This document provides information on postpartum care. It discusses the aims of postpartum care including supporting the mother and family, preventing and treating complications, supporting breastfeeding, educating on nutrition and contraception, and immunizing infants. It outlines the needs of women, newborns, and special groups during the postpartum period. These include information, counseling, health care, social support, and integration. The document also discusses postpartum exercises, nutrition, resuming sexual activity, contraception, coping with deaths, counseling, and formats used for investigating maternal deaths.
Introduction about postnatal care
Define postnatal care
Aims & objectives postnatal care
Important conditions we should enquire in postnatal care
Schedule of postnatal care
Postnatal exercise
Advice given to the mother during discharge postnatal care
Advice regarding family planning and sterilization during puerperium
Puerperium is the period following childbirth during which the body tissues, specially the pelvic organs revert back approximately to the pre-pregnant state both anatomically and physiologically. puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks when the uterus becomes regressed almost to the non-pregnant size.
Introduction about postnatal care
Define postnatal care
Aims & objectives postnatal care
Important conditions we should enquire in postnatal care
Schedule of postnatal care
Postnatal exercise
Advice given to the mother during discharge postnatal care
Advice regarding family planning and sterilization during puerperium
Puerperium is the period following childbirth during which the body tissues, specially the pelvic organs revert back approximately to the pre-pregnant state both anatomically and physiologically. puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks when the uterus becomes regressed almost to the non-pregnant size.
Postnatal care (PNC) for the mother should respond to her special needs, starting within an hour after the delivery of the placenta and extending through the following six weeks. The care includes the prevention, early detection and treatment of complications, and the provision of counselling on breastfeeding, birth spacing, immunization and maternal nutrition. To standardise the PNC service, you are advised to use the screening, counselling and postnatal care cards. These cards ensure that you have covered all the essential steps in every home visit.
this ppt is beneficial for nursing and obstetric and gynaecology students.
Antenatal exercises are exercises performed by the women in their antenatal period to enhance the circulation and prevent various kind of complications. It also gives a feeling of well being to the women.
This topic contains detailed description regarding Normal puerperium, it's definition, duration, phases, involution of uterus and other pelvic organs, lochia, general physiological changes of puerperium, lactation, management of normal puerperium, management of ailments and postnatal care.
Postnatal care (PNC) for the mother should respond to her special needs, starting within an hour after the delivery of the placenta and extending through the following six weeks. The care includes the prevention, early detection and treatment of complications, and the provision of counselling on breastfeeding, birth spacing, immunization and maternal nutrition. To standardise the PNC service, you are advised to use the screening, counselling and postnatal care cards. These cards ensure that you have covered all the essential steps in every home visit.
this ppt is beneficial for nursing and obstetric and gynaecology students.
Antenatal exercises are exercises performed by the women in their antenatal period to enhance the circulation and prevent various kind of complications. It also gives a feeling of well being to the women.
This topic contains detailed description regarding Normal puerperium, it's definition, duration, phases, involution of uterus and other pelvic organs, lochia, general physiological changes of puerperium, lactation, management of normal puerperium, management of ailments and postnatal care.
Case Study Report on PIH and Severe Pre eclampsiaRashmi Regmi
it is a case study report on PIH and Severe Pre eclampsia
I did when I was posted on Kist Medical TEaching Hospital for Midwifery Practicum
Prepared by:
Rashmi Regmi
B Sc Nursing
Manmohan Memorial Institute Of health Sciences
Approach to internship (mbbs in bangladesh perspective)Pritom Das
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
Do Adolescents with Eating Disorders Ever Get Well?Dr David Herzog
Dr. David Herzog presents a slideshow regarding adolescents and their struggle with eating disorders. Do they ever get better and move past their eating disorders?
Antenatal care which is just the care given to a pregnant woman through out pregnancy from the time of conception until the time the woman goes into labor.
12SOAP Note Patient with UTIUnited StateEttaBenton28
1
2
SOAP Note Patient with UTI
United State University
FNP xxx: Common Illness Across the Lifespan -Clinical Practicum
Dr. xxxx
SOAP Note Patient with UTI
ID: L.U. a female patient presented to the clinic accompany by self, patient is a reliable historian.
Client’s Initials: L.U
Age :65 years.
Race: African American
Gender: Female
Date of Birth: 08
Insurance: BlueCross BlueShield .
Marital Status: Married
Subjective: “ I have been having pain and burning during urination for two weeks now and the pain goes to my lower abdomen, and I have been unable to hold urine, I now urinate on myself because I can no longer hold it until I get to the bathroom”.
CC: Pain and burning during urination.
HPI:
Patient stated symptoms began within the past two weeks and have worsened over the past seven days. The patient complains of severe pain and burning sensation during urination that radiates to lower abdomen, with urgency. The urine is cloudy and has a foul smell odor. After attempting to pass urine, the pain subsides for a little while, yet it reoccurs. Patient states that she has been sexually active only with the same partner for the past 15 years. On assessment patient reports pain of 8 /10 on pain scale. Patient denies having blood in urine, fever, headache, shortness of breath or chest pain at the moment.
ROS
Constitutional: Patient states she is in good state of health she denies headache , chest pain weakness fever chills, weight loss or gain.
Eyes: Denies double vision, change in vision factors, or blurry vision.
Ears/Nose/Mouth/Throat: denies sore throat, hearing issues, or nose congestion.
Cardiovascular: denies any kind of orthopnea, rapid heart rate, palpitations, or chest pain.
Pulmonary: Denies
Gastrointestinal: c/o moderate to severe pain in the abdominal area.
Genitourinary: acknowledged presence of increase in urgency and frequency of urination. Major pain while urinating for the past ten days.
Musculoskeletal: Denies any kind of pain
Integumentary & breast: Denies issues
Neurological: Denies issues
Psychiatric: Denies any kind of depression or mood swing
Endocrine: Denies having any problem
Hematologic/Lymphatic: Denies
Allergic/Immunologic: No Known allergy
Past Medical History:
· Medical problem list: patient denies having any major illnesses and only reports headaches and sometimes common seasonal allergy or cold.
· Denies history of chronic medical problems with father or mother.
· Preventative care: None indicated
· Surgeries: Denies
· Hospitalizations: Denies
· LMP: Patient states she do have a 28 days menstrual cycle and the last cycle was 2 weeks ago. She has had three pregnancies and three cesarean section.
Allergies: No known food or drug allergy
· Medications: Patient takes only Centrum vitamins and sometimes Tylenol for headache. Family History: Patient’s mother has hypertension that she manages by taking daily medication and exercising. The patient’s father has hypertension too a ...
1
2
SOAP Note Patient with UTI
United State University
FNP xxx: Common Illness Across the Lifespan -Clinical Practicum
Dr. xxxx
SOAP Note Patient with UTI
ID: L.U. a female patient presented to the clinic accompany by self, patient is a reliable historian.
Client’s Initials: L.U
Age :65 years.
Race: African American
Gender: Female
Date of Birth: 08
Insurance: BlueCross BlueShield .
Marital Status: Married
Subjective: “ I have been having pain and burning during urination for two weeks now and the pain goes to my lower abdomen, and I have been unable to hold urine, I now urinate on myself because I can no longer hold it until I get to the bathroom”.
CC: Pain and burning during urination.
HPI:
Patient stated symptoms began within the past two weeks and have worsened over the past seven days. The patient complains of severe pain and burning sensation during urination that radiates to lower abdomen, with urgency. The urine is cloudy and has a foul smell odor. After attempting to pass urine, the pain subsides for a little while, yet it reoccurs. Patient states that she has been sexually active only with the same partner for the past 15 years. On assessment patient reports pain of 8 /10 on pain scale. Patient denies having blood in urine, fever, headache, shortness of breath or chest pain at the moment.
ROS
Constitutional: Patient states she is in good state of health she denies headache , chest pain weakness fever chills, weight loss or gain.
Eyes: Denies double vision, change in vision factors, or blurry vision.
Ears/Nose/Mouth/Throat: denies sore throat, hearing issues, or nose congestion.
Cardiovascular: denies any kind of orthopnea, rapid heart rate, palpitations, or chest pain.
Pulmonary: Denies
Gastrointestinal: c/o moderate to severe pain in the abdominal area.
Genitourinary: acknowledged presence of increase in urgency and frequency of urination. Major pain while urinating for the past ten days.
Musculoskeletal: Denies any kind of pain
Integumentary & breast: Denies issues
Neurological: Denies issues
Psychiatric: Denies any kind of depression or mood swing
Endocrine: Denies having any problem
Hematologic/Lymphatic: Denies
Allergic/Immunologic: No Known allergy
Past Medical History:
· Medical problem list: patient denies having any major illnesses and only reports headaches and sometimes common seasonal allergy or cold.
· Denies history of chronic medical problems with father or mother.
· Preventative care: None indicated
· Surgeries: Denies
· Hospitalizations: Denies
· LMP: Patient states she do have a 28 days menstrual cycle and the last cycle was 2 weeks ago. She has had three pregnancies and three cesarean section.
Allergies: No known food or drug allergy
· Medications: Patient takes only Centrum vitamins and sometimes Tylenol for headache. Family History: Patient’s mother has hypertension that she manages by taking daily medication and exercising. The patient’s father has hypertension too a ...
MOTHER AND CHILD HEALTH CARE is an important topic in community. They are two vulnerable group who need special care that's why government provides special care to them for preventing mortality rate of both. Mother is pillar of the family and child is future of nation.
*I hope its help you all for preparation part 1 exam for MRCOG & MOG and your daily job.Good Luck May ALLAH bless our work and study,Good luck to all.dont forget to pray to ALLAH.if i wrong please correct me..process of learning..
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
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
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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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
2. The postpartum period
(puerperium) is from the
end of labour until the
genital tract has returned to
normal. It usually last for
42 days.
INTRODUCTION
3. The Aims of Postpartum Care:
Support mother and family
Prevention, early diagnosis and treatment of
complications
Referral
counselling
4. The Aims of Postpartum Care:
Support of breastfeeding
Educate on nutrition, and supplementation
Counselling contraception and the resumption of
sexual activity
Immunization of infant
5. Is to increase the awareness of warning
signal and appropriate intervention at all
level.
About 2/3 of the maternal deaths occur
during the postnatal period
RATIONALE
6. NEEDS OF WOMEN AND NEWBORN
1.Information/counselling on:
Herself-Health
Self care
Sexual life
Nutrition
Contraception
7. NEEDS OF WOMEN AND NEWBORNNEEDS
NEEDS OF WOMEN AND NEWBORN
2. Support on physical &
psychological
from :
Health care providers
Partner and family
Employer
8. NEEDS OF WOMEN AND NEWBORN
3.Health care for suspected or occurring
complications eg PPH/Fever
4. Time to care for the baby (esp if on bottle
feeding)
5. Help with domestic tasks
9. NEEDS OF WOMEN AND NEWBORN
6. Social reintegration into
her family and community
7. Protection from
abuse/violence Women
10. WOMEN MAY FEAR
Inadequacy ( physical and Emotional )
Loss of marital intimacy -
Isolation
Constant responsibility for care for the baby and
others
13. NEEDS OF SPECIAL GROUPS
NO. Problems Steps to be taken
Women
staying
in
Remote
area
Maternal Mortality Ratio
(MMR) is higher compared
to the general population
Higher incidence of
pregnancy problems
Mobile group and
inaccessible
Delay discharge from the
hospital
Discharge to ‘pusat transit’/
any other health facilities and
keep them there
Education of patients and
support group
14. NEEDS OF SPECIAL GROUPS
NO. Problems Steps to be taken
Urban
poor
Poor ante natal care
leading to postpartum
problems
Non-compliance to post
natal care plan/ defaulter
Inaccessibility
Cost and implications
Education regarding the
importance of post natal
care especially those
with problems
Reassurance, care is
totally health directed
Availability of services at
all centres
15. NEEDS OF SPECIAL GROUPS
NO. Problems Steps to be taken
Single
mothers
They have poor social
support
They are usually financially
unstable
The pregnancy may be
unwanted
Delay discharge They
should be encouraged to
see a social workers
Fees can be waived
Counselling should be
given
Option on adoptions / social
support should be given
from the hospital
16. NEEDS OF SPECIAL GROUPS
NO. Problems Steps to be taken
Illegal
immigrants
Poor ante natal care
leading to postpartum
problems
Non-compliance to post
natal care plan/ defaulter
Inaccessibility
Cost and implication
Legal/ immigrant
implication
Education regarding the
importance of post natal
care especially those with
problem
Reassurance, care is totally
health directed.
Waving charges for
indicated care (Refer to fee
act)
Availability services to all
centres
17. FREQUENCY OF POSTNATAL CARE
1.Day 1
2.Day 2
3. Day 3
4.Day 4
5. Day 6
6.Day 10
7. Day 20
19. Every visit
Mother
Health and well-being.
Symptoms of abnormal lochia,
Chest pain,
Difficulty in breathing,
Redness and inflammation of lower limbs
Calf swelling and tenderness.
21. Ask Mother about Baby:
Health and well-being.
Feeding
Bowel opening
Passed urine
Other concerns.
Every visit
22. Assessment On Baby
body weight
body temperature
eyes, skin
umbilical cord.
If the mother accompanies her baby in the ward, the
postnatal care should be continued for the mother by
the hospital staff as scheduled.
24. CHECK LIST TO IDENTIFY HIGH RISKS
Senarai semak bagi mengesan factor risiko semasa post
natal digunakan oleh anggota jururawat/ pegawai
perubatan ketika menjalankan jagaan postnatal.
Ibu diberikan pemeriksaan post natal mengikut senarai
semak dan carta alir adalah seperti dalam rajah 1.
Jika ibu tersebut diberi kod merah, kes tersebut haruslah
dirujuk ke hospital dan cara pengendaliannya adalah sepert
dalam jadual 1.
25. CHECK LIST TO IDENTIFY HIGH RISKS
Jika ibu tersebut diberi kod warna kuning, kes
dirujuk kepada pegawai perubatan/ Pakar Perubatan
Keluarga (FMS) klinik kesihatan atau hospital dan
cara pengendaliannya adalah seperti jadual 2.
26. Carta Alir Pengendalian Kes postnatal
JADUAL 1: PENGENDALIAN KES-KES BERISIKO KOD MERAH
JADUAL 2: PENGENDALIAN KES-KES BERISIKO KOD KUNING
APPENDIX 7
SENARAI SEMAK PEMERHATIAN PENYUSUAAN
STANDARD OPERATING PROCEDURE
FLOW CHART FOR INVESTIGATION AND REVIEW OF MATERNAL DEATH
27. NUTRITION
Mothers
eat a healthy
balanced diet
vitamins
minerals.
plan simple and healthy meals that include
choices from all of the recommended groups
from the food pyramid.
28.
29. Resumption of sexual activity post
natally
Some Studies shown
By eight weeks postpartum 71% of respondents
had resumed intercourse, and by ten weeks 90%
of the women who had partners had resumed
intercourse (Glazener 1997).
Another factor that influences sexual behavior
post partum is pain related to perineal damage
and sutures, caused by vaginal tears and
episiotomies (Glazener 1997).
30. Resumption of sexual activity cont..
Mother and her partner should decide together
Sexual intercourse may be resumed after mother’s
vaginal bleeding has stopped and stitches are
healed (usually within 4- 6 weeks)
Be aware that sex first few times following birth
may be painful – Advised for lubricants and
comfortable positioning.
31. Contraception:
Counseling to all postnatal mothers regarding the
risk of next pregnancy.
Should be started before any sexual activity.
Offered to all Postnatal mothers especially those
high risk cases.
Method as in MEC (MOH 2006)
All high risk mothers should be registered in both
PPC and FP Clinic.
32. POSTNATAL EXERCISE
1. Pelvic floor exercise
Start soon after birth.
Reduce the possibility of stress
incontinence and restore the pelvic floor
muscle strength.
2. Position
Sitting, standing or crook lying
3. Steps
Imagine you are trying to hold back a
stream of urine and tighten your muscles to
prevent leaking.
Breath normally, hold for 5 seconds.
Do not tighten the gluteal and thigh
muscles
Relax for 10 seconds
Repeat 10 times
33. ABDOMINAL EXERCISE
Benefits:
Strengthen the abdominal muscle
Improve abdominal stabilization in the
activities of daily living.
Position:
Lie on the floor with your knees bent
and head supported
Steps:
Breath in, then breath out as you pull
in your abdomen and push your lower
back down into the floor.
Hold for 5 seconds and relax/
Repeat 5 times.
34. PELVIC EXERCISE
Benefits:
To maintain mobility of the pelvis
To tone the natural abdominal corset
Improve posture
Prevent and relieve backache
Position:
Lie down with the back supported, arm
by the side, knees bent together.
Steps:
Tighten the abdominal muscles and
move the coccyx forward.
Hold for 5 seconds.
Repeat 5 times.
35. ARM EXERCISES
Benefits:
Relieve heartburn.
Improve circulation
Improve breathing and lung expansion.
Position:
Stand upright
Steps:
Stand straight with feet apart. Keep
your shoulders back.
Lift both arms as far back as you can
reach without bending your elbows.
Move your arms forward by 180 .
Swing arms back again and repeat 5
times.
36. ANKLE EXERCISES
Benefits:
Improve circulation
Maintain range o motion.
Position:
Long sitting – sitting on the floor with
both legs straight.
Sitting – on the chair with the leg
supported or elevated.
Steps:
Lift one foot off the floor and circle the
ankle several times, first one way the
the other.
Don’t move your knee.
Repeat with the other leg
37. WARNING SIGNS TO TERMINATE EXERCISE
Dyspnoea before exertion
Dizziness
Headache
Chest pain
Muscle weakness
Calf pain or swelling (to rule out thrombophlebitis)
38. COPING WITH DEATHS
GRIEF:
Emotional and somatic responses felt by an
individual on the death of another individual.
More intense if the death occurs in a person who is
closely related.
41. COUNSELLING
Death (Maternal or Stillbirth or Neonatal Death)
The bereaved persons needs:
- talk about the loss
- express feelings of the sadness, guilt or anger
- understand the normal course of grieving
Help needed:
- to accept that loss is real
- to work though stages of grief
- to adjust to life without the deceased
42. GUIDELINES ON COUNSELING
Provide an environment and circumstances for feeling
hurt ,guilty, angry or other strongly negative feelings.
Allow the spouse and relatives to ventilate.
Validate the extent of grief.
Be sensitive for the need for postmortem in cases of sudden
death.
Encourage spouse to built a support network of family and
friend.
Be alert for suicidal intention or behavior.
Remember that grief takes time.
43. THE "DO"THE "DO" THE “DON’T”THE “DON’T”
Express sympathy
Talk about deceased by name
Elicit question about
circumstances of the death.
Elicit question about feeling
and about the death has
affected the person.
Have a casual or passive
attitude
Give statements that death is
for the best
Assume that the bereaved is
strong and will get through this
Avoid discussing the death
44. TEAR
T - To accept the reality of the loss
E - Experience the pain of the loss
A - Adjust to the new environment
without the lost object
R - Reinvest in the new reality
45. FORMATS USED FOR INVESTIGATION AND REVIEW
OF MATERNAL DEATHS.
KIK/K1-1 -Penyiasatan Kematian Ibu
Mengandung pind.Jul.91
KIK/K1-2 -Investigation of Maternal
Deaths
KIK/K1-3 -Borang Maklumat Kes
Kematian Ibu.
KIK/K1-4 -Feedback format on Maternal
Deaths from State to the
District to State Level.
46. KIK/K1-5 Reporting Format to QA
health Services Committee by
technical Committee for
Investigation and review of
Maternal Deaths at District,
State and National levels
KIK/K1-6 Borang Maklumat bedahsiasat
Atas Kes Kematian Ibu