Saturday, 29 December 2012

problems encountered in breadst feeding

Problems Encountered With Breastfeeding


¦ Breasts are swollen, hard, hot, tender, and may be dry and red due to
vascular congestion before secreting milk (lactation); usually occurs
3–5 days postpartum

¦ Nursing:
¦ Breastfeed q2h and empty breasts entirely by pumping (back pressure
on full milk glands .milk production)
¦ Apply ice between feedings 15min on and 45min off (heat .vascular


¦ Nipples are below surface of surrounding skin

¦ Nursing:
¦ Wear breast shield to draw nipple out
¦ Use electric breast pump before attempting latching-on
¦ Apply ice and tug and roll nipple with hands before feeding


¦ Nipple irritation resulting in discomfort

¦ Nursing:
¦ Alternate infant position
¦ Ensure infant is on areola and not just the nipple
¦ Apply ice before feeding to .nipple erectness and .soreness OR breast
massage and warm compress before feeding to .let-down reflex
¦ Analgesic 1hr before feeding to .soreness
¦ Use less sore nipple first
¦ Use breast shield. At end of feeding apply breast milk to nipples and



1. The most common pathogenic mechanism of acute pancreatitis is –
Auto digestion of the pancreas.

2. What does the nurse monitors for, in a patient with Acute Renal Failure?
Pulmonary edema and ECG changes.

3. A disease caused by Treponema pallidum is –

4. Which of the following is an important nursing intervention for a patient with Cushing Syndrome?
(a) Left Middle Cerebral Artery (b) Observe for hypotension
(c) Protect from infection (d) Restrict carbohydrate intake.

Ans: Protect from infection.

5. Involvement of which of the following structures will lead to right-sided hemiplegia and aphasia?
(a) Left Middle Cerebral Artery (b) Vertebral Artery (c) Brain stem
(d)Right Middle Cerebral Artery.

Ans: Left Middle Cerebral Artery

6. Which one of the following is a common response expected in a patient with stroke, to the change in body image?
(a)Denial (b) Dis association (c) Delusion (d) Depression.
Ans: Depression.

7. A patient with early osteoporosis must be advised to-
Stop smoking

8. For doing nasotracheal suctioning, during which of the following patient activities, the catheter should be inserted?
(a)Swallowing (b) Inhaling (c) Exhaling (d) Retching
Ans: Inhaling

9. The simple most effective method for reducing the risks of stasis of pulmonary secretions is-
Two hourly position change.

10. What is cyanosis?
Blue discoloration of skin.

11. The period from conception to birth is denoted as –

12. Role of nursing is “having charge of somebody’s health” Whose vision is this?
Florence Nightingale

13. Which of the following developmental stage corresponds to infancy?
(A) Trust Vs Mistrust (b) Autonomy Vs Shame (c) Initiative Vs Guilt (d) Industry Vs Inferiority.

Ans: Trust Vs Mistrust

14. Who proposed the nursing theory of self-care deficit?
Dorothea orem

15. The head circumference of a normal infant is –
33-35 cm

16. The leading cause of death in adolescence is –
17. The legal definition of ‘death’ that facilitates organ donation is, cessation of –
Function of brain

18. The body temperature at which tissues and cells can best function is –
36-38o C

19. Men have a higher Basal Metabolic Rate because, their body contains more-

20. The mechanism by which body loses heat to the environment, without having direct contact is --?

21. Which of the following structures controls heat loss?
(a) Anterior pituitary (b) Posterior pituitary (c) Posterior hypothalamus (d) Anterior hypothalamus
22. Exposure of the body to subnormal temperature can lead to …

23. What is the effect of an antipyretic?
Reduce fever

24. The volume of blood pumped by the heart during one minute is called….
Cardiac output

25. What is the normal pulse rate of an infant?
26. The phase of respiration in which gases move in and out of the lungs is ….

27. What is the normal partial pressure of carbon dioxide in arterial blood? (mm Hg)

28. What is the equipment that indirectly measures arterial oxygen saturation?
Pulse Oximeter

29. What is the term used to denote regular, abnormally slow respirations?

30. What technique of assessment helps to determine ketoacidosis?

31. Inflammation of skin at base of nail is?

32. The condition in which both eyes do not focus on an object simultaneously is known as?
33. The most effective way to break the chain of infection is by?
Hand hygiene

34. How many drops in a standard drip set makes one ml.?

35. The prescription orders 0.125 mg digoxin orally. Tablets containing 0.25 mg is available. How many tablets will you administer?

36. A patient who is receiving intravenous fluids develops tenderness, warmth, erythema and pain at the infusion site. Which of the following conditions will you suspect?
(a) Sepsis (b) Infiltration (c) Fluid overload (d) Phlebitis

37. When providing oral hygiene to an unconscious patient, care must be taken to prevent?

38. What is the intrinsic rate of the normal A-V node?
40-60 per minute

39. Which of the following structures is the pacemaker of the heart?
(a) S-A node (b) Septum (c) A-V node (d) Bundle of His
Ans: S-A node

40. The prescription is for two tablespoons of milk of magnesia. How many ml. will you give?
30 ml

41. Which of the following is intravascular fluid?
(a) Lymph (b) Pleural fluid (c) Plasma (d) Synovial fluid
Ans: Plasma

42. If the serum potassium level is less than normal, the condition is known as –

43. What electrolyte abnormality is likely to develop in a patient with vomiting?

44. How much sodium is normally present in the extra cellular fluid? (in MEq/L).

45. What is the primary cause of hyperkalemia?
Renal failure

46. Which of the following is an isotonic solution?
(a)Lactated Ringers (b) Half –Normal Saline (c) One-third Normal Saline
(d) Mannitol
Ans: Lactated Ringers

47. Thousand ml. of Normal Saline is to be infused in 8 hours. What should be the rate of flow per minute?
30 drops

48. A patient admitted with vomiting, has the following arterial blood gas levels-pH 7.30; PaCO2 36 mm Hg; Pa O2 92mm Hg; and HCO3 18; what is the acid-base imbalance that is present?
Metabolic acidosis

49. Which of the following is a first-line drug used for pain management?
(a)Acetaminophen (b) Clonidine (c) Morphine (d) Ketamine
Ans: Acetaminophen

50. Which of the following is the organism that causes peptic ulcer disease?
(a) Staphylococcus (b) Coryne bacterium (c) Helicobacter pylori
(d) Streptococcus.
Ans: Helicobacter pylori

51. Which of the following nutrients helps for tissue repair?
(a)Vitamin (b) Fat (c) Carbohydrate (d) Protein
Ans: Protein

52. Microscopic examination of urine reveals elevated levels of red blood cells. What does it indicate?
Damage to Glomeruli.

53. Which of the following patient activities helps to relax the external anal sphincter, while administering enema?
(a)Separating the buttocks (b) Lubricating the catheter tip
(c)Inserting the catheter slowly (d) Breathing out through the mouth.

Ans: Breathing out through the mouth.

54. What length of the catheter tip should be inserted into the rectum, for giving enema to an adult patient?
7.5-10 cm

55. The stool discharged from an ostomy is called?

56. Which of the following is the best method to confirm placement of the nasogastric tube:
(a) Checking patient’s ability to talk (b) Aspiration of intestinal content
(c) Introducing air and auscultating (d) X-ray of chest and abdomen

Ans: X-ray of chest and abdomen

57. Which of the following is a common cause of orthostatic hypotension in a bedridden Patient?
(a)Increased autonomic response (b) Decreased circulating blood volume
(c) Increased cardiac output (d) Decreased blood pooling
Ans: Decreased circulating blood volume.

58. Which of the following body parts has a condyloid joint?

(a) Shoulder (b) Elbow (c) Wrist (d) Forearm

Ans: Wrist
59. Who was the first president of the International Council of Nurses?

60. Which of the following minerals should be taken by a child suffering from rickets?
(a)Potassium (b) Calcium (c) Sodium (d) Iron
Ans: Calcium

61. Who introduced antiseptic spray during surgery?
Joseph Lister

62. A large infection made up of several boils is known as :

63. Which of the following drugs will be administered to treat anaphylaxis?
(a) Atropine (b) Sodium bicarbonate (c) Digoxin (d) Epinephrine
Ans: Epinephrine

64. Which of the following is a vesicant drug?
(a)Dactinomycin (b) Morphine (c) Azithrocin (d) Voveran
Ans: Dactinomycin

65. Pain caused by damage to somatic tissue is known as –

66. Which of the following immunoglobulin are responsible for anaphylactic reactions?
(a) IgA (b) IgE (c) IgM (d) IgG
Ans: IgE

67. The separation and disruption of previously joined wound edges is termed as?

68. What types of dressing is Duoderm?

69. The role of the complement system in opsonization affects which response of the inflammatory process?

70. Contractures frequently occur after burn healing because of ….?
Excess fibrous tissue formation.

71. Association between HLA antigens and diseases is most commonly found in what disease conditions?
Autoimmune diseases.

72. What is the most common cause of secondary immunodeficiencies?

73. If a person is having an acute rejection of a transplanted organ, which of the following drugs would most likely to be used?
(a)Tacrolimus (b) Cyclosporine (c) Cellcept (d) Daclizumab.

Ans: Daclizumab.

74. The primary difference between benign and malignant neoplasm is the ….
Characteristic of tissue invasiveness.

75. If the blood plasma has a higher osmolality than the fluid within a red blood cell, the mechanism involved in equalizing the fluid concentration is?

76. Which of the following symptoms should be watched for in a patient receiving a loop diuretic?
(a)Restlessness and agitation (b) Paresthesias. (c)Increased blood pressure
(d)Weak irregular pulse.

Ans: Weak irregular pulse.

77. Which of the following should be watched for in a patient who has just undergone a total thyroidectomy?
(a)Weight gain (b) Depressed reflexes (c) Positive chvostek sign (d) Personality changes.

Ans: Positive chvostek sign

78. Which of the following surgical procedures involves removal of a body organ?
(a) Tracheostomy (b) Laparotomy (c) Mammoplasty (d) Mastectomy.
Ans: Mastectomy.
79. The cause of arcus senilis is?
Cholesterol deposits.

80. What is the cause of presbyopia?
Inflexible lens.

81. The most appropriate technique to assess skin for temperature and moisture is ….

82. Complete absence of melanin pigment in patchy areas on a patient’s hand is described as …..

83. What instruction will you give to a patient after a chemical peel?
Avoid sun exposure
84. Childhood atopic dermatitis is commonly seen in which body area?
Antecubital space.

85. Which of the following parameters is commonly used to assess adequacy of fluid replacement in a patient with burns?
Urine output.

86. Which of the following is an earliest manifestation of inadequate oxygenation?
(a) Diaphoresis (b) Cyanosis (c) Restlessness (d) Hypotension

Ans: Restlessness

87. A diagnostic procedure which involves removal of pleural fluid for analysis is :


88. Which of the following helps to identify flail chest in a patient with chest trauma:
(a)Multiple rib fractures seen in X-ray. (b)Decreased movement of chest wall
(c)Tracheal deviation (d) Paradoxic chest movement during respiration.
Ans: Paradoxic chest movement during respiration.

89. Which of the following is an intervention for a patient with chronic obstructive pulmonary disease?
(a) Pursed-lip breathing (b) Chronic steroid therapy (c) High flow oxygen
(d)High Carbohydrate diet
Ans: Pursed-lip breathing

90. Which of the following is a normal finding obtained during a lymph node palpation?
(a) Hard, fixed node (b) Firm, mobile node (c) Enlarged tender nodes
(d)Hard, nontender nodes

Ans: Firm, mobile node

91. Which is the most common type of leukemia seen in older adults?
Chronic lymphocytic.

92. The blood vessel that brings blood to the right atrium is ….
Inferior Venae Cavae

93. Which of the following conditions is caused by elevated intra ocular pressure?
(a)Glaucoma (b) Cataract (c) Strabismus (d) Myopia.
Ans: Glaucoma.

94. Which of the following is the most common pathologic finding in individuals at risk for sudden cardiac death?
(a)Aortic valve disease (b) Mitral valve disease
(c) Left ventricular dysfunction (d) Atherosclerotic heart disease
Ans: Atherosclerotic heart disease

95. Which of the following is an absolute contraindication for the use of fibrinolytic therapy?
(a) Current use of anticoagulants (b) Severe liver disease
(c) Suspected aortic dissection (d) Active peptic ulcer disease
Ans: Suspected aortic dissection

96. Which of the following drugs provide relief of anxiety and decreases both preload and after load?
(a) Amrinone (b) Morphine sulphate (c) Furosemide

Ans: Morphine sulphate

97. In a normal sinus rhythm, the measurement of an S.T.segment is …..?
0.12 seconds

98. The ECG monitor of a patient admitted with myocardial infarction shows ventricular bigeminy. What is the nurse’s responsibility in this situation?
Assess the patient’s response

99. What is the usual treatment of Rayanaud’s Phenomenon?
Calcium Channel blockers.

100. A patient is admitted with a diagnosis of diarrhea with dehydration. What could be the cause of increased peristalsis resulting in diarrhea?
Parasympathetic stimulation.

Friday, 25 November 2011


Admission notice

National Institute of Mental Health & Neuro Sciences (Deemed University)P.B. No. 2900, Hosur Road, Bangalore – 560029. India

Grams: Nimhans Ph: 26995000/26995015 Fax: 0091-080-26564830/26562121

No. NIMH/ACA/ADMN/2012-13/1

Dated: 31/10/2011

Admission Notice

Online Applications are invited on prescribed form for Admission to the following courses for the Academic Year 2012-2013.

The last date to submit the application online is 2nd December 2011 and the last date for receipt of Application Abstract at this Institute is 7th December 2011.
Post Graduate Degree/Diploma Courses

MD Degree in Psychiatry 22# Seats (1 for Sponsored)

Diploma in Psychiatry (DPM) 9 Seats (8 for Karnataka Domicile and 1 for Sponsored)

M.Phil. in Clinical Psychology 21 Seats (3 for Foreign/Sponsored)

M.Phil. in Psychiatric Social Work 21 Seats (3 for Foreign/Sponsored)

M.Phil. in Neurophysiology 2 Seats

M.Phil. in Biophysics 3 Seats

M.Phil. in Neurosciences 4 Seats

M.Sc. in Psychiatric Nursing 9 Seats

Diploma Courses

Post Basic Diploma in Psychiatric/Mental Health Nursing 45 Seats

Post Basic Diploma in Neuroscience Nursing 9 Seats

#Subject to clearance from the Government of India

Sponsored candidates means sponsored by the State/Central Government or Public Sector undertaking of State/Central Government.

For Details Regarding Submission of Applications online, Prospectus, Application Fee, Eligibility Conditions for Admission, Minimum Qualification, Guidelines, Course Fees, Emoluments, Reservation of Seats, Relaxation, Instructions to Fill the Applications, Age Limit. Last Date and For All Other Information, Please Visit The NIMHANS Website:

Thursday, 24 November 2011


Last Updated On: Nov-20-11 19:50
Type Of Job: Full Time
Locality: Ernakulam

Function: Other
Designation: NURSES, DOCTORS, TEC...

Education: Graduate
Experience: 1 - 3 Yrs
Annual Compensation: Rs. 5L - Rs. 8L


Tuesday, 22 November 2011


Gazette Date: 31.05.2011
Last Date: 06.07.2011
Category No: 125/2011

Applications with a latest photograph uploaded are invited online only exclusively from qualified candidates
belonging to reservation group of communities of Kerala State viz.ST for appointment in the under mentioned post.
1. Department : Health Services
2. Name of post : Staff Nurse Gr.II
3. Scale of pay : `7480-11910
4. No. of vacancies : Districtwise
Kannur-ST –1(One)



Gazette Date:11.11.2011
Last Date:14.12.2011
Category No.:388/2011

Applications with a latest photo uploaded are invited online only from qualified Physically Handicapped
candidates belonging to partially Deaf category in the state of Kerala against the vacancies reserved for them for
the following post.
1. Department : Health Services
2. Name of post : Staff Nurse Gr.II
3. Scale of pay : `13900-24040
. No. of vacancies : Districtwise
Physically Handicapped (Partially Deaf)
Alappuzha -2(Two)
Kasaragod -1 (One)

Note:- (i) Applications submitted by candidates other than those belonging to Physically Handicapped
(Partially Deaf) will be summarily rejected. No rejection memo will be issued to them
(ii) Separate Ranked list will be prepared for Alappuzha and Kasaragod districts in pursuance of
this notification. Ranked list thus prepared and published by the Commission shall
remain in force until candidates are advised and appointed against the vacancies
earmarked for Physically Handicapped persons- (Partially Deaf turns) remains
unfilled due to the paucity of candidates during the currency of the Ranked list
published for the post in the following districts.
Name of District Date of publication of
Ranked list
Category No.
Alappuzha 11/07/07 15/2006
Kasaragod 29/06/07 15/2006
(iii) Candidates shall submit application for this post to anyone of the Districts where the vacancy
is in existence and shall note the name of the district against the relevant column.
Application shall not be sent to more than one District in response to this notification.
If applications are sent contrary to the above direction and if he/she is selected his/her
name will be removed from the Ranked List and disciplinary action will be taken
against him/her.
(iv) The selection in pursuance of this notification will be made on a Revenue District basis,
subject to the special conditions laid down in GO(Ms) No.154/71/PD dated 27.05.1971.
A candidate advised for appointment in one revenue district from the Ranked List
prepared is not eligible for transfer to another district unless he/she completes five
years continuous service from the date of commencement of service in the former
district. Even if transfer is allowed after five years, it will be subject to the rules in
GO(MS) No.4/61/PD, dated 2.1.1961.Candidates already in Government Service
holding the same post in any one district are prohibited from applying again for this
post, but they can apply to higher posts when notified.
5. Method of appointment : Direct Recruitment [from among Physically Handicapped (Partially
Deaf) candidates only]
6. Age : 20-35; Only candidates born between 2.1.1976 and 1.1.1991 (Both
dates included) are eligible to apply for this post. For details regarding
age relaxations , subject to the condition that the maximum age limit
shall in no case exceed 50 (fifty) years please see para (2) of the
General Conditions under Part II of this Notification.
7. Qualifications:
(1) A pass in Plus Two/Pre degree (with Science subjects) course/pass in VHSE (with science
subjects)/ VHSE in Domestic Nursing of a recognized University or its equivalent.
(2) A pass in B.Sc Nursing of a recognized University or a pass in General Nursing & Midwifery
Course having not less than3 years duration from any institution recognized by Government.
(3) Certificate of Registration with Kerala Nurses and Midwives Council as Nurse and Midwife, in the
case of woman candidates and as Nurse in the case of male candidates.
8. Last date of receipt of applications: 14.12.2011 Wednesday upto 12.00 midnight
9. Mode of submitting applications:-
The application with Photo uploaded shall be submitted online only. Detailed instructions regarding the
submission of application are available on the website of Kerala Public Service Commission viz No application fee is required. The candidates applying on-line shall keep the print out
(Receipt) of their applications and the bar code number shall be quoted in all further enquiries /correspondence.
Documents to prove qualifications, age and community have to be produced as and when called for.
Applications which are submitted not in accordance with the instructions given in the website will be
summarily rejected.
10. Address to which applications are to be sent :
11. If a written test/OMR test is conducted as a part of the selection, hall ticket of eligible candidates will be
made available in the website of Kerala Public Service Commission. Candidates are instructed to
download their hall tickets as per the instructions given in the website.
12. At the time of examination , Interview etc candidates shall produce their photo affixed ID proof in
original (Voter's Identity card, Driving Licence, Passport, Identity card issued by Social Welfare
Department, Govt of Kerala, to PH candidates, photo affixed passbook issued by Nationalised Banks,
PAN card, Identity card issued to Govt. employees by the concerned Departments) and its self attested
photocopy along with the hall tickets.


Specialist Doctor/ ANM/ Nurse, Jobs In District Health Society Jamui Bihar
District Health Society, Jamui (Bihar)
District Health Society, Jamui (Bihar)
Ist Floor, Sadar Hospital, Jamui 811307

Contractual Vacancies of Specialist Doctor, Nurse and ANM in District Health Society, Jamui

Applications are being invited by District Health Society from eligible candidates for the recruitment of Specialist Doctor, Nurse and ANM. Under the National Rural Health Mission (NRHM) these posts (Doctor, ANM and Nurse) are available. In the specialization General / Surgeon / Gynaecology / Child Specialist / Physician posts of doctors are available. On the basis of contract, which will be given to 02 years of initial period,  these post will be filled. Recruitment related rest of the information can be seen below: -
2. Nurse (Grade A)

No. of Posts: – 17 (UR-02, EBC-07, SC-08)

Age Limit: – Minimum 18 years; Maximum 64 years (age would be recloned on 01.12.2011)

Essential Qualification: – Diploma in General Nursing from govt. recognised institutions. Applicants should be enrolled in State Nursing Council.

Salary: – Rs. 20000/- per month (inclusive)

Job Tenure: - 03 years

3. ANM

No. of Posts: – 38 (UR-09, EBC-07, SC-22)

Age Limit: – same as shown above

Educational  Qualification: – Matriculation with ANM Trained from Govt.. recognised institutions. Candidates should also be enrolled with State Nursing Council

Salary: – Rs. 11500/- per month (Inclusive)

Tenure: – 03 years

Process of Selection: – On the basis of Interview performance, candidates eligible will be selected. The selection committee will arrange a Walk In Interview for conducting Interview of eligible candidates.

Date of Walk In Interview: – On 28.11.2011 Walk In Interview will be organised for Specialist Doctor. On 12.12.2011 and 19.12.2011 Walk In will be held for ANM and Nurse respectively

Venue of Walk In: – District Health Society, Jamui

Note: - On appropriate Time of Walk In Interview candidates have to appear with Original Certificates along with attested true copies of one set of it.

General Instructions: -

1. Between 11.00 AM to 2.00 PM Interview will be held, therefore candidates have to appear much before the interview schedule as per their eligibility.

2. After completion of tenure candidature will be terminated

3. Any given information found wrong will cast the candidature and legal action will be taken against candidates.

4. Candidates wont be considered as Govt. of Bihar employee

5. During the process of selection rules of roaster will be applicable.
 for more govt jobs visit Government Jobs.