Professional Documents
Culture Documents
Gravidity: number of times the woman has been pregnant (THIS INCLUDES CURRENT
PREGNANCY, MISCARRIAGES, ABORTIONS and *twins/triplets count as one).
Term Births: number born (alive or stillborn) at 37 weeks gestation onward (*twins/triplets count
as one)
Preterm births: number born 20-37 weeks (alive or stillborn) (*twins/triplets counts as one)
Abortion: pregnancy losses before 20 weeks (counts as a pregnancy…so would put in gravidity as
well)** if baby died after 20 weeks it is added under preterm or term not abortion.
Question 2: A 35 year old female is currently pregnant with twins. She has 10 year old triplets who
were born at 32 weeks gestation, and 16 years old who was born at 41 week gestation. Twelve years
ago she had a miscarriage at 8 weeks gestation. What is her GTPAL?
It is used for estimating an expected due date based on the woman’s last menstrual period
(LMP).
It bases it calculation that the woman has a 28 day menstrual cycle (many woman
vary)AND that it will be a gestation period of 280 days (40 weeks)… again this varies because
gestation is slightly longer for first time mothers. Hence, Naegele’s Rule calculation in JUST an
estimation!
Always give February 28 days (regardless of a leap year…to keep things simple).
Know which months have 30 days vs 31 days (September, April, June & November have 30
days)
OR
LMP Date
*Please watch the lecture video above for why it is best to use these different calculations based on
when the LMP falls to prevent errors.
NOTE: Remember that there is a FRONT AND BACK percentage value assigned to EACH
Adult:
Perineum: 1%
Total: 100%
Perineum: 1%
Total: 68.5%
As we learned in the last review on burns, patients who’ve experienced 15% or more of a total body
surface area that is burned will have an increase in capillary permeability and will most likely need fluid
replacement. (Diver, 2008). This calculation helps determine that total amount.
Why Lactated Ringer’s? It’s an isotonic solution that will help expand the intravascular compartment,
which is essential with this type of injury because the fluid in the intravascular compartment is moving
into the interstitial tissues……leading to a risk of hypovolemic shock.
Note: To use the Parkland Burn Formula, you must know how to calculate the total body surface area
that is burned. If you don’t know how to do this, check out my review on the Rule of Nines (it makes
calculating TBSA so easy).
How is the total amount of fluid administered? 1/2 during the first 8 hours and then the other 1/2
over the next 16 hours to equal 24 hours
Answer: 1st 8 hours: 1,292 mL/hr and next 16 hours: 646 mL/hr (total amount: 20,664 mL)
Rationale:
4 mL x 63 x 82 = 20,664 mL of LR total
1st 8 hours: 20,664 divided by 2 = 10,332 mL…hourly rate (divide by 8): 1,291.5…..1,292 mL/hr
Next 16 hours: 20,664 divided by 2 = 10,332 mL….hourly rate (divide by 16): 645.75……646 mL/hr
19. 1 t (teaspoon)= 5 ml
1 T(tablespoon)= 3 t = 15 ml
1 oz= 30 ml
1 cup= 8 oz
1 quart= 2 pints
1 pint= 2 cups
1 gr (grain)= 60 mg
1 g (gram)= 1000 mg
1 kg= 2.2 lbs
1 lb= 16 oz
20. TETANY – hypocalcemia (+) Trousseau’s sign/carpopedal spasm; Chvostek sign (facial
spasm).
28. INTUSSUSCEPTION – sausage shaped mass, Dance Sign (empty portion of RLQ)
39. HODGEKIN’S DSE/LYMPHOMA – painless, progressive enlargement of spleen & lymph tissues,
Reedstenberg Cells
40. INFECTIOUS MONONUCLEOSIS – Hallmark: sore throat, cervical lymph adenopathy, fever
49. GERD – Barretts esophagus (erosion of the lower portion of the esophageal mucosa)
58. GLAUCOMA – Painfull vision loss, tunnel/gun barrel/halo vision (Peripheral Vision
Loss)
59. CATARACT – Painless vision loss, Opacity of the lens, blurring of vision
Tuberculosis
• If a TB patient is unable/unwilling to comply with tx they may need supervision (direct
observation).
A positive ppd confirms infection, not just exposure. A sputum test will confirm active
disease.
Ventilators
HOLD
High alarm – Obstruction due to incr. secretions, kink, pt. coughs, gag, or bites the tubing
Low press alarm – Disconnection or leak in ventilatior or in pt. airway cuff, pt. stops
spontaneous breathing
Thoracentesis:
• Pre Op – Take V/S, shave area around needle insertion, move the patient into tripod
position over a bed table, while holding a pillow
• During – Withdraw no more than 1000cc at one time
• Post Op – Listen for bilateral breath sounds, V/S, check leakage, sterile dressing.
For nasotracheal suctioning, the nurse should set wall suction for an
infant, at 50 to 95
for a child 95 to 115 mm ,
for an adult. or 80 to 120 mm Hg
intransic rate
BACTERICIDAL-
A chemical that kills microorganisms
BACTERIOSTATIC-
An agent that prevents bacterial multiplication but does not kill microorganisms
HEMOPHILIA
- Deficient clotting factor
- X link recessive inheritance
- Sex link
- Excessive bleeding upon cutting of cord or circumcision
- Carrier mother passed to son, when son becomes a father he will pass it to his
daughter
Hemophilia A (classic) – deficiency of the coagulation component (Factor VIII)
Hemophilia B (Christmas disease) – deficiency in clotting factor IX
Hemophilia C – deficiency in clotting facter xi
6
4.
Antidotes
⬥ Digoxin→ Digiband
⬥ Coumadin→ Vitamin K
⬥ Benzodiazepines→ Flumazenil (Tomazicon)
⬥ Mg Sulfate→ Calcium Gluconate
⬥ Heparin→ Protamine Sulfate
⬥ Tylenol→ Mucomist (17 doses + a loading dose)
⬥ Opiates (heroin/morphine)→ Narcan (Naloxone)
⬥ Cholinergic Drugs (myesthenic bradycardia)→ Atropine
⬥ Methotrexate→ Leucovorin