Obstetric and Gynecological Nursing - The Carter Center

More documents

Recommendations

Info

and descend. The anterior shoulder reaches the pelvic floor and rotates forward, this cause. 7. External rotation of the head: 8. Lateral flexion of the body: The shoulders escape under the symphysis, and the rest of the body is born by lateral flexion. NOTE: The mechanism in any other position follows the same principles of ENGAGEMENT – DESCENT – INTERNAL ROTATION, BIRTH AND EXTERNAL ROTATION. MANAGEMENT OF THE SECOND STAGE Once the patient is in the second stage the nurse must not LEAVE HER, and a constant and careful supervision must be kept on her: 1. General condition, pulse, uterine contractions & Vulva 2. Bladder should be empty 3. Fetal heart more frequently (after every second contraction) 4. Descent of the presenting part and programs is soon. 5. Membrane should be ruptured Preparation for Delivery: A. Equipment: have ready Delivery: Set with 2 clamps, scissors, sterile towels, cord tigh, Bowl and kidney dish 96
ERGOMETRINE: 0.5mgs. in a syringe with swab ready to be given SUCTION APARATUS, READY AND WORKING SAVLON 1 – 80 or any antiseptic lotion IDENTIFICTIONS: with name and number of mother EMPTY CONTAINER B. Patient: - Position the mother, watch descent of head fetal heart and mothers condition. - Encourage the mother & place her in position - Explain to her what is happening - Gloves on. - Arrange and check equipment, - Keep constant contact with mother Conduct of Delivery 1. SWAB VULVA: Drape delivery area with sterile towels. A sterile pad is used to cover the anus. 2. If necessary do episiotomy on contraction 3. When the Head Bulges: The perineum and the head is crowned, place one hand over it to control it and prevent it coming out quickly. The other hand is on a pad or gauze over the rectum to keep away stool and help control the head. 4. When the head is born, keep one hand on it and wide the eyes with the other hand using dry cotton swab. 97
Page 1 and 2:
LECTURE NOTES For Nursing Students
Page 3 and 4:
Preface This lecture note offers nu
Page 5 and 6:
Acknowledgement My deepest apprecia
Page 7 and 8:
2.3.5 Fallopian tube or uterne tube
Page 9 and 10:
CHAPTER SIX : ABNORMAL PREGNANCY 12
Page 11 and 12:
8.5 Subinvolution 225 Review Questi
Page 13 and 14:
LIST OF FIGURES Figuer 1. Normal Fe
Page 15 and 16:
ABBRIVATIONS ACTH Adreno cortico tr
Page 17 and 18:
CHAPTER ONE INTRODUCTION Care of ch
Page 19 and 20:
Hemorrhage, sepsis (infection), tox
Page 21 and 22:
CHAPTER TWO ANATOMY OF FEMALE PELVI
Page 23 and 24:
sacrum is concave and is referred t
Page 25 and 26:
diamond in shape. The obstretrical
Page 27 and 28:
Table 2 .Features of the four types
Page 29 and 30:
The Fetal Skull The fetal head is t
Page 31 and 32:
Regions of the Skull A. The occiput
Page 33 and 34:
. Suboccipitofrontal 10cm from belo
Page 35 and 36:
Figure 6 . Female external genitali
Page 37 and 38:
Position:- In the non-pregnant fema
Page 39 and 40:
• Round ligament - Ligaments form
Page 41 and 42:
• provides a site for fertilizati
Page 43 and 44:
maturation of reproductive organs a
Page 45 and 46:
Thispain, called mitlelschmerz may
Page 47 and 48:
2.5. The Breast Anatomy The female
Page 49 and 50:
Amplulla: the widened-out portion o
Page 51 and 52:
Review Questions 1. List different
Page 53 and 54:
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 and 106: Method - by abdominal palpation ide
Page 107 and 108: Eg. Partograph Name _______________
Page 109 and 110: - Caput - Sutures and Fontanelles.
Page 111: Echanism of Labour in a Normal Vert
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,
Page 157 and 158: The liver is affected in sever case
Page 159 and 160: Moderate - Preeclampsia is usually
Page 161 and 162: Management during labour The nurse/
Page 163 and 164:
35% with in the first few hours aft
Page 165 and 166:
- The volume of urine and the album
Page 167 and 168:
Type 1 placenta praevia - The major
Page 169 and 170:
Diagnosis - Using ultrasonic scanni
Page 171 and 172:
Complications • Post partam haemo
Page 173 and 174:
If the blood loss is revealed; More
Page 175 and 176:
- Rarely, Rhesus- isoimmunization -
Page 177 and 178:
The mother should rest in bed. An u
Page 179 and 180:
The first encounter may not result
Page 181 and 182:
The degree of haemolysis and the nu
Page 183 and 184:
Transmission of infection to the fe
Page 185 and 186:
Post natal care Separation of the b
Page 187 and 188:
giving several short pushes during
Page 189 and 190:
- Maternal hyperglycemia should be
Page 191 and 192:
Review Questions 1. List the differ
Page 193 and 194:
All ill fitting part is associated
Page 195 and 196:
On auscultation The fetal heart bea
Page 197 and 198:
cord prolapse). - Sedation often ne
Page 199 and 200:
up gently delivery slowly taking 2
Page 201 and 202:
Diagnosis On palpation - the head i
Page 203 and 204:
Complications Maternal Fetal - Obst
Page 205 and 206:
make sure no cord prolapsed and to
Page 207 and 208:
If diagnosed during the first stage
Page 209 and 210:
Management Encourage the mother to
Page 211 and 212:
7.2.1 Atonic Postpartum Hemorrhage
Page 213 and 214:
Cause - Delivery through partially
Page 215 and 216:
Management of Severe PPH in a Healt
Page 217 and 218:
Cause in 1 st stage 1) In-efficient
Page 219 and 220:
4 Reduced pelvic out let. A forceps
Page 221 and 222:
- If the fetus is not alive and the
Page 223 and 224:
Methods of determining C.P.D. 1. De
Page 225 and 226:
3 Placenta percrata- through muscle
Page 227 and 228:
2. Tonic contraction and Bandl’s
Page 229 and 230:
Condition of the baby - Usually sti
Page 231 and 232:
3. Control head, keep it flexed, so
Page 233 and 234:
Review Questions 1. What are the co
Page 235 and 236:
More severe infection may consist o
Page 237 and 238:
Prevention The best method of treat
Page 239 and 240:
Managing Puerperal sepsis 1. Isolat
Page 241 and 242:
8.5 Subinvolution Sub involution is
Page 243 and 244:
CHAPTER NINE INDUCTION OF LABOUR At
Page 245 and 246:
Table 6 .Bishops Score System Induc
Page 247 and 248:
- Fluid balance chart - Urine test
Page 249 and 250:
Nipple stimulation, which releases
Page 251 and 252:
Conditions in which trial of scar i
Page 253 and 254:
CHAPTER TEN OBSTETRIC OPERATIONS At
Page 255 and 256:
Indication for forceps delivery - F
Page 257 and 258:
In the infant: Bruising: Severe bru
Page 259 and 260:
10.2 Caesarean Section Caesarean se
Page 261 and 262:
Possible indications include: - The
Page 263 and 264:
types of decapitating hooks and kni
Page 265 and 266:
procedure is extremely rare in cont
Page 267 and 268:
- The head must be engaged. - The w
Page 269 and 270:
CHAPTER ELEVEN CONGENITAL ANOMALIES
Page 271 and 272:
A single remiuterus results when on
Page 273 and 274:
E. Persistence of male (Wolffcan) d
Page 275 and 276:
CHAPTER TWELVE INFECTION OF THE FEM
Page 277 and 278:
Sign Major Minor Cervical motion Ab
Page 279 and 280:
- Gentamycin iv or in loading dose
Page 281 and 282:
In those persons with recurrent les
Page 283 and 284:
Presentation Sign and symptom A wom
Page 285 and 286:
Risk Factor Studies have indicates
Page 287 and 288:
ecto vaginal fistula. Other types m
Page 289 and 290:
12.6 Prolaps of the Uterus A descen
Page 291 and 292:
- If no symptoms are present and th
Page 293 and 294:
Forced inversion caused by excessiv
Page 295 and 296:
therapy may be initiated to prevent
Page 297 and 298:
Local disorders of the genital trac
Page 299 and 300:
. Missed abortion This is the term
Page 301 and 302:
The membranes may have ruptured and
Page 303 and 304:
operation. Many mothers do not make
Page 305 and 306:
I. Septic abortion Infection may oc
Page 307 and 308:
Dysmenorrhea Definition-Dysmenorrhe
Page 309 and 310:
esult from tension, anxiety (stress
Page 311 and 312:
Implantation may occur in the fimbr
Page 313 and 314:
the rupture is on the mesenteric si
Page 315 and 316:
Diagnosis - The presence of interna
Page 317 and 318:
Causes of infertility Female - Vagi
Page 319 and 320:
Benign A. Fibrocystic breast diseas
Page 321 and 322:
- Pain in the breast - Blood staine
Page 323 and 324:
Treatment - Oestrogen - Progesteron
Page 325 and 326:
E. Gently squeeze the nipple of eac
Page 327 and 328:
- Poor uterine contraction - Subinv
Page 329 and 330:
cervical canal and are multiple. Th
Page 331 and 332:
Vulval Cysts Bartholin’s cyst- It
Page 333 and 334:
GLOSSARY Abortion Termination of pr
Page 335 and 336:
Intra uterine growth retardation Fe
show all

Obstetric and Gynecological Nursing - The Carter Center

Create successful ePaper yourself

Delete template?

Save as template?