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Nurse pushing wheelchair: work done by patient's weight:
Weight acts vertically, displacement horizontal โ ฮธ=90ยฐ, cos90=0 โ W=0.
Paralytic ileus is the temporary cessation of bowel motility after abdominal surgery. Return of bowel function is confirmed by:
- Passage of flatus (gas) โ earliest and most reliable sign of return of peristalsis
- Bowel sounds (return in small bowel first, usually 24โ48 hrs; large bowel 48โ72 hrs)
- Passage of stool
Assessment sequence for bowel function return:
- Auscultate for bowel sounds (all four quadrants, 2 minutes each)
- Ask patient about passage of gas (flatus)
- Advance diet only after confirmed peristalsis (clear liquids โ soft โ regular)
Failure of bowel function to return may indicate mechanical obstruction, which requires surgical intervention โ a critical distinction for Charge/Head Nurses.
Management by Objectives (MBO) was introduced by Peter Drucker in his 1954 book The Practice of Management. MBO is a process where:
- Managers and employees jointly set specific, measurable objectives
- Performance is evaluated against these pre-set objectives
- Feedback and appraisal are systematic
In nursing management, MBO helps Head Nurses set clear performance targets for nursing staff, improving accountability and service quality. Other options: Frederick Taylor โ Scientific Management; Maslow โ Hierarchy of Needs; McGregor โ Theory X and Y.
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