Obstetric and Gynecological Nursing - The Carter Center

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CHAPTER TWELVE : INFECTION OF THE 259 FEMALE REPRODUCTIVE ORGANS 12.1 Pelvic Inflammatory Disease 260 12.2 Vulval Infection 263 12.3 Candidiasis 266 12.4 Trichomoniasis 268 12.5 Trauma of the female genital tract fistulae 270 12.6 Prolaps Of The Uterus 273 12.7 Inversion of the Uterus 275 12.8 Abortion 279 12.8.1 Types Of Abortion 281 12.9 Abnormalities Of The Menstrual Cycle 290 (Menstrual Disorder) 12.9.1 Menstral Disordenrs 290 12.10 Ectopic Pregnancy 293 12.11 Infertility 300 12.12 Disorder Of The Breast 302 12.13. Menopause 306 Self examination of the breast 307 12.14. New growths 310 Review Questions 316 GLOSSARY 317 BIBILIOGRAPHY 320 x
LIST OF FIGURES Figuer 1. Normal Female Pelvis 6 Figuer 2. Pelvic ligaments(Posterior view) 8 Figure 3. Types of female pelvis 11 Figuer 4. Fetal skull 16 Figuer 5.Diameters of fetal skull 17 Figure 6 Female external genitalia 19 Figure 7. Anterior view of female internal reproductive 26 organ Figure 8. Menstrual cycle 30 Figure 9. Anatomy of female breast 34 Figure 10. The fetal circulation 43 Figure 11. Anatomical variation of placenta and cord 48 insertion Figure 12. Fundal palpation 69 Figure 13. Lateral palpation 70 Figure 14. Deep pelvic palpation 71 Figure 15. Pwelick’s grip 72 Figure 16. Types of placenta praevia in relation with 152 cervical os Figure 17. The ventouse or vacuum extractor 252 Figure 18. Abnormal uterine types 255 Figure 19. Possible outcomes of tubal pregnancy 294 Figure 20. Self breast examination 309 xi
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: 8.5 Subinvolution 225 Review Questi
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
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Oarl cavity feels salivation Gums-
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• Creatinine and BUN decrease bec
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- Increase in the lower extermities
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- Lower part cervix and isthmus cha
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6. Fainting: - In early pregnancy f
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women feels it at 18-20 weeks the m
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Multipara a woman who has given bir
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The Obstetric History 1. Past Obste
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Breast Examination Asses the size,
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1.2 Fundal Palpation Purpose- To kn
Page 87 and 88:
3. Deep pelvic Palpation: (3 rd Leo
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Auscultation: Check Fetal heart, ra
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• Rest at least 10 hrs at night a
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CHAPTER FOUR NORMAL LABOUR At the e
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- Labour is said to be established
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To assess progress of labour - Stat
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Relief of pain & promotion of comfo
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Uterine contraction - Frequency per
Page 103 and 104:
advanced labour women may be assess
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Method - by abdominal palpation ide
Page 107 and 108:
Eg. Partograph Name _______________
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- Caput - Sutures and Fontanelles.
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Echanism of Labour in a Normal Vert
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ERGOMETRINE: 0.5mgs. in a syringe w
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1. Separation of the placenta Mecha
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3. Controlled cord traction with ou
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Advantage: It allows the placenta t
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Inspect the umbilical cord a) Check
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Ergometrine Route Time to act Durat
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The guiding principles is to watch
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B. Delayed cord clamping The cord c
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- Method of delivery- spontaneous o
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4.4. Episiotomy Definition: The mak
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4. Lateral: The incision is begun o
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Layers to be repaired 1. Vaginal wo
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CHAPTER FIVE THE NORMAL PUERPERIUM
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Lochia- discharge from the uterus d
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5.2 Management of the Puerperium An
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answer her questions and through ou
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CHAPTER SIX ABNORMAL PREGNANCY At t
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One fetus may be died and be retain
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Management of Pregnancy - Early dia
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are labeled as ‘ Twin one ‘ and
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a) Both twins presenting by the ver
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- 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
Page 189 and 190:
- Maternal hyperglycemia should be
Page 191 and 192:
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
Page 211 and 212:
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
Page 233 and 234:
Review Questions 1. What are the co
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More severe infection may consist o
Page 237 and 238:
Prevention The best method of treat
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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
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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
Page 251 and 252:
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
Page 263 and 264:
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
Page 281 and 282:
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
Page 297 and 298:
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
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
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