NurseNora

NurseNora BSN, RN

L&D

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All Content by NurseNora

  1. How to identify uterine irritability from contractions?

    NurseNora replied to Jiayou's topic in Ob/Gyn

    I'm not sure of the exact mechanism of back lying causing irritability. It's probably related to the decreased uterine perfusion secondary to reduced cardiac output secondary to compression of the...

  2. Nurses role if Dr is not giving all options (VBAC specifically)

    NurseNora replied to maiday's topic in Ob/Gyn

    God takes good care of us. We're a rural hospital and it's a 3 hour flight to the nearest hospital where these things can be done rapidly. Prolapsed cord? You get a real cramp in your hand holding the...

  3. How to identify uterine irritability from contractions?

    NurseNora replied to Jiayou's topic in Ob/Gyn

    HFLA contractions often precede the onset of preterm labor. I'd get the patient up to empty her bladder and make sure she wasn't on her back, perhaps hydrate her a little more as all these things can...

  4. Nurses role if Dr is not giving all options (VBAC specifically)

    NurseNora replied to maiday's topic in Ob/Gyn

    This has been worked out between the patient and her provider before she gets to the hospital and by then she is resigned to what will happen. I wouldn't ask a patient if she considered VBAC. The only...

  5. Do "ominous" fetal heart tone strips ever improve if you wait awhile?

    NurseNora replied to beachmom's topic in Ob/Gyn

    Once again, you have to look at the entire picture. What was the 2 on the BPP for? If it was for amniotic fluid volume, whatever is going on is acute. If it's for something else, it's likely a chronic...

  6. L&D skills checklist - what is 'phono'?

    NurseNora replied to klone's topic in Ob/Gyn

    In the Intermediate class, auscultation methods are discussed and practiced. That is where you're most likely to hear about when a fetoscope is most useful. A FSE is reliable, but is not always an...

  7. L&D skills checklist - what is 'phono'?

    NurseNora replied to klone's topic in Ob/Gyn

    I'm not sure, but I seem to remember when fetal monitors were first being used that Phono picked up FHR by microphone rather than by ultra sound. I haven't seen it in 20 or 30 years at least. As far...

  8. Do we need to deal with the hypotension caused by lateral position?

    NurseNora replied to Jiayou's topic in Ob/Gyn

    I'm betting your patient isn't really hypotensive. If the arm is above the heart (the top arm) the BP will be spuriously low. That's why ideally the BP should be taken in the same arm with the patient...

  9. Narcan administration in newborns

    NurseNora replied to jennf83's topic in Ob/Gyn

    Haven't used it in years. Used to use it more often back in the 70s, but we used Demerol 50 mg then. Now we usually use Stadol or Nubain; shorter acting and both are agonist/antagonists. Back in the...

  10. OB Rapid response team

    NurseNora replied to momsdabom's topic in Ob/Gyn

    I also work in a small rural hospital; we do about 1000 deliveries per year. No dedicated OB anesthesia. We have started doing our own C/S within the last year. I truly believe that God takes special...

  11. Pitocin Calculation

    NurseNora replied to babies_r_us's topic in Ob/Gyn

    Leda explains it well. Use that to explain to new nurses what the concentration is. If you have 10,000mU in 1000ml, you have 10mU in 1ml or 1mU in 0.1ml. If you have 20,000mU in 1000ml, you have 20mU...

  12. Pitocin Calculation

    NurseNora replied to babies_r_us's topic in Ob/Gyn

    You would put the contents of the 10U vial into the liter bag of LR. That is, 1ml Pitocin into the liter of LR. Yes, that would give you 10U in 1001 ml LR if the bag of LR really only had 1000ml in...

  13. Physiology of FHR monitoring

    NurseNora replied to butterball1980's topic in Ob/Gyn

    A spiral electrode picks up electrical activity. It measures R to R intervals to calculate the

  14. Managing decelerations

    NurseNora replied to jennf83's topic in Ob/Gyn

    Take the basic online AWHONN class now. The intermediate class requires 6 months monitoring experience, so you'll be ready for that when that staff member is ready to teach. If that doesn't happen...

  15. Cesarean Sections staffed by L&D nurses and techs

    NurseNora replied to paularnc's topic in Ob/Gyn

    Check with the OR and PACU to find the AORN and ASPAN standards, or go to their websites and order a copy of their standards. If your hospital requires PACU nurses to have ACLS, then your OB nurses...

  16. IUPC scope of practice

    NurseNora replied to obgoddess's topic in Ob/Gyn

    Check with your state Nurse Practice Act. AWHONN teaches IUPC placement in the Intermediate Fetal Monitoring class, so AWHONN does consider it to the OK for nurses to place them. There are 3 states...

  17. one of my biggest fear happened.. in need of some words of wisdom

    NurseNora replied to mctina_20's topic in Ob/Gyn

    It happens. I tell patients that I can't guarantee they won't be back in an hour. I also ask if they feel safe going home. If they don't, I'll let them walk for another hour and check again. If she...

  18. Do you have a baby nurse at delivery?

    NurseNora replied to RNBelle's topic in Ob/Gyn

    Currently the L&D RN responsible for the mom is also entirely responsible for the delivery/baby. There is no baby RN/baby tech etc to assist during/after delivery. IF it is a "slow" day and IF...

  19. Do you have a baby nurse at delivery?

    NurseNora replied to RNBelle's topic in Ob/Gyn

    In the small rural hospital where I now work we have two NRP trained nurses present for delivery. If all is well, the second nurse can leave (although she usually stays to do measurments and eyes and...

  20. edema in the postpartum period

    NurseNora replied to yellowbox's topic in Ob/Gyn

    I bet that you'll find that the patients who had epidurals have the most edema (other than real preeclamptics). We tend to run in lots and lots of fluids in our epidural patients which dilutes the...

  21. How long will it take you to admit a new patient to L&D?

    NurseNora replied to Jiayou's topic in Ob/Gyn

    It depends on how close to change of shift you get the patient-- 6, 6:30, 6:45? and how active she is. Get the monitor on and ask the most important questions: G, P, EDC, complications, PIH symptoms,...

  22. First loss...

    NurseNora replied to ibambamama's topic in Ob/Gyn

    There is nothing you can say that can make it worse, it's about as bad as it can get now for the parents. Just going in to the family and saying "I'm sorry" is meaningful. If you cry with them a...

  23. Transitioning to L&D

    NurseNora replied to Kath27's topic in Ob/Gyn

    Doula training wouldn't hurt, and it would show potential bosses how serious you are. It could also give you a better idea of if you really want to do L&D. I don't know how much L&D experience...

  24. allergic reaction during prepidil induction or ..razor burn?

    NurseNora replied to greenykilt's topic in Ob/Gyn

    Did she have any other allergic symptoms? did she know it was there? did she know how long it had been there? does she usually have this kind of reaction when she shaves? Did the nurse you were...

  25. Secretly seeking L&D

    NurseNora replied to LoveANurse09's topic in Ob/Gyn

    I doubt you will be able to find a per diem in L&D if you have no experience in it. It takes a while to learn L&D (even though your preceptorship was in OB) and no one is willing to train a...