The long wait is over... NEW NURSES marching in the red carpet. (Click below for the complete list of new nurses)
CONGRATULATIONS TO ALL OF YOU!
With the number of nurses who took the board exam last November, it is bit sad to know that less than half of the examinees passed the nursing board exam.
Personally as an academician, it makes me think what really happened in the nursing education. Must it be because of the students, the instructors, the curriculum, or the passion for nursing itself.
A colleague told me, "I hope that would serve as an encouragement to continue inspiring and motivating students to exert effort and take their studies seriously.." May this message reminds us that every success is a joint effort. We can never attain success on our own nor by the help of other people only. We have to strive, reach the top and use whatever resources we have to attain what we want to achieve.
With a total of 94,462 examinees, only 37, 527 nursing graduates passed the November 2009 licensure examination. Again, a failure for many or success for some. But then, what is important is that, may it be a challenge for each and everyone that whether, you passed or you failed this examination, this is the start of a challenge... for those who failed the licensure exam, it is a challenge to take the exam again and conquer it and for those who passed the examination, it is a challenge to prove that truly you are a registered nurse.
To my students, I am so proud of you and I am overwhelmed to be part of your success! Continue to carve your way to your chosen field and you will surely be a good nurse.
Let's continue to uplift our profession! CONGRATULATIONS NURSES! :)
For the complete list of passers, Click here:
List of November Nursing Board Exam Passers
Sunday, January 31, 2010
Saturday, January 30, 2010
November 2010 Exam Results
The long wait is over... NEW NURSES marching in the red carpet. (Click below for the complete list of new nurses)
With the number of nurses who took the board exam last November, it is bit sad to know that less than half of the examinees passed the nursing board exam.
Personally as an academician, it makes me think what really happened in the nursing education. Must it be because of the students, the instructors, the curriculum, or the passion for nursing itself.
A colleague told me, "I hope that would serve as an encouragement to continue inspiring and motivating students to exert effort and take their studies seriously.." May this message reminds us that every success is a joint effort. We can never attain success on our own nor by the help of other people only. We have to strive, reach the top and use whatever resources we have to attain what we want to achieve.
With a total of 94,462 examinees, only 37, 527 nursing graduates passed the November 2009 licensure examination. Again, a failure for many or success for some. But then, what is important is that, may it be a challenge for each and everyone that whether, you passed or you failed this examination, this is the start of a challenge... for those who failed the licensure exam, it is a challenge to take the exam again and conquer it and for those who passed the examination, it is a challenge to prove that truly you are a registered nurse.
To my students, I am so proud of you and I am overwhelmed to be part of your success! Continue to carve your way to your chosen field and you will surely be a good nurse.
Let's continue to uplift our profession! CONGRATULATIONS NURSES! :)
CONGRATULATIONS TO ALL OF YOU!
With the number of nurses who took the board exam last November, it is bit sad to know that less than half of the examinees passed the nursing board exam.
Personally as an academician, it makes me think what really happened in the nursing education. Must it be because of the students, the instructors, the curriculum, or the passion for nursing itself.
A colleague told me, "I hope that would serve as an encouragement to continue inspiring and motivating students to exert effort and take their studies seriously.." May this message reminds us that every success is a joint effort. We can never attain success on our own nor by the help of other people only. We have to strive, reach the top and use whatever resources we have to attain what we want to achieve.
With a total of 94,462 examinees, only 37, 527 nursing graduates passed the November 2009 licensure examination. Again, a failure for many or success for some. But then, what is important is that, may it be a challenge for each and everyone that whether, you passed or you failed this examination, this is the start of a challenge... for those who failed the licensure exam, it is a challenge to take the exam again and conquer it and for those who passed the examination, it is a challenge to prove that truly you are a registered nurse.
To my students, I am so proud of you and I am overwhelmed to be part of your success! Continue to carve your way to your chosen field and you will surely be a good nurse.
Let's continue to uplift our profession! CONGRATULATIONS NURSES! :)
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Friday, January 15, 2010
ONGOING TUTORIAL SCHEDULES FOR JANUARY
BATCH 1: Psychiatric Nursing
Mondays 6:30 pm to 7:30 pm
Tuesday 6:30 pm to 7:30 pm
Wednesdays 1:00 pm to 2:00 pm
Thursdays 1:00 pm to 2:00 pm
Fridays 10:00 am to 11:00am
Saturdays 5:30 pm to 6:30 pm
Every other Sundays 9:00am to 10:00 am
BATCH 2: Medical Surgical Nursing
Mondays 11:30am to 12:30 pm
Tuesdays 11:30am to 12:30 pm
Wednesdays 11:30am to 12:30 pm
Thursdays 11:30am to 12:30 pm
Fridays 11:30am to 12:30 pm
Saturdays 8:00 pm to 9:00 pm
Every other Sundays 8:00am to 9:00am
*Full slots for January. No requests for extensions at the moment :( Sorry...
**Enrollees who wish to extend their tutorials should register again for scheduling. Thank you.
***Kindly update your modules. Modules are already sent via email. Follow instructions. See you! :)
NEW SCHEDULE FOR OTHER BOARD SUBJECTS UPON REQUEST.
Email: academic.advancement.institute@gmail.com for details
Mondays 6:30 pm to 7:30 pm
Tuesday 6:30 pm to 7:30 pm
Wednesdays 1:00 pm to 2:00 pm
Thursdays 1:00 pm to 2:00 pm
Fridays 10:00 am to 11:00am
Saturdays 5:30 pm to 6:30 pm
Every other Sundays 9:00am to 10:00 am
BATCH 2: Medical Surgical Nursing
Mondays 11:30am to 12:30 pm
Tuesdays 11:30am to 12:30 pm
Wednesdays 11:30am to 12:30 pm
Thursdays 11:30am to 12:30 pm
Fridays 11:30am to 12:30 pm
Saturdays 8:00 pm to 9:00 pm
Every other Sundays 8:00am to 9:00am
*Full slots for January. No requests for extensions at the moment :( Sorry...
**Enrollees who wish to extend their tutorials should register again for scheduling. Thank you.
***Kindly update your modules. Modules are already sent via email. Follow instructions. See you! :)
NEW SCHEDULE FOR OTHER BOARD SUBJECTS UPON REQUEST.
Email: academic.advancement.institute@gmail.com for details
Thursday, January 14, 2010
MATERNAL ASSESSMENT
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
MATERNAL ASSESSMENT
Signs of Labor
Preliminary signs
- Lightening
- ↑ in level of activity
- Braxton hicks contractions
- Ripening of the cervix
Signs of True Labor
- Uterine contractions
- Show or bloody show
- Rupture of the membranes
Maternal assessment
- initial interview: EDC
: Duration, intensity, frequency of contractions
: amt & character of show
: Rupture of membranes
: vital signs, time of last meal
: drug allergies
: past pregnancy history
- Physical Exam
- Abdominal Assessment
: Fundic height
: Leopolds maneuver
- Laboratory analysis
Fetal assessment
a. FHR
- Auscultation
- Electronic monitoring
- Acid-base assessment
: pressure application on fetal scalp in dilated cervix
: absence of fetal acceleration suggests fetal distress
- Fetal reactivity
b. Fetal blood
- Blood sampling
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
MATERNAL ASSESSMENT
Signs of Labor
Preliminary signs
- Lightening
- ↑ in level of activity
- Braxton hicks contractions
- Ripening of the cervix
Signs of True Labor
- Uterine contractions
- Show or bloody show
- Rupture of the membranes
Maternal assessment
- initial interview: EDC
: Duration, intensity, frequency of contractions
: amt & character of show
: Rupture of membranes
: vital signs, time of last meal
: drug allergies
: past pregnancy history
- Physical Exam
- Abdominal Assessment
: Fundic height
: Leopolds maneuver
- Laboratory analysis
Fetal assessment
a. FHR
- Auscultation
- Electronic monitoring
- Acid-base assessment
: pressure application on fetal scalp in dilated cervix
: absence of fetal acceleration suggests fetal distress
- Fetal reactivity
b. Fetal blood
- Blood sampling
MATERNAL ANESTHESIA
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Maternal Regional Anesthesia
Spinal
Subarachnoid
L3-L5
Side effect on the lower extremities and spinal headache
Epidural
L3-L4
Involves the vagina and perineum
No postpartum headache side effect
Pudendal
Transvaginal route
Takes effect for 30 minutes
Local Infiltration
No side effect
Given just before giving birth
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Maternal Regional Anesthesia
Spinal
Subarachnoid
L3-L5
Side effect on the lower extremities and spinal headache
Epidural
L3-L4
Involves the vagina and perineum
No postpartum headache side effect
Pudendal
Transvaginal route
Takes effect for 30 minutes
Local Infiltration
No side effect
Given just before giving birth
NURSING CARE DURING THE STAGES OF LABOR
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Nursing Care of the Mother
1. Care of the Woman During the First Stage
Stage Profile: Marked by duration and stress of labor
Nursing interventions:
- Reduce anxiety and offer assistance
- Do not interrupt breathing during contractions
- Promote change of positions
- Encourage voiding and promote bladder care
- Encourage client to suck on hard candy, ice chips
- Apply cream on dry lips of client
- Administer IV solution in case of DHN
- When hyperventilating, keep paper bag nearby and teach on how to use it
2. Care of the Woman During the Second Stage
Stage Profile: Marked by intense contractions
Nursing Interventions:
- Provide client support
- Assess and record v/s, FHR, uterine contractions
- Prepare place of birth in advance
- Convert the labor room to birth room
- Make the client select positioning for birth
- Promote second stage pushing
- Clean perineum with warm antiseptic before birth
As soon as head is about 8cm across:
Perform the Ritgen’s maneuver
Encourage the woman to continue pushing until the occiput of fetal head is firmly a the pubic arch
Once head is delivered
Note time of birth, announce sex of infant
Cut and clamp the cord
Introduce infant to initiate parent child relationship
3. Care of the Woman in the Third and Fourth Stages of Labor
Stage Profile: Placental separation and delivery
Nursing interventions:
- Administer oxytocin (IM or IV
- Inspect delivered placenta
- Monitor vital signs (q 15 minutes)
- Palpate fundus
- Observe character and amount of lochia
Non Pharmacologic Pain relief
Relaxation
Focusing on imagery
Support from a doula or coach
Breathing techniques
Bathing/ hydrotherapy : C/I in ruptured membranes
Therapeutic touch and massage
Hypnosis: deep form of relaxation
Biofeedback: based on belief that people can control and
regulate internal events like HR and pain response
Acupressure and acupuncture
Heat or cold application
Pharmacologic pain relief
Local infiltration
Pudendal nerve block
Spinal anesthesia
Epidural anesthesia
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Nursing Care of the Mother
1. Care of the Woman During the First Stage
Stage Profile: Marked by duration and stress of labor
Nursing interventions:
- Reduce anxiety and offer assistance
- Do not interrupt breathing during contractions
- Promote change of positions
- Encourage voiding and promote bladder care
- Encourage client to suck on hard candy, ice chips
- Apply cream on dry lips of client
- Administer IV solution in case of DHN
- When hyperventilating, keep paper bag nearby and teach on how to use it
2. Care of the Woman During the Second Stage
Stage Profile: Marked by intense contractions
Nursing Interventions:
- Provide client support
- Assess and record v/s, FHR, uterine contractions
- Prepare place of birth in advance
- Convert the labor room to birth room
- Make the client select positioning for birth
- Promote second stage pushing
- Clean perineum with warm antiseptic before birth
As soon as head is about 8cm across:
Perform the Ritgen’s maneuver
Encourage the woman to continue pushing until the occiput of fetal head is firmly a the pubic arch
Once head is delivered
Note time of birth, announce sex of infant
Cut and clamp the cord
Introduce infant to initiate parent child relationship
3. Care of the Woman in the Third and Fourth Stages of Labor
Stage Profile: Placental separation and delivery
Nursing interventions:
- Administer oxytocin (IM or IV
- Inspect delivered placenta
- Monitor vital signs (q 15 minutes)
- Palpate fundus
- Observe character and amount of lochia
Non Pharmacologic Pain relief
Relaxation
Focusing on imagery
Support from a doula or coach
Breathing techniques
Bathing/ hydrotherapy : C/I in ruptured membranes
Therapeutic touch and massage
Hypnosis: deep form of relaxation
Biofeedback: based on belief that people can control and
regulate internal events like HR and pain response
Acupressure and acupuncture
Heat or cold application
Pharmacologic pain relief
Local infiltration
Pudendal nerve block
Spinal anesthesia
Epidural anesthesia
LANDMARKS OF THE FETAL SKULL
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN
LANDMARKS OF THE FETAL SKULL
FETAL POSITIONS
OCCIPUT ANTERIOR
Usually the easiest position for the fetal head to traverse the maternal pelvis.
Shown here is the "direct OA" position. While some fetuses deliver in this position, others deliver slightly rotated clockwise (LOA) or counterclockwise (ROA). Either way, the fetus is still considered to be an "anterior" position.
RIGHT OCCIPUT ANTERIOR (ROA)
The fetal occiput is directed towards the mother's left, anterior side.
LEFT OCCIPUT ANTERIOR
normal and usually are the easiest way for the fetus to traverse the birth canal.
LEFT OCCIPUT TRANSVERSE
This LOT position and its' mirror image, ROT, are common in early labor.
RIGHT OCCIPUT TRANSVERSE
OCCIPUT POSTERIOR
Occiput posterior positions, including direct OP, LOP (Left Occiput Posterior) and
ROP (Right Occiput Posterior) are positions favored by certain internal pelvic shapes. This position has some obstetrical significance.
LEFT OCCIPUT POSTERIOR
RIGHT OCCIPUT POSTERIOR
RIGHT SACRUM POSTERIOR
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN
LANDMARKS OF THE FETAL SKULL
FETAL POSITIONS
OCCIPUT ANTERIOR
Usually the easiest position for the fetal head to traverse the maternal pelvis.
Shown here is the "direct OA" position. While some fetuses deliver in this position, others deliver slightly rotated clockwise (LOA) or counterclockwise (ROA). Either way, the fetus is still considered to be an "anterior" position.
RIGHT OCCIPUT ANTERIOR (ROA)
The fetal occiput is directed towards the mother's left, anterior side.
LEFT OCCIPUT ANTERIOR
normal and usually are the easiest way for the fetus to traverse the birth canal.
LEFT OCCIPUT TRANSVERSE
This LOT position and its' mirror image, ROT, are common in early labor.
RIGHT OCCIPUT TRANSVERSE
OCCIPUT POSTERIOR
Occiput posterior positions, including direct OP, LOP (Left Occiput Posterior) and
ROP (Right Occiput Posterior) are positions favored by certain internal pelvic shapes. This position has some obstetrical significance.
LEFT OCCIPUT POSTERIOR
RIGHT OCCIPUT POSTERIOR
RIGHT SACRUM POSTERIOR
LABOR PROCESS
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN
INTRAPARTUM AND POSTPARTUM
LABOR PROCESS
Components of labor
a. Passage
b. Passenger
c. Powers of Labor (uterine factors)
Passage
Fetal Presentation: Cephalic
Attitude
Vertex Sinciput Brow Face
Complete Moderate Partial Poor
flexion flexion extension flexion
Presentation: Breech
POSITION
Position
Refers to the relation of a chosen portion of the presenting part to the right or left side of the maternal birth canal
Positions (side of the mother)
Right
Left
Determining points (in the fetus)
Occiput
Mentum (chin)
Sacrum
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN
INTRAPARTUM AND POSTPARTUM
LABOR PROCESS
Components of labor
a. Passage
b. Passenger
c. Powers of Labor (uterine factors)
Passage
Fetal Presentation: Cephalic
Attitude
Vertex Sinciput Brow Face
Complete Moderate Partial Poor
flexion flexion extension flexion
Presentation: Breech
POSITION
Position
Refers to the relation of a chosen portion of the presenting part to the right or left side of the maternal birth canal
Positions (side of the mother)
Right
Left
Determining points (in the fetus)
Occiput
Mentum (chin)
Sacrum
DANGER SIGNS AND SYMPTOMS DURING PREGNANCY
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Danger Signs and Symptoms
- ↑ or ↓ fetal movements
- Persistent vomiting
- Sudden escape of fluid from the vagina
- PIH
- Facial or finger swelling
- Dimness or blurring of vision
- ↓ urine output
PERINEAL AND ABDOMINAL EXERCISES
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
PERINEAL AND ABDOMINAL EXERCISES
Tailor Sitting
Squatting
Pelvic Floor Contractions
Abdominal Muscle Contractions
Pelvic Rocking
The Bradley Method
The Lamaze Method
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
PERINEAL AND ABDOMINAL EXERCISES
Tailor Sitting
Squatting
Pelvic Floor Contractions
Abdominal Muscle Contractions
Pelvic Rocking
The Bradley Method
The Lamaze Method
PSYCHOLOGICAL CHANGES DURING PREGNANCY
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Psychological Changes
First trimester
- Accepting pregnancy
- Common reaction: Ambivalence
Second trimester
- Accepting the baby; concentrates on
the new role
- Common Reactions: narcissism,
introversion, role playing, ↑
dreaming
Third trimester
- preparing for the baby and end of pregnancy
- Common reaction; impatience on the upcoming birth
Other psychological changes
Attitude towards body image
Increased stress
COUVADE syndrome: physical s/sx of pregnancy manifested in the woman’s husband
Emotional lability: mood swing bec of hormones
Changes in sexual desire: ↑ or ↓ libido
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Psychological Changes
First trimester
- Accepting pregnancy
- Common reaction: Ambivalence
Second trimester
- Accepting the baby; concentrates on
the new role
- Common Reactions: narcissism,
introversion, role playing, ↑
dreaming
Third trimester
- preparing for the baby and end of pregnancy
- Common reaction; impatience on the upcoming birth
Other psychological changes
Attitude towards body image
Increased stress
COUVADE syndrome: physical s/sx of pregnancy manifested in the woman’s husband
Emotional lability: mood swing bec of hormones
Changes in sexual desire: ↑ or ↓ libido
DIAGNOSTICS FOR A PREGNANT WOMAN
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
DIAGNOSTICS FOR PREGNANT WOMEN on the FIRST PRENATAL VISIT
Gravidity and Parity
Gravidity: number of pregnancies
Parity: number of births
Use of GTPALM
G: number of pregnancies
T: term births
P: preterm births
A: abortions (included in gravida is before 20 weeks
L: living children
M: Multiple Pregnancies
Clean Catch Urine
Used to check the presence of urinary tract infection during pregnancy
Pain upon urination is a common sign of urinary tract infection especially during pregnancy
Able to identify presence of HCG as indicative of pregnancy
Laboratory Tests
Radioimmunoassay test
Enzyme linked immunosorbent assay
Radioreceptor assay
Test for the first 24-48 hours after implantation
50 mIU/ml 7 to 9 days after conception
Peaks to 100 ml between 60th and 80th week of gestation
Pelvic Examination
Bimanual examination
Notes ovarian cysts, enlarged fallopian tubes, enlarged uterus, Hegar’s sign
Estimating Pelvic Size
Type of Pelvis: Android, Anthropoid, Gynecoid, Platypelloid
Diagonal conjugate: distance between the anterior surface of the inferior margin of the symphysis pubis
more than 12.5 cm
Ischial Tuberosity diameter: distance between the ischial tuberosities or transverse diameter of the outlet
9-11 cm is adequate
Assessment of Fetal Growth
Nagele’s Rule
- determines estimated birth date
McDonald’s Rule
- estimates fetal growth in utero
- fundic height or uterine height
Assessment of Fetal Well Being
- FHR
- Fetal movement
- Fetal presentation and position
-Leopolds maneuver
Late decelerations
Uteroplacental insufficiency
Begins well after the contraction but returns to baseline after 30 to 40 seconds
VARIABLE DECELERATIONS
Occurs at any time during uterine contracting phase
Decrease is usually >15bpm, lasts 15secs, return to baseline in <2mins from onset = indicates cord compression
NSG INTERVENTIONS:
Change in the mother’s position
Administer O2
D/C oxytocin
Alpha fetoprotein screening test
Assess the quantity of fetal serum proteins
Elevated levels of protein are associated with open neural tube and abdominal defects
Blood sample drawn at 15 to 18 weeks AOG
Amniocentesis
Aspiration of amniotic fluid done 13 to 14 weeks AOG
Performed to determine genetic disorders, metabolic defects and fetal lung maturity
Risks:
Maternal hemorrhage
Infection
Isoimmunization
Abruptio placentae
Amniotic fluid embolism
PROM
Nitrazine Test
Used to detect the presence of amniotic fluid
Amniotic has ph of 7 to 7.5 and turns yellow nitrazine to blue to blue green
Vaginal secretions have a ph of 4.6 to 7
Non stress test
Evaluates fetal heart rate in response to fetal movement
Results:
Unsatisfactory
Cannot be interpreted as a result of poor fetal tracing
Reactive: (negative)
Healthy fetus
2 or more FHR accelerations of at least 15 beats per minute lasting at least 15 seconds during a 20minute period
Non reactive: (positive)
No accelerations of at least 15 beats per minute or lasting less than 15 seconds in duration during a 40minute period
KICK COUNTS
Pregnant client should sit or lie quietly on her side.
Place hands on the largest area of the abdomen & concentrate on fetal movements.
Record the number of movements felt during a specific time period.
< 10 kicks in 12hr-period = NOTIFY MD
Fetal Monitoring
Displays the fetal heart rate
Monitors uterine activity which assesses the frequency, duration and intensity of contractions
A tocotransducer is placed over the fundus where contractions are felt strongest
Percutaneous Umbilical Cord Sampling
Cordocentesis or funicentesis
Blood studies to check blood count, blood gases, and isoimmunization
Changes during Pregnancy
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
DIAGNOSTICS FOR PREGNANT WOMEN on the FIRST PRENATAL VISIT
Gravidity and Parity
Gravidity: number of pregnancies
Parity: number of births
Use of GTPALM
G: number of pregnancies
T: term births
P: preterm births
A: abortions (included in gravida is before 20 weeks
L: living children
M: Multiple Pregnancies
Clean Catch Urine
Used to check the presence of urinary tract infection during pregnancy
Pain upon urination is a common sign of urinary tract infection especially during pregnancy
Able to identify presence of HCG as indicative of pregnancy
Laboratory Tests
Radioimmunoassay test
Enzyme linked immunosorbent assay
Radioreceptor assay
Test for the first 24-48 hours after implantation
50 mIU/ml 7 to 9 days after conception
Peaks to 100 ml between 60th and 80th week of gestation
Pelvic Examination
Bimanual examination
Notes ovarian cysts, enlarged fallopian tubes, enlarged uterus, Hegar’s sign
Estimating Pelvic Size
Type of Pelvis: Android, Anthropoid, Gynecoid, Platypelloid
Diagonal conjugate: distance between the anterior surface of the inferior margin of the symphysis pubis
more than 12.5 cm
Ischial Tuberosity diameter: distance between the ischial tuberosities or transverse diameter of the outlet
9-11 cm is adequate
Assessment of Fetal Growth
Nagele’s Rule
- determines estimated birth date
McDonald’s Rule
- estimates fetal growth in utero
- fundic height or uterine height
Assessment of Fetal Well Being
- FHR
- Fetal movement
- Fetal presentation and position
-Leopolds maneuver
Late decelerations
Uteroplacental insufficiency
Begins well after the contraction but returns to baseline after 30 to 40 seconds
VARIABLE DECELERATIONS
Occurs at any time during uterine contracting phase
Decrease is usually >15bpm, lasts 15secs, return to baseline in <2mins from onset = indicates cord compression
NSG INTERVENTIONS:
Change in the mother’s position
Administer O2
D/C oxytocin
Alpha fetoprotein screening test
Assess the quantity of fetal serum proteins
Elevated levels of protein are associated with open neural tube and abdominal defects
Blood sample drawn at 15 to 18 weeks AOG
Amniocentesis
Aspiration of amniotic fluid done 13 to 14 weeks AOG
Performed to determine genetic disorders, metabolic defects and fetal lung maturity
Risks:
Maternal hemorrhage
Infection
Isoimmunization
Abruptio placentae
Amniotic fluid embolism
PROM
Nitrazine Test
Used to detect the presence of amniotic fluid
Amniotic has ph of 7 to 7.5 and turns yellow nitrazine to blue to blue green
Vaginal secretions have a ph of 4.6 to 7
Non stress test
Evaluates fetal heart rate in response to fetal movement
Results:
Unsatisfactory
Cannot be interpreted as a result of poor fetal tracing
Reactive: (negative)
Healthy fetus
2 or more FHR accelerations of at least 15 beats per minute lasting at least 15 seconds during a 20minute period
Non reactive: (positive)
No accelerations of at least 15 beats per minute or lasting less than 15 seconds in duration during a 40minute period
KICK COUNTS
Pregnant client should sit or lie quietly on her side.
Place hands on the largest area of the abdomen & concentrate on fetal movements.
Record the number of movements felt during a specific time period.
< 10 kicks in 12hr-period = NOTIFY MD
Fetal Monitoring
Displays the fetal heart rate
Monitors uterine activity which assesses the frequency, duration and intensity of contractions
A tocotransducer is placed over the fundus where contractions are felt strongest
Percutaneous Umbilical Cord Sampling
Cordocentesis or funicentesis
Blood studies to check blood count, blood gases, and isoimmunization
Changes during Pregnancy
FERTILIZATION AND IMPLANTATION
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
FERTILIZATION AND IMPLANTATION
Occurs in the upper region of the fallopian tubes
Occurs within 2 hours of ovulation within 2 to 3 days of insemination
Takes place when sperm and ovum unite
Zygote is propelled toward the uterus
Zygote is implanted 6 to 8 days after ovulation
Blastocyts secretes chorionic gonadotropin to ensure that corpus luteum remains viable and secretes estrogen and progesterone for the first 2 to 3 months of gestation
GERM LAYERS
ECTODERM
- CNS, PNS, skin hair, nails,
sebaceous glands sense organs,
mucous membranes of anus, mouth,
nose, tooth enamel, mammary glands
MESODERM
- Body supporting structures,
dentin of teeth, kidneys ureters, repro syst,
heart, circ syst, blood, lymph vessels
ENDODERM
- bladder, urethra, lining of pericardial,
pleural peritoneal cavities,
lining of GIT, RT, tonsils, thyroid,
parathyroid, thymus
Signs and Symptoms of Pregnancy
1. Indications of Pregnancy
Presumptive signs
Probable signs
Positive signs
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
FERTILIZATION AND IMPLANTATION
Occurs in the upper region of the fallopian tubes
Occurs within 2 hours of ovulation within 2 to 3 days of insemination
Takes place when sperm and ovum unite
Zygote is propelled toward the uterus
Zygote is implanted 6 to 8 days after ovulation
Blastocyts secretes chorionic gonadotropin to ensure that corpus luteum remains viable and secretes estrogen and progesterone for the first 2 to 3 months of gestation
GERM LAYERS
ECTODERM
- CNS, PNS, skin hair, nails,
sebaceous glands sense organs,
mucous membranes of anus, mouth,
nose, tooth enamel, mammary glands
MESODERM
- Body supporting structures,
dentin of teeth, kidneys ureters, repro syst,
heart, circ syst, blood, lymph vessels
ENDODERM
- bladder, urethra, lining of pericardial,
pleural peritoneal cavities,
lining of GIT, RT, tonsils, thyroid,
parathyroid, thymus
Signs and Symptoms of Pregnancy
1. Indications of Pregnancy
Presumptive signs
Probable signs
Positive signs
CONTRACEPTION
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Ideal Contraceptive
Safe
100% effective
Free of side effects
Easily obtainable
Affordable
Acceptable to the user and sexual partner
Free of effects on future pregnancies
Abstinence
Most effective way of preventing contraception and sexually transmitted diseases
0% failure rate
Natural family planning methods
Calendar rhythm
Basal body temperature method
Billings Method (Cervical Mucus Method)
Symptothermal
Artificial Family Planning methods
Oral contraception
Subcutaneous Implants (Norplant)
Medroxyprogesterone acetate (Depo Provera)
IUD
Barrier methods:
Condom
Diaphragm/Cervical caps
Surgical Methods
Vasectomy: vas deferens
Tubal Ligation: fallopian tube
Birth Control Methods Failure Rate
Oral steroidal contraceptives FR: 3%
IUD’s FR: 2-4%
Vaginal spermicides FR: 30%
Hormonal implants FR: 0.04%
Diaphragm FR: 5-8%
Female and male condom FR: 2% ideal
Cervical cap FR: 8-18%
Vasectomy FR: 0.1%
Tubal ligation FR: 0.1%
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Ideal Contraceptive
Safe
100% effective
Free of side effects
Easily obtainable
Affordable
Acceptable to the user and sexual partner
Free of effects on future pregnancies
Abstinence
Most effective way of preventing contraception and sexually transmitted diseases
0% failure rate
Natural family planning methods
Calendar rhythm
Basal body temperature method
Billings Method (Cervical Mucus Method)
Symptothermal
Artificial Family Planning methods
Oral contraception
Subcutaneous Implants (Norplant)
Medroxyprogesterone acetate (Depo Provera)
IUD
Barrier methods:
Condom
Diaphragm/Cervical caps
Surgical Methods
Vasectomy: vas deferens
Tubal Ligation: fallopian tube
Birth Control Methods Failure Rate
Oral steroidal contraceptives FR: 3%
IUD’s FR: 2-4%
Vaginal spermicides FR: 30%
Hormonal implants FR: 0.04%
Diaphragm FR: 5-8%
Female and male condom FR: 2% ideal
Cervical cap FR: 8-18%
Vasectomy FR: 0.1%
Tubal ligation FR: 0.1%
BIOPHYSICAL ASPECTS OF HUMAN REPRODUCTION
NOTES IN MATERNAL AND CHILD NURSING
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Obstetrics
Branch of medicine that deals with parturition, its antecedents and sequel
Etymology
Comes from the word “OBSTETRIX” which means “midwife”
Biophysical Aspects of Human Reproduction
Reproductive Development
- occurs during intrauterine life, gender determined through chromosome information
- Puberty (childhood-sexual maturity transitional age)
Girls: 10-13y/o Boys: 12-14y/o
- Androgen and estrogen production
- Secondary sex characteristics
Secondary Sex characteristics
Growth spurt
Increase in the transverse diameter of the pelvis
Growth of pubic hair
Onset of Menstruation
Growth of Axillary hair
Vaginal secretions
Increase in weight
Growth of testes
Growth of face, axillary and pubic hair
Voice changes
Penile growth
Increase in height
Spermatogenesis
Human Sexual Response
Excitement
Plateau
Orgasm
Resolution
THE MENSTRUAL CYCLE
Menstruation
Also termed as the female reproductive cycle
Menarche: average age of onset 12-13 years old; average range or 9-17 years old
Interval between cycles: average of 28 days; cycles of 23 to 35 days
Duration of the menstrual flow: average of 30-80ml per menstrual period
Color: dark red
Odor: like marigolds
Menstrual Cycle
Proliferative phase
Immediately after menstrual flow
Ovary produces estrogen
Endometrium thickens
Approx 5 to 14 days
Also known as estrogenic, follicular or postmenstrual
Secretory phase
Formation of progesterone in the corpus luteum
Capillaries of the endometrium increase in amount until the lining takes on the appearance of a rich spongy velvet
Ischemic
Decrease in both estrogen and progesterone occurs
Capillaries ruptures and corpus luteum degenerates
Menstrual
Degenerated portion of the endometrium is shed
Reference: NURSE’S NOTES: MATERNAL and CHILD NURSING
Maritess Manalang-Quinto, RN, MAN(c)
Obstetrics
Branch of medicine that deals with parturition, its antecedents and sequel
Etymology
Comes from the word “OBSTETRIX” which means “midwife”
Biophysical Aspects of Human Reproduction
Reproductive Development
- occurs during intrauterine life, gender determined through chromosome information
- Puberty (childhood-sexual maturity transitional age)
Girls: 10-13y/o Boys: 12-14y/o
- Androgen and estrogen production
- Secondary sex characteristics
Secondary Sex characteristics
Growth spurt
Increase in the transverse diameter of the pelvis
Growth of pubic hair
Onset of Menstruation
Growth of Axillary hair
Vaginal secretions
Increase in weight
Growth of testes
Growth of face, axillary and pubic hair
Voice changes
Penile growth
Increase in height
Spermatogenesis
Human Sexual Response
Excitement
Plateau
Orgasm
Resolution
THE MENSTRUAL CYCLE
Menstruation
Also termed as the female reproductive cycle
Menarche: average age of onset 12-13 years old; average range or 9-17 years old
Interval between cycles: average of 28 days; cycles of 23 to 35 days
Duration of the menstrual flow: average of 30-80ml per menstrual period
Color: dark red
Odor: like marigolds
Menstrual Cycle
Proliferative phase
Immediately after menstrual flow
Ovary produces estrogen
Endometrium thickens
Approx 5 to 14 days
Also known as estrogenic, follicular or postmenstrual
Secretory phase
Formation of progesterone in the corpus luteum
Capillaries of the endometrium increase in amount until the lining takes on the appearance of a rich spongy velvet
Ischemic
Decrease in both estrogen and progesterone occurs
Capillaries ruptures and corpus luteum degenerates
Menstrual
Degenerated portion of the endometrium is shed
Wednesday, January 13, 2010
THE COMPLICATED POSTPARTAL EXPERIENCE
THE COMPLICATED POSTPARTAL EXPERIENCE
Postpartum Hemorrhage
Bleeding of 500mL of more following delivery
Caused by uterine atony, lacerations and retained placental fragments
Nursing interventions:
Massage the fundus
Monitor vital signs every 5 to 15 minutes
Maintain asepsis
Do pad counts
Prepare to administer oxytocin if prescribed
Administer fluids and monitor intake and output
Disseminated Intravascular Coagulation (DIC)
Assessment findings
Bleeding may range from massive, unanticipated blood loss to localized bleeding (purpura and petechiae)
Presence of special maternity problems
Interventions
Assist with medical mgt. of underlying condition.
Administer blood component therapy (white blood cells, packed cells, fresh frozen plasma, cryoprecipitate) as ordered.
Observe for signs of insidious bleeding (oozing IV site, petechiae, lowered hematocrit).
Institute nursing measures for severe bleeding /shock if needed.
Provide emotional support to client and family as needed.
Postpartum Infection
Any infection of the reproductive organs that occurs within 28 days of delivery or abortion
Signs:
Fever
Chills
Anorexia
Pelvic discomfort or pain
Vaginal discharge
Elevated white blood cell count
Urinary tract infection (UTI)
Interventions
Encourage high fluid intake
Provide warm baths to relieve discomfort and promote perineal hygiene
Administer and monitor intake of prescribed medications (antibiotics, urinary analgesics)
Stress good bladder-emptying schedule
Monitor for signs of premature labor from severe or untreated infection
Interventions for Postpartum Infection
Monitor vital signs
Make the mother comfortable as possible
Keep the mother warm if chilled
Encourage fluids to 3000 to 4000 mL per day if not contraindicated
Encourage frequent voiding and monitor intake and output
Administer antibiotics as prescribed
Interventions for Thrombophlebitis
Avoid pressure behind the knees
Avoid prolonged sitting
Avoid constrictive clothing
Avoid crossing of legs
Never massage the legs
Use support hose if prescribed
Comply with an anticoagulant as prescribed
Interventions for Hematoma
Monitor vital signs
Place ice at the hematoma site
Administer analgesics and antibiotics as prescribed
Encourage fluids and voiding
Prepare for incision and evacuation of hematoma if necessary
Mastitis
Inflammation of the breast as a result of infection
Primarily occurs in breast feeding mothers 2-3 weeks after delivery
Signs:
Localized heat and swelling
Pain
Elevated temperature
Complains of flu-like symptoms
Nursing interventions:
Good hand washing
Wear support bras
Do manual expression of breast milk or use breast pump every 4 hours
Administer pain relievers and antibiotics as prescribed
Postpartum Hemorrhage
Bleeding of 500mL of more following delivery
Caused by uterine atony, lacerations and retained placental fragments
Nursing interventions:
Massage the fundus
Monitor vital signs every 5 to 15 minutes
Maintain asepsis
Do pad counts
Prepare to administer oxytocin if prescribed
Administer fluids and monitor intake and output
Disseminated Intravascular Coagulation (DIC)
Assessment findings
Bleeding may range from massive, unanticipated blood loss to localized bleeding (purpura and petechiae)
Presence of special maternity problems
Interventions
Assist with medical mgt. of underlying condition.
Administer blood component therapy (white blood cells, packed cells, fresh frozen plasma, cryoprecipitate) as ordered.
Observe for signs of insidious bleeding (oozing IV site, petechiae, lowered hematocrit).
Institute nursing measures for severe bleeding /shock if needed.
Provide emotional support to client and family as needed.
Postpartum Infection
Any infection of the reproductive organs that occurs within 28 days of delivery or abortion
Signs:
Fever
Chills
Anorexia
Pelvic discomfort or pain
Vaginal discharge
Elevated white blood cell count
Urinary tract infection (UTI)
Interventions
Encourage high fluid intake
Provide warm baths to relieve discomfort and promote perineal hygiene
Administer and monitor intake of prescribed medications (antibiotics, urinary analgesics)
Stress good bladder-emptying schedule
Monitor for signs of premature labor from severe or untreated infection
Interventions for Postpartum Infection
Monitor vital signs
Make the mother comfortable as possible
Keep the mother warm if chilled
Encourage fluids to 3000 to 4000 mL per day if not contraindicated
Encourage frequent voiding and monitor intake and output
Administer antibiotics as prescribed
Interventions for Thrombophlebitis
Avoid pressure behind the knees
Avoid prolonged sitting
Avoid constrictive clothing
Avoid crossing of legs
Never massage the legs
Use support hose if prescribed
Comply with an anticoagulant as prescribed
Interventions for Hematoma
Monitor vital signs
Place ice at the hematoma site
Administer analgesics and antibiotics as prescribed
Encourage fluids and voiding
Prepare for incision and evacuation of hematoma if necessary
Mastitis
Inflammation of the breast as a result of infection
Primarily occurs in breast feeding mothers 2-3 weeks after delivery
Signs:
Localized heat and swelling
Pain
Elevated temperature
Complains of flu-like symptoms
Nursing interventions:
Good hand washing
Wear support bras
Do manual expression of breast milk or use breast pump every 4 hours
Administer pain relievers and antibiotics as prescribed
CARE OF THE NEWBORN
CARE OF THE NEWBORN
Immediate care of the newborn
Cord Care
Alcohol only
Vitamin K administration
Crede’s prophylaxis
Erythromycin drops or ointment
Promotion of warmth
Minimum oxygenation
APGAR SCORING
Appearance
pink
Pulse Rate
100 bpm
Grimacing
Cough or sneeze, cry or withdraw foot
Activity
Well flexed
Respiratory Rate
Good, strong cry
Newborn measurements
HC: 34-35 cm
CC: 32-33 cm
HR: 120-140 bpm
RR: 30-60 cpm
Weight: 2.5 to 3.4 kg
Length: 46-54 cm
Cold stress
Mottling of the skin and acrocyanosis with irregular respirations
Occurs within 24 hours after birth
Immediate care of the newborn
Cord Care
Alcohol only
Vitamin K administration
Crede’s prophylaxis
Erythromycin drops or ointment
Promotion of warmth
Minimum oxygenation
APGAR SCORING
Appearance
pink
Pulse Rate
100 bpm
Grimacing
Cough or sneeze, cry or withdraw foot
Activity
Well flexed
Respiratory Rate
Good, strong cry
Newborn measurements
HC: 34-35 cm
CC: 32-33 cm
HR: 120-140 bpm
RR: 30-60 cpm
Weight: 2.5 to 3.4 kg
Length: 46-54 cm
Cold stress
Mottling of the skin and acrocyanosis with irregular respirations
Occurs within 24 hours after birth
THE NORMAL POSTPARTAL EXPERIENCE
THE NORMAL POSTPARTAL EXPERIENCE
Postpartum Chills
May be the result of sudden release of pressure on pelvic nerves of excess epinephrine production during labor
Signs and symptoms:
Elevated Temperature
Tachycardia
Tachypnea
Hypotension
Nursing Interventions:
Monitor the vital signs every 2 to 4 hours
Make the client comfortable as possible
Keep the mother warm
Encourage fluids 3000-4000mL if not contraindicated
Breast Engorgement
Caused by vascular and lymphatic congestion
Encourage wearing of a support bra at all times even while the client is sleeping
Encourage to use ice packs between feedings if the client is breast feeding
Encourage warm soaks or a warm shower before breast feeding
Massage the breasts before feeding to stimulate let- down
Administer analgesics as prescribed if comfort measures are unsuccessful
Positive mother-neonate interaction
Speaks of infant as desirable and attractive
Is not upset by the drooling and vomiting of the infant
Holds baby warmly
Makes eye contact with the neonate
Plays with and soothes the infant
Talks or sings to the baby
Expresses confidence that the infant is well
Is able to discriminate the needs of the infant
Rubin’s postpartum Phases of Regeneration
Taking-in phase: first 3 days
Mother focuses on own primary needs such as s sleep and food
Baby care teaching is not effective at this time
Taking-hold phase: 3 to 10 days
More in control of independence
Begins to assume tasks of mothering
Letting-go phase
Deep loss of separation from the baby
Mothers may be caught in a dependent/independent role
After birth pains
Results from the contractions of the uterus
More common in:
Multiparas
Breast feeding mothers
Treated with oxytocin
Over distended uterus during pregnancy such as carrying twins
Carunculae Mystiformes/Carunculae Hymenales
Fibrous nodules of mucosa resulting from the healing of a torn hymen
Remnants of a ruptured hymen that appears as irregular projections of a normal skin around the vagina
Postpartum Chills
May be the result of sudden release of pressure on pelvic nerves of excess epinephrine production during labor
Signs and symptoms:
Elevated Temperature
Tachycardia
Tachypnea
Hypotension
Nursing Interventions:
Monitor the vital signs every 2 to 4 hours
Make the client comfortable as possible
Keep the mother warm
Encourage fluids 3000-4000mL if not contraindicated
Breast Engorgement
Caused by vascular and lymphatic congestion
Encourage wearing of a support bra at all times even while the client is sleeping
Encourage to use ice packs between feedings if the client is breast feeding
Encourage warm soaks or a warm shower before breast feeding
Massage the breasts before feeding to stimulate let- down
Administer analgesics as prescribed if comfort measures are unsuccessful
Positive mother-neonate interaction
Speaks of infant as desirable and attractive
Is not upset by the drooling and vomiting of the infant
Holds baby warmly
Makes eye contact with the neonate
Plays with and soothes the infant
Talks or sings to the baby
Expresses confidence that the infant is well
Is able to discriminate the needs of the infant
Rubin’s postpartum Phases of Regeneration
Taking-in phase: first 3 days
Mother focuses on own primary needs such as s sleep and food
Baby care teaching is not effective at this time
Taking-hold phase: 3 to 10 days
More in control of independence
Begins to assume tasks of mothering
Letting-go phase
Deep loss of separation from the baby
Mothers may be caught in a dependent/independent role
After birth pains
Results from the contractions of the uterus
More common in:
Multiparas
Breast feeding mothers
Treated with oxytocin
Over distended uterus during pregnancy such as carrying twins
Carunculae Mystiformes/Carunculae Hymenales
Fibrous nodules of mucosa resulting from the healing of a torn hymen
Remnants of a ruptured hymen that appears as irregular projections of a normal skin around the vagina
CESAREAN DELIVERY
CESAREAN DELIVERY
Indications of Cesarean Section
pMaternal Factors
nActive genital herpes or papilloma
nAIDS or HIV positive status
nCephalocaudal disproportion
nCervical cerclage
nSevere HPN
nFailure to progress in labor
nObstructive malignant tumor
nPrevious CS
Indications of Cesarean Section
pPlacental Factors
nPlacenta Previa
nPremature separation of the placenta
nCord Prolapse
pFetal Factors
nBreech lie
nLow birth Weight
nFetal distress
nMajor fetal anomalies
nTwins
nTransverse presentation
Caesarian Delivery: Types
pClassical – vertical incision
pLow uterine – “bikini”, for aesthetic purposes
Monday, January 4, 2010
Notes about Anxiety Disorders
NOTES ABOUT ANXIETY DISORDERS
(Excerpts from NURSE’S NOTES: Reviewer’s Edition)
Maritess Manalang-Quinto, RN, MAN(c)
Nurse Educator/Nurse Instructor/Resource Speaker
Reviewer V for Local and International Nurse Licensure Examinations
Certified Foreign Graduate Nurse
Registered Nurse, Vermont State, USA
Registered Nurse, Republic of the Philippines
STRESS
• : is an inevitable part of a human’s life
• : causes wear and tear in the body, both physical and psychological
• : known to occur whenever a person has difficulty with life situations, experiences, problems and goals.
GENERAL ADAPTATION SYNDROME by Hans Selye
3 Stages of reaction to stress:
1. Alarm reaction stage
• : Stress stimulates the bodily systems to send messages to the brain which serves as the body’s defense mechanism
• : The body tries to struggle and cope up with the stress felt by the individual
• : The individual is very much alert
• : Activation of sympathetic nervous system happens
2. Resistance stage
• : The bodily system adapts to stress felt; has the tendency to fight or flight.
3. Exhaustion stage
• : Happens when a person has negatively responded to stress such as inability to cope up with life situations and experiences
Anxiety
• :a vague feeling of dread, apprehension or death
• :an unexplainable response to external or internal stimuli that can have either behavioral, emotional, cognitive, and physical symptoms.
• :it is a feeling of apprehension caused by anticipation of danger.
Etiology
• Genetic
• Neurochemical
• Psychoanalytic
• Interpersonal
Levels of Anxiety
1. Mild Level of Anxiety +1
• -the individual will feel that something is different and warrants special attention.
2. Moderate level of anxiety +2
• -disturbing feeling of an individual indicating that something is definitely wrong and needs immediate attention
Levels of Anxiety
3. Severe Level of Anxiety +3
• -has trouble thinking and reasoning
• -crying with ritualistic behavior
4. Panic Level of Anxiety +4
• -perceptual field may be reduced to focus on self
• -may be suicidal
TYPES OF ANXIETY DISORDER
PANIC DISORDERS
• -composed of discrete episodes of panic attacks that is 15 to 30 minutes of rapid, intense, escalating anxiety in which the person experiences great emotional fear as well a physiologic discomfort.
TYPES OF ANXIETY DISORDER
PHOBIA
• -It is an illogical, irrational and an intense persistent fear of a specific object, a social situation or any stimuli that causes extreme distress which alters normal functioning and behavior.
3 Categories of Phobia
a. Agoraphobia
-fear of open spaces such as going out of the house and characterized by inability to keep up with appointments, doing activities outside the home or simply having attacks when leaving home.
b. Specific Phobia
• -Natural environmental phobia
(eg. natural disasters, floods, rain)
• Blood-injection phobia
(eg. surgical procedures, immunization)
• -Situational Phobia
(eg. speaking in front, singing, stage freight)
• -Animal phobia
(eg. snakes, spider, rats)
• c. Social Phobia
(eg. speech, stage freight)
Behavioral Therapy
Systematic desensitization
Flooding
TYPES OF ANXIETY DISORDER
OBSSESSIVE COMPLULSIVE DISORDERS
• Ritualistic Behaviors
• Touching Rituals
• Hoarding Rituals
• Counting Rituals
• Chanting/Praying Rituals
• Checking Rituals
Behavioral Therapy
• Exposure
• Response Prevention
TYPES OF ANXIETY DISORDER
GENERALIZED ANXIETY DISORDER
• It is an anxiety disorder characterized by 6 months or more of excessive worrying and anxiety over an impulse or stimuli
TYPES OF ANXIETY DISORDER
ACUTE STRESS DISORDER
It is a disorder which occurs when the individual experiences dissociative symptoms during, or immediately after a distressing symptom or situation by using dissociation as common coping mechanism.
ANXIOLYTICS
BENZODIAZEPINES
NON-BENZODIAZEPINES
FOR NURSING UPDATES, visit:
www.maritessmanalangquintorn.weebly.com
www.tuesdayrn.blogspot.com
(Excerpts from NURSE’S NOTES: Reviewer’s Edition)
Maritess Manalang-Quinto, RN, MAN(c)
Nurse Educator/Nurse Instructor/Resource Speaker
Reviewer V for Local and International Nurse Licensure Examinations
Certified Foreign Graduate Nurse
Registered Nurse, Vermont State, USA
Registered Nurse, Republic of the Philippines
STRESS
• : is an inevitable part of a human’s life
• : causes wear and tear in the body, both physical and psychological
• : known to occur whenever a person has difficulty with life situations, experiences, problems and goals.
GENERAL ADAPTATION SYNDROME by Hans Selye
3 Stages of reaction to stress:
1. Alarm reaction stage
• : Stress stimulates the bodily systems to send messages to the brain which serves as the body’s defense mechanism
• : The body tries to struggle and cope up with the stress felt by the individual
• : The individual is very much alert
• : Activation of sympathetic nervous system happens
2. Resistance stage
• : The bodily system adapts to stress felt; has the tendency to fight or flight.
3. Exhaustion stage
• : Happens when a person has negatively responded to stress such as inability to cope up with life situations and experiences
Anxiety
• :a vague feeling of dread, apprehension or death
• :an unexplainable response to external or internal stimuli that can have either behavioral, emotional, cognitive, and physical symptoms.
• :it is a feeling of apprehension caused by anticipation of danger.
Etiology
• Genetic
• Neurochemical
• Psychoanalytic
• Interpersonal
Levels of Anxiety
1. Mild Level of Anxiety +1
• -the individual will feel that something is different and warrants special attention.
2. Moderate level of anxiety +2
• -disturbing feeling of an individual indicating that something is definitely wrong and needs immediate attention
Levels of Anxiety
3. Severe Level of Anxiety +3
• -has trouble thinking and reasoning
• -crying with ritualistic behavior
4. Panic Level of Anxiety +4
• -perceptual field may be reduced to focus on self
• -may be suicidal
TYPES OF ANXIETY DISORDER
PANIC DISORDERS
• -composed of discrete episodes of panic attacks that is 15 to 30 minutes of rapid, intense, escalating anxiety in which the person experiences great emotional fear as well a physiologic discomfort.
TYPES OF ANXIETY DISORDER
PHOBIA
• -It is an illogical, irrational and an intense persistent fear of a specific object, a social situation or any stimuli that causes extreme distress which alters normal functioning and behavior.
3 Categories of Phobia
a. Agoraphobia
-fear of open spaces such as going out of the house and characterized by inability to keep up with appointments, doing activities outside the home or simply having attacks when leaving home.
b. Specific Phobia
• -Natural environmental phobia
(eg. natural disasters, floods, rain)
• Blood-injection phobia
(eg. surgical procedures, immunization)
• -Situational Phobia
(eg. speaking in front, singing, stage freight)
• -Animal phobia
(eg. snakes, spider, rats)
• c. Social Phobia
(eg. speech, stage freight)
Behavioral Therapy
Systematic desensitization
Flooding
TYPES OF ANXIETY DISORDER
OBSSESSIVE COMPLULSIVE DISORDERS
• Ritualistic Behaviors
• Touching Rituals
• Hoarding Rituals
• Counting Rituals
• Chanting/Praying Rituals
• Checking Rituals
Behavioral Therapy
• Exposure
• Response Prevention
TYPES OF ANXIETY DISORDER
GENERALIZED ANXIETY DISORDER
• It is an anxiety disorder characterized by 6 months or more of excessive worrying and anxiety over an impulse or stimuli
TYPES OF ANXIETY DISORDER
ACUTE STRESS DISORDER
It is a disorder which occurs when the individual experiences dissociative symptoms during, or immediately after a distressing symptom or situation by using dissociation as common coping mechanism.
ANXIOLYTICS
BENZODIAZEPINES
NON-BENZODIAZEPINES
FOR NURSING UPDATES, visit:
www.maritessmanalangquintorn.weebly.com
www.tuesdayrn.blogspot.com
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