Mrs. Paridhi, a 29-year-old housewife, was admitted to the hospital with complaints of vaginal bleeding at 32 weeks of pregnancy. She was diagnosed with placenta previa. Her care included intravenous fluids, monitoring of bleeding, and administration of medications as ordered by the doctor. After 1 day of care, her health improved as the bleeding reduced. She was indicated for a cesarean delivery to terminate the pregnancy due to the placenta previa diagnosis.
Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina. Placenta previa happens in about 1 in 200 pregnancies.
Placenta praevia risk factors include a previous delivery, age older than 35 and a history of previous surgeries, such as a caesarean section (C-section) or uterine fibroid removal.
The main symptom is bright red vaginal bleeding without pain during the second-half of pregnancy. The condition can also cause severe bleeding before or during delivery.
Limited physical activity is recommended. A C-section is often required in severe cases.
Please find the power point on Vacuum delivery. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina. Placenta previa happens in about 1 in 200 pregnancies.
Placenta praevia risk factors include a previous delivery, age older than 35 and a history of previous surgeries, such as a caesarean section (C-section) or uterine fibroid removal.
The main symptom is bright red vaginal bleeding without pain during the second-half of pregnancy. The condition can also cause severe bleeding before or during delivery.
Limited physical activity is recommended. A C-section is often required in severe cases.
Please find the power point on Vacuum delivery. I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
Detail description has been provided in this pdf regarding history collection, physical examination, treatment modalities, investigations and a detail description on Ectopic Pregnancy. causes, clinical manifestations. management, diagnostic evaluation and nursing care plan which is compared between patient and book data.
This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
Detail description has been provided in this pdf regarding history collection, physical examination, treatment modalities, investigations and a detail description on Ectopic Pregnancy. causes, clinical manifestations. management, diagnostic evaluation and nursing care plan which is compared between patient and book data.
Taking a good history is very important in making a proper and most appropriate diagnosis.
And it is applicable to all specialties of the medical field.
History and Examination in OBGYN Skill lab.pdfElhadi Miskeen
By the end of this presentation, students :
1. Should be able to refine communication and clinical care skills in taking a pertinent comprehensive medical history
2. Assessing risk and patient adherence to health care recommendations.
3. Should be able to use this information to formulate a diagnosis and management plan while communicating important findings and recommendations to the patient
incorporating her socioeconomic and cultural context
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.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
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
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...
Case study on placenta prevea (1)
1. IDENTIFICATION DATA:
Name of the patient – Mrs. Paridhi
Age – 29 yrs.
IP no. – 543210
Address – Saraswati colony, Bombay motor, Jodhpur.
Date of admission – 20/08/21
Religion –Hindu
Education – +12
Occupation – housewife
Marital status – married for 2 year
Income – nil
Obstetrical score – G1 P0 L0 A0
Diagnosis -Placenta Previa
L.M.P - 17/01/21
E.D.D – 24/10/21
PRESENT HISTORY : - Mrs. Paridhi got admitted to Hospital, on with a complaint of vaginal
bleeding.
PAST MEDICAL HISTORY : - Mrs. Paridhi doesn’t have any significant medical illness.
Mrs. Paridhi has taken two doses of injection TT during her pregnancy period. Mrs. Paridhi
does not have any drug allergies.
PAST SURGICAL HISTORY
Mrs. Paridhi doesn’t have any history of gynecological or other operation in past.
FAMILY HISTORY: - Mrs. Paridhi is living in a nuclear family. Mrs. Paridhi is living with
her husband. All her family members do not have any hereditary or communicable diseases.
They do not have medical or surgical history even.
2. FAMILY COMPOSITION
Sr.
No
Name relationship
with the
patient
Age sex education occupation Health
status
1 Mr.Sandeep Husband 29
year
male MBA Manager in
C.company
Healthy
2. Mrs. Paridhi Self 28year female BCA Housewife Twins
Pregnancy
MENSTRUAL HISTORY: - She attended her puberty at the age of 13 years. Mrs. Paridhi does
not have any history of dysmenorrhoea or irregularity of the menstrual cycle.
CURRENT OBSTETRICAL HISTORY:-Now Mrs. Paridhi is in the 32 weeks of pregnancy
and in while doing USG reveals placental implantation site.
NUTRITIONAL HISTORY: - Mrs. Paridhi is a vegetarian and takes two meals a day. She
takes rice, ragi, maize, pulses, etc. Mrs. Paridhi does not have any food allergy.
SOCIO-ECONOMIC STATUS:-Her husband is the bread winner of the family and Mrs.
Paridhi is a housewife. There is adequate supply of water and electric facility in their house.
They practice closed drainage system. There is adequate ventilation in the surrounding
environment. They maintain good interpersonal relationship with the neighbours.
PHYSICAL EXAMINATION
General appearance:
Mrs. Paridhi is has a moderate body built. Mrs. Paridhi is groomed neatly but she looks anxious.
Posture - Mrs. Paridhi has an erect body. And does not have any abnormal body curvature like
kyphosis or scoliosis.
Skin - Mrs. Paridhi has a normal skin colour. The skin is cold and moist.
Head and face: Her hair is black in colour. It is thin and smooth in texture. The scalp is clean
and clear. Her face looks anxious.
Eyes: Her eyebrows are symmetrically present; there is equal distribution of eyelashes. Eyelids
are free of infection or sty; the conjunctiva is pink in colour. Sclera is transparent in nature. The
pupils are equally reacted to light and her vision capacity is adequate.
3. Nose: It is normal in shape and structure. The nostril is clean and it is free of discharges and
crust collection. Both the nostrils are symmetrical in opening as equally divided by the nasal
septum.
Ears: The external ears are normal in shape and structure. There free of discharges, cerumen
collection or the perforation of the tympanic membrane and infection in the internal ear.
Mouth: The lips are smooth, the teeth are white in colour and they are free of dental carries. The
gum is pink in colour and it’s free from swelling and bleeding. The tongue is pale in colour,
moist.
Neck: During inspection there is no enlargement of the thyroid gland and all the range of
movement are possible without causing any pain. There is no enlargement of the lymph node
during palpation.
Chest:
On inspection - There is symmetrical expansion of the thorax and she has a normal breathing
pattern.
On auscultation - There is no abnormal breath sound like whistling sound, rale or crackle
sound, etc. While doing examination there is no abnormal heart sound like cardiac murmur.
Breast:
Inspection: Both breasts are symmetrical. Nipples are erected. Primary and secondary areola is
present. Montgomery’s tubercles are prominent. Veins are visible and dilated.
Palpation: Thick yellow secretions (colostrum) are present. Breast is warm to tough and lump is
not presence.
Abdomen:
Inspection : skin over the abdomen is tense shiny with broad stria gravidarum; umbilicus is
everted.
Palpation:
Genitalia:
The genitalia are seen to be clean. Vaginal bleeding is not present. No any vulval edema or veins
are dilated.
4. Extremities:
The extremities were free from oedema or varicosities present. All the range of movement is
performed by the mother without any difficulty.
Back:
Mrs. Paridhi has an erect body. There is no abnormal spinal curvature like lordosis, kyphosis, or
scoliosis.
INVESTIGATION
Sr. no. Name of investigation Patient’s value Normal value Remark
1. Blood:
Hb.
Group
HIV I&II
VDRL
10.8
B +ve
Non reactive
Nil
12-14gm%
-
-
-
Normal
Normal
Normal
Normal
DISEASE ASPECT ON PLACENTA PREVIA
Definition:
The placenta is located low in the uterine cavity, partially or completely covering the
cervix.
Incidence:
About one third cases of ante-partum hemorrhage belong to placenta previa. The
incidence
ranges from 0.5-1% among hospital deliveries.
Degree / Types Of Placenta Previa:
Placenta previa is classified according to the placement of the placenta:
Type I or low lying: The placenta encroaches the lower segment of the uterus but does
not infringe on the cervical OS.
5. • Type II or marginal: The placenta touches, but does not cover, the top of the cervix.
• Type III or partial: The placenta partially covers the top of the cervix
• Type IV or complete: The placenta completely covers the top of the cervix
Etiology:
The exact cause of placenta previa is unknown. The following have been identified as
risk factor for placenta previa:
• Dropping down theory: fertilized ovum drop down and is implanted in lower uterine segment
• large placenta from twins or erythroblastosis encroaches in lower segment
• multiple pregnancy
• Advanced maternal age
Pathophysiology:
Placental implantation is initiated by the embryo (embryonic plate) adhering in the lower
(caudad) uterus. With placental attachment and growth, the developing placenta may cover the
cervical OS. However, it is thought that a defective decidual vascularization occurs over the
cervix, possibly secondary to inflammatory or atrophic changes. As such, sections of the placenta
having undergone atrophic changes could persist as a vasa previa.
A leading cause of third trimester hemorrhage, placenta previa presents classically as painless
bleeding. Bleeding is thought to occur in association with the development of the lower uterine
segment in the third trimester. Placental attachment is disrupted as this area gradually thins in
preparation for the onset of labor. When this occurs, bleeding occurs at the implantation site as
the uterus is unable to contract adequately and stop the flow of blood from the open vessels.
Clinical Manifestation / Sign And Symptoms:
• Sudden, painless, causeless and recurrent vaginal bleeding
• Bleeding is unrelated to activity often occur during sleep.
• Bleeding is unassociated with pain unless labour starts simultaneously
Diagnosis
I. Localization of placenta (Placentography):
II. clinical
6. Complication of placenta previa:
▪ Related to mother:
▪ Ante partum hemorrhage
▪ Malpresentation
▪ Premature labour
▪ Related to baby:
▪ Fetal hypoxia
▪ Low birth weight
Treatment :
Medical management:
▪ Iv fluid administration
▪ Laboratory examination: blood grouping and cross matching
▪ Assessment of blood loss by inspection of blood clots and pads.
▪ Administration of betamethasone .
▪ Bed rest, Constant fetal monitoring
✓ Surgical treatment:
▪ Amniocentesis
▪ Caesarean
Nursing management:
1. Altered Tissue Perfusion related to excessive bleeding causing fetal compromise as
evidence by vaginal bleeding.
2. Fluid volume deficit related to excessive bleeding
3. Risk for infection related to excessive blood loss
4. Anxiety related to excessive bleeding and outcome of pregnancy after episodes of bleeding
5. Knowledge deficits related to disease condition and management
6. Ensure maternal and fetal well being
7. APPLICATION OF BETTY NEUMAN'S SYSTEMS MODEL
SYSTEM MODEL- BETTY NEUMAN
A theory is a group of related concepts that propose action that guide practice. A nursing theory
is a set of concepts, definitions, relationships, and assumptions or propositions derived from
nursing models or from other disciplines and project a purposive, systematic view of
phenomena by designing specific inter-relationships among concepts for the purposes of
describing, explaining, predicting, and /or prescribing.
1. Nursing Diagnosis - based of necessity in a thorough assessment, and with consideration given
to five variables in three stressor areas.
2. Nursing Goals - these must be negotiated with the patient, and take account of patient's and
nurse's perceptions of variance from wellness
3. Nursing Outcomes - considered in relation to five variables, and achieved through primary,
secondary and tertiary interventions.
NURSING PROCESS BASED ON SYSTEM MODEL
Assessment: Neuman’s first step of nursing process parallels the assessment and nursing
diagnosis of the six phase nursing process. Using system model in the assessment phase of
nursing process the nurse focuses on obtaining a comprehensive client data base to determine
the existing state of wellness and actual or potential reaction to environmental stressors.
Nursing diagnosis- the synthesis of data with theory also provides the basis for nursing
diagnosis. The nursing diagnostic statement should reflect the entire client condition.
Outcome identification and planning- it involves negotiation between the care giver and the
client or recipient of care. The overall goal of the care giver is to guide the client to conserve
energy and to use energy as a force to move beyond the present.
Implementation – nursing action are based on the synthesis of a comprehensive data base
about the client and the theory that are appropriate to the client’s and caregiver’s perception
and possibilities for functional competence in the environment. According to this step the
evaluation confirms that the anticipated or prescribed change has occurred. Immediate and long
range goals are structured in relation to the short term goals.
Evaluation – evaluation is the anticipated or prescribed change has occurred. If it is not met
the goals are reformed.
8.
9. Assessment Nursing
diagnosis
Nursing
objective
Planning Rationale Implementation Evaluation
Subjective data
:
Mrs. Paridhi
says that “ I am
feeling
discomfort
because of large
abdomen”.
Objective data:
Uterine size is
more than
period of
amenorrhea;
fundal height
and abdominal
girth are more
than weeks of
gestation.
Discomfort
related to
increased
uterine size
The mother
will express
minimal
discomfort.
Monitor fundal height,
weight gain unrelated to
edema
Arrange for sonography.
The theory focus on
improving nutritional
status
Administer adequate diet
rich in protein.
Administer food rich in
iron and vitamins.
Administer food rich in
fiber
Administer more fluids.
Increase in fundal height
may cause hydramnios
which may result in
preterm labour.
Assessment helps in
Recognition of discordants
growth
To improve health
condition
To improve health
condition
To improve health
condition
To prevent from shock.
Fundal height is
checked.
Weight is checked.
Assessed the dietary
pattern of the
mother.
This measure will
help in increase the
bulk of the intestine
and promotes
elimination.
This measure are
safe and natural
preventive measure.
The client
reported
having a
bowel
movement
of a
moderate
amount of
soft brown
stool every
other days..
10. Subjective
data:
The mother says
the “I am not
taking adequate
food and tell me
regarding the
balanced.”
Objective
data:
Mrs. Paridhi
looks pale
conjunctiva and
mucus
membranes.
Body wt: 45kgs
Hb: 9-2gm/%
Nutrition
status less
than body
requirement
related to less
knowledge
regarding
balanced diet.
Mrs. Paridhi
gains
knowledge
regarding
balanced
diet.
Assess the progression of
anxiety through
psychological task of
pregnancy.
Provide a quiet and calm
environment.
Teach about the
physiological changes
and response of the body
during labour process.
Explain the condition of
the fetus to the mother.
Assess the knowledge
level of the mother
Teach about the process
of normal labour .
Explain the mother after
how many days after
delivery Mrs. Paridhi can
resume for the daily
routine.
This will help in knowing
the dietary habit.
This measure will help in
softening the faces
To promote peristalsis
movement.
To aid tissue renewal and
milk production.
To know the baseline data
for planning.
To make the mother to
understand the normal
mechanism of labour.
Providing the information
about the well being of the
fetus will help to reduce
the fear and anxiety of the
mother.
Assessed the level of
fear and anxiety of
the mother by using
anxiety scale.
Provided quiet and
calm environment by
asking the visitors to
talk in a low tone.
Taught about the
physiological
changes and
response of the body
during the labour
process.
Explained the
condition of the fetus
to the mother.
Allowed the patient
to ventilate her
feeling towards
labour by listening to
what Mrs. Paridhi
Mrs Paridhi
Gained
knowledge
regarding
balanced
diet and
practices
the
instruction
in
improving
the
nutritional
status.
By
providing
11. Teach the outcome and
benefits of normal
delivery.
says. all the
above the
above
measures,
12. Health education for antenatal mother:
1. Antenatal diet: advise the mother to take food rich in vitamin, protein, minerals, iron etc.
such as green leafy vegetables and fresh fruits. Advice her to take plenty of water.
2. Antenatal hygiene: advice the mother to take daily bath. Perineal care should be
maintained. Advice her to wear tight fitted bra’s and wear cloth according to weather.
3. Antenatal exercise: advice the mother to do antenatal exercise for 10-15 mins. Advice her
to avoid stressful or heavy activities.
4. Preparation for labour: educate the mother about the process of labour and give
psychological support. Clarify the doubt of the mother related to labour.
5. Breast feedings: advice the mother about the importance of breast feeding and technique
of feedings.
6. Immunization: advise the mother about the immunization of the newborn infant. Describe
the scheduled and importance of the immunization.
7. Family planning: educate the mother regarding temporary and permanent methods of
family planning.
8. Antenatal visit: advise her for next antenatal visit and tell her importance of antenatal
visit.
9. Care of the baby: advise or educate the mother about the care of the baby such as baby
bath, cord care.
13. Summary:
My Patient came with complain of abdominal pain, back pain, and bleeding from per vagina.
Patient is primi para women. On admission she is having abdominal pain and vaginal bleeding
after she diagnosed with placenta previa. So she is admitted in antenatal ward.
Administered medicine as per doctors order and advise her to drink more oral fluids.
After providing 1days care, Patient’s health is good and reduce bleeding and indicate for
termination of delivery.
Conclusion:
During my clinical posting in Civil hospital in antenatal ward, I got chance to provide care to,
Mrs. Paridhi diagnosis of Placenta previa by this study I learn in detail about Placenta previa
definition, causes and its management. I thank my client for her cooperation and my clinical
coordinator for her valuable guidance.
14. Bibliography:-
1. Basvanthappa B.T : “TEXT BOOK OF MIDWIFERY AND
REPRODUCTIVE HEALTH NURSING”; first edition 2006, Jaypee brother
publication, New Delhi. Page no; 213-290.
2. Dutta D.C : “TEXT BOOK OF OBTETRICS” ; 6 TH
Edition , 2004;
New central book agency publication, Calcutta. Page no: 130-150.
3. Jacob Anamma : “A COMPREHENSIVE TEXT BOOK OF
MIDWIFEREEY”;1st
edition 2005; Jaypee brother medical publication; New
Delhi, page no:164-172.
4. Kumari Neelam; (2010); 1st
edition; “MIDWIFERY AND
GYNAECOLOGICAL NURSING”; S.vikas and company; Jalandhar city; Page
no :170-189.
5. Myles : “ TEXT BOOK OF MIDWIVES” ; Fourteenth edition,2003 ;
Elsevier publisher, Philadelphia. Page no; 285-287.
6. Rao Kamini “TEXT BOOK OF MIDWIFERY AND OBSTETRICS
FOR NURSES”; First edition, 2011, Elsevier publisher, Philadelphia. Page no:
277-281.
Internet resources:-
1. http://www.en.wikipedia.org/wiki/postpartumhemorrhage
2. http://www.healthline.com
3. http://www.uptodate.com/contents/postpartumhemorrhage
4. http://www.lexic.us/definition-of/postpartumhemorrhage
5. http://www.empowher.com/media/reference/postpartumhemorrhage