PPH Refers to excessive bleeding from the genital tract after birth of the baby, up to 6(six) weeks or 42 days postpartum. Description • Excessive bleeding from the birth canal after 2ndstage of labour and within the puerperium period. • It amounts to 500 ml or more, or any volume that causes deterioration of maternal condition.

COMPONENTS OF THE URINARY SYSTEM A: Anatomical 1. Kidneys 2. Ureters 3. Urinary bladder 4. Urethra COMPONENTS OF THE URINARY SYSTEM A: Functional 1. Secretory units the nephrons 2. Urine collecting units •Kidneys have both*

Its when the umbilical cord comes out of the uterus with or before the presenting part. The concern is that pressure on the cord from the baby will compromise blood flow to the baby

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Refers to a condition where the uterus partly or completely turns inside out, such that the inner surface of the fundus prolapses to appear at the internal cervical os level for the mild, mid-way in the vagina for the moderate and at the vaginal introitus or on the vulva for the severe.

• Rupture of the uterus is a serious complication, which should not occur in today’s obstetric care where there is good prenatal and intra partum care. • Its is one of the most serious complications in midwifery & obstetrics. • It is often fatal for the foetus & may also be responsible for the death of the mother • It remains a significant problem worldwide. However, with effective antenatal and intrapartum care, some cases may be avoided.

Primary (Immediate) PPH Definition • It’s excessive bleeding occurring during 3 rd stage or any time within the first 24 hours of delivery. Major causes • Uterine atony or atonic uterus (Tone /tissue = 70% ) • Trauma along the genital tract. ( Trauma = 20% ) • Blood coagulation disorder. ( Thrombin = 1% ) (4 Ts – Tone, Tissue, Trauma, Thrombin)

It is a rare condition, but highly fatal. (5th most common cause of maternal mortality.). It is a severe obstetrical emergency which occurs either as the first stage ends, though rare, or shortly after separation of the placenta. In either situation, the uterus is injured (torn) or uterine sinuses do not close instantly. So some amniotic fluid is forced into the maternal circulation by the strong uterine contractions hence embolism.

Perineal tears are injuries that occur in the perineal area (the region between the vaginal opening and the anus). • They are classified based on their severity and the structures involved. Risk factors • Large baby (macrosomia) • Instrumental delivery (forceps or vacuum) • Primigravida • Prolonged second stage of labour • Shoulder dystocia • Previous perineal tears

Medical-surgical nursing involves the nursing care of adult patients whose conditions or disorders are treated medically/pharmacologically, or surgically • It is also defined as the diagnosis and treatment of human responses of individuals and groups to actual or potential health problems • It is the nursing care of the adults with suspected or diagnosed pathology of physiological function

These are organized bodies of knowledge to define what nursing is, what nurses do, and why they do it

Right to emergency treatment in a health facility • In emergency situations irrespective of the patient’s ability to pay for treatment, treatment to stabilize the patient’s condition shall be provided • Right to be informed of all the provisions of one’s medical scheme/health insurance policy • Anyone enjoying the provisions of medical cover is entitled to know all the privileges accorded and also entitled to challenge, where and if necessary, the contents and decisions of the medical scheme and health insurance policy

Dorothea Orem was born in 1914 in Maryland. She began her nursing education in 1939 in Providence hospital school of nursing in Washington DC where she received a diploma. She later earned her BSC in nursing education in 1939 and a MSc. in nursing education in 1945. Orem kept asking herself what conditions existed in a person that made it necessary to bring in a nurse. This led to the evolution of her idea of self- care.

It’s any bleeding from or into the genital tract occurring after 28 weeks gestation which is unrelated to labor and delivery. • Any bleeding after 28weeks gestation and before 2nd stage of labour

Critical thinking Definition is a continuous process characterized by open-mindedness, continual enquiry combined with a willingness to look at each unique patient situation and determine which identified assumptions are true and relevant. Critical Thinking is a method of analyzing and looking at problems, decisions, and goals. This results in faster decisions, more creative and innovative solutions, and higher quality deliverables. Critical thinking Involves recognizing that an issue (e.g., patient problem) exists, analyzing information about the issue (e.g. clinical data about a patient), evaluating information and making conclusions.

Hyperemesis Gravidarum • It’s a condition characterized by excessive & persistent pregnancy related nausea or vomiting or both, associated with weight loss of >5% of body mass, & ketosis. • Ossurs between 4th -10th week and resolves before 20th week of pregnancy after interventions. • In its severe state, malnutrition and metabolic disturbance occur which may be fatal.

In linguistics, the Sapir-Whorf Hypothesis states that there are certain thoughts of an individual in one language that cannot be understood by those who live in another language. The hypothesis states that the way people think is strongly affected by their native languages. It is a controversial theory championed by linguist Edward Sapir and his student Benjamin Whorf.

These notes describe in detail of a baby at risk. Post partum.

Introduction to obstetrics, midwifery and gynaecology

Expound on abnormal puerperium, breast complications,anatomy of the breasts etc.