NURSING PRACTICE 3-FINALS

RESEARCH Key Features:

RESEARCH DESIGN refers to the overall plan or  Data is collected once from different
strategy used to conduct research, ensuring that participants.
the study effectively answers the research  Used to determine prevalence or
question or hypothesis. relationships.
1. Experimental Research Design 6. Longitudinal Research Design
Purpose: To establish causal relationships Purpose: To study changes in variables or trends
between variables. over time.
Key Features Key Features:
 Manipulation of the independent  Repeated observations of the same
variable. subjects.
 Control over extraneous variables.
 Random assignment of participants. 7. Qualitative Research Design

2. Descriptive Research Design Purpose: To explore in-depth understanding of

human behavior, experiences, or meanings.
Purpose: To describe characteristics of a
Key Features:
population or phenomenon.
Key Features:  Data collection through interviews,
focus groups, or observations.
 Observational, no manipulation of  Emphasis on themes, patterns, and
variables. narratives.
 Answers "what" rather than "why."
Types:
Types:
Phenomenological Design: Understanding
Survey Research: Uses questionnaires or lived experiences.
interviews to collect data.
Ethnographic Design: Studying cultures or
Observational Studies: Non-intrusive communities.
observation of behaviors (e.g., naturalistic
observation). Grounded Theory: Developing theories from
collected data.
Case Studies: In-depth study of an individual,
group, or situation. Narrative Research: Exploring stories and
personal experiences.
3. Correlational Research Design
8. Mixed-Methods Research Design
Purpose: To determine the relationship between
Purpose: Combines both quantitative and
two or more variables.
qualitative approaches to provide
Key Features: comprehensive results.

 Variables are observed, not Key Features:

manipulated.
 Uses numerical and narrative data.
4. Exploratory Research Design  Offers greater validity and depth.
Purpose: To explore a research problem that is Types:
not well understood.
Explanatory Sequential: Quantitative data
Key Features: collected first, followed by qualitative.
 Focuses on gaining insights and Exploratory Sequential: Qualitative data
understanding rather than confirming collected first, then quantitative.
hypotheses.
Concurrent Design: Collects both types of data
 Often qualitative in nature.
simultaneously.
5. Cross-Sectional Research Design
Purpose: To study data at a single point in time.

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9. Diagnostic Research Design more comprehensive understanding of a

research problem.
Purpose: To evaluate the causes or diagnosis of
a specific issue or condition. Characteristics:
Key Features:  Data is collected using both qualitative
(non-numerical) and quantitative
 Identifies underlying causes and (numerical) methods.
treatment pathways.
 The integration of both approaches
10. Action Research Design provides a more complete picture of the
research question.
Purpose: To solve an immediate problem  Can be sequential or concurrent.
through iterative cycles of planning, action, and
reflection. Methods:

Key Features: Explanatory Sequential: Collect quantitative

data first, followed by qualitative data to explain
 Collaboration between researchers and the findings.
participants.
 Practical and context-specific. Exploratory Sequential: Collect qualitative
data first to explore concepts, then collect
quantitative data to test these concepts.
RESEARCH METHODOLOGY refers to the Concurrent Design: Collect both types of data
process, techniques, and approaches simultaneously and compare them.
researchers use to collect, analyze, and interpret
data. It defines how the research will be 4. Descriptive Research Methodology
conducted and helps ensure the results are Purpose: To describe characteristics of a
reliable and valid. phenomenon or population without influencing
1. Qualitative Research Methodology it.

Purpose: To explore and understand human Characteristics:

experiences, behaviors, and meanings from the
 Observational and non-interventional;
perspective of the participants.
focuses on "what" rather than "why."
Characteristics:  Provides a snapshot of the current state
of affairs.
 Focuses on in-depth understanding,  Data is typically collected through
rather than numbers. surveys, observations, or case studies.
 Data is typically non-numerical, like
words, images, or observations. 5. Experimental Research Methodology
 Inductive reasoning is often used, with Purpose: To investigate cause-and-effect
theories emerging from the data. relationships between variables.
2. Quantitative Research Methodology Characteristics:
Purpose: To quantify the problem by generating
 Involves manipulation of one or more
numerical data or data that can be transformed
independent variables to observe the
into usable statistics.
effect on dependent variables.
Characteristics:  Control group or placebo group is often
used for comparison.
 Data is collected in numerical form and
analyzed using statistical methods. 6. Correlational Research Methodology
 Uses deductive reasoning to test Purpose: To examine the relationship or
hypotheses or theories. association between two or more variables
 Aims for objectivity and generalizability. without manipulating them.
3. Mixed-Methods Research Methodology Characteristics:
Purpose: To combine both qualitative and  Looks for patterns or trends in data.
quantitative research approaches to provide a

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 Cannot determine cause-and-effect research design, objectives, and the type of data
relationships—only if variables are needed.
related.
1. Surveys and Questionnaires
 Variables are measured as they naturally
occur. Purpose: To gather data from a large number of
respondents, typically to measure attitudes,
7. Action Research Methodology
opinions, behaviors, or characteristics.
Purpose: To solve practical problems through
Characteristics:
iterative cycles of planning, action, and
reflection.  Can be administered online, by mail, in
person, or over the phone.
Characteristics:
 Structured with predefined questions,
 Participatory and collaborative; often either open-ended or closed-ended.
involves the subjects of the research in  Useful for quantitative data, but can also
the research process. provide qualitative insights if open-
 Results in immediate practical ended questions are included.
solutions to problems.
2. Interviews
 Focuses on improving practices and
systems. Purpose: To collect detailed and personal data
by engaging with participants directly.
8. Historical Research Methodology
Characteristics:
Purpose: To investigate past events to
understand their causes, effects, and  One-on-one interaction, either face-to-
significance. face, over the phone, or via video calls.
Characteristics:  Can be structured, semi-structured, or
unstructured.
 Uses primary and secondary sources of  Ideal for qualitative data, as it allows
historical data. deeper exploration of thoughts and
 Seeks to establish timelines and context. feelings.

9. Case Study Research Methodology 3. Observations

Purpose: To deeply explore and analyze a single Purpose: To collect data through direct
case or a small number of cases. observation of subjects in their natural setting.

Characteristics: Characteristics:

 Provides rich, detailed insights into the  Can be structured (focused on specific
case being studied. behaviors) or unstructured (open-
 Can be qualitative, quantitative, or ended).
mixed methods.  Useful for studying behavior in natural
settings, especially when participants
10. Phenomenological Research Methodology may not be able to communicate
Purpose: To understand the essence of verbally.
individuals' lived experiences regarding a  Data collected can be qualitative
phenomenon. (descriptive) or quantitative (counting
occurrences).
Characteristics:
4. Focus Groups
 Focuses on human experiences from the
participants' perspective. Purpose: To gather data from a small group of
 Data is typically collected through people discussing a particular topic.
interviews or focus groups. Characteristics:

 Typically consists of 6-10 participants

DATA COLLECTION is the process of gathering who share their views on a specific
information for analysis. The type of data subject.
collection method chosen depends on the  Useful for exploring group dynamics and
understanding different perspectives.

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 Often used in qualitative research to  Provides quantitative data but can also
gain insights into attitudes, opinions, yield qualitative insights depending on
and perceptions. the design of the test.
5. Case Studies 9. Secondary Data Collection
Purpose: To collect detailed, contextualized Purpose: To use data that was already collected
information about a specific individual, group, or for a different purpose, rather than gathering
situation over a period of time. new data. Characteristics:
Characteristics:  Involves using existing datasets, such as
governmental reports, medical records,
 Involves intensive investigation of a or previously published studies.
single case or a few cases.
 Efficient and cost-effective, but the
 Useful for exploring rare or complex researcher has no control over the
phenomena. quality or accuracy of the data.
 Data collected from multiple sources  Useful for large-scale studies where
such as interviews, observations, and primary data collection is not feasible.
documents.
10. Longitudinal Data Collection
6. Experiments
Purpose: To gather data over an extended
Purpose: To gather data by manipulating one or period of time, often to observe changes or
more variables to observe the effect on other developments.
variables.
Characteristics:
Characteristics:
 Typically used to study trends or long-
 Used in experimental research designs to term effects.
establish cause-and-effect relationships.
 Involves repeated data collection at
 Data collection typically involves multiple time points.
quantitative measurements.
 Common in health and social sciences to
 Often conducted in controlled study the progression of diseases or
environments to reduce bias and ensure behaviors.
validity.
7. Document or Content Analysis
DEPENDENT AND INDEPENDENT VARIABLE
Purpose: To gather data from existing
documents, records, or other media. 1. Independent Variable (IV): the variable that
the researcher manipulates or changes to
Characteristics:
observe its effect on the dependent variable. It is
 Involves analyzing written, visual, or audio considered the cause in the cause-and-effect
materials for patterns or themes. relationship.
 Can be used for both qualitative and Characteristics:
quantitative data collections.
 Often used in historical, social, and media  It is the presumed cause or factor that
research. influences or determines changes in the
dependent variable.
8. Tests and Assessments  The researcher controls or selects the
Purpose: To measure cognitive abilities, skills, independent variable.
knowledge, or psychological traits.  It is often referred to as the predictor or
explanatory variable.
Characteristics:
2. Dependent Variable (DV): the variable that is
 Structured instruments or tools used to measured in the study. It is the outcome that
assess participants in a standardized changes as a result of the manipulation of the
manner. independent variable. It is considered the effect
 Commonly used in educational, in the cause-and-effect relationship.
psychological, and medical research.

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Characteristics: Action:

 It is the presumed effect or response  Choose an appropriate research design

that is being observed or measured. (e.g., experimental, descriptive,
 The dependent variable is affected by correlational, etc.).
the independent variable, so it  Decide on the data collection methods
"depends" on the independent variable. (e.g., surveys, interviews, observations).
 It is often referred to as the outcome  Choose a sample size and the type of
variable. participants.
 Define the variables and how they will
be measured.
The RESEARCH PROCESS is a systematic  Determine the data analysis approach
sequence of steps that researchers follow to (e.g., statistical tests, qualitative
answer research questions or solve problems. analysis).
These steps ensure that the research is
4. Collect Data
structured, thorough, and credible. While
specific approaches may vary depending on the Purpose: To gather the necessary information to
field or methodology, the following general answer your research question.
steps are commonly involved in the research
process: Action:

1. Identify the Research Problem  Follow the procedures outlined in the

research design.
Purpose: To define the topic or issue you want  Use the chosen data collection tools
to investigate. (e.g., surveys, interviews, experiments)
to obtain primary or secondary data.
Action:
 Ensure ethical standards are
 Choose a subject area of interest. maintained, such as informed consent
 Narrow it down to a specific, and confidentiality.
researchable problem or question.  Accurately record all observations,
 Ensure the problem is feasible, relevant, responses, or measurements.
and significant to the field.
5. Analyze the Data
 Formulate a clear and concise research
question or hypothesis. Purpose: To process the collected data and
derive meaningful insights.
2. Conduct a Literature Review
Action:
Purpose: To review existing research and gain a
comprehensive understanding of the topic.  Organize and clean the data to remove
any errors or outliers.
Action:
 Choose the appropriate statistical or
 Gather information from books, qualitative analysis methods based on
academic journals, articles, and other the type of data collected.
reliable sources.  Apply analysis techniques such as
 Summarize key findings, theories, and descriptive statistics, correlation,
methods used in previous studies. regression analysis, or thematic coding
 Identify gaps in the literature that your (for qualitative data).
research could address.  Interpret the results in the context of
 Refine your research question or your research question and hypothesis.
hypothesis based on existing knowledge.
6. Interpret the Results
3. Develop a Research Design
Purpose: To make sense of the data in the
Purpose: To plan how the study will be context of the research question and hypothesis.
conducted, ensuring the methodology aligns
Action:
with the research question.
 Analyze whether the results support or
contradict the original hypothesis.
 Consider the implications of the findings.

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 Discuss the potential reasons for the determine whether the observed results are
results and compare them with previous statistically significant or due to chance. The
research findings. choice of statistical test depends on the research
 Identify any limitations of the study and question, data type, and the assumptions about
suggest areas for future research. the data.

7. Draw Conclusions 1. Descriptive Statistics

Purpose: To summarize the overall findings and Before applying statistical tests, researchers
implications of the research. often use descriptive statistics to summarize and
describe the main features of the dataset:
Action:
 Mean (average)
 Synthesize the key insights gained from  Median (middle value)
the study.  Mode (most frequent value)
 Make recommendations based on the  Standard deviation (measure of
results. variability)
 Discuss how the research contributes to  Range (difference between the highest
existing knowledge in the field. and lowest values)
 Identify any practical applications or
policy recommendations. These are not inferential tests but provide an
initial understanding of the data.
8. Communicate the Results
2. Parametric Tests
Purpose: To share the findings with the broader
academic or professional community. Parametric tests are used when the data follows
a normal distribution (bell-shaped curve) and
Action: meets certain assumptions like homogeneity of
 Prepare a research report, paper, or variance. These tests are more powerful but
presentation that includes the research require assumptions about the population
problem, methodology, results, and distribution.
conclusions. a. T-test: Compares the means of two groups to
 Submit the work for publication in determine if they are significantly different from
academic journals, conferences, or each other.
other professional platforms.
 Ensure that the results are clearly b. Analysis of Variance (ANOVA): Compares the
communicated and accessible to the means of three or more groups to see if at least
intended audience. one is significantly different.

9. Reflect and Revise c. Pearson’s Correlation: Measures the strength

and direction of the linear relationship between
Purpose: To evaluate the overall research two continuous variables.
process and make improvements for future
studies. Values range from -1 (perfect negative
correlation) to +1 (perfect positive correlation).
Action: A value of 0 means no linear relationship.
 Reflect on the strengths and weaknesses 3. Non-Parametric Tests
of your research design and methods.
 Assess the validity and reliability of your Non-parametric tests are used when the data
data and findings. does not meet the assumptions required for
 Revise your research based on feedback parametric tests, such as normality. These tests
from peers, experts, or your own are often used with ordinal or nominal data.
reflections. a. Chi-Square Test: Tests the relationship
 Consider how the research could be between two categorical variables.
expanded or improved in future studies.
b. Mann-Whitney U Test: Non-parametric
alternative to the independent samples t-test. It
STATISTICAL TESTS compares the medians of two independent
groups.
Used to analyze data and draw meaningful
conclusions. These tests help researchers

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c. Wilcoxon Signed-Rank Test: Non-parametric 7. Power Analysis

alternative to the paired t-test. It compares the
differences between paired observations. A statistical test to determine whether the
sample size is adequate to detect a significant
d. Kruskal-Wallis H Test: Non-parametric effect.
alternative to one-way ANOVA. It compares the
ranks of data from three or more independent Action: Power analysis helps in determining the
minimum sample size required for a study to
groups.
detect an effect of a certain size with a given
4. Regression Analysis level of confidence (e.g., 0.80 power).
Regression analysis is used to model the
relationship between dependent and
independent variables, especially for prediction. OB/PEDIA

a. Linear Regression: Analyzes the relationship NURSING CARE FOR PATHOLOGIC

between one dependent variable and one or PREGNANCIES
more independent variables (predictors) to Nursing care involves monitoring, providing
model a straight-line relationship. interventions, emotional support, and ensuring
b. Multiple Regression: Extends linear safe outcomes for both mother and fetus.
regression to include multiple independent 1. Ectopic Pregnancy
variables to predict a single dependent variable.
Monitor: Vital signs, signs of internal bleeding
c. Logistic Regression: Used when the (tachycardia, hypotension, abdominal pain).
dependent variable is binary (e.g., yes/no,
success/failure). It models the probability of a Intervene:
certain outcome occurring.
 Prepare for surgery or administration of
5. Tests for Normality methotrexate (to stop cell growth).
 Monitor for post-operative
Before conducting parametric tests, it’s often complications.
necessary to assess whether the data follows a
normal distribution. Educate: Teach about early recognition of
ectopic pregnancy in future pregnancies.
a. Shapiro-Wilk Test: A test for normality. It
compares the distribution of the data to a Support: Provide emotional support as
normal pregnancy loss is often difficult.

b. Kolmogorov-Smirnov Test: Another test for 2. Molar Pregnancy (H-MOLE)

normality. It compares the sample distribution
Monitor: Vital signs, bleeding, and symptoms of
to a specified distribution (e.g., normal
complications (e.g., gestational trophoblastic
distribution).
neoplasia).
6. Effect Size
Intervene:
Measures the magnitude of the difference
 Prepare for uterine evacuation (D&C).
between groups or the strength of a
relationship. Effect size is especially useful when  Monitor hCG levels post-procedure to
comparing results across studies. ensure resolution.

Common measures: Educate: Emphasize avoiding pregnancy for 6–

12 months to monitor hCG levels.
 Cohen’s d (used for t-tests): Measures
the standardized difference between Support: Address feelings of grief and loss.
two means. 3. Preeclampsia/Eclampsia
 Pearson’s r (used for correlation):
Measures the strength of the linear Monitor: Blood pressure, urine output
relationship between two variables. (proteinuria), deep tendon reflexes, and fetal
well-being.

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Intervene: Intervene:

 Administer antihypertensive  Encourage rest and a balanced diet.

medications and magnesium sulfate to  Provide supplemental oxygen and
prevent seizures. monitor placental perfusion.
 Monitor for magnesium toxicity
(decreased reflexes, respiratory Educate: Advise regular fetal kick counts and
depression). frequent prenatal visits.
8. Oligohydramnios and Polyhydramnios
Educate: Teach warning signs (severe headache,
blurred vision, epigastric pain). - Oligohydramnios:
Support: Prepare for possible early delivery if Monitor: Fetal growth and amniotic fluid index
condition worsens. (AFI).
4. Placenta Previa Intervene: Encourage hydration and monitor
Monitor: Vaginal bleeding (painless), fetal heart fetal heart rate.
rate, maternal vital signs. - Polyhydramnios:
Intervene: Monitor: Maternal discomfort, respiratory
distress, and AFI.
 Maintain bed rest and monitor for
worsening bleeding. Intervene: Monitor for preterm labor and
 Prepare for a possible C-section delivery. prepare for possible amnioreduction.
Educate: Avoid vaginal exams, heavy lifting, and 9. Multiple Gestation Complications
sexual activity.
Monitor: Monitor for preterm labor and fetal
Support: Provide emotional reassurance. well-being.
5. Placental Abruption Intervene:
Monitor: Assess for severe abdominal pain,  Provide frequent ultrasounds to assess
vaginal bleeding, and fetal distress. growth and amniotic fluid levels.
Intervene:  Educate on nutrition, rest, and signs of
preterm labor.
 Provide oxygen therapy, IV fluids, and
10. Rh Isoimmunization
prepare for an emergency delivery.
 Monitor maternal and fetal status Monitor: Maternal blood type and antibody
closely. screening.
Support: Provide psychological support for the Intervene:
emergency situation.
 Administer Rh immunoglobulin
6. Gestational Diabetes Mellitus (GDM) (RhoGAM) at 28 weeks or after
trauma/birth.
Monitor: Blood glucose levels, fetal growth
(ultrasound), and signs of macrosomia.  Monitor fetal well-being using Doppler
ultrasound and amniotic fluid analysis.
Intervene:
11. Preterm Labor and PROM
 Administer insulin or oral hypoglycemics
Monitor: Signs of labor, contractions, and fetal
as prescribed.
heart rate.
 Provide nutritional counseling and
encourage regular physical activity. Intervene:
Educate: Teach glucose monitoring, diet control,  Administer tocolytics to delay labor and
and risks for the baby (hypoglycemia, corticosteroids to mature fetal lungs.
macrosomia).  Monitor for infection (fever, foul-
7. Intrauterine Growth Restriction (IUGR) smelling discharge).

Monitor: Fundal height, fetal movements, and Educate: Teach bed rest, hydration, and early
growth via ultrasound. warning signs of labor.

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12. Stillbirth/IUFD 1. Newborn (0–1 Month)

Monitor: Confirm fetal demise via ultrasound Gross Motor: Turns head side-to-side when
and provide emotional care. prone; primitive reflexes (Moro, grasp).
Intervene: Fine Motor: Hands mostly clenched; strong
grasp reflex.
 Support the mother through induction
or delivery. Language: Cries for needs; startles to loud
 Provide grief counseling and referrals to sounds.
support groups.
Social/Cognitive: Fixates on faces; briefly follows
Support: Help with memory-making (photos, objects with eyes.
keepsakes) if desired.
2. 2 Months
13. Hyperemesis Gravidarum
Gross Motor: Holds head up when prone; begins
Monitor: Weight loss, electrolyte imbalances, to push up with arms.
and dehydration.
Fine Motor: Opens hands briefly; follows objects
Intervene: past midline.

 Administer IV fluids, antiemetics, and Language: Coos; turns head toward sounds.
provide small, frequent meals.
Social/Cognitive: Smiles responsively (social
Educate: Encourage bland foods and ginger tea smile); recognizes caregiver’s voice.
to manage nausea.
3–4 Months
14. Cervical Insufficiency
Gross Motor: Rolls from front to back; supports
Monitor: Assess for cervical changes via head and chest on arms.
ultrasound.
Fine Motor: Reaches for objects; hands open
Intervene: more often.

 Prepare for a cervical cerclage (suturing Language: Laughs; babbles; makes consonant
the cervix) if indicated. sounds.
 Advise pelvic rest and reduce physical Social/Cognitive: Enjoys play; recognizes
activity. familiar people.
Educate: Teach about signs of preterm labor 6 Months
(pressure, discharge, contractions).
Gross Motor: Rolls both ways; sits with support;
15. Congenital Anomalies begins to sit without support.
Monitor: Detect abnormalities through Fine Motor: Transfers objects between hands;
ultrasound and genetic testing. rakes objects with fingers.
Intervene: Language: Responds to own name; babbles (e.g.,
 Collaborate with specialists (e.g., NICU "ba," "da").
team, surgeons). Social/Cognitive: Recognizes strangers (stranger
 Provide prenatal counseling and discuss anxiety); enjoys social play.
options with parents.
9 Months
Support: Offer emotional support and involve
the family in care planning. Gross Motor: Sits without support; pulls to
stand; crawls.
Fine Motor: Pincer grasp develops (thumb and
DEVELOPMENTAL MILESTONES forefinger); bangs objects together.
Developmental milestones in pediatrics are Language: Says "mama" and "dada" non-
specific skills or behaviors that most children specifically; understands "no."
achieve at certain ages.
Social/Cognitive: Waves "bye-bye"; plays peek-
a-boo; has object permanence.

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12 Months (1 Year) Social/Cognitive: Cooperative play; follows

rules; prefers group play.
Gross Motor: Stands alone; takes a few steps
(walks). 5 Years
Fine Motor: Feeds self with fingers; can bang Gross Motor: Skips; balances on one foot for 10
two blocks together. seconds; swings.
Language: Says "mama" and "dada" specifically; Fine Motor: Copies a triangle; prints some
1–3 simple words. letters; ties shoelaces.
Social/Cognitive: Imitates gestures; shows Language: Speaks clearly; uses future tense;
separation anxiety; follows simple commands. counts to 10.
15–18 Months Social/Cognitive: Understands rules; shows
empathy; follows multi-step instructions.
Gross Motor: Walks well; climbs stairs (one step
at a time); throws ball.
Fine Motor: Stacks 2–3 blocks; scribbles; uses Red Flags in Development
spoon with help.
3 Months: Not tracking objects or social
Language: Says 10–25 words; points to body smiling.
parts. 6 Months: No babbling or inability to sit
with support.
Social/Cognitive: Shows interest in others; 9 Months: No pincer grasp or response
imitates chores; plays alone briefly. to name.
2 Years 12 Months: Not standing, no words, no
interest in play.
Gross Motor: Runs; climbs stairs with 2 feet per 2 Years: Not walking, not combining
step; kicks a ball. words.
Fine Motor: Stacks 6 blocks; uses a spoon well; 3 Years: Speech not intelligible, no
turns book pages. imaginative play.

Language: Combines 2–3 words (phrases); 50+

word vocabulary; follows 2-step commands. PEDIATRIC RESPIRATORY CASES are common in
Social/Cognitive: Plays alongside others (parallel clinical practice and range from mild to life-
play); begins pretend play. threatening conditions

3 Years 1. Acute Bronchiolitis

Gross Motor: Rides a tricycle; climbs stairs with Cause: Respiratory Syncytial Virus (RSV) is the
alternating feet; jumps. most common cause in infants (0–2 years).

Fine Motor: Copies a circle; builds tower of 9 Key Features:

blocks; uses utensils well.  Cough, nasal congestion, wheezing,
Language: 3–4 word sentences; speech 75% tachypnea.
intelligible; knows name, age, and gender.  Retractions, nasal flaring, and poor
feeding in severe cases.
Social/Cognitive: Plays cooperatively; shows
imagination; takes turns. Nursing Management:

4 Years  Monitor respiratory status (O2

saturation, rate, and effort).
Gross Motor: Hops on one foot; catches a ball;  Provide humidified oxygen and suction
climbs well. nasal secretions.
Fine Motor: Copies a square; draws a person  Administer bronchodilators if prescribed
with 3–4 parts; uses scissors. (limited efficacy).
 Ensure adequate hydration (IV fluids if
Language: Speaks in complete sentences; tells necessary).
stories; knows colors and numbers.  Educate parents about hand hygiene
and RSV prevention.

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2. Croup (Laryngotracheobronchitis)  Administer bronchodilators (e.g.,

albuterol) via inhaler or nebulizer.
Cause: Viral (Parainfluenza virus is most
 Provide corticosteroids to control
common).
inflammation.
Key Features:  Educate on trigger avoidance, proper
inhaler technique, and asthma action
 Barking cough, inspiratory stridor, plans.
hoarseness, and low-grade fever.
 Symptoms worsen at night. 5. Foreign Body Aspiration

Nursing Management: Cause: Inhalation of food, small objects, or toys.

 Administer humidified air (cool mist). Key Features:

 Provide corticosteroids (e.g.,  Sudden onset of choking, coughing, and
dexamethasone) to reduce airway respiratory distress.
swelling.
 Unilateral wheezing and decreased breath
 In severe cases, administer nebulized sounds.
epinephrine to improve breathing.
 Monitor for signs of respiratory distress Nursing Management:
(retractions, nasal flaring).
 Monitor respiratory status and prepare
3. Pneumonia for emergent intervention.
 If partial obstruction: Encourage
Cause: Bacterial (e.g., Streptococcus
coughing.
pneumoniae) or viral pathogens.
 If severe: Perform back blows/chest
Key Features: thrusts (infants) or Heimlich maneuver
(children).
 Fever, cough, tachypnea, and crackles  Post-removal, monitor for airway edema
on auscultation. or infection.
 Chest pain, nasal flaring, and retractions.
6. Epiglottitis (Medical Emergency)
Nursing Management:
Cause: Haemophilus influenzae type B (Hib),
 Monitor respiratory status and oxygen though less common due to Hib vaccination.
saturation.
 Administer antibiotics for bacterial Key Features:
pneumonia.  Rapid onset of high fever, drooling,
 Provide oxygen therapy and antipyretics dysphagia, stridor, and tripod
for fever. positioning.
 Encourage fluid intake to thin  Child appears anxious and avoids lying
secretions. down.
 Educate parents about completing
antibiotic therapy and vaccination (e.g., Nursing Management:
PCV13).
 Do NOT inspect the throat or use a
4. Asthma tongue depressor (risk of airway
obstruction).
Cause: Chronic inflammatory airway disease  Maintain airway patency and prepare
triggered by allergens, exercise, infections, etc. for intubation.
Key Features:  Administer oxygen and IV antibiotics.
 Keep the child calm and provide
 Recurrent episodes of wheezing, emotional support.
coughing, breathlessness, and chest
tightness. 7. Cystic Fibrosis (CF)
 Prolonged expiratory phase and Cause: Genetic disorder causing thick mucus in
accessory muscle use. lungs, pancreas, and GI tract.
Nursing Management:

 Assess airway patency and peak flow

rate.

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Key Features: 10. Acute Respiratory Distress Syndrome

(ARDS)
 Chronic cough, recurrent respiratory
infections, wheezing, and clubbing of Cause: Secondary to severe infections, trauma,
fingers. or aspiration.
 Failure to thrive and greasy stools due to
Key Features:
pancreatic insufficiency.
 Severe respiratory distress, hypoxemia,
Nursing Management:
and crackles.
 Provide chest physiotherapy and  Requires intensive care.
postural drainage.
Nursing Management:
 Administer bronchodilators, mucolytics
(e.g., dornase alfa), and antibiotics.  Administer oxygen and mechanical
 Ensure high-calorie, high-protein diet ventilation as needed.
with pancreatic enzyme supplements.  Position in prone to improve
 Educate on infection prevention and CF oxygenation.
management.  Monitor fluid balance and provide
supportive care.
8. Respiratory Distress Syndrome (RDS) in
Neonates
Cause: Surfactant deficiency in preterm infants VACCINES
(< 34-week gestation).
Vaccine Vaccine Form Disease
Key Features: Schedule
BCG 1 dose @ Live PTB, Leprosy
 Tachypnea, grunting, nasal flaring, and
birth attenuate
intercostal retractions.
(deltoid- d
 Cyanosis and decreased breath sounds.
ID)
Nursing Management: PENTA 3 doses Combinati Pertussis
@ 6 on of (whooping
 Administer surfactant replacement weeks bacteria cough)
therapy. with 4 and virus Diphtheria
 Provide continuous positive airway weeks toxins HIB(Haemophilu
pressure (CPAP) or mechanical interval s Influenza type-
ventilation. (IM B bacteria)
 Monitor oxygen levels and blood gases. vastus Tetanus
 Prevent hypothermia and maintain lateralis) Hepa-B
thermoregulation. OPV 3 doses SABIN Poliomyelitis
9. Pertussis (Whooping Cough) @ 6 (freeze
weeks dried)
Cause: Bordetella pertussis infection (prevented with 4
by DTaP vaccine). weeks
interval
Key Features:
(oral)
 Paroxysmal cough followed by a IPV 2 doses SALK Poliomyelitis
“whooping” sound. @ vastus
 Post-tussive vomiting and apnea (in lateralis
infants). 1st dose:
OPV 3
Nursing Management: 2nd dose:
MMR 1
 Administer antibiotics (e.g.,
(9th
azithromycin) early.
month)
 Provide oxygen and monitor for apnea in
MMR 2nd dose: Freeze Measles
infants.
9th dried (Blindness)
 Educate about vaccine compliance and
month Mumps (affect
infection control measures.
and 12th- males)

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15th Rubella  Encourage breathing techniques and

month (teratogenic) comfort measures (e.g., massages,
(SQ position changes).
vastus  Administer analgesia or epidural if
lateralis) requested.
C. Transition Phase
STAGES OF LABOR
Cervical Dilation: 8–10 cm (complete dilation).
1. First Stage of Labor: The first stage begins with
the onset of regular contractions and ends with Duration: 20–40 minutes.
complete cervical dilation (10 cm). It is divided Contractions:
into three phases:
 Strong to very strong intensity.
A. Latent Phase (Early Labor)  Occur every 2–3 minutes, lasting 60–90
Cervical Dilation: 0–3 cm. seconds.

Duration: 6–12 hours (may vary). Characteristics:

Contractions:  Severe pain, nausea/vomiting, sweating,

shaking, and intense pressure.
 Mild to moderate intensity.  Mother may feel the urge to push.
 Occur every 5–10 minutes, lasting 30–45
seconds. Nursing Management:

Characteristics:  Provide continuous support and

reassurance.
 Excitement and anticipation in the  Encourage short, focused breathing to
mother. resist pushing before full dilation.
 Bloody show and mild backache may  Monitor maternal vitals, FHR, and
occur. contractions closely.
Nursing Management:

 Encourage ambulation, rest, and 2. Second Stage of Labor (Pushing Stage)

relaxation techniques.
 Provide emotional support and Begins: Complete cervical dilation (10 cm).
reassurance. Ends: Delivery of the baby.
 Monitor maternal vital signs, fetal heart
rate (FHR), and contraction pattern. Duration: 30 minutes to 3 hours for
primigravidas; shorter for multiparas.
B. Active Phase
Contractions: Strong and frequent (every 2–3
Cervical Dilation: 4–7 cm. minutes).
Duration: 3–6 hours. Characteristics:
Contractions:  Intense urge to push with contractions.
 Moderate to strong intensity.  Crowning occurs (baby’s head visible at
 Occur every 3–5 minutes, lasting 45–60 the vaginal opening).
seconds. Nursing Management:
Characteristics:  Guide and encourage effective pushing
 Increased discomfort, more focused techniques.
breathing required.  Monitor FHR continuously.
 Mother may feel fatigued and  Provide emotional support and
experience stronger back pain. encouragement.
 Assist the provider with delivery
Nursing Management: preparations.
 Assess perineal area and support the
 Monitor maternal and fetal well-being
mother to prevent tears.
(FHR and contractions).

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3. Third Stage of Labor deviate significantly from cultural expectations.

These patterns are pervasive, inflexible, and
Begins: Birth of the baby. typically emerge in adolescence or early
Ends: Delivery of the placenta. adulthood.

Duration: 5–15 minutes (typically). The DSM-5 categorizes personality disorders

into three clusters: Cluster A, Cluster B, and
Characteristics: Cluster C.
 Uterine contractions continue to expel Cluster A: Odd or Eccentric Disorders
the placenta.
 Signs of placental separation include: These individuals often appear peculiar,
 Gush of blood. suspicious, or detached.
 Lengthening of the umbilical cord. 1. Paranoid Personality Disorder
 Uterus becomes firm and rises in the
abdomen. Characteristics:

Nursing Management:  Distrust and suspicion of others without

sufficient basis.
 Administer oxytocin (if ordered) to  Preoccupation with unjustified doubts
facilitate uterine contractions and about loyalty.
prevent hemorrhage.  Reluctance to confide in others.
 Assess for intactness of the placenta  Misinterprets benign remarks as
after delivery. threatening.
 Monitor maternal vital signs and
bleeding. Nursing Management:
 Provide immediate newborn care
 Establish trust through consistency and
(APGAR scoring, skin-to-skin contact).
honesty.
 Avoid confrontation or challenging their
beliefs.
4. Fourth Stage of Labor (Recovery Stage)  Provide clear, straightforward
Begins: Delivery of the placenta. communication.

Ends: First 1–2 hours post-delivery.

Characteristics: 2. Schizoid Personality Disorder

 Uterus contracts to control bleeding. Characteristics:

 Mother experiences fatigue, chills, or  Detachment from social relationships.
mild uterine cramping.  Restricted emotional expression.
Nursing Management:  Prefers solitude; little interest in sexual
or emotional experiences.
 Monitor vital signs, uterine firmness
(fundal assessment), and vaginal Nursing Management:
bleeding (lochia).  Avoid forcing social interaction.
 Massage the fundus if boggy to prevent  Respect need for privacy and autonomy.
hemorrhage.  Focus on building trust slowly.
 Encourage breastfeeding to promote
uterine contraction. 3. Schizotypal Personality Disorder
 Monitor for complications (e.g.,
Characteristics:
postpartum hemorrhage).
 Provide emotional support and  Odd beliefs, magical thinking, and
encourage bonding with the baby. eccentric behavior.
 Unusual perceptual experiences (e.g.,
illusions).
PSYCHIATRIC NURSING  Social anxiety and difficulty maintaining
close relationships.
PERSONALITY DISORDERS are mental health
conditions characterized by enduring patterns of
behavior, cognition, and inner experience that

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Nursing Management: Nursing Management:

 Encourage reality-based thinking.  Encourage assertive communication

 Respect the client's space and unique instead of dramatization.
behaviors.  Maintain professional boundaries.
 Offer supportive therapy and social skills  Reinforce strengths without excessive
training. flattery.
7. Narcissistic Personality Disorder
Cluster B: Dramatic, Emotional, or Erratic Characteristics:
Disorders
 Grandiosity, need for admiration, and
These individuals often exhibit impulsive, lack of empathy.
dramatic, and unstable emotions.  Exaggerated sense of self-importance.
 Sensitive to criticism and preoccupied
4. Antisocial Personality Disorder
with fantasies of success.
Characteristics:
Nursing Management:
 Disregard for and violation of others'
 Use a non-confrontational approach.
rights.
 Avoid challenging their sense of
 Impulsivity, deceitfulness, and
superiority.
irresponsibility.
 Acknowledge feelings while maintaining
 Lack of remorse for actions.
professional objectivity.
 Often associated with criminal behavior.
Nursing Management:
Cluster C: Anxious or Fearful Disorders
 Set clear boundaries and limits.
 Monitor for manipulative behaviors. These individuals often exhibit anxiety,
 Avoid power struggles; use calm, firm fearfulness, and perfectionism.
communication.
8. Avoidant Personality Disorder
5. Borderline Personality Disorder (BPD)
Characteristics:
Characteristics:
 Social inhibition and feelings of
 Unstable relationships, self-image, and inadequacy.
emotions.  Hypersensitivity to criticism or rejection.
 Intense fear of abandonment.  Avoids interpersonal contact despite
 Impulsivity in areas like spending, sex, or wanting relationships.
self-harm.
Nursing Management:
 Recurrent suicidal behaviors or gestures.
 Provide a supportive, non-judgmental
Nursing Management:
environment.
 Use therapeutic communication and  Gradually encourage social interactions.
validate feelings.  Build self-esteem through positive
 Establish clear boundaries and avoid feedback.
enabling behavior.
9. Dependent Personality Disorder
 Encourage coping strategies and refer to
DBT (Dialectical Behavior Therapy). Characteristics:
6. Histrionic Personality Disorder  Excessive need to be taken care of.
Characteristics:  -Submissive and clingy behavior.
 Difficulty making decisions or expressing
 Excessive emotionality and attention- disagreement.
seeking behavior.
Nursing Management:
 Overly dramatic, theatrical, and shallow
expression of emotions.  Encourage independence and decision-
 Easily influenced by others. making.

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 Offer emotional support without  Loss of interest in hobbies or activities.

fostering dependency.
Complications of Alcoholism
 Promote problem-solving and
assertiveness skills. 1. Physical Health Complications:
10. Obsessive-Compulsive Personality Disorder  Liver diseases: Fatty liver, hepatitis,
(OCPD) cirrhosis.
Characteristics:  Gastrointestinal issues: Gastritis, ulcers,
pancreatitis.
 Preoccupation with orderliness,  Cardiovascular problems:
perfectionism, and control. Hypertension, cardiomyopathy.
 Inflexibility about morals, ethics, or  Neurological effects: Alcoholic
values. neuropathy, brain shrinkage, Wernicke-
 Difficulty delegating tasks due to fear of Korsakoff syndrome.
imperfection.  Increased risk of cancers (e.g., liver,
mouth, throat).
Nursing Management:
2. Psychosocial Complications:
 Avoid power struggles over control.
 Encourage flexibility and relaxation  Depression, anxiety, and suicidal
techniques. ideation.
 Support gradual changes in rigid  Impaired memory and decision-making.
routines.  Relationship problems, unemployment,
and financial instability.
 Legal issues (e.g., DUI offenses).
ALCOHOLISM, also known as Alcohol Use
3. Fetal Alcohol Spectrum Disorders (FASD):
Disorder (AUD), is a chronic disease
characterized by an inability to control or stop  Occurs when alcohol is consumed during
alcohol use despite its negative consequences on pregnancy.
health, relationships, and daily functioning. It  Leads to developmental delays,
involves both physical dependence and cognitive impairment, and physical
psychological addiction to alcohol. abnormalities in infants.
Signs and Symptoms Nursing Management of Alcoholism
1. Behavioral: 1. Assessment
 Inability to limit alcohol consumption. History: Assess quantity, frequency, and
 Spending excessive time drinking or duration of alcohol use.
recovering from its effects.
 Neglecting responsibilities at work, Screening Tools:
school, or home.  CAGE Questionnaire: Identifies problem
 Continued use despite relationship or drinking.
legal problems.  AUDIT (Alcohol Use Disorders
Identification Test): Assesses severity.

2. Physical: Physical Exam: Look for signs of liver damage,

withdrawal symptoms, or malnutrition.
 Increased tolerance (needing more
alcohol to achieve the same effect). 2. Management of Acute Alcohol Withdrawal
 Withdrawal symptoms when not Alcohol withdrawal can be life-threatening and
drinking: requires close monitoring.
 Tremors, sweating, nausea, vomiting,
anxiety, insomnia, seizures. Symptoms: Tremors, sweating, agitation,
seizures, hallucinations, and delirium tremens
3. Psychological: (DTs).
 Strong cravings for alcohol.
 Drinking to relieve stress, sadness, or
anxiety.

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Interventions: 5. Stress the importance of relapse

prevention strategies.
 Administer *benzodiazepines* (e.g.,
diazepam or lorazepam) to prevent
seizures.
ANXIETY is a natural response to stress,
 Monitor vital signs, hydration status, and
characterized by feelings of worry, nervousness,
electrolyte balance.
or fear. When anxiety becomes excessive,
 Provide a calm, quiet environment to
persistent, and interferes with daily life, it may
reduce agitation.
be classified as an anxiety disorder. Anxiety
 Thiamine supplementation (Vitamin B1)
disorders are among the most common mental
to prevent Wernicke’s encephalopathy.
health conditions.
3. Long-Term Treatment and Rehabilitation
Types of Anxiety Disorders
1. Medications:
1. Generalized Anxiety Disorder (GAD)
 Disulfiram: Causes unpleasant effects - Excessive worry or anxiety about everyday
(e.g., nausea, flushing) when alcohol is activities.
consumed.
 Naltrexone: Reduces alcohol cravings Symptoms: Restlessness, fatigue, difficulty
and the pleasure associated with concentrating, muscle tension, and sleep
drinking. disturbances.
 Acamprosate: Helps maintain
2. Panic Disorder
abstinence by stabilizing brain
chemistry. - Recurrent, unexpected panic attacks (sudden
episodes of intense fear).
2. Counseling and Therapy:
Symptoms: Heart palpitations, shortness of
 Cognitive Behavioral Therapy (CBT):
breath, dizziness, chest pain, sweating, and
Helps identify and manage triggers for
feelings of impending doom.
alcohol use.
 Motivational Interviewing: Encourages 3. Social Anxiety Disorder
the individual to commit to change.
- Intense fear of social situations due to
 Family Therapy: Involves family
concerns of being judged or embarrassed.
members to support recovery and
address codependency. Symptoms: Avoidance of social gatherings,
physical symptoms (blushing, sweating,
3. Support Groups:
trembling).
 Alcoholics Anonymous (AA): 12-step
4. Specific Phobias
recovery program.
 Peer support plays a critical role in - Irrational fear of a specific object, situation, or
maintaining abstinence. activity (e.g., heights, spiders, flying).
4. Lifestyle Modifications: Symptoms: Immediate anxiety response when
exposed to the trigger.
 Promote healthy coping strategies,
stress management, and hobbies. 5. Obsessive-Compulsive Disorder (OCD)
 Encourage a balanced diet and regular
- Repeated intrusive thoughts (obsessions) and
exercise to improve overall health.
ritualistic behaviors (compulsions) to reduce
Health Education for Patients and Families anxiety.
1. Explain the impact of alcohol on physical Example: Excessive handwashing due to fear of
and mental health. contamination.
2. Discuss the importance of detoxification
6. Post-Traumatic Stress Disorder (PTSD)
and rehabilitation.
3. Encourage family involvement in - Anxiety following exposure to a traumatic
recovery. event.
4. Promote participation in support groups
(e.g., AA). Symptoms: Flashbacks, nightmares,
hypervigilance, and avoidance of reminders of
the trauma.

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7. Separation Anxiety Disorder  Teach coping strategies, like positive

self-talk.
- Excessive fear about being separated from
loved ones or home. 4. Relaxation Techniques
- More common in children but can also occur - Deep breathing, meditation, guided imagery,
in adults. and progressive muscle relaxation.
General Signs and Symptoms of Anxiety 5. Encourage Physical Activity
1. Physical Symptoms: - Exercise reduces stress hormones and
increases endorphins (natural mood boosters).
 Increased heart rate (tachycardia)
 Shortness of breath 6. Medication Management
 Sweating, trembling
Antianxiety Medications:
 Headaches, dizziness
 Muscle tension or weakness  Benzodiazepines (short-term):
Diazepam, Lorazepam.
2. Emotional Symptoms:
 SSRIs/SNRIs (long-term): Fluoxetine,
 Excessive worry or fear Sertraline, Venlafaxine.
 Irritability  Monitor for side effects and educate
 Restlessness or feelings of being “on about medication adherence.
edge”
7. Promote Healthy Lifestyle Habits
3. Cognitive Symptoms:
- Encourage adequate sleep, balanced
 Difficulty concentrating nutrition, and limiting stimulants like caffeine.
 Racing thoughts 8. Provide Education
4. Behavioral Symptoms:  Teach patients and families about
 Avoidance of anxiety-inducing situations anxiety triggers, symptoms, and
 Changes in eating or sleeping habits treatment options.
 Discuss strategies to manage stress and
Nursing Management of Anxiety prevent escalation of anxiety.
1. Assessment 9. Refer for Psychotherapy
 Assess for physical symptoms, anxiety  Recommend professional therapy, such
triggers, and impact on daily functioning. as:
 Use anxiety assessment tools: GAD-7  Cognitive Behavioral Therapy (CBT)
(Generalized Anxiety Disorder Scale);  Exposure therapy (for phobias)
Hamilton Anxiety Scale  Trauma-focused therapy (for PTSD).
2. Interventions Patient Education for Anxiety
1. Create a Safe Environment 1. Identify and manage triggers.
 Establish trust and a calm, therapeutic 2. Practice relaxation techniques daily.
relationship. 3. Incorporate regular physical activity into
your routine.
 Ensure the patient feels supported and
4. Avoid stimulants like caffeine, alcohol,
listened to.
or drugs.
2. Calm the Patient 5. Seek professional help if symptoms
persist or worsen.
 Encourage slow, deep breathing
techniques.
 Guide the patient to focus on the
DEPRESSION is a common but serious mental
present using grounding techniques
health disorder that affects how a person feels,
(e.g., “5-4-3-2-1” method).
thinks, and handles daily activities. It is
3. Cognitive Behavioral Techniques (CBT) characterized by persistent feelings of sadness,
hopelessness, and a lack of interest or pleasure
 Help identify and challenge irrational
thoughts that trigger anxiety.

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in activities. It can impact physical health,  Interpersonal Therapy: Addresses

behavior, and overall quality of life. relationship problems that contribute to
depression.
Symptoms of Depression
2. Medications:
 Persistent sadness or low mood
 Loss of interest or pleasure in activities  Antidepressants (e.g., SSRIs, SNRIs)
once enjoyed help balance brain chemicals.
 Changes in appetite or weight (weight
3. Lifestyle Changes:
gain or loss)
 Difficulty sleeping (insomnia) or  Regular exercise, a balanced diet,
oversleeping quality sleep, and social support.
 Fatigue or lack of energy
 Feelings of worthlessness, hopelessness, 4. Brain Stimulation Therapies:
or guilt  Electroconvulsive Therapy (ECT) or
 Difficulty concentrating or making Transcranial Magnetic Stimulation
decisions (TMS) for severe cases.
 Thoughts of death, self-harm, or suicide
Nursing Considerations:
Types of Depression
1. Assess the patient’s mental status, risk
1. Major Depressive Disorder (MDD): Severe for self-harm, and support systems.
and persistent symptoms lasting more than 2 2. Build trust and provide a safe
weeks. environment.
2. Persistent Depressive Disorder (Dysthymia): 3. Encourage adherence to treatments and
Chronic low-grade depression lasting for 2 years therapies.
or more. 4. Educate on coping mechanisms, stress
reduction, and lifestyle modifications.
3. Postpartum Depression: Occurs after
childbirth, characterized by extreme sadness and
anxiety.
4. Seasonal Affective Disorder (SAD):
Depression that occurs seasonally, often during
winter months.
5. Bipolar Disorder: Alternating episodes of
depression and mania (high energy, impulsive
behavior).
Causes of Depression
1. Biological factors: Brain chemistry
imbalances, genetics, hormonal
changes.
2. Psychological factors: Trauma, grief,
personality traits, or chronic stress.
3. Environmental factors: Isolation,
financial difficulties, or major life
changes.
4. Medical conditions: Chronic illnesses
(e.g., diabetes, cancer) and medications.
Treatment Options
1. Psychotherapy (Talk Therapy):

 Cognitive Behavioral Therapy (CBT):

Focuses on identifying and changing
negative thoughts.

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