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.

A local doctor says that the new pap smear guidelines makes sense for many women

Tampon for The First Time

http://www.amerra.com In this patient education video from Colorectal Surgical Associates in Houston, Texas, learn more about the single incision laparoscopic colectomy procedure. This minimally invasive procedure uses a mini incision that
results in less pain, fewer complications, earlier recovery, and a smaller scar. Colorectal cancer is the second leading cause of cancer death in the United States. For more information please visit our website: www.csamd.com or call (713)-790-0600.

Prediabetes means that your blood sugar level is higher than normal but not yet high enough to be type 2 diabetes. Without lifestyle changes, people with prediabetes are very likely to progress to type 2 diabetes. If you have prediabetes, the long-term damage of diabetes — especially to your heart, blood vessels and kidneys — may already be starting. There's good news, however. Progression from prediabetes to type 2 diabetes isn't inevitable. Eating healthy foods, incorporating physical activity in your daily routine and maintaining a healthy weight can help bring your blood sugar level back to normal. Prediabetes affects adults and children. The same lifestyle changes that can help prevent progression to diabetes in adults might also help bring children's blood sugar levels back to normal.

To record the sequence, Stephan Gordts and Ivo Brosens of the Leuven Institute for Fertility & Embryology in Belgium performed transvaginal laparoscopy, which involves making a small cut in the vaginal wall and observing the ovary with an endoscope.

"This allows us direct access to and observation of the tubo-ovarian structures without manipulation using forceps," says Gordts.

For the photos of ovulation, which only accidentally captured the critical moment, Jacques Donnez at the Catholic University of Louvain (UCL) in Brussels, Belgium, used gas to distend the organs for photography. However, Gordts and Brosens planned the procedure to coincide with ovulation and used saline solution to "float" the structures.
Perfect timing

Observation was timed for the day of the peak of the patient's luteal hormone cycle. Ovulation was predicted to occur on the evening of the day of the LH peak, and the endoscope introduced at 6 pm.

A small amount of saline was used to float the opening of the fallopian tube, its fimbriae (the "fingers" that sweep the egg into the tube) and the ovary itself. This gives a more natural appearance than gas, says Gordts.

In the video, the fimbriae can be seen sweeping in time with the patient's heartbeat. A mucus plug can be seen protruding from the ovary – this contains the egg.

"The ovum is not captured 'naked'," says Gordts. "There is no eruption like a volcano."

Gordts says that in clinical practice it is not easy to organise the observation of ovulation. "We were probably lucky to be successful at our first attempt," he says.

Osteomyelitis is an infection in a bone. Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Infections can also begin in the bone itself if an injury exposes the bone to germs. In children, osteomyelitis most commonly affects the long bones of the legs and upper arms. Adults are more likely to develop osteomyelitis in the bones that make up the spine (vertebrae). People who have diabetes may develop osteomyelitis in their feet if they have foot ulcers. Once considered an incurable condition, osteomyelitis can be successfully treated today. Most people require surgery to remove parts of the bone that have died — followed by strong antibiotics, often delivered intravenously, typically for at least four to six weeks.

This video: Patent ductus arteriosus (PDA) is a persistent opening between two major blood vessels leading from the heart. The opening, called the ductus arteriosus, is a normal part of a baby's circulatory system before birth that usually closes shortly after birth. If it remains open, however, it's called a patent ductus arteriosus. A small patent ductus arteriosus often doesn't cause problems and might never need treatment. However, a large patent ductus arteriosus left untreated can allow poorly oxygenated blood to flow in the wrong direction, weakening the heart muscle and causing heart failure and other complications. Treatment options for a patent ductus arteriosus include monitoring, medications and closure by cardiac catheterization or surgery.

The type of operation performed for removal of pancreatic cancer is based on the location of the tumor. For tumors of the head and neck of the pancreas a Whipple procedure, (also called a pancreaticoduodenectomy) is performed. This is a complex operation perfected at Johns Hopkins. This video will explain the surgery and what patients can expect.

Learn more about the Whipple procedure at Johns Hopkins:
http://www.hopkinsmedicine.org..../pancreatic_cancer_c

Watch that video of Tying The Sperm Canal to Avoid Ejaculation

Delivery using foreceps

A narrowing of the major artery (the aorta) that carries blood to the body. This narrowing affects blood flow where the arteries branch out to carry blood along separate vessels to the upper and lower parts of the body. CoA can cause high blood pressure or heart damage.

Graphic images focusing on the reconstruction of an ear after the removal of a long-standing skin cancer that this patient allowed to slowly grow over many years because he was afraid of what the surgery to remove might entail. Go to www.skincancercentre.com to learn more about the importance of the early diagnosis of skin cancer. BTW, when you put on your sunscreen, don't forget your ears, and wear a broad brimmed hat to cover this very vulnerable area of your anatomy. www.skincancercentre.com

UPMC liver surgeons are among the most experienced in the world in performing minimally invasive liver surgery. Most patients benefit from less trauma and pain, minimal scarring, a shorter hospital stay, and faster recovery than from traditional surgery.
To learn more, please visit https://www.upmc.com/services/....liver-cancer/treatme

Male Urethral Prostate Stent/Catheter.Removal and insertion.

Removal of pregnancy within the fallopain tube using laparoscopic keyhole surgery. A segment of the tube together with the pregnancy within is removed.

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Dressing Changes- Wet to Dry (Nursing Skills)

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Get the full Dressing Change lesson here: https://nursing.com/lesson/ski....lls-05-04-wound-care

Click here for the related lesson on Wound Assessment: https://nursing.com/lesson/ski....lls-05-02-wound-care

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Dressing Changes- Wet to Dry (Nursing Skills):
In this video we’re going to look at how to do a wet to dry dressing change. Wound care and dressing changes should be performed at least daily or more often depending on orders. Dressing changes should be sterile to avoid introducing any new bacteria to the wound and to promote wound healing.

Bookmarks:
0:05 Introduction
0:10 Wound Assessment link above
0:24 Dressing Change Prep
1:24 Wet vs Dry Gauze
1:37 Soaking Gauze
2:00 Gauze Ring Out
2:25 Packing the wound
3:00 Covering the wound bed
3:37 Dry gauze barrier
4:00 ABD pad application
4:46 Documentation
4:54 Outro

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Pinch air out of the tip of the condom. Unroll condom all the way down the penis. After sex but before pulling out, hold the condom at the base. Then pull out, while holding the condom in place. Carefully remove the condom and throw it in the trash.

This Is What The SHAPE OF YOUR BUTT Has To Say About Your Health. AMAZING!!