Coronavirus Premarital counseling

Def :- infectious disease caused by the SARS- Def :- communication process in which the
CoV-2 virus , has caused a pandemic of counselor tries to provide a couple with
respiratory illness complete and accurate information about the
responsibilities of marriage.
Clinical picture:
Components
 Most common symptoms:
- fever , cough  Financial planning
- tiredness  Roles in the marriage
- loss of taste or smell  Decision-making processes
 Less common symptoms:  Family relationships
- sore throat  Sexual health
- headache  Family planning
- aches and pains Premarital examination
- diarrhoea 1. History taking
- a rash on skin
 Personal history
- red or irritated eyes
 Menstrual history
 Serious symptoms:  Medical history
- difficulty breathing or SOB  Medical history
- loss of speech or mobility 2. Physical examination
- chest pain
 heart examination
High risk group :-  Chest examination
 Older age  pelvic measurement to detect
 Chronic lung disease contracted of deformed pelvis
 Heart disease
3. Laboratory examination
 Diabetes & Obesity
 Smoking  CBC , HT , HG → anemia
 Cancer survivor  RH type → RH incompatibility
 Immunocompromised  Antibody test →detect (HIV).
Complications  Urine analysis for sugar and
 Respiratory problem, Pneumonia albumin →to exclude D.M or
kidney diseases.
 Organ failure in several organs
 Heart problems  Analysis of the man's seminal fluid
 Blood clots →early detection and intervention
in case of infertility.
 Septic shock
 Acute kidney injury  x-ray →exclude pulmonary T.B
 Secondary infections Ante- natel visit number
 Meningitis  Every one month for first 6 months
 Rhabdomyolysis  Every two week for 7th & 8th month
Treatment  Every one week for 9th month
 Anti viral
 Monoclonal antibodies
Prevention Danger signs during pregnancy
 Wear a mask CRAMPS UP
 Clean your hands 1. Cramping , Contractions (uterine)
 Keep a safe distance at least 1 metre 2. Rupture of membranes
 Cough & sneeze in your elbow 3. Absence of fetal movement
 Stay home if you feel unwell 4. Muscle irritability
 Check fever frequently 5. Pain
 Avoid crowded area 6. Spotting or vaginal bleeding
Nutrition during pregnancy 7. Urinary frequency
First trimester 8. Persistent vomiting
1) Folic acid Family planning method
- Importance in neural tube closure Natural
- leafy green , nuts , seeds  Coitus interruption
2) Vitamin B6  Lactating amenorrhea
- in nuts, eggs & beans  Basel body temperature
- helps ease nausea  Calendar method
3) Vitamin C  Cervical mucus monitoring
- Protects cells against damage Hormonal
- keeps the immune system in good  Vaginal ring
4) Omega-3  Hormonal IUD
- in salmonin mackerel, caviar  Oral contraceptive ( combined , mini)
- aids in brain formation for baby , eye  Hormonal patch
development & CV health woman  Implants
 Inject
✓ Hyperemesis gravidarum in 1st trimester Chemical
o get plenty of rest  Foam , Gel , cream
o avoid foods with strong odor
 Suppository
o Eat dry crackers before arising in  Soluble filme
morning
o Avoid an emty stomach Mechanical
o Drink fluids between meals  Female/male Condoms
o eat small, frequent meals  Cervical cap
Second trimester  Diaphragm
1. Calcium & Vitamin D  IUD
- Important bone & teeth formation Surgical
2. Iron  Female → tubal ligation
- fetal oxygenation & viability  Male → vasectomy
3. Magnesium Post-natel visit
- help of bone formation & regulate 2nd , 4th , 7th , 14th post day & 6 week
body temp , convert food to energy
- in carrot , spinach, coca , avocado
Third trimester How to reduce maternal morbidity
1. Vitamin C  Facilitate asses MCH, health services
2. Vitamin B1
 Full maternal examination in pre ,
- Helps to release energy from foods natel, post natel period
- in peas , egg  Provide emergency contraception
3. Water & fiber  Pregnancy counseling
- ease constipation  Management of any gynaecological
4. Vitamin K disease
- help with blood clotting in delivery  Immunization during pregnancy
- leafy vegetable
Benefits of Breastfeeding
✓ Constipation & heart burn in 2,3 trimester
For infants
Immunization during pregnancy
 B.M is warm , ready , sterile , has
Tetanus vaccine balanced nutrients, easy accessible
In PG → 2 dose by 1 month  easily digested than cow milk
In MG →1 one  Infants have greatr immunity , Protect
 If MP > 5 she not given vaccine from allergy
 If MP with long distance → ttt as PM  Important for normal growth
Flu vaccine , HAV , HRV  Improve child psychological
development
Principal of weaning
 Available all time
 Continue breast feeding
For mother
 around six months old
 Promote involution of uterus
 Variety of foods (from all 4 groups)
 help mother to use fat stored during
 Soft consistency pregnancy
 Gradually increase serving size  Relaxing
 Small frequents meals  decrease breast cancer, oestoprocesis
 Skimmed or semi-skimmed milk are  Protect from hip fracture
not suitable  healthy space between childee
 The need for fluid increases with the For family
intake of solids  Provide better nutrition, health
 Children's vitamin drops 6 - 2,5 year wellbeing
 avoid adding salt  Cost less than artificial feeding
 encourage cup rather than bottle  Lower medical care cost
For hospital
 Less staff time needed
 Lower Neonatal infection
 Improve hospital image & prestige
 Warmer emotional environment
Vitamin Latin name Deficiency disorder How can mother deal with asthma at home
A Retinol Night Blindness
Health Education
D Calciferol Rickets  Educate parents about disease nature ,
E Tocopherol hemolytic anemia trigger, ttt, side effects of drugs
K Phytomenadione Hemorrhage Environmental control
 Avoid exposure to house dust
 Avoid passive smoking
B1 Thiamine Berberi  Control environmental hazards
B2 Riboflavine Riboflavinosis  Clean humidifier properly
 Wash blanket with warm water
B3 Niacin Pellagra (4d) → death, Medication
diarrhoea, dehydration,
dementia, dermatitis  depends on antiinflammatory drug
B5 Pantothenic Paresthesia and Bronchodilators
Acid
Signs and symptoms of addition
B6 Pyridoxine Peripheral Neuropathy
Physical signs
B7 Biotin Dermititis
 Over/underactive
B9 Folic Acid Neural tube defect
 Weight Gain or Loss
B12 Cobalamin Megaloplastic Anaemia  Nausea, vomiting, diarrhoea
C Ascorbic acid Scurvy  Skin Damage , pale
 Red eye
Behavioral sign
Principal of Screening test
 Lying
 For important health problem  Financial Troubles
 accepted treatment for patients with  Stealing, Money or Substances
reconized disease.
 Isolating
 Facilities for diagnosis and treatment  Work / school /legal problem
should be available. Psychological sign
 recognizable latent or early  Mood swing
symptomatic stage.  Tiredness
 be a suitable test  Agitation
 acceptable to the population.  Memory problem
Refrigerator arrangements
 The natural history of the condition is
well understanding including  Temp : 2 →8 °
 Freezer : ice pack , ice cup
 agree policy on whom to treat as  Top shelf : oral polio , measles
patients
 Inexpensive  Middle shelf : DPT,HAV, HBV, BGG
, typhoid
 Case-finding should be a continuing
process  Bottom : coloured solution to maintain
temp when electricity is off
Contraindications of immunization
 Elevated body temperature
 Allergic reaction from vaccine components
 anaphylaxis following a previous dose of the relevant vaccine
 Taking antibiotics with oral typhoid vaccine
 Low immunity
Side effects of immunization
 Fever & Chills  lump where the shot is given
 Tenderness  Muscle aches
 Redness, itching  Headaches or fatigue
 Minor discomfort during pregnancy Parasitic infection
1. Heartburn Signs and symptoms
Causes  Frequently hungry
 Progesterone hormone relaxes the  Abdominal pain
cardiac sphincter of the stomach and  Bloating and gas
allows back of gastric contents into the  Vomiting
esophagus.
 Diarrhea
 The pressure of the growing uterus on  Itchy anus
the stomach
 Weight loss
Management  Skin rashes
 Avoid lying flat.
Management
 Sleeping with more pillows
 Stool analysis to determine ttt regmin
 Do not lie down after eating
 Give ORS , ↑ fluids intake
 Maintain good posture
 TTT all family
 Small frequent meals
 Washing hands frequently
 Take sips of milk or hot tea
 Trims child nail
 Take antacids.
 baby cream in case of prineal itching
 Avoid fried, spicy, and fatty food
Prevention
 avoid citrus juices
 Treating all infected pt
2. Constipation
 Health Education
Causes:
 eradicate of host reservoir & vector
 Intestinal motility decreased during control
pregnancy as a result of progesterone.
 ↑ immunity against infection
 side effect of iron therapy is  Control of hygienic & sanitation
constipation
Warning signs of cancer
Management
CAUTION
 Maintain regular bowel habits
 Change in bowel or bladder habits
 Increase fiber in diet
 A sore that does not heal
 Increase fluids.
 Unusual bleeding or discharge
 Eat fruit and vegetables
 Thickening or lump in a breast
 Exercise and walking
 Indigestion or difficulty swallowing
 Laxatives could prescribed
 Obvious change in a wart or mole
3. Edema
 Nagging cough or hoarseness
Causes Puerperal sepsis
 ↓ blood circulation in Lower Signs and symptoms
extremities as uterus put pressure on  fever≥38,5 , anorexia , headache
large vessels  Tachycardia , suprapubic pain
 Sudden increase of weight  Offensive lochia
 Proteinuria  delayed involution
 Secondary PPH
Management Complications
 Maintain good posture  pelvic tenderness
 Avoid prolonged standing or sitting.  General peritonitis
 Wear support stockings.  endomyometrisis
 Increase fluid intake  Thrombophlebitis
 Get adequate rest and exercise  Bacteremia, Septicemia
 Elevate the feet as often as possible.  Abcess
 Diuretics are contraindicated Management
4. Urinary frequency
 Antibiotics
Causes
 Heparin therapy
 In early pregnancy →vascular  Incision and drainage of abcess
engorgement & altered bladder
function. (hormonal changes)  Isolation
 Meticulous hand washing
 In late pregnancy →reduction of  Folwer position
bladder capacity →( the pressure of
the growing uterus on the bladder). First cause of death in
Management  Maternal→PPH
 Limit fluid intake before bedtime
 Infant →Rota virus , Dehydration,
 Wear perineal pads gastroentritis
 Void when feel the urge.
 Kegel exercises  Toddler →Respiratory Tract infection
 Bladder training  Pre-school →home accident
5. Backache  School →malnutrion , communicable
Causes disease
 muscular fatigue and strain that  Adolescent →motor vehicle accident,
accompany poor body balance addition
(lordosis ) Compare prevalence & incidence rate
Management  Prevalence: no of old cases
 Wear shoes with low heal  Incidence: no of new cases
 Wear firmer mattress Compare duration and length
 Walk with pelvic tilt forward  D: measures time ‫ﺑﺘﻘﻌﺪ ﻗﺪ اي‬
 Maintain good posture
 L: distance ‫ﻛﻞ ﻗﺪ اي‬
 Sit with knee slightly higher than hip
 Assessment Hypoglycemia Hyperglycemia

S&S  Acute  Gradual

 Pale, cold, clammy skin  Flushed, hot, dry skin.
 Bounding, rapid pulse.  Weak, rapid pulse.
 Normal or ↑ blood pressure.  Low blood pressure.
 shallow breathing.  Rabid,deep ( kussmaul )
 Irritable, confused  Sweet, fruity breath.
 tremors and convulsions  Abdominal pain, N , V
 Headache , Dizziness.  Polydipsia, Polyuria ,Polyphagia
 Tremors & convulsions  General depression
 Rapid loss of consciousness  Unconsciousness.
Management Intermediate management Intermediate management
1. Give patient sugary food 1. Drink a lot of water
2. Measures blood sugar after 2. Fluids replacement ( IV )
15-20 min 3. Tack insulin ( fast acting)
If you see unconscious patient in coma , you don't know if he high or low :-
1) Asses ABC 2) blood sugar levels 3) Elevate leg
 If he returns so it was hypoglycemia
 If he doesn't return it was hyperglycemia & should transport to any hospital
Hypertension Hypotension
Definition Bp> 140/90 Bp < 90/ 60
S&S  Severe headaches.  Dizziness or lightheadedness.
 Nosebleed • chest pain  Nausea.
 Fatigue or confusion  Fainting (syncope)
 Vision problems  Dehydration , unusual thirst
 Difficulty breathing.  Lack of concentration.
 Irregular heartbeat.  Blurred vision.
 Blood in the urine.  Cold, clammy, pale skin.
Causes  Obesity, lack exercise  Emotional stress , head exercise
 Smoking, alcohol, caffeine  Dehydration , Heart stroke
 Salt food , ↑ cholesterol  Internal bleeding
 Renal/ heart disease  Overdose HTN drugs
Complications  Aneurysm • Loss of vision  Shock , Ischemia
 Stroke. •Osteoporosis  Angina, heart attack
 Heart , Renal failure  Heart , Renal failur
Characteristics Measles German measles

Caustive agent Rubeola virus Rubella virus

Incubation 7-14 day 14-21 day

S&S  Rash  Rash

 High Fever ≥40°  Mild fever
 Koplik spot  No koplic spot
 Runny nose & cough  Forchhiemer spot
 Conjunctivitis , teary eyes  Enlarged lymph nodes
 Sore throat  Muscle pain , red eye
 Rach appear in 3rd day and  Rach start bluish color while
start from head → chest → fade in 3rd day
extremities with brown color
Complications  Diarrhoea & vomiting  Congenial heart disease
 Otitis media  Conginatal deafness
 Bronchitis  Conginatal Cataract
 Pneumonia  Mental retardation
 Encephalitis  liver or spleen damage.
 Nephritis
Management  Bed rest until fever and  no specific medicine, many
cough subside cases, symptoms are mild
 Fever reducer  Isolation
 ↑ fluids intake  Hear & eye screening
 ↑ room humidity for cough  ↑ fluids intake
 Use taped path and lotion to  Bed rest
relieve itching  Terminate pregnancy in the
1st trimester
 ↓ light in room due to light
sensitivity
 Irritate eye with solution to
relieve itching
 Antibiotics for pneumonia
 Moisten your nose with
Saline nasal sprays
 Typhoid fever ( entric) Para - typhoid fever
Caustive Salmonella typhi Para salmonella typhi
agent
Incubation 7-21 day 1:10 day
S&S First week
 Temp rise slow, fever flactuation
 Headache , Malaise , epistaxis
 abdominal pain , Nausea, vomiting
 Widely test negative
Second week
 High grade fever
 Diarrhoea or Constipation
 Rose spot
 Hepatosplenomegaly
 Widel test positive
Third week
 intestinal perforation Similar but milder and
shorter than typhoid
 Delirium
 abdominal haemorrhage
 Encephalitis
 inflammation
Fourth week
 Fever subside
 S&S can return up to 2 week after fever
has subside

Complications  Hepatitis, cholecystitis, myocarditis

 Shock, Anemia
 Encephalopathy, pneumonia
The same
 Seizure , meningitis