Team Faculty Of Nursing internship 💙

لأجل أننا مُسلمون وتعظيم شعائرِ الله فريضة Eid Mobarak 🕋♥️ وكل عامٍ وأنتم بخير ♥️ . أدام الله بَهجة أعَيادكم بقُرب مَن تحبّون ♥️♥️♥️♥️♥️♥️♥️🦋:)

. ' مُــحاضـرات طـرق بـحـث ' . ↳ Overview about research ↳ Research process ↳ Cross sectional research designs ↳ Analytical research design ↳ Experimental research design ↳ Sampling ↳ Data Collection ↳ Qualitative

استراحه بصمجي ونخش عاللي بعده 💀😂😂 ودعواتكوا لشباب متقدم اطفال 🤍

Duration of the first stage of labor: 🔻In multipara : about 6-8 hours. 💎In nullipara : about 12-16 hours. Duration of the second stage of labor: 🔻In multipara : about 20-30 minutes. 💎In nullipara : about 1-2 hour. Duration of the third stage of labor: 💎🔻A time frame of 5-20 minutes is considered normal for both primipara and multipara. 🔗 💫 Cervical Dilatation 🔻Nulliparous : 1.2 cm/hr 💎Multiparous : 1.5 cm/hr 📌لو جه طلب average of cervical dilation during active phase هناخد الاتنين نجمعهم ونقسمهم علي 2 هيدينا 1.9 يعني بالتقريب 2 cm

شابتر Labor

Descent

is the moving of the fetus through the birth canal.

Engagement

occurs when the largest diameter of the fetal presenting part has passed the pelvic inlet.

Flexion

of the fetal head allows the smallest head diameters pass through the pelvis.

The station

is the relationship of the fetal presenting part to the level of the ischial spines.

Lightening

is the descent of the fetus toward the pelvic inlet before labor.

Lie

is the relationship of the long axis of the fetus to the long axis of the mother.

Molding

The sutures and fontanels allow the bones of the fetal head to move slightly, changing the shape of the fetal head so it can adapt to the size and shape of the pelvis.

Presentation

is the fetal part that first enters the pelvic inlet.

تاني تاني😂

خلال الحمل ال placenta بتشتغل كغده وبتفرز هرومونات تساعد علي استمرار الحمل.. 🔵hCG 》 ●ودا بيبدا بيظهر في دم الام بدايه من (اليوم العاشر) 🔟 وبيتقاس عن طريق الدم او البول ●وممكن ياكد الحمل لو موجود في البول بنسبه اكبر من > 50IU/L ●Peaks at 9-10 weeks ●بيحفز الجسم الاصفر يفرز الاستروجين والبروجستيرون الي حين نضوج الplacenta ●if hCG is high >> twins hydatidiform mole Choriocarcinoma Embryonal carcinoma ● if levels are low>> ectopic pregnancy , threatened abortion , or missed abortion can occur. 🔵progesterone 》 ●اهم وظيفه ليه انه بيسهل ال implantation وبيقلل الutrine contraction ●بيفرزه الجسم الاصفر لحد اليوم 35 بعد كدا بيتفرز من الPlacenta ●promotes smooth muscle relaxation  and raises body temperature. ●prevents preterm labor 🔵Estrogen (oestradiol) 》 ●Breast and nipple growth, ● and pigmentation of the areola ●Promote uterine blood flow, myometrial growth, cervical softening ●بيزود الحساسيه لمستقبلات الاوكسيتوسين في عضلات الرحم ●Water retention and protein synthesis. 🔵hPL/HCS》 📌ودا الهرمون اللي بيجهز جسم الام للbreast feeding ●Produced by syncytiotrophoblast ●له وظيفه وتركيب كميائي شبهه ال growth hormone ●بيظبط عمليه الايض (metabolism) عند الام عشان يزود الenergy اللي بتروح للجنين ●بيزود افراز الانسولين ولكنه بيقلل تأثيره المحيطي وبيقلل الحساسيه للانسولين 📌If levels are low>> , threatened abortion or intrauterine growth restriction (IUGR) can occur. ●Promotes fetal growth by regulating glucose available to the developing human. ●Stimulates breast development in preparation for lactation. 🔵Prostaglandin 📌بيزود الcontraction  اللي بتحصل في الuterus ودا اللي بدوره بيسهل الtransport of sperm 🔵الpitutary gland بيحصل فيها تضخم وهينتج عن التضخم دا زياده في شويه هرمونات🤏  >prolactin > plasma adreno _corticotrophic hormone (ACTH) >cortisone ◀️بس الكلام دا مش هيمشي علي كل الكورتيزون تؤ تؤ في مستويات اسمها unbound ودي من اسمها غير مقيده يعني مش مجبره دي مستواها هيفضل ثابت عادي مش هيزيد ❗️بس فيه هرمون بيحصله inhibit يعني تثبيط ودا ال Gonadotrophin هرمون الغدد التناسليه 📌اخر حاجه بالنسبه للغده النخاميه انها بتفرز الاوكسيتوسين من الفص الخلفي خلال الfirst stage of labor و خلال الsuckling عشان بيزود الكونتراكشن زي ما عرفت في العملي 🔵ال thyroid gland 👈كذلك بيحصل فيها تضخم ودا هيزود افراز ال T3 و الT4  (ثروكسين ) بس هيرجعو طبيعي بعد الحمل والهرمومات دي بتعدي للplacenta ولكن بنسب ضئيله جدا 👈اما الTSH هيقل شويه ولكن في المستوي الطبيعي 👈ال(thyroid-bindung globulin (TBG هيتضاعف 👈وال iodide هيقل 📌بالمختصر كله هيزيد ماعدا اتنينTSH و iodide __ ___ 💥مهم جداً 💥 🔵Estradiol »»»» during the nonpregnant 🔵 Estriol = estrogen »»»» during the pregnancy 🔵 Estrone »»»» during menopause

تعالى معايا هقولك حدوتة الهرمونات دي كلها 🙈 هتبدا معانا من ال menstrual بتبدا من👈 ال follicular phase ▶️ which starts on the first day of the period and ends with ovulation بيحصل فيها pituitary gland release ⟩⟩ FSH بيعمل ايه دا 🔻stimulates the growth of follicles Peak > before ovulation طب هي ايه ال follicles دي؟ 🔻Each follicle contains an egg. لما يحصل لواحده منهم development و تبقى mature بتبدا تفرز estrogen و اللي بدوره 🔻causes the endometrium to thicken و تبدا المرحلة التانية 👉ovulation phase when the dominant follicle releases its egg into the fallopian tube غالبا بنكون في ال 📌14 days before the next period egg can be fertilized > 12 to 24 hours after ovulation. 🔵The release of the egg also triggers a surge of another hormone called luteinizing hormone (LH) طب و الاخ دا بيعمل ايه دل اللي بيحول ال 🔻follicle to transform into a structure called the corpus luteum و  ايه لازمته ال corpus luteum دا في المرحلة التالتة واللي هي  The final phase 👉luteal phase 🔻The corpus luteum produces »  progesterone طب و انا ايه اللي وصلني ل هنا مهو دا اللي 📌maintain the endometrium for a potential pregnancy يعني نظريا دا اللي جابك هنا 👈👉 و هنا نخش بقى في حالتين اما يحصل fertilization او لا لو لا 🔻the corpus luteum degenerates "" 22-24th day of the cycle. "" and the levels of estrogen and progesterone drop. 🔻FSH and LH increase 🔻This causes the endometrium to break down and the cycle to start over again بملخص سريع تاني 🔵FSH > development follicles >Help follicle > to produce estrogen 🔵LH > Formation of corpus luteum >stimulates the corpus luteum to > produce progesterone ....... 👈اما لو حصل fertilization فا اولا 🔵FSH and LH: decrease; produced by the pituitary gland 🔵Progesterone and estrogen: increase; produced by the corpus luteum and the placenta و تبدا حياة الزيجوت كالاتي..

🔵Goodle's sign :softning of cervix 🔵Shadwik's sign: Bluish color of cervix and vagina 🔵 Ripening: Softning, shortening and dilation of cervix 🔵Hager's sign : Softning of isthmus of cervix 🔵Retraction: Cervical shortening

شابتر physiology of normal pregnancy • 3⃣ week 》 [  " 3⃣ " layer formation ] • Pre-embryonic stage》⟩ fertilization to 2⃣ WeeK • Fetal stage 》9⃣ WeeK to birth • Embryonic 》 2⃣ WeeK :  8⃣ WeeK • Ovum》》 24 to 48 h 🔘 • Sperm  》 24 : 72 h 〰〰 Sperm 300 : 600 million 〰〰 • seminal fluid 》3⃣ ml 🔵Miotic division ➗ 》 [ كل 12 ساعة ] • Morula . 》》 3⃣rd Day • Blastocyst 》》5⃣th Day • trophoblast development finger 》> 6⃣th Day • blastocysts تنغرس " implantation" بشكل كامل في بطانه الرحم وتسمي decidua  》 10th Day 🔻أول سته أسابيع تحديد الجنس indistinguishable يعني لا يمكن تحديده • surface of blastocyst covered by branching villi which best development at embryonic 》 16 to17 day 🔻1 trimester amniotic fluid produce b amniotic membrane 🔺2 , 3 trimester amniotic fluid produce by fetal kidney 🔵Peak of amniotic fluid 34 week 》 800:1000 "Decrease" 》 500:600 📌Hcg first appear 🔟 day Peak 9⃣ : 🔟 Week Falls 20:22 week • Corpus lutem produce Estrogen and progesterone for》 35 day • Placenta fully developed 8:10 week • 9 month : placenta 15:25 lobe thick 3 ,, weight 600g 🔻Positive > sign حاجه بنسمعها ونشوفها ونحسها 🔺Probable > هاجر بالونه ايجابيه Hagar's sign • ballotment " second movement of fetus "  positive pregnancy test • Uterine softer and thinner at term ○ 0,5 cm • Hypertrophy of uterus 》 20 Week • At term blood flow》 500:600ml/m • Increase Blood flow increase 40:50% ↗️Increase Plasma. 》》 30% ↘️Decrease Hgb 80% ⤴️Coagulability slightly increase Plug operculum (show) dislodge: early signs of pregnancy + formed 8w ↗️Breast increase 500 each one Veins in breast visible.   》》🎱  , 8⃣ WeeK • Montgomery's tubercles at 12th w,, (غدد بارزه حولين الحلمه ) 🤰Lordosis وضع للأم في نهايه الحمل • Last trimester dyspnea • Fetal sac 6⃣ : 7⃣ w . - بنشوفه بال ultra sound • measured head 》 13 WeeK ✦ Weight: Total Weight gain》 9:12 kg ,  و ممكن 》gain 17 kg First trimester >>> 1:2 kg - Second trimester >>> 6:7 kg - Third trimester >>> 3:4 kg

🔻 Position

أرقام postpartum

↳ Stages after delivery Acute phase first 24 h • Early phase first one week • Late Phase up to 6 weeks ↳ Stages after abortion • Early stage ten days • Late stage after 10 days • Uterus weight become 50mg • Healing Placenta site at 7th weeks ( 40 days ) ↳ Lochia • during first 4-6 weeks • Healing Large raw area left on inner uterine 2 Weeks • Maximum Bleeding in first 2-3 days ↳ Amount of lochia • Scanty 1 inch 2.5 cm • Light 4 inch 10 cm • moderate 6 inch 15.2 cm • Heavy one pad saturated whitin 1 hours • Excessive one pad saturated whitin 15 hours ↳ Cervix • immediately after delivery opening 2-3 cn • After 7 days opening for just tip of finger ↳ Vagina • Rugea reappear in third week ↳ Bowel elimination ↣ 2 to 3 days ↳ Cardiac output return ↣ 2 to 3 weeks ↳ Wight الست الحامل بتزيد ١٠ كجم Time of delivery of the baby 4kg After delivery loss due elimination of water 3kg ↳ Postpartum diuresis began within 12h continue 2-5 day • Spontaneous voiding 6-8 h • urine should be passed approximately 8-12h ↳ involution • Immediate after delivery ↣ halfway between the umbilicus and symphysis pubis • at 1h postpartum ↣ below slightly the level of the umbilicus • about 6-12h ↣ at level of umbilicus • within 12h ↣ Above 1/2 inch umbilicus • by 24 h ↣below 1/4 inch umbilicus • 10 - 14 days ↣ pelvic cavity