Search

Saturday, March 26, 2011

Fungsi Scroll pada Mouse

Posted by vini np at 8:15 PM 0 comments
Fungsi utama scroll itu yang kita tau biasanya untuk scroll up atau scroll down halaman seperti pada browser atau yang lainnya. Tapi sebenarnya ada fungsi tersembunyi dari menu scroll tersebut.

1. Untuk fungsi tombol new tab pada browser

Biasanya klo mo klik suatu link di internet pasti kan klo mo ngebuka link tersebut harus dengan klik kanan terus new tab.


Mempergunakan fungsi scroll bisa untuk mengganti fungsi manual klik kanan new tab. Yakni dengan mengarahkan kursor pada link yang akan di tuju lalu klik tombol scroll tersebut layaknya klik pada tombol kanan atau kiri mouse.
Alhasil new tab akan terbuka !


2. Menutup tab browser dengan cepat
saat berinternet dengan membuka tab-tab browser dan ingin menutupnya, biasanya hal yang anda lakukan adalah mengarahkan kursor mouse ke tanda X yang ada di kanan atas untuk menutup tab tersebut. Anda bisa lebih cepat menutup tab browser anda dengan menggunakan scrool mouse. Caranya adalah sebagai berikut :
tekan scroll mouse di tab browser anda di manapun lokasinya..maka browser anda akan tertutup dengan cepat. anda tidak harus mengarahkan mouse dan klik di tanda “X”, cukup klik scroll mouse di bagian manapun tab browser anda. Menghemat waktu bukan.

3. Membuka kumpulan link bookmark sekaligus
Jika anda memiliki situs – situs favorit yang sering anda kunjungi atau ingin anda kunjungi setiap hari, maka biasanya anda melakukan klik di satu per satu link situs tersebut di bookmark anda. Namun ternyata ada cara yang lebih cepat yaitu dengan melakukan klik di folder bookmark dengan scroll mouse. Maka secara otomatis semua link-link situs favorit anda di folder tersebut akan terbuka seluruhnya secara otomatis. Anda tidak perlu lagi membuka satu per satu, karena jika bookmark anda berjumlah banyak akan memakan banyak waktu. Scroll mouse mempercepat semuanya untuk anda.

4. Scroll otomatis dokumen atau halaman yang sedang anda buka
Jika anda membuka sebuah halaman situs atau sebuah dokumen yang panjang di program – program seperti Word, Excel, Adobe reader, firefox atau explorer, maka untuk melakukan scrolling, biasanya anda lakukan dengan cara memutar scroll mouse dengan jari. Namun jika halaman tersebut panjang sekali..maka hal ini akan membuat jari anda capek . Untuk menghindari hal itu, cukup klik dan tahan sebentar tombol scroll mouse anda. Maka anda akan masuk di fitur autoscroll dimana anda bisa menggerakkan dan melakukan scrolling halaman yang sedang anda buka hanya dengan sedikit menggerakkan mouse tanpa harus memutar – mutar tombol scroll. Jari anda tidak akan capek karena membuka sebuah dokumen yang amat sangat panjang.

5. Buat zoom in/zoom out halaman web

cukup tekan ctrl+scroll mouse


6. Buat go Back and Forward Page (tambahan dari agan g3l05)

caranya shift+scroll


7. Buat memperlambat gerak scroll up / down

caranya tekan Alt+scroll


8. Buat kalo mw pindah ke tab lain

di browser internet tanpa ngeklik tabnya, Kursor diletakkan di antara Tab yang udah agan buka, coba tahan klik kanan+scroll nya diputer. Fungsi ini sama klo misal pake Mouse logitect ato Mouse lain yang mempunyai fungsi scroll kanan/kiri.

Tahapan Perkembangan Motorik Anak

Posted by vini np at 8:05 PM 0 comments
Tahapan perkembang motorik kasar dan halus, yaitu :

Usia 1-2 tahun

Motorik Kasar

Motorik Halus

• merangkak
• berdiri dan berjalan beberapalangkah
• berjalancepat
• cepat-cepat duduk agar tidak jatuh
• merangkak di tangga
• berdiri di kursi tanpa pegangan
menarik dan mendorong benda-benda berat
melempar bola

• mengambil benda kecil dengan ibu jari atau telunjuk
• membuka 2-3 halaman buku secara bersamaan
• menyusun menara dari balok
• memindahkan air dari gelas ke gelas lain
• belajar memakai kaus kaki sendiri
• menyalakan TV dan bermain remote
• belajar mengupas pisang

Usia 2-3 tahun

Motorik Kasar

Motorik Halus

• melompat-lompat
• berjalan mundur dan jinjit
• menendang bola
• memanjat meja atau tempat tidur
• naik tangga dan lompat di anak tangga terakhir
• berdiri dengan 1 kaki

• mencoret-coret dengan 1 tangan
• menggambar garis tak beraturan
• memegang pensil
• belajar menggunting
• mengancingkan baju
• memakai baju sendiri

Usia 3-4 tahun

Motorik Kasar

Motorik Halus

• melompat dengan 1 kaki
• berjalan menyusuri papan
• menangkap bola besar
• mengendarai sepeda
• berdiri dengan 1 kaki

• menggambar manusia
• mencuci tangan sendiri
• membentuk benda dari plastisin
• membuat garis lurus dan lingkaran cukup rapi

Usia 4-5 tahun

Motorik Kasar

Motorik Halus

• menuruni tangga dengan cepat
• seimbang saat berjalan mundur
• melompati rintangan
• melempar dan menangkap bola
• melambungkan bola

• menggunting dengan cukup baik
• melipat amplop
• membawa gelas tanpa menumpahkan isinya
• memasikkan benang ke lubang be

Usia 5 – 12 tahun

Perkembangan motorik pada usia ini menjadi lebih halus dan lebih terkoordinasi dibandingkan dengan masa bayi. Anak – anak terlihat lebih cepat dalam berlari dan pandai meloncat serta mampu menjaga keseimbangan badannya. Untuk memperhalus ketrampilan – ketrampilan motorik, anak – anak terus melakukan berbagai aktivitas fisik yang terkadang bersifat informal dalam bentuk permainan. Disamping itu, anak – anak juga melibatkan diri dalam aktivitas permainan olahraga yang bersifat formal, seperti senam, berenang, dll.

Beberapa perkembangan motorik (kasar maupun halus) selama periode ini, antara lain :

a). Anak Usia 5 Tahun

- Mampu melompat dan menari

- Menggambarkan orang yang terdiri dari kepala, lengan dan badan

- Dapat menghitung jari – jarinya

- Mendengar dan mengulang hal – hal penting dan mampu bercerita

- Mempunyai minat terhadap kata-kata baru beserta artinya

- Memprotes bila dilarang apa yang menjadi keinginannya

- Mampu membedakan besar dan kecil

b). Anak Usia 6 Tahun

- Ketangkasan meningkat

- Melompat tali

- Bermain sepeda

- Mengetahui kanan dan kiri

- Mungkin bertindak menentang dan tidak sopan

- Mampu menguraikan objek-objek dengan gambar

c). Anak Usia 7 Tahun

- Mulai membaca dengan lancar

- Cemas terhadap kegagalan

- Peningkatan minat pada bidang spiritual

- Kadang Malu atau sedih

d). Anak Usia 8 – 9 Tahun

- Kecepatan dan kehalusan aktivitas motorik meningkat

- Mampu menggunakan peralatan rumah tangga

- Ketrampilan lebih individual

- Ingin terlibat dalam sesuatu

- Menyukai kelompok dan mode

- Mencari teman secara aktif.

e). Anak Usia 10 – 12 Tahun

- Perubahan sifat berkaitan dengan berubahnya postur tubuh yang berhubungan dengan

pubertas mulai tampak

- Mampu melakukan aktivitas rumah tangga, seperti mencuci, menjemur pakaian sendiri.

dll.

- Adanya keinginan anak unuk menyenangkan dan membantu orang lain

- Mulai tertarik dengan lawan jenis.

Blood Tranfusion

Posted by vini np at 8:00 PM 10 comments

Blood transfusion is the process of receiving blood products into one's circulation intravenously. Transfusions are used in a variety of medical conditions to replace lost components of the blood. Early transfusions used whole blood, but modern medical practice commonly uses only components of the blood, such as red blood cells, white blood cells, plasma, clotting factors, and platelets.

Blood transfusion therapy involves transfusing whole blood or blood components (specific portion or fraction of blood lacking in patient). One unit of whole blood consists of 450 mL of blood collected into 60 to 70 mL of preservative or anticoagulant. Whole blood stored for more than 6 hours does not provide therapeutic platelet transfusion, nor does it contain therapeutic amounts of labile coagulation factors (factors V and VIII).

Blood components include:

  1. Packed RBCs (100% of erythrocyte, 100% of leukocytes, and 20% of plasma originally present in one unit of whole blood), indicated to increase the oxygen-carrying capacity of blood with minimal expansion of blood.
  2. Leukocyte-poor packed RBCs, indicated for patients who have experience previous febrile no hemolytic reactions.
  3. Platelets, either HLA (human leukocyte antigen) matched or unmatched.
  4. Granulocytes ( basophils, eosinophils, and neutrophils )
  5. Fresh frozen plasma, containing all coagulation factors, including factors V and VIII (the labile factors).
  6. Single donor plasma, containing all stable coagulation factors but reduced levels of factors V and VIII; the preferred product for reversal of Coumadin-induced anticoagulation.
  7. Albumin, a plasma protein.
  8. Cryoprecipitate, a plasma derivative rich in factor VIII, fibrinogen, factor XIII, and fibronectin.
  9. Factor IX concentrate, a concentrated form of factor IX prepared by pooling, fractionating, and freeze-drying large volumes of plasma.
  10. Factor VIII concentrate, a concentrated form of factor IX prepared by pooling, fractionating, and freeze-drying large volumes of plasma.
  11. Prothrombin complex, containing prothrombin and factors VII, IX, X, and some factor XI.

Advantages of blood component therapy

  1. Avoids the risk of sensitizing the patients to other blood components.
  2. Provides optimal therapeutic benefit while reducing risk of volume overload.
  3. Increases availability of needed blood products to larger population.

Principles of blood transfusion therapy

  1. Whole blood transfusion
    • Generally indicated only for patients who need both increased oxygen-carrying capacity and restoration of blood volume when there is no time to prepare or obtain the specific blood components needed.
  2. Packed RBCs
    • Should be transfused over 2 to 3 hours; if patient cannot tolerate volume over a maximum of 4 hours, it may be necessary for the blood bank to divide a unit into smaller volumes, providing proper refrigeration of remaining blood until needed. One unit of packed red cells should raise hemoglobin approximately 1%, hemactocrit 3%.
  3. Platelets
    • Administer as rapidly as tolerated (usually 4 units every 30 to 60 minutes). Each unit of platelets should raise the recipient’s platelet count by 6000 to 10,000/mm3: however, poor incremental increases occur with alloimmunization from previous transfusions, bleeding, fever, infection, autoimmune destruction, and hypertension.
  4. Granulocytes
    • May be beneficial in selected population of infected, severely granulocytopenic patients (less than 500/mm3) not responding to antibiotic therapy and who are expected to experienced prolonged suppressed granulocyte production.
  5. Plasma
    • Because plasma carries a risk of hepatitis equal to that of whole blood, if only volume expansion is required, other colloids (e.g., albumin) or electrolyte solutions (e.g., Ringer’s lactate) are preferred. Fresh frozen plasma should be administered as rapidly as tolerated because coagulation factors become unstable after thawing.
  6. Albumin
    • Indicated to expand to blood volume of patients in hypovolemic shock and to elevate level of circulating albumin in patients with hypoalbuminemia. The large protein molecule is a major contributor to plasma oncotic pressure.
  7. Cryoprecipitate
    • Indicated for treatment of hemophilia A, Von Willebrand’s disease, disseminated intravascular coagulation (DIC), and uremic bleeding.
  8. Factor IX concentrate
    • Indicated for treatment of hemophilia B; carries a high risk of hepatitis because it requires pooling from many donors.
  9. Factor VIII concentrate
    • Indicated for treatment of hemophilia A; heat-treated product decreases the risk of hepatitis and HIV transmission.
  10. Prothrombin complex-Indicated in congenital or acquired deficiencies of these factors.

Complications of Blood Transfusion

  1. Hemolytic transfusion reaction- is a life-threatening complication occurring from transfusion of donor blood that is incompatible with the recipient’s blood.
  2. In hemolytic transfusion reaction, antibodies in the recipient’s plasma combine with antigens on donor erythrocytes, causing agglutination and hemolysis in circulation or in the reticuloendothelial system. Similarly, antibodies in donor plasma combine with antigenon the recipient’s eyhrocytes; however, complications from infusion of incompatible plasma are less severe than those associated with infusion of incompatible erythrocytes. The most rapid hemolysis occurs in ABO incompatibility; Rh incompatibility is often less severe.
  3. Delayed hemolytic transfusion reaction –occurs 1 to 2 weeks after transfusion; erythrocytes hemolyzed by antibody are not detectible during crossmatched but are formed rapidly after transfusion. It generally is not dangerous, but subsequent transfusions may be associated with acute hermolytic reaction.
  4. In hemolytic reaction, severity of complications correlates with the amount of incompatible blood transfused; chances of fatal reactions are decreased if less than 100 ml of incompatible blood is infused.
  5. Febrile, non hemolytic Transfusion reaction, the most common type of reaction, is commonly caused by sensitivity to leukocyte or platelet antigens.
  6. Septic reaction is an often serious complication resulting from transfusion if a blood product contaminated with bacteria.
  7. Allergic reactions may result from sensitivity to plasma protein or donor antibody, which reacts with recipient antigen.
  8. Circulatory overload results from administration at a rate or volume greater than can be accommodated by the circulatory system, precipitating congestive heart failure or pulmonary edema.
  9. Several infectious diseases can be transmitted through blood transfusion, including:
    • Hepatitis B
    • Non-A, non-B hepatitis
    • Malaria
    • Syphilis
    • Acquired immunodeficiency syndrome (AIDS)
  10. Graft-versus-host (GVH) disease results from engraftment of immunocompetent lymphocytes in bone marrow of immunosuppressed recipients, which triggers the immune response of the graft against the host.
  11. Reactions associated with massive transfusions (>10 units of packed RBCs on 1 or 6 hours) include:
    • Hypocalcemia, resulting from binding of recipient’s circulating calcium to anticoagulant (citrate) in packed RBC’s.
    • Citrate intoxication due to accumulation of citrate.
    • Hyperkalemia, in which stored red cells progressively increase extracellular potassium concentrations.
    • Exacerbation of liver disease die to increased ammonia levels in stored blood.
    • Hypothermia, in which transfusion of cold blood (below 37 C) at rates >100 mL/min may produce dysrhythmias and cardiac arrest.
    • Aggregates of leukocytes and platelets in the lungs, resulting from accumulation of these aggregates during blood storage.
    • Hemorrhage resulting from excessive dilution of the recipient’s platelets and clotting factors.

Assessment findings

  1. Clinical manifestations of transfusions complications vary depending on the precipitating factor.
  2. Signs and symptoms of hemolytic transfusion reaction include:
    • Fever
    • Chills
    • low back pain
    • flank pain
    • headache
    • nausea
    • flushing
    • tachycardia
    • tachypnea
    • hypotension
    • hemoglobinuria (cola-colored urine)
  3. Clinical signs and laboratory findings in delayed hemolytic reaction include:
    • fever
    • mild jaundice
    • gradual fall of hemoglobin
    • positive Coombs’ test
  4. Febrile non-hemolytic reaction is marked by:
    • Temperature rise during or shortly after transfusion
    • Chills
    • headache
    • flushing
    • anxiety
  5. Signs and symptoms of septic reaction include;
    • Rapid onset of high fever and chills
    • vomiting
    • diarrhea
    • marked hypotension
  6. Allergic reactions may produce:
    • hives
    • generalized pruritus
    • wheezing or anaphylaxis (rarely)
  7. Signs and symptoms of circulatory overload include:
    • Dyspnea
    • cough
    • rales
    • jugular vein distention
  8. Manifestations of infectious disease transmitted through transfusion may develop rapidly or insidiously, depending on the disease.
  9. Characteristics of GVH disease include:
    • skin changes (e.g. erythema, ulcerations, scaling)
    • edema
    • hair loss
    • hemolytic anemia
  10. Reactions associated with massive transfusion produce varying manifestations

Possible Nursing Diagnosis

  1. Ineffective breathing pattern
  2. Decreased Cardiac Output
  3. Fluid Volume Deficit
  4. Fluid Volume Excess
  5. Impaired Gas Exchange
  6. Hyperthermia
  7. Hypothermia
  8. High Risk for Infection
  9. High Risk for Injury
  10. Pain
  11. Impaired Skin Integrity
  12. Altered Tissue Perfusion

Planning and Implementation

  1. Help prevent transfusion reaction by:
    • Meticulously verifying patient identification beginning with type and cross match sample collection and labeling to double check blood product and patient identification prior to transfusion.
    • Inspecting the blood product for any gas bubbles, clothing, or abnormal color before administration.
    • Beginning transfusion slowly ( 1 to 2 mL/min) and observing the patient closely, particularly during the first 15 minutes (severe reactions usually manifest within 15 minutes after the start of transfusion).
    • Transfusing blood within 4 hours, and changing blood tubing every 4 hours to minimize the risk of bacterial growth at warm room temperatures.
    • Preventing infectious disease transmission through careful donor screening or performing pretest available to identify selected infectious agents.
    • Preventing GVH disease by ensuring irradiation of blood products containing viable WBC’s (i.e., whole blood, platelets, packed RBC’s and granulocytes) before transfusion; irradiation alters ability of donor lymphocytes to engraft and divide.
    • Preventing hypothermia by warming blood unit to 37 C before transfusion.
    • Removing leukocytes and platelets aggregates from donor blood by installing a microaggregate filter (20-40-um size) in the blood line to remove these aggregates during transfusion.
  2. On detecting any signs or symptoms of reaction:
    • Stop the transfusion immediately, and notify the physician.
    • Disconnect the transfusion set-but keep the IV line open with 0.9% saline to provide access for possible IV drug infusion.
    • Send the blood bag and tubing to the blood bank for repeat typing and culture.
    • Draw another blood sample for plasma hemoglobin, culture, and retyping.
    • Collect a urine sample as soon as possible for hemoglobin determination.
  3. Intervene as appropriate to address symptoms of the specific reaction:
    • Treatment for hemolytic reaction is directed at correcting hypotension, DIC, and renal failure associated with RBC hemolysis and hemoglobinuria.
    • Febrile, nonhemolytic transfusion reactions are treated symptomatically with antipyretics; leukocyte-poor blood products may be recommended for subsequent transfusions.
    • In septic reaction, treat septicemia with antibiotics, increased hydration, steroids and vasopressors as prescribed.
    • Intervene for allergic reaction by administering antihistamines, steroids and epinephrine as indicated by the severity of the reaction. (If hives are the only manifestation, transfusion can sometimes continue but at a slower rate.)
    • For circulatory overload, immediate treatment includes positioning the patient upright with feet dependent; diuretics, oxygen and aminophylline may be prescribed.

Evaluation

  1. The patient maintains normal breathing pattern.
  2. The patient demonstrates adequate cardiac output.
  3. The patient reports minimal or no discomfort.
  4. The patient maintains good fluid balance.
  5. The patient remains normothermic.
  6. The patient remains free of infection.
  7. The patient maintains good skin integrity, with no lesions or pruritus.
  8. The patient maintains or returns to normal electrolyte and blood chemistry values.



source: wikipedia, nursingcrib.com

 

vini np's site | 2008-2014 |Template by Ipietoon Blogger Template | Gadget Review

Winking Line Smiley