Obstetric and Gynecological Nursing - The Carter Center

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- Aspiration of cysts under local anesthesia B. Fibro adenoma Fibro adenoma are tumors consisting of both fibrotic and glandular components that occur in response to estrogen stimulation. They tend to occure in young women and are rerely seen after menoupuse and are non malignant. The tumors may increase in size during adolescence, pregnancy and lactation or when a woman takes an oestrogen source such as oral contraceptive. Sign and symptom - No pain (pain less) and freely movable - Round and well delineated tumors - Feel firmer and more rubbery - Occasionally calcify and feel extremely hard - Not cause skin retraction Management:- Surgical excision Carcinoma of breast The carcinoma of the reast commonly occurs from 30 to 60 years of age. Sign and Symptoms - Lump and hard fixed mass 304
- Pain in the breast - Blood stained discharge (late stage) - Retracted nipple ,of cancer has spread to the lymph - Orange like colour of the skin Clinical and histological staging of breast cancer Clinical stage (American Joint Committee) Stage I Tumor less than 2 cm in diameter Nodes, if palpable, not felt to contain metastases Without distant metastases Stage II Tumor less than 5 cm in diameter Modes, if palpable, not fixed Stage III Tumor less than 5 cm or Tumor of any size with invasion of skin or attached to chest wall Nodes in supra clavicular area with out distant metastases Stage IV With distant metastases Management - Surgery - Radiation - Hormonal therapy - Cytotoxic agent 305
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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
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Blastocyst Trophoblast Inner cell m
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penetrate. Viruses, however, can cr
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Figure 10 . The fetal circulation (
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Appearance of the Placenta at Term
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Identification On inspection, the p
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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
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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 -
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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
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: Benign A. Fibrocystic breast diseas
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
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