NurseNora

NurseNora BSN, RN

L&D

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All Content by NurseNora

  1. Making the switch to OB/women's health nursing...

    NurseNora replied to IloveSnoopy's topic in Ob/Gyn

    Asking to shadow another nurse may give you a better idea of what to expect. I agree that with 6 years of experience, you'll be an asset because you have a certain level of confidence in the abilities...

  2. postpartum hemorrage PPH

    NurseNora replied to livtek's topic in Ob/Gyn

    The first fundal check I do on a recently delivered patient HURTS. I tell her I'm going to push really hard, just once. If a clot comes out, then I'll do it again until no clot comes out. If no clot...

  3. When doctors don't listen

    NurseNora replied to eden's topic in Ob/Gyn

    Yes, with a pulse oximeter on, it is easier to tell if the monitor is recording mom's pulse. But in your situation you probably lost fetal recording while mom was pushing and you may well have lost...

  4. staffing

    NurseNora replied to OB Nurtz's topic in Ob/Gyn

    Your professional orginazition is your best friend. AWHONN has guidelines for how many patients a nurse may care for depending on their acuity. For instance, active labor should be 2:1, but second...

  5. Uterine rupture & maternal code

    NurseNora replied to RNLaborNurse4U's topic in Ob/Gyn

    I've seen 2 uterine ruptures, both previous sections attempting VBAC. The first one was atraumatic for the mom. She felt no unusual pain and was sectioned for failure to progress. At delivery, the...

  6. suprapubic pressure

    NurseNora replied to Mrs.S's topic in Ob/Gyn

    That website was very good. I'm going to bookmark it for my staff to see. Near the end it says that if the various manouvers do not work, they may be repeated in various combinations with increased...

  7. Epidural-induced Hypotension

    NurseNora replied to RaeT,RN's topic in Ob/Gyn

    In my hospital, we have standing orders to mix 1 amp of Ephedrine (50mg/ml) with 9ml of normal saline. This results in a concentration of 50mg/10ml or 5mg/1ml. I find this much easier to administer...

  8. Epidural-induced Hypotension

    NurseNora replied to RaeT,RN's topic in Ob/Gyn

    Having had severe hypotension after one epidural doesn't predispose you to having it happen again. Discuss this with your OB and anesthesiologist anyway. Forewarned is forearmed. Preloading with...

  9. External Version??

    NurseNora replied to sueb's topic in Ob/Gyn

    I've never had a version, but have assisted with many. As far as pain goes, I've seen women respond with severe pain to some discomfort but no big deal. With polyhydramnios, seems the extra fluid...

  10. L&D Straight out of Nursing School?

    NurseNora replied to Siouxz2's topic in Ob/Gyn

  11. New OB Nurses, Grads and Students, Please Feel Free to post your questions here:

    NurseNora replied to SmilingBluEyes's topic in Ob/Gyn

    Once a woman is sensitized, future pregnancies need to be closely monitored. If the baby is negative, there's no problem. (An Rh positive man can father Rh negative babies if he is heterozygous--one...

  12. Induction Question

    NurseNora replied to tumblebug's topic in Ob/Gyn

    Thirty nine week babies do well. The problem is, are you really 39 weeks? Due dates are usually accurate +/_ 2 weeks; so at 39 weeks, you could be 37-41 weeks. Early ultrasound makes the due date more...

  13. How Many sucessful VBAC's..

    NurseNora replied to Cherry2's topic in Ob/Gyn

    Yes, the patient waits for anesthesia to come in from home to get an epidural. And in emergencies. That's why smaller hospitals without 24hr anesthesia will section for fetal distress much earlier. If...

  14. I really need to talk about this! (long)

    NurseNora replied to NurseforPreggers's topic in Ob/Gyn

    The doctor's complaint was that you kept asking if she was coming in. Did you tell her what you wanted directly? "The patient's condition is deteriorating and I want you to see her now." Then you get...

  15. I Stink at IV's.

    NurseNora replied to Mrs.S's topic in Ob/Gyn

    Do as many as possible. Ask your coworkers to get you every time they have an IV to start, especially if the woman has really good, big veins. Nothing beats

  16. fundal pressure

    NurseNora replied to labor93's topic in Ob/Gyn

    Some physicians are more willing than others to work with a patient's desire for a lady partsl delivery over a Cesarean delivery. It was done with full disclosure to the patient of the risks/benefits...

  17. fundal pressure

    NurseNora replied to labor93's topic in Ob/Gyn

    They were being induced for medical reasons, that's why they were seeing the perinatologist and being induced with an unfavorable cervix. Before doing a high station AROM, they had usually had 2-3...

  18. How Many sucessful VBAC's..

    NurseNora replied to Cherry2's topic in Ob/Gyn

    My current hospital doesn't do VBAC's because we can't meet the time requirement; no in-house anesthesia or OR. We've had a couple of accidental ones where the woman delivered before the OR crew got...

  19. fundal pressure

    NurseNora replied to labor93's topic in Ob/Gyn

    I have done this for a perinatologist in a Level III hospital when it was a question of "section her later for failure to go into labor" (a medically indicated induction) or risk prolapse with a high...

  20. How many deliveries do you have per month?

    NurseNora replied to RaeT,RN's topic in Ob/Gyn

    75-80 deliveries a month (our record is 102) 4 LDR's 10 PP beds (5 semi private rooms) 0 triage, we use an empty LDR all C/S and recovery done in main OR and PACU 1 tiny "last resort" room, wired for...

  21. Difference between Level I and Level II for L&D

    NurseNora replied to newnurse.rs's topic in Ob/Gyn

    It used to be that the Level I, II, or III applied to the nursery, not L&D. Has that changed? Mother is the best infant transporter known, so when a baby is likely to need specialized care after...

  22. Precipitous Labor

    NurseNora replied to RaeT,RN's topic in Ob/Gyn

    Sounds like you did great. Everyone has given you great advice on how to deal with a precip. The only thing I'd like to add is to keep reassuring the mother. It is very frightening for most women when...

  23. Bad Week...

    NurseNora replied to fourbirds4me's topic in Ob/Gyn

    I get mom's vital signs before, or while, putting on the EFM. The baby is there or it isn't. Moms have very little tolerance for having their VS taken after they realize you can't find the baby's...

  24. Is it true?

    NurseNora replied to NurseforPreggers's topic in Ob/Gyn

    My understanding is that if you've had it once, your more likely to have it with a subsequent pregnancy. If you didn't have it, you're less likely to have it with a subsequent pregnancy, unless this...

  25. New OB Nurses, Grads and Students, Please Feel Free to post your questions here:

    NurseNora replied to SmilingBluEyes's topic in Ob/Gyn

    I use an inexpensive Sprague-type stethescope. I use the adult diaphragm on one side and the pediatric or infant bell on the other side. That way, when I'm doing couplets I don't have to go find an...