RN lecture ZONE

RN lecture ZONE Nursing is caring and through caring, we need to work together Mr G@orge

07/11/2025

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✅ *Pre-eclampsia* is a disorder that occurs after 20 weeks of gestation, characterized by high blood pressure (≥140/90 m...
28/10/2025

✅ *Pre-eclampsia* is a disorder that occurs after 20 weeks of gestation, characterized by high blood pressure (≥140/90 mmHg) and proteinuria (≥+1 on urine dipstick), with or without edema.
[10/28, 20:08] MR G@ORGE: ✅ *PRE-MONITORY* (WARNING) STAGE
Lasts 20–30 seconds.
The eyes roll and stare, face and hand muscles twitch, there is restlessness, loss of consciousness, and the woman may call out.G@
✅ *TONIC STAGE*
Lasts 15–20 seconds.
All muscles become rigid, breathing stops due to diaphragmatic spasm, cyanosis appears, the back arches, teeth clench, and eyes may bulge.G@or
✅ *CLONIC STAGE*
Lasts 1–2 minutes.
Violent jerky movements occur with frothing at the mouth (sometimes blood-stained), tongue biting, deep noisy breathing, and a congested swollen face. G@
✅ *STAGE OF COMA*
Lasts minutes to hours.
The woman remains unconscious with stertorous breathing, facial congestion, and swelling; cyanosis fades gradually, and more fits may occur before full recovery.
[10/28, 20:48] MR G@ORGE: *MEDICAL MANAGEMENT*
*Aims*
✅To control convulsions
✅To lower blood pressure to a safe level
✅To prevent complications
✅To deliver the baby once the mother is stable
*History Taking*
✅ I will obtain a detailed history of presenting complaints such as headache, blurred vision, epigastric pain, and twitching to assess severity.
✅ I will take obstetric history including parity, previous pregnancies, and antenatal care attendance to identify risk factors.
✅ I will collect past medical history on hypertension, renal disease, or seizure disorders to rule out other causes.
*Physical Examination*
✅ I will check vital signs (BP, pulse, respirations, temperature) to monitor the degree of hypertension.
✅ I will assess for edema on face, hands, and feet as an indicator of pre-eclampsia.
✅ I will examine reflexes and urine output to detect magnesium toxicity or renal impairment.
*Laboratory Investigations*
✅ *Urinalysis* : To check for proteinuria.
✅ *Liver and Renal Function Tests* : To assess organ involvement.
✅ *Full Blood Count* : To detect hemoconcentration or thrombocytopenia.
*Treatment and Drugs*
✅ *Magnesium Sulphate (MgSO₄)*
Loading dose: 4 g IV slowly over 5 minutes + 10 g IM (5 g in each buttock)
*Maintenance dose* 5 g IM every 4 hours for 24 hours after last fit
*Mode of action* Depresses the central nervous system to prevent seizures.
✅ *Hydralazine* 5–10 mg IV every 20–30 minutes as needed
*Mode of action* Relaxes arteriolar smooth muscle, reducing peripheral resistance.
Alternatively, Labetalol 20 mg IV slowly.

Tonight ✅IRH-OBS✅NMCZ Q✅Don't forget to join other special groups and pamphlets 0773382520
28/10/2025

Tonight ✅
IRH-OBS✅
NMCZ Q✅
Don't forget to join other special groups and pamphlets 0773382520

27/10/2025

Post operative management 👇👇 for hemorrhoids

✅ *Internal haemorrhoids* – Occur above the dentate (pectinate) line and are covered by mucous membrane.✅ *External haem...
27/10/2025

✅ *Internal haemorrhoids* – Occur above the dentate (pectinate) line and are covered by mucous membrane.
✅ *External haemorrhoids* Occur below the dentate line and are covered by skin.
[10/27, 20:27] MR G@ORGE: ✅ *Bleeding during defecation* Usually bright red blood seen on stool or tissue due to rupture of engorged veins.
✅ *A**l protrusion or swelling* Especially after defecation due to pr*****ed internal haemorrhoids.
✅ *Pain or discomfort at the a**s* Common in external haemorrhoids or when thrombosed.
✅ *Itching or irritation around the a**s* Due to mucous discharge and poor hygiene.
✅ *Feeling of incomplete evacuation* Because pr*****ed haemorrhoids obstruct the a**l ca**l.
[10/27, 20:33] MR G@ORGE: ✅ *Proctoscopy* To visualize internal haemorrhoids and assess the extent.
✅ *Digital re**al examination (DRE)* To feel for lumps, tenderness, or masses.
✅ *Sigmoidoscopy or colonoscopy* To rule out other causes of re**al bleeding such as polyps or carcinoma.
[10/27, 21:03] MR G@ORGE: *Dietary Advice*
✅ I will advise her to eat a high-fiber diet (vegetables, fruits, whole grains) and drink plenty of water to prevent constipation.
*Bowel Care*
✅ I will teach her not to strain during defecation and to respond promptly to the urge to pass stool.
*Wound Care at Home*
✅ I will instruct her to take warm sitz baths 2–3 times daily and after each bowel movement to keep the area clean and reduce pain.
*Follow-up and Warning Signs*
✅ I will advise her to report to the hospital immediately if she experiences heavy bleeding, severe pain, pus discharge, or fever.

✅ *Cholera* is an acute infectious disease caused by the bacterium Vibrio cholerae, characterized by sudden onset of pro...
25/10/2025

✅ *Cholera* is an acute infectious disease caused by the bacterium Vibrio cholerae, characterized by sudden onset of profuse watery diarrhoea and vomiting, leading to severe dehydration and electrolyte imbalance if not promptly treated.
[10/25, 20:05] MR G@ORGE: ✅ *Poor sanitation* due to open defecation or poor waste disposal.
✅ *Contaminated water supply* drinking or using water infected with Vibrio cholerae.
✅ *Poor personal hygiene* such as unwashed hands after using the toilet.
✅ *Consumption of raw* especially fish contaminated with the organism.
✅ *Overcrowding* which facilitates spread during outbreaks.
[10/25, 20:17] MR G@ORGE: ✅ *Evacuation Phase*
Characterized by sudden onset of profuse “rice-water” diarrhoea and vomiting.
Rapid loss of fluids and electrolytes leads to dehydration.
✅ *Collapse Phase*
Features include sunken eyes, dry mucous membranes, weak pulse, low blood pressure, and muscle cramps.
Patient may develop hypovolemic shock due to severe fluid loss.
✅ *Recovery Phase*
After rehydration, diarrhoea and vomiting reduce gradually.
Appetite returns, urine output increases, and patient regains strength.
[10/25, 20:24] MR G@ORGE: *Medical Management*
*Aims*
✅To restore and maintain fluid and electrolyte balance.
✅To eliminate Vibrio cholerae.
✅To prevent complications and death.
*History Taking*
✅ I will do history taking which will reveal sudden onset of profuse watery diarrhoea and vomiting.
✅ I will ask about source of drinking water and other contacts with similar symptoms.
*Physical Examination*
✅ I will assess for signs of dehydration such as sunken eyes, dry tongue, and poor skin turgor.
✅ I will check pulse, blood pressure, and respiratory rate to determine severity of dehydration.
*Laboratory Investigations*
✅ *Stool culture* to identify Vibrio cholerae.
✅ *Serum electrolytes* to check sodium, potassium, and chloride levels.
*Treatment and Drugs*
✅ *Fluids Intravenous* Ringer’s Lactate –Plan C (100 mL/kg over 3 hours).
✅ *Doxycycline* 300 mg single dose (adult) or Erythromycin 12.5 mg/kg every 6 hours for 3 days (alternative).
✅ *Zinc supplements* 20 mg orally once daily for 10–14 days to enhance intestinal healing.

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