NurseNora

NurseNora BSN, RN

L&D

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All Content by NurseNora

  1. Terminations vs Fetal Demises

    NurseNora replied to nurse79's topic in Ob/Gyn

    If a woman ruptures membranes at 21 or 22 weeks, there is a very high incidence of infection as it is often an infection that weakened the membranes and caused the PROM in the first place. Another...

  2. Terminations vs Fetal Demises

    NurseNora replied to nurse79's topic in Ob/Gyn

    The hospital where I now work does not do terminations of any sort. But we do use Cytotec for term inductions. In other facilities, where I did work with some 2nd trimester terminations, the mother...

  3. How much fluid bolus before epidural on your unit?

    NurseNora replied to mitchsmom's topic in Ob/Gyn

    One liter is what is on our anesthesia orders. If pressures drop, we're to bolus with another 500ml in addition to ephedrine. If the woman has been in labor for a long time, has really dark urine, or...

  4. What to do with this kind of patient?

    NurseNora replied to shortstuff31117's topic in Ob/Gyn

    Sometimes therapeutic rest is helpful in this situation. If Vistaril hasn't worked, try Morphine 10mg IM. The patient gets some pain relief whatever the cause and is usually able to get some sleep....

  5. Assessing labor

    NurseNora replied to m0m2boys's topic in Ob/Gyn

    Most places I've worked do something very similiar. Try to encourage the woman to walk rather than stay in bed. Talk about gravity and jiggling the baby into the optimum position. We have a whirlpool...

  6. Creative Pushing Positions

    NurseNora replied to LizzyL&DRN's topic in Ob/Gyn

    If the patient had an epidural, you could let her "labor down" without pushing. It's amazing how well some babies move down with just the strength of the contractions without the added stress of the...

  7. Being a new grad in postpartum and needing assistance

    NurseNora replied to azzurra29's topic in Ob/Gyn

    When teaching new Mom's the S/S of dehydration, I tell them that by the end of the first week the baby should be making 5-7 wet diapers a day (heavy wet, not just a little spot), until then we're OK...

  8. Is PP Hemorrhage usually pretty obvious???

    NurseNora replied to azzurra29's topic in Ob/Gyn

    No new suggestions, but I just had a PPH last night. Off going nurse told me the patient had had a very large amount of bleeding about an hour before with a clot 10-15 cm in size. When I went to meet...

  9. Curious

    NurseNora replied to tvccrn's topic in Ob/Gyn

    The definition of labor is "progressive cervical change". So when you started moving along on the second day of Pit was when your labor

  10. Change in the way we practice

    NurseNora replied to DEB52's topic in Ob/Gyn

    Giving Pitocin straight IV push with the anterior shoulder or the head. Ergotrate is the natural Methergine. It's from a fungus that grows on rye grain or flour and is closely related to LSD. I've...

  11. Do you get a lot of false alarms coming in?

    NurseNora replied to Jo Dirt's topic in Ob/Gyn

    I try to remember to tell the patients that are "false alarms" that they did the right thing to come in and be checked. After all, we are open 24/7 for a reason. I tell my patients that they aren't a...

  12. Is PP Hemorrhage usually pretty obvious???

    NurseNora replied to azzurra29's topic in Ob/Gyn

    You are unlikely to rupture a post partum uterus with pressure, it's fundal pressure on an undelivered uterus that's likely to rupture it. Before delivery, the uterine wall is very thin and giving...

  13. Change in the way we practice

    NurseNora replied to DEB52's topic in Ob/Gyn

    It wasn't always that bad. The ones who really carried on weren't usually given enough pain medication. Most of the women I saw with Scop were pretty out of it. Not everyone got the anmesia the Scop...

  14. Change in the way we practice

    NurseNora replied to DEB52's topic in Ob/Gyn

    Thirty eight years in OB, I've seen a lot of changes: No fetal monitors, listen with the heavy fetascope or the one you put on your head. No IV pumps: Start the Pit at 5gtts/min and increase by...

  15. Newborn Transition Policy

    NurseNora replied to JaneyW's topic in Ob/Gyn

    I don't like to see people do the eyes before mom and baby have had a chance to look at each other for a while. The ointment probably blurrs the baby's vision even more than it is anyway (did you know...

  16. Help please! Second stage/delivery questions

    NurseNora replied to mandykatrn's topic in Ob/Gyn

    This is a time of major multitasking. You have to keep an eye on the monitor strip, the doctor, the patient as a whole, the perinium in particular. While you're tying the provider's gown, watch Mom's...

  17. I Need Some Help...

    NurseNora replied to hoping to be an rn's topic in Ob/Gyn

    Take careful note of what you see when you call the doc in and how long it takes to deliver from there. Just keep watching and you'll get a feel for how long it will take. Until then... Watch the head...

  18. Teaching in OB

    NurseNora replied to bluePhilly17's topic in Ob/Gyn

    Many people who have done babysitting think they know all they need to know about caring for a baby. Recently I had a primaparous couple insist on going home at 10:30 PM (24hr after delivery). Most...

  19. Unsafe staffing in OB dept

    NurseNora replied to rntobe2005's topic in Ob/Gyn

    I agree that the second person SHOULD be a qualified nurse. However, you were alone, you were told you could not have another nurse and you did not get another nurse. I believe that in that particular...

  20. PLEASE HELP... starting the night shift

    NurseNora replied to cinthern's topic in Ob/Gyn

    Make sure your sleeping room is dark enough. I've found that I do best with a sleep mask--an expensive one that doesn't fit tightly over my eyeballs, but does fit around the nose so there are no light...

  21. Unsafe staffing in OB dept

    NurseNora replied to rntobe2005's topic in Ob/Gyn

    Stick to your guns, it was an unsafe situation. The only thing I can add is that the second person that night did not have to be a nurse. I can see why the supervisor didn't want to to send you a...

  22. Interesting places where women have given birth

    NurseNora replied to JeanettePNP's topic in Ob/Gyn

    I had a friend with fast labors. The first was born in the elevator, the second in the ER, the third while she was brushing her teeth!!!!, and the next two in the bathtub as that was the easiest to...

  23. Just a Quick Question

    NurseNora replied to bluePhilly17's topic in Ob/Gyn

    I use a Sprague type stethoscope; it has two heads and comes with different sizes of heads: adult and pediatric diaphram and adult, pediatric and infant cups. So I use it with the adult diaphragm and...

  24. Mother/Baby nursing?

    NurseNora replied to rnin02's topic in Ob/Gyn

    And yes, night shift does the weights, stocking, etc. AWHONN guidelines suggest 3-4 couplets maximum or 6-8 normal PP or newborns per nurse. Eight healthy patients isn't too

  25. Mother/Baby nursing?

    NurseNora replied to rnin02's topic in Ob/Gyn

    When I worked in the big city medical center, the L&D nurse was expected to recover mom and babe together. Then both went together to PP where couplet care was the norm. Now I work in a small,...