Obstetric and Gynecological Nursing - The Carter Center

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emergencies also prevent so many of complications. The importance of the obstetric and gynecology nursing are: - Equip the nurse with the knowledge and understanding of the Anatomy and physiology of reproductive organ be able to apply it in practice - With a good knowledge of obstetric drugs including, the effect of diseases their Complications and know how to deal with them. - Develop skills in carrying out antenatal care and be able to detect any abnormality, recognize and prevent complications. - Select high risk cases for hospital delivery and provide health education. - Develop skills in supporting the women in labour, maintain proper records, and deliver her safely and resuscitate her new born when necessary. - Be able to care for the mother and baby during the post partum period and be able to identify abnormalities and help them to get-over it. - Be able to educate them on care of the baby, immunization, family guidance and family spacing. - Be ready to offer advice to support the mother and understand her problems as a mature, kind and helpful nurse. 4
CHAPTER TWO ANATOMY OF FEMALE PELVIS AND THE FETAL SKULL Learning Objectives At the end of this chapter the students will be able to: - Describe anatomy of the Female pelvis and Female external genitalia - Mention parts of fetal skull with its features. - Differntiat organs contained in the pelivic cavity. - Describe characteristic of menustral cycle and its disorder - List anatomy of female breast - Define puberity and its featuers. 2.1 Female Pelvic Bones The female pelvis is structurally adapted for child beaing and delivery. There are four pelvic bones - innominate or hip bones - Sacrum - Coccyx 5
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: Hemorrhage, sepsis (infection), tox
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
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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
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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
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advanced labour women may be assess
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Method - by abdominal palpation ide
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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 -
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
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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
Page 195 and 196:
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
Page 209 and 210:
Management Encourage the mother to
Page 211 and 212:
7.2.1 Atonic Postpartum Hemorrhage
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Cause - Delivery through partially
Page 215 and 216:
Management of Severe PPH in a Healt
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Cause in 1 st stage 1) In-efficient
Page 219 and 220:
4 Reduced pelvic out let. A forceps
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- If the fetus is not alive and the
Page 223 and 224:
Methods of determining C.P.D. 1. De
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3 Placenta percrata- through muscle
Page 227 and 228:
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
Page 239 and 240:
Managing Puerperal sepsis 1. Isolat
Page 241 and 242:
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
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
Page 269 and 270:
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
Page 289 and 290:
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
Page 307 and 308:
Dysmenorrhea Definition-Dysmenorrhe
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esult from tension, anxiety (stress
Page 311 and 312:
Implantation may occur in the fimbr
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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
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E. Gently squeeze the nipple of eac
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- 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
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