Nurses association

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ToDaYs imPoRtANt Point 👉 Oligomenorrhea = irregular, infrequent menstrual cycle more than 35 day in duration 👉 Polymenorrhoea = Regular and frequent menstrual cycle less than 21day in duration. 👉 Menorrhagia = Excessive menstrual blood loss more than 80 ml with normal duration of cycle. 👉 Mettorhagea = Excessive irregular menstrual cycle with normal amount of menstrual blood loss. 👉 Meno-mettorhagea = Excessive irregular menstrual cycle with excessive amount of blood loss 👉 Hypomenorrhoea = decrease amount of blood loss Less than 20 ml and less than 2day in duration. 👉 Dysmenorrhea = Excessive painful menstrual bleeding with normal duration of menstrual cycle and normal amount of menstrual blood loss. 👉 Cryptomenorrhoea = present of menstrual like symptoms but absence of menstrual bleeding {Most common course- Imperforate hymen}

🔹Approximate percentage of elements in Human body :- • Oxygen - 65% • Carbon - 18% • Hydrogen - 10% • Nitrogen - 3% • Calcium - 2% • Phosphorous - 1% • Potassium - 0.35% • Sodium - 0.15% • Chloride - 0.15% • Magnesium - 0.05% • Iron - 0.0004%

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*🎯Blue man syndrome* - Amiodarone side effect *🎯Blue baby syndrome* - lack of oxygen *🎯Rad man syndrome* - Vancomycin side effect *🎯Gray baby syndrome* - Chloramphenicol side effect *🎯Bronze baby syndrome* - Phototherapy side effect *🎯Mask like face -* parkinsonism (Pragnancy mask - chloasma) *🎯Moon like  face* - cushing's syndrome & - kwashiorkor *🎯Snarling face* - myasthenia gravis

🩺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 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. @nurseschattinggroup

🩺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 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. @ nurseschattinggroup

Common Signs and Symptoms 01. PTB – low-grade afternoon fever. 02. PNEUMONIA – rusty sputum. 03. ASTHMA – wheezing on expiration. 04. EMPHYSEMA – barrel chest. 05. KAWASAKI SYNDROME – strawberry tongue. 06. PERNICIOUS ANEMIA – red beefy tongue. 07. DOWN SYNDROME – protruding tongue. 08. CHOLERA – rice watery stool. 09. MALARIA – stepladder like fever with chills. 10. TYPHOID – rose spots in abdomen. 11. DIPTHERIA – pseudo membrane formation 12. MEASLES – koplik’s spots. 13. SLE – butterfly rashes. 14. LIVER CIRRHOSIS – spider like varices. 15. LEPROSY – lioning face. 16. BULIMIA – chipmunk face. 17. APPENDICITIS – rebound tenderness. 18. DENGUE – petechiae or (+) Herman’s sign. 19. MENINGITIS – Kernig’s sign (leg flex then leg pain on extension), Brudzinski sign (neck flex = lower leg flex). 20. TETANY – hypocalcemia (+) Trousseau’s sign/carpopedal spasm; Chvostek sign (facial spasm). 21. TETANUS – risus sardonicus. 22. PANCREATITIS – Cullen’s sign (ecchymosis of umbilicus); (+) Grey turners spots. 23. PYLORIC STENOSIS – olive like mass. 24. PDA – machine like murmur. 25. ADDISON’S DISEASE – bronze like skin pigmentation. 26. CUSHING’S SYNDROME – moon face appearance and buffalo hump. 27. HYPERTHYROIDISM/GRAVE’S DISEASE – exopthalmus. 28. INTUSSUSCEPTION – sausage shaped mass, Dance Sign (empty portion of RLQ) 29. MS – Charcot’s Triad (IAN) 30. MG – descending muscle weakness 31. Guillain Barre Syndrome – ascending muscle weakness 32. DVT – Homan’s Sign 33. CHICKEN POX – Vesicular Rash (central to distal) dew drop on rose petal 34. ANGINA – Crushing stubbing pain relieved by NTG 35. MI – Crushing stubbing pain which radiates to left shoulder, neck, arms, unrelieved by NTG 36. LTB – inspiratory stridor 37. TEF – 4Cs’ Coughing, Choking, Cyanosis, Continous Drooling 38. EPIGLOTITIS – 3Ds’ Drooling, Dysphonia, Dysphagia 39. HODGEKIN’S DSE/LYMPHOMA – painless, progressive enlargement of spleen & lymph tissues, Reedstenberg Cells 40. INFECTIOUS MONONUCLEOSIS – Hallmark: sore throat, cervical lymph adenopathy, fever. 41. PARKINSON’S – Pill-rolling tremors 42. FIBRIN HYALIN – Expiratory Grunt 43. CYSTIC FIBROSIS – Salty skin 44. DM – polyuria, polydypsia, polyphagia 45. DKA – Kussmauls breathing (Deep Rapid RR) 46. BLADDER CA – painless hematuria 47. BPH – reduced size & force of urine 48. PEMPHIGUS VULGARIS – Nikolsky’s sign (separation of epidermis caused by rubbing of the skin) 49. RETINAL DETACHMENT – Visual Floaters, flashes of light, curtain vision 50. GLAUCOMA – Painfull vision loss, tunnel/gun barrel/halo vision (Peripheral Vision Loss) 51. CATARACT – Painless vision loss, Opacity of the lens, blurring of vision 52. RETINO BLASTOMA – Cat’s eye reflex (grayish discoloration of pupils) 53. ACROMEGALY – Coarse facial feature 54. DUCHENNE’S MUSCULAR DYSTROPHY – Gowers’ sign (use of hands to push one’s self from the floor) 55. GERD – Barretts esophagus (erosion of the lower portion of the esophageal mucosa) 56. HEPATIC ENCEPHALOPATHY – Flapping tremors 57. HYDROCEPHALUS – Bossing sign (prominent forehead) 58. INCREASE ICP – HYPERtension BRADYpnea BRADYcardia (Cushing’s Triad) 59. SHOCK – HYPOtension TACHYpnea TACHYcardia 60. MENIERE’S DSE – Vertigo, Tinnitus 61. CYSTITIS – burning on urination 62. HYPOCALCEMIA – Chvostek & Trosseaus sign 63. ULCERATIVE COLITIS – recurrent bloody diarrhea 64. LYME’S DSE – Bull’s eye rash Ottorhea s/s of basilar fracture @nurseschattinggroup

*Normal value of important subastance in blood.* *Glucose 100~120 mg/dl* *creatinine 0•5~1•5mg/dl* *cholesterol 200mg/dl* *plasma protein 6•4~8•3g/dl* *bilirubin 0•5~1•5mg/dl* *copper 100~200mg/dl* *iron 50~150micro g/dl* *calcium 9~11mg/dl* *sodium 135~145mEq/l* *potassium 3•5~5mEq/l* *magnesium 1•5~2mEq/l* *chloride 100~110mEq/l* *Bicarbonate 22~26mEq/l* *total protein 7•3g/dl* *serum albumin 4•7g/dl* *serum globulin 2•3g/dl* *fibrinogen 0•3g/dl* *A/G ratio 2•1* *IgG 1000mg/dl* *IgA 200mg/dl* *IgM 120mg/dl* *IgD 3mg/dl* *IgE 0•05mg/dl* ANTIDOTE AND DRUG OF CHOICE PROPHYLAXIS(Dx/Px):- 1.Drug for PCM poisoning :- N acetylecystine (mucomyst) 2. DOC for Acute Asthma:- Salbutamol 3.DOC for Chronic Asthma:- Salmetrol 4.Drug of choice for bipolar disorder:- Lithium 5.Drug of choice for mania:- Lithium 6.Drug of choice for acute mania:-Haloperidol 7.Drug of choice for chronic mania:-Lithum 8.Drug of choice for hyperkalamia:- Kayxalate/sodium natropuroside/insuline+dextrose 9.Drug of choice for Ketoacidosis:- Insuline+dextrose 10.Prophylaxis for Asthma:-Montalucast 11.Drug for Digitalis Toxicity:-Digibind 12.Drug of choice for Acute migraine:-Sumatripatan 13 Drug of choice for ADHD:-Methylphenidate(Amphetamine) 14.Drug of choice for Alzeihmers disease:-Tacrine/donepzil/Rivastigmine 15.Drug of choice for Myasthenia gravis:-Neostigmine 16.Drug of choice for Anaphylactic Shock:-Adrenaline 17.Drug of choice for Hyperthyroidism in pregnancy/Lactation:-Propylthiouracil 18.Drug of choice for Atonic Seizures:-Sodium valproate 19.Drug of choice for Febrile Seizures:-Diazepam 20.Antidote for Aspirine poisoning:-Sodium bicarbonate 21.Antidote for organophosphate poisoning:-Atropine 22.Drug of choice for Central Diabetic Insipidus:-Vasoprassin/desmopressin 23.DOC for Chemotherapy induced vomiting:-Ondasteron 24.DOC for chloroquine resistant malaria:-Quinine 25.DOC for cholera:Tetracycline 26.Antidote for Benzodiazapine poisoning:-Flumazenil 27.Antidote for Barbiturate poisoning:-Sodium bicarbonate 28.Antidote for Atropine poisoning:-Physostigmine 29.DOC for Chese reaction:-Phentolamine 30.DOC for Acute Gout:-Indomethacin 31.DOC for Chronic Gout:-Allopurinol 32.DOC for complicated Malaria:-Artesunate 33.Antidote for Cyanide poisoning:-Amyl nitrate 34.DOC for Depression:-Any of SSRI                 drug(Citalopram,Escitalopram,Fluoetine,Paroxetine,Sertraline,Vilazodone) 35.DOC for disease modifying anti Rheumatic drug(DMARD):-Methotrexate 36.DOC for drug induced parkinson disease:-Benzhexol 37.Choice of Muscle relaxant for Endotracheal intubation:-Succinylcholine 38.Choice for Relaxant for ECT:-succinylcholine 39.Treatment of choice for severe Depression:-ECT 40.DOC for Enteric Fever:-Ceftrixone 41.DOC for Epilepsy in pregnancy:-Lamotrigine 42.Antidote for Fibrinolytics:-Aminocaproic acid 43.DOC for BPH(Benign prostate hypertrophy):-Prozosin 44.Antidote for Heparine Toxicity:-Protamine sulphate 45.prophylaxis for herpes:-Acyclovir 46.prophylaxis for rheumatic fever:-Benzathaine penicilline 47.prophylaxis for MI:-Asprine 48.DOC for Malaria:-Chloroquine 49.DOC for hypertensive emergency:-Sodium nitroprusside 50.DOC for hypertension in pregnancy:-Lobetalol 51.DOC for Eclampsia:-Mgso4 52.DOC for Hypothyroidism:-Levothyroxin 53.DOC for hypovolemic Shock:-IV fluids 54.Antidote for Iron toxicity :-Desferoxamine 55.DOC for Methanol poisoning:-Fomepizole 56.DOC FOR Methicillin resistant staphylococcus aureus :- Vencomycin 57.Mydriatic of choice in Adults:-Tropicamide 58.Mydriatic of choice in children:-Atropine 59.DOC for syphillis:-Benzathine penicilline 60.DOC for noctural enuresis :- Desmopressin/imipramine 61.DOC for obsessive compulsive disorders:-SSRI drug(Citalopram,Escitalopram,Fluoetine,Paroxetine,Sertraline,Vilazodone) 62.Antidote for Opiod poisoning:-Nalaxone 63. DOC for oral hypoglycemic drug in obese :- metformine 64.DOC for oral hypoglycemic drug in thin:-Sulfonylureas 65.DOC for cardiogenic Shock:-Dobutamine @nurseschattinggroup