DNCC Delhi (official)

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Infection Control Transmission-Based Precautions: Airborne → TB, Measles, Chickenpox (N95) Droplet → Influenza, Meningitis (Surgical mask) Contact → MRSA, Scabies (Gloves + Gown) Biomedical Waste: Yellow = Human anatomical waste Red = Plastic waste White = Sharps Blue = Glass

Pediatrics Exclusive breastfeeding = 6 months First vaccine = BCG + OPV + Hepatitis B Tet spell = Knee-chest position Vitamin K at birth Severe dehydration = Plan C ORS + Zinc = Acute diarrhea

Obstetrics Normal FHR = 110–160/min Placenta previa = Painless bleeding Abruptio placentae = Painful bleeding Boggy uterus = Uterine atony First action in PPH = Fundal massage Oxytocin = First-line uterotonic Magnesium sulfate = Eclampsia Calcium gluconate = MgSO₄ antidote

Burns Rule of Nines (Adult): Head = 9% Each arm = 9% Each leg = 18% Front trunk = 18% Back = 18% Perineum = 1% Parkland Formula: 4 × Weight (kg) × %TBSA Give half in first 8 hours.

Electrolytes Hyperkalemia Peaked T waves Muscle weakness Calcium gluconate stabilizes myocardium Hypokalemia U waves Muscle weakness Arrhythmias Hyponatremia Confusion Seizures Hypernatremia Thirst Irritability

Pediatrics 161. Normal newborn weight = 2.5–4 kg. 162. Birth weight doubles by 5 months. 163. Birth weight triples by 1 year. 164. Anterior fontanel closes by 18 months. 165. Posterior fontanel closes by 6–8 weeks. 166. BCG scar develops in 6–12 weeks. 167. Measles vaccine at 9 months (as per UIP). 168. Vitamin A first dose = 9 months. 169. ORS contains glucose and electrolytes. 170. Zinc for diarrhea = 14 days.

Obstetrics 171. Normal pregnancy duration = 40 weeks. 172. Quickening in primigravida = ~20 weeks. 173. Fundal height at 20 weeks = Umbilicus. 174. Bishop score assesses cervical readiness. 175. Oxytocin should not be given as IV bolus. 176. Preeclampsia = HTN + Proteinuria after 20 weeks. 177. Eclampsia = Seizures in preeclampsia. 178. Rh-negative mother → Anti-D immunoglobulin. 179. Lochia rubra lasts about 3–4 days. 180. Breastfeeding should begin within 1 hour of birth.

Infection Control 181. Hand hygiene is the most effective infection control measure. 182. Airborne diseases → TB, Measles, Chickenpox. 183. Droplet diseases → Influenza, Meningitis. 184. Contact precautions → MRSA. 185. Sterile gloves for invasive procedures. 186. Biomedical waste Yellow bag → Human anatomical waste. 187. Red bag → Contaminated plastic waste. 188. White container → Sharps. 189. Blue container → Glassware. 190. Needle recapping is prohibited.

Research & Nursing Management 191. Reliability = Consistency of a tool. 192. Validity = Accuracy of a tool. 193. Cronbach's Alpha ≥0.70 is acceptable. 194. Chi-square compares categorical variables. 195. Pearson correlation measures linear relationship. 196. Standard deviation measures data dispersion. 197. Incident report is not part of the patient's medical record. 198. Nursing process = Assessment → Diagnosis → Planning → Implementation → Evaluation. 199. ABC always takes priority in emergencies. 200. Treat the most unstable patient first, not the first patient who arrived.

Cardiovascular System 101. Cardiac Output = HR × Stroke Volume 102. Normal Cardiac Output = 4–8 L/min 103. Normal Ejection Fraction (EF) = 55–70% 104. Pulseless VT → Defibrillation immediately. 105. Symptomatic Bradycardia → Atropine is first-line. 106. NSTEMI → No ST elevation but Troponin positive. 107. STEMI → Immediate PCI within 90 minutes if available. 108. Right ventricular MI → Avoid Nitroglycerin. 109. Cardiogenic shock → Cold, clammy skin with hypotension. 110. BNP increases in Heart Failure.

Research & Management Random sampling = Probability sampling p-value <0.05 = Significant Mean = Arithmetic average Median = Middle value Mode = Most frequent value Informed consent is mandatory Delegation retains accountability Primary survey = ABCDE Triage: Red = Immediate Priority principle: Airway → Breathing → Circulation (ABC)

Community Health Nursing Cold chain = +2°C to +8°C BCG = Intradermal Pentavalent = IM OPV = Oral Vitamin A starts at 9 months RBSK covers birth–18 years ASHA = Community volunteer MMR = Maternal Mortality Ratio IMR = Infant Mortality Rate NFHS = National Family Health Survey

Pharmacology Insulin lispro = Rapid acting NPH = Intermediate acting Regular insulin = IV insulin Monitor K⁺ with Furosemide ACE inhibitors may cause cough Beta-blockers reduce HR Atropine treats bradycardia Adenosine for SVT Amiodarone for VT Naloxone reverses opioid overdose

Pediatrics Neonatal HR = 120–160/min Vitamin K prevents hemorrhagic disease Phototherapy → Turn baby frequently Tet spell → Knee-chest position ORS + Zinc for diarrhea Plan C = Severe dehydration First vaccine → BCG + OPV + Hep B Exclusive breastfeeding = 6 months Normal newborn RR = 30–60/min Caput crosses suture line

Obstetrics Normal FHR = 110–160/min Boggy uterus = Uterine atony PPH >500 mL (vaginal birth) Oxytocin = First-line for PPH Magnesium sulfate for Eclampsia Calcium gluconate = MgSO₄ antidote Placenta previa → Painless bleeding Abruptio placentae → Painful bleeding Fundal massage for uterine atony APGAR at 1 and 5 minutes

Respiratory COPD patients require low-flow oxygen ARDS → PEEP is beneficial PaO₂ normal = 80–100 mmHg PaCO₂ normal = 35–45 mmHg pH normal = 7.35–7.45 Respiratory acidosis → High CO₂ Respiratory alkalosis → Low CO₂ Crackles → Pulmonary edema Wheezing → Bronchospasm Stridor → Upper airway obstruction

Cardiology ST Elevation = Acute MI Ventricular fibrillation → Defibrillation Asystole → CPR + Epinephrine Atrial fibrillation → Irregularly irregular pulse Normal HR = 60–100/min Cardioversion requires synchronization Defibrillation does not require synchronization Troponin = Most specific marker of MI Inferior MI → Leads II, III, aVF Anterior MI → V1–V4

Medical-Surgical Nursing Normal CVP: 2–6 mmHg Normal ICP: 5–15 mmHg CPP = MAP − ICP Head elevation for raised ICP: 30° Normal Urine Output: ≥0.5 mL/kg/hr Hypokalemia → U wave Hyperkalemia → Peaked T wave Warfarin antidote → Vitamin K Heparin antidote → Protamine sulfate Digoxin antidote → Digoxin Immune Fab Morphine can cause respiratory depression Nitroglycerin contraindicated with Sildenafil First sign of hypoxia → Restlessness Most sensitive indicator of oxygenation → ABG Normal SpO₂ → 95–100% Rule of Nines (Adult): Entire arm = 9% Chest tube bubbling continuously → Air leak Tension pneumothorax → Needle decompression Left heart failure → Pulmonary edema Right heart failure → Peripheral edema