the sexual obstacle that quite often was experienced by the men apart from dysfunction ereksi was the premature ejaculation. Was not ready in having sexual relationship, became wrong his cause factor. It is not surprising, if often was male that did not realise if he experienced the premature ejaculation. "Had sexual relationship that needed readiness." Not only the physical matter but also bounced. The premature ejaculation because of the man was not ready to face sexual relations. Because this illness was linked with the nervous system. To parents, generally because his nerves capacity to control the ejaculation was disrupted, said Dr Dr A Wardihan Sinrang, Ms to the Dawn in his office in the Unhas Rectorate, on Wednesday June 14. The man usually did not understand and only complained concerning the problem of the too fast ejaculation. In fact, that has been the sexual disturbance. Basically, the man that the premature ejaculation, could ereksi and carried out sexual relations but yes that earlier, too fast the ejaculation (reached the peak and issued sperm). The premature ejaculation, said Wardihan, was the inability to control the ejaculation so as to happen in a short time, that was not in accordance with his wish. Even was that the ejaculation, in fact penis could not penetration in the vagina. In dysfunction ereksi, sexual relations could not take place because ereksi was disturbed. Although being connected, but ereksi was still being lost. There were several theories of the cause of the premature ejaculation. Firstly, the habit achieved orgasm and the ejaculation
FAIL ACUTE BREATH
Acute respiratory failure is the failure of gas exchange in the lung, marked by the downs in arterial oxygen levels (hypoxemia) or rising levels of carbon dioxide (hypercarbia) or a combination thereof.
criteria for diagnosis in patients who breathe the air in the room get the results of blood gas analysis:
1. PaO2 less than 60 mmHg
2. PaCO2 more than 49 mmHg without any disruption of primary metabolic alkalosis
ETIOLOGY OF BREATH FAIL ACUTE DISEASE
respiratory failure can be caused by a wide - range of both acute and chronic diseases that become acute again (acute on chronic). Acute respiratory failure can also arise from chronic lung disease, especially chronic obstructive pulmonary disease (PPOM or chronic obstructive pulmonary disease), which became acute again (acute on chronic respiratory failure).
in this case causes obstruction of breath in hypersecretion, mucosal edema and bronchi spasms. bronchi spasm frequently occurs in asthma. Chronic bronchitis can develop into emphysema. spasm of the bronchi in asthma can be caused by immunological reactions, substances such as smoke, dust, cold air can also induce bronchial spasm, substances such as serotonin, histamine can cause spasm of the bronchi directly. in emphysema is characterized by changes in the anatomy of the lungs in the form of excessive inflation in the distal space and bronkhiolus terminalis, alveolar capillary membrane damage resulting in a progressive, also damage the walls of the alveoli so it can happen collapse of the alveoli - tiny alveoli during expiration.
2 forms of the disorder known as follows:
1.bronchitis "blue Bloater"
damage mainly in the airway, in addition to hypoxemia also arise in the
accompanied hypercarbia due to chronic CO2 retention, this led to stimulation of
the respiratory center is no longer the state of hypercarbia (hypercarbic drive)
but by the state of hypoxia (hypoxic drive) and the respiratory center becomes
very sensitive to the drug - drugs such as narcotics mendepresi breath central
also to the high oxygen concentration.
2.emphysema "pink puffer" here mainly in the form of emphysema lung damage PaCO2
usually not too high, failed to breath more easily overcome this type.
PROCESS MAY (Pathophysiology) INTRA Cerebral hematoma
Intracerebral hemorrhage is usually caused by head trauma. Bleeding is due to arterial or venous bleeding in the brain, bleeding walk slowly - the land so that symptoms that occur too slowly, intracerebral hemorrhage is more common in the area before the cases were diagnosed and evaluated early so prognosanya recovery will occur which is usually good.
With intracerebral hemorrhage have an accompanying picture is a history of head trauma, signs and symptoms appear in people depending on size and location of bleeding in the brain. Sign of increased intra kronial pressure showed a large bleeding and suppress vital structures of the brain. Bleeding that occurred in temporal areas can be dangerous because of potential side effects of lateral herniation.
Intra-cerebral hemorrhage caused by hemorrhagic stroke occurs when a blood vessel in the brain ruptures causing ischemia (reduced flow) and hypoxia on the downstream. Causes of hemorrhagic stroke include hypertension, rupture of the arteria venosa malforasi aneurysm or abnormal relationships
Clinical manifestations of cerebral hematoma INTRA
1. When the hematoma enlarges sufficiently to suppress hemister cerebri, decreased consciousness occur gradually - gradually develops into a coma and death if the bleeding is not excluded
2. When the decreased level of consciousness, pupillary dilatation in these lesions have occurred hemiplegic and contralateral.
3. In an emergency can happen sensory disorders.
In intra-cerebral hemorrhage, due process demanded space will be an increase in intra-cranial pressure.
EXAMINATION SUPPORT
1. CT. Scan head which is the choice procedure to diagnose the bleeding.
2. angiography may be used if the procedure CT.Scan no result.
TREATMENT FOR PATIENTS intra cerebral hematoma
Patients with intra cerebral hematoma requiring intensive care and need to be dealt with:
1. Oxygen examination.
2. Ensure airway
3. Hemostatika
4. Anti cerebral edema (koralkosteroid, deuretik)
5. Stimulant SPP (nicholin)
6. Anticonvulsants (Dilantin, Valium)
7. Antibiotics for the prevention or treatment of infection
8. handling of the complications that occur
9. Pemdahan surgery for cases such as hematoma, aneurysm, ateria malformations, venous and others - others.
NURSING DIAGNOSIS WHICH MAY OCCUR IN PATIENTS WITH DISEASE intra cerebral hematoma
1. Cerebral tissue perfusion changes associated with cerebral edema.
2. Ineffective breathing pattern related to damage neurovaskuler.
3. Changes in sensory perception associated with neurological deficits.
4. pikier process changes associated with physiological changes.
5. Damage to physical mobility related to immobilization.
6. Risk of infection associated with invasive procedures.
7. Nutrition less than body requirements related to hyper metabolic status.
8. High risk associated with changes in the process of family crisis transition situations.
9. lack the knowledge to know the prognosis and treatment needs related to not knowing the source of information.
THE CAUSE OF INTRA-CEREBRAL HEMATOMA INCLUDE:
a. Hypertension
b. Cerebral aneurysm
c. Angioma malformations arterio - venus
d. Trauma
e. Blood disease
f. Encephalitis
g. Primary or metastatic brain tumor
h. Emboliu septic
i. Hernia septic
j. Bleeding from the spinal
Bleeding that arriveds in the brain tissue is a form that destroy the hemorrhagic stroke and can occur at any age. Various - kind of spontaneous bleeding in the brain and are generally multi-factorial.
Various forms of congenital and are present in cardiovascular disease is the most common causal mechanism, but similar structures can also occur from complications of primary and secondary brain tumors, inflammation and autoimmune diseases of the brain, brain trauma, or a manifestation of systemic disease that causes hypertension.
Intra cerebral hematoma is a hematoma caused by bleeding in the cerebral cortex is usually most common in temporal lobe, followed in the frontal, parietal, and sometimes on sereblum.
This bleeding usually comes from the artery, so that very quickly entered into the ventrical and pressing the brain stem as well as others.