measuring rectal temperature

Wash hands.

Shake the rectal thermometer below 35 ° C.

Insert thermometer into thermometer sheath.

Apply lubricant to bulb end of thermometer.

Open up the diaper to expose genital area.

Wear gloves if necessary. With non-dominant hand holds on the feet to stabilize the infant in position while insert thermometer about 0.5-1 inch into the anus as guarded by the dominant hand.

Hold thermometer in place for 3 minutes

Remove thermometer gently.

Dress up the infant.

Discard thermometer sheath.

Read thermometer reading at eye level.

Wash hands.

baby bathing

Planning
- perform hand hygiene, gather all necessary and appropriate equipment
- prepare basin with water and check the water temperature (around 38 degree of celsius) with elbow or liquid crystal thermometer

Implementation
- remove baby's clothing except diaper, cover baby with towel/blanket
- with football hold position, wash the infant's head in circular motion using shampoo and rinse
(洗頭時掩耳)
- dry hair and remove diaper
- immerse the infant in the tub of water, hold infant securely with one hand positioned behind neck and upper back (suppose BB head 在左邊，left wrist behind the neck), grasping the opposite upper arm (左手夾實BB左上臂近shoulder); wash infant's body with the other hand
- change hand to well support the infant before lean the infant forward to wash the back (雙手夾住BB，即右手按心口，然後將BB翻轉，即俯臥而BB頭向右邊，洗背時右手support chin)
- carefully remove infant from water, with one hand supporting head and neck of the baby and the other hand supporting buttocks and legs.
- pad dry and dress up with diaper and gown,, wrap with blanket

assess for general condition of infant during and after bathing

bottle feeding

Planning
- perform hand hygiene; gather all necessary and appropriate equipment
- arrange a chair for feeding and wrap the baby with shawl (a piece of fabric worn by women over the shoulders or head or wrapped around a baby) to keep warm

Implementation
- (pour milk powder and warm water into the bottle)
- assemble the teat (嬰兒奶瓶上的橡皮奶頭) onto the bottle without contamination; use a pair of forceps if needed
- test the milk temperature on the inner aspect of wrist before feeding the baby
- sit in a comfortable chair and to cuddle (hug) baby securely with baby's head slightly upward before feeding
- place small towel under the baby's chin and touch the corner of the mouth with teat to allow rooting of the infant for the teat
- place teat on top of the tongue
- tilt the bottle at an angle to keep the teat and the neck of the bottle full of the milk
- burp (noisily release air from the stomach through the mouth) the infant halfway through with the infant in sitting position and after feeding
- clean off dribbled milk around baby's mouth, chin
- check diaper and placing the baby back in crib (嬰兒床) in lateral position

(change napkin before feeding?)

Post-op (C5)

SpO2/TPR(vital signs) Q1H
Patient-controlled analgesia (morphine)
(respiratory distress)
bradycardia
blood pressure drops?
drowsiness?
constipation
chest drain

Pre-op (C5)

NPO (Nil per oral) 6-8 hrs
vital signs
withhold insulin
H'stix (blood glucose) stat (immediately)
+/- Fleet enema
shower
consult anesthesia (doctor)
draw blood
- complete blood count
- random glucose
clotting factor
consent form
ECG
X-ray
renal function test
liver function test
cardiac enzyme
troponin (CK-MB)

apical (rate) position

apex of the heart

It lies behind the 5th left intercostal space,
8-9 cm from the mid-sternal line, slightly medial to the mid-clavicular line

luer fit

The Luer taper is a standardized system of small-scale fluid fittings used for making leak-free connections between a male-taper fitting and its mating female part on medical and laboratory instruments, including hypodermic syringe tips and needles or stopcocks and needles.

(en.wikipedia.org0

abbreviation

TDW: touch down walking
CTLS: cervical, thoracic, lumbar, sacral
I&D: incision and drainage
D/C: discharge
MRI: magnetic resonance imaging
PLT: platelet count
WCC: white cell count
AFB: acid-fast bacillus
CVC: central venous catheter
LMWH: low molecular weight heparin

CRL

Crown-rump length (CRL) is the measurement of the length of human embryos and fetuses from the top of the head (crown) to the bottom of the buttocks (rump). It is typically determined from ultrasound imagery and can be used to estimate gestational age.

(google.com)

gravida/para

Gravida indicates the number of times the woman has been pregnant, regardless of whether these pregnancies were carried to term. A current pregnancy, if any, is included in this count.

Parity, or "para" indicates the number of >20-week births (including viable and non-viable; i.e., stillbirths). Pregnancies consisting of multiples, such as twins or triplets, count as one birth for the purpose of this notation.

(en.wikipedia.org)

e.g. G2P1

entonox

nitrous oxide and oxygen

techniques in OBS

court respiratory rate

then, measure apical rate

prevent crying

X napkin over cord

HBsAg

This tests for the presence of virus. A "positive" or "reactive" HBsAg test result means that the person is infected with the hepatitis B virus, which can be an "acute" or a "chronic" infection. Infected people can pass the virus on to others through their blood and infected bodily fluids.

(hepb.org)

eclampsia and pre-eclampsia

Eclampsia is the onset of seizures (convulsions) in a women with preeclampsia. Preeclampsia is a disorder of pregnancy in which there is high blood pressure and either large amounts of protein in the urine or other organ dysfunction. Onset may be before, during, after delivery.

(en.wikipedia.org)

meconium stained liquor

http://www.patient.co.uk/doctor/meconium-stained-liquor

惡露 (lochia)

http://www.fhs.gov.hk/tc_chi/health_info/faq/women_health/PN2_2_2.html

non-stress test

http://americanpregnancy.org/prenatal-testing/non-stress-test/

empathy is better than sympathy

http://www.diffen.com/difference/Empathy_vs_Sympathy

work distribution

clinical : management
nursing officer 7:3
ward manager 3:7

Mediastinal shift

Mediastinal shift a shifting or moving of the tissues and organs that comprise the mediastinum (heart, great vessels, trachea, and esophagus) to one side of the chest cavity … This can produce compression of the other lung and kinking or twisting of one or more of the great blood vessels, which in turn seriously impairs blood flow to and from the heart.

(medical-dictionary.thefreedictionary.com)