume lukewarm, or cold food and fluids, which may minimize discomfort and result in increased intake.

Q7) define Hernia and types of hernia

Define Hernia

A condition in which part of an organ is displaced and protrudes through the wall of the cavity containing it (often involving the intestine at a weak point in the abdominal wall)

Types of hernia

1.) Inguinal hernia

i.) Indirect inguinal hernia

ii.) Direct inguinal hernia (in contrast)

2.) Hiatal Hernia

3.) Femoral hernias (protrude through the femoral ring)

4.) Umbilical hernia (congenital/acquire)

5.) Incisional/ventral hernias (occur at the site of previous surgical incision)