INTRODUCTION TO NURSING

Nursing is an applied health discipline dealing with the health conditions

of the individual, family, and the community, which has succeeded in

renewing and adapting itself to the daily social, central and technological

changes from the past to the present.

The Nurses Day began to be celebrated since May 12, 1954 in Honour of

Florence Nightingale’s Birthday. It has been defined by the International

Nursing Council (ICN) as a profession that helps to protect and improve

the health of the individual, the family and the country and provide

support for the rehabilitation and recovery from the diseases.

Nursing is one of the leading professions that has an indispensable role in

the protection and improvement of Human’s Health. The Significances of

the profession arises from the fact the Nurses work in a position where

they help the most precious being in the world i.e. individuals in case of

failure to meet basic needs themselves, protect and enable them to recover

from illness and so on. It is therefore impressive that they are competent

and capable enough to learn affective behaviours, cognitive and technical

skills in the provision of quality Public Nursing Sciences.

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The professional values that Nurses have are guiding the interactions with

Healthy/Sick individuals, colleagues, other team members and the

community as well as making decisions on value added practices and

providing the Basis for Nursing Practice.

DEFINITION OF NURSING

Nursing is the diagnosis and treatment of Human responses and advocacy

in the care of individuals, families, group, communities and populations in

recognition of the connection of all humanity.

WHAT ARE FIVE BASIC NURSING PROCESS

Nursing Basic process functions as a systemic guide to client centered

care with five (5) sequential steps. These are: -

(1) Assessment

(2) Diagnosis

(c) Planning

(d) Implementation

(e) Evaluation

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(1) ASSESSMENT

This is the First step and involves critical thinking skills and data

collection.

(2) DIAGNOSIS

This is the second basic process in Nursing that involves the

outcome of your assessment to guide you toward the outcome of

your findings.

(3) PLANNING

This is the process of carrying out the aim and establishment of one’s

goal.

(4) IMPLEMENTATION

This is the act of putting in action by executing your plans in other to

achieve ones goals.

(5) EVALUATION

This is the last step involves in Nursing processes which stands as

assessment and analysis of implemented action.

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WHO IS A NURSE?

(1) a Nurse is a Healthcare provider who focuses on the needs of each

individual person

(2) A Nurse is a person who is trained to give care to people who are

sick or injured. Nurses work with doctors and other Health

healthcare workers to make patients well and to keep them fit and

healthy.

(3) In a simple form, a Nurse is a person who cares for the sick or

infirm

WHAT ARE THE QUALITIES OF A NURSE?

Essential Qualities of a good Nurse are:-

1. Compassion and Empathy

2. Clinical acumen

3. Dedication to continuous education

4. Ability to work as a team member

5. Strength in problem solving

6. Supers in communication skills

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7. Ability to handle pressure

8. Commitment to safety

DUTIES OF A NURSE

1. Nurses care for injuries

2. Administer medications; conduct frequent physical medical

examinations

3. Record detailed medical history

4. Monitor heart rate and blood pressure, perform diagnosis test,

operate medical equipment.

5. Draw blood, admit/discharge patients according to physical orders.

WHAT ARE THE TEN (10) NURISNG ETHNICAL VALUE?

1. Human Dignity

2. Privacy

3. Justice

4. Autonomy in decision making

5. Precision and accuracy in caring

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6. Commitment

7. Human relationship

8. Sympathy

9. Honesty

10. Individual and professional competency

HEALTH CARE DELIVERY SYSTEM IN NIGERIA

A Healthcare Delivery System includes all the institutions, organizations,

people and resources that help a particular group of people stay healthy.

Healthcare Delivery System in Nigeria both Private and Government

Business, the federal and state government are allowed to set up Hospitals

and other Health facilities. Effective healthcare Delivery is usually a

function of the quality, accessibility and affordability of the service.

Healthcare provision is usually compared to a pyramid with three (3)

levels (Primary, Secondary and Tertiary) just like the three (3) levels of

government Healthcare system of government. Healthcare consists of all

the organizations, institutions, resources and people whose primary

purpose is to improve health.

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FORMS OF TRADITIONAL HEALTHCARE

1. General healthcare delivery system

2. Specific healthcare delivery system

3. Divination

4. Poison Neutralizing

5. Birth attendance

6. Bone setting/adjustment

7. Psychiatry

8. Frame work for explaining traditional medicine

REFERRAL SYSTEM

Referral System is a dynamic process in which a health worker at one

level of the health system, having insufficient resources (drugs,

equipment, skills) to manage clinical condition, seeks the help of a better

or differently resourced facility at the same or higher level to assist in.

Referral system according to PHC states that it is a process by which

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patient care is transferred from one Health professional to another for

necessary diagnostic and therapeutic intervention.

TYPES OF REFERRAL SYSTEM

Acerating to the disease’s diagnostic and treatment, a referral management

system can be of two types – Routine and Emergency.

HEALTH EDUCATION

The World Health Organization defined Health Education as any

combination of learning experiences designed to help individual and

communities improve their health, by increasing their knowledge or

influencing their attitude’s. Health Education is also seen as a profession

that educate people about health. Areas within this profession encompass

environmental health, Physical health, Social health, Emotional health,

Intellectual health and Spiritual health.

THE GOALS OF HEALTH EDUCATION

1. Prevention

2. Maintenance and improvement of health

3. Reduced exposure to risk

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4. Adjustment to disability.

Health Education is a course that aim to give you an understanding of

how to use health promotion & protection strategies to prevent Disease

Outbreak as well as to heal people to improve their health.

OUTREACH HEALTH SERVICE

What is outreach health service?

It is important to clarify what is meant by “OUTREACH SERVICE”.

In this study, the term is used to describe any type of health service that

mobilizes health workers to provide services to the population or to

other health workers, away from the location where they usually work

and live.

HOSPITAL SETTING

A hospital setting refers to the Environment in a Hospital where

patients receive medical care, which may differ from a clinic setting in

terms of time, stress level, unfamiliar medical teams.

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Hospital is an institution that is built, staffed, and equipped for the

Diagnosis of Disease, for treatment, both medical and surgical, of the

sick and injured for their housing during this process.

The modern hospital also often serves as a Centre for investigation and

for teaching.

The following instrument are found in Hospitals:

1. Defibrillators

2. Patient monitors

3. Surgical tables

4. E K GS

5. Anesthesia machines

6. Sterilizers

7. Lights

8. Ultrasound

9. Electro surgical units

10. Blanket/ fluid warmer

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WHAT ARE THE CONTENTS OF A HOSPITAL

A Hospital contains one or more wards that house hospital beds for in

patients. It may also have acute service such as an Emergency

Department, Operating theatre, and intensive care units, as well as a range

of medical specialty Departments. A well equipped hospital may be

classified as a trauma / Centre.

DIFFERENCES BETWEEN HOSPITALS & CLINIC

A clinic is a health care Centre where you receive routine preventative

care when you are healthy or visit your Doctor / Primary care provider

when you are sick.

Medical clinics are usually smaller in size and have a pool of staff. While

a hospital typically has a larger workforce of medical teams and

manpower.

NURSING CARE BED

A nursing care bed (also Nursing bed or care bed) is a bed that has been

adapted to the particular needs of people who are ill or disabled. Nursing

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care bed are used in private home care as well as in inpatient care

(Retirement of nursing homes).

IMPORTANT OF OUTREACH SERVICE:

Outreach service is one of the possibilities to enhance access to health

workers and to improve overall retention at country level. Better

mobilization of unfair health workers to serve remote or undersured areas

in a strategy to improve access to health to the population in remote and

rural areas.

Outreach & Engagement are two Distinct ways to connect with your

community. Outreach is one – way communication that tells community

members about an issue, problem, opportunity or decision.

Outreach programs are an important tool for building relationships

&engaging with audiences. The benefits of having a successful outreach

program can include increased brand recognition, improved customer

service, and better public relations.

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DIFFERENCES ANATOMICAL POSITIONS IN NURSING.

Anatomical positions, or standard anatomical position, refers to the

positioning of the body when it is standing upright & facing forward with

each arm hanging on either side of the body and the palm facing forward,

the legs are parallel, with feets flat on the floor and facing forward.

In prone position, the anatomical position is place down. While supine

position is place face up.

Health talk start some directional terms used in Nursing.

Anterior At or near the front of the body (front view.)

Posterior At or near the back of the body (Back view)
Midline An imaginary vertical line that dividesthe body equally

(right down and middle)

Lateral Farther from midline (Side view)
Media Nearer to midline (side view)
Superior Toward the Head / Upper part of a structure
Inferior Away from the Head lower part of a structure
Superficial Close to the surface of the body
Deep Away from the surface of the body
Proximal Nearer to the originated of a structure

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Distal Farther from the origination of a structure
IDENTIFICATION OF A SURGICAL INSTRUMENT AND USES

1. Scapel, surgical Blades, Layer scissor straight & curve, Forceps,

Kocher, Niddle holder, Retractors, suction Devices.

If we classify them according to their uses, there are three types of

surgical instrument.

I. Cutting Surgical instrument such as blades, knives, scissors

and scalpels.

II. Grasping surgical instrument anything you used to hold

something in places such as forceps.

III. Retracting surgical instrument for holding organs and tissues

out of the way while operating.

VITAL SIGNS

What are vital signs?

Vital signs are body temperature pulse, respiration rate, blood pressure.

(Blood Pressure is considered a vital sign, but is often measured along

with the vital sign).

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Vital signs are an objective measurement of the essential physiological

function of a living organism. They have the name “Vital” as their

measurement & assessment in the critical first step for any clinical

evaluation. The first set of clinical examinations is an evaluation of the

vital signs of the patient.

In another definition, it can easily be seen as a signs that reflect body

functions, including your heartbeat, respiratory rate, temperature and

blood pressure.

I. TEMPERATURE

This is the measurement of hotness or coldness expressed in terms of

any several scales, including Fahrenheit and celcius. Temperature

indicates the direction in which heat energy will spontaneously flow i.e

from a hotter body (one at a high temperature) to a colder body (one at

a lower temperature).

Medically, temperature is defined as the degree of heat or cold within

an object or a human body. In humans, the brains hypothalamus act as

the body’s thermostat and is responsible for regulatingits temperature.

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 FACTORS THAT INFLUNCE BODY TEMPERATURE

Body temperature can be affected by diurnal fluctuations throughout

the days (e.g lowest in the morning, highest in the late afternoon to

early evening) Hormones exercise, Smoking, Consumption of hot or

cold beverages and ageward sex and environment.

II. PULSE

This refers to as the numbers at which the heart beat per minute. The

pulse can be felt at the wrist, side of the neck, back of the kneels, top

of the foot, groin and other places of the body where an artery is close

to the skin.

As the heart pump blood through the arteries, the arteries expand and

contract with the flow of the blood.

A normal resting heart rate for adults range from 60 to 100 beat per

minute. Generally, a lower heart rate at rest implies more efficient heart

function and better cardiovascular fitness.

FACTOR THAT INFLUNCE PULSE RATE IN THE BODY

1. Age, fitness and activity levels

2. Being a smoke
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 3. Having a cardiovascular disease, high cholesterol or diabetes

4. Temperature from the air

5. Body position (standing up or lying down for an example)

6. Emotions

7. Body size

8. Sickness E.T.C

III. RESPIRATION

The world respiration is commonly used to describe the process of

breathing in oxygen and breathing out carbon dioxide. However, the term

more formally refers to the chemical process which an organism uses to

release the energy from food, which typically involves the consumption of

oxygen and release of carbon dioxide within the environment. In air

breathing vertebrates, respiration takes in the lungs. In fish & many

vertebrates, respiration takes place through the gills.

Respiration is categorized in four (4) stages which are:

a) Pulmonary Ventilation: Air move, into and out of the lungs is known

as breathing.

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 b) Internal Respiration: It involves the exchange of gases between

tissues fluids and the body.

c) External Respiration: It involves a gas exchange between inhaled air

and the pulmonary blood.

d) Cellular Respiration: It involves aerobic and anaerobic respiration.

FACTORS THAT INFLUENCE RESPIRATORY RATE

Rate of respiration depends on several factors such as temperature,

oxygen level and glucose level.

IV. BLOOD PRESSURE

Blood pressure is the force of your blood pushing against the walls of

your arteries. Each time your heart beats, it pumps blood into the arteries.

Your blood pressure is the highest when your heart beats, pumping the

blood. This is called systolic pressure.

Normal blood pressure for most adults is defined as a systolic pressure of

less than 120 and a diastolic pressure of less than 80

FACTORS THAT ARE RESPONSIBLE FOR HIGH BLOOD

PRESSURE

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 1. Obesity or being over weight

2. Family history of high blood pressure

3. Not being physically active

4. Diet high in salt (sodium) or low in potassium

5. Tobacco use

6. Drinking too much alcohol

7. Certain chronic condition

8. Age

DRUG

Drug is a medicine or other substance which has a physiological effect

when ingested or otherwise introduce into the body.Drugs can also be

defined as a substance that changes person mental or physical state, they

can affect the way your brain works, how you feel and behave, your

understanding and your senses.

This makes them unpredictable and dangerous, especially for your people.

The effect of drugs are different for each and age.

According to World Health Organization (W H O), defines drug as a

substances that, when taken in or administered into one’s system, affect

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mental processes, e.g perception, consciousness, cognition or mood and

emotions.

FORMS OF DRUGS

1. Liquid, the active part of the medicine is combined with a liquid to

make it easier to take or better absorbed.

2. Tablets: The active ingredient is combined with another substances

and pressed into a round or oval solid shape.

3. Capsule

4. Topical medicine

5. Suppository

6. Drops

7. INHALER

8. Injection

9. Powdered E.T.C

DRUG MANUFACTURING

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Pharmaceutical manufacturing is the process of industrial scale synthesis

of pharmaceutical drugs as part of the pharmaceutical industry. The

process of drugs manufacturing can be broken down into a series of unit

operations, such as milling, granulating, coating, tablet pressing and

others.Pharmaceutical manufacturing comprises physical process such as

Blending, Compressing, filtration, Heating, Encapsulating, Shearing,

tableting, Granulating, Coating and Drying.

Pharmaceutical manufacturing of drugs is divided into two major stages.

1) The production of the active ingredient or drug (primary processing

and manufacturing) and

2) Secondary manufacturing, the conversion of the active drugs into

products suitable for administration.

WHAT IS MANUFACTURED DRUG

The law defines manufacturing as an act where an individual participates

in any process of creating an illicit drug.

PHARMACOLOGY

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 Pharmacology is the science of drugs and medication including a

substances origin, composition, pharmacokinetics, pharmacodynamics,

therapeutic use, and toxicology.

Pharmacology in the broadest sense, is the study of how chemical agents,

both natural and synthetic (i.e drugs) affects biological system.

 PHARMACOKINETIC: The branch of pharmacology concerned with

the movement of drugs within the body.

 PHARMACODYNAMIC: The study of the biochemical and

physiological effects of drugs.

 PHARMACOVIGILANCE: The science and activities relating to the

detection, understanding and prevention of adverse effects or any other

medicine / vaccine related problem.

The word drug is taken from French word “Drogue” which means dry

herb, strongly suggest that earliest drugs were taken out from plant

sources.

Disease by some unconventional methods using plants, animal products

and minimal of them plant was given priority.

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TREATMENT OF MINOR AILMENT

1. MALARIA: Malaria is disease cause by a parasite. The parasite is

spread to human through the bites of infected mosquitoes. People

who have malaria usually feel very sick with high fever and shaking

chills. While the disease is uncommon in temperateanimates, malaria

is still common in tropical and subtropical countries.

Malaria is caused by protozoa of the germ’s plasmodium. Four

species cause disease in humans: plasmodium falciparum,

plasmodium vivax, plasmodium ovale, and plasmodium malaria.

Other species of plasmodium infect reptiles, birds and other

mammals including plasmodium knowlesi.

MORPHOLOGY OF MALARIA PARASITE

Parasite morphology: malaria parasite form four developmental stages in

humans (hepatic schizonts and then intraerythrocytic trophozoites,

schizonts and gamonts) and three developmental stages in mozartites

(ookinetes, oocysts and sporozoites). Malaria parasites of the genius

plasmodium spread by successively infecting two types of hosts: Female

Anopheles mosquitoes and Human.

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The most common plasmodium parasites causing malaria in humans are

plasmodium falciparum, which is responsible for the majority of malaria

deaths globally, and plasmodium vivax, which has added complication of

a dormant liver stage, which can be reactivated in the absence of a

mosquito bite, leading to relapsing malaria.

LIFE CYCLE STAGES OF THE MALARIA PARASITE IN THE

ANOPHELES MOSQUITO

Lifecycle stages in the mosquito begin when an insect feeds on the blood

of a person infected with malaria, in whom the parasite exist as mature

male and female preproductive cells called gametocytes. These

gametocytes are taken into the mosquito gut when it feeds, where they

develop further into males &females gametes.

A male gamete fertilizes the female one to form a zygote. The zygote then

enlarges to form an ookinetes that migrates to the outer wall of the

mosquito gut, where parasite named oocysts of this stage multiply several

times. Eventually, the new parasites are released and migrate to the

mosquito’s salivary glands, ready for transmission to another human.

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When the mosquito bites another human, the parasites, now called

sporozoites leaves the mosquito salivary gland and enter the human skin

making their way, intimacy, to the human liver.

Signs and Symptoms of Malaria

 Fever

 Chills

 General feeling of discomfort

 Headache

 Nauseas & vomiting

 Diarrhea

 Abdominal pain

 Muscle or joint pain

Malaria is a serious disease that can be life threatening, without

treatment. However, with treatment, most people make a full recovery.

Without treatment, symptoms may last from two weeks, depending on

the type of plasmodium.

TREATMENT

Malaria can be treated with the following medication:

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 Artemisinin drug (Artemether and Artesunate). The best treatment for

plasmodium falciparum malaria, if available, is artemisinin

combination therapy.

 Atovaquone (mepron)

 Chloroquine

 Doxycycline

 Mefloarine

 Quinine

 Primaquine

2. TYPHOID FEVER

Typhoid fever is a bacteria infection that can spread throughout the body,

affecting many organs without prompt treatment, it can cause serious

complication and can be fatal. It is caused by bacteria that cause

salmonella typhi, which is related to the bacteria that causes salmonella

food poisoning. These bacteria can travel down to your intestines, and

then into your blood. In the blood, they travel to your lymph modes,

gallbladder, liver, spleen, and other parts of the body.

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Some people become carrier of S typhi and continue to release the

bacteria in their stools, sometime for years, spreading the disease.

MODE OF TRANSMISSION

How does a person get typhoid?

People who drink contaminated water or eat food washed in a

contaminated water, can develop typhoid fever. Other ways typhoid fever

can be contaminated include:

Using a toilet contaminated with bacteria and touching your mouth before

washing your hands. Eating seafood from a water source contaminated by

infected poo or pee.

SIGNS & SYMPTOMS

Early Signs & Symptoms of Typhoid Include:

 Fever

 Generally ill feeling

 Abdominal pain

 Severe diarrhea

 Rash
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 Headache

PREVENTION

Typhoid fever is common in places with poor sanitation and a lack of

safe drinking water.

Access to safe water and adequate sanitation, hygiene among food

handlers and typhoid vaccination are all effective in preventing typhoid

fever.

Wash before eating or preparing food or after using the toilet. Carry an

alcohol-based hand sanitizer for time when soap and water are not

available.

3. HIGH BLOOD PRESSURE

High blood pressure is when the force of blood pushing against the artery

walls is consistently too high. This damage your arteries overtime and can

lead to serious complication like: Heart attack and stroke “hypertension”

is another name for this common condition.

Health providers call high blood pressure a “silent killer” because you

usually don’t have any symptoms. So, you may not be aware that anything

is wrong, but the damage is still occurring within your body.

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Blood pressure is the measurement of the pressure or force of blood

pushing against blood vessel walls. Your BP reading has two numbers.

 The top number is the systolic pressure, which measures the pressure

on your artery walls when your heart beats or contracts.

 The bottom number is the diastolic blood pressure. This measures the

pressure on your artery walls between best when your heart is relaxing.

Health care provider measure blood pressure in millimeters of mercury

(mmHq) causes of hypertension are: smoking, drinking, being

overweight, and eating too much salt are the primary risk factors for

hypertension.

High blood pressure in younger children is often related to other health

conditions, such as heart defects, kidney disease, genetic condition or

hormone disorder.

For those who have hypertension, regular physical activities can bring

blood pressure down to safer levels. Some examples of aerobic exercise

that can help lower blood pressure include walking, togging, cycling,

swimming and dancing.

WHAT IS AN ACCIDENT &EMERGENCY

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 Accident is defined as an unfortunate incident that happens

unexpectedly and unintentionally, typically resulting in damage or

injury.

WHAT IS EMERGENCY?

An emergency is a serious, unexcepted and often dangerous situation

requiring immediate section. In other hand, an emerging in an

unexpected and difficult or dangerous situation, especially an accident

that happens suddenly and that requires quick action to deal with it.

Most common medical emergencies

 Bleeding cuts and wounds cause bleeding

 Breathing difficulties

 Someone collapses

 Fit and epileptic seizure

 Severe pain

 Heart attack

 A stroke

Four life threading emergency situation are, recognize that breathing

emergency, choking, heart attack, stroke heavy bleeding poisoning and

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shock are life threating situations make decision and take appropriate

steps to keep a victim alive and keep injuries from getting worse until the

emergency medical sciences system arrives.

SERILIZATION IN NURSING
DEFINATION

Sterilization desecrates process that destroys or eliminate all forms of

Microbial life and in carried out in health facilities by physical or

chemical method sterilization can be achieved through various means,

include heat, chemicals, irradiation, high pressure and filtration.

Sterilization is distinct from defection, sanitization and platinization in

that those method reduce rather than eliminate all form of life. And

biological agents present.

Medical devices are sterilized in a variety of ways include using moist

heat (steam), dry heat, radiation, ethylene oxide (ETO) gas, vaporized

hydrogen peroxide, and other sterilization methods (for example chlorine

dioxide gas, vaporized peracetic acids, and nitrogen dioxide).

WHAT IS PREGNANCY?

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Pregnancy is the term used to describe the period in which a fetus

develops inside a woman’s womb or uterus. The term used at which the

uterus is housing a fetus is called Gravid. Pregnancy usually last for about

40 weeks, or just over 9 months as measured from the last menstrual

period to delivery.

According to a study published in the journal of clinical epidemiology,

most women (59 percent) experienced an onset of pregnancy symptoms

by their fifth or sixth weeks, while 71 percent reported symptoms by the

end of week six and 89 percent by eight week. If you don’t feel any

symptoms at all, don’t worry.

EARLY SIGNS & SYMPTOMS OF PREGNANCY

When you have decided that you are ready for a baby, sometimes waiting

to see the two lines on a pregnancy test can feel like forever. Will it be this

month? When you are trying to conceive, you may overanalyze any new

feeling that you are experiencing. Are you bloated? Sore breast? Is your

lunch not sitting in your stomach?

We break down the most common early signs of pregnancy and what you

can do to feel comfortable while your little bundle of joy is growing.

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WHEN DO PREGNANCY SYMPTOMS START?

Every woman has their own journey to motherhood, so symptoms and

timing can vary. Some women may begin noticing the first early sign of

pregnancy a week or two after conception, while others will start to feel

symptoms closer to four or five weeks after conception. Some women

may not feel symptoms until their period is noticeably late, or even farther

into pregnancy. According to a study published in the journal of clinical

epidemiology most women (59 percent) experience an onset of pregnancy

symptoms by their fifth or six weeks, while (71 percent) reported

symptoms by the end of week six and (89 percent) by week eight.

If you don’t feel any symptoms at all, don’t worry, some women won’t

feel any symptoms and go on to have healthy pregnancy consider yourself

one of the lucky ones.

1. MISSED PERIOD:

If you are ready for a baby, you have probably been tracking your

period and watching closely every time you use the restroom to see

if it has shown up this month. A missed period is often one of the 1 st

symptoms of pregnancy and can be a sign of that a little one is on the

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 way. Take a home pregnancy test to see if you are pregnant. If it is

positive, call your OB/GYN to schedule your first prenatal visit

around 8 weeks gestation.

2. SORE BREASTS:

Are your breast feeling tender and swollen?

Sore breast are another symptoms that you may have conceived this

circle but unfortunately, some women experience soreness as part of

their normal menstrual flow or circles so it can be hard to tell the

difference. Usually, if you have conceived, the soreness gets worse

overtime, and you may begin noticing changes on how your breast

look.

3. DARKENING AREOLAS:

We told you that your breast may begin to look different, have you

noticed darkening of the areolas? The areolas are the area around

your nipples. They can start to appear darker and larger as early as

one or two weeks after conception, making this one of the more

noticeable early signs of pregnancy. You may also begin to see more

visible veins and little bumps popping up along the edge of the

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 areolas. They are called “Montgomery Tubercles” and will help to

rubricate your nipples to get them ready for your baby to nurse when

they are here. This is only the beginning of breast changes in

pregnancy.

4. FATIGUE

Are you feeling exhausted just by doing your normal everyday

activities?

Unfortunately, fatigue may be here to stay for the duration of your

pregnancy and beyond your body in producing more blood to carry

nutrient to your growing baby. You should begin to feel little more

energy during the second trimester.

5. HEIGHTENED SENSE OF SMELL

Is the smell of scrambled egg that you usually make for breakfast

suddenly making you feel nauseated? A heightened sense of smell is

often associated with incoming sickness and usually subsides after

the 1st trimester.

6. BLOATING

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 Another not so pleasant early pregnancy symptoms is gas. An

increase in progesterone and estrogen is the culprit hehing this

symptom and may cause abdominal pain, bloating, belching and

passing gas. These symptoms may be around for the entire 9 months

of pregnancy.

7. MOOD SWINGS

You may start to experience mood swings similar to those you feel in

the days leading to your normal period. These uncontrollable shifts

in your emotion occur due to change in your hormones, especially in

the first trimester when the level of estrogen & progesterone changes

dramatically.

8. CRAMPING

Similar to ore breasts, cramping is an early sign of pregnancy.

Cramping should not be severe, if you are in tense pain, its only on

one side, or if bleeding is accompanying it and it is not menstrual

symptoms, contact your doctor right away.

9. SPOTTING

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 Did you notice some spotting about 1-2 weeks after ovulation and

sexual intercourse? It may be implantation bleeding. Spotting

happens six to twelve days after conception when a fertilized egg

digs deep into the lining of your uterus, causing a bit of mild

irritation. You may confuse it with the beginning of your period but

it can eventually mean that you are expecting.

Implantation bleeding is light and should not fill up a pad or tampon.

It is usually light pink or brown tinge.

10. HIGH BASAL BODY TEMPERATURE

Many women don’t realize that their temperature may be able to give

them a sign hat they are pregnant. If you have been charting your

basal body temperature and you get a higher than normal reading,

then you may want to buy a pregnancy test. When you are charting,

your basal (or walking) temperature peaks when you ovulate, then

gradually decrease during the latter part of your circle until your

period begins. But if you get pregnant during the circle, your basal

temperature won’t get plumet instead, it will stay high.

11. FREQUENT URINATION

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 Are you feeling the urge of going to the bathroom more than usual?

Having to urinate more frequently is definitely a common pregnancy

symptomand will remain throughout your pregnancy.

12. MORNING SICKNESS

Feeling queasy? Morning sickness is not just in the morning but can

occur at any time of the day. Try some of these remedies to help ease

your nauseas. Usually, morning sickness will begin to subside after

the 1st trimester, but some women may experience it throughout their

pregnancy. If you are experiencing any of these symptoms and due

receive a positive pregnancy test, make sure to set up your 1 st

prenatal visit with your OB/GYN around 8 week gestation.

DANGER SIGNS DURING PRENANCY

Most women go through pregnancy, Labour and delivery without

any complication. However, a significant number will have

unpleasantexperience ranges from mild to severe and even leading to

maternal and fetal mortality. These complications usually give

warning signs before they go out of hands. Expectant mother should

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 be aware of and pay attention to them to prevent untoward

complications. Some of these are as follows:

1. BLEEDING PER VAGINUM

Vagina bleeding at anytime during pregnancy requires attention. The

causes maybe due to various types of abortions, Ectopic pregnancy,

abnormal location of the placenta (abruptio placenta) vasapraevia.

Other may include abnormal pregnancy (molar pregnancy or

choriocarcinoma), vagina yeast infection and trauma during

intercourse. They may be accompanied or associated with other signs

and symptoms.

All these requires quick professional evaluation and treatment to

make proper diagnoses, treat or prevent deterioration of the

condition.

2. ABDOMINAL PAIN DURING PREGNANCY

The significant of pain during pregnancy is related to the gestation of

age. Spontaneous abortions (miscarriage), Ectopic pregnancy and

fibroid coexisting with pregnancies are common causes of pains in

pregnancy in our environment.

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 Other causes may include ovarian cysts, subchorionic Hematoma,

round ligament pain or cramps due to distension of the uterus.

Appendicitis, cholecystitis, small bowel obstruction, pneumonia and

urinary track infection are other medical condition that may cause

pain, placenta abruption, premature contractions or major and severe

hypertension in pregnancy are causes of pain in the 3rd trimester.

Pain is an early warning by the body that something serious and /or

dangerous may be in the offing quick and current evaluation is

necessary to prevent unwanted consequences to the fetus, mother or

both.

3. SEVERE NAUSEA/VOMITING

Hyperemesis or excessive vomiting in pregnancy. Hormonal changes

in pregnancy may cause vomiting or Nausea and inability to tolerate

fluids and foods leading to dehydration, weight loss and sometimes

features of malnutrition especially in early pregnancy. For most

ladies, this usually gets better after 3 to 4 months.

Prompts assessment, dietary advice with attention to fluid, salt and

calorie intake are all that are required in most women.

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4. FEVER AND SEVERE WEAKNESS

The common cause of fever, weakness and ache in our environment

is malaria; caused by plasmodium F. Bacteria and viral agents may

cause upper respiratory infections, pharyngitis, pneumonia and

urinary track infection. Recently Covid-19 has come to the world.

High fever (Temp of 38oC or more) is particularly dangerous in early

pregnancy because it can easily kill the fetus in the uterus and also

stimulate the uterus to contract and expel the fetus. Malaria parasite

can cause high fever and also invade the placenta tissue to cause

abortion.

Quick evaluation and appropriate treatment will prevent some of the

serious complications that may follow.

5. SEVERE HEADACHE / BLURRED VISION / CONVULTION

All these may be caused by hypertensive disease in pregnancy. There

may be edema, proteinemia and / or upper abdominal pain dure to

distention of the liver capsule. Hypertension with protein in urine is

pre-eclampsia. Pre-eclampsia with fits in eclampsia. Severe

hypertension, pre-eclampsia and eclampsia are obstetrics emergency

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 that requires prompt and specialist attention because of the high fetal

and maternal morbidity and mortality. Management will include

control of blood pressure, prevent fits, delivery of the baby and post-

delivery care of the baby mother.

6. REDUCE FETAL MOVEMENTS / KICKS

Babies start to move early in pregnancy. Most mothers start to notice

fetal kicks around 20 weeks of pregnancy. Each baby has its own

pattern of movement and mothers need to be aware of their baby’s

pattern. Mothers should keep track of the baby’s movement.

Reduction in movement should be discussed with the health care

provider especially during the 3rd trimester of pregnancy. Stressful

condition to the baby may cause reduced fetal kicks/movement just

like adult also rest when indisposed. Early recognition and attention

may prevent outward consequences.

PLACENTA

What is placenta?

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 The placenta is a temporary organ that connect the baby to uterus

during pregnancy. The placenta develops shortly after conception

and attaches to the wall of the uterus.

Your baby is connected to the placenta by the umbilical cord.

Together, the placenta and umbilical cord act as your baby’s lifeline

while in the uterus. Functions of the placenta include:

a. Provide the baby with oxygen and nutrients.

b. Removes harmful waste and carbon dioxide from your baby.

c. Produce hormones that help your baby grow.

d. Passes immunity from you to your baby.

The placenta begins to form after a fertilized egg implants in your

uterus around seven to 10 days after conception. It continues to grow

throughout your pregnancy to support your baby. The placenta starts

as few cells and grow to be several inches long. The placenta takes

over hormone production by the end of the first trimester (12 weeks

of pregnancy), up until this time, the carpsulateum handle most of

the hormone production. Many people’s first trimester. Symptoms of

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 nausea and fatigue go away once the placenta takes over in the

second trimester.

 WHAT DOES THE PLACENTA DO?

The placenta helps to keep your baby alive and healthy during

pregnancy. Your blood passes through the placenta and provide oxygen,

glucose and nutrients to the baby through the umbilical cord. The

placenta can also filter out harmful waste and carbon dioxide from your

baby’s blood. The placenta enables the exchange of oxygen and

nutrient between the bloodstreams of you and your baby without ever

mixing them. It acts as your baby’s lungs, kidney and liver until birth.

As you get closer to delivery, the placenta passes antibodies to your

baby to jumpstart its immunity. This immunity sticks with your baby

for the first several months of life. The placenta produces several

important hormones like lactogen, estrogen and progesterone during

pregnancy. These pregnancy hormones are beneficial to both you and

your baby for example, the placenta produced a hormone that

suppresses milk production during pregnancy.

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 DOES THE PLACENTA MOVES?

First of the placenta appears to move only because the uterus expands

as the pregnancy and fetus grows your healthcare provider will look at

the location of your placenta during your 20 weeks anatomy ultrasound

and determine if its position may cause complication. Most placenta

move to the top side of the uterus by 32 weeks of pregnancy.

 WHERE DOES THE PLACENTA FORM?

The placenta can form anywhere in your uterus. It develops wherever

the fertilizer egg implants into your uterine wall. Some of the positions

of the placenta are:

1. Posterior placenta: The placenta grows on the back wall of your

uterus.

2. Anterior placenta: The placenta grows on the front wall of your

uterus closet to your abdomen.

3. Fundal placenta: The placenta grows at the top of your uterus.

4. Lateral placenta: the placenta grows on the right or left wall of your

uterus.

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 The placenta can move up until about 32 weeks of pregnancy. Its

common to have a placenta that moves upward and away from your

cervix as your baby get bigger.

 WHAT DOES THE PLACENTA LOOK LIKE?

The placenta looks like a disc of bumpy tissue rich in blood vessels,

making it appear dark red at term. Most of the mature placenta tissue is

made up of blood vessels. They connect with the baby through the

umbilical cord and branch throughout the placenta disc like limbs of a

tree.

 WHAT COLOUR IS PLACENTA?

The placenta has two side: The side attached to your uterus and the side

closest to your baby. The side attached to your uterine wall is a deep

reddish colour, while the side facing your baby is gray.

CONDITION AND DISORDERS OF PLACENTA

Any issue with placenta can be dangerous for both you and your baby.

Some of the complications associated with the placenta are:

1. Placenta previa: The placenta covers all or part of the cervix.

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 2. Placenta accreta: The placenta attached too deep to the wall of your

uterus.

3. Abruption placenta: A condition during pregnancy when the placenta

separates from the uterus too early.

4. Placenta insufficiency: When the placenta isn’t providing enough

nutrient or oxygen to your baby.

5. Retained placenta: when part of the placenta stays inside your uterus

after pregnancy.

MOST COMMON SIGN OF PLACENTA DISODER

Bleeding from your vagina is the most common sign that there is a

problem with the placenta. Not everyone experience bleeding, so it’s

important to discuss your pregnancy symptoms with your healthcare

provider.

Symptoms like abdominal pain or contraction could also means there is a

problem with the placenta. In some cases, a baby that measures too small

for dates suggests a problem with the placenta.

LABOR

What is labor?

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Labor is a series of continuous, progressive contractions of uterus that

help the cervix dilate (open) and efface (thin). This allows the fetus move

through the birth canal. Labor usually starts two weeks before or after the

estimated date of delivery. During the three stages of labor, your body will

prepare for the birth of your baby (stage one), delivery of baby (stage

two), the delivery of placenta (stage three) throughout labor, your body

will use contractions to dilate and efface your cervix.

HOW DOES LABOR WORKS?

As your pregnancy begins to wrap up, your body will prepare for labor

and delivery. This is the process through which your baby will be born.

Labor is often different for each person. Some have quick labor and some

long, difficult labors. Other people may even experience labor that stalls

or stops leading to medical intervention.

EARLY LABOR

The average labor last 12 to 24 hours for a first birth and is typically

shorter (8 to 10 hrs.) for other birth. Throughout this time, you will

experience three stages of labor the first stage of labor is usually the

longest and it ranges from when you first go into labor until the cervix

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open. The beginning of this stage is called early labor. Early labor is

described as dilating from 0 to 6 centimeters.

ACTIVE LABOR

As the progress and your contractions become stronger, you will move

into the second part of the first stage of labor called active part. Active

labor is dilating from 6 to 8 centimeters and then transmitting into the

second stage as you dilate 8 to 10 centimeters. Your contraction will

become even more stronger during active labor and your cervix will open

up quickly, the second stage of labor is when you push. This is the phase

of your labor when you will actually give birth to your baby.

AFTER BIRTH

The third stage is the point when you deliver the placenta. This is also

called after birth.

WHAT ARE THE EARLY SIGN OF LABOR

The most 10 common early labor signs and symptoms include:

1. THE BODY DROPS

Medically known as “lightening”, this is when the baby “drops”. The

baby’s head descends deeper into the pelvis. For some women, this

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 occurs up to 2 weeks prior to the beginning of labor. Other women

may not notice this event at all.

2. INCREASED URGE TO URINATE

An increase urge to urinate can be a result of the body’s head

dropping into the pelvis. The low position of the baby’s head put

even more pressure on the urinary bladder, so, many women

approaching labor might feel a frequent need to urinate. As the baby

drops, breathing can become easier since there is less pressure on the

diaphragm from underneath.

3. THE MUCUS PLUG PASSES

Passage of the mucus plug is a known sign that labor is near. Thick

mucus produced by the cervical glands normally keeps the cervical

opening closed during pregnancy. This mucus plug must be expelled

before delivery. Pressure from the baby’s head causes the mucus

plug to be expelled from the virginal, discharge (referred to as

bloody show) for some women, the mucus plug is not expelled until

after labor begins, other may notice the mucus discharge in the days

prior to the onset of labor.

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4. THE CERVIX DILATES

Dilation of cervix is a sign that labor is approaching, although this is

detected by the healthcare professional during a pelvic examination.

This begins in the days of labor. Fully dilated means the cervix ha

dilated to a width 10cm.

5. THINNING OF THE CERVIX

In addition to dilation, thinning (effacement) of the cervix also

occurs in the weeks prior to labor since a thinned cervix dilated more

easily. This sign is also detected by the healthcare professional

during pelvic examination.

6. BACK PAIN

Many women note they experience back pain, especially dull pain in

the lower back that comes and goes as labor approaches. Back pain

may accompany contractions felt in other location or may occur on

its own. Women also notice loosening of the joints, particularly in

the pelvic areas, as the third trimester progresses, in preparation for

delivery.

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7. CONTRACTION

Contractions, which can vary among women and can be describe as

pounding, and tightening, stabbing, or similar to menstrual cramps,

increase in strength and frequency as labor approaches. They are

called also pains.

8. RUPTURE OF AMNIOTIC FLUID OR ONE’S WATER

BREAKING

Usually is a sign that labor has begun despite how it is often

portrayers in movies, it is typically not dramatic gush of fluid but

rather a slower dripping or trickle. Amniotic fluid should be colorless

and odorless.

It can sometimes be hard to distinguish from urine, but amniotic

fluid does not have odor.

SOME COMMON COMPLICATIONS DURING LABOR OR

DELIVERY

Each pregnancy and delivery is different and problems may arises if

complications occur, provider may assist by monitoring the situation

closely and intervention as necessary.

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Some of the more common complications are:

1. LABOR THAT DOES NOT PROGRESS

Sometimes contraction weaken, the cervix does not dilate enough or

in a timely manner or the infant’s descent in the birth canal does not

proceed smoothly. If labor is not progressing, a Health care provider

may give the women medications to increase contractions and speed

up labor, or the woman may need a caesarean delivery.

2. PERINEAL TEARS

A woman’s Vagina and the surrounding tissues are likely to tear

during the delivery process.Sometimes these tears heal on their own.

If a tear is more serious on the woman has had an Episiotomy (a

surgical cut between the Vagina and anus) her provider will help

repair the tear using stitches.

3. PROBLEMS WITH THE UMBILICAL CORD

the umbilical cord may get caught on an arms or leg as the infant

travels through the birth canal. Typically, a provider intervenes if the

cord becomes wrapped around the infants neck, is compressed or

comes out before the infant.

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4. ABNORMAL HEART RATE OF THE BABY

Many times, an abnormal heart rate during labor odes not mean that

there is a problem. A health care provider will likely ask the woman

to switch positions to help the infant get more blood flow. In certain

instances, such as when test results show a larger problem, delivery

might have to happen right away. In this situation, the woman is

more likely to need to do an episiotomy to widen the vaginal

opening for delivery.

5. WATER BREAKING EARLY

Labor usually starts on its own within 24hrs of the woman’s water

breaking. If not ad if the pregnancy is it or near team, the provider

will likely induce labor. If a pregnant woman’s water break’s before

34 weeks of pregnancy, the woman will be monitored in the

Hospital. Infection can become a major concern if the woman’s

water break’s early and major does not begin on its own.

6. PERINSTAL ASPHYXIA

This ambition occurs when the fetus does not get enough oxygen

during labor or delivery or just affect birth.

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 7. SHOULDER DYSTOCIA

In this situation, the infant’s head has come out of the vagina but one

of the shoulders become stuck.

8. EXCESSIVE BLEEDING

If delivery results in tears to the uterus, or if the uterus does not

contract to deliver the placents, heavy bleeding can result.

Worldwide, such bleeding is a leading cause of internal depth.

PHYSICAL CHANGES AFTER DELIVERY

A.LOCHIA (VAGINS DISCHARGE)

Lochia is the vaginal delivery. It has a stale, musty order like

menstrual discharge.

Lochia for the first 3 days after delivery is dark red in color. A few

smells blood a lots, No larger than a plum, are normal. For the fourth

through tenth day after delivery, the lochia will be mere watery and

pinkish to brownish in color. From about the fourteeth day after

delivery, the lochia is creamy or yellowish in color. You might notice

increased lochia’s when you get up in the moving when you a

physically. Moma who have cesarean sections may have less lochia

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 after 24hrs then Moma who had vaginal deliveries. The bleeding

generally stops within 4 to 6 weeks after delivery. You should wear

pads, not tampons, as nothing should go in the vagina for six weeks.

B. INCISION AND DRAINAGE

If you had a C-section or tubal ligation, it is normal to have smell

amount of pink, watery drainage from the incision keeps the incision

clean and dry. Wash the incision with soap and water (warm). You

can bath or shower as usual. If the drainage doesn’t stop, call your

health care provider.

OTHER SIGNS TO NOTE ARE:

 Breast Discharge

 Breast Engorgement

 Discomfort in the Perineal Area

 Utenin Contraction

 Unary Contraction

 Constipation

 Menstration (Seize).

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BREAST FEEDING

Breast feeding also called Nursing and breast feeding, is feeding a

babyhuman milk from the breast. Usually, breast milk is given

directlyfrom the breast. However, it may also be pumped, store, and

offered from bottle. Some people breastfeed exclusively.

That means their baby does not receive formula or other foods. Others

breast feed partially, which means that their baby may also receive

formula or solid foods. “Chest feeding is a term used by some

transmasculine and nonbinary parents to describe the act of feeding their

baby human milk.

TYPE OF BREAST FEEDING

Some people feed their babies only breast milk. Others combine breast

feeding with formula or solid food you may find that when your baby is

very young, you exclusively breastfeed, but them later, you may partially

breastfeed.

a) EXCLUSIVE BREAST FEEDING

Exclusive breast feeding describes the act of only feeding a baby breast

milk. An exclusively breast feed baby does not receive supplemental

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formula or solid food. Exclusive breast feeding a child for 6 months

without any other supplementary food.

Exclusive breast feeding might look different for different people, for

instance, the term exclusive breast feeding can describe any of the

following.

1. A baby who only receives breast milk directly from the breast.

2. A baby who nurse at the breast and receive pumped breast milk

from a bottle.

3. A baby who only pumped breast milk from a bottle.AAP

recommends exclusive breast feeding for the first 6 months of life,

after that time, you can introduce solid food. The AAP

recommends continuing to breast feed until a baby is at least 1 year

old, and then after that, as long as it mutually desired by the parent

or infant. Breast milk is the ideal Nutrition for Human infants.

However, the AAP recommends vitamin D supplement for

breastfeeding infants.

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b) PARTIAL BREASTFEEDING

Partial Breastfeeding describe a situation in which a baby is fed

breast milk along with formula or solid food. Some people partially

breastfeed from the beginning, while others transit to partial breast

feeding as their baby begins to eat solid foods. Some reasons parents

choose partial breastfeeding rather than exclusive Breast Feeding

include

1. Difficulty breastfeeding

2. Returning from work and not wanting to pump or not having

access to a convenient place to pump.

3. Wanting a break places, women have the right to pump at work.

The Federal Break time for Nursing mothers law requires certain

employers to provide breastfeeding moms time and space to

pump. Specially, this means;

(a) A private functional space that isn’t a bathroom

(b) A reasonable break time to pump each time you need to

express milk while you are working.

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This law covers most hourly and some salaried employees covered

by the fair labor standard act (FLSA). If this doesn’t apply to you,

your state may have laws that protect your right to pump at work.

You have these right for one year after your baby’s birth.

BENEFIT AND RISK

There are benefits and very few risk associated with breastfeeding.

The main risk are breastfeeding related complication or difficulties

often, these can be managed with proper support.

BENEFIT

Breast Feeding benefits extend to both the breastfeeding mother and

the infants. Breast milk is uniquely designed to meet a human’s

infant proportional needs.

Human milk changes as a baby grows. For example, the First milk a

baby receives is called ‘COLOSTRUM’ it is also referred to as

‘Liquid Gold’ because of the colour of the milk (yellowish) and

because of the potant immune benefits. By your baby’s third to fifth

day, your milk transitions to mature milk. This milk contains the

perfect mixture of Nutrients and antibodies for your growing baby.

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The benefit of Breastfeeding to a baby include reduced risk of :-

i. Asthma: A condition in which the air way become inflamed,

narrow and swollen and reduce extra mucus.

ii. Diabetes: A condition characterized by High blood sugar level

iii. Ear infection

iv. Eczema: an itching inflammation of the skin

v. Gastrointestinal upset or disease

vi. Leukemia during childhood

vii. Lower respiratory infection including Pneumonia and

bronchitis

viii. Sudden infant death syndrome (SIDs)

In addition, for breastfeeding parents, the risk of the following health

conditions is lower

i. Breast and Ovarian cancer

ii. High blood pressure

iii. Type 2 diabetics

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RISK

For most people, breastfeeding is a healthy and safe choice.

However, in certain situations, breastfeeding can pose risks which

include: -

(a) Breast infection: Mastitis is an infection that can occur in the

breast when you are breast feeding. It is caused by a plugged

milk diet. Mastitis is treatable and does not require that you

stop breastfeeding. However, if its not addressed promptly it

can be serious.

(b) Allergies: Some infants have allergies (Food Allergies)

Sometimes the allergen causing the allergies are passed through

breast milk. If a baby has food allergies, the breastfeeding

parent must work closely with their doctors to pinpoint the

allergen and eliminate it.

(c) Breastfeeding difficulties: Some parents struggle with

breastfeeding especially at first. This can lead to a baby not

getting enough to eat or to weaning prematurely. Be sure to

contact your doctor if you are having trouble with your baby’s

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 latch or your milk supply or if you are experiencing any pain

associated with breastfeeding.

IMMUNITY AND IMMUNIZATION

What is immune?

Immune is define as totally or partially resistant to a particular infections

disease or pathogen. For one to stay immune, it means one is protected

against substance in the blood. The immune system protects your child

from outside invaders. The include germs such as bacteria, viruses, and

fungi and toxins (chemicals made by microbes). The immune system is

made up of different organs, cells and proteins that work together. These

specialized cells and parts of the immune system offer the body protection

against diseases. This protection is called immunity. Human have three

types of Immunity – Innate, adaptive and passive:

(a) INNATE IMMUNITY: Everyone is born with innate (or natural)

immunity, type of general protection. For example, the skin acts as

barrier to block germs from entering the body and the immune

system recognizes when certain invaders are foreign and could be

dangerous.

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 (b) ADAPTIVE IMMUNITY (ACTIVE): Adaptive Immunity

develops throughout our lives. We develop adaptive immunity when

we are expose to diseases or when we are immunized against them

with vaccine.

(c) PASSIVE IMMUNITY: Passive Immunity is borrowed from

another source and it last for a short time. For example, antibodies in

a mother’s breast milk give a baby temporary immunity to diseases

the mother has been exposed the immune system takes a while to

develop and needs help from vaccines by getting at your child’s

recommended vaccines on time, you can help keep your child as

healthy as possible.

WHAT IS VACCINE?

Vaccine is a substance used to stimulate immunity to a particular

infections diseases or pathogens typically prepared from an inactivated or

weakened form of the conative agent or from its constituent or product.

Vaccine is also a medical treatment that helps your body’s immune system

recognize and fight diseases.

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There are several types of vaccines include, inactivated vaccines, Live

attenuated vaccines, messenger RNA vaccines. Submit, recombinant,

polysaccharides, and conjugate vaccines.

A vaccine is a biological respiration that provides active acquired

immunity to a particular infections or malignant disease. The safety and

effectiveness of vaccines has been widely studied and verified.

IMMUNIZATION

Immunization is the process of giving vaccine to a person to protect them

against diseases. Immunity (Protection) by immunization is similar to the

immunity a person would get from disease, but instead of getting the

diseases you get a vaccine. This is what makes vaccine much powerful

medicine the process of given a vaccine is called vaccination, though

many doctors use the general terms immunization. Vaccines that contain

live but weaken organism include Basile Calmette Guerin (BCG for

tuberculosis) Chicken Pox (Varicella).

Immunizations help the body fight off diseases, such as hepatitis B,

Diphtheria, Tetanus, pertussis, Polio, Haemophilus Influenzae type b,

65
measles, mumps, prubella, baricella, meningococcal, Pneumococcal,

infuenz, Hepatitis A, Rota virus and Human Papllomavirus (HPV).

CHILDHOOD IMMUNIZATION SCHEDULES

The childhood vaccine schedule is a list of all the vaccines your child

needs as they grow and develop, and the exact ages for when they should

happen. Experts choose the time base on when each vaccine will best

protect your child. Your pediatrician will tell you if your child needs any

additional vaccine or doses to meet their health needs.

WHAT IS THE CHILDHOOD VACCINE SCHEDULE

The childhood vaccine schedule also called an immunization schedule is a

list of vaccine your child should have at specific ages. Infectious disease

experts recommend your child get these vaccines to protect them from

scenario. Potentially life threatening diseases and their complication. You

might be wondering how important it is for your child to follow the

schedule of immunizations.

Its very important because the timing of each vaccine affects how well it

can protect your child. Experts develop and update this schedule based on

the latest science. The choose vaccination ages according to:

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 - When your child’s immune system will best respond to a specific

vaccine (by making antibodies to develop enough protection)

- When your child faces the greatest risk of catching the diseases in

question.

Your child will get their vaccines set routine well-check visits. Following

the well check schedule means your child will stay on track with vaccines.

But its still helpful to know which vaccine your child needs and at what

ages, so, let dive a little deeper.

AT WHAT AGES DO KIDS GET VACCINES

Your child will get most of the immunizations by their second birthday

and a good chunk of these occur during their first year of Life. Infant are

vulnerable to many different diseases that could cause serious illness or

even death. So, following the infant vaccine schedules (Birth through 12

months) is crucial for protecting your baby.

Most childhood vaccine happen at a certain age or series of ages and then

they’re done but there are a couple of exception. Experts recommend on

influenza (FLU) vaccine and a Covid-19 vaccine at regular intervals

starting at 6 months of age and continuing throughout childhood and

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adolescent flu vaccine is yearly. Your pediatrician will tell you how often

your child needs the Covid-19 vaccine based on their age and the latest

science.

Below is a list of childhood vaccine by age. Expert recommend most

children follow this schedule. Your pediatrician will tell you if your child

needs any additional vaccine or doses based on their health status or other

risk factor.

NEWBORN VACCINES

1. Hepatitis B (HEP B) within 24hrs of birth this is the first dose in a

three dose series.

2. RSV (Respiratory Syncytial Virus) Antibody within one week of

birth. This only happens if your baby is born during RSV season

(Typically October to March) and you didn’t receive the RSV

vaccine while pregnant. If it’s not yet RSV session, your baby can

wait until just before the season starts for this immunization.

RSV antibody technically isn’t a vaccine, as it provides ready made

protection. This makes it different from a vaccine, which trains your

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 baby’s immune system to crest antibodies. So, providers call its an

immunization. But most people use the words interchangeable.

2 MONTH VACCINES

- Hep B dose two

- Rota virus, dose one

- Diphtheria, tetanus and scellularpertasis (D Tap) dose one

- Haemophilus influenza type B (Hib) dose one

- Pneumococcal conjugate (PCV) Dose one

- Inactivated poliovirus (IPV) dose one

4 MONTH VACCINES

- Rotavirus, dost two

- DTAP, dose two

- HIS, dose two

- PCV, dose two

- IPV dose two

6 MONTH VACCINE

- HEP B, dose three

- Rota virus dose three only if doing the three series

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 - DTAP, dose three

Fear- dose series

- PCV, dose three

- Flue vaccine

- Covid-19 vaccine

12 MONTH VACCINES

- Measles, mumpls and Rubella (MMR) dose one

- Hepatitis A (HEPA) dose one

- PCV, dose four

15 MONTH VACCINES

- Varicella (VAR) dose one

- DTAP, dose four

- HIB, Final dose- this will be dose three or four depending on the

series.

18 MONTH VACCINE

- HEPA, dose two

Vaccine four 4 years old

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DTAP, dose five

IPV, dose four

MMR, dose two

VAPI, dose two

Your child can have these vaccines starting at age 4 but a little later is ok,

too -up until their 6th birthday. Your pediatrician can advise you on

appropriate timing and help make sure your child get all the vaccines they

need before turning 6.

VACCINE FOR 11-12 YEARS OLDS.

 Tefanos, Diphtherial and scellularPetusis (TDSP), dose one (one dose

in Childhood, but every 10 years of life)

 Human Papiloma Virus (HPV), dose one and two dose, separated by at

least five month. Your child can begin this series prior to their 11 th

birthday starting at age 9

 Meningococcal (Men ACWY), dose one.

VACCINE FOR 16 YEARS OLD

 Men ACWY Dose two.

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POST PARTUM HEMMORAGE (ALSO CALLED PPH).

Is a serious but rare condition when a woman has heavy bleeding after

given birth. It usually happens within 1 day of giving birth, but it can

happen up to 12 weeks after having a baby. About 1to 5 in 100 women

who have baby (1to 5 percent) have PPH. It is normal to lose some blood

after given birth. Women usually loose about half a quart (500-Mililiters)

during Vagina birth or about 1 quart (1,000 Milliliters) after a caesarian

birth (also called C-Section). A C-Section is a surgery in which your baby

is born through a cut that your doctor makes in your belly and uterus

(womb) with PPH, you can loose much more blood, which is what makes

it a dangerous condition. PPH can cause a severe drop in blood pressure if

not treated quickly, this can lead to shock and death. shock is when your

organs don’t get enough blood flow.

WHEN DOES PPH HAPPEN?

After your baby is delivered, the uterus normally contracts to push out the

placenta. The contraction then helps put pressure on bleeding vessels

where the placenta was attached in your uterus. The placenta grows in

your uterus and supplies the baby with food and oxygen through the

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umbilical cord. If the contractions are not strong enough, the vessels bleed

more. It can also happen if small pieces of the placenta stay attached.

BELOW ARE SIGNS AND SYMPTOMS OF PPH

i. Heavily bleeding from the vagina that does not slow or stop.

ii. Drop in blood pressure or signs of shock. Signs of low blood

pressure and shock include blurry vision having chills, damy skin

or a really fast heartbeat feeling confused, dizzy, sleepy or weak,

or feeling like you are going to faint.

iii. Nausea (feeling sick to your stomach or throwing up)

iv. Pale skin

v. Swelling and pain around the vagina or perineum. The perineum

is the area between the vagina and rectum.

ARE SOME WOMEN MORE LIKELY TO HAVE PPH THAN

OTHERS?

Yes, things that make you more likely than others to have PPH are

called risk factors. Having a risk factors doesn’t mean for sure that

you will have PPH, but it may increase your chances.

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 PPHusually happens without warning but talk to your healthcare

provider about what you dan do to help reduce your risk of having

PPH. You are more likely to have it if you have it before than other

women this is called having a history of PPH. Asian and Hispanic

women also are more likely than others to have PPH. Several medical

conditions are risk factors of PPH. You may be more likely than other

women to have PPH if you have any of these conditions.

CONDITIONS THAT AFFECT THE UTERUS

i. Uterine atony – This is the most common cause of PPH. It

happens when the muscles in your uterus don’t contract

(tighten)well after birth. Uterine contractions after birth help stop

bleeding from the place in the uterus where the placenta breaks

away. You may have uterine atony if your uterus is stretched or

enlarged (also called distended) from given birth to twins or a

large baby (more than 8 pounds, 13 ounces). It also can happen if

you have already had several children, you’re in labor for a long

time or you have too much amniotic fluid that surround your baby

in the womb.

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ii. Uterine invention –This is a rare condition when the uterus turns

inside out after birth

iii. Uterine rapture – This is when the uterus tears during labor. It

happens rarely, it may happen if you have a sear in the uterus from

having a C-section in the past or if you have had other kinds of

surgery on the uterus.

CONDITIONS THAT AFFECT THE PLACENTA

iv. Placental Abruption – This is when the placenta separates early

from the wall of the uterus before birth. It can separate partially or

completely.

v. Placenta accrete – This condition happen when the placenta grows

into the walls of the uterus too deeply and cannot separate

vi. Placenta previa – This is when the placenta lies very low in the

uterus and covers or part of the cervix. The cervix is the opening

to the uterus that sits at the top of the vagina.

vii. Retain placenta – This happens if you don’t pass the placenta

within 30 to 60minutes after you give birth. Even if you pass the

placenta soon after birth your provider checks the placenta to

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make sure its not missing any tissue. If tissue is missing and is not

removed from the uterus right away, it may cause bleeding.

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