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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



✔ 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



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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