RBSE SS Voc Health Care cheat sheet

Anatomical position: standing erect, face forward, arms at sides with palms facing anteriorly; all directional terms assume this stance.

Directional pairs: superior/inferior (toward head/tail), anterior/posterior (front/back), medial/lateral (toward/away from midline), proximal/distal (toward/away from trunk attachment).

Body planes: sagittal divides left/right, coronal (frontal) divides anterior/posterior, transverse divides superior/inferior.

Organ system count is 11: integumentary, skeletal, muscular, nervous, endocrine, cardiovascular, lymphatic/immune, respiratory, digestive, urinary, reproductive.

Vital sign adult reference ranges: pulse 60-100/min, respirations 12-20/min, oral temperature 36.5-37.5 C, blood pressure below 120/80 mmHg.

Four tissue types: epithelial (covering), connective (support), muscle (contraction), nervous (signalling).

Homeostasis is maintenance of a stable internal environment via negative feedback loops; positive feedback amplifies a change (e.g., labour contractions).

Cells require oxygen and glucose for aerobic ATP production; absence of oxygen shifts metabolism to anaerobic glycolysis producing lactic acid.

Steps of the nursing process in order: assessment, diagnosis, planning, implementation, evaluation (ADPIE).

Before any procedure verify identity using two identifiers: full name and date of birth or registration number.

Pressure injury risk is staged 1-4 plus unstageable and deep tissue injury; stage 1 is non-blanchable erythema of intact skin.

Reposition an immobile patient at least every 2 hours to relieve pressure over bony prominences.

Intake-output record: 1 mL urine weighs approximately 1 g; normal adult urine output is roughly 0.5-1 mL/kg/hour, about 30 mL/hour minimum.

Range-of-motion exercises are active (patient moves joint) or passive (caregiver moves joint); stop if pain or resistance occurs.

Oral care for an unconscious patient is done in a side-lying position without water rinsing to prevent aspiration.

Measure pulse for a full 60 seconds when the rhythm is irregular; count respirations without telling the patient to avoid altering the rate.

Sequence for adult basic life support: check responsiveness and breathing, call for help, start chest compressions at 100-120/min, depth 5-6 cm, ratio 30 compressions to 2 breaths.

Severe choking with ineffective cough: give 5 back blows then 5 abdominal thrusts, alternating, until the object is expelled.

Severe external bleeding: apply direct pressure with a clean dressing, add layers without removing soaked ones, and elevate if no fracture.

Burn first aid: cool with running water for about 20 minutes, remove jewellery, do not apply ice, butter, or toothpaste, cover with a clean non-fluffy dressing.

Fracture immobilisation: splint joints above and below the injury, check distal pulse, sensation, and colour before and after splinting.

Anaphylaxis: give intramuscular adrenaline (0.5 mg of 1:1000 for adults) into the outer thigh and call emergency services immediately.

Recovery position is for an unconscious but breathing casualty; it maintains an open airway and allows drainage of vomit.

Stroke screening uses FAST: Face droop, Arm weakness, Speech difficulty, Time to call emergency services.

Chain of infection links: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host; breaking any link prevents transmission.

Five moments for hand hygiene: before touching a patient, before a clean procedure, after body fluid exposure risk, after touching a patient, after touching patient surroundings.

Alcohol-based hand rub is used for visibly clean hands; soap and water is required when hands are visibly soiled or after caring for a patient with C. difficile or norovirus.

Standard precautions apply to all patients regardless of diagnosis; transmission-based precautions (contact, droplet, airborne) are added for specific pathogens.

Personal protective equipment order to don: gown, mask or respirator, goggles, gloves; remove gloves first, then goggles, gown, mask, and perform hand hygiene last.

Sterile field rule: sterile items touching non-sterile items become contaminated; never turn your back on or reach over a sterile field.

Sharps: never recap a needle by hand; place used sharps immediately into a puncture-resistant, colour-coded container filled no more than three-quarters.

Airborne precautions require a fit-tested N95 or higher respirator and a negative-pressure room, as used for pulmonary tuberculosis and measles.

Bed bath water temperature is approximately 43-46 C; test with the inner wrist and change water when it cools or becomes soiled.

Fall prevention: keep bed in lowest position, wheels locked, call bell within reach, non-slip footwear, and adequate lighting.

Safe patient handling uses mechanical lifts and team assistance; keep the load close to the body and bend the knees, not the waist.

Oxygen safety: post 'no smoking, no open flame' signs, keep oxygen at least 1.5 m from heat sources, and avoid oil-based products on the face.

Restraint use requires a physician order, the least restrictive device, and monitoring of circulation, skin, and toileting at least every 15-30 minutes.

Fire response uses RACE: Rescue, Alarm, Contain, Extinguish/Evacuate; PASS for extinguisher use: Pull, Aim, Squeeze, Sweep.

Environmental cleaning follows the principle of clean to dirty and top to bottom; frequently touched surfaces are cleaned more often.

Sharps injury first action: wash the site with soap and water, do not squeeze or scrub, report immediately, and follow post-exposure prophylaxis protocol.

Macronutrients supply energy: carbohydrate 4 kcal/g, protein 4 kcal/g, fat 9 kcal/g; alcohol supplies 7 kcal/g.

Essential nutrients the body cannot synthesise in adequate amounts include nine amino acids, two fatty acids (linoleic and alpha-linolenic), vitamins, minerals, and water.

Water-soluble vitamins are B-complex and C; they are not stored and excess is excreted in urine. Fat-soluble vitamins A, D, E, K are stored in liver and fat.

Protein requirement for a healthy adult is about 0.8 g per kg body weight per day; needs rise with pregnancy, lactation, illness, and wound healing.

Dietary fibre intake target is roughly 25-30 g/day; fibre increases stool bulk and reduces constipation and cholesterol absorption.

Iron from animal sources (haem iron) is absorbed better than plant iron; vitamin C enhances non-haem iron absorption, while tea and calcium inhibit it.

Deficiency patterns: vitamin C causes scurvy, vitamin D causes rickets, iodine causes goitre, iron causes microcytic anaemia, vitamin B12 causes pernicious anaemia.

BMI equals weight in kilograms divided by height in metres squared; adult BMI 18.5-24.9 is normal, 25-29.9 overweight, 30 or more obese.

Therapeutic diet principles: diabetic diet controls refined carbohydrate and total energy, low-sodium diet limits salt to about 5 g/day, renal diet limits potassium, phosphate, sodium, and fluid.

DASH eating pattern emphasises fruits, vegetables, whole grains, and low-fat dairy while reducing sodium and saturated fat to lower blood pressure.

Lifestyle risk factors for non-communicable disease: tobacco use, harmful alcohol use, physical inactivity, unhealthy diet, and obesity.

WHO physical activity recommendation for adults is 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous activity weekly plus muscle strengthening twice weekly.

Glycaemic index ranks carbohydrate foods by blood glucose rise; low-GI foods are digested slowly and blunt post-meal glucose peaks.

Enteral nutrition is delivered via nasogastric or gastrostomy tube; parenteral nutrition bypasses the gut and is given intravenously.

Refeeding syndrome risk is highest in severely malnourished patients; restart feeding slowly and monitor phosphate, potassium, and magnesium.

Smoking cessation advice follows the 5 A's: Ask, Advise, Assess, Assist, Arrange follow-up.

Levels of prevention: primary (prevent onset, e.g., immunisation), secondary (early detection, e.g., screening), tertiary (limit disability, e.g., rehabilitation).

Community health assessment uses tools such as community diagnosis and participatory rural appraisal to identify priority health problems.

Cold chain for vaccines: most vaccines are stored at 2-8 C; freeze-sensitive vaccines such as hepatitis B and DPT must never be frozen.

Home visiting steps: pre-visit planning, establishing rapport, assessment, action and referral, recording, and follow-up scheduling.

Referral system levels: primary health centre, secondary or district hospital, tertiary or specialist hospital; a referral note must state reason, findings, and treatment given.

Community health worker roles include health education, growth monitoring, first aid, sanitation promotion, and linking people to services.

Epidemiological transition describes a shift from infectious disease burden to chronic non-communicable disease burden as populations develop.

Village health and nutrition day activities typically include immunisation, growth monitoring, antenatal check-ups, and health education.

Incidence measures new cases over a period (risk of disease); prevalence measures all existing cases at a point or period (burden of disease).

Attack rate equals new cases divided by population at risk, times 100, used in outbreak investigations.

Mortality rate equals deaths in a period divided by population at risk, times 1000; infant mortality rate uses deaths under 1 year per 1000 live births.

Epidemiological triad: agent, host, environment; disease results from interaction among these three factors.

Study designs: cross-sectional (prevalence), case-control (past exposure, odds ratio), cohort (follow-up, relative risk), and randomised controlled trial (strongest for causation).

Sensitivity is the proportion of true cases correctly identified; specificity is the proportion of non-cases correctly identified.

Herd immunity threshold depends on disease transmissibility; measles requires roughly 95% coverage, polio about 80-85%.

Notifiable diseases must be reported to public health authorities; examples include tuberculosis, measles, cholera, and dengue.

Antenatal schedule: at least four visits; first visit as early as possible in the first trimester, then monthly until 28 weeks, fortnightly to 36 weeks, weekly thereafter.

Danger signs in pregnancy requiring urgent referral: bleeding, severe headache with blurred vision, convulsions, high fever, reduced fetal movement, and leaking fluid.

Preeclampsia is hypertension after 20 weeks with proteinuria or organ involvement; eclampsia adds seizures and is treated with magnesium sulphate.

Exclusive breastfeeding for the first 6 months, then complementary feeding from 6 months with continued breastfeeding to 2 years or beyond.

Growth monitoring plots weight-for-age and length-for-age on charts; a flat or falling weight curve signals faltering growth and needs assessment.

Childhood immunisation schedule generally includes BCG and hepatitis B at birth, then DPT, polio, and other antigens at 6, 10, and 14 weeks.

Postpartum haemorrhage is the leading cause of maternal death; active management of the third stage reduces risk.

Newborn assessment uses Apgar score at 1 and 5 minutes: appearance, pulse, grimace, activity, respiration, each scored 0-2.

Six rights of medication administration: right patient, right drug, right dose, right route, right time, right documentation.

Routes: oral (onset slower, first-pass metabolism), sublingual (rapid, avoids first pass), intramuscular, subcutaneous, intravenous (100% bioavailability, fastest onset).

Common abbreviations: PO by mouth, IM intramuscular, IV intravenous, SC subcutaneous, PR per rectum, BD twice daily, TDS three times daily, QID four times daily.

Metric conversions: 1 g = 1000 mg, 1 mg = 1000 micrograms, 1 L = 1000 mL, 1 teaspoon = 5 mL.

Dose formula: dose required = (desired dose / stock strength) x stock volume; check that units match before calculating.

Never administer a drug prepared by someone else or from an unlabelled container; verify against the prescription and check allergies first.

High-alert medications such as insulin, heparin, and opioids require an independent double-check by a second qualified person.

Adverse drug reaction versus side effect: a side effect is a predictable, usually mild effect; an adverse reaction is harmful and unintended.

Word parts: prefix (position or number), root (core meaning), suffix (condition or procedure); example: brady-card-ia means slow heart rate.

Common prefixes: tachy- fast, brady- slow, hyper- above, hypo- below, dys- difficult, poly- many, a- or an- without.

Common suffixes: -itis inflammation, -ectomy removal, -otomy incision, -ostomy opening, -algia pain, -ology study of, -emia blood condition.

Root examples: cardi- heart, nephr- kidney, hepat- liver, gastr- stomach, pulmon- lung, derm- skin, oste- bone, neur- nerve, hem- or hemat- blood.

Abbreviations: BP blood pressure, HR heart rate, RR respiratory rate, NPO nothing by mouth, PRN as needed, SOB shortness of breath, ROM range of motion.

Directional terms: bilateral both sides, unilateral one side, ipsilateral same side, contralateral opposite side, proximal nearer the trunk.

Colour terms: cyan/o blue, erythr/o red, leuk/o white, melan/o black, xanth/o yellow.

Diagnostic suffixes: -graphy imaging, -scopy visual examination, -gram record or image, -metry measurement.

Documentation principles: factual, accurate, complete, timely, legible, signed with name and designation, and written in objective terms.

Never alter or backdate a record; a late entry must be clearly marked as a late entry with the date and time it is written.

Quote a patient's exact words for subjective data; record observable findings as objective data.

SBAR handover: Situation, Background, Assessment, Recommendation, used for structured communication between clinicians.

Active listening techniques include paraphrasing, reflecting, open questions, and clarifying; closed questions are used to confirm facts.

Therapeutic communication avoids false reassurance, giving advice, judging, and changing the subject.

Documentation is a legal record and may be used in court; if it is not written, it is generally treated as not done.

Use standard abbreviations only; error-prone abbreviations such as 'U' for units or 'qd' for daily are avoided.

Four principles of biomedical ethics: autonomy (respect patient choice), beneficence (do good), non-maleficence (do no harm), justice (fair distribution).

Informed consent requires capacity, adequate information about risks and alternatives, understanding, and voluntary choice.

Confidentiality may be breached only when required by law, when the patient consents, or when there is serious risk to others.

Veracity is the duty to tell the truth; fidelity is the duty to keep promises and remain loyal to the patient.

Advocacy means acting in the patient's interest, including raising concerns when care appears unsafe.

Ethical decision-making steps: identify the dilemma, gather facts, consider principles and stakeholders, weigh options, decide, act, and review.

Paternalism overrides patient autonomy for the patient's perceived benefit and is generally not acceptable for competent adults.

Research ethics require voluntary participation, informed consent, risk minimisation, and ethics committee approval.

Negligence requires four elements: duty of care, breach of duty, causation, and actual harm.

Professional scope of practice defines tasks a health worker is trained and authorised to perform; performing beyond it creates legal risk.

Assault is the threat of harmful contact; battery is actual unauthorised contact; both can arise from treatment without consent.

Patients have a right to privacy, access to their records, information about their care, and to refuse treatment.

Mandatory reporting duties include suspected child abuse, certain communicable diseases, and sharps injuries, depending on local law.

Professional boundaries: never accept gifts of significant value, never engage in dual relationships, and maintain patient dignity during personal care.

Record errors are corrected with a single line, initialled and dated, leaving the original entry legible; correction fluid is never used.

Whistle-blowing is justified when internal reporting has failed and patient safety is at serious risk.

Vital signs sequence: measure and record temperature, pulse, respiration, blood pressure, and oxygen saturation, then compare with previous readings and report abnormalities.

Hand hygiene is performed before and after every skill station, and gloves do not replace hand hygiene.

Clinical skill demonstration is assessed on preparation (equipment and patient), explanation, technique, safety, documentation, and aftercare.

Vocational project structure: title, introduction and rationale, objectives, methodology, results, discussion, conclusion, references, and annexures.

Project objectives must be specific and measurable, and each result should map back to an objective.

Data collection tools include questionnaires, checklists, interviews, and observation schedules; pilot-test the tool before full use.

Ethics in student projects: obtain institutional permission, informed consent, and anonymity of participants.

Maintain a logbook with dated entries, supervisor signatures, and reflection on each clinical skill practised.

Plural forms: -a becomes -ae, -us becomes -i, -um becomes -a, -is becomes -es, -on becomes -a.

Suffix -plegia means paralysis, -paresis means weakness, -oma means tumour, -pathy means disease.

Prefixes of number: mono- one, bi- two, tri- three, quadri- four, multi- many.

Terms of position: supine lies on the back, prone lies on the abdomen, lateral lies on the side, Fowler's is sitting up at 45-60 degrees.

Common vital-sign abbreviations: T temperature, P pulse, R respiration, BP blood pressure, SpO2 oxygen saturation.

Suffix -scopy is examination with an instrument; -stomy is a surgical opening; -centesis is puncture to remove fluid.

Prefix peri- means around (pericardium), endo- means within (endocardium), myo- means muscle (myocardium).

Abbreviations for frequency: OD once daily, BD twice daily, TDS three times daily, QID four times daily, HS at bedtime.

Medical asepsis reduces the number of microorganisms; surgical asepsis eliminates all microorganisms from objects and the field.

Isolation room door should remain closed for airborne and droplet precautions; keep it closed for contact precautions where practical.

Droplet precautions apply to influenza, pertussis, and meningococcal meningitis; a surgical mask is worn within about 1 metre of the patient.

Contact precautions apply to MRSA, VRE, scabies, and C. difficile; gloves and gown are worn on entry and removed before leaving.

Disinfection kills most pathogens on inanimate objects; sterilisation destroys all microorganisms including spores, usually by autoclave.

Spore-forming bacteria such as Clostridium are resistant to alcohol; use soap and water or chlorine-based agents.

Immunisation of health workers and post-exposure prophylaxis are components of infection prevention programmes.

A nosocomial infection is acquired in a health facility and was not present or incubating at admission.

Balanced diet food groups: cereals and millets, pulses and legumes, milk and meat products, fruits and vegetables, fats and sugars.

Vitamin sources: A from liver and yellow-orange vegetables, C from citrus and amla, D from sunlight and fish oil, K from green leafy vegetables.

Mineral functions: calcium for bone and clotting, iron for haemoglobin, iodine for thyroid hormone, potassium for nerve and muscle function.

Food safety: keep hot foods above 60 C and cold foods below 5 C; the danger zone is 5-60 C.

Breast milk provides immunoglobulins, especially IgA, and is the ideal first food for the newborn.

Kwashiorkor is protein deficiency with oedema; marasmus is severe energy and protein deficiency with marked wasting.

Sodium intake above about 5 g salt per day is linked to hypertension; processed foods are the main hidden source.

Nutritional assessment tools include 24-hour dietary recall, food frequency questionnaire, and anthropometry such as weight and mid-upper arm circumference.

A medical record must record date, time, observation, intervention, patient response, and signature.

Telephone orders must be written down, read back to the prescriber, and countersigned within the locally defined timeframe.

Confidential information is shared only on a need-to-know basis among the care team.

Barriers to communication include noise, language difference, hearing loss, pain, anxiety, and use of jargon.

Interpreters should be used for patients with limited language proficiency rather than family members where possible.

Incident reports document what happened, when, where, who was involved, and immediate action; they are not part of the clinical record.

Objective data examples: blood pressure 150/90 mmHg, temperature 38.4 C, wound 3 cm with serous discharge.

Consent discussions are documented with what was explained, questions asked, and the patient's decision.

Skeletal system functions: support, protection, movement, mineral storage, and blood cell production in red marrow.

The heart has four chambers; the right side pumps deoxygenated blood to the lungs and the left side pumps oxygenated blood to the body.

Normal breathing involves diaphragm contraction and negative pressure in the thoracic cavity.

The nephron is the functional unit of the kidney and performs filtration, reabsorption, and secretion.

The nervous system divides into central (brain and spinal cord) and peripheral (somatic and autonomic) parts.

Endocrine glands secrete hormones directly into the bloodstream; the pituitary is often called the master gland.

The skin has three layers: epidermis, dermis, and subcutaneous tissue; it regulates temperature and acts as a barrier.

Blood components: plasma, red cells (oxygen transport via haemoglobin), white cells (defence), and platelets (clotting).

Types of bed-making include occupied, unoccupied, and post-operative or recovery bed with the head lowered and sides raised.

Aseptic technique for wound dressing: clean from the least contaminated to the most contaminated area and use one swab once only.

Urinary catheter care includes daily meatal hygiene, keeping the bag below bladder level, and avoiding kinks in tubing.

Oxygen delivery devices: nasal cannula 1-6 L/min, simple mask 6-10 L/min, non-rebreather 10-15 L/min.

Pulse oximetry below 94% at rest warrants assessment and reporting; values are affected by cold extremities and nail polish.

Pain assessment uses a 0-10 numeric scale or Wong-Baker faces for children; reassess after intervention.

Specimen collection: label at the bedside, use the correct container, and send promptly to the laboratory.

Pre-operative preparation includes fasting instructions, consent verification, removal of jewellery and dentures, and bladder emptying.

Primary survey uses ABCDE: Airway, Breathing, Circulation, Disability, Exposure.

Hypoglycaemia in a conscious person: give fast-acting oral sugar; in an unconscious person, do not give anything by mouth and seek emergency care.

Heat exhaustion causes heavy sweating and weakness; heat stroke causes hot dry skin and confusion and is a medical emergency.

Snake bite first aid: immobilise the limb, keep the patient calm, remove tight items, and transport to hospital; do not cut or suck the wound.

Poisoning: identify the substance, do not induce vomiting, and contact a poison information centre.

Drowning rescue: reach, throw, or use a boat before entering the water; begin CPR with rescue breaths if trained.

Fainting: lay the person flat, raise the legs, loosen tight clothing, and ensure fresh air.

Emergency triage sorts casualties by urgency so that life-threatening conditions receive care first.

Personal hygiene practices for health workers include short clean nails, hair tied back, no dangling jewellery, and clean uniform.

Oral hygiene is provided at least twice daily and after meals; dentures are removed at night and cleaned separately.

Pressure-relieving devices include air mattresses, cushions, and heel protectors; keep skin clean and dry.

Safe injection practice uses a new sterile needle and syringe for each injection and never shares multi-dose vials between patients.

Electrical safety: check plugs and cords, keep equipment away from water, and report faulty devices immediately.

Waste segregation uses colour-coded bins: yellow for infectious waste, red for sharps, and black for general waste in many systems.

Body mechanics: maintain a wide base of support, keep the centre of gravity close to the load, and avoid twisting while lifting.

Noise control and adequate lighting contribute to a safe environment and reduce patient falls and confusion.

Diabetic exchange lists group foods by carbohydrate content so portions can be swapped while keeping energy and glucose stable.

Low-potassium diet advice avoids bananas, oranges, potatoes, and tomatoes in large amounts; high-potassium foods are restricted in renal failure.

High-fibre diet for constipation includes whole grains, fruits, vegetables, and adequate fluids.

Clear liquid diet contains only transparent fluids; full liquid diet adds milk, strained cereals, and ice cream.

Soft diet is mechanically altered for chewing or swallowing difficulty; it avoids tough, fibrous, and fried foods.

Alcohol limit guidance is generally no more than two standard drinks per day for men and one for women.

Sleep hygiene and stress management are lifestyle measures that influence blood pressure, weight, and glucose control.

Nutrition counselling follows assessment, goal setting, education, and follow-up evaluation.

Community health nursing focuses on populations, health promotion, and prevention rather than individual curative care.

Health education planning steps: assess needs, set objectives, choose methods and materials, implement, and evaluate.

Sanitation measures include safe water supply, safe excreta disposal, refuse disposal, and vector control.

School health programmes provide screening, immunisation, health education, and first aid in schools.

Occupational health services include pre-employment screening, workplace hazard control, and periodic medical examination.

Home-based care for chronic illness includes medication supervision, wound care, nutrition support, and caregiver education.

Community participation improves programme sustainability; involve local leaders and groups in planning.

Health management information systems collect routine service data used for planning and monitoring.

Screening tests should have high sensitivity for serious diseases where early detection changes outcome.

Relative risk is used in cohort studies; odds ratio approximates relative risk in case-control studies of rare diseases.

A confounding variable is associated with both exposure and outcome and distorts the observed association.

Bias types include selection bias, information bias, and recall bias.

Outbreak investigation steps: verify the diagnosis, define and find cases, describe by time, place, and person, form a hypothesis, test it, and control the source.

An epidemic curve plots cases by date of onset and helps identify point-source versus propagated outbreaks.

Immunisation coverage and sanitation are the strongest population-level interventions for infectious disease control.

Surveillance is the continuous collection, analysis, and dissemination of health data for action.

Stages of labour: first stage from onset to full cervical dilatation, second stage to delivery of the baby, third stage to delivery of the placenta.

Normal fetal heart rate is 110-160 beats per minute; auscultate during and between contractions.

Active management of the third stage uses a uterotonic, controlled cord traction, and uterine massage.

Newborn care essentials: warmth, immediate drying, skin-to-skin contact, early breastfeeding within one hour, and eye care.

Danger signs in the newborn include poor feeding, lethargy, jaundice in the first 24 hours, fast breathing, and hypothermia.

Oral rehydration solution is used for childhood diarrhoea; zinc supplementation reduces duration and recurrence.

Integrated management of childhood illness assesses danger signs, cough, diarrhoea, fever, ear problems, and nutrition.

Family planning counselling covers effectiveness, side effects, reversibility, and protection against infection.

Pharmacokinetics covers absorption, distribution, metabolism, and excretion; pharmacokinetics determines onset, intensity, and duration.

First-pass metabolism reduces the oral bioavailability of drugs such as nitroglycerin, which is given sublingually.

Common routes and sites: deltoid for adult vaccines, ventrogluteal for intramuscular injections, abdomen for subcutaneous insulin.

Insulin is measured in units and must be drawn with an insulin syringe; store unopened vials at 2-8 C.

Antibiotic stewardship means using the right drug, dose, and duration to limit resistance.

Analgesic ladder for pain: non-opioid, then weak opioid, then strong opioid, with adjuvants at any step.

Adverse drug events are reported through pharmacovigilance systems; report even suspected reactions.

Check expiry dates and discard expired or discoloured medicines according to local disposal rules.

A living will or advance directive records a patient's wishes about future treatment when capacity is lost.

Surrogate decision-makers should follow the patient's previously expressed wishes rather than their own preferences.

Resource allocation decisions raise justice concerns and should be based on transparent, consistent criteria.

Cultural and religious beliefs affect care decisions and must be respected within legal limits.

Ethical research conduct requires minimal risk, fair selection of participants, and independent review.

Duty of care continues until a formal handover to another competent professional is complete.

Consent for a child is given by a parent or guardian, with assent from the child where developmentally appropriate.

Conflicts of interest must be declared and avoided in clinical and procurement decisions.

Registration and licensure define the legal right to practise; practising without it is an offence.

Patients may withdraw consent at any time, and treatment must stop when consent is withdrawn.

Confidentiality continues after death in most jurisdictions, subject to legal exceptions.

Defamation, whether spoken (slander) or written (libel), can arise from careless comments about patients or colleagues.

A patient's property and valuables must be recorded and secured on admission.

Professional codes require honesty, respect, and maintenance of competence through continuing education.

Discrimination on grounds of sex, caste, religion, disability, or disease status is both unethical and often unlawful.

An incident involving a patient must be reported promptly to the supervisor, even if harm appears minor.

Skill assessment checklists award marks for correct sequence, asepsis, patient comfort, and documentation.

Equipment must be checked before use and cleaned or disposed of after use according to protocol.

Explain each step to the patient before performing it and obtain cooperation.

Record the procedure performed, date, time, findings, and any untoward event.

A case study project includes patient history, assessment findings, care plan, interventions, and outcome.

Survey projects use sampling methods such as simple random, systematic, or convenience sampling, and the method must be stated.

Data presentation uses tables, bar charts, and line graphs; label axes and units clearly.

Supervisor feedback should be documented and acted upon before the final submission.

Positioning types: supine, lateral, Fowler's, Trendelenburg, and prone; each has specific indications and contraindications.

Trendelenburg position is head-down and is not used routinely for shock; it can impair breathing.

Enema administration: position left lateral, instil slowly, and record the result.

Oxygen should be humidified at high flow rates to prevent mucosal drying.

Urine output below 30 mL/hour in an adult may indicate dehydration or poor perfusion and must be reported.

Nasogastric feed is checked by verifying placement and is given at room temperature with the head elevated.

Pressure injury prevention includes skin inspection each shift and keeping heels off the mattress.

Patient education before discharge includes medication schedule, warning signs, follow-up date, and contact details.

Adult choking with a good cough: encourage coughing and monitor; do not perform blind finger sweeps.

Shock signs: pale clammy skin, rapid weak pulse, thirst, restlessness, and falling blood pressure.

Shock first aid: lie the person down, keep warm, raise the legs if no injury, do not give food or drink, and get urgent help.

Sprain management uses RICE: Rest, Ice, Compression, Elevation.

Eye splash: irrigate with clean water or saline for at least 15 minutes and refer for assessment.

Chemical burn: brush off dry powder before irrigating and check the safety data sheet for the substance.

Head injury: monitor consciousness level, pupils, and vomiting; keep the person still if spinal injury is suspected.

Emergency call information to give: location, number of casualties, type of incident, and contact number.

Hand hygiene duration: soap and water for at least 40-60 seconds, alcohol rub for 20-30 seconds until dry.

Isolation waste and linen are bagged at the point of use and labelled before transport.

Sputum and body fluid spills are cleaned with gloves, absorbent material, and a disinfectant such as chlorine solution.

Pest control and safe food handling reduce vector-borne and food-borne disease in health facilities.

Patient identification bands are checked before every procedure and replaced if illegible.

Bed rails are raised for unconscious patients and after procedures, and lowered when the patient is unattended at the bedside.

Medication storage areas should be locked, temperature-monitored, and free of expired stock.

Emergency equipment such as a resuscitation bag and oxygen must be checked and available at all times.

Basal metabolic rate is the energy needed at complete rest; total energy needs add activity and illness factors.

Energy requirement is estimated from body weight and activity level; fever and trauma increase needs.

Anthropometric measures include weight, height, BMI, waist circumference, and mid-upper arm circumference.

Waist circumference above 90 cm in men and 80 cm in women indicates central obesity in South Asian populations.

Food fortification adds micronutrients to staple foods; iodised salt prevents iodine deficiency disorders.

Exclusive breastfeeding provides about 500-600 kcal per day to the mother's requirement during lactation.

Vegetarian diets need attention to vitamin B12, iron, zinc, and calcium intake.

Dehydration is assessed by thirst, dark urine, dry mucosa, and reduced skin turgor; oral rehydration is the first-line treatment.

Drug names: chemical, generic (non-proprietary), and brand (proprietary); the generic name is used in prescriptions and records.

Controlled drugs require double-locked storage, a register of receipt and administration, and witnessed disposal.

Subcutaneous injection sites are rotated to prevent lipohypertrophy; the abdomen, thigh, and upper arm are common sites.

Intramuscular injection volume should generally not exceed 3 mL in adults; aspirate is not routinely required for all sites.

Elderly patients are at higher risk of adverse reactions due to reduced renal and hepatic clearance.

Medication reconciliation compares the current medication list with the new prescription at admission, transfer, and discharge.

Look-alike and sound-alike drug names require tall-man lettering or verbal confirmation to prevent errors.

Antidotes: naloxone for opioids, flumazenil for benzodiazepines, and N-acetylcysteine for paracetamol overdose.

Cardiovascular terms: tachycardia, bradycardia, hypertension, hypotension, myocardial infarction, and angina pectoris.

Respiratory terms: dyspnoea, tachypnoea, apnoea, haemoptysis, and cyanosis.

Gastrointestinal terms: dysphagia, haematemesis, melaena, diarrhoea, and constipation.

Neurological terms: hemiplegia, paraesthesia, aphasia, ataxia, and syncope.

Urinary terms: dysuria, haematuria, polyuria, oliguria, and anuria.

Suffix -tomy is incision, -ectomy is excision, -plasty is repair, and -pexy is fixation.

Prefixes: inter- between, intra- within, trans- across, sub- under, supra- above, retro- behind.

Terms for fever: pyrexia, febrile, and afebrile; antipyretic means fever-reducing.

A care plan documents identified problems, goals, interventions, and evaluation dates.

Flow sheets record routine observations such as vital signs, intake-output, and turning schedules.

Nursing notes may follow SOAP format: Subjective, Objective, Assessment, Plan.

Discharge summary includes diagnosis, treatment given, condition at discharge, medications, and follow-up advice.

Written patient education materials should use plain language, short sentences, and pictures where helpful.

Non-verbal communication includes posture, eye contact, touch, and facial expression; cultural norms vary.

Handover should include allergies, falls risk, and any pending investigations.

Verbal orders are acceptable only in emergencies and must be documented and confirmed in writing.

Body cavities: cranial, spinal, thoracic, abdominal, and pelvic; the diaphragm separates thoracic from abdominal cavities.

The respiratory tract divides into upper (nose, pharynx, larynx) and lower (trachea, bronchi, lungs) parts.

Gas exchange occurs in the alveoli, where oxygen diffuses into blood and carbon dioxide diffuses out.

The digestive tract includes mouth, oesophagus, stomach, small intestine, large intestine, and accessory organs liver and pancreas.

The liver produces bile, stores glycogen, and detoxifies substances; the pancreas secretes insulin and digestive enzymes.

The menstrual cycle averages 28 days, with ovulation near day 14 in a regular cycle.

Bone healing stages: haematoma, fibrocartilage callus, bony callus, and remodelling.

The immune system has innate (non-specific) and adaptive (specific, memory-forming) components.

Primary health care principles from Alma-Ata include equity, community participation, appropriate technology, and intersectoral collaboration.

Health promotion uses the Ottawa Charter actions: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, and reorient services.

Epidemiological data used in community diagnosis include birth rate, death rate, morbidity, and service coverage.

Referral feedback from higher facilities is essential for continuity of care.

Community support groups help with adherence to tuberculosis and HIV treatment.

Health education methods include lectures, demonstrations, role play, group discussion, and mass media.

Water safety: chlorination and boiling are common household methods of disinfection.

Vector control for mosquitoes includes eliminating standing water, using nets, and indoor residual spraying.

Descriptive epidemiology describes disease by person, place, and time; analytic epidemiology tests associations.

Person-time denominators are used in incidence density calculations.

Standardised mortality ratios allow comparison between populations with different age structures.

A p-value indicates the probability of observing a result by chance; confidence intervals show the range of plausible effect sizes.

Causation assessment may use Bradford Hill criteria, including temporality, strength, consistency, and biological plausibility.

Primary attack rate applies to the first wave; secondary attack rate measures spread among contacts.

Contact tracing identifies exposed persons and interrupts transmission chains.

Screening programmes require follow-up and treatment pathways, not just testing.

Antenatal investigations include haemoglobin, blood group, blood sugar, urine protein, HIV, and syphilis screening.

Iron and folic acid supplementation is given during pregnancy to prevent anaemia and neural tube defects.

Tetanus toxoid immunisation in pregnancy protects mother and newborn.

Preterm birth is delivery before 37 completed weeks; low birth weight is under 2500 g.

Kangaroo mother care provides skin-to-skin contact and exclusive breastfeeding for low birth weight infants.

Growth chart weight-for-age below the third percentile suggests undernutrition and needs evaluation.

Developmental milestones: head control by 3 months, sitting by 6-8 months, walking by 12-18 months.

Adolescent health services address nutrition, menstrual health, mental health, and substance use.

Capacity assessment checks understanding, appreciation, reasoning, and expression of a choice.

Emergency treatment may proceed without consent when the patient lacks capacity and delay would cause serious harm.

Euthanasia and assisted dying are illegal in many jurisdictions and must be distinguished from withholding futile treatment.

Organ donation requires consent or family authorisation under local law and confirmed death criteria.

Genetic information raises privacy concerns for relatives as well as the individual.

Allocation of scarce resources such as ventilators should follow published, consistent triage criteria.

Truth-telling about prognosis must be balanced with cultural preferences and the patient's expressed wishes.

Ethical leadership includes modelling integrity, reporting misconduct, and protecting those who raise concerns.

Vicarious liability holds an employer responsible for acts of employees performed in the course of employment.

Documentation of consent must be completed before the procedure, not after.

A patient may request a copy of their medical record under most access-to-information laws.

Restraint use is legally restricted and must be justified, time-limited, and reviewed.

Privacy laws govern storage, transfer, and disposal of patient records and electronic data.

Professional misconduct includes falsifying records, practising under the influence, and abandoning a patient.

A duty to warn may arise when a patient threatens serious harm to an identifiable person.

Insurance and indemnity protect professionals against claims but do not replace safe practice.

Viva preparation: know the rationale for each step, common errors, and safety considerations.

Project referencing should follow a consistent style, and all sources cited in the text must appear in the reference list.

Plagiarism is avoided by paraphrasing, quoting with citation, and keeping source records.

A pilot study tests feasibility and refines the tool before the main data collection.

Informed consent forms for projects state purpose, procedures, risks, benefits, and the right to withdraw.

Data should be stored securely and anonymised before analysis.

Discussion should compare findings with published literature and acknowledge limitations.

Presentation skills include clear slides, time management, and answering questions with evidence.

Weight management combines a modest energy deficit with increased physical activity and behaviour change.

Very low-calorie diets require medical supervision because of electrolyte and nutritional risks.

Dietary approaches for hypertension include reducing sodium, increasing potassium-rich foods, and limiting alcohol.

Diabetes medical nutrition therapy emphasises consistent carbohydrate intake, fibre, and healthy fats.

Post-operative diet progresses from clear liquids to full liquids, soft diet, and regular diet as tolerated.

Food allergies require strict avoidance and reading of labels; the common allergens include milk, egg, peanut, and wheat.

Lactose intolerance is managed by limiting lactose and using lactase-treated products or alternatives.

Behaviour change models such as the stages of change include precontemplation, contemplation, preparation, action, and maintenance.

Immunisation of children and health workers reduces vaccine-preventable transmission in facilities.

Antimicrobial resistance is driven by unnecessary antibiotic use and incomplete courses.

Sterile gloves are used for invasive procedures; clean gloves are used for contact with body fluids.

A surgical mask is removed by the ties or loops without touching the front surface.

A respirator must be fit-checked by the user each time it is worn.

Isolation precautions are discontinued according to pathogen-specific criteria, not simply when symptoms improve.

Environmental cultures are not routinely used to monitor cleaning; visual inspection and audit are standard.

Outbreak control in a ward includes cohorting patients, reinforcing hand hygiene, and screening contacts.

Bath water is changed for the perineal area, cleaning from front to back to reduce urinary infection risk.

Nail care for diabetic patients requires caution and referral to a podiatrist for foot lesions.

Mouth care for patients receiving oxygen or with a nasogastric tube is performed frequently to reduce infection.

Safe disposal of used linen avoids shaking, which disperses microorganisms into the air.

Bed rails must be checked for secure locking after raising.

Wheelchair safety includes locking brakes before transfer and using a gait belt.

Crutches should be fitted so the handgrips are at wrist level with arms slightly bent.

Reporting near misses helps identify system hazards before harm occurs.

Protein-energy malnutrition is assessed using weight-for-age, height-for-age, and weight-for-height indices.

Stunting reflects chronic undernutrition; wasting reflects acute undernutrition.

Micronutrient supplementation programmes include vitamin A for children and iron-folic acid for pregnant women.

Food labels list energy, protein, carbohydrate, fat, and micronutrients per serving and per 100 g.

Saturated fat intake should be limited and replaced with unsaturated fats where possible.

Added sugar intake should be limited; sugar-sweetened beverages contribute to obesity and dental caries.

Dietary counselling for a patient with renal disease restricts protein, sodium, potassium, phosphate, and fluid as indicated.

Nutrition support teams coordinate enteral and parenteral feeding for complex patients.

Drug interactions can be pharmacokinetic (affecting absorption, metabolism, excretion) or pharmacodynamic (additive or opposing effects).

Enzyme inducers such as rifampicin reduce the effect of many drugs; inhibitors such as erythromycin increase it.

Warfarin interacts with many drugs and foods; monitor INR and watch for bleeding.

Corticosteroids should not be stopped abruptly after long-term use because of adrenal suppression.

Antibiotic courses should be completed as prescribed to reduce resistance.

Adverse effects of opioids include respiratory depression, constipation, and sedation.

Adverse effects of insulin include hypoglycaemia; monitor blood glucose and recognise sweating, tremor, and confusion.

Medication errors should be reported, and the patient must be assessed and monitored after the error.

Terms for inflammation: arthritis, dermatitis, gastritis, hepatitis, nephritis, and bronchitis.

Terms for surgical procedures: appendectomy, cholecystectomy, hysterectomy, and mastectomy.

Terms describing cell changes: hyperplasia, hypertrophy, atrophy, dysplasia, and neoplasia.

Terms for diagnostic imaging: radiography, ultrasonography, computed tomography, and magnetic resonance imaging.

Terms for laboratory tests: haemogram, urinalysis, culture and sensitivity, and biopsy.

Terms for vital sign abnormalities: tachycardia, bradycardia, tachypnoea, bradypnoea, hypertension, and hypotension.

Terms for mental state: coma, stupor, confusion, delirium, and dementia.

Terms for skin lesions: macule, papule, vesicle, pustule, and ulcer.

Patient identification errors are prevented by checking the wristband against the request form.

Consent forms must be signed by the patient or legal guardian and witnessed as required.

Observation charts use early warning scores to trigger escalation when values deviate from normal.

Critical results must be communicated to the responsible clinician promptly and documented.

Patient complaints should be acknowledged, recorded, and escalated through the formal process.

Interpreter-mediated communication should be documented, including the interpreter's name.

Discharge instructions should be given in writing and explained, with understanding checked by teach-back.

Confidentiality applies to verbal conversations in corridors and lifts as well as written records.

The cardiovascular system consists of the heart, blood vessels, and blood; circulation has pulmonary and systemic circuits.

Blood pressure is cardiac output multiplied by peripheral resistance.

Cardiac output is heart rate multiplied by stroke volume; normal adult output is about 5 L/min.

The respiratory centre in the medulla controls breathing rate and depth, responding to carbon dioxide levels.

Kidney function includes fluid and electrolyte balance, acid-base regulation, and hormone production such as erythropoietin.

The nervous system transmits impulses via neurons; the synapse uses neurotransmitters such as acetylcholine.

The musculoskeletal system includes bones, joints, muscles, tendons, and ligaments.

Thermoregulation is controlled by the hypothalamus through sweating, shivering, and blood vessel changes.

Admission procedure includes orientation, initial assessment, valuables recording, and baseline vital signs.

Discharge procedure includes medication instructions, follow-up appointment, and checking the room for belongings.

Transfer of a patient requires adequate personnel, a transfer belt, and explanation to the patient.

Bowel care includes monitoring frequency and consistency and reporting constipation or diarrhoea.

Bladder training and pelvic floor exercises are used for urinary incontinence.

Pressure area care records should include the site, stage, size, and dressing used.

Wound assessment uses the acronyms of size, site, exudate, pain, and edge appearance.

Specimen labelling must include patient identifiers, date, time, and specimen type.

CPR for a child uses 30:2 for one rescuer and 15:2 for two rescuers, with a compression depth of about 5 cm.

Infant CPR uses two fingers or two thumbs encircling the chest, with a depth of about 4 cm.

Automated external defibrillator use: attach pads, follow voice prompts, ensure nobody touches the patient during analysis and shock.

Recovery position is not used for a suspected spinal injury unless the airway is at risk.

Epistaxis: sit upright, lean forward, pinch the soft part of the nose for 10 minutes, and do not tilt the head back.

Fainting with injury or slow recovery requires medical assessment.

Hypothermia: move to a warm place, remove wet clothing, and warm gradually; do not rub the limbs.

Frostbite: warm the affected part in water at about 37-40 C and do not rub or use direct heat.

Occupational exposure to blood-borne viruses is reduced by gloves, eye protection, and safe sharps disposal.

Hepatitis B vaccination is recommended for all health workers.

Latex allergy precautions include using nitrile gloves and a latex-free environment.

Manual handling risk assessment considers the load, the task, the environment, and the individual's capability.

Slips and trips are prevented by prompt spill cleaning and dry floors.

Patient identification and allergy bands are part of routine safety checks.

Emergency evacuation plans must identify routes, assembly points, and staff roles.

Medication refrigerator temperature should be monitored and recorded daily.

Carbohydrate foods include rice, wheat, maize, potato, and sugar; complex carbohydrates are preferred over refined sugars.

Protein sources include pulses, milk, eggs, fish, and meat; combining cereals and pulses improves amino acid balance.

Fat intake should favour unsaturated oils and limit trans fats.

Vitamin A deficiency causes night blindness; supplementation and dietary diversification are preventive measures.

Anaemia prevention includes iron-rich foods, vitamin C, deworming, and iron-folic acid supplementation.

Iodine deficiency is prevented by iodised salt and monitoring of urinary iodine.

Calcium and vitamin D are needed for bone health; sunlight exposure supports vitamin D synthesis.

Food hygiene includes handwashing, safe water, and proper cooking and storage temperatures.

Nutrition screening tools identify patients at risk and trigger a full assessment.

Nutrition assessment includes anthropometry, biochemistry, clinical examination, and dietary history.

Enteral feeding complications include aspiration, diarrhoea, and tube blockage; elevate the head during feeding.

Parenteral nutrition requires central venous access for concentrated solutions and strict aseptic technique.

Physical activity counselling should match the person's ability and preferences.

Tobacco cessation medicines include nicotine replacement therapy, bupropion, and varenicline.

Alcohol screening tools such as AUDIT identify harmful drinking patterns.

Lifestyle interventions are most effective when combined with regular follow-up and social support.

Community health workers are trained to recognise danger signs and refer promptly.

Health education on sanitation includes handwashing with soap at critical times.

Safe motherhood programmes promote antenatal care, skilled birth attendance, and postnatal visits.

Child health programmes include immunisation, growth monitoring, and oral rehydration.

National health programmes target tuberculosis, malaria, HIV, and non-communicable diseases.

Community-based rehabilitation supports people with disability through local resources.

School health screening includes vision, hearing, dental, and nutritional assessment.

Health camps provide screening and referral services in underserved areas.

Modes of transmission include direct contact, droplet, airborne, vector-borne, vehicle-borne, and vertical transmission.

Incubation period is the time between exposure and onset of symptoms; it determines quarantine duration.

Period of communicability is the time during which an infected person can transmit the disease.

Case fatality rate equals deaths from a disease divided by diagnosed cases, times 100.

Sensitivity and specificity trade off with the chosen cut-off value of a test.

Positive predictive value depends on disease prevalence as well as test accuracy.

Randomisation reduces selection bias in controlled trials.

Blinding reduces observer and reporting bias.

Postnatal care visits should occur within 24 hours, on day 3, and on day 7, with later visits as needed.

Lochia progresses from red to brown to white over several weeks.

Signs of puerperal sepsis include fever, foul-smelling lochia, and uterine tenderness.

Breastfeeding problems include poor attachment, engorgement, and mastitis; correct positioning helps.

Complementary feeding from 6 months should include energy-dense, mashed family foods.

Immunisation adverse events following immunisation must be reported and investigated.

Adolescent pregnancy carries higher risks of anaemia, preterm birth, and obstructed labour.

Family planning methods include barrier, hormonal, intrauterine devices, and sterilisation.

Respect for persons requires protecting those with diminished autonomy.

Justice in health care includes equitable access and fair allocation of resources.

Beneficence and non-maleficence must be balanced when treatments carry risk.

Informed refusal is as valid as informed consent when the patient has capacity.

Ethical committees review research and clinical dilemmas and provide recommendations.

Confidentiality in teaching settings requires de-identification of case material.

Professional boundaries protect both patients and clinicians from exploitation.

Moral distress occurs when a clinician knows the right action but is constrained from taking it.

Informed consent for minors varies by jurisdiction; mature minor doctrines may apply.

Documentation of refusal should include the patient's understanding of consequences.

Patient restraint and seclusion require legal authority and regular review.

Health records are retained for a legally defined period before destruction.

Electronic records require access controls and audit trails.

Professional indemnity insurance is commonly required for clinical practice.

Reporting of adverse events supports system improvement and may be legally protected.

Defamation claims can arise from remarks in handover or social media.

Skill practice should be supervised until competence is demonstrated.

Objective structured clinical examination stations test communication, examination, and procedure skills.

Feedback should be specific, behavioural, and timely.

Reflective practice uses what happened, what was felt, what was learned, and what will change.

Project timelines should include planning, data collection, analysis, writing, and submission.

An abstract summarises purpose, methods, results, and conclusion in a short paragraph.

Appendices contain tools, consent forms, and raw data summaries.

Ethical clearance must be obtained before data collection begins.

Chain of infection can be broken by sterilisation, hand hygiene, isolation, and immunisation.

Antiseptics are applied to skin; disinfectants are applied to inanimate objects.

Chlorine solutions are prepared at specified concentrations and used within a defined time.

Autoclave sterilisation uses steam under pressure at about 121 C for 15-20 minutes.

Hand hygiene compliance is improved by availability of alcohol rub at the point of care.

Isolation signage states the precautions required and the personal protective equipment needed.

Immunocompromised patients require protective isolation and restricted visitors.

Waste from isolation rooms is treated as infectious waste.

Respiratory assessment includes rate, rhythm, depth, breath sounds, and oxygen saturation.

Pulse sites include radial, carotid, brachial, femoral, popliteal, and dorsalis pedis.

Blood pressure measurement requires the correct cuff size and the arm supported at heart level.

Temperature routes include oral, axillary, tympanic, and rectal; the route affects the reading.

Neurological observation includes consciousness, pupils, and limb power.

Fluid balance records include all oral, intravenous, and tube intake and all urine, vomit, and drain output.

Specimen collection for blood culture is done before antibiotics when possible.

Patient positioning for lumbar puncture is side-lying with the back flexed.

Primary assessment ends with a handover using the SBAR format to emergency services.

Cervical spine immobilisation is considered in falls, road traffic crashes, and diving injuries.

Chest pain first aid: rest, loosen clothing, and seek emergency help; aspirin may be given if not allergic and directed.

Asthma attack: sit the person upright, use a reliever inhaler, and call for help if no improvement.

Seizure first aid: protect the head, do not restrain or put anything in the mouth, and time the seizure.

Diabetic emergency: if conscious and able to swallow, give sugar; if unconscious, seek emergency care.

Amputation: control bleeding, wrap the severed part in clean material, place it in a sealed bag on ice, and transport.

Bites and stings: wash the area, remove the stinger, and watch for allergic reaction.

Patient environment should be free of clutter and have adequate ventilation and lighting.

Bed linen is changed when soiled and at regular intervals; soiled linen is handled with gloves.

Personal protective equipment must be removed carefully to avoid self-contamination.

Safe use of oxygen includes avoiding grease and oil on equipment.

Electrical equipment must be checked before use and repaired by qualified staff.

Emergency call systems must be tested and functional.

Staff immunisation and health screening protect both staff and patients.

Fire extinguishers should be appropriate to the type of fire and inspected regularly.

Energy requirements vary with age, sex, activity, and physiological state.

Protein quality is determined by amino acid composition and digestibility.

Fibre types: soluble fibre lowers cholesterol and glucose; insoluble fibre adds bulk.

Water requirement is about 2-3 litres per day for adults, adjusted for climate and activity.

Vitamin C is heat-sensitive; cooking methods that minimise heating preserve it.

Iron absorption is reduced by phytates and tannins and enhanced by vitamin C.

Calcium absorption is supported by vitamin D.

Food security means reliable access to sufficient, safe, and nutritious food.

Nutrition education should be culturally appropriate and use local foods.

Portion control and plate models help patients estimate serving sizes.

Reading food labels helps identify added sugar, salt, and saturated fat.

Meal planning for diabetes includes regular meals and consistent carbohydrate portions.

Physical activity for older adults includes balance and strength exercises to prevent falls.

Sleep duration and quality affect appetite hormones and weight regulation.

Stress management techniques include breathing exercises, relaxation, and physical activity.

Community gardens and walking groups support healthy lifestyles.

Community diagnosis identifies health problems, available resources, and priority actions.

Health education should be followed by evaluation of knowledge and behaviour change.

Home visits allow assessment of the living environment and family dynamics.

Referral pathways should be known to all community health workers.

Community mobilisation engages local leaders and organisations in health activities.

Water and sanitation programmes reduce diarrhoeal disease.

Vector control programmes target mosquito breeding sites and rodent control.

Health information systems support monitoring of coverage and outcomes.

Prevalence equals incidence multiplied by average duration for stable diseases.

Crude rates are unadjusted for population structure; adjusted rates allow comparison.

Maternal mortality ratio is maternal deaths per 100,000 live births.

Under-five mortality rate is deaths under five per 1000 live births.

Life expectancy at birth summarises overall mortality conditions.

Disability-adjusted life years combine years lost to premature death and years lived with disability.

Outbreak control measures include isolation, contact tracing, and environmental intervention.

Vaccination programmes require cold chain and coverage monitoring.

Antenatal danger signs include bleeding, severe abdominal pain, and reduced fetal movement.

Labour monitoring includes cervical dilatation, fetal heart rate, and maternal vital signs.

Episiotomy care includes keeping the area clean and dry and watching for infection.

Newborn resuscitation begins with drying, warmth, and airway positioning.

Exclusive breastfeeding reduces diarrhoea and respiratory infections.

Growth faltering requires assessment of feeding, illness, and social factors.

Immunisation schedules vary by country but follow WHO recommendations for timing.

Adolescent-friendly services protect privacy and build trust.

Drug absorption is affected by route, food, gastric emptying, and formulation.

Drug distribution depends on blood flow, protein binding, and lipid solubility.

Metabolism occurs mainly in the liver; excretion mainly via the kidneys.

Half-life determines dosing interval and time to steady state.

Loading doses achieve therapeutic levels faster than maintenance doses.

Narrow therapeutic index drugs require monitoring of blood levels.

Allergies must be documented prominently and checked before administration.

Patient education about medicines improves adherence and safety.

Terms for procedures: biopsy, endoscopy, laparoscopy, and catheterisation.

Terms for positions: supine, prone, lateral, lithotomy, and Trendelenburg.

Terms for onset of disease: acute, chronic, subacute, and insidious.

Terms for disease cause: idiopathic, iatrogenic, congenital, and acquired.

Terms for spread: metastasis, local, regional, and systemic.

Terms for treatment: conservative, palliative, curative, and prophylactic.

Terms for prognosis: favourable, guarded, and poor.

Terms for complications: haemorrhage, infection, thrombosis, and dehiscence.

Documentation should be contemporaneous, ideally immediately after the event.

Objective language avoids judgemental terms such as 'difficult' or 'uncooperative'.

Patient education should be documented with the topic, method, and understanding.

Incident reports are factual and avoid blame.

Handover should include the patient's current condition and any changes.

Consent discussions should record who explained and who was present.

Records should be legible and written in permanent ink.

Corrections should be signed and dated.

The cell membrane controls movement of substances via diffusion, osmosis, and active transport.

Osmosis is movement of water across a semipermeable membrane from low to high solute concentration.

Mitosis produces identical cells for growth and repair; meiosis produces gametes.

The skeleton has axial (skull, spine, rib cage) and appendicular (limbs, girdles) divisions.

Muscle types: skeletal (voluntary), smooth (involuntary), and cardiac (involuntary, striated).

The respiratory system includes the diaphragm and intercostal muscles for ventilation.

The endocrine system includes the thyroid, adrenal, pancreas, and gonads.

The lymphatic system returns tissue fluid and supports immunity.

Patient comfort measures include positioning, pain relief, temperature control, and noise reduction.

Nutrition support includes assisting with feeding and monitoring intake.

Elimination care includes toileting assistance and continence promotion.

Skin care includes bathing, moisturising, and inspecting for breakdown.

Mobility care includes early mobilisation and falls prevention.

Psychosocial care includes listening, reassurance, and involving family.

End-of-life care includes comfort, dignity, and family support.

Infection prevention is integrated into every care activity.

First aid kits should contain gloves, dressings, bandages, antiseptic, scissors, and a CPR mask.

Emergency action plan includes recognising, alerting, and acting.

Casualty assessment includes history, signs, and symptoms.

Vital signs in first aid include responsiveness, breathing, and circulation.

Shock positioning depends on the cause and injuries.

Immobilisation of suspected fractures reduces further injury.

Wound cleaning reduces infection risk.

Documentation of first aid includes time, findings, and actions.

Hand hygiene is the single most effective measure to prevent infection.

Alcohol rub is not effective against spores and some viruses.

Sterile technique requires a sterile field and sterile gloves.

Isolation precautions require signage and education of visitors.

Waste segregation reduces infection risk and environmental contamination.

Sharps containers should not be overfilled and must be replaced when three-quarters full.

Immunisation of staff reduces transmission.

Surveillance of infections identifies outbreaks and trends.

Personal hygiene includes bathing, oral care, hair care, and nail care.

Environmental hygiene includes cleaning, disinfection, and waste management.

Safety includes falls, burns, scalds, and medication safety.

Patient identification prevents wrong-patient errors.

Emergency preparedness includes fire, disaster, and evacuation plans.

Manual handling includes assessment and equipment use.

Infection control is part of safety.

Reporting incidents improves safety.

Macronutrients provide energy and building blocks.

Micronutrients support metabolism and health.

Water is essential for life.

Balanced diet includes variety and moderation.

Nutritional needs change across the lifespan.

Food safety prevents illness.

Nutrition assessment identifies risk.

Nutrition education supports behaviour change.

Therapeutic diets modify nutrients for disease management.

Lifestyle factors influence chronic disease risk.

Physical activity supports health.

Tobacco and alcohol are major risk factors.

Behaviour change requires motivation and support.

Nutrition counselling is patient-centred.

Monitoring and follow-up improve outcomes.

Community programmes support healthy lifestyles.

Community health focuses on populations.

Prevention is central to community health.

Community participation is essential.

Health education supports behaviour change.

Referral systems link services.

Home visits assess family and environment.

Community health workers extend services.

Health information systems support planning.

Epidemiology studies distribution and determinants of disease.

Incidence measures new cases.

Prevalence measures existing cases.

Study designs answer different questions.

Bias and confounding affect validity.

Outbreak investigation controls spread.

Surveillance informs action.

Prevention reduces burden.

Antenatal care improves outcomes.

Skilled birth attendance reduces mortality.

Postnatal care supports recovery.

Breastfeeding supports infant health.

Immunisation prevents disease.

Growth monitoring identifies malnutrition.

Danger signs require urgent referral.

Family planning supports maternal health.

Pharmacokinetics describes drug movement.

Pharmacodynamics describes drug action.

Dose calculation requires unit consistency.

Routes affect onset and bioavailability.

Adverse reactions require reporting.

High-alert medications require double checks.

Patient education improves adherence.

Medication reconciliation prevents errors.

Word parts build medical terms.

Prefixes indicate position, number, or speed.

Suffixes indicate condition or procedure.

Roots indicate body part or system.

Abbreviations must be standard.

Terms describe signs, symptoms, and diagnoses.

Terms describe procedures and treatments.

Terms describe positions and directions.

Documentation is a legal record.

Objective language is essential.

SBAR structures handover.

Confidentiality applies to all communication.

Active listening improves understanding.

Written materials should be plain language.

Consent discussions must be documented.

Errors must be corrected properly.

Autonomy respects patient choice.

Beneficence promotes good.

Non-maleficence avoids harm.

Justice ensures fairness.

Confidentiality protects privacy.

Informed consent requires capacity and information.

Advocacy protects patient interests.

Ethical decisions require reflection.

Negligence requires duty, breach, causation, and harm.

Scope of practice defines authorised tasks.

Consent is required for treatment.

Confidentiality is a legal duty.

Records must be accurate and secure.

Mandatory reporting protects vulnerable people.

Professional boundaries protect patients.

Incident reporting improves safety.

Skill demonstration requires preparation and safety.

Documentation follows every procedure.

Projects require clear objectives and methods.

Data collection tools must be piloted.

Ethics approval is required for research.

Referencing must be consistent.

Reflection improves practice.

Supervision supports learning.

Anatomy is structure; physiology is function.

Cells are the basic unit of life.

Tissues form organs; organs form systems.

Homeostasis maintains stability.

Body systems work together.

Directional terms describe location.

Planes divide the body.

Vital signs reflect physiological status.

Nursing process guides care.

Assessment collects data.

Planning sets goals.

Implementation delivers care.

Evaluation measures outcomes.

Vital signs are core observations.

Hygiene and comfort are essential.

Documentation records care.

Primary survey uses ABCDE.

CPR saves lives.

Choking management clears the airway.

Bleeding control uses direct pressure.

Burns require cooling.

Fractures require immobilisation.

Anaphylaxis requires adrenaline.

Recovery position protects the airway.

Chain of infection has six links.

Hand hygiene is essential.

Personal protective equipment protects.

Sterile technique prevents contamination.

Isolation precautions prevent spread.

Sharps safety prevents injury.

Waste segregation reduces risk.

Immunisation prevents infection.

Hygiene prevents infection.

Safety prevents injury.

Falls prevention is essential.

Fire safety uses RACE.

Manual handling protects staff.

Oxygen safety prevents fire.

Restraint use is restricted.

Incident reporting improves safety.

Macronutrients provide energy.

Micronutrients support health.

Water is essential.

Balanced diet supports health.

Nutritional needs vary.

Food safety prevents illness.

Nutrition assessment identifies risk.

Nutrition education supports change.

Therapeutic diets manage disease.

Lifestyle affects chronic disease.

Physical activity supports health.

Tobacco and alcohol are risks.

Behaviour change requires support.

Counselling is patient-centred.

Monitoring improves outcomes.

Community programmes support health.

Community health focuses on populations.

Prevention is central.

Community participation is essential.

Health education supports change.

Referral systems link services.

Home visits assess families.

Community health workers extend services.

Health information systems support planning.

Epidemiology studies disease distribution.

Incidence measures new cases.

Prevalence measures existing cases.

Study designs answer questions.

Bias affects validity.

Outbreak investigation controls spread.

Surveillance informs action.

Prevention reduces burden.

Antenatal care improves outcomes.

Skilled birth attendance reduces mortality.

Postnatal care supports recovery.

Breastfeeding supports infant health.

Immunisation prevents disease.

Growth monitoring identifies malnutrition.

Danger signs require referral.

Family planning supports maternal health.

Pharmacokinetics describes drug movement.

Pharmacodynamics describes drug action.

Dose calculation requires accuracy.

Routes affect onset.

Adverse reactions require reporting.

High-alert medications require checks.

Patient education improves adherence.

Medication reconciliation prevents errors.

Word parts build terms.

Prefixes indicate position or number.

Suffixes indicate condition or procedure.

Roots indicate body part.

Abbreviations must be standard.

Terms describe signs and symptoms.

Terms describe procedures.

Terms describe positions.

Documentation is a legal record.

Objective language is essential.

SBAR structures handover.

Confidentiality applies.

Active listening improves understanding.

Written materials should be plain.

Consent must be documented.

Errors must be corrected properly.

Autonomy respects choice.

Beneficence promotes good.

Non-maleficence avoids harm.

Justice ensures fairness.

Confidentiality protects privacy.

Informed consent requires capacity.

Advocacy protects interests.

Ethical decisions require reflection.

Negligence requires duty and harm.

Scope of practice defines tasks.

Consent is required.

Confidentiality is a legal duty.

Records must be accurate.

Mandatory reporting protects people.

Professional boundaries protect patients.

Incident reporting improves safety.

Skill demonstration requires preparation.

Documentation follows procedures.

Projects require objectives.

Tools must be piloted.

Ethics approval is required.

Referencing must be consistent.

Reflection improves practice.

Supervision supports learning.