Obstetric and Gynecological Nursing - The Carter Center

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Figure 9 . Anatomy of Female breast (Sylvia Verrals,1993) 34
Review Questions 1. List different menastrial disorder and responsablitiies of the nurse in their management: 2. List the main femal gentail orgns that are important in the process of reproduction. 3. Mention the main pelvic land mark that are important in obstatrics during proegnancy and labour process. 4. What are the obstratrical importancy of fontanalles and sutures in the process of labour mangment. 35
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: Amplulla: the widened-out portion o
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 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
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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
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B. Delayed cord clamping The cord c
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- Method of delivery- spontaneous o
Page 131 and 132:
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
Page 137 and 138:
CHAPTER FIVE THE NORMAL PUERPERIUM
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Lochia- discharge from the uterus d
Page 141 and 142:
5.2 Management of the Puerperium An
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answer her questions and through ou
Page 145 and 146:
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
Page 161 and 162:
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
Page 167 and 168:
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
Page 183 and 184:
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
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
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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
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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
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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
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
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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
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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
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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
Page 289 and 290:
12.6 Prolaps of the Uterus A descen
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- If no symptoms are present and th
Page 293 and 294:
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
Page 301 and 302:
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
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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
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
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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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