Start in RLQ (so you don’t miss a giant spleen). Get your fingers set then ask patient to take a deep breath. Don’t dip your fingers or do anything but wait. When patient expires, take up new position. Note lowest point of spleen below costal margin, texture of splenic contour, and tenderness If spleen is not felt, repeat with pt lying on right side. Gravity may bring spleen within reach. “LET THE SPLEEN PALPATE YOUR FINGERS AND NOT THE OTHER WAY AROUND. THERE IS NO GOLD, SO DON’T DIG!”

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LIS Closed done at 5 O clock position, using Scalpel blade 15. After feeling the groove between internal and external anal sphincter, the blade is passed in and the lower 1/2 of Internal anal sphincter is cut. Remain below dentate line. If anal mucosa is accidently cut suture with 4-0 rapid vicryl. In event of bleeding, pinchcock for 5 minutes.

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In this animated episode of eOrthopodTV, orthopedic surgeon Randale C. Sechrest, MD narrates the procedure to replace an arthritic knee with an artificial joint.

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Vial medication administration nursing skill. Learn techniques to withdraw medication from a vial using a syringe with a needle.

Medications can come in different forms, such as ampules, vials, tablets, capsules, and so forth. When withdrawing medication from a vial, there are a few things you'll want to know as a nursing student or nurse.

First, there are different needles that can be attached to the syringe. You can use a traditional needle with a beveled tip; you can use a blunt-tip needle to reduce the risk of needle sticks; or you can use a filter needle, which is sometimes required or recommended when drawing medication from a vial, particularly in cases of reconstituted medication.

When withdrawing from a vial, you'll want to do these things (assuming they fit with the protocols and manufacturer's instructions):


NOTE: Some medications or vaccines may require a different technique, so always consult with the manufacturer's instructions.

-gather your supplies
-perform hand hygiene
-clean the vial's top with alcohol prep
-attach the appropriate needle
-stick the needle using a technique to prevent coring of the rubber on the vial (start with 45 degree angle, and as you puncture the vial, rotate the needle to a 90 degree angle in one smooth motion).
-push air into the vial equal to the amount of medication you plan to draw
-invert the vial to withdraw medication
-remove air bubbles
-and much more

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Notes: https://www.registerednursern.....com/how-to-withdraw-

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An orgasm is a feeling of intense sexual pleasure that happens during sexual activity. It's sometimes called "coming" or "climaxing". Both men and women have orgasms.

The human brain is the command center for the human nervous system. It receives input from the sensory organs and sends output to the muscles. The human brain has the same basic structure as other mammal brains, but is larger in relation to body size than any other brains.

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