Need Help with OB/GYN Clinic Information

[angelique777]

Hi could use some help from OB/GYN nurses

I have about three years nursing experience thus far but in cardiology and in addition I do per diem work at a family clinic as Adult Triage Nurse in walkin area in that clinic.

The clinic has a OB/GYN area and has its own nurse therefore other than doing screening pregnancy test I dont see any pregnant patients. The OB/GYN nurse will be on vacation and I will be covering her duties there until she returns.

Hence my coming to this forum and asking for some help. The nurse did review some of my task while she will be away. Which included

What test to insure patient gets on discharge, what they get when its follow-up how to transfer patient out, about some things about Depo, Rhogam injection, how to use nonstress test exam, how to hear fetal heart with doppler and some other basic stuff

However I would like your help if any one has some notes or important info that will come in handy for me I would be greatful for any input, cheat sheet , web sites with important nursing facts for OB/GYN, important medications, birthcontrol information etc (For example cardiology forum has list of Critical Care and Cardiology resource information hoped this section might have the same etc.

My covering this nurse will be a great learning experience for me in introduction to OB/GYN therefore I appreciate your input

Please note I am of course reading and brushing up on my own from my nursing books and I am asking questions of the OB/GYN nurse herself but this is just another resource I am using (in case some thought I was solely relying on this) I come here because there are some great nurses that often have some great input and help therefore any advise or information will be great

Some of my question:

1.How soon after intercourse will the urine pregnancy test and blood test detect if patient pregnant

2. Do you know a web site that shows strips on what is a good or bad nonstress test exam

3. Web site for fetal heart sounds

4. when does a person get morning after pill

5. information on depo/ rhogam injection (protocols for giving)

6.most common OB/GYN questions ask by patients

Cant think of all my questions right now but I will start with this post to see what replys and information that I get. Really appreciate your feed back and help

Sincerely,

Angela

[jil0328]

Hi Angela

I'm an RN and I've worked in an Ob/Gyn office for 15 years now. Handle 40-45 patient triage calls a day on average and worked with the patients and physician. I'll try and answer your questions as best as I can.

1. Urine preg test are getting much more sensitive. One thing is they can give you a false positive due to the LH surge so I still tell pt to wait until they miss their period to use. Qhcg ( blood test) and be done 9 days after they believed they ovualted and preg may have occured.

2. NST just need to show variabilities and an increase in FHR (fetal heart rate) of at least 10 bpm when the baby moves. You usually need at least 3 good increases in FHR without any D-cells.

3. Fetal heart sounds are easy. Usually we don't try to hear FHR until 15 weeks because it can be hard to find on some ob patients. I can usually find them at 10 weeks but will defer till later if they are obese. You will have to try and pick up the FHR just above the pubic hair line in early obs, up higher as the preg progresses. As the fetus grows feel for the baby's back and that is where you should listen. You can't mistake the FHR from the moms heart beat . The fetus's heart rate will be very fast. Normal is 120 to 160 bpm. Mom's will be alot slower. Early ob are sometimes in the 170's.

4. The morning after pill is now OTC (over the counter) believe it or not. They will need to ask the pharm for it. It must be taken within 72 hours of intercourse.

5. Depo Provera needs to be given the 1st time during the first 5 days of the pt's period. Repeaters will have a time frame they need to get their next injection in. There is a chart to refer to to determine when the next injection will be due.

6. Rhogam is given between 24-28 weeks gestation for patients who are RH neg. They will receive a second injection after delivery. If the patient has an miscarriage she will need to get the Rhogam within 72 hours after the miscarriage. The regular ob patient who is RH Neg will need to get blood work prior to the injection during the 24-28 week period. An antibody screen and coombs (direct and indirect).

7. common questions:

OB patients: Can I dye my hair? Best to wait till after 1st trimester (1st 12 week period). This is the answer to alot of questions since this is the time frame the fetal organs and brain are developing.

Spotting in early pregnancy could be due to a low progesterone level. Get a progesterone level drawn. Values less than 20 will require a progesterone supplement throughout the 1st trimester. Spotting can also be secondary to inplantation, or cervical.

Increase in lady partsl discharge is normal as long as there is not itching, irratation, oder.

When will I feel the baby move? Primigrav probably won't feel anything till 18 to 20 weeks. Multigrav sooner.

When can the sex be determined? We tell patients 20 weeks because it can be difficult unless you have a very good sonographer. :redbeatheGood luck! I love OB/GYN!!!!

[angelique777]

Thanks so much I know the ob/gyn nurse will be on vacation next week so I really appreciate your answer wish more nurses gave feed back but often quality over quantity and you definitely took time for me so thanks so much for that. Those where all very important points that will help me thanks.

appreciatively

Angela :heartbeat:D:nurse: