We need to empower the midwife to be decision maker and provied appropriate care fore pregnant women, knowledge is power hope this presentation help first year midwifery student to understand the perpouse of physical assessment
The EINC initiative of the Philippine Department of Health- Non Communicable Diseases Prevention and Control-Family Health Office (DOH-NCDPC-FHO) and DOH Center for Health Promotions (NCHP), supported by the Joint Programme on Maternal and Neonatal Health (JPMNH), and being funded by AusAID, was piloted in 11 hospitals in the Philippines, and has yielded favorable results.
The recommended EINC practices during the intrapartum period include continuous maternal support by having a companion of choice during labor and delivery, freedom of movement during labor, monitoring progress of labor using the partograph, non-drug pain relief before offering labor anesthesia, position of choice during labor and delivery, spontaneous pushing in a semi-upright position, non-routine episiotomy, and active management of the third stage of labor (AMTSL).
For newborns, four core steps were recommended in a time bound sequence. A social marketing handle, “The First Embrace,” accompanied the initiative for practice change among health workers.
it contains information about the important measurements , the vital signs, head, eyes, ears, nose , mouth and throat, neck, chest, breast and abdomen of a newborn. You'll find the normal and the abnormal findings on each category.
We need to empower the midwife to be decision maker and provied appropriate care fore pregnant women, knowledge is power hope this presentation help first year midwifery student to understand the perpouse of physical assessment
The EINC initiative of the Philippine Department of Health- Non Communicable Diseases Prevention and Control-Family Health Office (DOH-NCDPC-FHO) and DOH Center for Health Promotions (NCHP), supported by the Joint Programme on Maternal and Neonatal Health (JPMNH), and being funded by AusAID, was piloted in 11 hospitals in the Philippines, and has yielded favorable results.
The recommended EINC practices during the intrapartum period include continuous maternal support by having a companion of choice during labor and delivery, freedom of movement during labor, monitoring progress of labor using the partograph, non-drug pain relief before offering labor anesthesia, position of choice during labor and delivery, spontaneous pushing in a semi-upright position, non-routine episiotomy, and active management of the third stage of labor (AMTSL).
For newborns, four core steps were recommended in a time bound sequence. A social marketing handle, “The First Embrace,” accompanied the initiative for practice change among health workers.
it contains information about the important measurements , the vital signs, head, eyes, ears, nose , mouth and throat, neck, chest, breast and abdomen of a newborn. You'll find the normal and the abnormal findings on each category.
Antenatal care /objectives/history collection abdominal examinationBabitha Mathew
Antenatal care is the care you get from healthcare professionals to ensure you have a healthy pregnancy. It includes information on services and support to make choices right for you. Antenatal care will include regular appointments with a midwife, ultrasound scans and screening tests for you and your baby.
Organizational planning for hospital nursing servicesJayashree Ajith
Nursing is a vital aspect of health care and need to be properly organized . nursing services administration s is complex of elements in interaction .It results in output of clients whose health is avoidable . deteriorating maintained or improved through input of personnel and material resources.
Importance of antioxidant micronutrients in pregancy, importance selenium, copper, zinc. vit c&E pathogenesis etc Deficiencynof micronutrients will cause pre eclampsia and low birth weight babies
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Antepartal nursing assessment
1. ANTEPARTAL NURSING ASSESSMENT
ANTEPARTAL NURSING ASSESSMENT
Antepartum – refers to the medical & nursing care
given to the woman between conception & onset of labor
PURPOSE OF PRENATAL CARE:
1. establish a baseline of present health
2. determine fetal AOG (age of gestation)
3. monitor fetal development
4. identify the woman at risk of complications
5. minimize the risk of positive complications
6. provide time for education about pregnancy & possible dangers
MAJOR CAUSES OF DEATH DURING PREGNANCY
1. intrapartum cardiac arrest
2. ectopic pregnancy
3. hypertension (can lead to ecclampsia)
4. embolism
FOCUS OF PRENATAL CARE
- to screen possible complications & danger such as:
o hypertension
o infection
o bleeding or circulatory impairment
DANGER SIGNS
1. Dysuria
2. Decrease fetal movement
3. Temp. > 101 F
4. Persistent vomiting
5. Severe abdominal pain
6. Gush of fluid from vagina
7. Vaginal bleeding
DIAGNOSIS
1. sample: urine, serum
2. HCG: human chorionic Gonadotropin
3. 40-100th day; peak of 60 days
PREGNANCY RISK FACTORS
1. age <18>35
2. decrease socioeconomic status
3. increase/ decrease weight
4. substance use/ abuse
2. 5. pre existing condition
6. –Rh factor
7. previous OB problem
…possible cause
1. rupture or membrane
2. infection
3. hyperemesis gravidarum
4. HPN, preecclampsia
5. UTI
6. compromised fetal well-being
A. Client history & initial interview
1. Establish rapport (harmonious relationship)
2. Gain information about the woman’s
physical & psychological health
3. Obtain a basis for anticipatory guidance
COMPONENT OF HEALTH HISTORY:
1. Demographic data
Includes:
- Name:
- age: <18>35 (high risk)
- address:
- tel #:
- religion:
- health insurance information:
2. Chief concern (cc)
Includes:
- reason why the woman has come to the HC setting
- inquire LMP (last menstrual period)
- elicit information about:
o signs of early pregnancy
o discomforts of pregnancy
o exposure to any contagious diseases
o danger signs & pregnancy
o medicine taken
o planned or not
3. Family profile
Inquire about:
1. marital status
2. couples’s age
3. 3. house structure
4. educational level
5. occupation
6. psychological assessment
a. emotions
b. support system
c. stability & functional level of immediate & extended family
d. economic support (housing, daily needs, medical expenses)
e. family integrity promotion
- involve family member in patient teaching sessions
- teach family about impact of pregnancy & birth
- encourage verbalization of feelings
4. Past medical History
Inquire about:
- pat medical disease
- childhood disease
- allergies/ drug – sensitivities
- past surgical procedure
o Medical/ Surgical History
- PMH - allergies
- PSH - nutritional history
- Medicines
- Substance use/ abuse
5. Family History
ASK:
- cardiovascular diseases
- renal diseases
- cognitive impairment
- blood disorder
- known inherited diseases
- congenital anomalies
- health status of parents/ siblings
- Partner’s Health history
o Genetic disorders
o Chronic disease/ infection
o Substance use/abuse
o Blood type & Rh
6. Social Profile
ASK:
- type, amount, frequency
- smoking/ dringking habits
- spouse abuse
4. - medication history
- prenatal health education
o substance use/abuse
o smoking (risk for: prematurity, cognitive problem)
o illegal drug use (risk for: abruption, preterm labor, CNS dysfunction)
7. Gynecologic History
ASK:
- information about menarche
- past surgery on the reproductive tract
- reproductive planning method
- sexual history
- stress incontinence
- menstrual history
o onset of menses
o regularity
o LMP
o Length of cycle
- contraceptives
o types/used
o Oral contraceptive is contraindicated 3 months prior to pregnancy
o IUD (risk: increase spon. Abortion)
8. Obstetric History
ASK:
- history of previous pregnancy
- history of present pregnancy
- (GTPALM) gravida, term, para, abortion, living children, multiple pregnancy
- Types of preganancy/ delivery
- Methods of feeding
- Maternal/ infant complications
- Maternal Psychological adaptations to pregnancy
o 1st trimester (focus on self)
“I am pregnant”
o 2nd trimester (focus on baby)
“I am going to have baby”
o 3rd trimester
“I am going to be a mom”
G - # or pregnancy regardless of the result
T - # of full term infant (born 37 wks or after)
P - # of preterm (born b/w 20-37 wks)
A - # of spontaneous abortion (before 20 wks)
L - # of living children currently alive
M – Multiple pregnancies
5. GP – describe woman’s childbearing history
GRAVIDA – total # of pregnancy
PARA - # of birth after 20 wks of gestation/
24-28 wks
> born dead or alive
> Multiple births (regardless of # of
infant count as delivery)
(See example)
9. Typical day history
B. Definition of terms (Terms associated with
pregnancy)
Gestational menstrual age (GMA) -measured from the 1st day of the last normal menstruation
period, in completed days
Ovulation (post- conception) age -2 weeks gestational age
Age of Viability -in Philippines: 24-26 wks
-US: 20-24 wks
-beyond 24th week of pregnancy is the stage of abortion
Obstetrical score (GTPALM) – full term – premature – abortions – live children – multiple births
Parturition -process of labor
Parturient -woman in labor
Puerperium -6-8 wks period
Abortion -medical term for any pregnancy terminated before age of viability
Preterm -a pregnancy that ends after 20 wks & before 37 wks of gestation
Post term -pregnancy that goes beyond 40 wks of gestation
Still birth -fetus born dead after 20 wks gestation
1. PARITY -number of pregnancies reaching viability. Same whether a single or multiple fetuses
were born alive/ stillborn
-born past the age of viability
primipara -delivered only 1 fetus w/c reached viability
Multipara -delivered 2 or more fetus w/c reached the viability
Nullipara -never completed pregnancy or the age of viability
2. GRAVIDA -woman who is/ who has been pregnant irrespective of pregnancy outcome
Primigravida -1st pregnancy
Multigravida -successive pregnancy
-has been pregnant previously
Nulligravida -who has never been pregnant
C. Initial Physical Assessment with each
Prenatal Visit should include
6. a.) Vital Sign (BP, PR, RR, weight)
Review of system:
Head
o (injury, seizures, dizziness)
Eyes
o (vision, glasses, infection, diplopia-double vision)
Ears
o (infection, discharge, tinnitus, vertigo, hearing loss-due to increase in estrogen there is also an
increase in production of mucous)
Nose
o (epistaxis, discharge, colds, allergy, sinus pain)
Mouth
o (pharynx dentures, teeth, gums, tonsillectomy)
Neck
o (stiffness, masses)
Breast
o (lumps, secretion, pain, tenderness, breast self exam)
Respiratory
o (cough, wheezing, asthma, pain, shortness of breaths, PTB)
Cardiovascular
o (heart disease, murmur, palpitation, hypertension)
GIT
o (vomiting, diarrhea, constipation)
Genitourinary system
o (urinary frequency)
Extremities
o (edema)
Skin
o (rashes, acne, psoriasis)
* Assessment from head to toe of major body system
* watch for an elevations of BP
Increase 30: systolic
Decrease 15: diastolic
b.) Weight
Average weight gain: 24-30 lbs
a. fetus = 7.5 lbs
b. placenta & membrane = 1.5 lb
c. amniotic fluid = 2 lb
d. uterus = 2.5 lb
7. c.) Physical Examination
Check for:
- General appearance & mental status
- Head & scalp (contour, symmetry, tenderness, dry)
- Eyes (edema, spots, diplopia)
- Nose (nasal congestion)
- Ears (nasal stiffness)
- Sinuses (should feel tender)
- Mouth, teeth & throat
- Neck (slight thyroid hypertrophy)
- Lymph (no palpable lymph nodes)
- Breast (areola darkens, size increase)
- Heart (70-80 beats)
- Back (scoliosis)
- Extremities & skin (hemorrhoids, palmar erythema, varicosities)
d.) DURATION OF PREGNANCY
- 266-280 days
- (38-42 weeks; average 40)
- 9 calendar month
- 10 lunar month/ 1 lunar month=28 days
• Perinatal period – start at 22 completed weeks of gestation & ends 7 completed days after birth
• Neonatal Period – from birth to 28 days of birth
DETERMINATION OF DELIVERY DATE
We can use:
1. Naegele’s rule
2. McDonald’s rule
3. Bartholomew’s rule
4. Haase’s rule
5. Johnson’s rule
ooOoo
1. Naegele’s rule
(Expected date of confinement)
Formula:
(1st day of LMP) + 7 days – 3 months + 1 year
8. Example 1: LMP: 10 July, 2006
10 7 06
+ 7 - 3 + 1
17 4 07
Thus, EDC: 17 April, 2007
Example 2: LMP: 31 January, 2008
31 01 08
+ 7 - 3
38
- 31 + 1
7 - 1
+12
7 11 08
Note:
- not applicable for January to March 24
(Add 12 to months)
- March 25 – December (add 1 to the year)
2. McDonald’s rule
(Estimation of the duration of the pregnancy)
- estimation using the fundic height
o fundal height (measured from symphisis pubis to top of uterus)
o used to app. Fetal age (in weeks)
- application from 22-34 weeks age of gestation
- FORMULA:
Distance in cm * 8 = total gestational
7 age
Note: inaccurate in 3rd trimester
3. Batholomew’s rule
- a tape measure is unavailable, these rough guidelines can be used:
3rd mo. – slightly above
5th mo. – symphisis pubis, umbilicus
9th mo. – below xiphoids
Fundic Height (in cm) = week AOG
e.g. If fundus is 24 cm = fetus is 24
week AOG
Alternative method: Use fundus as a landmark AOG
9. - Above symphysis pubis 12
- Halfway b/w symphisis pubis & umbilicus 16
- Level of Umbilicus 20
- 6 cm above SP 28 weeks
- 2 cm above SP 36 weeks
- 4 cm above SP 40 weeks
4. Haase’s rule
- determine length of fetus in cm
- 1st half of pregnancy (20 weeks)
– square the number of the month (4 ½
mon.)
- 2nd half of pregnancy – multiply the no. by 5
Example:
(1st half) 3 mon. * 3 old = 9 cm long
(2nd half) 6 mon. * 5 old = 30 cm long
5. Johnson’s rule
- estimates the weight of the fetus in grams
- FORMULA:
o [ (funic height in cm) – h ] * K
K is constant = 155
N is = 12, if the fetus is engaged
11, if unengaged
e.) UTERINE ASSESSMENT
1. Fundal height
2. Fetal heart sounds
- 120-160 bpm
- 10-12 wks heard by “Doppler technique”
- 18-20 wks heard by a regular stethoscope
- After 28th weeks = fetal outline & position can be palpated
3. Fetal growth & development
4. Pelvic adequacy/ examination
Equipments:
- Speculum - culture tube
- Spatula - Gloves
- Glass slide -Sterile cotton; tipped applicator (2-3)
10. Specimen taken
1. edocervix
2. cervical OS
3. vaginal pool
Cardinal rule: Empty bladder first
Position: Dorsal Lithotomy
f.) LABORTAORY ASSESSMENTS
a. Blood studies
1. CBC – HCT, HgB, RBC, WBC
2. VDRL – Papanicolaou Smear
What is a Pap smear?
- test to check the health of your cervix (opening of uterus/ womb)
- sometimes change occurs in the cell of the cervix & abnormal cell develop
- treatment of these changes can prevent cervix cancer
Papanicolaou Screen & Cytologic study
- screen for cervical dysplasia & assess hormone cytology & inflammatory disease of genital
tract
3. Blood typing
4. Indirect Coomb’s Test
5. Rubella Titer
6. Hepa B & HIV screening
7. Rh
b. Urinalysis (clean catch urine)
- performed to assay for albumin, glycosuria (diabetes), ketones (breakdown of protein),
leukocytes (WBC), pyuria (presence of pus)
c. TB screening
- Chest X-ray
- Tuberculin skin test
D. Return Visits
Schedule:
• Every 4 weeks - 1st 28th week/ 7 months
• Every 2 weeks – until the 36th week
• Every week – until delivery
*More frequent visit: as the need arises
11. Subsequent Visits
1. Assessment
a. Maternal & fetal Evaluation
- BP, PR, RR, T
- Weight
- FHR: 120-160
- Fundus height
o 30 cm estimate: 6 – 6 ½ lbs
o 31 cm: 6 ½ - 7 lbs
o 32 cm: 7 – 7 ½ lbs
b. Lab test
c. Symptoms felt
d. Vaginal/ internal examination
2nd Trimester
- Period of rapid growth
- Monthly visits
- General, emotional, physical well being
- Questions
- Success failure of self care
Interview
Must be:
1. Careful
2. Precise
3. Concise
4. Checklist of care – used as communication tool