M Vishwakrma classes

❇ 12th November 🫁 *World Pneumonia Day*

> Theme25 : "Child Survival"

🫁 World Pneumonia Day was first observed on 12 November 2009

🔸Haemophilus infulenzae type B and streptococcus Pneumonia are the two most common cause of deadly pneumonia.
🔸India Target eliminate pneumonia - 2025
🔸SAANS : Social Awareness and Actions to Neutralize Pneumonia Successfully

3 months ago | [YT] | 2

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🔹 _PEDIATRICS_ :

▪️ 👶 Newborn heart rate → 120–160 bpm
▪️ 👶 Apgar score checked at → 1 min & 5 min
▪️ 👶 Vitamin K given to → Prevent bleeding disorder
▪️ 👶 First vaccine after birth → BCG
▪️ 👶 Exclusive breastfeeding for → 6 months
▪️ 👶 Bulging fontanelle → Increased ICP
▪️ 👶 Sunken fontanelle → Dehydration
▪️ 👶 Birth weight doubles by → 5 months
▪️ 👶 Birth weight triples by → 1 year

3 months ago | [YT] | 3

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M Vishwakrma classes

Loss of deep tendon reflex, respiratory depression (less than 12 breaths/min), cardiac depression, and urine output below 30 ml/hr are the classical side effects of Magnesium Sulfate (MgSO₄) therapy.

*💡 These parameters must be monitored and recorded regularly during MgSO₄ administration to prevent toxicity.*

#NursingExam #MagnesiumSulfate #NursingConcepts #NORCETPrep

3 months ago | [YT] | 4

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M Vishwakrma classes

*Spinal Cord Injury — Key Points for Quick Revision*

*Early Signs:*
* Sudden loss of reflexes below the level of injury
* Injury in sacral/conus medullaris → bowel & bladder areflexia, flaccid lower limbs, paralytic ileus, urinary retention
* If only upper sacral segments damaged → penile erection, ejaculation & micturition reflexes may remain
* Flaccid paralysis below injury level
*• Neurogenic shock: ↓ sympathetic tone → vasodilation, venous pooling, hypotension, bradycardia, no sweating*

*⚡ Later Signs:*
* Reflex hyperexcitability (spastic paralysis) → muscles below the injury become spastic & hyperreflexic
* Diminished reflex excitability may be seen

3 months ago | [YT] | 2

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M Vishwakrma classes

Night Dose Topic: SHOCK (Critical Care Nursing)
📘 Full concept + clinical points + exam focus + easy to revise at night

🌙 Night Dose – SHOCK (Critical Care Nursing)

💉 For NORCET 10 | NCLEX-Level | High-Scoring Concept

🩸 1️⃣ Definition

➡️ Shock = Inadequate tissue perfusion → cellular hypoxia → organ dysfunction.

🧠 Key Mechanism:
↓Circulating volume or ↓Cardiac output → ↓O₂ delivery → Anaerobic metabolism → Lactic acidosis.

💡 2️⃣ Types of Shock

Type Primary Cause Key Signs Example

Hypovolemic Fluid/blood loss ↓BP, ↑HR, ↓Urine Hemorrhage, burns
Cardiogenic Pump failure Crackles, ↑CVP, weak pulse MI, arrhythmia
Distributive Vasodilation → ↓Resistance Warm skin, ↓BP Septic, Anaphylactic, Neurogenic
Obstructive Physical block to flow Distended neck veins, muffled heart Cardiac tamponade, PE

⚙️ 3️⃣ Stages of Shock

1️⃣ Initial: ↓O₂ → anaerobic metabolism → lactic acidosis.
2️⃣ Compensatory: SNS activation → tachycardia, vasoconstriction.
3️⃣ Progressive: ↓BP, ↓CO, altered LOC, acidosis worsens.
4️⃣ Irreversible: Multiorgan failure → death.

🩺 Goal: Detect before progressive stage!

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🧬 4️⃣ Key Parameters to Monitor

Parameter Normal Shock Finding

MAP 70–105 mmHg <65 mmHg = poor perfusion
Urine Output ≥0.5 mL/kg/hr ↓ indicates hypoperfusion
CVP 2–8 mmHg ↓ = Hypovolemia; ↑ = Cardiogenic
Lactate <2 mmol/L >4 = severe shock

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💊 5️⃣ Management Principles (ABCDE)

A – Airway: Secure, give high-flow O₂
B – Breathing: Monitor SpO₂, ABG
C – Circulation:
- Rapid IV crystalloids (NS, RL)
- Vasopressors if MAP < 65 (Norepinephrine 1st choice)
D – Disability: Assess LOC (GCS)
E – Exposure: Identify cause (bleed, allergy, sepsis)

💉 IV Access: 2 large-bore cannulas
⚡ Avoid Trendelenburg (may impair breathing)

💉 6️⃣ Drug Focus

Drug Use Key Nursing Point

Norepinephrine Septic shock Titrate to MAP ≥ 65
Dopamine Cardiogenic shock Watch arrhythmia
Dobutamine Low CO with adequate BP Inotrope effect
Epinephrine Anaphylactic shock IM 0.3–0.5 mg mid-thigh
Hydrocortisone Refractory septic shock Check glucose, infection

🧠 7️⃣ Nursing Priorities

✅ Monitor vital signs & hemodynamics continuously
✅ Measure urine hourly (insert Foley)
✅ Maintain normothermia
✅ Prevent infection (asepsis)
✅ Reassess after each fluid bolus
✅ Educate: early reporting of chest pain, SOB, dizziness

📈 8️⃣ Diagnostic Clues (Exam Focus)

Septic Shock: Warm skin → Cold, mottled later

Anaphylactic: Stridor, hypotension, rash

Cardiogenic: Crackles, ↑CVP, weak pulse

Neurogenic: ↓HR + ↓BP (only shock with bradycardia)

Obstructive: JVD + muffled heart (Beck’s triad in tamponade)

🩺 9️⃣ Formula to Remember

MAP = (DBP × 2 + SBP) ÷ 3
👉 Maintain MAP ≥ 65 mmHg

✨ 10️⃣ Quick NCLEX/NORCET Points

Best indicator of perfusion: Urine output

First sign of shock: Tachycardia

Late sign: Hypotension

In shock → never give vasopressors without fluids first

Warm shock → septic; Cold shock → cardiogenic/hypovolemic

Epinephrine = drug of choice for anaphylaxis

🌙 Motivational End Line

💭 “In Critical Care, seconds save lives — and knowledge gives speed.”
Keep revising, keep saving lives 💪