Luciano-Give Praise.mp4

Why?

 WHY?,...wasn't that our most asked one-word question when we were all kids just some few years ago? ;) So why do we stop asking the "whys" as we grow up and some of us for some reasons just tend to be more and more gullible to everything we hear or assume? Lack of questions to me equates lack of growth. Nobody knows it all, and that is why asking questions such as "whys" in a child-like manner is the gateway to the world of advanced growth, maturity and personal development.Therefore let's regress back to our "WHY" days :) TGIF everyone.

Pal, Ron

To the Unborn-St. Joseph of Cupertino-Pray for Us!!!

Leopold maneuvers

For your patients who are pregnant, Leopold maneuvers comprise a stepwise method of abdominal palpation you can use to determine the number of fetuses, the presenting part, the fetal lie, the fetal attitude, the fetal position, the degree of the descent into the pelvis, and the best location for auscultating fetal heart tones. That location is the point of maximal intensity (PMI) of the fetal heart rate on the patient’s abdomen.

The four Leopold maneuvers are:

• Identifying the fetal part in the uterine fundus to determine fetal lie and the presenting part
• Palpating the fetal back to identify fetal presentation
• Determining which fetal part lies over the pelvic inlet to identify fetal attitude
• Locating the fetal cephalic prominence to identify the attitude of the head

Begin the procedure by asking your patient to empty her bladder so that she won’t feel any discomfort during palpation. Position a small rolled towel under one hip to shift her uterus away from large blood vessels and thus prevent supine hypotensive syndrome. If you are right-handed, stand on the patient's right side facing her. Use the flat palmar surfaces of your fingers to perform Leopold maneuvers.

For the first maneuver, face your patient and place both hands on her abdomen, cupping your hands around the fundus or the top of the uterus. Palpate for the fetal part that occupies the fundus to help identify fetal lie and presentation. Feel for shape, consistency, and mobility. The fetal head will feel firm and round. The breech, that is, the buttocks and legs, will feel softer and less defined.

For the second maneuver, position the palms of your hands on the side of the patient’s abdomen. Use the palmar surface of one hand to locate the fetal back and the various irregularities to identify hands, feet, and elbows. The fetal back will feel smooth and hard. The smaller fetal parts, such as the hands, feet, and elbows, will feel like irregular nodules when you palpate them. This also helps you identify the fetal presentation.

For the third maneuver, use your right hand to grasp the lower section of the patient’s abdomen between your index finger and thumb and press inward over the inlet to the true pelvis. Note any movement and determine whether the presenting part is soft or firm. If there is movement, the presenting part is not engaged. If the head is the presenting part, determine fetal attitude, that is, whether the head is flexed or extended.

For the fourth maneuver, face the patient’s feet and place both hands on both sides of her uterus. Outline the fetal head with your fingertips. Palpate both sides of her abdomen to determine the cephalic prominence, or brow. Note that this maneuver applies only to cephalic presentations. If you find the cephalic prominence on the same side as the feet, hands, and elbows, the head is flexed and the vertex is presenting. If you find the cephalic prominence on the same side as the back, then the head is extended and the face is presenting.

After the procedure, assess the patient's response and then assess fetal well-being. Do this by checking the fetal heart tones and by noticing any changes in fetal position. Document the procedure and discuss the results with your patient’s provider.

References

Lowdermilk, D. L., Perry, S. E, Cashion, K., & Alden, K. R. (2012). Maternity & women’s health care (10th ed.). St. Louis, MO: Elsevier Mosby. p. 443.

Pillitteri, A. P. (2007). Maternal & child health nursing: Care of the childbearing & childrearing family.Philadelphia, PA: Lippincott Williams & Wilkins. pp. 515-516.

The Tomb is Empty

It's Easter Sunday and Catholics with other Christian denominations across the globe celebrate this day in memory of the death and resurrection of our Lord Jesus Christ. This day was when Mary Magdalene, the other Mary, and John the beloved according to the scriptures went and found the tomb empty as was told by the angel that Jesus wasn't here, he has risen from the dead.

His death was for the salvation of mankind and I for one is grateful for the blood of Jesus Christ. This death also symbolizes hope for us men that Christ's death brought us newness of life as we all like new as to beginning.

I hope you and you family have a a wonderful season of utter newness.

God bless!!

Pal Ron