NURSING TOOL BOX SERIES

  GENITAL TRACT INFECTION:  PUERPERAL SEPSIS INTRODUCTION Genital tract infection following delivery is referred to as Peuperal Sepsis and is synonymous with older descriptions of peuperal fever, milk fever and child bed fever. It can also be deemed as infection of the birth canal in the first six weeks following labour or abortion with the temperature reaching 38 ° C or more for 24 hours, or for at least two days of the first 14 days post delivery due to entry, growth and multiplication of pathogenic organisms (Sallers, 2010). Peuperal Sepsis was not realized until the mid 19 th century that the high maternal mortality and morbidity was due to poor hygiene of birth attendants; the establishment of lying in hospitals and overcrowding perpetuated the condition to epidemic proportions. Until 1937, peuperal sepsis was the major cause of maternal mortality. The discovery of the sulphonamides in 1935 and the simultaneous reduction in the virulence of the hemolytic streptoco...

  Stages of Indirect Healing Acute Inflammatory Response The acute inflammatory response peaks within 24 hours and ends after 7 days and is essential for healing to occur.A haematoma forms immediately after trauma. This consists of cells from the peripheral and intramedullary blood and bone marrow cells. The inflammatory response causes the haematoma to coagulate around the fracture ends and within the medulla, which creates a model for callus formation. Recruitment of Mesenchymal Stem Cells Bone is unable to regenerate unless specific mesenchymal stem cells are recruited, proliferated and differentiated into osteogenic cells. It is not currently understood exactly where these cells come from. Generation of Cartilaginous and Periosteal Bony Callus After the haematoma has formed, a fibrin-rich granulation tissue forms. Endochondral formation occurs between the fracture ends and beyond the periosteal sites in this tissue. These areas are less stable, so the cartilaginous tissue forms...

  What Happens as Broken Bones Heal? There are three stages of bone healing: the inflammatory, reparative, and remodeling stages. The Inflammatory Stage When a bone breaks, the body sends out signals for special cells to come to the injured area. Some of these special cells cause the injured area to become inflamed (red, swollen, and painful). This tells the body to stop using the injured part so it can heal. Other cells that come to the area during this stage form a  hematoma  (blood clot) around the broken bone. This is the first bridge between the pieces of the broken bone. The Reparative Stage The reparative stage starts within about a week of the injury. A soft  callus  (a type of soft bone) replaces the blood clot that formed in the inflammatory stage. The callus holds the bone together, but isn't strong enough for the body part to be used. Over the next few weeks, the soft callus becomes harder. By about 2–6 weeks, this hard callus is strong enough for th...

FETAL CIRCULATION The fetal circulation system is distinctly different from adult circulation. This intricate system allows the fetus to receive oxygenated blood and nutrients from the placenta. It is comprised of the blood vessels in the placenta and the umbilical cord, which contains two umbilical arteries and one umbilical vein. Fetal circulation bypasses the lungs via a shunt known as the ductus arteriosus; the liver is also bypassed via the ductus venosus and blood can travel from the right atrium to the left atrium via the foramen ovale. Normal fetal heart rate is between 110 and 160 peats per minute. When compared to adults, fetuses have decreased ventricular filling and reduced contractility.  Fetal circulation undergoes a rapid transition after birth to accommodate extra-uterine life.  Human understanding of fetal circulation originated from fetal sheep but ultrasound and magnetic resonance imaging (MRI) during the fetal period now provide detailed...