PEDS: 4-21-09 ch 9 -a normal uterus holds approx. 2 teaspoons of volume prepregnant. -a full term uterus hold approx. 5 litters of volume * NLCEX question: 3 days for lochia rubra. (Page 201 in book on bleeding time) REEDA- redness, edema, echymosis, discharge, approximation -should not have engorged, red nipples first day after birth. Its is usually in the first week after birth -easy to palpate the uterus if woman is supine, head flat, and feet flexed. -1 pad saturated with blood after the first day is not normal. -a full bladder may lead to hemorrhage. MEDSURGE: 4-21-09 neuro -cortid- is towards the body -defebrate- away from the body B-brisk S-sluggish A-absent -for babinski reflex—normal response is toes go down -need to know about lumbar puncture for test MRI- nothing magnetic -if taking out too much CSF, you may get a headache as it serves as a shock absorber, and when it gone, there is low amount that cushions the brain, resulting in headache MANITOL- a good medication that reduces fluid to relieve pressure in the brain. -the head is a vascular organ. During head trauma, there is a lot of bleeding but it doesn’t necessarily mean it’s dangerous. -staples are used more often than stitches. CONTUSION- if they get agitated and confused, it’s a serious sign of brain injury -in cases of trauma and penetrating objects in the head, you leave the object in the brain. Just stabilize condition. The PHD will take care of removing object. -don’t write the word entry. Exit would on documents, charting. INEFFECTIV TISSUE PERFUSION- related to CSF blood and anoxia -SX of brain tumor depends on where it is PARKINSON’S- dopamine problem HUNTINGTON’S DISEASE- has psychiatric problems -antichoterase inhibits the cholinesterase enzyme from breaking down acetycholine. MEDSURGE REVIEW FALLS-restrains, how long should stay on -assesments -parkinson’s -difference between extrinsic and intisnstric factors relating to falls IMMOBILITY-pressure ulcers-stage 1,2,3,4 (2 questions) -water substance coming out of rectum and patient complains of needing to defecate, that is what? (fecal impaction) (6 questions on immobility) Paraplegic care DEATH-what do you need to do about the body -impending death -kubler ross -CPR and death, what you need to do -grieving what kind is it? (dysfunctional, unresolved, adaptive, maldaptive) -in the ER there is a recent dead person, what do you need to do? (coroner with 24hours?) -when do you need to call the police? -dying, what actions do you need to take, (x2) NEURO- 88 YO abnormal patient finding, age related - What is comatose, semicomotose, and somnolent, lethargic - Babinski- abnormal/normal - Manitol fo icp- how would you know its effective - MS - Parkinson’s l-dopasinament. (go to green book for pharm if can’t find info) - Seizures- what you do and don’t do - ICP how do you keep it down besides drugs, (coughing, elevate, fluid?) - Palative care - Pressure ulcer documentation - 6 YO child and dead grandfather, (berievement?) DISCLAIMER: THESE ARE STUDENT NOTES TAKEN OF LECTURE INFORMATION PRESENTED IN CLASS AND IS NOT AN OFFICIAL DOCUMENT FROM THE INSTRUCTORS OR THE FACULTY OF RTC. THE INFORMATION PRESENTED MAY NOT BE 100% COMPLETE OF WHAT WAS LECTURED IN CLASS AND SHOULD NOT BE USED AS AN ONLY SOURCE OF INFORMATION FOR ANY TESTS, QUIZ, OR FINAL EXAMS.