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The obstetric examination is distinct from other examinations in that you, the clinician, are trying to assess the health of two individuals – the mother and the fetus – simultaneously. From the initial history, you should be able to judge the health of the pregnancy, any risk factors that need to be addressed, and any concerns from the parents. The history is an opportunity for you to find out how much the parents know about pregnancy, labour and delivery and if they have any preferences to which these events are carried out. A carefully taken history will also direct your attention to specific signs during the examination. As such, it is important that you develop a concise and systematic method of taking the history and carrying out the examination so that you do not miss any important information. This article focuses primarily on the examination. Pregnancy is a sensitive issue, especially for the primigravida’s. Therefore, extra care is needed when you approach a pregnant woman. Always obtain expressed informed consent before examining her and have a chaperone accompany you throughout the examination. A walk-through of what you will be doing is a good way of reassuring the patient and allows the examination to go on smoothly. It is also important to let your patient know that if the examination is too painful, she can stop at any time she wants. Finally, before you begin, you should always wash your hands, especially at an OSCE station.
Overview
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach the heart.
Heart bypass surgery begins with an incision in the chest, and the breastbone is cut exposing the heart. Next, a portion of the saphenous vein, which is very large, is harvested from the inside of the leg. Pieces of this large vein are used to bypass the blocked coronary arteries, which are arteries that supply blood to the heart. The venous graft is sewn to the aorta, the main artery of the body, and to the affected coronary artery, to bypass the blocked site.
The internal mammary artery from the chest may also be used to bypass a clogged artery.
Several arteries may be bypassed depending on the condition of the heart. After the graft is created, the breastbone and chest are closed.
The headache, lethargy, and neck stiffness suggest subarachnoid hemorrhage secondary to rupture of a mycotic aneurysm. Mycotic or infected arterial aneurysms can develop due to metastatic infection from IE, with septic embolization and localized vessel wall destruction in the cerebral (or systemic) circulation. Intracerebral mycotic aneurysms can present as an expanding mass with focal neurologic findings or may not be apparent until aneurysm rupture with stroke or subarachnoid hemorrhage. The diagnosis of mycotic cerebral aneurysm can usually be confirmed with computed tomography angiography. Management includes broad-spectrum antibiotics (tailored to blood culture results) and surgical intervention (open or endovascular).
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Trach Care Overview (Nursing Skills):
In this video we’re going to look at trach care. Remember you should always suction the patient before trach care, so if you haven’t watched that skill video yet, make sure you watch it!
Click here: https://nursing.com/lesson/ski....lls-03-03-trach-suct
And remember as you’re doing this, you want to be assessing the stoma for signs of infection or skin breakdown.
Bookmarks:
0:00 Introduction
0:30 Set up sterile field
1:00 Apply gloves
1:12 Remove inner canula and dressing
1:30 Apply sterile gloves
2:05 Clean secretions
2:56 Clean stoma
3:48 Replace inner canula
4:14 Change trach ties
5:50 Apply dressing
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enile implants are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. Penile implants are typically recommended after other treatments for ED fail. There are two main types of penile implants, semirigid and inflatable.
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Although the exact cause of abdominal aortic aneurysms is unknown, a number of factors may play a role, including: Tobacco use. ... Hardening of the arteries (atherosclerosis). ... High blood pressure. ... Blood vessel diseases in the aorta. ... Infection in the aorta. ... Trauma. ... Heredity.
Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain. You may initially experience short, mild attacks. But trigeminal neuralgia can progress and cause longer, more-frequent bouts of searing pain. Trigeminal neuralgia affects women more often than men, and it's more likely to occur in people who are older than 50. Because of the variety of treatment options available, having trigeminal neuralgia doesn't necessarily mean you're doomed to a life of pain. Doctors usually can effectively manage trigeminal neuralgia with medications, injections or surgery.
Shoulder dystocia is a specific case of obstructed labour whereby after the delivery of the head, the anterior shoulder of the infant cannot pass below, or requires significant manipulation to pass below, the pubic symphysis. It is diagnosed when the shoulders fail to deliver shortly after the fetal head. Shoulder dystocia is an obstetric emergency, and fetal demise can occur if the infant is not delivered, due to compression of the umbilical cord within the birth canal. It occurs in approximately 0.3-1% of vaginal births. Contemporary management of shoulder dystocia requires a calm operator and a well-thought-out plan of action. It is imperative that if not already present, help is summoned immediately after shoulder dystocia is recognized. This help may include additional nursing staff, an anesthesiologist, a pediatrician or neonatologist and an additional obstetrician or midwife. Future coordination may demonstrate that rapid response teams are best suited to attend to this emergency.