Pelvic inflammatory disease (PID) is a vague condition referring to an infection of the upper part of the female reproductive system (uterus, fallopian tubes, ovaries, and inside of pelvis), which accounts for a substantial portion of gynecology-related hospital admissions.
Most common causative organisms in order:
-N. gonorrhoeae (often coexists with chlamydia)
-E. coli, staphylococcus, streptococcus, enterococcus, bacteroides, peptostreptococcus, H. influenzae, G. vaginalis (often associated with instrumentation and tend to cause recurrent PID)
-Actinomyces israelii (gram-positive, non acid-fast anaerobe)
-Others (TB, gram-negatives, CMV, etc.)
-Age <25 yr.
-STI infection (often Chlamydia + gonorrhea)
-Multiple sex partners
-IUD within first 10 d after insertion
-Up to 2/3 asymptomatic, or with mild symptoms
-Common: fever, lower abdominal pain + tenderness, abnormal discharge (cervical or vaginal)
-Uncommon: N/V, dysuria, abnormal uterine bleeding
-Chronic disease (often Chlamydia): persistent pelvic pain, dyspareunia, palpable mass, resistant to treatment
For diagnosis, must have lower abdominal pain plus one of either cervical motion or adnexal tenderness, plus one or more of:
-high risk partner
-fever > 38 degrees Celscius
-positive culture for N. gonorrhoeaem C. trachomatis, E. coli, or other vaginal flora
-sac fluid, pelvis abscess, or inflammatory mass on U/S or bimanuak
-elevated ESR or CRP
Treatment depends on the infectious agent and generally involves the use of antibiotic therapy.
1 2520 minutes ago
🌡📈back to the basics - vital signs!📉⏱
I didn’t realize the importance of strict vital sign monitoring until I started in the ICU. Typically we record VS q1hr, but this can increase or decrease depending on what’s happening with your patient. Changes in vital signs are often the first signal🚨 that something is going on with your patient, and therefore it is important to make note of and address any changes.
⏱🗣respiratory rate: I know we’ve all been guilty of writing down 18 over and over 😂buuut RR is extremely important when monitoring critical patients- think ABGs. ✅N= 12-20 BPM
❌tachypnea -> hyperventilation: 20> BPM. Because the rate of breathing is faster, tidal volume of the lungs will decrease (less O2 in the lungs per breath) and CO2 is ‘blown off’. This can be a compensatory mechanism in the body to metabolic acidosis (the body is trying to get rid of acids/ CO2 in whatever way it can), or could lead to respiratory alkalosis (due to decreased pCO2 levels).
❌bradypnea -> <12 BPM. Decreased respirations lead to an increase in CO2/ pCO2 (hypercapnia) and a decrease in oxygen/ O2 (hypoxemia), and depending on your patient’s situation, this may be a result OR cause of respiratory acidosis. Hypoxemia leads to obvious tissue death (not enough O2 to the cells); hypercapnia leads to eventual shut down of the respiratory system - read up on ventilation- perfusion mismatch; super confusing at first but eventually it makes sense! 👩🏼⚕️if you know of anything to add to this, feel free to mention it in the comments! I am still learning lots too.👩🏼🎓💉
This image shows a portion of the stomach that was removed during a laparoscopic sleeve Gastronomy, which is a surgical weight loss procedure.
Vertical sleeve gastrectomy is surgery to help with weight loss. The surgeon removes a large portion of your stomach. About 75% of the stomach was removed in this case by a resection along the greater curvature, leaving a narrow gastric tube or 'sleeve.' The intestines are not removed or bypassed during this procedure. The new, smaller stomach is about the size of a banana. It limits the amount of food that the patient can eat by allowing the patient to feel full after eating small amounts of food. Tag a friend who is interested in a career as a surgeon! .
Credit: @estudiante_quirurgico .
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Who's excited for the weekend?! Feels like the week went by super quickly (I'm not complaining!). Also yes I love @pusheen 😅😁 Tonight I am writing notes on the endocrine system, which I already started reviewing a couple days ago. Next is flashcards! Hope you all have a wonderful friday tomorrow! ❤
I almost failed nursing school. .
Yup! I was 0.5 points away from being held back an entire year because I couldn’t pass one class. . . AND it was 3 days before graduation 😩 Talk about stressful!
I cried so hard and thought I wouldn’t be able to walk across the stage with the rest of my graduating class... but FAVOR 🙌🏾 I was able to talk to the professor and retake the final exam and passed! Sometimes we wonder why things happen in our lives and why we can’t be as smart or as successful as the next person , but one thing I know is that when God has His hands on you the end result is always greater than what we had been stressing over.
Now, 4 years later I’m working as a travel nurse from New York to California and now Hawaii! and I wouldn’t have made it this far without God. Feeling extremely grateful this morning and had to share. Never give up on your dreams, never let anyone talk you out of what your heart is set on and most importantly, never doubt yourself! We all have different paths and we all have those times where we feel we aren’t good enough or won’t make it, but you will make it! And you will reach your goals! It’s your race, so stop looking around at everyone else and focus on you !😘 scrubs: @affinitymedwear
33 24811 hours ago
Shout out to all the labor and delivery nurses. I remember the only time I felt queasy was in nursing school during our L&D rotation. I almost passed out witnessing a precipitous birth. It was cray 😜
💚 @peachiestudies - In a perfect world, I would be wearing the correct sized gloves and the fake arm would give me flashback 🌎🧤💉
Throughout nursing school, I unfortunately haven't had much hands on practice with starting IVs. It feels like it's a skill that I should be somewhat competent in even though people tell me that I'll eventually learn it when I'm actually working as an RN. It's so nerve-wracking to practice on real people though since I don't want to poke them more than once lol😱 Hopefully I'll get more comfortable because I found out I'll be practicing with an IV therapy team in the next couple of weeks and I can't wait to learn from them! - #stetholifestyle#medicine#nurse#nursing#rn#medical#nursingschool#nursingstudent#tbt#stethopassport#surgery