Nursing knowledge.com

20/01/2026

1. The most light-sensitive vaccine is:
A. OPV
B. Measles
C. BCG
D. DPT
✅ Answer: C. BCG
Rationale: BCG loses potency rapidly when exposed to sunlight.
2. Which of the following vaccines is damaged by sunlight?
A. DPT
B. OPV
C. Measles
D. Hepatitis B
✅ Answer: C. Measles
Rationale: Measles is a live vaccine and is light-sensitive.
3. After reconstitution, BCG vaccine should be used within:
A. 24 hours
B. 12 hours
C. 6 hours
D. 48 hours
✅ Answer: C. 6 hours
4. Which vaccines must be protected from light?
A. OPV and Hepatitis B
B. DPT and TT
C. BCG and Measles
D. IPV and PCV
✅ Answer: C. BCG and Measles
5. Which vaccine is the most heat sensitive?
A. BCG
B. OPV
C. Measles
D. DPT
✅ Answer: B. OPV
6. Which vaccine is supplied in dark (amber) colored vials?
A. DPT
B. Hepatitis B
C. BCG
D. IPV
✅ Answer: C. BCG
7. Which vaccine should NOT be frozen?
A. OPV
B. BCG
C. Measles
D. DPT
✅ Answer: D. DPT
(also Hepatitis B, TT)
8. Live attenuated vaccines used in EPI include:
A. DPT
B. TT
C. BCG and Measles
D. Hepatitis B
✅ Answer: C. BCG and Measles

11/01/2026

🚨 Diabetic Ketoacidosis (DKA)

What is DKA?
A life-threatening complication of diabetes caused by lack of insulin, leading to high blood sugar and ketone buildup.
Most common in Type 1 DM.

🧠 Phase 1: Initial Management

💧 Fluids – 0.9% Normal Saline (NaCl)
• 1 L in 30 min
• 1 L in 1 hr
• 1 L in 2 hrs
• 1 L in 4 hrs
• 1 L in 6 hrs

💉 Insulin – IV infusion
• 0.1 unit/kg/hr (≈ 6 units/hr)
• Goal: ↓ glucose 3–5 mmol/L per hour
• Continue patient’s usual long-acting insulin if already on it.

⚡ Potassium (KCl)
• K⁺ >5.0 → Do not give
• K⁺ 3.5–5.0 → add 10 mmol/L
• K⁺ ❤.5 → add 20 mmol/L
• Max rate: 20 mmol/hr

🧪 Special situations
• BP

28/12/2025

18/12/2025

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15/12/2025

20/07/2025

HCV Antibody Test
________________________________________
1. Objective:
The objective of the HCV antibody test was to detect antibodies against the Hepatitis C virus in a patient's blood, indicating past or present infection.
________________________________________
2. Principle:
The test was based on immunochromatographic or ELISA methods. It used antigens specific to HCV that bound to anti-HCV antibodies in the patient's sample. A color change or line on the test device indicated the presence of antibodies.
________________________________________
3. Materials:
• Patient’s blood, serum, or plasma
• HCV rapid test cassette or ELISA kit
• Buffer solution
• Micropipette or dropper
• Lancet and gloves
• Timer
• Alcohol swab
• Biohazard disposal container
________________________________________
4. Procedure (Rapid Test):
1. A blood sample was collected through finger prick or venipuncture.
2. 2–3 drops of the sample were placed into the test cassette’s sample well.
3. 1–2 drops of buffer were added.
4. The test cassette was left undisturbed for 15–20 minutes.
5. The result was read by checking the appearance of colored lines.
________________________________________
5. Result:
• Positive: Two lines appeared — one in the control (C) region and one in the test (T) region, indicating anti-HCV antibodies were present.
• Negative: Only one line appeared in the control region; no line in the test region.
• Invalid: No control line appeared — test result was invalid and had to be repeated.
________________________________________
6. Uses:
• It was used to screen for HCV infection in at-risk populations.
• It aided in diagnosis of Hepatitis C in symptomatic patients.
• It was part of routine screening in blood donors and pre-surgical evaluations.
________________________________________
7. Consultation:
Patients with a positive result were advised to consult a healthcare provider for confirmatory testing (e.g., HCV RNA PCR) to assess active infection. Counseling on liver health, transmission prevention, and antiviral treatment options was recommended.

03/07/2025

✅ Routes of Drug Administration and Their Functions

1. Oral (PO – Per Orals)

• Function= Swallowed and absorbed via the gastrointestinal tract.
• Uses= For systemic effect (e.g., pain relief, blood pressure meds).
• Advantages= Convenient, safe, economical.
• Disadvantages= Slower onset, affected by food, not suitable if vomiting/unconscious.

2. Sublingual (SL) / Buccal

• Function= Drug placed under the tongue (SL) or in the cheek (buccal) for absorption through oral mucosa.
• Uses= Rapid absorption for drugs like nitroglycerin (angina).
• Advantages= Fast onset, bypasses first-pass liver metabolism.
• Disadvantage= Not suitable for irritating drugs or large doses.

3. Re**al (PR – Per Re**um)

• Function= Inserted into the re**um and absorbed via re**al mucosa.
• Uses= Vomiting patients, seizures, fever (e.g., diazepam suppositories).
• Advantage= Useful when oral not possible.
• Disadvantages= Variable absorption, patient discomfort.

4. Intravenous (IV)

• Function= Injected directly into the bloodstream.
• Uses= Immediate effect, emergencies, fluid resuscitation, chemotherapy.
• Advantages= Fastest action, precise control of dose.
• Disadvantages= Requires sterile technique, risk of infection, skilled personnel needed.

5. Intramuscular (IM)

• Function= Injected into muscle tissue.
• Uses= Vaccines, antibiotics (e.g., penicillin), long-acting meds.
• Advantages= Rapid absorption, longer duration than IV.
• Disadvantages= Painful, risk of nerve damage or bleeding.

6. Subcutaneous (SC or SubQ)

• Function= Injected into the fat layer under the skin.
• Uses= Insulin, heparin, some vaccines.
• Advantages= Slower, sustained release.
• Disadvantages= Limited volume, irritation possible.

7. Inhalation

• Function= Breathed into lungs via inhalers, nebulizers.
• Uses= Asthma, COPD (e.g., salbutamol, corticosteroids).
• Advantages= Rapid onset, localized effect, avoids systemic side effects.
• Disadvantage= Technique-dependent.

8. Topical

• Function= Applied to skin or mucous membranes for local effect.
• Uses= Skin infections, inflammation, rashes (e.g., creams, ointments).
• Advantages= Local effect, minimal systemic absorption.
• Disadvantages= Slow action, limited to surface conditions.

9. Transdermal

• Function= Drug absorbed through skin into bloodstream via patches.
• Uses= Hormones (e.g., estrogen), ni****ne patches, pain meds (fentanyl).
• Advantage= Sustained release over time.
• Disadvantages= Slow onset, risk of irritation.

10. Intradermal (ID)

• Function= Injected just under the skin’s surface.
• Uses= Allergy testing, TB test.
• Advantage= Easy to monitor reaction.
• Disadvantage= Only small volume possible.

11. Intrathecal / Epidural

• Function= Administered into spinal canal (intrathecal) or epidural space.
• Uses= Anesthesia, chemotherapy, pain management.
• Advantage= Direct CNS access.
• Disadvantage= Invasive, high risk if done incorrectly.

12. Nasal (Intranasal)

• Function= Sprayed or dropped into nostrils.
• Uses= Nasal decongestants, insulin, naloxone (opioid overdose).
• Advantage= Rapid systemic absorption via rich blood supply.
• Dis-Advantages= Irritation, not suitable for all drugs.