Midline Episiotomy

Ellis demonstrates how to administer an intradermal, subcutaneous, and intramuscular injection.

Our Critical Nursing Skills video tutorial series is taught by Ellis Parker MSN, RN-BC, CNE, CHS and intended to help RN and PN nursing students study for your nursing school exams, including the ATI, HESI and NCLEX.

#NCLEX #ClinicalSkills #injections #HESI #Kaplan #ATI #NursingSchool #NursingStudent⁠ #Nurse #RN #PN #Education #LVN #LPN #nurseeducator

00:00 What to expect
00:20 Intradermal injections
00:35 Cleaning site
00:54 Explaining bevel up
1:40 Inserting needle
2:00 Injecting medication
2:16 Withdrawing needle
2:29 Subcutaneous Injections
2:39 Selecting site for subcutaneous injections
3:08 Cleaning subcutaneous injections site
3:18 Pinching subcutaneous injections site
3:30 Inserting needle subcutaneous injections
4:13 Injecting medication subcutaneous injections
4:23 Post injection
4:36 Intramuscular injection
4:54 Locating intramuscular injection site
5:18 Cleaning intramuscular injection site
5:38 Inserting needle intramuscular injection
6:28 Anchoring needle intramuscular injection
6:44 Injecting medication intramuscular injection
6:55 Withdrawing needle intramuscular injection
7:05 Disposing of needle
7:43 Cleaning site
8:00 Displacing with Z-track
8:10 Inserting needle
8:23 Releasing tissue

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Transurethral resection of the prostate (also known as TURP, plural TURPs and as a transurethral prostatic resection TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name indicates, it is performed by visualising the prostate through the urethra and removing tissue by electrocautery or sharp dissection. This is considered the most effective treatment for BPH. This procedure is done with spinal or general anesthetic. A large triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete. Outcome is considered excellent for 80-90% of BPH patients. Because of bleeding risks associated with the surgery, TURP is not considered safe for many patients with cardiac problems. As with all invasive procedures, the patient should first discuss medications they are taking with their doctor, most especially blood thinners or anticoagulants, such as warfarin (Coumadin), or aspirin. These may need to be discontinued prior to surgery. Postop complications include bleeding (most common), clotting and hyponatremia (due to bladder irrigation).

Additionally, transurethral resection of the prostate is associated with low but important morbidity and mortality.

exam

Watch that video to know what G spot is

Watch that Skin Jiggers Removal Procedure

The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.

his patient had spilled boiling water on his lower leg a couple days before. This isn't complicated but the teaching points should focus on draining the large blistered areas and attempting to maintain moisture as long as we can so the skin doesn't contract down on itself.

catheterization of the male urethra by a foley catheter

Breast cancer is a malignant tumor that develops from the cells of
the breast. It is the most common type of cancer among women in
the United States. It is most often curable when found early. The
normal breast consists of three main components: the lobules
(milk-producing glands), the ducts (thin tubes that connect the
lobules to the nipple) and the stroma (fatty tissue and ligaments
surrounding the ducts and lobules, blood vessels, and lymphatic
vessels). About 80% of breast cancers start in the ducts.

Professional breast exam

this video about identifying a hernia vs a cyst

An ectopic pregnancy (EP) is a condition in which a fertilized egg settles and grows in any location other than the inner lining of the uterus. The vast majority of ectopic pregnancies are so-called tubal pregnancies and occur in the Fallopian tube.

This minimally invasive technique allows surgeons to remove skull base tumors as large as softballs through the nose, with less trauma to the brain and critical nerves than with a traditional craniotomy.

To learn more, please visit https://www.upmc.com/

How Male to Female Sex Gender Reassignment Surgery Really Works

A hematoma is a collection of blood outside of a blood vessel. There are several types of hematomas and they are often described based on their location. Examples of hematomas include subdural, spinal, under the finger or toenail bed (subungual), ear, and liver (hepatic). Some causes of hematomas are as pelvic bone fractures, fingernail injuries (subungual), bumps, passing blood clots, blood clot in the leg (DVT), blood cancers, and excessive alcohol use. Symptoms of hematomas depend upon their location and whether adjacent structures are affected by the inflammation and swelling associated with the bleeding and may include

The is a time lapse video animation of a complicated ear infection with a ruptured eardrum causing drainage with eventual healing. The video also shows why a period of hearing loss and clogged/muffled ear sensation may occur.

Nursing skills lab procedure for wound care dressing change with irrigation and packing.

Amniotomy is the official term for artificially breaking the bag of waters during labor. It is believed that breaking the bag of waters will help to speed up an otherwise slow labor. Amniotomy is part of the Active Management of Labor practiced in some hospitals. Amniotomy is performed by a midwife or doctor. A long, thin instrument with a hook on the end is inserted into the vagina and through the cervix so it can catch and rip the bag of waters. To perform an amniotomy, the cervix must be dilated enough to allow the instrument through the cervix, generally at least a two. Why choose Amniotomy? Unlike other medical methods of starting labor, amniotomy does not add synthetic hormones to your labor. Instead it seems to stimulate your body’s own labor process. Amniotomy allows the use of an internal electronic fetal monitor. How effective is Amniotomy? Amniotomy alone is unpredictable, it may take hours for labor to start with amniotomy. Because amniotomy increases the risk for infection, most caregivers use amniotomy in combination with synthetic oxytocin. Birth does happen faster when amniotomy is combined with synthetic oxytocin than when amniotomy is used alone. Risks of Amniotomy Risks for Mother Increases the risk for infection. This risk is increased with length of time the waters are broken and with vaginal exams. Because of the infection risk, a time limit is given by which the mother must give birth. As the time limit approaches attempts to progress labor will become more aggressive. The fore waters equalize pressure on the cervix so it will open uniformly. When they are broken, the mother increases her chances of having uneven dilation. Risks for Baby Increases the risk of umbilical cord compression. The fore waters equalize pressure on the baby’s head as it presses against the cervix. When they are broken, the pressure on the baby’s head may be uneven causing swelling in some parts.

Surgeons in London removed a woman's brain tumor during a very unusual procedure. CBS News' Tina Kraus reports, the patient's love of music helped guide the surgery.

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