pass the board exam!!!
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8/6/2019 Pass the Board Exam!!!
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VITAL SIGNS
✔ Remittent Fever :fluctuates; non-normal between
fluctuations✔ Intermittent : “ON-
OFF”
✔ Relapsing : shortfebrile periods of a fewdays
✔ POINT OF MAXIMAL IMPULSE located at the LEFT 5 TH
INTERCOSTAL SPACE, MIDCLAVICULAR LINE
✔ PULSE DEFICIT: difference between the apical and peripheral pulse: TWO NURSES!!
✔ PULSE PRESSURE
: difference between the systolic (numerator) anddiastolic (denominator) pressure
✔ Stridor: shrill, harsh during inspiration
✔ Wheeze: high-pitched musical during expiration✔ Bubbling: gurgling sound produced by moist
secretions
PHYSICAL ASSESSMENTSKIN
✔ Pallor : pale ; inadequate circulating blood orHGB
✔ Jaundice : yellow-orange ; accumulation of bilirubin
✔ Cyanosis : blue ; increased concentration of
deoxyHGB
FLAT
✔ Macule : circumscribed,1mm-1cm
✔ Patch : irregularly-shaped; >1cm
ELEVATED
FLUID-FILLED
✔ Wheal : irregularly-shaped, reddened,elevated localized collection of edema fluid
✔ Vesicle : translucent circumscribed, roundor oval, filled with serous fluid or blood,<0.5cm
✔ Bulla : thin-walled blister, >0.5 cm, withclear serous fluid
✔ Pustule : circumscribed elevation
✔ Tumor : solid hard mass with irregularborder, >2cm
✔ Cyst : 1cm or larger, elevated,encapsulated
MATERNAL AND CHILD
PHASES OF MENSTRUAL CYCLE
PROLIFERATIVE✔ Endometrium increases its thickness 8x
REMEMBER!!F = C X 1.8 + 32C = F X 32 / 1.8
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✔ Also called: Estrogenic, Follicular or PostmenstrualPhase
SECRETORY✔ Increase Estrogen
✔ Formation of Progesterone in the Corpus Luteum
✔ Also called: Progestational, Luteal or PremenstrualISCHEMIC✔ Progesterone and Estrogen production decreases✔ Withdrawal of progesterone stimulation causes the
endometrium to degenerate
MENSES✔ Endometrium sloughs off (to cast off)
SEXUAL RESPONSE CYCLE
EXCITEMENT✔ Rapid erection of penis, clitoral enlargement and
vaginal lubricationPLATEU✔ Cowper gland releases fluids with continuous
enlargement and thickening of the penis✔ Full elevation of uterus with concurrent rising of
cervixORGASM✔ Climatic expulsive contraction of the entire urethra
with ejaculation✔ Orgasmic platform or contraction of outer third of
vaginaRESOLUTION✔ Return to pre-arousal states in
both sexes✔ FUNDUS
: Palpable above the level of symphysis pubis between 12-14 weeks: Midway between the umbilicusand symphysis pubis at 16
weeks: Level of umbilicus or 20 cmabove symphysis pubis at the20th week : Rises 1 cm per week until 36 weeks
✔ T refers to term births (after 37 weeks gestation
✔ P refers to premature births
✔ A refers to abortions
✔ L refers to living children
✔ GRAVIDA: number of times the mother has been pregnant
: regardless of whether these pregnancies werecarried to term
: current pregnancy, if any, is included in this count.✔ PARA
: indicates the number of viable (>20 wks) births: Pregnancies consisting of multiples, such astwins or triplets, count as ONE birth for thepurpose of this notation.
✔ FHR: heard below the mother’s umbilicus LOA (LeftOcciput Anterior): Doppler = 10 weeks: Stethoscope = 18-20 weeks: Fetoscope = 16 weeks
ABORTION✔ Threatened
: bleeding, cramping and softening of the uterus: CLOSED CERVIX, (+) BOW
✔ Inevitable: unpreventable cervical dilation with hemorrhageand severe cramping: (-) BOW
✔ Incomplete
: expulsion of some part of conception✔ Complete
: expulsion of all parts of conception✔ Missed
: fetus dies in utero and has not been expelled: CERVIX MAYBE CLOSED
✔ Habitual: history of 3 or more abortions
LOCHIA
✔ Rubra: red, fresh odor and some clots: 1-3 days
✔ Serosa: pink to brown, fleshy smell: 4-9 days
✔ Alba: yellow to white: 10th day
✔ WITHIN 12 HOURS AFTER BIRTH, FUNDUS IS1CM OR FINGER BREADTH ABOVE THEUMBILICUS. IT THEN DESCENDS BY ONE FINGERBREADTH EACH SUCCEEDING DAY UNTIL IN ITSNORMAL ON THE 10TH DAY
LEOPOLD’S MANEUVER
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A✔ PresentationB✔ Fetal BackC
✔ Engagement of the presenting partD✔ Degree of flexion of the head✔ Determine the attitude
INTRAVENOUS SOLUTIONS
Hypertonic
– concentrated– high osmolality
– water from cells into the
ECFHypotonic
– diluted
– low osmolality
– movement of water into
the cellsIsotonic
– same osmolality with
body fluids
– increase ECF Volume
Complications1. Air embolism
– bolus of air enters the
vein
– signs: tachycardia,
dyspnea, hypotension,cyanosis, and decreasedLOC
1. Catheter Embolism
– obstruction that results
from breakage of cathetertip
– signs: decrease BP, pain
along the vein, weak and
rapid pulse, cyanosis of nail bed, loss of LOC
1. Phlebitis
– inflammation of the vein
that can occur frommechanical or chemicaltrauma or from a localinfection
– development of a clot
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