This document provides a cram sheet for the NCLEX-RN nursing exam, summarizing key test information, normal vital signs and lab values, therapeutic drug levels, common medical conditions and diets, and cultural considerations for patients. It condenses important nursing content into an easy to remember format for study.
Anti-D prophylaxis involves administering Anti-D immunoglobulin to Rh-negative women to prevent the production of antibodies against Rh-positive blood cells. This prevents hemolytic disease of the newborn. Anti-D immunoglobulin suppresses the immune response and prevents sensitization. Routine antenatal anti-D prophylaxis reduces the rate of sensitization during pregnancy to 0.2% by providing anti-D at 28 weeks even if fetal blood type is unknown. First trimester events like bleeding or termination procedures also require anti-D administration to prevent sensitization. The document discusses the history, mechanisms, testing and management of Rh sensitization and anti-D prophylaxis.
This document discusses gynaecologic tumours that can occur during pregnancy, including fibroids, ovarian tumours, and cervical cancer. Fibroids can cause complications during pregnancy like abortion, premature labor, and obstructed labor. Ovarian tumours risk torsion and rupture during pregnancy. Small ovarian cysts are monitored while larger or complex cysts are removed. Cervical cancers are screened for, and pre-invasive lesions may be followed until after delivery when treated. Invasive cervical cancer carries risks of preterm delivery, obstructed labor, and infection, and is typically treated with surgery or radiation after early delivery.
Multiple pregnancies consists of two or more fetuses ,there are exceptions to this such as twins gestations made of a singleton viable fetus & a complete mole.
The document discusses prevention of parent-to-child transmission (PPTCT) of HIV. It outlines NACO's four-pronged strategy for PPTCT, which includes primary prevention of HIV among women, preventing unintended pregnancies in HIV+ women, preventing transmission from mother to child, and treatment/care for women and children living with HIV. It then discusses factors influencing transmission risk and interventions to reduce risk during pregnancy, delivery, and infancy including antiretroviral prophylaxis and therapy.
Jadella Implant is a form family planning which comes in two silicon rods,implan subdermal Over the years it release progestin to prevent ovulation thus prevent pregnancy
This document provides guidelines for syndromic management of sexually transmitted infections (STIs). It discusses the syndromic approach to treating STIs based on common causative organisms for each syndrome. Flow charts are provided to guide clinicians through history taking, examination, risk assessment, diagnosis and treatment based on presenting symptoms and signs for various STI syndromes, including urethral discharge, vaginal discharge, lower abdominal pain, genital ulcers, scrotal swelling, and inguinal swelling. Treatment recommendations are given for each syndrome. The document emphasizes partner treatment, prevention counseling, and ensuring treatment compliance.
Vaginal hysterectomy is a procedure to remove the uterus through the vagina. It has advantages over abdominal hysterectomy like earlier recovery, less pain, and lower morbidity. The key steps involve exposing and clamping the uterine vessels and ligaments, then removing the uterus. The vaginal cuff and pelvic floor are repaired with sutures to prevent prolapse. Post-operative care involves bladder drainage, antibiotics, pain relief, and monitoring for potential complications like bleeding or infection.
Some important questions in obstetrics and gynecologyAboubakr Elnashar
1. A retrospective study of 1,242 women found that performing myomectomy during cesarean section was as safe as cesarean section alone and did not result in increased complications. Smaller studies also found caesarean myomectomy to be safe and that it did not affect future fertility or pregnancy outcomes.
2. For infertile women over 35 years old, an initial evaluation including tests like TSH should be done. If no cause is found, ovulation induction with letrozole may be considered.
3. For infertile women whose husband is only present 2-3 months per year, timing intercourse with the fertility cycle and options like IUI or storing semen for future IUI
Anti-D prophylaxis involves administering Anti-D immunoglobulin to Rh-negative women to prevent the production of antibodies against Rh-positive blood cells. This prevents hemolytic disease of the newborn. Anti-D immunoglobulin suppresses the immune response and prevents sensitization. Routine antenatal anti-D prophylaxis reduces the rate of sensitization during pregnancy to 0.2% by providing anti-D at 28 weeks even if fetal blood type is unknown. First trimester events like bleeding or termination procedures also require anti-D administration to prevent sensitization. The document discusses the history, mechanisms, testing and management of Rh sensitization and anti-D prophylaxis.
This document discusses gynaecologic tumours that can occur during pregnancy, including fibroids, ovarian tumours, and cervical cancer. Fibroids can cause complications during pregnancy like abortion, premature labor, and obstructed labor. Ovarian tumours risk torsion and rupture during pregnancy. Small ovarian cysts are monitored while larger or complex cysts are removed. Cervical cancers are screened for, and pre-invasive lesions may be followed until after delivery when treated. Invasive cervical cancer carries risks of preterm delivery, obstructed labor, and infection, and is typically treated with surgery or radiation after early delivery.
Multiple pregnancies consists of two or more fetuses ,there are exceptions to this such as twins gestations made of a singleton viable fetus & a complete mole.
The document discusses prevention of parent-to-child transmission (PPTCT) of HIV. It outlines NACO's four-pronged strategy for PPTCT, which includes primary prevention of HIV among women, preventing unintended pregnancies in HIV+ women, preventing transmission from mother to child, and treatment/care for women and children living with HIV. It then discusses factors influencing transmission risk and interventions to reduce risk during pregnancy, delivery, and infancy including antiretroviral prophylaxis and therapy.
Jadella Implant is a form family planning which comes in two silicon rods,implan subdermal Over the years it release progestin to prevent ovulation thus prevent pregnancy
This document provides guidelines for syndromic management of sexually transmitted infections (STIs). It discusses the syndromic approach to treating STIs based on common causative organisms for each syndrome. Flow charts are provided to guide clinicians through history taking, examination, risk assessment, diagnosis and treatment based on presenting symptoms and signs for various STI syndromes, including urethral discharge, vaginal discharge, lower abdominal pain, genital ulcers, scrotal swelling, and inguinal swelling. Treatment recommendations are given for each syndrome. The document emphasizes partner treatment, prevention counseling, and ensuring treatment compliance.
Vaginal hysterectomy is a procedure to remove the uterus through the vagina. It has advantages over abdominal hysterectomy like earlier recovery, less pain, and lower morbidity. The key steps involve exposing and clamping the uterine vessels and ligaments, then removing the uterus. The vaginal cuff and pelvic floor are repaired with sutures to prevent prolapse. Post-operative care involves bladder drainage, antibiotics, pain relief, and monitoring for potential complications like bleeding or infection.
Some important questions in obstetrics and gynecologyAboubakr Elnashar
1. A retrospective study of 1,242 women found that performing myomectomy during cesarean section was as safe as cesarean section alone and did not result in increased complications. Smaller studies also found caesarean myomectomy to be safe and that it did not affect future fertility or pregnancy outcomes.
2. For infertile women over 35 years old, an initial evaluation including tests like TSH should be done. If no cause is found, ovulation induction with letrozole may be considered.
3. For infertile women whose husband is only present 2-3 months per year, timing intercourse with the fertility cycle and options like IUI or storing semen for future IUI
This document discusses vaccination during pregnancy. It begins by outlining the success of maternal immunization and different types of vaccines. It then covers immunization before, during, and after pregnancy. Vaccines recommended during pregnancy include tetanus, diphtheria, pertussis (Tdap), and inactivated influenza vaccines. Live attenuated vaccines are generally contraindicated due to theoretical risk to the fetus. Postpartum, women should receive any recommended vaccines not administered during pregnancy. Vaccines are an effective way to prevent infectious diseases posing risks to mothers and newborns.
Dr. Monika Madaan discusses postpartum hemorrhage (PPH), a leading cause of maternal mortality. PPH is defined as blood loss over 500ml after delivery. Risk factors include placenta previa/accreta, coagulopathy, overdistended uterus, grand multiparity, abnormal labor, and previous PPH history. Active management of the third stage of labor can help prevent PPH. Treatment involves resuscitation, fluid replacement, administering uterotonics and other drugs, uterine tamponade, compression sutures, devascularization, and hysterectomy if needed. New developments include tranexamic acid and recombinant factor VII. Proper documentation and debriefing are also
1) Bleeding in the first trimester occurs in 20-25% of pregnancies, with 50% resulting in miscarriage.
2) There are both obstetrical and non-obstetrical causes of bleeding, with obstetrical causes like threatened abortion, blighted ovum, and ectopic pregnancy being more common.
3) Diagnosis involves examination, ultrasound, and tests for bleeding disorders if needed. Management depends on the diagnosis and ranges from observation for threatened abortion to surgical evacuation for incomplete or septic abortion.
This document discusses amniotic fluid disorders including polyhydramnios and oligohydramnios. It defines polyhydramnios as excessive amniotic fluid over 2 liters and oligohydramnios as diminished fluid under 500 ml. Causes, diagnosis, and complications are described for each condition. Polyhydramnios can be caused by fetal abnormalities or diabetes and risks preterm labor and cord problems. Oligohydramnios risks pulmonary hypoplasia and deformities from compression and is often caused by renal issues. Management may include treating underlying issues, monitoring fetal wellbeing, and amnioinfusion.
This document discusses gestational trophoblastic disease (GTD), specifically hydatidiform moles. It defines a hydatidiform mole as a pregnancy characterized by vesicular swelling of placental villi, usually with the absence of an intact fetus. Molar pregnancies can be complete or partial based on whether there is a fetus present. Complete moles have no fetus and are diploid, while partial moles may contain defective fetuses and are usually triploid. Symptoms include vaginal bleeding and an enlarged uterus. Diagnosis involves beta-hCG levels and ultrasound showing a "snowstorm" pattern. Treatment is surgical evacuation followed by chemotherapy for high-risk cases to prevent invasive tumors.
The PPTCT program in India provides services through ICTCs to test pregnant women for HIV and prevent mother-to-child transmission. If tested positive, women receive counseling, ART treatment, monitoring, and are encouraged to have institutional deliveries. Infants receive post-exposure prophylaxis. The goal is to eliminate vertical transmission through antenatal, intrapartum, postnatal care and promoting safe infant feeding practices.
This document discusses cervicitis, an inflammation of the cervix. It notes that cervicitis is commonly caused by certain sexually transmitted infections like Chlamydia trachomatis and Neisseria gonorrhoeae. The document outlines the symptoms, signs, diagnosis, and treatment recommendations for cervicitis. It provides treatment guidelines for common causes like chlamydia, gonorrhea, trichomoniasis, and bacterial vaginosis. The document emphasizes the importance of treating sex partners to prevent reinfection.
Rh isoimmunization occurs when an Rh-negative mother carries an Rh-positive fetus. During pregnancy or delivery, fetal red blood cells can enter the mother's circulation, stimulating her immune system to produce antibodies against the Rh antigen. These antibodies can then cross the placenta during subsequent pregnancies and destroy fetal red blood cells, causing hemolytic disease of the newborn. Effects range from mild anemia to severe jaundice, hydrops fetalis, or fetal death. Management involves monitoring maternal antibody levels and fetal well-being through amniocentesis and ultrasound. At-risk pregnancies may require intrauterine transfusions or early delivery. Prevention relies on administering Rh immunoglobulin to the mother during
This document discusses evaluating and managing bad obstetric history (BOH). BOH refers to previous disappointments in childbearing like miscarriages, stillbirths, preterm births, or other complications. A detailed history and medical record review aims to identify recurrent or non-recurrent causes. Common causes include pre-eclampsia, inherited or acquired thrombophilia, parental genetic disorders, anatomical factors, endocrine issues, and infections. Investigation may include screening tests for these conditions. Management focuses on modifying identified risks in the current pregnancy through treatments like low-dose aspirin for pre-eclampsia risk and close monitoring throughout pregnancy. The goal is to learn from past pregnancies to optimize outcomes in future pregnancies.
1) The document discusses the management of pre-eclampsia and eclampsia. It outlines goals of treatment, definitions, assessments, and principles of management including controlling blood pressure, preventing seizures with magnesium sulfate, fluid management, and timing of delivery.
2) Magnesium sulfate is the primary treatment for preventing and controlling seizures, with protocols for loading doses and maintenance doses as well as monitoring for toxicity.
3) Management involves strict fluid balance, blood pressure control with antihypertensive medications, fetal monitoring, and timely delivery once the mother is stabilized. Close monitoring is needed after delivery to watch for recurrence of seizures.
The document discusses intrauterine fetal demise (IUFD), defined as the death of a fetus weighing over 500g or over 24 weeks gestation before the onset of labor. It notes that the cause is unknown in 25-60% of cases. Identifiable causes include maternal conditions like diabetes or hypertension, fetal conditions like birth defects or infections, and placental conditions like abruption or insufficiency. Evaluation of an IUFD involves examining the mother's medical history and current pregnancy, evaluating the stillborn infant, investigating the placenta, and certain laboratory tests. Management depends on factors like gestation, number of fetuses, and the parents' wishes regarding expectant or active management such as labor induction. Complications can
This document discusses first trimester bleeding, which occurs in 20-40% of pregnancies. The main causes are miscarriage (95%), ectopic pregnancy (2%), hydatidiform mole (<1%), and vanishing twin. Diagnosis involves history, examination, ultrasound to determine if the pregnancy is intrauterine, extrauterine, viable, or nonviable. Common ultrasound findings for miscarriage include no fetal heartbeat, subchorionic bleeding, or an empty gestational sac over 20mm. Ectopic pregnancies may appear as an adnexal mass. Rare causes are molar pregnancies, appearing on ultrasound as a "snowstorm" pattern of cysts in the placenta. First trimester bleeding
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANIDR SHASHWAT JANI
This document discusses the management of vault prolapse, which is the descent of the vaginal cuff after a hysterectomy. It defines vault prolapse and lists risk factors. Conservative management includes pessaries but surgery is often needed. Surgical options include vaginal approaches like sacrospinous ligament fixation or abdominal approaches like sacral colpopexy. The document compares techniques and factors to consider in surgical planning like prolapse severity and patient factors. Prevention techniques like culdoplasty at time of hysterectomy are also discussed.
Gestational diabetes mellitus (GDM) is glucose intolerance that develops during pregnancy. Risk factors include obesity, family history of diabetes, and ethnicity. During pregnancy, hormones cause insulin resistance and the pancreas must produce more insulin to maintain blood glucose levels. Untreated GDM can lead to complications for both mother and baby like preeclampsia, macrosomia, and neonatal hypoglycemia. Screening and tight glucose control are important. Pre-gestational diabetes also requires careful management to reduce risks of birth defects, complications, and future diabetes in the child.
This document discusses multiple pregnancies, also known as twins, triplets, etc. It defines multiple pregnancies as when two or more fetuses are present in the uterus at the same time. Multiple pregnancies are considered a pregnancy complication due to the increased risks of preterm birth and mortality for both mother and fetuses. The document covers terminology, incidence rates, complications, diagnosis, and management of multiple pregnancies.
Presentation on the description of normal and abnormal uterine bleeding, menstrual cycle, FIGO classification with PALM-COEIN, common differentials of AUB, assessment, diagnosis, and management.
GESTATIONAL TROPHOBLASTIC DISEASES BY DR SHASHWAT JANIDR SHASHWAT JANI
This document discusses trophoblastic diseases including hydatidiform moles and choriocarcinoma. It begins by introducing Dr. Shashwat Jani and his credentials. It then covers the WHO classification of gestational trophoblastic disease and describes the different types. Key points include that hydatidiform moles represent abnormal placentas with genetic abnormalities, while choriocarcinomas are true neoplasms. The document provides details on the presentation, diagnosis, management and complications of complete and partial hydatidiform moles.
This document provides information on the approach to vaginal discharge. It discusses the most common causes of vaginitis which are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. It describes the pathophysiology, symptoms, risk factors, diagnostic tests, and treatment options for each condition. Physical examination findings and microscopic examination of vaginal discharge samples are important for diagnosis. Treatment typically involves oral or topical antifungal medications for candidiasis and oral metronidazole for bacterial vaginosis and trichomoniasis.
This document discusses molar pregnancy, also known as hydatidiform mole. It begins by classifying gestational trophoblastic disease as either benign, premalignant, or malignant. It then discusses the characteristics of complete and partial moles. Complete moles have no fetal tissue and are caused by fertilization of an empty ovum, while partial moles contain some fetal tissue and are usually triploid. Symptoms of a complete mole include vaginal bleeding, hyperemesis gravidarum, and a uterus larger than dates. Diagnosis involves ultrasound showing a "snowstorm" pattern, elevated hCG levels, and pathological examination of tissue. Complications can include theca-lutein cysts, pre
This document summarizes several medical journal articles from 2013-2014. It finds that restrictive fluid and salt management for heart failure patients in the hospital is not beneficial. A trial on patients with upper GI bleeding showed no benefit to transfusion unless hemoglobin is below 7. Another study found that monitoring gastric residuals when tube feeding ICU patients did not reduce pneumonia rates compared to symptom monitoring alone. The document also discusses overtreatment of diabetes in older patients and risks of using new oral anticoagulants in patients with mechanical heart valves.
CASE PRESENTATION ON SYSTEMIC HYPERTENSION IN SOAP FORMAT.pptxHome
Systemic hypertension, or high blood pressure, is a chronic condition characterized by elevated pressure in the arteries. Typically measured in millimeters of mercury (mmHg), it's diagnosed when readings consistently exceed 130/80 mmHg. This condition, often symptomless, increases the risk of serious health complications like heart disease, stroke, and kidney failure. Contributing factors include genetics, age, unhealthy lifestyle habits, obesity, and stress. Treatment involves lifestyle changes—such as a healthy diet, regular exercise, and stress management—and, if necessary, medications to lower blood pressure. Regular monitoring and management are crucial to mitigate risks and maintain overall health.
This document discusses vaccination during pregnancy. It begins by outlining the success of maternal immunization and different types of vaccines. It then covers immunization before, during, and after pregnancy. Vaccines recommended during pregnancy include tetanus, diphtheria, pertussis (Tdap), and inactivated influenza vaccines. Live attenuated vaccines are generally contraindicated due to theoretical risk to the fetus. Postpartum, women should receive any recommended vaccines not administered during pregnancy. Vaccines are an effective way to prevent infectious diseases posing risks to mothers and newborns.
Dr. Monika Madaan discusses postpartum hemorrhage (PPH), a leading cause of maternal mortality. PPH is defined as blood loss over 500ml after delivery. Risk factors include placenta previa/accreta, coagulopathy, overdistended uterus, grand multiparity, abnormal labor, and previous PPH history. Active management of the third stage of labor can help prevent PPH. Treatment involves resuscitation, fluid replacement, administering uterotonics and other drugs, uterine tamponade, compression sutures, devascularization, and hysterectomy if needed. New developments include tranexamic acid and recombinant factor VII. Proper documentation and debriefing are also
1) Bleeding in the first trimester occurs in 20-25% of pregnancies, with 50% resulting in miscarriage.
2) There are both obstetrical and non-obstetrical causes of bleeding, with obstetrical causes like threatened abortion, blighted ovum, and ectopic pregnancy being more common.
3) Diagnosis involves examination, ultrasound, and tests for bleeding disorders if needed. Management depends on the diagnosis and ranges from observation for threatened abortion to surgical evacuation for incomplete or septic abortion.
This document discusses amniotic fluid disorders including polyhydramnios and oligohydramnios. It defines polyhydramnios as excessive amniotic fluid over 2 liters and oligohydramnios as diminished fluid under 500 ml. Causes, diagnosis, and complications are described for each condition. Polyhydramnios can be caused by fetal abnormalities or diabetes and risks preterm labor and cord problems. Oligohydramnios risks pulmonary hypoplasia and deformities from compression and is often caused by renal issues. Management may include treating underlying issues, monitoring fetal wellbeing, and amnioinfusion.
This document discusses gestational trophoblastic disease (GTD), specifically hydatidiform moles. It defines a hydatidiform mole as a pregnancy characterized by vesicular swelling of placental villi, usually with the absence of an intact fetus. Molar pregnancies can be complete or partial based on whether there is a fetus present. Complete moles have no fetus and are diploid, while partial moles may contain defective fetuses and are usually triploid. Symptoms include vaginal bleeding and an enlarged uterus. Diagnosis involves beta-hCG levels and ultrasound showing a "snowstorm" pattern. Treatment is surgical evacuation followed by chemotherapy for high-risk cases to prevent invasive tumors.
The PPTCT program in India provides services through ICTCs to test pregnant women for HIV and prevent mother-to-child transmission. If tested positive, women receive counseling, ART treatment, monitoring, and are encouraged to have institutional deliveries. Infants receive post-exposure prophylaxis. The goal is to eliminate vertical transmission through antenatal, intrapartum, postnatal care and promoting safe infant feeding practices.
This document discusses cervicitis, an inflammation of the cervix. It notes that cervicitis is commonly caused by certain sexually transmitted infections like Chlamydia trachomatis and Neisseria gonorrhoeae. The document outlines the symptoms, signs, diagnosis, and treatment recommendations for cervicitis. It provides treatment guidelines for common causes like chlamydia, gonorrhea, trichomoniasis, and bacterial vaginosis. The document emphasizes the importance of treating sex partners to prevent reinfection.
Rh isoimmunization occurs when an Rh-negative mother carries an Rh-positive fetus. During pregnancy or delivery, fetal red blood cells can enter the mother's circulation, stimulating her immune system to produce antibodies against the Rh antigen. These antibodies can then cross the placenta during subsequent pregnancies and destroy fetal red blood cells, causing hemolytic disease of the newborn. Effects range from mild anemia to severe jaundice, hydrops fetalis, or fetal death. Management involves monitoring maternal antibody levels and fetal well-being through amniocentesis and ultrasound. At-risk pregnancies may require intrauterine transfusions or early delivery. Prevention relies on administering Rh immunoglobulin to the mother during
This document discusses evaluating and managing bad obstetric history (BOH). BOH refers to previous disappointments in childbearing like miscarriages, stillbirths, preterm births, or other complications. A detailed history and medical record review aims to identify recurrent or non-recurrent causes. Common causes include pre-eclampsia, inherited or acquired thrombophilia, parental genetic disorders, anatomical factors, endocrine issues, and infections. Investigation may include screening tests for these conditions. Management focuses on modifying identified risks in the current pregnancy through treatments like low-dose aspirin for pre-eclampsia risk and close monitoring throughout pregnancy. The goal is to learn from past pregnancies to optimize outcomes in future pregnancies.
1) The document discusses the management of pre-eclampsia and eclampsia. It outlines goals of treatment, definitions, assessments, and principles of management including controlling blood pressure, preventing seizures with magnesium sulfate, fluid management, and timing of delivery.
2) Magnesium sulfate is the primary treatment for preventing and controlling seizures, with protocols for loading doses and maintenance doses as well as monitoring for toxicity.
3) Management involves strict fluid balance, blood pressure control with antihypertensive medications, fetal monitoring, and timely delivery once the mother is stabilized. Close monitoring is needed after delivery to watch for recurrence of seizures.
The document discusses intrauterine fetal demise (IUFD), defined as the death of a fetus weighing over 500g or over 24 weeks gestation before the onset of labor. It notes that the cause is unknown in 25-60% of cases. Identifiable causes include maternal conditions like diabetes or hypertension, fetal conditions like birth defects or infections, and placental conditions like abruption or insufficiency. Evaluation of an IUFD involves examining the mother's medical history and current pregnancy, evaluating the stillborn infant, investigating the placenta, and certain laboratory tests. Management depends on factors like gestation, number of fetuses, and the parents' wishes regarding expectant or active management such as labor induction. Complications can
This document discusses first trimester bleeding, which occurs in 20-40% of pregnancies. The main causes are miscarriage (95%), ectopic pregnancy (2%), hydatidiform mole (<1%), and vanishing twin. Diagnosis involves history, examination, ultrasound to determine if the pregnancy is intrauterine, extrauterine, viable, or nonviable. Common ultrasound findings for miscarriage include no fetal heartbeat, subchorionic bleeding, or an empty gestational sac over 20mm. Ectopic pregnancies may appear as an adnexal mass. Rare causes are molar pregnancies, appearing on ultrasound as a "snowstorm" pattern of cysts in the placenta. First trimester bleeding
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANIDR SHASHWAT JANI
This document discusses the management of vault prolapse, which is the descent of the vaginal cuff after a hysterectomy. It defines vault prolapse and lists risk factors. Conservative management includes pessaries but surgery is often needed. Surgical options include vaginal approaches like sacrospinous ligament fixation or abdominal approaches like sacral colpopexy. The document compares techniques and factors to consider in surgical planning like prolapse severity and patient factors. Prevention techniques like culdoplasty at time of hysterectomy are also discussed.
Gestational diabetes mellitus (GDM) is glucose intolerance that develops during pregnancy. Risk factors include obesity, family history of diabetes, and ethnicity. During pregnancy, hormones cause insulin resistance and the pancreas must produce more insulin to maintain blood glucose levels. Untreated GDM can lead to complications for both mother and baby like preeclampsia, macrosomia, and neonatal hypoglycemia. Screening and tight glucose control are important. Pre-gestational diabetes also requires careful management to reduce risks of birth defects, complications, and future diabetes in the child.
This document discusses multiple pregnancies, also known as twins, triplets, etc. It defines multiple pregnancies as when two or more fetuses are present in the uterus at the same time. Multiple pregnancies are considered a pregnancy complication due to the increased risks of preterm birth and mortality for both mother and fetuses. The document covers terminology, incidence rates, complications, diagnosis, and management of multiple pregnancies.
Presentation on the description of normal and abnormal uterine bleeding, menstrual cycle, FIGO classification with PALM-COEIN, common differentials of AUB, assessment, diagnosis, and management.
GESTATIONAL TROPHOBLASTIC DISEASES BY DR SHASHWAT JANIDR SHASHWAT JANI
This document discusses trophoblastic diseases including hydatidiform moles and choriocarcinoma. It begins by introducing Dr. Shashwat Jani and his credentials. It then covers the WHO classification of gestational trophoblastic disease and describes the different types. Key points include that hydatidiform moles represent abnormal placentas with genetic abnormalities, while choriocarcinomas are true neoplasms. The document provides details on the presentation, diagnosis, management and complications of complete and partial hydatidiform moles.
This document provides information on the approach to vaginal discharge. It discusses the most common causes of vaginitis which are bacterial vaginosis, vulvovaginal candidiasis, and trichomoniasis. It describes the pathophysiology, symptoms, risk factors, diagnostic tests, and treatment options for each condition. Physical examination findings and microscopic examination of vaginal discharge samples are important for diagnosis. Treatment typically involves oral or topical antifungal medications for candidiasis and oral metronidazole for bacterial vaginosis and trichomoniasis.
This document discusses molar pregnancy, also known as hydatidiform mole. It begins by classifying gestational trophoblastic disease as either benign, premalignant, or malignant. It then discusses the characteristics of complete and partial moles. Complete moles have no fetal tissue and are caused by fertilization of an empty ovum, while partial moles contain some fetal tissue and are usually triploid. Symptoms of a complete mole include vaginal bleeding, hyperemesis gravidarum, and a uterus larger than dates. Diagnosis involves ultrasound showing a "snowstorm" pattern, elevated hCG levels, and pathological examination of tissue. Complications can include theca-lutein cysts, pre
This document summarizes several medical journal articles from 2013-2014. It finds that restrictive fluid and salt management for heart failure patients in the hospital is not beneficial. A trial on patients with upper GI bleeding showed no benefit to transfusion unless hemoglobin is below 7. Another study found that monitoring gastric residuals when tube feeding ICU patients did not reduce pneumonia rates compared to symptom monitoring alone. The document also discusses overtreatment of diabetes in older patients and risks of using new oral anticoagulants in patients with mechanical heart valves.
CASE PRESENTATION ON SYSTEMIC HYPERTENSION IN SOAP FORMAT.pptxHome
Systemic hypertension, or high blood pressure, is a chronic condition characterized by elevated pressure in the arteries. Typically measured in millimeters of mercury (mmHg), it's diagnosed when readings consistently exceed 130/80 mmHg. This condition, often symptomless, increases the risk of serious health complications like heart disease, stroke, and kidney failure. Contributing factors include genetics, age, unhealthy lifestyle habits, obesity, and stress. Treatment involves lifestyle changes—such as a healthy diet, regular exercise, and stress management—and, if necessary, medications to lower blood pressure. Regular monitoring and management are crucial to mitigate risks and maintain overall health.
The document discusses the importance of pre-anaesthetic checkup and premedication. It outlines the goals of preoperative medical assessment which include reducing surgery morbidity, increasing perioperative care quality while decreasing costs, and helping the patient return to function quickly. The summary also describes the process of taking patient history, examining cardiovascular, respiratory and other systems, assessing airway, and conducting relevant medical tests. Finally, it provides guidelines on premedication for different patient groups and surgeries.
This document provides information on pre-anesthetic checkups and premedication. It discusses the goals of preoperative medical assessment which include reducing surgery morbidity, increasing perioperative care quality while decreasing costs, and helping the patient return to function quickly. It covers topics like history taking, physical examination, laboratory investigations, ASA physical status classification, pediatric considerations, medication guidelines, preoperative fasting, and informed consent. Common premedication drugs are also outlined along with their advantages and disadvantages.
The document summarizes a case of a 16 month old female patient named Naseeba who presented with pallor and difficulty breathing for the past month and 5 days respectively. She was diagnosed with thalassemia major based on her history of severe anemia requiring regular blood transfusions since 8 months of age. Her examination revealed signs of severe anemia, failure to thrive, and secondary malnutrition. The discussion section provided an overview of thalassemia including pathogenesis, classification, management with regular blood transfusions and chelation therapy, as well as complications. It emphasized the importance of lifelong management, counseling, and screening to improve quality of life for patients with thalassemia major.
1. The document discusses watery diarrhea, its causes, clinical features, assessment, management, treatment, prevention and complications. 2. The main causes listed are Vibrio cholerae, ETEC, food poisoning and viruses. Clinical features include rice water stools and phases of evacuation, collapse and recovery. 3. Management involves assessing and treating dehydration with oral rehydration solution or intravenous fluids, administering antibiotics like doxycycline or tetracycline, and preventing complications and further spread through sanitation and hygiene practices.
BMS 561, Hematology Fall 2016 Case studiesThe following case .docxAASTHA76
BMS 561, Hematology Fall 2016 Case studies
The following case studies are not actual patients. They combine elements from different cases to emphasize important aspects
Case 1
HISTORY: Patient Presentation
A four-year-old African American male diagnosed with sickle cell disease in the newborn period was admitted to the hospital with abdominal pain. Two days prior to admission, he was seen in the emergency room for abdominal pain and sent out on pain medicine.
PHYSICAL EXAM
Height
100 cm (25th percentile on growth chart)
Weight
15 kg (25th percentile on growth chart)
Temperature:
38.9ºC
Heart Rate:
135
Respiratory Rate:
40
Blood Pressure
100/60 mmHg
Oxygen Saturation Level:
87% (normal range: 92%-98%)
HEENT:
Normocephalic, pupils reactive, tympanic membranes clear, oropharynx clear
Neck:
No adenopathy
Chest:
Mild subcostal retractions. Audible rales at lung bases.
Heart:
Tachycardic with III/VI murmur
Abdomen:
Mild distension, diffusely tender to palpation
Genitourinary:
Circumcised male, no priapism
Extremities:
Warm
Neurologic:
Crying, alert boy. Face was symmetric. Moved all extremities.
LABORATORY DATA
Patient Value
Normal Value
WBC
15,000
4,000-12,000/μL
HGB
6.3
11.5-13.5 g/dL
HCT
18
34%-40%
PLT
560,000
140,000-440,000/μL
MCV
89.0
75-87 fl
Retic %
14%
0.5%-1.5%
Rectic Absolute
0.2125
0.024-0.084 M/μL
1 What history, including symptoms, would be most helpful in evaluating this patient?
2 What does a prior history of abdominal pain reflect? What does Bone pain and swollen, painful fingers (dactylitis) reflect in this disease?
3 He had a temperature of 101 degrees Fahrenheit yesterday.what does that indicate?
4 He has been coughing 2-3 times a day and intermittently through the night.what does that indicate??
5 Does family history indicate sickle disease?
6 What additional physical findings might occur in patients with sickle cell disease? Discuss Jaundice and Splenomagaly??
7 What other labs would you request? Compare the lab findings with normal ranges
Discuss Peripheral smear, hemoglobin electrophoresis,
Blood culture; Blood Type and screen for antibodies
LDH; Haptoglobin levels
Amylase and Lipase
8 Discuss MCV, MCH, RDW, ESR, Hematocrit and red cell morphology in this disease
9 What was your differential diagnosis when you first saw the patient? Discuss the following in diagnosing the disease
Cholecystitis; Pneumonia; Upper respiratory tract infection; Vaso-occlusive pain crisis
10 what are the differences between sickle cell disease, HbC, HbE and Thalassemia diseases?
11 Discuss Iron deficiency anemia, thalassemia syndromes and sickle cell anemia
12 How would you treat this patient?
Case 2
On review of symptoms, The patient reports difficulty concentrating, fatigue, feeling faint when she stands quickly, and vague gastrointestinal discomfort with some decrease in appetite.
She denies any history of previous trauma, diplopia, dysphagia, vertigo, vision loss, loss of consciousne ...
Case presentation of ventricular septal defect VSD 30 4-2019Draftab3
1. This document presents the case of a 1 year old male child admitted to the hospital with shortness of breath, fever, and loose stool over the past few days.
2. On examination, the child appeared ill and irritable with tachycardia, tachypnea, and a pansystolic murmur. Chest x-ray and echocardiogram revealed ventricular septal defect.
3. The child was admitted to the PICU for intravenous fluids and antibiotics to treat presumed pneumonia complicating his ventricular septal defect.
This document outlines guidelines for the management of dengue in children. It discusses dengue classification, the course of dengue illness and shock. It provides a stepwise approach to dengue management including history taking, clinical assessment to divide patients into groups for outpatient or inpatient management. For each group, it details monitoring, fluid resuscitation and criteria for discharge.
This baby needs prostaglandin infusion urgently.
The chest X-ray shows oligemic lung fields suggesting decreased pulmonary blood flow. The clinical features of cyanosis, tachycardia, weak pulses and metabolic acidosis point towards ductal dependant circulation.
Prostaglandin infusion will help open the ductus arteriosus and improve pulmonary blood flow which is critical for survival in this neonate. Ventilator support, inotropes and antibiotics/antifungals may also be needed. An urgent echocardiogram will help identify the underlying cardiac lesion.
The key is to recognize this is not pneumonia but a ductal dependant cardiac lesion and start prostaglandin without delay.
This document discusses hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy. It begins by defining hyperemesis gravidarum and listing its risk factors, which include high levels of hCG and estrogen, primigravidity, and a history of this condition. The document then covers signs and symptoms, pathogenesis, diagnosis, and both outpatient and inpatient management. Outpatient management involves medications, dietary changes, and lifestyle adjustments while inpatient management focuses on IV rehydration and electrolyte replacement, antiemetics, and monitoring until discharge criteria are met. Complications are also outlined.
This soap note documents a visit for a 65-year-old male patient complaining of headaches for the past two weeks. On examination, the patient's blood pressure was elevated at 159/92 mmHg. The patient was assessed with essential (primary) hypertension. The treatment plan includes starting hydrochlorothiazide 25 mg daily along with lifestyle modifications like diet changes, exercise, and stress reduction. The patient will follow up with his primary care provider in one week to monitor his blood pressure and treatment plan.
Pediatrics History Taking and Physical Examination.pptxAJAY MANDAL
This document outlines the components and steps for taking a pediatric history and conducting a physical examination for newborns, infants, children, and adolescents. It discusses obtaining a thorough history, including chief complaint, history of present illness, review of systems, past medical history, family history, and social history. The document also provides guidance on performing a complete physical exam for newborns, assessing vital signs, appearance, and examining each body system.
This document outlines the learning objectives and case of a 75-year-old female stroke patient named Mrs. M. The objectives are to understand stroke including its definition, causes, signs and symptoms, complications, and treatment. Mrs. M's profile notes her medical history, vital signs, symptoms of right-sided weakness and difficulty swallowing. Her diagnosis is ischemic stroke and high cholesterol. The document further details her lab results, CT brain results, medications, nursing diagnoses and interventions.
This document provides a concise summary of key pediatric medical information including normal vital signs, common lab values, disease processes, medications, and other important clinical references organized by topic for quick reference. Key areas covered include normal heart rates, temperatures, electrolytes, endocrine labs, ABG values, common infections, newborn assessments, growth charts, and more.
This document presents the case of a 4-year-old child who presented with 2 days of abdominal pain, vomiting, and loose stool. On examination, the child appeared unwell with tachycardia and mild dehydration. Initial labs showed normal electrolytes. After IV fluids and reassessment, the child remained unwell with ongoing vomiting and stool. Repeat labs found normal electrolytes but an elevated blood glucose and urine ketones. A venous blood gas then revealed metabolic acidosis consistent with diabetic ketoacidosis (DKA), requiring a change in management. The key takeaways are that not all vomiting and diarrhea cases are gastroenteritis, to consider DKA if dehydration is not improving, and to
This document presents a case of a 58-year-old male with nephrotic syndrome. The patient presented with leg swelling, lower urinary tract symptoms, and respiratory difficulty. Laboratory tests showed proteinuria, hypoalbuminemia, and hyperlipidemia. The patient was diagnosed with nephrotic syndrome and stage 1 hypertension. The treatment plan included medications to relieve symptoms, lower cholesterol, improve kidney function, eliminate fluid accumulation, and improve quality of life. The pharmacist provided interventions on monitoring for adverse effects and recommended diet and lifestyle modifications.
Paediatrics Clinicopathological Conference - Approach to a Child with PallorAzizul Halid, MBBS
This document presents the case of an 8-year-old boy who presented with pallor for 7 months and fever with cough for 5 days. On examination, he was found to have pallor, hepatosplenomegaly, and lymphadenopathy. Investigations revealed pancytopenia, microcytic hypochromic anemia, elevated LDH and ferritin, and prolonged aPTT. Bone marrow aspiration showed myelodysplastic syndrome. The patient was diagnosed with myelodysplastic syndrome with concurrent atypical pneumonia. He received two blood transfusions which provided only minimal improvement in his hemoglobin levels.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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ISO/IEC 42001 Artificial Intelligence Management System - EN | PECB
General Data Protection Regulation (GDPR) - Training Courses - EN | PECB
Webinars: https://pecb.com/webinars
Article: https://pecb.com/article
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it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
South African Journal of Science: Writing with integrity workshop (2024)
Nurseslabs cram-sheet
1. Via: http://nurseslabs.com/nclex-cram-sheet/
Nursing Exam Cram Sheet for the NCLEX-RN
The final mountain that nursing students must summit before becoming a registered nurse is the NCLEX. Preparing for the NCLEX can be stressful as
taking in colossal amounts of information has never been easy. This is where this cram sheet can help-- it contains condensed facts about the licensure
exam and key nursing information. When exam time comes, you can write and transfer these vital information from your head to a blank sheet of paper
provided by the testing center.
1. Test Information
Six hours—the maximum time allotted
for the NCLEX is 6 hours. Take breaks if
you need a time out or need to move
around.
75/265—the minimum number of
questions you can answer is 75 and a
maximum of 265.
Read the question and answers
carefully—do not jump into conclusions
or make wild guesses.
Look for keywords—Avoid answers with
absolutes like always, never, all, every,
only, must, except, none, or no.
Don’t read into the question—Never
assume anything that has not been
specifically mentioned and don’t add
extra meaning to the question.
Eliminate answers that are clearly wrong
or incorrect—to increase your probability
of selecting the correct answer!
Watch for grammatical
inconsistencies—Subjects and verbs
should agree. If the question is an
incomplete sentence, the correct answer
should complete the question in a
grammatically correct manner.
Rephrase the question—putting the
question into your own words can pluck
the unneeded info and reveal the core of
the stem.
Make an educated guess—if you can’t
make the best answer for a question
after carefully reading it, choose the
answer with the most information.
2. Vital Signs
Heart rate: 80—100 bpm
Respiratory rate: 12-20 rpm
Blood pressure: 110-120/60 mmHg
Temperature: 37 °C (98.6 °F)
3. Hematology values
RBCs: 4.5—5.0 million
WBCs: 5,000—10,000
Platelets: 200,000—400,000
Hemoglobin (Hgb): 12—16 gm (female);
14—18 gm (male).
Hematocrit (Hct): 37—47 (female); 40—
54 (male)
4. Serum electrolytes
Sodium: 135—145 mEq/L
Potassium: 3.5—5.5 mEq/L
Calcium: 8.5—10.9 mEq/L
Chloride: 95—105 mEq/L
Magnesium: 1.5—2.5 mEq/L
Phosphorus: 2.5—4.5 mEq/L
5. ABG Values
pH: 7.36—7.45
HCO3: 24—26 mEq/L
CO2: 35—45 mEq/L
PaO2: 80%—100%
SaO2: >95%
6. Acid-Base Balance
Remember ROME (respiratory
opposite/metabolic equal) to remember
that in respiratory acid/base disorders
the pH is opposite to the other
components.
Use the Tic-Tac-Toe Method for
interpreting ABGs. Read more about it
here (http://bit.ly/abgtictactoe).
7. Chemistry Values
Glucose: 70—110 mg/dL
Specific Gravity: 1.010—1.030
BUN: 7-22 mg/dL
Serum creatinine: 0.6—1.35 mg/dL
LDH: 100-190 U/L
Protein: 6.2—8.1 g/dL
Albumin: 3.4—5.0 g/dL
Bilirubin: <1.0 mg/dL
Total Cholesterol: 130—200 mg/dL
Triglyceride: 40—50 mg/dL
Uric acid: 3.5—7.5 mg/dL
CPK: 21-232 U/L
2. Via: http://nurseslabs.com/nclex-cram-sheet/
8. Therapeutic Drug Levels
Carbamazepine (Tegretol): 4—10
mcg/ml
Digoxin (Lanoxin): 0.8—2.0 ng/ml
Gentamycin (Garamycin): 5—10 mcg/ml
(peak), <2.0 mcg/ml (valley)
Lithium (Eskalith): 0.8—1.5 mEq/L
Phenobarbital (Solfoton): 15—40
mcg/mL
Phenytoin (Dilantin): 10—20 mcg/dL
Theophylline (Aminophylline): 10—20
mcg/dL
Tobramycin (Tobrex): 5—10 mcg/mL
(peak), 0.5—2.0 mcg/mL (valley)
Valproic Acid (Depakene): 50—100
mcg/ml
Vancomycin (Vancocin): 20—40 mcg/ml
(peak), 5 to 15 mcg/ml (trough)
9. Anticoagulant therapy
Sodium warfarin (Coumadin) PT: 10—12
seconds (control). The antidote is
Vitamin K.
INR (Coumadin): 0.9—1.2
Heparin PTT: 30—45 seconds (control).
The antidote is protamine sulfate.
APTT: 23.3—31.9 seconds
Fibrinogen level: 203—377 mg/dL
10. Conversions
1 teaspoon (t) = 5 ml
1 tablespoon (T) = 3 t = 15 ml
1 oz = 30 ml
1 cup = 8 oz
1 quart = 2 pints
1 pint = 2 cups
1 grain (gr) = 60 mg
1 gram (g) = 1,000 mg
1 kilogram (kg) = 2.2 lbs
1 lb = 16 oz
Convert C to F: C+40 multiply by 9/5 and
subtract 40
Convert F to C: F+40 multiply by 5/9 and
subtract 40
11. Maternity Normal Values
Fetal Heart Rate: 120—160 bpm
Variability: 6—10 bpm
Amniotic fluid: 500—1200 ml
Contractions: 2—5 minutes apart with
duration of < 90 seconds and intensity
of <100 mmHg.
APGAR Scoring: Appearance, Pulses,
Grimace, Activity, Reflex Irritability. Done
at 1 and 5 minutes with a score of 0 for
absent, 1 for decreased, and 2 for
strongly positive. Scores 7 and above
are generally normal, 4 to 6 fairly low,
and 3 and below are generally regarded
as critically low.
AVA: The umbilical cord has two arteries
and one vein.
12. STOP—Treatment for maternal hypotension
after an epidural anesthesia:
Stop infusion of Pitocin.
Turn the client on her left side.
Administer oxygen.
If hypovolemia is present, push IV fluids.
13. Pregnancy Category of Drugs
Category A—No risk in controlled human
studies
Category B—No risk in other studies.
Examples: Amoxicillin, Cefotaxime.
Category C—Risk not ruled out.
Examples: Rifampicin (Rifampin),
Theophylline (Theolair).
Category D—Positive evidence of risk.
Examples: Phenytoin, Tetracycline.
Category X—Contraindicated in
Pregnancy. Examples: Isotretinoin
(Accutane), Thalidomide (Immunoprin),
etc.
Pregnancy Category N—Not yet
classified
14. Drug Schedules
Schedule I—no currently accepted
medical use and for research use only
(e.g., heroin, LSD, MDMA).
Schedule II—drugs with high potential
for abuse and requires written
prescription (e.g., Ritalin,
hydromorphone (Dilaudid), meperidine
(Demerol), and fentanyl).
Schedule III—requires new prescription
after six months or five refills (e.g.,
codeine, testosterone, ketamine).
Schedule IV—requires new prescription
after six months (e.g., Darvon, Xanax,
Soma, and Valium).
Schedule V—dispensed as any other
prescription or without prescription
(e.g., cough preparations, Lomotil,
Motofen).
15. Medication Classifications
Antacids—reduces hydrochloric acid in
the stomach.
Antianemics—increases blood cell
production.
3. Via: http://nurseslabs.com/nclex-cram-sheet/
Anticholinergics—decreases oral
secretions.
Anticoagulants—prevents clot
formation,
Anticonvulsants—used for management
of seizures and/or bipolar disorders.
Antidiarrheals—decreases gastric
motility and reduce water in bowel.
Antihistamines—block the release of
histamine.
Antihypertensives—lower blood
pressure and increases blood flow.
Anti-infectives—used for the treatment
of infections,
Bronchodilators—dilates large air
passages in asthma or lung diseases
(e.g., COPD).
Diuretics—decreases water/sodium
from the Loop of Henle.
Laxatives—promotes the passage of
stool.
Miotics—constricts the pupils.
Mydriatics—dilates the pupils.
Narcotics/analgesics—relieves
moderate to severe pain.
16. Rules of nines for calculating Total Body
Surface Area (TBSA) for burns
Head: 9%
Arms: 18% (9% each)
Back: 18%
Legs: 36% (18% each)
Genitalia: 1%
17. Medications
Digoxin (Lanoxin)—Assess pulses for a
full minute, if less than 60 bpm hold
dose. Check digitalis and potassium
levels.
Aluminum Hydroxide (Amphojel)—
Treatment of GERD and kidney stones.
WOF constipation.
Hydroxyzine (Vistaril)—Treatment of
anxiety and itching. WOF dry mouth.
Midazolam (Versed)—given for
conscious sedation. WOF respiratory
depression and hypotension.
Amiodarone (Cordarone)—WOF
diaphoresis, dyspnea, lethargy. Take
missed dose any time in the day or to
skip it entirely. Do not take double dose.
Warfarin (Coumadin)—WOF for signs of
bleeding, diarrhea, fever, or rash. Stress
importance of complying with
prescribed dosage and follow-up
appointments.
Methylphenidate (Ritalin)—Treatment of
ADHD. Assess for heart related side-
effects and reported immediately. Child
may need a drug holiday because the
drug stunts growth.
Dopamine—Treatment of hypotension,
shock, and low cardiac output. Monitor
ECG for arrhythmias and blood pressure.
Rifampicin—causes red-orange tears
and urine.
Ethambutol—causes problems with
vision, liver problem.
Isoniazid—can cause peripheral neuritis,
take vitamin B6 to counter.
18. Developmental Milestones
2—3 months: able to turn head up, and
can turn side to side. Makes cooing or
gurgling noises and can turn head to
sound.
4—5 months: grasps, switch and roll
over tummy to back. Can babble and
can mimic sounds.
6—7 months: sits at 6 and waves bye-
bye. Can recognize familiar faces and
knows if someone is a stranger. Passes
things back and forth between hands.
8—9 months: stands straight at eight,
has favorite toy, plays peek-a-boo.
10—11 months: belly to butt.
12—13 months: twelve and up, drinks
from a cup. Cries when parents leave,
uses furniture to cruise.
19. Cultural Considerations
African Americans—May believe that
illness is caused by supernatural causes
and seek advice and remedies form faith
healers; they are family oriented; have
higher incidence of high blood pressure
and obesity; high incidence of lactose
intolerance with difficulty digesting milk
and milk products.
Arab Americans—May remain silent
about health problems such as STIs,
substance abuse, and mental illness; a
devout Muslim may interpret illness as
the will of Allah, a test of faith; may rely
on ritual cures or alternative therapies
before seeking help from health care
provider; after death, the family may
4. Via: http://nurseslabs.com/nclex-cram-sheet/
want to prepare the body by washing
and wrapping the body in unsewn white
cloth; postmortem examinations are
discouraged unless required by law.
May avoid pork and alcohol if Muslim.
Islamic patients observe month long
fast of Ramadan (begins approximately
mid-October); people suffering from
chronic illnesses, pregnant women,
breast-feeding, or menstruating don’t
fast. Females avoid eye contact with
males; use same-sex family members as
interpreters.
Asian Americans—May value ability to
endure pain and grief with silent
stoicism; typically family oriented;
extended family should be involved in
care of dying patient; believes in “hot-
cold” yin/yang often involved; sodium
intake is generally high because of
salted and dried foods; may believe
prolonged eye contact is rude and an
invasion of privacy; may not without
necessarily understanding; may prefer
to maintain a comfortable physical
distance between the patient and the
health care provider.
Latino Americans—May view illness as a
sign of weakness, punishment for evil
doing; may consult with a curandero or
voodoo priest; family members are
typically involved in all aspects of
decision making such as terminal
illness; may see no reason to submit to
mammograms or vaccinations.
Native Americans—May turn to a
medicine man to determine the true
cause of an illness; may value the ability
to endure pain or grief with silent
stoicism; diet may be deficient in
vitamin D and calcium because many
suffer from lactose intolerance or don’t
drink milk; obesity and diabetes are
major health concerns; may divert eyes
to the floor when they are praying or
paying attention.
Western Culture—May value technology
almost exclusively in the struggle to
conquer diseases; health is understood
to be the absence, minimization, or
control of disease process; eating
utensils usually consists of knife, fork,
and spoon; three daily meals is typical.
20. Common Diets
Acute Renal Disease—protein-restricted,
high-calorie, fluid-controlled, sodium and
potassium controlled.
Addison’s disease—increased sodium,
low potassium diet.
ADHD and Bipolar—high-calorie and
provide finger foods.
Burns—high protein, high caloric,
increase in Vitamin C.
Cancer—high-calorie, high-protein.
Celiac Disease—gluten-free diet (no
BROW: barley, rye, oat, and wheat).
Chronic Renal Disease—protein-
restricted, low-sodium, fluid-restricted,
potassium-restricted, phosphorus-
restricted.
Cirrhosis (stable)—normal protein
Cirrhosis with hepatic insufficiency—
restrict protein, fluids, and sodium.
Constipation—high-fiber, increased
fluids
COPD—soft, high-calorie, low-
carbohydrate, high-fat, small frequent
feedings
Cystic Fibrosis—increase in fluids.
Diarrhea—liquid, low-fiber, regular, fluid
and electrolyte replacement
Gallbladder diseases—low-fat, calorie-
restricted, regular
Gastritis—low-fiber, bland diet
Hepatitis—regular, high-calorie, high-
protein
Hyperlipidemias—fat-controlled, calorie-
restricted
Hypertension, heart failure, CAD—low-
sodium, calorie-restricted, fat-controlled
Kidney Stones—increased fluid intake,
calcium-controlled, low-oxalate
Nephrotic Syndrome—sodium-restricted,
high-calorie, high-protein, potassium-
restricted.
Obesity, overweight—calorie-restricted,
high-fiver
Pancreatitis—low-fat, regular, small
frequent feedings; tube feeding or total
parenteral nutrition.
Peptic ulcer—bland diet
Pernicious Anemia—increase Vitamin
B12 (Cobalamin), found in high amounts
on shellfish, beef liver, and fish.
5. Via: http://nurseslabs.com/nclex-cram-sheet/
Sickle Cell Anemia—increase fluids to
maintain hydration since sickling
increases when patients become
dehydrated.
Stroke—mechanical soft, regular, or
tube-feeding.
Underweight—high-calorie, high protein
Vomiting—fluid and electrolyte
replacement
21. Positioning Clients
Asthma—orthopneic position where
patient is sitting up and bent forward
with arms supported on a table or chair
arms.
Post Bronchoscopy—flat on bed with
head hyperextended.
Cerebral Aneurysm—high Fowler’s.
Hemorrhagic Stroke: HOV elevated 30
degrees to reduce ICP and facilitate
venous drainage.
Ischemic Stroke: HOB flat.
Cardiac Catheterization—keep site
extended.
Epistaxis—lean forward.
Above Knee Amputation—elevate for
first 24 hours on pillow, position on
prone daily for hip extension.
Below Knee Amputation—foot of bed
elevated for first 24 hours, position
prone daily for hip extension.
Tube feeding for patients with
decreased LOC—position patient on
right side to promote emptying of the
stomach with HOB elevated to prevent
aspiration.
Air/Pulmonary embolism—turn patient
to left side and lower HOB.
Postural Drainage—Lung segment to be
drained should be in the uppermost
position to allow gravity to work.
Post Lumbar puncture—patient should
lie flat in supine to prevent headache
and leaking of CSF.
Continuous Bladder Irrigation (CBI)—
catheter should be taped to thigh so
legs should be kept straight.
After myringotomy—position on the side
of affected ear after surgery (allows
drainage of secretion).
Post cataract surgery—patient will sleep
on unaffected side with a night shield
for 1-4 weeks.
Detached retina—area of detachment
should be in the dependent position.
Post thyroidectomy—low or semi-
Fowlers, support head, neck and
shoulders.
Thoracentesis—sitting on the side of the
bed and leaning over the table (during
procedure); affected side up (after
procedure).
Spina Bifida— position infant on prone
so that sac does not rupture.
Buck’s Traction—elevate foot of bed for
counter-traction.
Post Total Hip Replacement—don’t
sleep on operated side, don’t flex hip
more than 45-60 degrees, don’t elevate
HOB more than 45 degrees. Maintain hip
abduction by separating thighs with
pillows.
Prolapsed cord—knee-chest position or
Trendelenburg.
Cleft-lip—position on back or in infant
seat to prevent trauma to the suture
line. While feeding, hold in upright
position.
Cleft-palate—prone.
Hemorrhoidectomy—assist to lateral
position.
Hiatal Hernia—upright position.
Preventing Dumping Syndrome—eat in
reclining position, lie down after meals
for 20-30 minutes (also restrict fluids
during meals, low fiber diet, and small
frequent meals).
Enema Administration—position patient
in left-side lying (Sim’s position) with
knees flexed.
Post supratentorial surgery (incision
behind hairline)—elevate HOB 30-45
degrees.
Post infratentorial surgery (incision at
nape of neck)—position patient flat and
lateral on either side.
Increased ICP—high Fowler’s.
Laminectomy—back as straight as
possible; log roll to move and sand bag
on sides.
Spinal Cord Injury—immobilize on spine
board, with head in neutral position.
Immobilize head with padded C-collar,
maintain traction and alignment of head
6. Via: http://nurseslabs.com/nclex-cram-sheet/
manually. Log roll client and do not
allow client to twist or bend.
Liver Biopsy—right side lying with pillow
or small towel under puncture site for at
least 3 hours.
Paracentesis—flat on bed or sitting.
Intestinal Tubes—place patient on right
side to facilitate passage into
duodenum.
Nasogastric Tubes—elevate HOB 30
degrees to prevent aspiration. Maintain
elevation for continuous feeding or
1hour after intermittent feedings.
Pelvic Exam—lithotomy position.
Rectal Exam—knee-chest position,
Sim’s, or dorsal recumbent.
During internal radiation—patient should
be on bed rest while implant is in place.
Autonomic Dysreflexia—place client in
sitting position (elevate HOB) first
before any other implementation.
Shock—bed rest with extremities
elevated 20 degrees, knees straight,
head slightly elevated (modified
Trendelenburg).
Head Injury—elevate HOB 30 degrees to
decrease intracranial pressure.
Peritoneal Dialysis when outflow is
inadequate—turn patient side to side
before checking for kinks in the tubing.
Myelogram
Water-based dye—semi Fowler’s
for at least 8 hours.
Oil-based dye—flat on bed for at
least 6-8 hours to prevent leakage
of CSF.
Air dye—Trendelenburg.
22. Common Signs and Symptoms
Pulmonary Tuberculosis (PTB)—low-
grade afternoon fever.
Pneumonia—rust-colored sputum.
Asthma—wheezing on expiration.
Emphysema—barrel chest.
Kawasaki Syndrome—strawberry
tongue.
Pernicious Anemia—red beefy tongue.
Down syndrome—protruding tongue.
Cholera—rice-watery stool and washer
woman’s hands (wrinkled hands from
dehydration).
Malaria—stepladder like fever with
chills.
Typhoid—rose spots in the abdomen.
Dengue—fever, rash, and headache.
Positive Herman’s sign.
Diphtheria—pseudo membrane
formation.
Measles—Koplik’s spots (clustered
white lesions on buccal mucosa).
Systemic Lupus Erythematosus—
butterfly rash.
Leprosy—leonine facies (thickened
folded facial skin).
Bulimia—chipmunk facies (parotid gland
swelling).
Appendicitis—rebound tenderness at
McBurney’s point. Rovsing’s sign
(palpation of LLQ elicits pain in RLQ).
Psoas sign (pain from flexing the thigh
to the hip).
Meningitis—Kernig’s sign (stiffness of
hamstrings causing inability to
straighten the leg when the hip is flexed
to 90 degrees), Brudzinski’s sign (forced
flexion of the neck elicits a reflex flexion
of the hips).
Tetany—hypocalcemia, [+] Trousseau’s
sign; Chvostek sign.
Tetanus— Risus sardonicus or rictus
grin.
Pancreatitis—Cullen’s sign (ecchymosis
of the umbilicus), Grey Turner’s sign
(bruising of the flank).
Pyloric Stenosis—olive like mass.
Patent Ductus Arteriosus—washing
machine-like murmur.
Addison’s disease—bronzelike skin
pigmentation.
Cushing’s syndrome—moon face
appearance and buffalo hump.
Grave’s Disease (Hyperthyroidism)—
Exophthalmos (bulging of the eye out of
the orbit).
Intussusception—Sausage-shaped
mass.
Multiple Sclerosis—Charcot’s Triad:
nystagmus, intention tremor, and
dysarthria.
Myasthenia Gravis—descending muscle
weakness, ptosis (drooping of eyelids).
Guillain-Barre Syndrome—ascending
muscles weakness.
7. Via: http://nurseslabs.com/nclex-cram-sheet/
Deep vein thrombosis (DVT)—Homan’s
Sign.
Angina—crushing, stabbing pain relieved
by NTG.
Myocardial Infarction (MI)—crushing,
stabbing pain radiating to left shoulder,
neck, and arms. Unrelieved by NTG.
Parkinson’s disease—pill-rolling tremors.
Cytomegalovirus (CMV) infection—Owl’s
eye appearance of cells (huge nucleus
in cells).
Glaucoma—tunnel vision.
Retinal Detachment—flashes of light,
shadow with curtain across vision.
Basilar Skull Fracture—Raccoon eyes
(periorbital ecchymosis) and Battle’s
sign (mastoid ecchymosis).
Buerger’s Disease—intermittent
claudication (pain at buttocks or legs
from poor circulation resulting in
impaired walking).
Diabetic Ketoacidosis—acetone breathe.
Pregnancy Induced Hypertension
(PIH)—proteinuria, hypertension, edema.
Diabetes Mellitus—polydipsia,
polyphagia, polyuria.
Gastroesophageal Reflux Disease
(GERD)—heart burn.
Hirschsprung’s Disease (Toxic
Megacolon)—ribbon-like stool.
Sexual Transmitted Infections:
Herpes Simplex Type II—painful
vesicles on genitalia
Genital Warts—warts 1-2 mm in
diameter.
Syphilis—painless chancres
Chancroid—painful chancres.
Gonorrhea—green, creamy
discharges and painful urination.
Chlamydia—milky discharge and
painful urination.
Candidiasis—white cheesy
odorless vaginal discharges.
Trichomoniasis—yellow, itchy,
frothy, and foul-smelling vaginal
discharges.
23. Miscellaneous Tips
Delegate sterile skills (e.g., dressing
change) to the RN or LPN.
Where non-skilled care is required,
delegate the stable client to the nursing
assistant.
Assign the most critical client to the RN.
Clients who are being discharged should
have final assessments done by the RN.
The Licensed Practical Nurse (LPN) can
monitor clients with IV therapy, insert
urinary catheters, feeding tubes, and
apply restraints.
Assessment, teaching, medication
administration, evaluation, unstable
patients cannot be delegated to an
unlicensed assistive personnel.
Weight is the best indicator of
dehydration.
When patient is in distress,
administration of medication is rarely
the best choice.
Always check for allergies before
administering antibiotics.
Neutropenic patients should not receive
vaccines, fresh fruits, or flowers.
Nitroglycerine patch is administered up
to three times with intervals of five
minutes.
Morphine is contraindicated in
pancreatitis because it causes spasms
of the Sphincter of Oddi. Demerol should
be given.
Never give potassium (K+) in IV push.
Infants born to an HIV-positive mother
should receive all immunizations of
schedule.
Gravida is the number of pregnancies a
woman has had, regardless of outcome.
Para is the number of pregnancies that
reached viability, regardless of whether
the fetus was delivered alive or stillborn.
A fetus is considered viable at 20 weeks’
gestation.
Lochia rubra is the vaginal discharge of
almost pure blood that occurs during
the first few days after childbirth.
Lochia serosa is the serous vaginal
discharge that occurs 4 to 7 days after
childbirth.
Lochia alba is the vaginal discharge of
decreased blood and increased
leukocytes that’s the final stage of
lochia. It occurs 7 to 10 days after
childbirth.
In the event of fire, the acronym most
often used is RACE. (R) Remove the
patient. (A) Activate the alarm. (C)
Attempt to contain the fire by closing
8. Via: http://nurseslabs.com/nclex-cram-sheet/
the door. (E) Extinguish the fire if it can
be done safely.
Before signing an informed consent
form, the patient should know whether
other treatment options are available
and should understand what will occur
during the preoperative, intraoperative,
and postoperative phases; the risks
involved; and the possible
complications. The patient should also
have a general idea of the time required
from surgery to recovery. In addition, he
should have an opportunity to ask
questions.
The first nursing intervention in a
quadriplegic client who is experiencing
autonomic dysreflexia is to elevate his
head as high as possible.
Usually, patients who have the same
infection and are in strict isolation can
share a room.
Veracity is truth and is an essential
component of a therapeutic relationship
between a health care provider and his
patient.
Beneficence is the duty to do no harm
and the duty to do good. There’s an
obligation in patient care to do no harm
and an equal obligation to assist the
patient.
Nonmaleficence is the duty to do no
harm.
Tyramine-rich food, such as aged
cheese, chicken liver, avocados,
bananas, meat tenderizer, salami,
bologna, Chianti wine, and beer may
cause severe hypertension in a patient
who takes a monoamine oxidase
inhibitor.
Projection is the unconscious assigning
of a thought, feeling, or action to
someone or something else.
Sublimation is the channeling of
unacceptable impulses into socially
acceptable behavior.
Repression is an unconscious defense
mechanism whereby unacceptable or
painful thoughts, impulses, memories, or
feelings are pushed from the
consciousness or forgotten.
People with obsessive-compulsive
disorder realize that their behavior is
unreasonable, but are powerless to
control it.
A significant toxic risk associated with
clozapine (Clozaril) administration is
blood dyscrasia.
Adverse effects of haloperidol (Haldol)
administration include drowsiness;
insomnia; weakness; headache; and
extrapyramidal symptoms, such as
akathisia, tardive dyskinesia, and
dystonia.
Hypervigilance and déjà vu are signs of
posttraumatic stress disorder (PTSD).
24. NCLEX Online Resources
NCLEX-RN Official Website
(https://www.ncsbn.org/nclex.htm)
Registration for the NCLEX
(https://portal.ncsbn.org/)
NCLEX-RN Practice Questions—Over
2,100 free sample questions
(http://nurseslabs.com/nclex-practice-
questions/)
20 NCLEX Tips and Strategies Every
Nursing Students Should Know
(http://nurseslabs.com/20-nclex-tips-
strategies-every-nursing-students-
know/)
12 Tips to Answer NCLEX Select All That
Apply (SATA) Questions
(http://nurseslabs.com/tips-answer-
select-apply-questions-nclex/)
5 Principles in Answering Therapeutic
Communication Questions—great tips
on how to answer TheraCom questions
(http://nurseslabs.com/5-principles-
answering-therapeutic-communication-
questions/)
11 Test Taking Tips & Strategies For
Nurses (http://nurseslabs.com/11-test-
taking-tips-strategies/)
Nursing Bullets—collection of bite-sized
nursing information, great for reviews!
(http://nurseslabs.com/tag/nursing-
bullets-2/)
Kevin’s Ultimate Guide: 28 Free NCLEX
Resources
(http://www.kevinsreview.com/nclexblo
g/ultimate-guide-28-free-nclex-reviews-
questions-and-resources/)
NCLEX Daily—Facebook page that posts
daily questions for NCLEX
(https://www.facebook.com/nclexdaily)
9. Via: http://nurseslabs.com/nclex-cram-sheet/
25. NCLEX Books
Saunders Comprehensive Review for the
NCLEX-RN by Silvestri, 6th edition
(http://amzn.to/1MhSw3C)
Saunders Q & A Review for the NCLEX-
RN Examination by Silvestri, 6th edition
(http://amzn.to/1J6gOhO)
Saunders 2014-2015 Strategies for Test
Success – Passing Nursing School and
the NCLEX Exam by Silvestri, 3rd edition
(http://amzn.to/1F45gJ8)
Saunders Q&A Review Cards for the
NCLEX-RN Examination by Silvestri and
Silvestri, 2nd edition
(http://amzn.to/1Ahi5yB)
Davis’s NCLEX-RN Success by
Lagerquist, 3rd edition
(http://amzn.to/1zbKboZ)
Mosby’s Comprehensive Review of
Nursing for the NCLEX-RN Exam by
Nugent et al., 20th edition
(http://amzn.to/1ytMYIR)
Kaplan NCLEX RN 2013-2014 Edition:
Strategies, Practice, and Review
(http://amzn.to/171hdQR)
Lippincott’s NCLEX-RN Questions and
Answers Made Incredibly Easy, 5th
edition (http://amzn.to/1vpd6Et)
Lippincott’s NCLEX-RN Alternate-Format
Questions, 5th edition
(http://amzn.to/19dEEIz)