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Concept:-

• Therapeutic communication: it is the use of communication for the purpose of creating a beneficial outcome for the client.
• The nurse uses personal attributes and clinical techniques while working with the client to bring about insight and behavioral change.

Explanation:

• Reflecting and clarifying are NOT forbidden during therapeutic communication.

Reflection: a rephrasing of the affective part of the client’s message.

Purpose:

• To encourage more expression of feelings
• To experience feelings more intensely
• To help acknowledge and manage feelings
• To discriminate among feelings

Clarifying: the moderator asks the speaker to clarify what was said.

Purpose:

• To encourage more elaboration
• To check out the accuracy of what you have heard
• To clear up vague and confusing messages.

Concept:-

• The fetal skull consists of the base of the skull and the vault or cranium. Also, the vault is made of occipital bone posteriorly, two parietal bones at the sides, and a pair of temporal bones and frontal bones anteriorly.
• Submentovertical — extends from the junction of the floor of the mouth and neck to the highest point on the sagittal suture. It is 11.5 cm in length and hence the largest diameter of the fetal Skull
• The Biparietal (9.4cm) is the largest transverse diameter in all cephalic presentations.  It is measured between the two parietal bones. (Hence option 3 is correct)
• The parietal bones are the two eminences on the side of each parietal bone.
• The skull is the largest part of the fetal body, these bones are thin and easily compressible, and joined by a membrane.

Important Points

Antero-Posterior Diameter

• Suboccipitobregmatic diameter (9.4cm) is measured from the undersurface of the occipital bone to the centre of the anterior fontanelle or bregma.
• Occipitofrontal diameter (11cm) was measured from the external occipital protuberance to the glabella.
• Suboccipito frontal (10.5cm) is diameter in occipito-posterior.
• Verticomental (13.5cm) measured from vertex to the chin and it is the longest anteroposterior diameter of the head.
• Submentobregmatic (9.4cm) extends from the junction of the neck and lower jaw to the centre of the anterior fontanelle.

Key Points

• Bitemporal diameter (8cm) is the shortest transverse diameter and is measured between two temporals.

Explanation:-

• Vaginal Bleeding is the most common presentation of Vesicular Mole which further may end up with the abortion.
• It mainly occurs in the first 3 months of pregnancy in which dark brown to bright red bleeding occurs.
• Vesicular mole is the non-cancerous mass formed by the blood clots, tissues, and the retained placenta after fetal death.

Additional Information

• Hydatiform Mole: is the rare mass or growth inside the uterus at the beginning of the pregnancy.  Most commonly occurs in late-age pregnant women. It can be of two types:

1. Partial Molar Pregnancy: in which abnormal placental and fetal development.
2. Complete Molar Pregnancy: in which abnormal placenta development but no fetus is present.

Explanation

• Phlebitis is sometimes reported at the IV site, and the first action is to stop the infusion and remove the cannula.

Concept:

• Pain and redness with swelling at the site of the cannula are termed superficial thrombophlebitis.
• In the case of thrombophlebitis, stop the infusion and remove the cannula.
• If the infusion continues, it may lead to pulmonary embolism.

Explanation:

• Care of the site of the cannula:
• Wash hands when touching the site.
• It should be changed every 72 hours.
• Always check the patency of the cannula before starting the infusion.
• Make sure to put on the date of insertion at the site of the cannula.
• Use only sterile injections and needles.
• Wipe the cannula after and before infusion.

Explanation

• Phenomenology: Type of a Qualitative research study in which a researcher tries to gather the data related to the lived experience of the population. In which the researcher tries to study particular phenomena.
• A phenomenology is an approach to qualitative research that focuses on the commonality of a lived experience within a particular group.
• The fundamental goal of the approach is to arrive at a description of the nature of the particular phenomenon.
• Phenomenology helps in answering the question of "what" rather than "how much".
• Qualitative research often depends on interviews and observation for collecting data, phenomenology aids in this process.
• The data is then read and reread and gathered for phrases and themes that are then grouped to form clusters of meaning. Through this process, the researcher may construct the universal meaning of the event, situation, or experience and arrive at a more profound understanding of the phenomenon.

Additional Information

• Ethnography: This type of study is mostly seen in Anthropological Studies. In this researcher gathers data from a particular ethnic group by experiencing their real life.
• Action Research: This type of research is also known as the cycle of actions and the cycle of inquiry. This research process follows a particular time period to gather the outcome data and to analyze the data.
• Grounded Theory: It involves collecting and analyzing the data and then grounding the collected finding into the theory and gathering the outcomes. This theory was given by Glaser and Strauss 1967.

Key Points

• The conjunctiva is a thin, transparent mucous membrane.
• It lines the inner surface of the eyelids and covers the sclera (the white part of the eye).
• The conjunctiva contains glands that produce secretions that help to keep the eyes moist, and antibodies, which reduce infection.
• Conjunctivitis means ‘inflammation of the conjunctiva’.

Additional Information

• It is usual for both eyes to be affected in infectious cases.
• Some causes include: 
• The commonest cause is an infection by viruses or bacteria.
• Due to chemical irritants.
• Traditional eye remedies or allergies.

Important Points

• Effects:
• The eyes are red and uncomfortable.
• Make the eyelids stick together.
• The vision is usually not affected.

Concept:-

According to kublar and ross grief is composed of 5 stages. Which are as follows-

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Additional Information

Key Points

• Tuberculosis (TB):
• It is caused by a bacterium called Mycobacterium tuberculosis, belonging to the Mycobacteriaceae family consisting of about 200 members.
• These bacteria are Gram-positive, aerobic, non-sporulating, non-motile, and often pleomorphic. They are generally smaller than other bacteria. Mycobacteria are acid-fast due to the lipid-rich cell cover.
• Some Mycobacteria cause diseases like TB and Leprosy in humans and others infect a wide range of animals.
• In humans, TB most commonly affects the lungs (pulmonary TB), but it can also affect other organs (extra-pulmonary TB).
• TB is a very ancient disease and has been documented to have existed in Egypt as early as 3000 BC.
• TB is a treatable and curable disease.
• Transmission:
• TB is spread from person to person through the air. When people with lung TB cough, sneeze, or sprit, they propel the TB germs into the air.
• BCG Vaccine:
• BCG was developed by two Frenchmen, Albert Calmette and Camille Guerin, by modifying a strain of Mycobacterium Bovis (that causes TB in cattle). It was first used in humans in 1921.
• In India, BCG was first introduced on a limited scale in 1948 and became a part of the National TB Control Programme in 1962.
• In addition to its primary use as a vaccine against TB, it protects against respiratory and bacterial infections of newborns and other mycobacterial diseases like Leprosy and Buruli’s ulcer.

Explanation

• Orthopnea is not a condition it is a symptom and it is a type of dyspnea that usually occurs when a person is lying down.
• It is characterized by the shortness of breath when the person is lying down during standing or sitting.
• Orthopnea is mainly seen in patients with Heart Diseases and Pulmonary Disease.

Orthopnea in Heart Diseases:

• In cardiac disease, the heart is unable to redistribute sufficient blood to the heart muscles and their associated organs because of which sudden change in the patient's position may lead to Orthopnea.
• Similarly in the case of Pulmonary Disease conditions increased pressure in the blood vessels lungs pushes the fluid to the alveoli and causes Pulmonary edema. Due to which gaseous exchange on the lungs is hampered which leads to orthopnea.

Correct Answer: Group A beta-hemolytic streptococcus.

Rationale:

• Rheumatic fever is an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever. These infections are caused by Group A beta-hemolytic streptococcus (Streptococcus pyogenes). This bacterium triggers an immune response that can cause inflammation in various body tissues, including the heart, joints, skin, and brain.

Explanation of Other Options:

Staphylococcus aureus:

• Rationale: While Staphylococcus aureus can cause a range of other infections, including skin infections, pneumonia, and bloodstream infections, it is not responsible for the development of rheumatic fever.

Streptococcal pneumonia:

• Rationale: Streptococcal pneumonia is caused by Streptococcus pneumoniae, which primarily causes pneumonia, meningitis, and other infections, but it does not cause rheumatic fever.

Haemophilus influenza:

• Rationale: Haemophilus influenzae is a bacterium that can cause a variety of respiratory tract infections, including pneumonia and meningitis, particularly in children, but it is not associated with rheumatic fever.

Conclusion:

• Group A beta-hemolytic streptococcus is the correct answer as it is the causative agent of rheumatic fever.