1/3(SBP-DBP)+DBP = MAP
Explanation.
Systole is the time when the ventricles are contracting and diastole is the relaxation time. In normal condition, the systole phase takes about half the time the diastole takes. In other words, diastole takes twice as longer as systole.
This explains why we cannot just add systolic blood pressure and diastolic blood pressure and divide it with 2. The time each takes is different. In-stead, if we divided the time in equal parts, we would have 3 equal parts, where the systole takes 1/3 and diastole takes 2/3 of total time.

To test if this is true, we can multiply systolic BP by 1/3 and diastolic BP by 2/3 and add the results together to come up with the mean arterial pressure.

Lets use real example using the known formula of 1/3(SBP-DBP)+DBP = MAP and control theoretical explanation and see if we will come up with the same results.
Lets say a patient BP = 120/60. Pulse pressure (SBP-DBP) would be 120-60 = 60.
Mean Arterial Formula: 1/3(SBP-DBP)+DBP = MAP
1/3 X 60 = 20
Add the result above to DBP (60)
20+60 = 80
Lets now use the theoretical way of testing if the formula above gives a true picture of how the heart works in normal conditions.
Our sample BP is 120/60

We will multiple SBP X 1/3 AND DBP X 2/3 and then add the total. We should get the same results as above
1/3×120 = 40 + 2/3×60 = 40. 40+40 = 80

Happy? Leave your comments/complements

PICC lines are also safe for patients to take home and administer medications intravenously. Home care for PICC lines can be tricky and likely to develop complications such as infection, dislodging or blockage.

PICC line is centrally placed into the big veins of the body, specifically the subclavian vein. This make PICC line a great asset that can be used for months if maintained properly.

Here are some few tips on how to care for a PICC line at home.

1. Make sure the clear occlusive dressing is intact all the time. Covering the PICC line with occlusive dressing when taking a shower is recommended.
2. Avoid heavy using of the arm that has a PICC line to avoid complications such as dislodging and kinking.
3. PICC line dressing must be changed every 72 hours under sterile technique is no Biopatch was used and every 7 days if a biopatch was used.
4. Flush each PICC line port with 10cc normal saline without mixing the syringe. This is a good way to prevent cross contamination of PICC line ports.
5. Always use alcohol prep to clean PICC line head/ports before and after use. Alcohol prep helps to prevent introducing bacteria into your body.
6. You must flush PICC line with atleast 10cc of normal saline after administering medications. This prevents mixing of incompatible medications that may precipitate and clog the PICC line.
7. Never administer any medication on PICC line without consulting your physician.
8. PICC line ports should be changed with every dressing change, Microclave male adaptors are recommended for use as PICC line access ports.

Advantages of using microclave male adaptors on PICC lines

1. Microclave male adaptors prevent PICC line leakages
2. The minimize/eliminate use of needles, thus making them safer for patient and staff use.
3. They minimize introduction of bacteria into the blood stream
4. Makes it easy to make a connection or disconnection without compromising sterility
5. They can be changed regularly with dressing changes and as needed.

How to flush a PICC line

1. Wash your hands with soap and warm water for at least 15 seconds and dry with clean towel.
2. Wear gloves for protection incase of accidental PICC line retrograde leakage.
3. Clean the tip of the microclave port with alcohol pad and wait for it to dry.
4. Using the luer, screw in a 10cc syringe filled with normal saline. Do not use less than 5cc syringe to prevent bursting out the tip of the PICC line, which can cause ischemic conditions like stroke, pulmonary embolism or heart attack.
5. Use turbulence flush technique. In turbulence PICC line/central line flush technique, you flush intermittently with the full 10 cc of normal syringe.
6. Never leave blood showing on PICC line tube.

1. If you are planning on having a baby, be healthy before you get pregnant and take folic acid to prevent birth defects of the brain and spine.
2. Tell your doctor if you have high blood pressure, diabetes or any other illness.If you think you may be pregnant, see a medical provider immediately. Early prenatal care could prevent having the baby too soon. Learn the signs of pre-term delivery – dads, family and friends need to know too.
3. If possible, breastfeed your baby. Breastfeeding during the first year may prevent the baby from getting sick and may reduce the risk of infant death. Research has shown that breast fed babies have very few cases of sudden infant death syndrome (SIDS)
4. Make the baby’s sleep environment safe. Babies should sleep on their back. Do not use soft bedding, don’t smoke around the baby and don’t let the baby get too warm. Avoid sharing the bed with an infant as this can facilitate SIDS. The true causes of SIDS are not clearly known but heat and possible suffocation/asphyxia has been blamed for infant deaths.
5. Use a car seat that is the right size for the age and weight of the baby. Make sure it is properly installed. If unsure how to secure a car seat, your local fire department can help you learn how to do it for free.
6. Never shake a baby. Crying is a baby’s way of communicating but if the crying is too much to handle, call someone to help or place the baby in a safe place and leave the room until you are calm. Shaking the baby can break bones, cause spinal cord injuries with permanent injuries and disability. Shaking a baby is illegal in USA punishable with jail time and fine and the baby taken away by child protection services.

• Do skin checks in the morning and the last thing at night. Look for redness, dark areas, cracks, bruises, and blisters. Note any white spots or areas. The skin may turn white before it reddens. Watch for red, tender, or swollen areas on the skin. Pay special attention to any areas that stay red after the pressure has been relieved. The goal is to find and correct problems before skin breakdown occurs.

• Feel for lumps, soft areas, or unusual warmth (use the back of the hand). Do not massage a reddened area.

• Clean when incontinent (wetting or soiling the bed) as soon as possible. Use a soft cloth or sponge to reduce injury to skin.

•  Minimize moisture from urine or stool, perspiration, or wound drainage. Use pads or briefs that absorb urine and have a quick drying surface that keeps moisture away from the skin.

• When bathing or showering, use warm (not hot) water and a mild soap.

• To prevent dry skin, use creams, ointments, or oils on the skin. Don’t use alcohol or other drying agents on the skin.

• Avoid cold or dry air.

Change positions often

• Limit pressure over bony parts by changing positions.

• If in bed, change position at least every 2 hours.

• If in a wheelchair, change position every 15 to 60 minutes.

• Be careful not to scrape sensitive areas when changing positions. Bed sheets or lifters can be used to help lift the body. A thin layer of cornstarch on the skin may help reduce damage from friction.

• Avoid lying directly on the hip bone when lying on your side. Also, choose positions that spread weight and pressure more evenly.

• Massage may help. Do not massage bony areas of the body such as knees and elbows.

• Exercise to relieve pressure, such as “push-ups” from the wheelchair or bed and shifting weight.

Use devices to relieve pressure

• Use a foam, gel, or air cushion or mattress to relieve pressure. Ask your healthcare provider which is best. Avoid donut-shape cushions because they reduce blood flow and cause tissue to swell, which can increase the risk of getting a pressure ulcer.

• The head of the bed should be raised as little and for as short a time as possible depending on the medical condition. When the head of the bed is raised more than 30[degrees], skin may slide over the bed surface, damaging skin and tiny blood vessels.

• Use pillows or wedges to keep knees or ankles from touching each other. If completely immobile, put pillows under the legs from mid-calf to ankle to keep the heels off the bed.

• Keep sheets wrinkle-free.

• Wear clothing without thick seams.

• Never put a heating pad where there is no sensation.

Eat well

• Eat a balanced diet. Protein and calories are very important. Healthy skin is less likely to be damaged.

• Drink plenty of liquids.

• If unable to eat a normal diet, talk to your healthcare provider about nutritional supplements.

• Some studies show zinc and Vitamin C help promote healing of large wounds.

• Limit stretching the areas around your wound. This will help prevent bleeding and swelling of the wound area. Try not to bump or hit your wound site on anything as this could open the wound up.

• Ask your caregiver how you should bathe or shower. You may need to cover your wound with a waterproof dressing. If you do not need to use a waterproof dressing, remove your bandage. Throw it away in the trash. Carefully wash your wound with soap and water. Pat the area dry with a clean towel. Ask your caregiver if you need to put medicine, such as an antibiotic (germ-killing) ointment, on your wound. Cover your wound with a clean, new bandage.

• Wear a binder. Conditions such as a long-term illness and weighing too much put you at a higher risk of your wound coming apart. Using steroid medicine can increase this risk. If you are at a high risk, you may need to use a binder over the area of your wound. A binder is a snug piece of clothing that you wear to help keep your wound from pulling apart.

• Manage your medical conditions. If you have certain diseases, such as diabetes (high blood sugar) or heart disease, it may take longer for your wounds to heal. Conditions where there is poor blood flow to your arms and legs can also slow healing. Take your medicines as ordered. If you have diabetes, keep your blood sugar level in the right range. Ask caregivers for help managing other medical conditions.

• If your wound is on your arm or leg, raise the wound higher than the level of your heart. Doing this may help decrease pain and swelling. You can use pillows to elevate your arm or leg while you are sitting or lying down.

• Drink enough liquids. Men 19 years old and older should drink about 13 eight- ounce cups of liquid each day. Women 19 years old and older should drink about 9 eight-ounce cups of liquid each day. Follow your caregiver’s advice if you must change the amount of liquid you drink. For most people, good liquids to drink are water, juices and milk. Limit juices to avoid too much sugar calories intake.

• Tell caregivers about all of the medicines that you use. Using certain medicines, such as steroids, cancer medicines and blood thinners may delay wound healing.

• Eat foods that are high in protein. Taking vitamins and eating healthy foods that are high in protein may help your wound heal. Poultry, meat, and dairy products such as eggs and cheese, are high in protein. Ask your caregiver if you should use vitamins, and for more information about a high-protein diet.

• Do not smoke cigars, pipes or cigarettes. Smoking may cause blood vessels on your wound site to get smaller. When this happens, your wound will not have a good supply of blood. A good blood supply is needed to carry oxygen and nutrients to your wound so that it will heal.

PICC lines are my favorite access because unlike other central lines like subclavian and internal jugular central lines, PICC lines are more durable and not as delicate. Although PICC lines are more durable, they tend to clot easily and fail to give blood return easily than other central lines.

Here are some tips for taking care of a PICC line.

1. Flush each port at least twice a shift. Use different 5cc or 10 cc syringe on each port to prevent cross contamination
2. Use turbulence flushing technique. This simply means, you flush intermittently with a whole 10cc syringe. This creates good enough pressure to prevent red blood cells clumping causing clots and blocked ports.
3. Never use less than 5 cc syringes on a PICC like or any other central line. To be on the safe side, always use 10cc syringe. The smaller the syringe, the higher the pressure it exerts on the ports and this can make the tip to break off and result in more serious damage like strokes and cardiac ischemia.
4. Always verify that there is a date and an initial on the date the last dressing was done. If there is a bio-patch™, the PICC line dressing can be done every 7 days unless it is not intact or signs of infection are noticed.
5. Always check your drugs compatibility to prevent drugs crystallization in the PICC causing blockage.
6. When PICC line is not in use, always make sure one port has normal saline “to keep open” (TKO). This again is to prevent from blockage from red blood cells clumping together.
7. When drawing blood from a PICC line, use turbulence technique (pull intermittently). This will not only prevent red blood cells clumping but it will also keep red blood cells intact. If you pull continuously and the pressure is high, the red blood cells will hemolyze, making it impossible to give accurate results on labs like CMP, BMP, CBC etc
8. Incase of PICC line blockage, always notify the provider and/or PICC nurse. If not comfortable, do not try to de-clot using TPA. Some facilities does not allow use of TPA on PICC lines except by PICC line nurses or MD
9. After removing a PICC line, always verify the tip is intact. Always make sure the measurements after removing the PICC corresponds with those documented on insertion date
10. If your PICC line is not working, you have no reason keeping it. Remove it and follow your facility protocol. Most facility required culture done for the tip.

Enjoy the great convenience of a PICC LINE

Since the elderly tend to use the Foley catheters for a longer time than the rest of the groups, I will give you tips on how to take care of a Foley catheter and how to prevent developing infections like urinary tract infections (UTI)

1. A Foley catheter should always be inserted using a sterile procedure by either a registered nurse of qualified vocational nurse.
2. Foley catheter should be done at least once daily. This includes washing the penis with warm soapy water, and the vagina in females.
3. Foley catheters should be changed at least once every 28 days and where contamination is suspected, should be changed sooner.
4. Patient with Foley catheters should be given urine-acidifying foods like cranberry juice. This acidity prevents bacteria colonization causing UTI.
5. Keep elderly patient with Foley catheters well hydrated. Elderly tend to loose third drive, making them not to crave for water or other fluids. This dehydration is attractive to bacteria.
6. Urine culture is recommended atleast every 2-4 weeks on patient who are chronically on Foley Catheters.

Here are some of tips about general Foley catheter care.

1. Never put a Foley catheter on a patient suspected or already diagnosed with UTI. This could push the infection into the bladder
2. Always use a sterile technique when inserting a Foley catheter.
3. Never take the patient to operating room without a Foley catheter. You need to monitor urine output every hour during surgery.

Call the doctor immediately if an elderly patient becomes confused with falls or likelihood to fall. These are the earliest signs of UTI in elderly patient.

Here are some few good tips you can use when taking care of a patient on mechanical ventilation, commonly known as “vented patient”.

1. Always note the ventilator settings during report even before you go into the room the patient is.
2. Make sure that the physician orders for ventilator settings are correct and correspond with the settings you got in nurse-to-nurse report.
3. Never ever turn ventilator alarms off. These alarms are your patient lifesavers and without the alarms, it is hard to know an emergent ventilation problem.
4. Never ever ignore a ventilator alarm or dismiss it as a false alarm. Always make sure you review your alarms as this may give you indication of impeding event.
5. Low pressure alarm troubleshooting:
   1. Make sure your tubing connected to the ventilator are not disconnected or have air leaks.
   2. Make sure that the endotracheal balloon is inflated; hence, there is no air leak when the vent machine is delivering positive pressure.
   3. Make sure the patient has not pulled out the endotracheal tube (self extubation)
   4. Make sure the machine is functioning properly
6. High pressure alarm troubleshooting:
   1. High-pressure alarm may go off when the patient is coughing.
   2. High-pressure alarm may go off when the patient is vomiting.
   3. Make sure your vent tubings are not kinked.
   4. The patient may have sputum blockage and may need to be suctioned. To suction a patient with endotracheal tube;

                                                              i.      Auscultate breath sounds before suctioning. This gives you a starting point and a way to evaluate if your suctioning is effective.

                                                             ii.      Elevate the head of bed as tolerated. (Vented patients should always have head of bed above 30 degrees to prevent G.I system content aspiration causing ventilator associated pneumonia.

                                                           iii.      Pre-oxygenate the patient with 100% oxygen. Once you turn on 100% oxygen, wait for about 15 seconds before you begin suctioning.

                                                          iv.      Using in-line suction, advance fast but gently until you feel resistance. This resistance is the “carina” where the trachea divides into right and left bronchi

                                                            v.      Pull the catheter backwards with intermittent suction. Let the patient receive 100% oxygen for about 15-20 seconds before advancing suction catheter again.

                                                          vi.      If the heart rate start going down, quickly remove the suction catheter and give 100% oxygen. This rapid drop in heart rate is an indication of myocardial tissue oxygenation compromise and must be corrected immediately.

                                                         vii.      Auscultate breath sounds after suctioning and notice the difference with the lung sounds before suctioning.

                                                       viii.      Document the procedure stating the procedure, amount and color of sputum obtained, how the patient tolerated and the lung sounds change before and after auscultation.

1.  
   1. Pneumothorax can also cause high-pressure alarms to go off. If this is suspected, call physician immediately and emergency chest tubes may need to be inserted.
   2. If all trouble shooting have been tried and still getting high pressure alarm call the physician and put the patient on 100% oxygen while you continue looking for the cause of the problem

                                                              i.      Make sure the lung sounds are equal bilaterally. This will help catching pneumothorax.

                                                             ii.      Make sure the sternum is symmetrical. This will help you catch tension pneumothorax.

                                                           iii.      Absent lung sounds may indicate pneumothorax or complete airway blockage

1. Never change vent settings without physician orders. I like to let the respiratory therapist do the vent settings change.
2. Always have Bi-valve mask by bedside at all times connected to 100% oxygen for use incase of an emergency.
3. Never try to do it all by yourself. If your instincts tell you there could be something wrong, call for help. Obey your instincts as time passed may be the difference between life and death.
4. Never leave a vented patient un-attended. Always let another nurse know incase you decide to step out for a break or anything.

Enjoy taking care of vented patients

I hope you will enjoy the lesson that I presented.

SEUZURES

Objectives:

1.  Define a seizure

2.  Differentiate a seizure from epilepsy

3.  Be able to differentiate types of seizures

4.  Review Causes of Seizures

5.  Review nursing responsibilities and priorities during a seizure

What is a seizure?

A seizure is an episode of abnormal electrical activity in the brain. A seizure, just like headache, is a symptom rather than a disease.

What is epilepsy?

Epilepsy is a diagnosis given when a person has two or more unprovoked seizures.

Difference between seizure and epilepsy:

All people with epilepsy have seizures but not all people with seizures have epilepsy. A seizure is a symptom of an underlying condition. Epilepsy is a clinical diagnosis assigned to a patient having more than two unprovoked seizures.

Types of Seizures:

There are two main categories of seizures: -

1.      Generalized Seizures

a.       Tonic Clonic Seizures (Grand mal)

b.      Absence Seizures (Petit mal)

2.      Partial Seizures.

a.       Simple partial

b.      Complex partial

Tonic Clonic Seizures (Grand mal)

Signs and symptoms:

1.      Sudden loss of consciousness

2.      Muscle rigidity and stiffening

3.      Jerking movements

4.      Shrill cry

5.      Incontinence

6.      Apnea (pt may turn blue)

7.      Dilated Pupils

Absence seizures

Signs and symptoms

1.      Sudden behavioral arrest

2.      Staring

3.      Unresponsiveness

4.      Only last for 1-15 seconds

Simple partial seizures:

Signs and symptoms

1.      No alteration or loss of consciousness

2.      There could subjective symptoms reported by the patients in absence of objective signs (smell, sound, taste or visual perception)

3.      Pt remains awake and aware, sometimes unable to communicate until the seizure is over

Complex Partial Seizures:

Signs and symptoms

1.      Alteration of consciousness (Not complete loss of consciousness)

2.      Automatisms: Simple repetitive uncontrollable actions performed during the seizure.

a.       Lip smacking

b.      Chewing

c.       Picking at clothes, etc

3.      Patient has no awareness of what they are doing

4.      Patient cannot remember what happened

5.      This is the most common seizure by those diagnosed with epilepsy.

Causes of seizures:

1.      Trauma

2.      Drug overdose

3.      Alcohol or drug withdrawal

4.      Non-compliance of anti-epileptic medications

5.       Stroke

6.      Febrile

7.      Intracranial processes and increase in intracranial pressure. E.g. tumors. A seizure occurring in an adult without any obvious underlying cause like alcohol, etc should be evaluated for brain cancer.

8.      Infections. E.g. Meningitis

9.      Metabolic and electrolyte imbalance. E.g. Uremia and Hyponatremia

Nursing Responsibilities and Priorities During Seizures.

What Do I do?

1.      Remain calm. This is your strength during any medical emergency. Make it an active process and tell your self: “I need to remain calm to help the situation and avoid causing errors, accidents or downright malpractice”.

2.      Mark the seizure start time.

3.      If a patient is standing, lay them to the ground and roll them to the side

4.      If the patient is in bed, roll them to the side;

5.      The patient can never swallow their tongue. Never place anything in patient mouth or try to open their mouth. This can compromise the airway or cause more harm to the patient.

6.      Never hold the patient down or try to stop their movements. This can cause injury to the patient. Instead, protect the patient from hitting hard surfaces with soft puddings like pillows.

Priorities

ABC assessments

1.      By rolling the patient to the sides, you may achieve a patent airway.

2.      Administer 100% oxygen

3.      Check oxygen saturation. It may be below 90 due to apnea. The patient may turn blue on the lips and fingers. Do not panic!

4.      Patient will have oral secretions. Suction at bedside to keep the airway patent.

5.      If help is available, establish an IV- line for possible IV medication administration if the seizure continues for a long time (Status epilepticus). You do not have to have a physician order to start an IV line in this case.

Safety:

1.      Do not run or panic. You may become a victim of the circumstance.

2.      Put the side rails up to prevent falls

3.      Pad the bed of any patient expected to get seizures. Injuries caused by unpadded bed can count against you.

4.      Your drug of choice during seizure is Ativan IV push.

Test.

1.      You are taking care of a patient with history of seizures. A nursing assistance calls you to the room and you find the patient having seizures. You should do all of the following except.

a.       Remain calm

b.      Roll the patient to the side

c.       Ask the nursing assistant to hold down the patient while you try to open their mouth

d.      Monitor oxygen saturation

2.      You are passing medication in a psychiatric unit and Mr. Crazy is sited quietly staring at you. You notice Mr. Crazy smacking his lips and making repetitive hands movements as if he is wiping the table. This goes on for a while and then stops. Mr Crazy cannot remember anything about the occurrence. What type of seizures did Mr. Crazy has?

a.       Simple partial seizures

b.      Grand mal Seizures

c.       Complex partial seizures

d.      Alcohol seizures.

3.      The drug of choice during a seizure activity is_____________.

a.       Methadone IV Push

b.      Morphine IV Push

c.       Lorazepam IV Push

d.      Dilantin IV Push

4.      The following are causes of seizures expect?

a.       Alcohol or drug withdrawal

b.      Infections like meningitis

c.       Toothache

d.      Trauma

5.      What is the first thing you should do as soon as notice a patient is having grand mal seizures?

a.       Note the time the seizure started

b.      Run down the hall and get the crash cart

c.       Administer IV Ativan per PRN orders

d.      Call 911

6.      What is the therapeutic level for dilantin that you must monitor on patients taking this medication? (Nurses only)

a.       1-5 ug/ml

b.      5-10 ug/ml

c.       10-20 ug/ml

a.       20-40 ug/ml

All patients with epilepsy have _______________ but not all patients with _________ have epilepsy.

 Lot of people all over the world wishes there could be a way to choose the gender of their unborn child naturally without going through artificial expensive procedures. It sound like a crazy wish to be able to choose the gender of your unborn child but it is a compelling factor to balance the family. So why am I talking about how to get a baby boy?

I happened to see one of my former co-worker on the streets and was happy for her that she was pregnant again. I asked her how excited she was at 7 months pregnant but I was surprised to hear her answer. She told me… “I am worried and afraid to go for a sonogram only to hear it another girl”. I had to be sensitive to her feelings and careful at the same time bearing in mind that others would die to have any baby. To cut the whole long story short, I decided to write this article so that anyone out there can read it and maybe get closer to having a baby gender of their choosing… but this is going to talk about how to get a baby boy. I will in future tell you how to get a baby girl.

I MUST MENTION THOUGH THAT THIS IS NOT MEDICALLY PROVEN WAY OF DETERMINING THE GENDER OF YOUR UNBORN CHILD AND YOU SHOULD ALWAYS ASK YOUR DOCTOR ABOUT ANY MEDICALLY RELATED THEORY YOU WANT TO PUT IN PRACTICE. THIS ARTICLE IS ONLY FOR INFORMATION PURPOSES ONLY ON SCIENTIFIC THEORIES THAT IF PUT TOGETHER CAN BETTER THE CHANCES OF GETTING THE BABY GENDER OF YOUR CHOICE.

With that out of the way, let’s go through some very basic scientific facts. They may not be very basic to everyone but anyone with college education with some classes in biology, anatomy and physiology will see these facts as basic and true. Since to give the whole information about how to conceive a baby gender of your choosing would take me writing a whole book, I will only list the important determinants of conception and gender determinants in human body. I will give you a good resource that you can read and it puts together all these facts for you in a language you can understand. By the way, we are expecting a baby girl in two months just like we had planned. Our best friends got a boy and a girl in the order they wanted following these scientific facts but in natural way. Here are the facts that you need to know and then work things out to favor a baby boy. I am only going to talk about a baby boy because if I mix the two, people with limited attention span and those not from scientific background might get completely lost.

1. A sperm is the male egg. It contains either “Y” or “X” chromosome
2. “Y” chromosome is for a baby boy (I will only talk about getting a baby boy)
3. Sperms with chromosome Y for a baby boy have a long tail than “X”.
4. Long tail means that they can swim faster than X for a baby girl.
5. Sperms for a baby boy dies very fast especially if exposed to vaginal acidity.
6. Even without being exposed to vaginal acidity, sperms for a baby boy live for about 12-24 hours.
7. They are normally produces three times more than that of a girl.
8. The vaginal fluid is acidic.
9. The uterus and the rest of the female reproductive system have alkaline PH which is favorable for sperm survival
10. Ovulation occurs 14 days before the first day of the cycle regardless your cycle pattern.
11. Timing the ovulation is important part of this process
12. The female ova survives for only about 24 hours after ovulation
13. Fertilization occurs in fallopian tubes.
14. The amount of sperms per ejaculation is directly proportional to the volume.
15. The number of healthy sperms capable for fertilization is directly proportional to the volume, but some people have unviable sperms, don’t get me wrong on this. This is just for people without capability of fertilizing an egg and result to a baby.
16. To make it easier for these weak sperms to swim, vaginal mucous must be of the right thickness and quality.
17. A long foreplay is encouraged when trying to get a baby boy
18. It is advisable for the woman to have an orgasm before the male orgasm or at the same time. Orgasmic contractions push fluids from cervical area (alkaline) making it to mix with acidic vaginal fluid. So when you are trying to have a baby boy, enjoy good sex
19. A deep penetration and ejaculation as close to the cervix is advised
20. The final point is: timing is everything here. You must time the right time to have sex and get it right and do it right. Without any techniques involved, you have 50% chance of getting either gender but with the right technique, this can boost your chances even higher. I have no statistic but it can raise your chances significantly.

Here is a good book called “pick the gender of your baby”. I think you should read it over and over again and get every word well understood! I recommend that book because I have read it and I approve it.

Here is what you need to do to get a baby boy. It is not a guarantee but you will increase your chances to a new high level.

1. Have sex only on the day of ovulation and especially, few hours after ovulation. This is because the baby boy sperm can only live for about 12 hours-24hours. But since they swim faster, they will get to the egg first and… there you have it!
2. The man should avoid any ejaculation for at least one week saving it for this day. You need large spern volume to conceive a baby boy. This increases the chances and probability of a baby boy conception.
3. Have a good foreplay and make sure to have both male and female orgasm. The female orgasm is recommended first. This will make the vaginal PH neutral. Remember acid + alkaline = Neutral
4. During male ejaculation, the man should go as deep as possible. Remember the sperms for a baby boy swim faster. You just made their journey shorter to fallopian tubes. You also saved them from swimming in a lot of acidic vagina by putting them close to the cervix.
5. Pray to God and thank God for any baby He might give you because a baby is a blessing. I will be willing to answer your questions or hear from you if you leave a comment on this post

This article cannot be copied on another website, sold or republished. If you would like to tell a friend about this article, just send them a link via email.

Enjoy:

GREG