Obstetric and Gynecological Nursing - The Carter Center

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Abnormal fetal heart rates A heart rate greater than 160/minute is tachylardia and a heart rate less than 120/minute is bradycardia and thse conditions may indicate fetal distress. If abnormal FHB is heard, listen it every 15 minutes for at least 1 minute immediately after contraction. If the fetal heart remains abnormal over 3 observations action should be taken urless delivery is very close. A heart beat of 100 or lower indicates very sever distress & action should be taken at once. - Moving to the right of the alert line means warning. Transfer woman from health center to hospital. - Reaching the action line means possible danger. Decision needed on further management. /usually by obstetrician/. 90
Eg. Partograph Name _____________________________ gravida ___________ para _______Reg No__________ Date of admission ___________Time of admission ________ ruptured memberane __________HRS Frequency Contraction Duration Intensity 10 Latent phase Active phase 9 8 7 Alert Action 6 5 4 3 2 1 0 Hrs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Time Pulse B.P Temp o C Drugs Given and I.V Fluids FHB 91
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LECTURE NOTES For Nursing Students
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Preface This lecture note offers nu
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Acknowledgement My deepest apprecia
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2.3.5 Fallopian tube or uterne tube
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CHAPTER SIX : ABNORMAL PREGNANCY 12
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8.5 Subinvolution 225 Review Questi
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LIST OF FIGURES Figuer 1. Normal Fe
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ABBRIVATIONS ACTH Adreno cortico tr
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CHAPTER ONE INTRODUCTION Care of ch
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Hemorrhage, sepsis (infection), tox
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CHAPTER TWO ANATOMY OF FEMALE PELVI
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sacrum is concave and is referred t
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diamond in shape. The obstretrical
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Table 2 .Features of the four types
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The Fetal Skull The fetal head is t
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Regions of the Skull A. The occiput
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. Suboccipitofrontal 10cm from belo
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Figure 6 . Female external genitali
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Position:- In the non-pregnant fema
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• Round ligament - Ligaments form
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• provides a site for fertilizati
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maturation of reproductive organs a
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Thispain, called mitlelschmerz may
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2.5. The Breast Anatomy The female
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Amplulla: the widened-out portion o
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Review Questions 1. List different
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the ampullar portion. The functiona
Page 55 and 56: Blastocyst Trophoblast Inner cell m
Page 57 and 58: penetrate. Viruses, however, can cr
Page 59 and 60: Figure 10 . The fetal circulation (
Page 61 and 62: Appearance of the Placenta at Term
Page 63 and 64: Identification On inspection, the p
Page 65 and 66: Placenta infarction Placental infar
Page 67 and 68: Oarl cavity feels salivation Gums-
Page 69 and 70: • Creatinine and BUN decrease bec
Page 71 and 72: - Increase in the lower extermities
Page 73 and 74: - Lower part cervix and isthmus cha
Page 75 and 76: 6. Fainting: - In early pregnancy f
Page 77 and 78: women feels it at 18-20 weeks the m
Page 79 and 80: Multipara a woman who has given bir
Page 81 and 82: The Obstetric History 1. Past Obste
Page 83 and 84: Breast Examination Asses the size,
Page 85 and 86: 1.2 Fundal Palpation Purpose- To kn
Page 87 and 88: 3. Deep pelvic Palpation: (3 rd Leo
Page 89 and 90: Auscultation: Check Fetal heart, ra
Page 91 and 92: • Rest at least 10 hrs at night a
Page 93 and 94: CHAPTER FOUR NORMAL LABOUR At the e
Page 95 and 96: - Labour is said to be established
Page 97 and 98: To assess progress of labour - Stat
Page 99 and 100: Relief of pain & promotion of comfo
Page 101 and 102: Uterine contraction - Frequency per
Page 103 and 104: advanced labour women may be assess
Page 105: Method - by abdominal palpation ide
Page 109 and 110: - Caput - Sutures and Fontanelles.
Page 111 and 112: Echanism of Labour in a Normal Vert
Page 113 and 114: ERGOMETRINE: 0.5mgs. in a syringe w
Page 115 and 116: 1. Separation of the placenta Mecha
Page 117 and 118: 3. Controlled cord traction with ou
Page 119 and 120: Advantage: It allows the placenta t
Page 121 and 122: Inspect the umbilical cord a) Check
Page 123 and 124: Ergometrine Route Time to act Durat
Page 125 and 126: The guiding principles is to watch
Page 127 and 128: B. Delayed cord clamping The cord c
Page 129 and 130: - Method of delivery- spontaneous o
Page 131 and 132: 4.4. Episiotomy Definition: The mak
Page 133 and 134: 4. Lateral: The incision is begun o
Page 135 and 136: Layers to be repaired 1. Vaginal wo
Page 137 and 138: CHAPTER FIVE THE NORMAL PUERPERIUM
Page 139 and 140: Lochia- discharge from the uterus d
Page 141 and 142: 5.2 Management of the Puerperium An
Page 143 and 144: answer her questions and through ou
Page 145 and 146: CHAPTER SIX ABNORMAL PREGNANCY At t
Page 147 and 148: One fetus may be died and be retain
Page 149 and 150: Management of Pregnancy - Early dia
Page 151 and 152: are labeled as ‘ Twin one ‘ and
Page 153 and 154: a) Both twins presenting by the ver
Page 155 and 156: - The urine will smell of acetone,
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The liver is affected in sever case
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Moderate - Preeclampsia is usually
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Management during labour The nurse/
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35% with in the first few hours aft
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- The volume of urine and the album
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Type 1 placenta praevia - The major
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Diagnosis - Using ultrasonic scanni
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Complications • Post partam haemo
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If the blood loss is revealed; More
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- Rarely, Rhesus- isoimmunization -
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The mother should rest in bed. An u
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The first encounter may not result
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The degree of haemolysis and the nu
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Transmission of infection to the fe
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Post natal care Separation of the b
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giving several short pushes during
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- Maternal hyperglycemia should be
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Review Questions 1. List the differ
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All ill fitting part is associated
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On auscultation The fetal heart bea
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cord prolapse). - Sedation often ne
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up gently delivery slowly taking 2
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Diagnosis On palpation - the head i
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Complications Maternal Fetal - Obst
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make sure no cord prolapsed and to
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If diagnosed during the first stage
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Management Encourage the mother to
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7.2.1 Atonic Postpartum Hemorrhage
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Cause - Delivery through partially
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Management of Severe PPH in a Healt
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Cause in 1 st stage 1) In-efficient
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4 Reduced pelvic out let. A forceps
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- If the fetus is not alive and the
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Methods of determining C.P.D. 1. De
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3 Placenta percrata- through muscle
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2. Tonic contraction and Bandl’s
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Condition of the baby - Usually sti
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3. Control head, keep it flexed, so
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Review Questions 1. What are the co
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More severe infection may consist o
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Prevention The best method of treat
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Managing Puerperal sepsis 1. Isolat
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8.5 Subinvolution Sub involution is
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CHAPTER NINE INDUCTION OF LABOUR At
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Table 6 .Bishops Score System Induc
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- Fluid balance chart - Urine test
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Nipple stimulation, which releases
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Conditions in which trial of scar i
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CHAPTER TEN OBSTETRIC OPERATIONS At
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Indication for forceps delivery - F
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In the infant: Bruising: Severe bru
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10.2 Caesarean Section Caesarean se
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Possible indications include: - The
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types of decapitating hooks and kni
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procedure is extremely rare in cont
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- The head must be engaged. - The w
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CHAPTER ELEVEN CONGENITAL ANOMALIES
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A single remiuterus results when on
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E. Persistence of male (Wolffcan) d
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CHAPTER TWELVE INFECTION OF THE FEM
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Sign Major Minor Cervical motion Ab
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- Gentamycin iv or in loading dose
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In those persons with recurrent les
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Presentation Sign and symptom A wom
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Risk Factor Studies have indicates
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ecto vaginal fistula. Other types m
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12.6 Prolaps of the Uterus A descen
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- If no symptoms are present and th
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Forced inversion caused by excessiv
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therapy may be initiated to prevent
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Local disorders of the genital trac
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. Missed abortion This is the term
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The membranes may have ruptured and
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operation. Many mothers do not make
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I. Septic abortion Infection may oc
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Dysmenorrhea Definition-Dysmenorrhe
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esult from tension, anxiety (stress
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Implantation may occur in the fimbr
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the rupture is on the mesenteric si
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Diagnosis - The presence of interna
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Causes of infertility Female - Vagi
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Benign A. Fibrocystic breast diseas
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- Pain in the breast - Blood staine
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Treatment - Oestrogen - Progesteron
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E. Gently squeeze the nipple of eac
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- Poor uterine contraction - Subinv
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cervical canal and are multiple. Th
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Vulval Cysts Bartholin’s cyst- It
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GLOSSARY Abortion Termination of pr
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Intra uterine growth retardation Fe
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Obstetric and Gynecological Nursing - The Carter Center

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