This document provides information on common psychiatric disorders that can occur during pregnancy, including depression, anxiety disorders, eating disorders, and psychosis. It defines each disorder, lists their signs and symptoms, and discusses their management through both psychological/non-pharmacological therapies and pharmacological treatments. Nursing responsibilities are also outlined, such as caring for patients, administering medications, organizing therapy sessions, and maintaining accurate records.
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.
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.
The placenta is said to be retained when it is not expelled from the uterus even 30 minutes after the delivery of the baby
Manual placenta removal is a procedure to remove a retained placenta from the uterus after childbirth.
Mannual removal of placenta is done under GA.
Patient placed in lithotomy position
Bladder is catheterized
The placenta is said to be retained when it is not expelled from the uterus even 30 minutes after the delivery of the baby
Manual placenta removal is a procedure to remove a retained placenta from the uterus after childbirth.
Mannual removal of placenta is done under GA.
Patient placed in lithotomy position
Bladder is catheterized
Mental health includes our emotional ,psychological, and social well-being. It affects how we think, feel and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.
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Depression is more than just feeling sad or blue. It is a common but serious mood disorder that needs treatment. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, and working.
Similar to Psychiatric Disorder during Pregnancy (20)
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and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
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of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
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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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
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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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2. INTRODUCTION
• Pregnancy is generally thought to be a time of happiness
and emotional well-being for a woman. However, for
many women, pregnancy and motherhood increase their
vulnerability to psychiatric conditions such as
depression, anxiety disorders, eating disorders, and
psychosis.
3. DEFINITION
Depression: Depression is a state of low mood and aversion
to activity. Classified medically as a mental and behavioural
disorder, the experience of depression affects a person's
thoughts, behaviour, motivation, feelings, and sense of well-
being.
Anxiety: Anxiety is an emotion characterized by feelings of
tension, worried thoughts and physical changes like
increased blood pressure.
4. Eating disorders: Eating disorders are illnesses in which
the person experience severe disturbances in eating
behaviours and related thoughts and emotions.
Psychosis: Psychosis is a mental health problem that causes
people to perceive or interpret things differently from those
around them. This might involve hallucinations or delusions.
7. DEPRESSION
According to The American Congress of
Obstetricians and Gynaecologists (ACOG),
between 14-23% of women will struggle
with some symptoms of depression during
pregnancy.
• RISK FOR DEPRESSION: Having a
history of depression, Age at time of
pregnancy, living alone, having limited
social support, experiencing marital conflict
and feeling ambivalent about pregnancy.
8. Signs of Depression
Persistent sadness
Difficulty concentrating
Sleeping too little or too much
Loss of interest in activities that you usually enjoy
Recurring thoughts of death, suicide, or hopelessness
Anxiety
Feelings of guilt or worthlessness
Change in eating habits.
11. ANXIETY DISORDERS
• Anxiety is a feeling of apprehension caused by
anticipation of an ill- defined threat or danger that is not
realistically based.
• It is the emotional reaction to a known, well defined
external threat or danger.
15. EATING DISORDERS
Pregnancy can be a stressful and anxious time for
some women, especially those with an eating disorder. The
accompanying weight gain and change in body shape can
lead to recurrence or worsening of the eating disorder.
Pregnant women with eating disorders need enhanced
monitoring and postnatal support.
16. Types Of Eating Disorders
• Anorexia nervosa: Loss of appetite.
• Bulimia Nervosa: Binge eating.
Symptoms seen in high risk women who should be screened
for eating disorders
• Low body mass index.
• Concerned about weight but not overweight.
• Menstrual disturbances or amenorrhoea.
• Gastrointestinal symptoms.
• Physical signs of starvation or repeated vomiting.
• Psychological problems
17. Management
• Treat the eating disorder before pregnancy.
• Nutritional advice before pregnancy.
• Educate women about nutrition and growth of the fetus.
• Refer the woman to an eating disorder service as early in
pregnancy as possible if she has an active eating disorder.
• Joint obstetric care is needed if the woman has active anorexia
nervosa or there are concerns that she is vulnerable.
• Liaise with the health visitor to monitor infant growth and
weight gain closely.
18. PSYCHOSIS
• Psychosis is a mental health problem that causes people to
perceive or interpret things differently from those around
them. This might involve hallucinations or delusions.
• However, for women with a history of psychosis,
particularly psychosis in previous pregnancies, the relapse
rates are high, with the most common manifestations being
bipolar illness, followed by psychotic depression and
schizophrenia.
20. Signs and symptoms
Hallucinations: Hearing voices, Seeing things which other
people do not see.
Delusions: Being followed by secret agents or members of
the public, That people are out to get you or trying to kill
you.
Cognitive experiences: Concentration problems, Memory
problems, Unable understand new information, and,
Difficulty making decisions.
21. Management
Non-Pharmacological
• Cognitive Behaviour Therapy
• Family Intervention
• Art Therapy
Pharmacological
• Olanzapine: Zyprexa, Zalasta, Zolafren, Olzapin, Rexapin 7.5
mg – 10 mg.
• Haloperidol: Halidace, Hexidol, Dolteus, Dolsi, Helinase,
Typidol – 0.5 to 2mg orally 2 – 3 times per day.
22.
23. NURSING RESPONSIBILITIES
Caring for patient with acute conditions.
Administering medications
Helping patient to overcome stressful events
Interacting with patient families
Preparing and maintaining patients records, producing care
plans and risk assessments.
Organizing group therapy sessions, including social and
artistic events, aimed at promoting patients' mental recovery.
24.
25. BIBLIOGRAPHY / REFERENCES
• Annamma Jabob. A comprehensive textbook of
Midwifery and Gynaecological Nursing, Fourth
edition.pp 724-741.
• Lily Podder. Fundamentals of Midwifery and Obstetrical
Nursing. ELSEVIER.pp 374-381.
• DC Dutta’s textbook of Obstetrics. Hiralal Konar 8th
Edition.Jaypee The Health Sciences Publisher.pp 440 –
457.
• DAVIS’S DRUG GUIDE for Nurses TWELFTH
EDITION. Pp 806-808,869-870.
• Mosby’s 2020. Nursing Drug Reference. Skidmore, Third
South Asia Edition. Pp 801-803,732-734.678 – 687.
26. • National Institute for Health and Clinical
Excellence. Eating disorders. Core interventions in the
treatment and management of anorexia nervosa,
bulimia nervosa and related eating
disorders. 2004. www.nice.org.uk/guidance/index.jsp?a
ction=byID&r=true&o=10932
• Karasu TB, Docherty JP, Gelenberg A, et al. Practice
guideline for major depressive disorder in adults.
American Psychiatric Association. Am J Psychiatry
1993;150(suppl 4):1-26. PubMed Citation
• Neziroglu F, Anemone R, Yaryura-Tobias JA. Onset of
obsessive-compulsive disorder in pregnancy. Am J
Psychiatry 1992;149:947-950. PubMed Abstract